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Treatment of Child and Adolescent Problems
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Growth And Development Including General Paediatri
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Dear Doctor, Here I would like to give a short-brief of my son's problem of epilepsy in the following words. He got birth in a private clinic here in Delhi in the month of March 13, 2008. The delivery was normal and on the very next day of discharge from the hospital, he got a fits-like behavior and we immediately took him to the same clinic where he got birth and admitted there. As per the Doctor treating him it was said that his sugar got down and he was not needed properly during the night. After 3-4 days treatment, the doctor referred to another hospital i.e. St. Stephens Hospital herein Delhi and got admitted. After a week’s time the child got recovered. After this, about three years there was no problem with the child. However, after the age of 3, we could noticed that when child was walking he was complaining of some difficulty in walking on his right leg and immediately he asks to pick-up and also noticed a slight behavioural activity on his mouth. This is the starting point and we approached Dr. B.K. Gupta (Neurologist herein Delh). As per his presumption it was epilepsy and started treatment for epilepsy by giving the syrup Trioptal. By taking the above medicine continuously there was no problem for about three years. Unfortunately, after third year the child got fits again intermittently and we again approached the same Doctor and he advised to change the dose of the same medicine. But even though the duration of fits got extended but some time it happened intermittently. In the meantime we approached another Dr. (Prof.) Aldrin (Head of Neuro in IBHAS, Delhi). As per him we got the child’s MRI taken and after diagnosis he also advised to continue the same syrup Trioptal. In the meantime the syrup was not available in the market and the doctor advised to take Oxcarbazepine Tab (300 ml in the morning and 400 ml in the evening) plus Frisium 5 mg tab (one tab in the evening). Now for the last one and a half years there is no problem of fits however he has been complaining of tiredness intermittently, mostly after waking up in morning and also when he was about to leave for school and we presume this might be by taking the medicine continuously. Unfortunately, for the last 2-3 months we could notice another problem i.e. His right hand palm gets trembling (jerking) like feeling for a few second mostly every day and by rubbing and/or holding tight it gets normal and when it happens he is not able to move his fingers or hold anything, and also loose strength of his palm and it gets normal within a minute’s time. Earlier it was once in a week but now-a-days it happens almost daily sometime in the afternoon otherwise at school. Last week i.e. On 16/01/2017 we again visited Dr. Aldrin because of this above new problem. After check-up the doctor advised to get EEG report. However, as per the EEG report it was normal and the doctor advised to increase the dose of the existing medicine i.e. Oxcarbazepine 400 ml tab in the morning instead of 300 ml and continue the other medicine as usual. But even though the above medicine has been taking as per the prescription for the last two week the problem still persists. He has also the problem of Adenoid for the last 3-4 years and now-a-days treating by homeopathy medicine. At night when he sleeps he inhales/exhales through mouth and I am presuming that the above problem is due to this reason only. Kindly, for your advice.
I am having a baby boy six months 22 days old he is having a PDA size 3mm and having shrinkage in one of his bicuspid valve in heart. Is there possibility that PDA can be filled on its own. Kindly suggest what is required to be done.
I am 15 years old and I suffering from tooth decay. Help me when I wake up in morning I got bad smell from my mouth. Please help me.
Good Morning! The age of my son is 3 months n 13 days now and weight is 5 KG. All regular vaccine have been injected. Kindly advise, if there is any suggestion. Thanks n Regards.
Hi. My son is 23 months old. Since he was 1 year. As sson as he drinks milk he gets pressure and does his potty.My pediatrician suggested not to give him milk. Is this really correct ?
Hi sir, my wife is 3months pregnancy n it was by ivf. Now we were done blood test today tsh is. 09 n t4 is 2.03. Is there any risk to baby? Please suggest me a good solution please.
My 3 year old son has had cold and cough three times back to back in the past 2 months. For the 1st time, he was given levolin and it became okay after 3 days. For 2nd time (happened after a week), levolin did not work, and hence nebulization (budecort levolin) along with Azee200 (antibiotic) was given. It became ok after 3 days. For 3rd time (happened again after a week from 2nd), we first gave him ayurvedic medicine. He started having fever and hence gave him antibiotic again for 5 days. Till antibiotic was on, he was neither having fever not cough. Immediately after stopping antibiotic, his cough started. Now its been near to 3 weeks, the cough has not gone completely. He normally does not cough in the day. Either when he is playing/running or laughing, then he starts coughing or during night he coughs 2-3 times (4-5 coughs continuously). What should I do? I am really worried.
I am 26 year old. I want know about what is the validity of tetanus injection after vaccination. Actually I take vaccination before 24 days. After 24 day have injured by rust iron. Should I take again vaccination? I have 3 times takes vaccination in last 6 months.
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.