Current principles, practices and trends in pediatricGnana Jyothi
Evolution of pediatrics, Pediatrics in India, Evolution of Pediatric Nursing in relationship to Child health, Historical background on the care of the child, Factors influencing the care of the child.........
(Kangaroo Mother Care) Kangaroo Mother Care is an affordable alternative technology that addresses the needs of low birth weight infants. The kangaroo Mother Care position where in the baby is held against the mother's chest on skin to skin contact provides all the basic requirements for newborn survival.
Current principles, practices and trends in pediatricGnana Jyothi
Evolution of pediatrics, Pediatrics in India, Evolution of Pediatric Nursing in relationship to Child health, Historical background on the care of the child, Factors influencing the care of the child.........
(Kangaroo Mother Care) Kangaroo Mother Care is an affordable alternative technology that addresses the needs of low birth weight infants. The kangaroo Mother Care position where in the baby is held against the mother's chest on skin to skin contact provides all the basic requirements for newborn survival.
This topic was presented by me in Neonatal Nursing Workshop in GUJNEOCON' 14. This presentation highlights some issues in the management of extremely low birth weight babies (<1000gm) from Nursing care point of view. Transport, Aseptic precautions, feeding issues are important aspects of cere which are not discussed here because were discussed by others. I had mainly focused on delivery room management, temperature and humidity maintenance, skin care and develpmental care because these are important aspects of ELBW care but often neglected.
seminar presentation on child guidance clinic its introduction definition concepts treatment of child family attitude and services provided at child guidance clinic area
the most effective method in maintaining temperature and also ensure thriving of low birth weight babies. this method can be used both at hospital and home setting.
This topic was presented by me in Neonatal Nursing Workshop in GUJNEOCON' 14. This presentation highlights some issues in the management of extremely low birth weight babies (<1000gm) from Nursing care point of view. Transport, Aseptic precautions, feeding issues are important aspects of cere which are not discussed here because were discussed by others. I had mainly focused on delivery room management, temperature and humidity maintenance, skin care and develpmental care because these are important aspects of ELBW care but often neglected.
seminar presentation on child guidance clinic its introduction definition concepts treatment of child family attitude and services provided at child guidance clinic area
the most effective method in maintaining temperature and also ensure thriving of low birth weight babies. this method can be used both at hospital and home setting.
Neonatal intensive care unit:
New born or neonatal intensive care unit, an intensive care unit designed or premature and ill new born babies.
NEONATAL CARE:
The management of complex life threatening diseases, provision of intensive monitoring and institution of life sustaining therapies in an organized manner to critically ill children in a separate paediatric intensive care unit.
INDICATIONS :
Babies less then 30 weeks
Very low birth weight babies of less then 1500 gm
Cardiopulmonary monitoring.
Surfactant therapy.
Convulsion
Sever birth asphyxia
Assisted ventilation
Total parenteral therapy
Major surgeries
aims:
Reducing the neonatal mortality and improving the quality of life among the survivors
basic facilities:
Adequate space
Availability of running water
Centralized oxygen and suction facilities
Maintenance of thermo- neutral environment
Availability of plenty of linen and disposables
Facilities for availability to treat common neonatal problems
EMPHASIS SHOULD BE LAID ON THEFOLLOWING:
Asepsis
Warmth and thermo neutral environment
Adequate nutrition with human milk
Non stimulating noise free ward
Safety from all biological, physical and chemical hazards.
NEONATAL CARE SERVICES
LEVEL - l NORMAL NEONATALCARE
LEVEL – II SPECIAL CARE NURSARY
LEVEL – III INTENSIVE NEONATALCARE UNIT
LEVEL - I
The minimal care
Provided by the mother under the supervision of basic health professionals.
Neonates weighting more than 2000 gm or having gestational age maturity of 37 weeks or more belong to this care.
This care can be includes care of delivery, provision of the warmth, maintenance of asepsis, and promotion of breastfeeding.
LEVEL - II
This care includes requirement for resuscitation, maintenance of thermo-neutral temperature, intravenous infusion, gavage feeding phototherapy and exchange transfusion.
10-15 percent of the newborn require this care
This care s is anticipated for the infants weighing in between1500 & 1800 gm or having gestational age maturity of 32 to 36weeks.
LEVEL - III
This care includes life saving support system like ventilator and best suited special intensive neonatal care.
Three to five percent of newborn require care of this level.
This level of care is for critically ill babies, for those weighing less than 1500 gm or having gestational age maturity of less than 32 weeks
TRANSPORT:
DEFINITION
Newborn transport is used to move premature and other sick infants from hospitals without specialist, intensive care facilities require for optimal care of the baby to hospitals with neonatal intensive care and other specialist services
Out born newborns:
A significant number of neonates require emergent transfer to a tertiary care center, often because of medical, surgical, or rapidly emerging postpartum problems. These are termed “out born” neonates, because they have been born somewhere besides the facility to which they’ve been transferred.
Neonatal Intensive Care Unit: Definition, objectives, major components, requirements, physical setup, admission criteria, space, location, baby care area, electrical outlet, ventilation, counselling, handwashing area, acoustic characteristics, personnel, equipments available in the NICU, services, levels of NICU
Organization, Transportation, Setting and Management of Neonatal Intensive Ca...Lipi Mondal
Neonatal Intensive Care Unit is a specialized are where newborn care is to be given as per need of the babies where each and every aspect is important in neonate's heath care management.
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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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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!
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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
2. INTRODUCTION
Treatment of sick neonate in specialized
neonatal intensive care unit (NICU) has been
associated with decrease in mortality and
morbidity .
In the early 1960s neonatal transport was
first used to make intensive care accessible to
those who needed it.
3. If there is an acute storage of neonatal beds
and majority of the sick neonate in need of
urgent admission are dumped in pediatric
ward with Inadequate Infrastructure
It is also transfer in pre-term delivery ,
prenatal illness, congenital malformation ,
critically ill, this baby need to transfer from
one health facility to another or ward to NICU.
4. Why transport of sick neonate is necessary
What is the difference between the organized transport and self transport
Which baby needs transport
What are the different types of transport
How to organize a neonatal transport system
What special care need to be given for a sick neonate during transport
what are the different modes of transport
How to transport in special condition
What are the equipments required for neonatal transport
Neonate deteriorates during transport
5. How should one communicate for neonatal transport.
What are the medico-legal issues related to neonatal transport
How the family should be supported during transport
How will transport a sick child in the absence of ambulance and equipments
6. In India majority of the deliveries still occurs at
home (approximately 60% in rural areas as
per NFHS-3) . Although hospital based
deliveries needs to be promoted, delivery of
sick neonates needing special care will still
take place at place with extremely limited
resources,necessitating need for transport.
7. Organized transport service provides almost
the same level of monitoring and the
quality of care during the transport that is
available in the advanced care facility.
ideally it should have the ability to
provide mechanical ventilation, multiple
fluid infusion therapy and cardio-
respiratory monitoring.
8. In India most sick neonate are transferred by their
parents or paramedical person either in private
vehicles or poorly equipped ambulance. There is
currently no dedicated neonatal services provided
by the states in India
In self transport services can not provided
the quality of care during the transport. In self
transport services can not provided mechanical
ventilation, multiple fluid infusion therapy,
cardio-respiratory monitoring.
9. Infants requiring advance medical and nursing care
exceeding what is available in there current
setting will need transfer to a higher health
facility.
The broad indication for which neonatal
transport should be considered are given,
Preterm neonate with respiratory distress but
facilities for respiratory support (CPAP,
mechanical ventilation) are not available
Very low birth weight
10. prematurity: gestational age <32wks
respiratory distress or apnea
cyanosis
hypoxic ischemic encephalopathy
jaundice
active bleeding in any site
congenital hearth disease
sever metabolic and electrolytes abnormality
heart failure
surgical condition
requires intubation and ventilation
11. The neonatal transport can be categorized as follows
1) home to health facility (hospital)
2) intra hospital transport (including delivery rooms,
operation theatres, neuroimaging, special procedure etc. )
3) to facilitate specialist management of the neonates
(movement to a regional center for cardiac, neurological,
renal or surgical opinion )
4) retrieval from a peripheral hospital for ongoing
intensive care (when mothers deliver prematurely without
warning )
12. The preparation would depend whether is from
home to health facility or pick from a health
facility by an organized transport team
ones a decision for transport is taken the
principles of neonatal transport are
assessment
stabilization before transport
care during transport
14. Step I- assessment
assess the baby and depending on facilities check
for temp. airway, breathing, circulation, sugar.
step II- temperature maintenance
KMC by mother or attendant is a useful way to
maintain temperature. KMC care is good method
of temp. maintenance during transport especially
in resource limited condition when transport
incubators are not available
15. Step III – airway & breathing –
Assess airway for presence of any secretion
and position of neck (keep neck of the baby
in slight extension position )
assess for respiratory distress ;
whether baby require ventilation
Step IV- circulation –
check heart rate , urine out put , blood
pressure , etc.
Step V – sugar-
Check sugar with glucometer (if blood glucose
<40mg/dl , given 2ml/kg of 10% dextrose)
16. The choice of vehicle will depend upon the
clinical urgency , traveling distance , weather
condition and its availability .
road ambulance
rotary wing fixed wing
(helicopter) aircraft
17. ROADAMBULANCE; (for 10 to 200 km)
ADVANTAGES
adequate room (height and width ) for neonatal system
transport staff can setting and monitoring
enough room to perform procedure
family member can accompany with transport team and
patient
relatively easily available
Lower costs or cost effective
More space , better patient assess
Can be stopped or diverted to the nearest hospital if any
emergency interventions
18. DISADVANTAGES
retrieval time is influenced by speed
limitation
traffic delays and road conditions
accidents may accurs
19. ROTARY WING (HELICOPTER) (50 to 300km)
ADVANTAGES
speedy retrieval
Better utilization of medical staff
Less travel time out of hospital
20. DISADVANTEGES ;
High cost
Limited space
Require a landing site close to the hospital
Limited patient assess
High noise and vibration level
22. DISADVANTAGES ;
require near by airport
immigration clearance
retrieval time and assistance with road
transport
23. The transportation of neonates requires
several equipments
POWER BACKUP
All the equipments in use should have a battery
backup and should be kept fully charged
sufficient adopters should be available
to make quick changeover to available mode
of power supply.
24. GAS SUPPLIES
make sure the cylinders are filled
prior to onset of journey and will last the
duration of transport
LIST OF EQUIPMENTS REQUIRED FOR TRANSPORT
1) transport incubators
2) temperature monitor and probes
3) Oxygen and air cylinder
26. The most appropriate action depends on the level of
skills of transport team, space, equipments available
in ambulance and distance from the receiving
hospital.
The two major strategies can be used in case of acute
deterioration are
1) Stop the vehicle and done the ET intubation (if skills,
space and equipments are available )
2) Don’t perform procedure in a moving vehicle; stop
the vehicle or get to the nearest hospital before
procedding.
27. Success of transport process depends on the effective
communication between the referral (sending) and receiving
hospital.
Communication for neonatal transport before, during and after
reaching hospital.
Subsequent to decision for transport – communication with parents
or family:
nature and severity of illness and need for transport
facility available at receiving hospital
give example of previous successful transfer and outcomes
28. type and mode of transport and time needed to
reach the receiving hospital
name and contact number of key personnel at
referral and receiving hospital
possible need for emergency procedure during
transport
the availability of bed should be asked before
starting transport
referred hospital should be informed to receiving
hospital in advance .
29. most medico-legal problems are a result of poor
communication and provision of inadequate information.
the condition of baby, risks involved during
transport and financial implications of transport and
treatment at the referral center should be discussed with
family and documented and the case record.
Ifbabyis diesduringtransport
the ambulance should be stopped and CPR should be
performed
if baby dies on the way , he/she should be first taken on
the higher health facility
30. casualty admission should be done
parents should be explained and death
certificate made by the medical person of
higher health facility.
its responsibility of transporting team to
make death certificate of baby.
31. in absence of availability of proper ambulance and equipments for
the transfer of a sick neonate , some innovative methods used in
the past can be used .
Thermocol boxes have been used to maintain neonates body
temperature
in today’s era of air-conditioned cares and taxis, ambient
temperature inside the vehicle can be maintained between 26-28℃
The accompanying person could provide kangaroo mother care
during transport
The infant should be given direct breast feeding or supplemental
feeds with spoon during transport to prevent the hypothermia