Kulanthai Maruththuvam

7/18/2019 Kulanthai Maruththuvam

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Pune’s Serum Institute of India (SII) launched its much awaited “cheaper” and “painless” solution against the virus -- a

ready-to-sniff intra-nasal vaccine, Nasovac, on Wednesday across the country.

NASOVAC meant for the H1N1 pandemic strain, is a nasal spray in powder form, which has to be reconstituted by

adding water.

“CHEAPER” AND “PAINLESS” SOLUTION AGAINST THE VIRUS



A single dose of 0.5ml of the vaccine is delivered directly to the nasal cavity through a device fitted at the top of the

syringe.

A quick spray in each nostril and the body develops antibodies to protect against the deadly virus for a period of over a

year or even more.

According to experts, the nasal spray may prove to be effective as it takes the same respiratory route as the H1N1

virus. It has the efficiency to fight H1N1 infection even if small changes occur in the virus.

After vaccination, some negligible or very mild reactions may be experienced for two to three days.

Safety and efficacy assessedThe safety and efficacy of the vaccine was assessed clinical trials on more than 300

human subjects in the country.

The vaccine has been approved by the Drug Controller of India (DCGI) and can be safely administered to anyindividual above three years.

However, SII is not recommending the vaccine for pregnant women and lactating mothers.

Nasovac should not be administered to pregnant and lactating women, besides children below three years.

"But the medical fraternity says this decision should be left to them. They think that if the women are in a high-risk

area, they should be vaccinated. So we have no objection, but it is better that if these vaccines are not given to them.”

Economically pricedIn order to increase its commercial use among the masses, Nasovac is economically priced.

SII has set a sale target of 20-25 million doses in first year.

In addition, SII donated vaccines worth Rs 10 crore to various hospitals NGOs, and the underprivileged.

It is priced at Rs. 158 per dose and available in the 5-vial pack for Rs. 790.

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6. , « t.

7. t, .

8. x .

9. ².

10. {¢t y.

11. t«} |. 12. ©z ¯{.

13. t .

14. ¸u .

15. .

16. ~©

17. , v.

18. ~ .

{ ¾{ ¾{ ¾{ ¾

1. { ~t} zt ( RBC Count )

2. { ~t} Hb } º.

3. {{ ¯©v {} º

uuuu

1. { ~t {

2. {} ¯©v {¢ z¢.



3. Vitamin B12 Folic Acid t ² {¢t z

{ .

4. { ~ z { ..

¯{¢¯{¢¯{¢¯{¢

} , t y { ¯{¢ ~z.

ºººº

© , , ¶ ,

, © , ©v , {

«¯u,

,z

,

¾v , ~y, , y

² y { º ¯© {¢ ¢.

«~¢ «~¢ , ¢t¢ ~¢ ¢t¢ ~¢? DENTITION AND BRUSHING HABITS IN CHILDREN

|t ² { ¯|¢ «t t ¯¢

z ¢t «{¢ ..² ¯|¢ z ¢

¸|¢ ¯y | «t . }

y ¢ « ¯{¢ |¢ ¢t «t.

¢t z t z º £u «} y

¢t { ¯| t z .

«t , , y} , .

, , , }, «y {¢t .

~y | {¢t t .

v v,, ©z v ©z v,, vt vvt v

TYPHOID FEVER IN CHILDREN.

¢ SALMONELLA TYPHI } ¤z ¾ ¯ . ¢

y t u { u

| ¯. |¶t ¢ 15 ¢ ~© t

~© .

««~~¢¢ ¢¢tt¢¢ ~~¢¢

vv,, ©©zz vv,, vvtt vv



INCUBATION PERIOD OF TYPHOID IS 777714141414 DAYS

¢ { , º(, ¿, t «y , y, ,)

~y } ¯ { ¯|¢ z u¶t } ¾

t .

::::¯ { y { } ¯

¯t .

« « « « : , , t , t ¢ ² t .

| ¯ ¢~© ( | ¯ ¢~© ,

TYPHOID FEVER | | º ¾t¢.RELATIVE BRADYCARDIA ) t}

{ |¢ ¯t (TONGUE COATING) ROSE SPOTS: |¢ ² ² ~© © }²

z z z z :º | ,² , ² ~© , z

t

WIDAL TEST POSITIVE .(WIDAL TEST }¢ y { zt º

¾ . { ¸ y¶t z.¸

y¶t «} } ¯.)

¬} ¬} ¬} ¬} : º , º , ¬v ,

² , { º ,~

¢¢¢¢ :²¢ ² . ¢ ~© t

¯| .

COMPLICATIONS OF TYPHOID ¾ { z{ {

} º

y

´©

º «º «º «º « : ¾t y z



y ¢ , º ¯| y ©z t

² {¢ {¢ z .

¾ z{¢ ¯|¢ ~ { ´ « ² y¶t

t . ´ y |¢ y¶t ANTIBIOTIC

¯| ~y z .² | ¯{¢ t

z ( y)

~© « :~© « :~© « :~© « : { , { ,º {

~© ~© ~© ~© :z ~© ¢ . ¬}² ¯u¶t

¯ « z .² y |¶t ¯ CAPSULE ¢ .

| | { ~ z , ² v

| } z { z , |¢ | ~¢

t .

« z ¬}² y t ~ . ¢ |t ¯

¯ ¯|¢ . ¯ } |t ¯ | .|t « ~© ¯|¢ }² .

© {¢ , ~© {¢t¶ .y}

º, ¾ ¢ . ¯ ¢

t z .

| | « z ¢ {¢ - . ¢

, ¬} { ¯| t

|t z { ¯ « ~ z .

|t } { ¯ « ~ .

t ² « 750 ml t , 500

600 ml t . z ¢ | ¢.

~ t © ©² , ¾ ©² t~ .

~ t }



| ¯ { { t t - .

t ¢ oxytocin } } ~ ¢

~ ¯u ¢ {t t .

|¢ ² ~ y {¢ |

, } « { { t«- .

t } z. ~ z.

| | « ² u¶t y z z

( )} 88 % ¢. ²

u¶t ´} º z z ¢ z .

|t }|t }

| |º} t « t ~ .¢

, x { ¯t . |t ¯ « ~© ¯|¢

. « 34 y y z .

(¸~, z, t ¯ |º} ¯ t u ¢, ¢ t .)

¾{¢ , |º} { º ~ y t

z, ~© t ¯ .(secretary IgA,

Macrophages,Lymphocytes,Lactoferrin, Lysozyme, Bifidus factor,Interferon) ²t ,

« t . ¢ ¾t .

|} ¬ v « z ¯u ¯t.

t CYSTIENE ,TAURINE {¢t ¾ . (}²y |º} ¢ , | { t ¯

¯ ¢) y ¾ y{ ¾ { ¯.

| ¢t| ¢tCORRECT VISUAL HABITS FOR CHILDREN

t ¢ , t ¢ y| t z , ~©

{, t { t ¢ ., t ¢ t

||tt }}

|| ¢¢tt



z, { t ¢. t ¢ , t ¢,

t ¢ { ¯ « z ¬

º tz .

¾ v ¯t z, v{ z} y

~- , v{ ¯ - . ¢

~ t z © |¢ }² ¯ º ²¢

.

t t{ { z,} z

©{¢v-} ¯t . t ¢ z ´|¢

.(Early to bed, early to rise)

{ ¢ ~ t z.z¶t

¸{{ ¯.({ t)

²z ²z ? ? ¯ ¯

² z² z² z² z(SQUINT) z z} {º ²z ¢ .

| ¯ º ~} {¢, |¢

z ¯{¢ z.

t ¢ z z¶ {

¯ , ²z ¯t ¯ z y

¯t .

z z z z

CONCOMITTANT SQUINT

NON CONCOMITTAT SQUINT - (PARALYTIC SQUINT)

t ¢ ¢ ¯ z¶ ¯tz ,PARALYTIC SQUINT } § ¯ z | ´

~ ¯t .

PARALYTIC SQUINT: ² v ¬ ¾ «-

CONCOMITTANT SQUINT z ~ CONVERGENT SQUNT, DIVERGENT SQUINT

²²zz ¯̄



CONVERGENT SQIUNT: t ¢ ¯ z y t, ¢

¬t t .

z ¢ 1.ACCOMMODATIVE TYPE , 2.NON ACCOMMODATIVE TYPE

ACCOMMODATIVE TYPE CONVERGENT SQIUNT: ¬}² ¯{¾

z{ ² z z ¬ ¾ «-. }

¢ ¯¢.(HIGH HYPERMETROPIC REFRACTORY ERROR)

NON ACCOMMODATIVE TYPE: ² v z

DIVERGENT SQIUNT: t ¢ ¯ z y t, ¢¢ t DIVERGENT SQUINT y ² v

z .¢ ¾ ¢.

² v ¾ ¢² v ¾ ¢² v ¾ ¢² v ¾ ¢ ?

{¢ ² z - 5 z , 5

z} º ¾ «

¯t¢.

² v ¢~² v ¢~² v ¢~² v ¢~ ?

² v z} ¢ z

z ¢, .

PATCHING FOR SQUINT: ² vt «}, u PATCHING }

« { ²z} t ¢t

. | « z ¬ {¢, ²zt ~¢ .

²z} ¾t.



} }¢ z ¯ ¯z ~© . ¢

u ¯ ¢ .

uuuu: , º , ² ¬ ¯ t¾, « ¤z¾ ¢

t ¯

z ¢

¢

¸u

¯ ~©

¸{ y

²

¯{¢¯{¢¯{¢¯{¢:::: ² v «| ~¢ ¢. { , º

¯|z .¯|¢ |¢ ¯{¢ ~ z



º y z, ¢ ¢~ º z , &

v ¯ ¢ |¾ ~© y ~©t z

² v ~¢² v ~¢² v ~¢² v ~¢ ? ~ z ~zyt ¢ ¯ ²~© |} ~©

tt }² .

¯ ¯{ ² «t } u |, quinsy }

y |, t |, retension cyst ~ y |

² v z.

|¶t t «|¶t t «

¬}² { ¯ « z y ¢ t

z ´ ¢, u} ¢ y t|¢ ¯| ~ allergy

z |¶t ²t ¢, ~} ~

|¢ } y |¢ ~© ¢ .

¢ diaper |¢ º t ¾t¢. y { ©¢

¢ }{ .

¢ ¢{} y } ¯ {

|¶t t.

|¶t ¯ ©z ² ¢ |¶t ¯ ©z ² ¢

|¶t ¯ ©z ² ¢ |¶t ¯ ©z ² ¢ |¶t ¯ ©z ² ¢ |¶t ¯ ©z ² ¢

¯ ¢t |¶t y ¯´ , {

´ { ¢ ~(ORAL THRUSH )

, ¢ ªx }(CANDIDA ) ¯ . t ¯| t

¾- . candid mouth paint } ¯| z

||¶¶tt tt ««

||¶¶tt ¯̄ ©©zz ²² ¢¢



| |¶t ¸{ , y} {¢ (y , y

)« ©z ¯¢

¢ u ( ¢ u ( ¢ u ( ¢ u (halitosis) {,² t, ©z,

©¸t, ¤ ¯ t (LUNG ABSCESS ) , ²

t :t :t :t : « z ¢t z, ² { ¯

« ªv ¯|¢ z, y} | º z

¸{ {¢ z.

|¶t ¯ v |¶t ¯ v ((GROWING PAIN/ GROWTH PAIN)) ¯ | ¯´ º { ~ y

¯t , "v "}² ¢ ¢ 35 ² 812

t } } | |¶t v ¯t.

¯ | , ~ } «}©, z ,

«u ¯t .

´© ² ¬y ¯|¢ ¯¢ , ¯| ¯¢.

, ´, ´t ´ {

y{´ ¯¢

¯{¢¯{¢¯{¢¯{¢ :¢ ¯{¢ ,| { .

w w w w

||¶¶tt ¯̄ vv (( ))



y yv z , ~¯}

{ ¯{¢ } ¾ ² ¬y

u, |¢ ¯{¢ } º.

| ¬t { (| ¬t { (EPISTAXIS IN CHILDREN )

| ¬t { | ¬t { | ¬t { | ¬t { :¬t { ¢ ¢ ~ ¯, º «²{¢, {¢ .

uuuu:¬t z, z ¯{, , {

} (haemophilia ), (winter ), ADENOID ~ z

y, , SINUSITIS §, ²

¯{¢¯{¢¯{¢¯{¢: y ¢, ¬t | ¢, ~

{t ¾t ¢.

~ «~ «~ «~ «

|| ¬¬tt {{ ((



| «} © {¢¶u ¬t y ² y } ¸{ tº, ~ {¢ { { }²

.

¬t ¯t } , } y ¯|¢

y.

t { |, ¯{¢ ¾ ¢ z.

|} z u¢ }|} z u¢ }?((EYE DISCHARGE DUE TO NASOLACRIMAL DUCTOBSTRUCTION)

| |, ¯ |¶t z u }¢ t

¯ ¯ . y ¢ ¯¢ }² {

« (~ z ¢, z {¢

y¢)

||}} zz uu¢¢ }} ((



t NLD (NASOLACRIMAL DUCT OBSTRUCTION ) ~ ~©

.

¯t zt ¬t ¯ ~© ¢.z

} ¬t} |¢.| |t | ~© ¾

v ¯|, ~© y ¯| z {¢} ¾t« ¬º ~© z .

¯{¢ :¯{¢ :¯{¢ :¯{¢ :NLD MASSAGING

w } ¬ ¾ . ¯ t ² « y

C { z ¬tt w z.

¯{¢ z y ¯|¢ y z .~

, z {¢ ~y ¢.

u |} { tu |} { tuu ||}} {{ tt



| } u | º ¯t } « ¬

«} y «- ,

z |z |z |z | } { ¯ u

z |z |z |z | z { ¯ u (¢) ¬}²

¢ ¬- ¢ { 1 .57 } z ¯t ¯ .

¢

Weech formula: predicting adult height (male) = o.545x (height at 3 years) + 0.544(mid parental height) +38 cms

Predicting adult height (female) = o.545x (height at 3 years) + 0.544(mid parental height) +26 cms

Midparental height }¢ ¾} ¾ (~ 160, 140 mph 150 )

u | ¬}² ¢ } ¯ { t«-.

|¶t ¯ ¢ |¶t ¯ ¢

¢ «t ~¢, y ¯¢ .

| | ¸¢ z ¯t. ¢ y

¬t |¢ } ¸{ ¾~ ¢

. | ¢{¢ z . ¢t y ¢ .~ ¸t

¢. x z t ¾ ¾{¢ ¢{¢ t

z.

||¶¶tt ¯̄ ¢¢



~ {¢ z t¢,

|} zt (middle

ear) ~©(Eustachian tube ) }² t.

©y {´ t. ¬t ~© ¯|´ ¢

, ¬t y ¯|¢ y z.

~ y z ²~ ~¢~ y z ²~ ~¢ ~~?

² | z y¢ ~ y¢ }¢ ¯

, y y t « :

²~} «} ¯´ y¶, ¢ ~} ´t

y ? ¢ ~ } ¸§t

}² t z .

´t y ¯|´t y ¯|´t y ¯|´t y ¯| :

« ~ } ¯|¢ {¾{¢ tz .(}y y

) ~¢ «} ~ y ¯t

1 } { y z .} ¸ t z .

} } ¾{ .

~~ yy zz ²²~~ ~~¢¢ ~~



´t ¸~§t ytz´t ¸~§t ytz´t ¸~§t ytz´t ¸~§t ytz

The Chomp and Squeeze Method:

| « yu z ¯ «- y

¸} ¯ © ¸{ z } ¬ .



Screw- driver Method:

¯ ¾ t¯ ¸} ¯ «¶t y

z. «} ¯ © y ¯t,

© © .}¯ « ¸}

yu z ²} ¬ , ¢ «}

z .

u ¯ « « } ¯{¢ º.}

¯|¢ ~ y y ¾{¢ {¢ | { t.

u uu u dengue fever in childrenuu uu



u u ¢ ¯(DEN 1,2,3,4) ¯ . |

¯ t ¬ º .

:tiger mosquito } ¯ z, } ©

z, ¾ y ¢ ¯ y ¢

¯ y} ¯y { u ¯|¢ t } ¢.

¢ ¾ y ¯(¸t , t t¢)

yº} , y, ~, z y ¾´ ¾yw

} , flower vase ¢ «y y

¯ } z¢ .

| t «t . , t} {

t ¢.(} ¯ z } u} ¯ t|¶

t~y source from flowervase ) ¯ «} ~ |¢

u u u u

u

u {º² (dengue hemorrhagic fever)

u t (dengue shock syndrome)



¬y

z} }©

|

{ |

¬t { º

² {tº

² ² { ©

y ¯~¢

¯~ ¢

| § | ¯~¢

{ ² « {¢ y¶t ¯. ¯t .|¢

y¶t } - | { } t ¯t

z .| ¯|¢ | ,¢ º²

¢ t t . |¢ y }² y

¯t¢ .

vvvv:º , ¯|¢ { | t ¢.

u { } , ´

{ t ¯|¢¶ | {tº ¾t .¾}

{ z~ t¢ ¢¢~

{¢ {

~© « :~© « :~© « :~© « : y ¤|¢ t ¢ y

¢ ´ ~©} ¯tz º

( ) , º¢ ¢, «| §

£u¢ ¢

y} ¯- , yt - u {¢tz.



|¶t ¯ ¯|¢ } t¢|¶t ¯ ¯|¢ } t¢? (cough & cold in children)

|¶t ¯ , ¯ }¢ ¯ «t ¢~© « ,

¢ ¢ ¬v £, ¯ , v ¤ t¢.

¯} ~¯} ~¯} ~¯} ~ :² ¸t~y, z ¯u}

¸{{¢} ² { t¢ . ¤

£,v t¢ .

||¶¶tt ¯̄ ¯̄||¢¢ }} tt¢¢



{ ¯´ t } ¢ . ¯¢ , t { .¯ |¢ ¬v ,

£t , z } | y ¯ syrup

{¢z .

² |} ¯ «´ ²{t¢ , ¯ ¬

u ² .¯ ²{ ¤ }²

atelectasis } ¤ ¯u } {.

¯´t © ´ z , } ¢ - ¢

¯ ¯¢ .

¯{¢ :¯{¢ :¯{¢ :¯{¢ :|¶t «´ ¯ y{ ¢ ¯¯¢ }² {¢ { z y ¯, z

¯| ¯ ¯|¢ ,£t ¯«, t

« ¯, ¯} « | u ¯|¢ z

¬t} «}© ¢ , ¬t} } ©« z -

¯ |¢z ¯t(postnasal drip ) .t ¬t y ¯|¢

y ¯ |¢ .

§ } ´ ¯|¢ , |¢ ¯¯t.

z¾ ~© y ~©t z, ¬t y ¯|¢

y z , ¾ tz , z {¢

~y tz

~¸¢ ¯{¢ z~¸¢ ¯{¢ z~¸¢ ¯{¢ z~¸¢ ¯{¢ z : x , v,

y ²¢, ¬v ¾t ¢ ¢

².



~© « 2 > 60 / ¯

2 « ¯ ¢ >50 /¯

¯ ¢ 5 ¢ > 40 / ¯

| ¢ | ¬v { ¯ «¸ {

zz. } ¯| ¢

} ¯t .

}tv ~© ¯|¢ «}tv ~© ¯|¢ «

1. ¬ ¢ - vaxiflu -s

}}ttvv ~~©© ¯̄||¢¢ ««



¢ 1860 ¢ ¶t y z .

2.¬t ~ ¯|¢ ¬}² ¢ « .¢ {¢

tº :

NASOVAC : ¬t} z ,¬}² ¯|¢ z

, { ¯| ¢ .( z y )

«y ¶ y ¢ . ¬

¢ .5 (5 ¯t ) , u - t¢

¾¾¾¾ «t«t«t«t u tu tu tu t http://www.youtube.com/watch?v=amIwMozhx9U

u |} t ¾~¢ ~u |} t ¾~¢ ~ ?

¯ , ¯ }² , |

{ t ¢ ¯ t }² .

uu ||}} tt ¾¾~~¢¢ ~~



{¢ : {¢ : {¢ : {¢ :

t, yt, ¯, t «¯ {¢ ¢ u

. ¢ « « | ¯t (}¾ ¾

). |¢ . | }¾ ¾ «¸ { ´{ |¢{ ¢ y ¾ .¢º {¢¶t

y ¯t .y ¾ ¯ ¯ -¢ ¢ y

t ² . tt º «t¢ z :1.

² , 2.¯ ¯



´ y t ~© ¢, ¢º ¢ }.

«¸¢ ¯t.

y { y { y { y { z ¾tz ¾tz ¾tz ¾t :explicit & implicit

explicit }¢ x { ºt z «-

implicit }¢ t ºt z ¯

º ² z t :

z y {¢

y ~¢ }¾ ¾

«} « y ² ¢ y ¾

{ { y¢ u explicit ¾

y¢ u implicit ¾ ( t¢)

º ¾t

1. - |t z , u ~¢ u ,

| , x u } |{¢

z

2.©¾ - t ¢ . ¯ ¾ ©¾ ¯ ´ .

3. «¸ .

4. mnemonics {¢ ~¢ ¯ . u |t ²

u news - north ,east,west,south

5. { º} ¸ t t{ { z. t }

¾ t ¸¢ u .

6. u¶} - tu ¯ ¯

|¢ t z

7. t . |¢

8 £t z~



8 . t £u t z

9. £u «} }² { {- ¯ « y º

{ t z. ~ - ¢ £u´ ¬}

¬ ~©} ¯|¢ y ¾ ¯|¢ u

¾ º ¢ z ¯t. ¢ «t .

10. º {¢ º | {¢ © | ¶

¾t {¢¢ ¢.

~~ 10 u u

1. £t }£t }£t }£t }: INSOMNIA |¶t y « {¢ «,

¾¶t ² « y ¢t .

2 .£t{ ¬v {£t{ ¬v {£t{ ¬v {£t{ ¬v {: SLEEP APNEA-| º z, © t

¶t ¯. t{ t ¬v }² }² ¯

«¸¢ ¯~.y £u´ z

£u ¯t .

¯{¢¯{¢¯{¢¯{¢ ~© , ©~ ²{¢

3 .²y º²y º²y º²y º : º ~ ¯{, ¾ º z,

~, º

,º

¯{¢ :¯{¢ :¯{¢ :¯{¢ : y º, u, º} ,

{.

4. { { { { :z¶t, |} ºt «t .

¯{¢¯{¢¯{¢¯{¢: ¯© {¢t º, , «y.

5 . ¸{ ¸{ ¸{ ¸{ : ¾ ¸{ ¯ ºt

¯{¢¯{¢¯{¢¯{¢ : ,

6 .THYROID HORMONE : ¾ } ¯ .

¯{¢ :¯{¢ :¯{¢ :¯{¢ :¾ ¢ } .

7. KAFFEINE OVERLOAD : x x t }

« ¯ |¢ } ² ¯ .

8. ¾º ¾º ¾º ¾º : 35 | ¢º ¯ ºt ¯ ²

110 MG , ~yº} 160 MG ¯tz .

~~ uu



9. ² ² ² ² :z ,² | ¾ ² y

ºt ¯{¢ :¯{¢ :¯{¢ :¯{¢ : z tº, tt ¢ .

10 . ,~© (~© (~© (~© ( DEHYDRATION ) t ¯~¢

² ,~© ~©. ¯{¢¯{¢¯{¢¯{¢ : ¯ t 3 y ¯|¢.

y y { z{ z ((MADRAS EYE- CONJUNCTIVITIS-FACTS& PREVENTION)

y { z :z} º | z ¢

y ~¢ . (ADENO VIRUS -CONJUNCTIVITIS)}

t ¯´

¢ ¯ ²y ¯ ¯ .| ,

t¢.

yy {{ zz ((



¢ ² ² (fomites) ( ~ , ¢z , ,} ,~} ,~)

´t ¬ º ¯ .¯~© z

¯t ¢ }¢ ², z ¾ v

¬ ¯ ¾v y t ¬- .

¯ }{ z } { ¢

z y ¯| ¯ t ² « y « ¯{¢

z. z t ¢ .

¢ , ¯ ¬« | º , ¢ {¢ ¯ºz | ¾ t ¸º , «}© } ~© y

¸º . |¾ ¢z {¢ { tº .



¯t { ¢ . ~© t ¶t, |¶t ¯ | ¬v ² ¬ ² .

¯{¢ } steroid y ¯|¢ u y z ~© . ¯{¢ ¯~ .

¢ ¾ (self limiting ).

} ~© t ¯{¢ 5 « 7 y ¢ - .

} ~©} ~©} ~©} ~©

( (AUTISM) }¢ !!}¢ !! (( }}¢¢ !!!!



1.z ¯~¢ .

2.~y ¯ t ¯~¢

3. « ~y ¯ « y ~¢

4.z z t y}

5.«{ ¯t t¢.

6. u ¯ ¯ ¾ ¢ z ¯~¢

º t z º ¢ .



} {} {} {} {

1.z z t y}.

2.{ , y t | v- y¢ ¯{

3.« {¢ ¾t¢ ¯{ t }²

4.|¶t ¬} |¢ .

5.© «u t ¯~ ¢ ¯{ .

12 {{{{

1.z z {- ¾~- { ¢ ¯{.

2. ¸~ ¯{. | { |¸~©.(babble)

3. yy ¯ t¢ ¯{.

4.y t ¾¢ ¯{.

5.bye bye ¾¢ ¯{

6.§ ¸ ¢ ¢ ¢ y

{¢z ¯{.

7. { t¢



8. z ̄ ©.

9.© { ² ²~¢.

10. y } t «¢(tip toe walking )

11.¢ ¯ ¯ ¾ tz ¯~¢

² ¯| } | ¯{¢

¾ z.

| |t ¯ ¾y(| |t ¯ ¾y(tiny menstrual period )

|¢ y z |¶t º { ~© ²~©

¯ ¢ {¢ .

|| ||tt ¯̄ ¾¾yy((



: | ¯t ¢ } { }¶|t z ~ x ¬ |t z¯t.

| |º} {¢ ²{¢.

| }} º {{ - . ¢ ¯

}y ¾y(tiny menstrual period) } {¢ .|}

¯|¢ º {t ¯ t. |t

¯t¢.

|} ²~© ² } ~© ¾ ¢ y¢. ¢ .(|

}² ) ¢ z |¶t y ¯.

z |¶t ¯ }² «¢ . }´

.y} º | |¶t

¯t. |º} vit k ¬ ¢.t



¢ y ¯| y} y¢

¢.

x x x !x x x !

¢ {{ ¯} } ¯ ¾~ x .

~ ¯ ¢ ¢ x -¯ ¢.(Latin b ī lis, bile + ruber, red )

{ ~~t

«}§:«}§:«}§:«}§: ¢ t { ~© t }

120 y . t z |¢} .

RBC } t} } ¢ ¯¢.¢ HEME ² GLOBIN

}² ¯ t ¢ .

xx xx xx !!



HEME } u¶t yy BILIRUBIN } x

²¢.

¯} {{ tz ¯t {{ ¯|¢ ¾{¢

{ {¢ ¾ - ¯ ²¢ .

} ¢ { |¢ ¯ ² ¯ ²¢

.STERCOBILIN zyzyzyzy UROBILINOGEN



STERCOBILIN {} ¬ ² {} { (BROWNISH YELLOW )¢

UROBILIN ¢ ¢ ²¾ ² y ¢ { } ¢

¾-.

} {¢ « t §

¯ { ² |´ x ¾ .

u t ²u t ²u t ²u t ²



I. RBC t ¯ ² RBC º (HEMOLYTIC JAUNDICE )

II . ~¢ (HEPATIC JAUNDICE)

III. ¯|¢ ² ¯} «

~ ¯ x (OBSTRUCTIVE JAUNDICE )

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No. Ear canal should not be cleaned frequently with hard objects such as earbuds, sticks etc.

Ear canal has two parts outer and inner. Outer part contain ceruminous gland from which wax like material is being secreted.

Cerumen or wax will be there in the ear canal which protects the ear.

We should not remove the wax.if we use earbuds to remove this you will push it further inside and it will damage the delicate

inner structures in the ear canal.

How to remove the wax?

No need to remove the wax.if it is causing discomfort and pain you can instill either clean coconut oil or wax dissolving drops

available from drug stores.

The moral of the story=) never ever use a ear buds in budding children

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WE SHOULD CLEAN THE EAR CANAL OF CHILDREN

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In observational studies anemia and iron deficiency are associated with cognitive deficits , suggesting that iron supplementation

may improve cognitive function.

Iron can improve cognitive domains: concentration,intelligence ,memory, psychomotor skills and scholastic achievement.

If the child is anemic, iron supplementation can improve I Q by 2.5 points. So if your child is poor in studies or getting worse in

scholastic performance consult your pediatrician for signs of anemia and iron deficiency.

IRON SUPPLEMENTATION CAN INCREASE I Q OF YOUR CHILDREN



Education should bring a change in your child s life not in her back. There is a growing concern over the effects of overloaded

school bags in children.

It is unfortunate that parents are not aware about the ill effects of excess weight

SIDE EFFECTS: Growing children have tender spine which is not meant for weight lifting.so weight bearing for long duration

can bend the back bone.it will result in backpain. Shoulder bag can restrict breathing of your kid.so air entry in to the lung is

reduced which may cause lung disease in future. Other pains such as hand pain and leg pain can occur ,Chronic weight bearing can

damage the knee joint and will cause early onset of osteo arthritis of knee joint.

HOW TO DEAL

It is recommended that children should not carry 15 % of their weight .that is if your kid is 15 kg ,he should not carry more than

2.25 kg.

As in earlier post the weight of the bag should not exceed 15% of the kids wt.

In India most kids are either malnourished or obese.only small number of kids fall in the normal weight category.so it is very

difficult to give a standard guideline according to age or grade of studiying.

But we can reduce the burden by following measures.

STEPS TO REDUCE SCHOOL BAG SIZE

1. Provide safe purified drinking water in the school campus itself.it will definitely reduce 300-500 Gms of weight

2. Provide mid day meal, reduce additional half kg wt.

3. Books should be split in to two or three parts and only that particular part should be taken for that terms

4. Make arrangements to keep few of the notebooks and text books in a safe place

5. Avoid single sided bag.always use strapped shoulder bags so that the weight will be distributed evenly.but remember that

shoulder bag can restrict breathing movement if it's overloaded.

I hope in the future the tablet pc will replace all the text and notebooks and children will be freed from this burden.

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Honey should not be fed to infants younger than 1 year old. Clostridium bacteria that cause infant botulism usually live in soil and

dust. They can also contaminate certain foods especialy honey in particular. Which causes botulism in less than one year

INFANT BOTULISM CAN CAUSE: Muscle weakness, poor sucking, weak cry, Constipation, Decreased muscle tone(floppiness).

Parents can reduce the risk of infant botulism by not introducing honey or any processed foods containing honey (like honey

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£ ¬ ¯ £ ¬ ¯ £ ¬ ¯ £ ¬ ¯: 6% water, 2% caffeine, 17% albumin, 8% soluble substances, 8% toxic

substances, 2% dectrine, 3% pectic acid and pictine, 17% tannic acid, 4% chlorophyll and raisin, 26% cellulose and 7% salt.

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Kulanthai Maruththuvam

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