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Treatment of Child and Adolescent Problems
Thyroid Problems Treatment
Thyroid Disorder Treatment
Paediatric Critical Care
Treatment of Childhood Infections
Child Nutrition Management
Growth And Development Including General Paediatri
Management of New Born Care
Preimplantation Genetic Diagnosis (Pgd)
Congenital Ear Problem Treatment
Treatment of Polycystic Ovary Syndrome In Adolesce
Treatment of Thyroid Disease in Children
Cleft Lip Treatment
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My baby is 10 month old. He is drinking formula milk plus my milk. In day time and evening time I give him Buffalo milk. Fruits and vegetables in day time. But in night time my baby wants formula milk .His present weight is 8 .95. Is it is good to have formula milk in night time.
Child sexual abuse is a pressing issue in society today. Statistically, there has been a considerable increase in the number of cases related to juvenile sex abuse over the past decade. Most of the cases report the abuser to be a close family member or a family friend rather than a complete stranger.
A sexually abused child may develop severe mental health conditions and have major difficulties coping with as an adult. One of the most common disorders affecting survivors of child sexual abuse is Post-Traumatic Stress Disorder (PTSD). This involves the individual reliving the trauma all his/her life, thus leading to panic, stress and difficulties in living a healthy life in the longer run.
The individuals who were abused as a child normally suffer from a very low self -esteem. They continue to blame themselves for the events that occurred and hence have a rather demeaning view of themselves, leading to adjustment issues in the future.
They may also be diagnosed with clinical depression owing to the previous trauma. This hampers the everyday functioning of the individual. The individual may continue to relive the past traumatic events in the mind that further fuels their depression and contribute to the vicious cycle, eventually.
Most often, survivors of child sexual abuse have a rather impulsive nature owing to the hampered functioning of impulse-control. They have lesser control over their emotions, especially anger and are rather quick to act on it.
Because of all the complications, they might be less socially competent and thus fail to build firm peer relationships. They grow up to be adults with severe trust issues; they are hence, often side-lined because of their cynicism which leads to further depressive symptoms.
Genophobia or the fear of sex is another complication that they may experience as adults. They may avoid sex altogether or engage in sexual activities that are rather violent in nature. Some survivors may develop certain sexual fetishes that can be rather dangerous; the most common being ‘paedophilia’ or the sexual arousal involving prepubescent children.
The seriousness of the condition is often undermined. In treatment, various therapeutic techniques are used according to the need and age of the patient. Therapists work to promote positive thinking among the sufferers so that it becomes easy for them to accept their past and move on in life with a better outlook. With proper guidance and help, the individuals are able to overcome their mental health issues and live a wholesome life.
If you wish to discuss about any specific problem, you can consult the doctor and ask a free question.
Hi doctors, My 20 month old baby girl, suddenly got cold, fever and loose stools with vomit, she tends to vomit whenever she coughs, my pead told due to infection from bottle feeding and to stop at once, then to avoid milk for 1 week, so I feed her with juices only, she prefers only orange juice so I give her fresh juice, but is it safe to give orange juice when cold is there? Any way stopping bottle suddenly is also quite challenging, she accepts milk n juice from bottle only, slowly I need to change her.
1.3 new goals – cure, prevent resistance and break chain of transmission.
2. Introduction of daily regime.
3. Definition and treatment of mono and polyresistance apart from mdr and xdr tuberculosis.
4. Treatment in cat 1 – 2 (hrze) + 4 (hre): continue ethambutol in continuation phase too.
5. Treatment in cat 2 – 2 (hrzes) + 1 (hrze) + 5 (hre).
6. Introduction of bedaquiline as a new drug. Atp synthase inhibitor specifically targets myc. Tb. Indicated in age more than 18 years. Contraindicatef in pregnancy and those taking hormonal ocp. It may be given in patients with stable arrythmia.
7. Definition of presumptive tuberculosis. Duration > 2 weeks etc.
8. New algorithm to diagnose tuberculosis – pulmonary, extrapulmonary, drug resistant.
9. Introduction of newer molecular methods like cbnaat and line probe assay in diagnostic algorithm apart from smear microscopy and chest xray.
10. Diagnosis of tuberculosis based on x-ray will be called as clinically diagnosed tuberculosis.
11. Sputum should be around 2ml and preferably be mucopurulent.
12. Follow up – new and previously treated drug sensitive pulmonary tuberculosis – no need to extend intensive phase, sputum microscopy at end of ip and end of treatment, weight monthly, chest x-ray if required.
13. Follow up – mdr tuberculosis – sputum smear monthly 3, 4, 5, 6, 7 months in intensive phase and at 3 months interval in continuation phase 9, 12, 15, extend ip phase by maximum 3 months total of 9 months.
Some more additions to it, adding here which might help to pg students.
1) monitoring health status of tb treated patients (for recurrence of tb) for 24 months after treatment
2) online monitoring of treatment adherence through 99dots programme (currently it is on pilot basis running for tb-hiv patients)
3) intensified tb case finding in clinically, socially and geographically vulnerable population. It's a provider initiated activity.
4) now'tb suspect' term is replaced by'presumptive tb case.
5) in diagnostic algorithm sputum examination along with chest x-ray is recommended.
6)'nsp' term is replaced by'microbiologically confirmed case'
7) nsn and others r called now onwards'clinically diagnosed tb' case. (terms replaced)
8) definitions of cured, defaulted, treatment completed, failure, failure to respond, loss to follow up are somwhat changed.
9) cat i, cat ii, cat iv terminologies r obsolete n replaced by drug sensitive (new or previously treated) and drug resistant tb categories.
Hello sir, I am getting cough and cold every month and it took more than a week to relief if I will not get any medicine. What should I do?
My son is now three years old, six months & twenty two days. Question is, he is not eating easily to any foods items. Only pressure then he will eating rice, chapati, vegetable, milk, any thing. Health is not weak, his body is normal. Now, what I can do for normal eating and what is your advice on this.? Thanks & regards
My son is 6 years old and he is suffering from Asthma . Please tell me how should I take care of him. Moreover please suggest me what should be given and not in his diet.
My one and half year old son always have digestion related problem whenever he eat something different he had fever, first his head become hot then he had fever, is balkadu like medicine ok for him or should I try something different medicine because of this problem he is not gaining weight, please help.
My son is 14 months old and do suffer from wheezing again n again. I am nebulising him twice a day with budecort .5 mg from past 8 months. His doctor says its a prevention medicine. He has never got any severe cough etc its just wheezing in chest which always bother. He is otherwise a normal n happy child born on due time n I had a normal delivery. He is a breastfeed baby throughout. Pls help if I can give him some syrup to avoid wheezing since now winters are coming n I am scared again. What precautions I can take. Pls help. Is ayurveda safe for such a small child. His weight is around 9 kgs.
My baby is 34 month old. For d last 20 days she has been suffering frm high fever 103-104 frequently, like 3-4 times a day. Consulted doctors. Examined n conducted blood n urine tests. Reports were normal. Dey suggested paracetamol n mefenamic acid n finally wid antibiotic also. But no change in her health condition. Wat to do.
Hello, my son is about to reach 2.5 old and still does not speak much. Though he listens and understands all our instructions & talks but does not feel compelled much to repeat us. He says only bare minimum required words to get his work done. He is quite active in playing with toys and ball games, but much behind than his age group children when it comes to articulate his expressions. Many a times he want to say a full statement but end up saying so many jibberish words, looks like he want to say so much things but not able to do so due to some speech problem. Could you please guide me on should we show him to a speech therapist or a psychiatrist? Are these signs of speech problems? Thanks in advance.
Dear Doctor, I am not able to do Breast feeding. My breast is not producing enough milk for my baby. I am just 3 days after my delivery. Dr. is there any medicine to produce milk so that I can do breastfeeding to my baby. Please help me.
Chronic hyperglycemia is captured by A1c but not by FPG (even when repeated twice).
Microangiopathic complications (retinopathy) are associated with A1c as strongly as with FPG.
A1c is better related to cardiovascular disease than FPG.
Fasting is not needed for A1c assessment.
No acute perturbations (e.G, stress, diet, exercise, smoking) affect A1c.
A1c has a greater preanalytical stability than blood glucose.
A1c has an analytical variability not inferior to blood glucose.
Standardization of A1c assay is not inferior to blood glucose assay.
Biological variability of A1C is lower than FPG and 2-h OGTT PG.
Individual susceptibility to protein glycation might be caught by A1c.
A1c can be used concomitantly for diagnosing and initiating diabetes monitoring
Natural history of T2DM in Asia
Diabetes is a global epidemic which is out of control, but worse in Asian countries.
It is a huge and growing problem and costs to the society are high and escalating.
Five countries from Asia figure in the top 10 and account for most cases of diabetes globally.
Asian countries share similar risk factors.
There is an association between economic growth and diabetes.
Rapid urbanization and modernization obesogenic environment i.E. Physical inactivity, psychosocial stress and abundance of food
Asians are prone to developing diabetes at a lower level of obesity.
Diabetes has the potential to negatively impact economy and may bankrupt healthcare systems.
Cost effective interventions in healthy living and diet decrease the burden of diabetes and save on healthcare costs and lost productivity.
There has been a dramatic rise in the number of diabetic population in Korea: economic growth, greater exposure to risk factors (lifestyle and diet), demographic changes (childhood obesity, aging population).
Hypertriglyceridemia: The most difficult lipid disorder to evaluate and treat
Hypertriglyceridemia is the most difficult lipid disorder to evaluate and treat. Hypertriglyceridemic disorder in adults is not a single gene. We do not know if TGs by themselves are an atherogenic risk or is it because of the company they keep.
The intra-individual biological variability (diurnal and monthly) of lipids make it more difficult to define hypertriglyceridemia.
TGs are inversely associated with HDL-C, if high HDL-C levels, almost always TGs are low.
Dietary treatment of severe hypertriglyceridemia: <5%, no alcohol, discontinue all TG-lowering drugs, monitor TG q 3 days until levels are below 1000, then restart treatment.
Fibrates do not reduce the CHD events in high risk patient groups. What impact hypertriglyceridemia has on CHD outcomes is not yet clear.
Lower fasting TG to less than 500 mg/dL; this will reduce the risk of pancreatitis.
Follow the current guideline recommendations to lower LDL-C.
The real value of Apo-B is in patients who do not have raised LDL-C (<100 mg/dL). In such patients it can be very informative and should be taken as an indicator of CVD risk.
Plasma apoB and the other cholesterol indexes are complementary rather than competitive indexes of atherosclerotic risk (Am J Cardiol. 2003 May 15;91(10):1173).
Baseline TGs are determinants of the response to bezafibrate (BIP trial).
Omega-3 fatty acids are beneficial in reducing CV risk (JELIS; Lancet 2007), especially in patients with high TG and low HDL-C (Atherosclerosis. 2008).
If fasting TG is >200 mg/dL and HDL-C <35 mg/dL, consider a fibrate or omega-3 fatty acid.