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Neonatal Jaundice

 
almostadoctor.com - free medical student revision notes
almost 6 years ago
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Genetics of Sickle Cell Disease

Sickle cell disease is an inherited genetic disorder and is a recessive trait. This video describes how the genetic mutation causing sickle cell disease is p...  
YouTube
almost 6 years ago
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38

Pediatric Cardiology-Tetralogy of Fallot-Peri-operative care

Pediatric Cardiology Teaching,lectures conducted by Dr Parvathi Iyer from Escorts Heart Institute and Research Centre, New Delhi. The topic is - Tetralogy of...  
YouTube
almost 6 years ago
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Pediatric Cardiology-Tetralogy of Fallot Current Management

Pediatric Cardiology Teaching,lectures conducted by Dr Krishna S Iyer from Escorts Heart Institute and Research Centre, New Delhi. The topic is - Tetralogy o...  
YouTube
almost 6 years ago
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Obstetrics and Newborn Care

A two-semester course in obstetrics and newborn care for prospective healthcare professionals.  
waybuilder.net
over 5 years ago
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Preterm birth and the role of neuroprotection

Preterm birth remains a common complication of pregnancy and causes substantial neonatal morbidity and mortality. As improvements in the care of preterm neonates have outpaced efforts to prevent preterm birth, the numbers of survivors with neurologic sequelae that affect quality of life have increased. The main strategies to reduce the impact of neurologic complications of prematurity include prevention of preterm birth and protection of the developing fetal brain through antenatal administration of drugs. These strategies rely on a basic understanding of the intertwined pathophysiology of spontaneous preterm labor and perinatal brain injury, which will be reviewed here. The review will outline current methods for the prevention of prematurity and neuroprotection. The use of magnesium sulfate as a neuroprotective compound will be discussed, including concerns over its association with increased pediatric mortality and abnormalities in bone density.  
bmj.com
about 5 years ago
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A Modest Man

The registrar's face was taking on a testy look. So enduring was the silence our furtive glances had developed a nystagmic quality. “Galactosaemia” came her peremptory reply. Right on queue the disjointed chorus of ahs and head nods did little to hide our mental whiteboard of differentials being wiped clean. At the time conjugated bilirubinaemia in children only meant one thing: biliary atresia. A fair assumption; we were sitting in one of three specialist centres in the country equipped to treat these patients. Ironically the condition has become the unwieldy yardstick I now measure the incidence of paediatric disease. Biliary atresia is the most common surgical cause of neonatal jaundice with a reported incidence of 1 in 14-16ooo live births in the West. It is described as a progressive inflammatory obliteration of the extrahapatic bile duct. And Dr Charles West, the founder of Great Ormond Street Hospital, offers an eloquent description of the presenting triad of prolonged jaundice, pale acholic stools and dark yellow urine: ‘Case 18...It was born at full term, though small, apparently healthy. At 3 days however, it began to get yellow and at the end of 3 weeks was very yellow. Her motions at no time after the second day appeared natural on examination, but were white, like cream, and her urine was very high coloured.’ 1855 was the year of Dr West's hospital note. An almost universally fatal diagnosis and it would remain so for the next 100 years. The time's primordial classification of biliary atresia afforded children with the 'noncorrectable' type, a complete absence of patent extrahepatic bile duct, an unfortunate label; they were beyond saving. Having discovered the extent of disease at laparatomy, the surgeons would normally close the wound. The venerable Harvardian surgeon, Robert E. Gross saved an enigmatic observation: “In most instances death followed a downhill course…” K-A-S-A-I read the ward’s board. It was scrawled under half the children's names. I dismissed it as just another devilishly hard acronym to forget. The thought of an eponymous procedure had escaped me and in biliary atresia circles, it's the name everyone should know: Dr Morio Kasai. Originating from Aomori prefecture, Honshu, Japan, Dr Kasai graduated from the National Tohoku University School of Medicine in 1947. His ascension was rapid, having joined the 2nd department of Surgery as a general surgeon, he would assume the role of Assistant Professor in 1953. The department, under the tenure of Professor Shigetsugu Katsura, shared a healthy interest in research. 1955 was the landmark year. Katsura and Kasai operated on their first case: a 72 day old infant. Due to bleeding at the incised porta hepatis, Katsura is said to have 'placed' the duodenum over the site in order to staunch the flow. She made a spectacular postoperative recovery, the jaundice had faded and there was bile pigment in her stool. During the second case, Katsura elected to join the unopened duodenum to the porta hepatis. Sadly the patient's jaundice did not recover, but the post-mortem conducted by Kasai confirmed the development of a spontaneous internal biliary fistula connecting the internal hepatic ducts to the duodenum. Histological inspection of removed extrahepatic duct showed the existence of microscopic biliary channels, hundreds of microns in diameter. Kasai made a pivotal assertion: the transection of the fibrous cord of the obliterated duct must contain these channels before anastomosis with the jejunal limb Roux-en-Y loop. This would ensure communication between the porta hepatis and the intrahepatic biliary system. The operation, entitled hepatic portoenterostomy, was first performed as a planned procedure for the third case at Tohoku. Bile flow was restored and Kasai published the details of the new technique in the Japanese journal Shujutsu in 1959. However, news of this development did not dawn on the West until 1968 in the Journal of Pediatric Surgery. The success of the operation and its refined iterations were eventually recognized and adopted in the 1970s. The operation was and is not without its dangers. Cholangitis, portal hypertension, malnutrition and hepatopulmonary syndrome are the cardinal complications. While diagnosing and operating early (<8 weeks) are essential to the outcome, antibiotic prophylaxis and nutritional support are invaluable prognostic factors. Post operatively, the early clearance of jaundice (within 3 months) and absence of liver cirrhosis on biopsy, are promising signs. At UK centres the survival after a successful procedure is 80%. The concurrent development of liver transplantation boosts this percentage to 90%. Among children, biliary atresia is the commonest indication for transplantation; by five years post-Kasai, 45% will have undergone the procedure. On the 6th December 2008, Dr Kasai passed away. He was 86 years old and had been battling the complications of a stroke he suffered in 1999. His contemporaries and disciples paint a humble and colourful character. A keen skier and mountaineer, Dr Kasai lead the Tohoku University mountain-climbing team to the top of the Nyainquntanglha Mountains, the highest peaks of the Tibetan highlands. It was the first successful expedition of its kind in the world. He carried through this pioneering spirit into his professional life. Paediatric surgery was not a recognized specialty in Japan. By founding and chairing multiple associations including the Japanese Society of Pediatric Surgeons, Dr Kasai gave his specialty and biliary atresia, the attention it deserved. Despite numerous accolades of international acclaim for his contributions to paediatric surgery, Dr Kasai insisted his department refer to his operation as the hepatic portoenterostomy; the rest of the world paid its originator the respect of calling it the ‘Kasia’. Upon completion of their training, he would give each of his surgeons a hand-written form of the word ‘Soshin’ [simple mind], as he believed a modest surgeon was a good one. At 5 foot 2, Kasai cut a more diminutive figure one might expect for an Emeritus Professor and Hospital Director of a university hospital. During the course of his lifetime he had developed the procedure and lived to see its fruition. The Kasia remains the gold standard treatment for biliary atresia; it has been the shinning light for what Willis J. Potts called the darkest chapter in paediatric surgery. It earned Dr Kasai an affectionate but apt name among his peers, the small giant. References Miyano T. Morio Kasai, MD, 1922–2008. Pediatr Surg Int. 2009;25(4):307–308. Garcia A V, Cowles RA, Kato T, Hardy MA. Morio Kasai: a remarkable impact beyond the Kasai procedure. J Pediatr Surg. 2012;47(5):1023–1027. Mowat AP. Biliary atresia into the 21st century: A historical perspective. Hepatology. 1996;23(6):1693–1695. Ohi R. A history of the Kasai operation: Hepatic portoenterostomy for biliary atresia. World J Surg. 1988;12(6):871–874. Ohi R. Morio Kasai, MD 1922-2008. J Pediatr Surg. 2009;44(3):481–482. Lewis N, Millar A. Biliary atresia. Surg. 2007;25(7):291–294. This blog post is a reproduction of an article published in the Medical Student Newspaper, April 2014 issue.  
James Wong
almost 6 years ago
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DiGeorge syndrome

Looking for online definition of DiGeorge syndrome in the Medical Dictionary? DiGeorge syndrome explanation free. What is DiGeorge syndrome? Meaning of DiGeorge syndrome medical term. What does DiGeorge syndrome mean?  
medical-dictionary.thefreedictionary.com
over 4 years ago
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Ventricular Septal Defect

This is an ultrasound picture of the heart, an echo cardiogram. It depicts a ventricular septal defect.  
upload.wikimedia.org
over 4 years ago
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CONGENITAL ABNORMALITIES OF THE CENTRAL NERVOUS SYSTEM -- Verity et al. 74 (suppl 1): i3 -- Journal of Neurology, Neurosurgery & Psychiatry

Advances in genetics and molecular biology have led to a better understanding of the control of central nervous system (CNS) development. It is possible to classify CNS abnormalities according to the developmental stages at which they occur, as is shown below. The careful assessment of patients with these abnormalities is important in order to provide an accurate prognosis and genetic counselling.  
jnnp.bmj.com
over 4 years ago
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Atopic eczema in under 12s: diagnosis and management | Guidance and guidelines | NICE

This guideline will shortly be checked to see if it needs updating, please register as a stakeholder to be informed about the decision.  
nice.org.uk
over 4 years ago
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Preterm Premature Rupture of Membranes: Diagnosis and Management - American Family Physician

Preterm premature rupture of membranes is the rupture of membranes during pregnancy before 37 weeks' gestation. It occurs in 3 percent of pregnancies and is the cause of approximately one third of preterm deliveries. It can lead to significant perinatal morbidity, including respiratory distress syndrome, neonatal sepsis, umbilical cord prolapse, placental abruption, and fetal death. Appropriate evaluation and management are important for improving neonatal outcomes. Speculum examination to determine cervical dilation is preferred because digital examination is associated with a decreased latent period and with the potential for adverse sequelae. Treatment varies depending on gestational age and includes consideration of delivery when rupture of membranes occurs at or after 34 weeks' gestation. Corticosteroids can reduce many neonatal complications, particularly intraventricular hemorrhage and respiratory distress syndrome, and antibiotics are effective for increasing the latency period.  
aafp.org
about 4 years ago
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Osteology of the Skull: 12 Newborn Skull

This video is part of the playlist "Osteology of the skull": http://www.youtube.com/playlist?list=PLRbPzV4ZYk0zwMUuDPnLjZxDkS7s4XyRb&feature=view_all . The l...  
youtube.com
almost 4 years ago
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Primitive reflexes

Demonstration of ATNR, rooting, palmar & plantar grasp, Galant, Moro, standing, and stepping reflexes in the newborn. Learn more about primitive reflexes at ...  
youtube.com
almost 4 years ago
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Focus On: Acute Chest Syndrome - The Critical Cough

Acute chest syndrome (ACS) is defined as any acute cardiopulmonary symptom accompanied by a new radiographic infiltrate in a patient with sickle cell disease.  
American College Of Emergency Medicine
over 9 years ago
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How important is Aspergillus in cystic fibrosis? by Rick Moss

Cystic fibrosis (CF) occurs in 1 in 4,000 births, and there are approximately 70,000 people worldwide who have CF. Aspergillus lung infection is often found in people with CF, is more common in adults and becomes increasingly common as lung function declines.  
Aspergillus Website
over 9 years ago
29647
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Step 5 - Ten Steps to Successful Breastfeeding

Every facility providing maternity services and care for newborn infants should: Show mothers how to breastfeed and how to maintain lactation, even if they should be separated from their infants. Nursing staff should offer further assistance with breastfeeding within six hours of delivery and mothers should be shown how to express their milk or given written information on expression and/or advised where they could get help, should they need it...Mothers with babies in special care should be helped to initiate and maintain lactation by frequent expression of breastmilk...Staff should teach mothers positioning/attachment and techniques for manual expression of breastmilk. A situation can arise when the baby has to be separated from her mother for a specific medical reason. The fifth step is to show the mother how to maintain lactation by expression of breast milk or to visit her baby in the intensive case as often as possible. More inf http://tensteps.org/step-5-successful-breastfeeding.shtml --.-- Ten Steps to Successful Breastfeeding - Video Series Babies who are breastfed are generally healthier and achieve optimal growth and development compared to those who are fed formula milk. If the vast majority of babies were exclusively fed breastmilk in their first six months of life -- meaning only breastmilk and no other liquids or solids, not even water -- it is estimated that the lives of at least 1.2 million children would be saved every year. If children continue to be breastfed up to two years and beyond, the health and development of millions of children would be greatly improved. This video series aims to raise awareness, encourage early adoption, promote training of health care staff, and build capacity for, and to stimulate dialogue about, breastfeeding and its impact on the public, in a range of community and public contexts in low- and middle-income countries. Our goal is to have these ten steps in every facility providing maternal services and care for newborn infants. Videos, presentations, research, evidence, papers, training and counselling materials, tools, and many other related and supporting resources are available. Visit us on-line a http://tensteps.org .  
Nand Wadhwani
over 9 years ago
29648
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Step 6 - Ten Steps to Successful Breastfeeding

Every facility providing maternity services and care for newborn infants should: Give newborn infants no food or drink other than breast milk unless medically indicated. For any breastfeeding babies being given food or drink other than breastmilk there should be acceptable medical reasons. No promotion for infant foods or drinks other than breastmilk should be displayed or distributed to mothers, staff, or the facility. The sixth step stresses that a newborn baby must not be given any food or drinks other than breast milk unless it is medically indicated. As the pregnant women are counseled in advance and the hospital staff is trained, we rarely have to give anything other than colostrums -- the first breast milk to the babies. More inf http://tensteps.org/step-6-successful-breastfeeding.shtml --.-- Ten Steps to Successful Breastfeeding - Video Series Babies who are breastfed are generally healthier and achieve optimal growth and development compared to those who are fed formula milk. If the vast majority of babies were exclusively fed breastmilk in their first six months of life -- meaning only breastmilk and no other liquids or solids, not even water -- it is estimated that the lives of at least 1.2 million children would be saved every year. If children continue to be breastfed up to two years and beyond, the health and development of millions of children would be greatly improved. This video series aims to raise awareness, encourage early adoption, promote training of health care staff, and build capacity for, and to stimulate dialogue about, breastfeeding and its impact on the public, in a range of community and public contexts in low- and middle-income countries. Our goal is to have these ten steps in every facility providing maternal services and care for newborn infants. Videos, presentations, research, evidence, papers, training and counselling materials, tools, and many other related and supporting resources are available. Visit us on-line a http://tensteps.org .  
Nand Wadhwani
over 9 years ago