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Radhika R.,Kanchi Kamakoti Childs Trust Hospital
Indian Journal of Practical Pediatrics

Point of care testing (POCT) is near-patient testing wherein diagnostic tests are performed near the patient. Specimen drawn from the patient is tested immediately and results are displayed instantly on the point of care device. Point of care testing evolved due to the need for a high-quality, efficient, timely laboratory testing at a reasonable cost. In an emergency situation, with an urgent need for rapid diagnosis and therapy, this provides a lot of supplemental information and is invaluable in patient management. POCT is accomplished at the bedside through the use of transportable, portable devices and test kits. Quantity of sample required is very minimal and results are obtained in a very short period of time at or near the location of the patient. Although only a limited number of investigations can be performed using a POCT and errors are prone to occur, newer tests are increasingly becoming available and it has been found to improve patient care. © Indian Academy of Pediatrics. Source

Viswanathan V.,Kanchi Kamakoti Childs Trust Hospital
Indian journal of pediatrics

Management of epilepsies in children has improved considerably over the last decade, all over the world due to the advances seen in the understanding of the patho-physiology of epileptogenesis, availability of both structural and functional imaging studies along with better quality EEG/video-EEG recordings and the availability of a plethora of newer anti-epileptic drugs which are tailormade to act on specific pathways. In spite of this, there is still a long way to go before one is able to be absolutely rational about which drug to use for which type of epilepsy. There have been a lot of advances in the area of epilepsy surgery and is certainly gaining ground for specific cases. Better understanding of the genetic basis of epilepsies will hopefully lead to a more rational treatment plan in the future. Also, a lot of work needs to be done to dispel various misunderstandings and myths about epilepsy which still exists in our country. Source

Sathiyasekaran M.,Kanchi Kamakoti Childs Trust Hospital
Indian Journal of Practical Pediatrics

Pediatric feeding disorders are challenging problems encountered commonly in day to day practice. 25% of normal children present with a mild disorder which increases to 80% in children with developmental delay. The etiology is multifactorial comprising of medical, nutritional, behavioral, psychological and environmental causes. Feeding disorders should be conceptualized as a bio-behavioral problem, a continuum between psycho-social and organic factors. The clinical spectrum includes food selectivity, food refusal, excessive meal duration, dysphagia, choking, vomiting and inappropriate mealtime behaviors. Nutritional and cognitive impairment, growth failure, susceptibility to chronic illness and even death may occur as a result of this disorder. Assessment and treatment are best conducted by an interdisciplinary team including a pediatrician, gastroenterologist, nutritionist, behavioral psychologist and occupational and/or speech therapist. Source

Balasubramaniam C.,Kanchi Kamakoti Childs Trust Hospital
Journal of Craniofacial Surgery

In pediatric neurosurgery departments in India, craniosynostosis is being increasingly identified and dealt with during the past several years. The management of this problem is well established in units that have a strong pediatric bias, whereas it is still in infancy in certain departments. Some misconceptions exist regarding this condition with reference to clinical, genetic aspects and management-in particular, the surgical indications. The experience gained for more than 2 decades of treating this condition as well as the problems faced in the management of this condition will be discussed. Although the terms craniostenosis and craniosynostosis do not mean quite the same thing, the terms are used interchangeably andwill be done so in this communication. Copyright © 2014 by Mutaz B. Habal, MD. Source

Archana S.R.,Kanchi Kamakoti Childs Trust Hospital
Indian Journal of Practical Pediatrics

The primary goal of oxygen therapy is to correct alveolar and/or tissue hypoxia. Therefore, any disorder causing hypoxia is a potential indication for oxygen administration. But the tissue oxygen delivery depends upon an adequate function of cardiovascular (cardiac output and flow), haematological (hemoglobin and its affinity for oxygen) and the respiratory (arterial oxygen pressure) systems. Therefore, tissue hypoxia is not relieved by oxygen therapy alone - functioning of all the three organ systems also needs to be improved. Oxygen therapy should be administered according to guidelines. Oxygen should be regarded as a drug and should be prescribed precisely as a drug. There are numerous devices available for administering oxygen and the type of device to be used depends on the age, percentage of oxygen needed, whether the child is spontaneously breathing or not and finally the availability of the paticular device. Proper monitoring of oxygen therapy is recommended to ensure adequate oxygenation and to save precious oxygen from wastage. Source

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