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Treatment of Child and Adolescent Problems
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My 20 months baby is due for vaccination. Can anyone please tell me if pentaxim (painless) is still available with any Paediatric doctor in Pune?
Attention deficit/hyperactivity disorder (ADHD) is among the most common neurobehavioral disorders presenting for treatment in children and adolescents. ADHD is often chronic with prominent symptoms and impairment spanning into adulthood. ADHD is often associated with co-occurring disorders including disruptive, mood, anxiety, and substance abuse. The diagnosis of ADHD is clinically established by review of symptoms and impairment. The biological underpinning of the disorder is supported by genetic, neuroimaging, neurochemistry and neuropsychological data. Consideration of all aspects of an individual’s life needs to be considered in the diagnosis and treatment of ADHD.
Multimodal treatment includes educational, family, and individual support. Psychotherapy alone and in combination with medication is helpful for ADHD and comorbid problems. Pharmacotherapy including stimulants, noradrenergic agents, alpha agonists, and antidepressants plays a fundamental role in the long-term management of ADHD across the lifespan.
The management of ADHD includes consideration of two major areas: non-pharmacological (educational remediation, individual and family psychotherapy) and pharmacotherapy.
I personally support Psychotherapy. Specialized educational planning based on the child’s difficulties is necessary in a majority of cases. Since learning disorders co-occur in one-third of ADHD youth, ADHD individuals should be screened and appropriate individualised educational plans developed. Educational adjustments should be considered in individuals with ADHD with difficulties in behavioral or academic performance. Increased structure, predictable routine, learning aids, resource room time, and checked homework are among typical educational considerations in these individuals. Similar modifications in the home environment should be undertaken to optimize the ability to complete homework. For youth, frequent parental communication with the school about the child’s progress is essential.
Symptoms in children and teenagers
The symptoms of ADHD in children and teenagers are well defined, and they're usually noticeable before the age of six. They occur in more than one situation, such as at home and at school. The main signs of each behavioural problem are detailed below:
Inattentiveness: having a short attention span and being easily distracted making careless mistakes – for example, in schoolwork appearing forgetful or losing things being unable to stick at tasks that are tedious or time-consuming appearing to be unable to listen to or carry out instructions constantly changing activity or task having difficulty organising tasks
Hyperactivity and impulsiveness: being unable to sit still, especially in calm or quiet surroundings constantly fidgeting being unable to concentrate on tasks excessive physical movement excessive talking being unable to wait their turn acting without thinking interrupting conversations little or no sense of danger
These symptoms can cause significant problems in a child's life, such as underachievement at school, poor social interaction with other children and adults, and problems with discipline.
Related conditions in children and teenagers
Although not always the case, some children may also have signs of other problems or conditions alongside ADHD, such as:
anxiety disorder – which causes your child to worry and be nervous much of the time; it may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness
oppositional defiant disorder (ODD) – this is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers
conduct disorder – this often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals
sleep problems – finding it difficult to get to sleep at night, and having irregular sleeping patterns
autistic spectrum disorder (ASD) – this affects social interaction, communication, interests and behaviour
epilepsy – a condition that affects the brain and causes repeated fits or seizures
Tourette’s syndrome – a condition of the nervous system, characterised by a combination of involuntary noises and movements called tics
learning difficulties – such as dyslexia Symptoms in adults In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD.
ADHD is a developmental disorder; it's believed that it can't develop in adults without it first appearing during childhood. But it's known that symptoms of ADHD often persist from childhood into a person's teenage years, and then adulthood. Any additional problems or conditions experienced by children with ADHD, such as depression or dyslexia, may also continue into adulthood. By the age of 25, an estimated 15% of people diagnosed with ADHD as children still have a full range of symptoms, and 65% still have some symptoms that affect their daily lives. The symptoms in children and teenagers, which are listed above, is sometimes also applied to adults with possible ADHD. But some specialists say that the way in which inattentiveness, hyperactivity and impulsiveness affect adults can be very different from the way they affect children. For example, hyperactivity tends to decrease in adults, while inattentiveness tends to get worse as the pressure of adult life increases. Adult symptoms of ADHD also tend to be far more subtle than childhood symptoms.
Some specialists have suggested the following list of symptoms associated with ADHD in adults:
carelessness and lack of attention to detail
continually starting new tasks before finishing old ones
poor organisational skills
inability to focus or prioritise
continually losing or misplacing things
restlessness and edginess
difficulty keeping quiet and speaking out of turn
blurting out responses and often interrupting others
mood swings, irritability and a quick temper
inability to deal with stress
taking risks in activities, often with little or no regard for personal safety or the safety of others – for example, driving dangerously
Additional problems in adults with ADHD As with ADHD in children and teenagers, ADHD in adults can occur alongside several related problems or conditions. One of the most common conditions is depression. Other conditions that adults may have alongside ADHD include:
personality disorders – conditions in which an individual differs significantly from an average person, in terms of how they think, perceive, feel or relate to others
bipolar disorder – a condition that affects your moods, which can swing from one extreme to another
obsessive-compulsive disorder (OCD) – a condition that causes obsessive thoughts and compulsive behaviour
The behavioural problems associated with ADHD can also cause problems such as difficulties with relationships, social interaction, drugs and crime. Some adults with ADHD find it hard to find and stay in a job. If you notice any of the above in your child or yourself , it is worth making the effort and spending some time and money to have your child and or yourself assessed on a priority basis as ADHD causes neural changes in the brain. If you wish to discuss about any specific problem, you can consult a psychologist.
Some physical conditions are especially common during the first couple of weeks after birth. If you notice any of the following in your baby, contact your pediatrician ONLINE lybrate.com/drsajeev
Possetting. ( Vomiting as mothers complain )
Most mothers complain that their babies " vomit " all the feed after feeding. It is in all normal conditions, just possetting ( belching out / regurgitating ) milk due to lack of tone/development of GE sphincter at the junction of esophagus and stomach. It will gain strength and this belching out mlk will stop by 6- 12 months (varies in each child) . All you need to do is just burp the baby by putting him/her on shoulders or laying upside down on your lap/thigh and gently stroke at the back.
All newborns cry, often for no apparent reason. If you’ve made sure that your baby is fed, burped, warm, and dressed in a clean diaper, the best tactic is probably to hold him and talk or sing to him until he stops. You cannot “spoil” a baby this age by giving him too much attention. If this doesn’t work, wrap him snugly in a blanket.
You’ll become accustomed to your baby’s normal pattern of crying. If it ever sounds peculiar—for example, like shrieks of pain—or if it persists for an unusual length of time, it could mean a medical problem. Call the pediatrician and ask for advice.
If the baby drinks very fast or tries to drink water for the first time, he may cough and sputter a bit; but this type of coughing should stop as soon as he adjusts to a familiar feeding routine. This may also be related to how strong or fast a breastfeeding mom’s milk comes down. If he coughs persistently or routinely gags during feedings, consult the pediatrician. These symptoms could indicate an underlying problem in the lungs or digestive tract.
Lethargy and Sleepiness
Every newborn spends most of his time sleeping. As long as he wakes up every few hours, eats well, seems content, and is alert part of the day, it’s perfectly normal for him to sleep the rest of the time. But if he’s rarely alert, does not wake up on his own for feedings, or seems too tired or uninterested to eat, you should consult your pediatrician. This lethargy—especially if it’s a sudden change in his usual pattern—may be a symptom of a serious illness.
Many normal, healthy newborns have a yellowish tinge to their skin, which is known as jaundice. It is caused by a buildup of a chemical called bilirubin in the child’s blood. This occurs most often when the immature liver has not yet begun to efficiently do its job of removing bilirubin from the bloodstream (bilirubin is formed from the body’s normal breakdown of red blood cells). While babies often have a mild case of jaundice, which is harmless, it can become a serious condition when bilirubin reaches what the pediatrician considers to be a very high level. Although jaundice is quite treatable, if the bilirubin level is very high and is not treated effectively, it can even lead to nervous system or brain damage in some cases, which is why the condition must be checked for and appropriately treated. Jaundice tends to be more common in newborns who are breastfeeding, most often in those who are not nursing well; breastfeeding mothers should nurse at least eight to twelve times per day, which will help produce enough milk and help keep bilirubin levels low.
Jaundice appears first on the face, then on the chest and abdomen, and finally on the arms and legs in some instances. The whites of the eyes may also be yellow. The pediatrician will examine the baby for jaundice, and if she suspects that it may be present—based not only on the amount of yellow in the skin, but also on the baby’s age and other factors—she may order a skin or blood test to definitively diagnose the condition. If jaundice develops before the baby is twenty-four hours old, a bilirubin test is always needed to make an accurate diagnosis. At three to five days old, newborns should be checked by a doctor or nurse, since this is the time when the bilirubin level is highest; for that reason, if an infant is discharged before he is seventy-two hours old, he should be seen by the pediatrician within two days of that discharge. Some newborns need to be seen even sooner, including:
Those with a high bilirubin level before leaving the hospital
Those born early (more than two weeks before the due date)
Those whose jaundice is present in the first twenty-four hours after birth
Those who are not breastfeeding well
Those with considerable bruising and bleeding under the scalp, associated with labor and delivery
Those who have a parent or sibling who had high bilirubin levels and underwent treatment for it
When the doctor determines that jaundice is present and needs to be treated, the bilirubin level can be reduced by placing the infant under special lights when he is undressed—either in the hospital or at home. His eyes will be covered to protect them during the light therapy. This kind of treatment can prevent the harmful effects of jaundice. In infants who are breastfed, jaundice may last for more than two to three weeks; in those who are formula-fed, most cases of jaundice go away by two weeks of age.
Most babies’ bellies normally stick out, especially after a large feeding. Between feedings, however, they should feel quite soft. Similarly in children upto 3-4 years, the abdomen is a little protuberant due to lack of muscle tone. This is normal and and will go away once the child grows and abdomen tones up. If your child’s abdomen feels swollen and hard, and if he has not had a bowel movement for more than one or two days or is vomiting, call your pediatrician. Most likely the problem is due to gas or constipation, but it also could signal a more serious intestinal problem.
It is possible for babies to be injured during birth, especially if labor is particularly long or difficult, or when babies are very large. While newborns recover quickly from some of these injuries, others persist longer term. Quite often the injury is a broken collarbone, which will heal quickly if the arm on that side is kept relatively motionless. Incidentally, after a few weeks a small lump may form at the site of the fracture, but don’t be alarmed; this is a positive sign that new bone is forming to mend the injury.
Muscle weakness is another common birth injury, caused during labor by pressure or stretching of the nerves attached to the muscles. These muscles, usually weakened on one side of the face or one shoulder or arm, generally return to normal after several weeks. In the meantime, ask your pediatrician to show you how to nurse and hold the baby to promote healing.
Babies may have mildly blue hands and feet, but this may not be a cause for concern. If their hands and feet turn a bit blue from cold, they should return to pink as soon as they are warm. Occasionally, the face, tongue, and lips may turn a little blue when the newborn is crying hard, but once he becomes calm, his color in these parts of the body should quickly return to normal. However, persistently blue skin coloring, especially with breathing difficulties and feeding difficulties, is a sign that the heart or lungs are not operating properly, and the baby is not getting enough oxygen in the blood. Immediate medical attention is essential.
When forceps are used to help during a delivery, they can leave red marks or even superficial scrapes on a newborn’s face and head where the metal pressed against the skin. These generally disappear within a few days. Sometimes a firm, flat lump develops in one of these areas because of minor damage to the tissue under the skin, but this, too, usually will go away within two months.
It may take your baby a few hours after birth to form a normal pattern of breathing, but then he should have no further difficulties. If he seems to be breathing in an unusual manner, it is most often from blockage of the nasal passages. The use of saline nasal drops, followed by the use of a bulb syringe, are what may be needed to fix the problem; both are available over the counter at all pharmacies.
However, if your newborn shows any of the following warning signs, notify your pediatrician immediately: YOu CAN CONSULT ONLINE PRIVATELY :-LYBRATE.COM/drsajeev
Fast breathing (more than sixty breaths in one minute), although keep in mind that babies normally breathe more rapidly than adults.
Retractions (sucking in the muscles between the ribs with each breath, so that her ribs stick out)
Flaring of her nose
Grunting while breathing
Persistent blue skin coloring
Hello Dr. Badam is good for pregnant lady how much we can take daily and how to increase baby weight, I have 24 weeks but baby not getting enough weight please suggest what I do. Thanks,
Dear doctor, my baby is 3 and half month of age. She put her fingers in her mouth and starts sucking too much. She almost do this activity 2 times in one hour. And when I forcefully extract her hand out mouth, she starts crying. Is continuously sucking her fingers is a symbol of her hunger? Or just her bad habit. M really confused.
My 7 week old has congestion for almost a month. No running nose but difficulty in breathing. Please advice.
My son is 2 month and 15 days old. He stated to vomit like thick milk after some time of feeding. What to do .his weight is 3.950 Kg. please let us know reason nd reason.
Hi, I am 30 years old and have a baby girls three years back through c-section. So after that I put on 15 kg weight, my current weight is 70 kg and I want to reduce it. I am a working women and my shift timings are 1 pm to 11 pm.in this shift I am not able to do any exercise and all. So please help me here.
My baby boy is 2 months old. Now a days he is not sleeping well. And his weight is 5 kg now. 3.4 kg is his birth weight. I'm in doubt that is my milk is sufficient for him. Please let me know.
My baby boy is 4weeks old. Suggest some sops and body lotions. Coconut oil/almond oil/olive oil which one is better? control old soap is better than Santoor baby soap? Please give me some information.
Diabetes or diabetes mellitus is referred to as a group of disorders that are characterized by a high blood sugar level. Diabetes mellitus occurs when the secretion of insulin (a pancreatic hormone responsible for converting the sugar from consumed foods into energy) is insufficient or the body cells do not properly respond to insulin. Insufficient secretion of insulin causes glucose formation in the bloodstream and mixes with the urine.
The psychological factors responsible for Diabetes Mellitus. In majority (not all), this disease originates with some recent stress in life. This disease is an epidemic in late thirties till fifties. In this age, a person is productive in his profession and most of the time there are job or financial issues that play a very vital role in generating stress and hence Diabetes.
Mostly, in my practice patients reported, before developing Diabetes, a recent financial loss or strain, love disappointment, a betrayal, or fear of loosing a job etc., sedentary habits, diet and genetic factors are secondary. Homeopathy keep such things in account before prescribing and in many cases Diabetes is irreversible. Thers is a vast field of diabetic complications where Homeopathy has a lot to offer. One of them is diabetic neuropathy. For example pain in soles, nerves, lack of energy, sexual dysfunction, mood disorders, diabetic ulcer etc.
Homeopathy For Diabetes
In homeopathy, the main focus is on functioning of the pancreas in efficient insulin production. There are specific medicines which are used effectively in the treatment of all the stages of the diseases.
Homeopathic treatment can help improve the general health of a person with diabetes:
If a person with diabetes is in good health, his or her insulin requirements will be steady and the blood glucose well controlled at the same time. Homeopaths resort to different approaches towards diabetes Management of Blood Sugar. First is when the blood sugar level is very high, the priority is to control it and there are homeopathic remedies that could reduce the sugar.
Homeopathy regards health as a state of balancing the equilibrium of the life force. Whatever treatment is taken it’s always advisable to be in regular touch with the doctor and keep sharing the health status with the doctor. The homeopathic preparations useful for diabetes are as follows:
Phosphoric acid: Useful remedy for diabetes with the symptoms of recurrent physical or mental exhaustion, loss of memory and numbness in the feet.
Abroma Augusta: This homeopathic preparation is useful for diabetics who show the symptoms of polyuria, an increased sensation of hunger and weakness in the muscles.
Syzygium Jambolanum: Useful in reducing the blood sugar level quickly and effectively. This homeopathic preparation is also useful to cure diabetics with the symptoms of polyuria, increased sensation of thirst and long-term ulcers.
Gymnema Sylvestre: This Homeopathic preparation acts as a useful remedy for diabetics who are experiencing the symptoms of weight loss with a severe lack in energy levels.
Uranium Nitricum: This homeopathic preparation is a useful cure for diabetes with the symptoms of depression, nausea, irregular urination, severe pain in the back, delayed menstrual periods in women, significant pain in the head and dry skin. If you wish to discuss about any specific problem, you can consult a homeopath.
My daughter got fever when she was vaccinated at 6 weeks and 10 weeks , but at at 14 weeks , she doesn't got any fever. Is it normal or should I need to see a doctor ?
So you've decided to straighten your teeth and get a great smile that too naturally but the road to a brilliant smile comes with a guide map and here are some of the key stops.
1. Keep them clean
While braces are a great tool that work on natural teeth with no side effects, caring for braces is extremely essential in order to ensure that you don't end up with any post orthodontic dental work.
Braces be it metal or ceramic tend to accumulate food and in turn cause cavities or stains. A lot of people suffer from post braces unnecessary treatments only because they couldn't keep them clean.
2. Know what foods to avoid
Wherever you are in your braces journey remember when you started you were warned about a bunch of things you have to stop eating and drinking. That memory maybe fading away but the truth is the dietary restrictions need to be followed atleast to a certain extent if you want the braces off on schedule.
Foods like pizzas, sticky candies or biting into anything from your front teeth is a strict no as it'll cause the front braces to come off and besides interrupting the treatment you may also end up hurting yourself.
Sodas should be avoided as they cause the braces glue to dissolve and they come off your teeth earlier than we would want.
3. Bracket breaks
The system of braces is basically individual brackets that are placed on your teeth to move them and a wire that engages all these brackets together.
A common occurrence with braces is the brackets come off or break if you're not careful. When this happens it's like a derailing a machine everything comes to a standstill and its very important to get this fixed at the earliest for the treatment to continue efficiently.
Bracket breakage can be prevented by maintaining dietary precautions, efficient brushing and avoiding trauma to the face.
4. Be on the lookout for pain or blisters
Although less common now there's an occasional chance of slight pain or ulceration after braces are placed in the mouth for the first time. Our body is getting used to a large foreign object and it may react by rejecting the areas that hurt and forming an ulcer which may last a few days and settle.
The pain sensation of tightness and tooth movement can be eased with a mild anti inflammatory or pain killer on the first appointment if need be.
5. Don't miss appointments
Missing your regular dental appointment is bad enough but your orthodontic (braces) appointment is the most important day of the month for you. Skipping or missing this appointment disrupts the schedule of tooth movement and you may delay an already prolonged treatment procedure.
So if you want that brilliant smile be as soon as possible follow the steps above and you will breeze through your orthodontics treatment without a snag!