The document discusses various behavioral disorders seen in children and adolescents. It defines conditions like enuresis, encopresis, temper tantrums, breath holding spells, pica, tics, anorexia nervosa, bulimia nervosa, stuttering, cluttering, school phobia and stranger anxiety. It describes the incidence, causes, clinical features and management of each condition. The management involves both pharmacological and non-pharmacological approaches like behavioral therapy, counseling and lifestyle modifications.
Play in Children or Play Therapy (Importance of Play, Functions of Play, Age-Related Play, Categories of Play, Types of Play, Selection, Safety and Guidelines)..
Play in Children or Play Therapy (Importance of Play, Functions of Play, Age-Related Play, Categories of Play, Types of Play, Selection, Safety and Guidelines)..
Every year more than 10 million children die in developing countries due to acute respiratory infections (mostly pneumonia), diarrhea, measles, malaria, or malnutrition - and often to a combination of these illnesses. In 1990s, the WHO, in collaboration with UNICEF and many other agencies, institutions and individuals, responded to this challenge by developing a strategy known as the Integrated Management of Childhood Illness (IMNCI).This strategy adopted in India as Integrated Management of Neonatal and Childhood Illness (IMNCI). IMNCI caters to two groups of children
• 0-2 months, referred to as young infants.
• 2 months to 5 years, referred to as children.
child health nursing : behavioural disorders - habit disorders (stereotypic movement disorder )
common habit disorder : thumb sucking, nail biting, tics, enuresis, encopresis, stealing , telling lie .
their definition , etiology, types , adverse effects management ( role of parents , assessment ,role of nurse , pharmacological and non pharmacological management . responsibilities of nurses.
Mother & Child is a vulnerable group. But many areas concerned with the health of these groups are preventable. This presentation helps you identify preventive aspects in pediatrics.
IMNCI (Integrated Management of Neonatal and Childhood Illness)Alam Nuzhathalam
An overview of IMNCI (Integrated Management of Neonatal and Childhood Illness). IMNCI - Introduction, Objectives, Components, Principles, Case Management Process - Assess, classify, identify and treat the sick child age up to 2 months and 2 months up to 5 years, F-IMNCI and C-IMNCI.
CHILDHOOD BEHAVIORAL DISORDERS AND ITS MANAGEMENT: AGE AND NATURE: INFANCY , ...Manisha Thakur
CHILDHOOD BEHAVIORAL DISORDERS AND ITS MANAGEMENT: AGE AND NATURE: INFANCY , TODDLERS , ADOLESCENCE: SPEECH DISORDERS: SOMNAMBULISM, SOMNILOQUY. EATING DISORDERS: ANOREXIA NERVOSA AND BULIMIA. MOVEMENT DISORDERS: TICS. SPEECH DISORDERS: STUTTERING, CLUTTERING, STAMMERING. DISORDERS OF TOILET TRAINING: ENURESIS, ECOPRESIS. DISORDERS OF HABIT: TEMPER TANTRUM, BREATH HOLDING SPELLS, THUMB SUCKING, NAIL BITING. ADHD, SCHOOL PHOBIA, STRANGER ANXIETY.
Every year more than 10 million children die in developing countries due to acute respiratory infections (mostly pneumonia), diarrhea, measles, malaria, or malnutrition - and often to a combination of these illnesses. In 1990s, the WHO, in collaboration with UNICEF and many other agencies, institutions and individuals, responded to this challenge by developing a strategy known as the Integrated Management of Childhood Illness (IMNCI).This strategy adopted in India as Integrated Management of Neonatal and Childhood Illness (IMNCI). IMNCI caters to two groups of children
• 0-2 months, referred to as young infants.
• 2 months to 5 years, referred to as children.
child health nursing : behavioural disorders - habit disorders (stereotypic movement disorder )
common habit disorder : thumb sucking, nail biting, tics, enuresis, encopresis, stealing , telling lie .
their definition , etiology, types , adverse effects management ( role of parents , assessment ,role of nurse , pharmacological and non pharmacological management . responsibilities of nurses.
Mother & Child is a vulnerable group. But many areas concerned with the health of these groups are preventable. This presentation helps you identify preventive aspects in pediatrics.
IMNCI (Integrated Management of Neonatal and Childhood Illness)Alam Nuzhathalam
An overview of IMNCI (Integrated Management of Neonatal and Childhood Illness). IMNCI - Introduction, Objectives, Components, Principles, Case Management Process - Assess, classify, identify and treat the sick child age up to 2 months and 2 months up to 5 years, F-IMNCI and C-IMNCI.
CHILDHOOD BEHAVIORAL DISORDERS AND ITS MANAGEMENT: AGE AND NATURE: INFANCY , ...Manisha Thakur
CHILDHOOD BEHAVIORAL DISORDERS AND ITS MANAGEMENT: AGE AND NATURE: INFANCY , TODDLERS , ADOLESCENCE: SPEECH DISORDERS: SOMNAMBULISM, SOMNILOQUY. EATING DISORDERS: ANOREXIA NERVOSA AND BULIMIA. MOVEMENT DISORDERS: TICS. SPEECH DISORDERS: STUTTERING, CLUTTERING, STAMMERING. DISORDERS OF TOILET TRAINING: ENURESIS, ECOPRESIS. DISORDERS OF HABIT: TEMPER TANTRUM, BREATH HOLDING SPELLS, THUMB SUCKING, NAIL BITING. ADHD, SCHOOL PHOBIA, STRANGER ANXIETY.
This slide contains information regarding Childhood Psychiatric Disorders (Enuresis, Encopresis and Pica). This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
4. DEFINITION
When children cannot adjust to a complex
environment around them, they become unable
to behave in the socially acceptable way
resulting in exhibition of peculiar behaviours
and this is called as behavioural problems.
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5. CAUSES
• Faulty Parental Attitude
• Inadequate Family Environment
• Mentally And Physically Sick or Handicapped
Conditions
• Influence of Social Relationships
• Influence of Mass Media
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12. Problems of Movements
• Head Banging
• Breath holding Spells
• Temper tantrums
• Tics
Problems of habit
• Thumb sucking
• Nail biting
• Pica
• Trichotillomania
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13. Problems of Toilet Training
• Enuresis
• Encopresis
Problems of Speech
• Stuttering
• Elective mutism
Problems at School
• School Phobia
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16. DEFINITION
• Enuresis is a disorder of involuntary
micturition in children who are beyond the age
when normal bladder control should have been
acquired.
• Enuresis refers to the wetting of one’s clothes
or one’s bed past the age of 3 years.
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17. INCIDENCE
• It is common during 4 years to 12 years age
group.
• Studies suggest that 2.5 % in the age group of
0-10 years have enuresis and at age 5, it is 7 %
for males and 3 % for females.
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18. Types
Enuresis has been classified into :
• Persistent(primary)
• Regressive (secondary)
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20. CLINICAL FEATURES
• Incontinence
• Dysuria
• Hematuria
• Straining on urination
• Dribbling
• Stress incontinence( with coughing, lifting or
running)
• Poor bowel control
• Continuous dampness
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21. INVESTIGATIONS
• Full medical history
• Genital and neurological examination
• Urinalysis for albumin, sugar, microscopy, and
culture
• if the child has UTI, he should be further
evaluated by USG, cysto urethrogram and uro
dynamic studies.
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28. ETIOLOGY
• Genetic Factors
• Biochemical Theory
• Pre, Peri and Postnatal
Factors
• Environmental Influences
• Psychosocial Factors
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29. RISK FACTORS
• Drug exposure in utero.
• Birth complications.
• Low birth weight.
• lead poisoning.
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30. DIAGNOSIS
• Complete medical evaluation.
• A psychiatric evaluation.
• Detailed prenatal history and early
developmental history.
• Direct observation, teacher’s school report,
parent’s report.
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31. CLINICAL FEATURES
• Sensitive to stimuli, easily upset by noise, light,
temperature and other environmental changes.
• At times the reverse occurs and the children are
flaccid and limp, sleep more and the growth and
development is slow in the first month of life.
• General coordination deficit.
• Short attention span, easily distractable.
• Failure to finish tasks
• Impulsivity.
• Memory and thinking deficits.
• Specific learning disabilities.
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33. NURSING INTERVENTION
• Develop a trusting relationship with the child.
• Ensure safe environment.
• Offer recognition for successful attempts and
positive reinforcement.
• Provide information and materials related to the
child’s disorder and effective parenting
techniques.
• Explain and demonstrate positive parenting
techniques
• Coordinate overall treatment plan with schools,
collateral personnel and the family.
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37. DEFINITION
From the age of 18 months to 3 years, the child
begins to develop autonomy and starts separating
from primary caregivers. When they can’t express
their autonomy they become frustrated and angry.
Some of them show their frustration and defiance
with physical aggression or resistance such as
biting , crying, kicking, throwing objects, hitting
and head banging. This kind of physical
aggressive behaviour is known as Temper
tantrum.
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39. ETIOLOGY
• Parental Factors
• Child personality
• Other Factors
Precipitants
• Not meeting demands
• Interruption of play
• Threat of abandonment
• Stranger anxiety, criticism
• Imitation
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40. CLINICAL FEATURES
• Screaming,
• biting,
• hammering,
• stamping feet, thrashing arms,
• kicking, throwing objects,
• rolling on the floor
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41. MANAGEMENT
• Temper tantrums often cease with age.
Remove underlying insecurity, over protection
and faulty parental attitude.
• During an attack, the child should be protected
from injuring himself and the others.
• Deviating his attention from the immediate
cause and changing the environment can
reduce the tantrum.
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42. • Parents should be calm, loving, firm and
consistent and such behaviour should not allow
the child to take advantage of gaining things.
• Some temper tantrums result from the child’s
frustration at failing to master a task. These
can be managed by distracting the child and
permitting success in more manageable
activity.
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43. • Ignoring is an effective way to avoid
reinforcing tantrums although young children
should be held till they regain control.
• “Time out procedure”- In using time out
procedure, parents should not attempt to inflict
a fixed number of minutes of isolation. The
goal should be to help the child develop self
regulation.
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45. Definition
Breath holding spells are reflexive events in
which typically there is a provoking event that
causes anger, frustration and child starts to cry.
The crying stops at full expiration when the
child becomes apnoeic and cyanotic or pale.
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46. Incidence
• Seen in 4-5 % of paediatric population.
• Common in the children of age group 1-5
years of age.
• Begins before 18 months of age;
• Common in girls and those from lower social
class and nuclear families.
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52. Definition
• Encopresis refers to passage of faeces into
inappropriate places at age when bowel control
should have been established.
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53. Etiology
• Inefficient intestinal motility
• Aggressive and prolonged medical
management (laxatives, enemas, suppositories)
• Dietary manipulation for perceived
constipation
• Anal fissures and rashes
• Surgical procedures for imperforate anus
• Psychosocial stresses or illness
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56. Definition
• Thumb sucking is defined as the habit of
putting thumb into the mouth most of the time.
• It usually involves placing the thumb into the
mouth and rhythmically repeating sucking
contact for a prolonged duration.
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57. Etiology
• A gratifying action especially under unpleasant
and unsatisfying feeding situation.
• Psychological
• Precipitants
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59. PICA (GEOPHAGIA)
Pica is a habit disorder of eating non edible
substances such as clay, paint, chalks, pencil,
plaster from wall etc.
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60. Causes
• Parental neglect, poor attention of the
caregiver, inadequate love and affection,
mental health conditions like mental
retardation and OCD etc.
• Nutritional deficiencies.
• Children of poor socio economic status family,
malnourished and mentally subnormal
children.
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61. Clinical Features
• Anaemia
• Perverted appetite
• Intestinal parasitosis
• lead poisoning
• Vitamins and mineral deficiency,
• Trichotillomania, trichobezoar etc.
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62. Diagnosis
• Blood investigations
• According to the DSM classification, a person is
said to have pica, only if:
• Persistent eating of non nutritive substances for a
period of at least one month
• Does not meet the criteria for either having
autism, schizophrenia, or Kleine-Levin syndrome.
• The eating behavior is not culturally sanctioned.
• If the eating behavior occurs exclusively during
the course of another mental disorder
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63. Treatment
• Treatment of the deficiencies.
• Parental counselling
• Education and guidance
• Behaviour modification
• Psychotherapy
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64. TICS
Tic is an abnormal involuntary movement
which occurs suddenly, repetitively, rapidly
and is purposeless in nature.
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65. Types
Motor Tics- characterized by repetitive motor
movements.
- Simple motor tics
- Complex motor tics
Vocal Tics- characterized by repetitive
vocalisations.
- Simple vocal tics
- Complex vocal tics
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66. Treatment
• Pharmacotherapy
• Haloperidol is the drug of choice. In severe
cases, pimozide or clonidine can be used.
• Antipsychotics (blocks dopamine receptors)
• Benzodiazepines to reduce anxiety.
• Serotonin reuptake inhibitors.
• Behaviour therapy may be used.
• Parents and the family should be educated and
counselled about course of disorder and
spontaneous resolvement of disorder
• Relaxation exercises have proven efficacy.
• Awareness training.
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68. Definition
Anorexia Nervosa is a eating disorder found as
a refusal of food to maintain normal body
weight by reducing food intake, especially fats
and carbohydrates.
The core psychopathological feature is the
dread of fatness, weight phobia and a drive for
thinness.
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69. Etiology
• Genetic causes
• A disturbance in hypothalamic function.
• Social Factors
• Individual psychological factors
• Causes within family
• Diseases of liver, kidney, heart or diabetes.
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70. Diagnosis
• Complete physical examination including lab
tests to rule out metabolic and CNS
abnormalities; malabsorption syndrome etc.
• Complete blood testing- haemoglobin levels,
platelet counts, cholesterol level, total protein,
sodium, potassium, chloride and BUN.
• ECG readings.
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74. Definition
Bulimia nervosa is characterised by episodes
of binge eating followed by feelings of guilt,
humiliation, depression and self condemnation.
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75. Etiology
• More common in first degree, biological relatives
of people with bulimia.
• Specific areas of chromosome 10p linked to
families with a history of bulimia
• Possible role of serotonin levels in brain.
• Society’s emphasis on appearance and thinness.
• Family disturbances or conflict.
• Sexual abuse.
• Learned maladaptive behaviour.
• Struggle for control or self identity.
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80. Definition
Stuttering or stammering is a defect in speech
characterized by interruptions in the flow of
speech, hesitations, spasmodic repetitions and
prolongation of sounds specially of initial
consonants.
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82. Causes
• It is evident in children who cannot cope with
the environmental and emotional stresses.
• It is commonly found in boys with fear,
anxiety and timid personality.
• Family history.
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84. Management
• Behaviour modification
• Relaxation therapy
• Parents need counselling
• Breath control exercises and speech therapy.
• Fluency Shaping Therapy
• Stuttering Modification Therapy
• Electronic Fluency Device
• Anti stuttering medications.
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85. CLUTTERING
• Cluttering is a speech and communication
disorder characterised by unclear and hurried
speech in which words tumble over each other.
There are awkward movements of hands, feet,
and body. These children have erratic and
poorly organized personality and behaviour
pattern
• Management includes behaviour modification
and psychotherapy.
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87. Definition
School phobia is persistent and abnormal fear
of going to school.
It is emotional disorder of the children who are
afraid to leave the parents, especially mother
and prefer to remain at home and refuse to go
to school profusely.
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88. Signs and Symptoms
Recurrent physical complaints like abdominal
pain, headaches which subside if allowed to
remain at home.
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89. Management
• Habit formation
• Improvement of school environment
• assessment of health status of the child to
detect any health problems for necessary
interventions.
• Family counselling
• Behaviour techniques
• Drugs
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91. By about 6-7 months, the infant can
differentiate between the primary caregivers
and others. Thus at this age, they develop fear
of unfamiliar people or strangers. The infant ,
when approached by unfamiliar person, turns
away, even cry or runs towards the primary
caregiver. This is known as stranger reaction.
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92. Management
• Nurses should advise the parents to be calm.
• Infant is managed with relaxation techniques.
• Reassurance of parents.
• child should be referred to psychiatrist to
evaluate for associated anxiety disorders.
• Cognitive behavioural therapy and family
therapy are being tried.
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94. DEFINITION
Colic is characterized by intermittent episodes
of abdominal pain and severe crying in infants
younger than 3 months of age.
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95. • According to Dr. Sethna, Juvenile delinquency
involves wrong doing by a child or a young
person who is under an age specified by the
law of the place concerned.
• A juvenile delinquent is a person who is
below 16 years of age (18 years in case of a
girl) who indulges in antisocial activity.
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98. SOMNAMBULISM
• Walking and carrying out complex activities during the state of sleep
is termed as somnambulism.
• Child moves aimlessly during the sleep.
• It is more common in boys. It is seen in 5-8 % of children in the age
of 5-12 years.
• Often sleep walking is related to stress.
• Management: Plan for scheduled awakenings. Room should be free
from dangerous articles. Provide comfortable happy environment.
Parents need to be educated and counselled regarding the disease.
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100. MATERNAL DEPRIVATION
Causes:
• Young age of the parent (teenage parent)
• Unwanted pregnancy.
• lower level of education
• Lower socio economic status
• Absence of father
• Mental Illness, including post partum
depression.
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101. Symptoms
• Decreased or absent linear growth.
• Lack of appropriate hygiene
• Lack of interaction between mother and child
• Weight less than 5th percentile or an inadequate
rate of weight gain.
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102. Treatment
• Multidisciplinary approach including
physicians, nutritionist, social workers and
visiting nurse.
• In severe cases hospitalization is required.
• Child’s intake is increased to 150 cal per
kg/day.
• Advise the parents to seek help from
programmes available for young parents,
single parent etc.
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104. Definition
• The term failure to thrive is applied to infants
and young children (usually up to the age of 2-
3 years) who show failure of expected weight
gain and striking lack of well being.
• The essential component in failure to thrive is
sluggish weight gain.
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106. Clinical Manifestations
• Infant is underweight for age (usually 3rd
percentile)
• Child appears small in size with expressionless
faces
• Poor gross motor activity
• Delayed vocalization
• Poor response.
• Child tends to remain absorbed in thumb sucking.
• Beyond infancy the child is underweight, thin and
inactive.
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