Next Ob G Watch 2004 KAGUYA Has 2
Next Ob. G Watch 2004
KAGUYA Has 2 Ammas but No Appa!
Born in Jan 2004 & weighing just 10 oz (284 gms), Zoe Koz fitted into his father’s palm. He went home on 4 th June after eye surgery & is still on Oxygen.
Cochrane Review 2004 Massage to Promote Growth, Decrease Stress & increase Tactile stimulation in Preterm & LBW Conclusion: ‘Evidence is weak’
• Incidence of 7. 1% of PTL & FGR in Group never consuming Fish to 1. 9% in Group eating Fish as hotmeal atleast once a week • In a study of 8729 women Maternal Nutrition Group Danish Epidemiology Science Center, Copenhagen BMJ Feb 2002
N-3 Fatty Acids: Docosahexaenoic Acid ( DHA ) And Prevention of Preterm labour DHA Gestational Duration PG Synthesis Uterine Contractions Preterm Labour Biol Med vol 226(6)2001 Am J Ob. G Apr 1997 BMJ Feb 2002
DHA & Brain Development ‘Intake of DHA-PUFA during Pregnancy&Lactation (Cod liver Oil) may improve child’s IQ’ -Helland et al Paed Jan 2003
Prenatal exposure to higher concentration Of DHA results in Mature pattern of Sleep Suggesting better CNS integrity - Am J Clin Nutr 2002
Maternal Nutrition during last 3 months of Pregnancy And Child’s Nutrition during first 3 years are crucial Brain reaches 70% of Adult size at Birth, 15% by 1 year and 10% in Pre school age Two thirds of Brain weight is Phospholipids & Longchain FA DHA & AA ( Fish oil & Sea food) are Brain friendly Breast-fed Babies have (>8 point) higher IQ (Lancet 1994) Singh M Ind Paed March 2003
• Fetal Neural Activity Begins at 10 weeks • Neurons spin out Axons • Electrical activity fine -tunes Brain circuitry • Learning begins at Birth with sensory experiences
WHAT GOES ON? • Babies can see at Birth • Knack of Focussing comes later What Parents can do? • Regular eye exam From 2 weeks onwards
What goes on? • Emotion circuits are Constructed early • Distress & Contentment Followed by Joy, Sadness, envy, Empathy, Pride, Shame What parents can do? • Loving care provides Emotional Stimulation • Neglect & Abuse lead to Anxiety & abnormal stress response
What goes on? • Tunes to Mother’s voice Even before Birth • Deciphers & reproduces Lyrics in 6 years • Can recognize vowels (Building Blocks of Speech) at 6 months What parents can do? • Talking a lot speeds up Learning process • High pitched sing song style help connect objects with words
What goes on? • Movements jerky at Birth • Refined circuits for Reaching Grabbing, Sitting, Crawling. Walking & Running in 4 years What parents can do? • Give Freedom to explore safely • Engage in Activities for Hand-eye coordination
Women with Low Waist to Hip Ratio And Large Breasts have 30% more Estradiol as well as Progesterone They have the Highest Reproductive Potential! - Jasienka G University of Krakow, Poland
“Coffee gives me warmth, Waking and an Unusual force”
BENEFITS: Increased Alertness ( Less RTA) Better Work Performance Elevates Mood ( More after Meal ) Anti oxydants Less: Suicides colorectal Ca Gall stones Cirrhosis Asthma Parkinson’s Type II DM Adverse Effects: Less Sleep Anxiety Crosses Placenta Secreted in Milk NO EFFECT ON: CV Problems MI, Arrhythmias, Atherosclerosis Hypertension Cholesterol Acid Peptic Disease Osteoporosis Ca Breast / Bladder Quality of Sleep Fertility Male/Female Fetus/Neonate Teratogenesis Abortion Uterine Contractions
A 17 -cm Scissors left inside abdomen at Surgery for Ca Colon 18 months ago at St George Hospital Sydney in 2001 -Sky TV
-Westinghouse 1941 American Men shave 48 sq inches 24 times/month Women, 412 sq inches 11 times/month -Gillette
HRT-The Evidence • 6 large RCTs in progress (HERS-EVTET-EST-WHI-ESPIRIT UK-WISDOM) • Of them, 3 involving CE + MPA were stopped prematurely, because • Incidence of Breast Ca > specified limits • Conclusion: Risk > Benefit Source: Chatterjee A JOGI Feb 2004
Million women study -Lancet 2003 • HRT increases risk of Breast Ca • CE + MPA carries higher risk than E alone • Advice to GPs: 1. Advocate short HRT (3 -6 mths) for relief of symptoms 2. Discourage long term HRT 3. If on HRT discontinue
Summary of 4 Publications (>20, 000 Women) Increased Risk: • Breast Ca • Stroke • Pulmonary Embolism Decreased Risk: • Colorectal Ca • # Femur No Difference: • CHD (Coronary) • Endometrial Ca • Alzeimer • Cognition
1. Eminence-Based Medicine 5. Diffidence-Based Medicine 6. 7. 3. Nervousness-Based Confidence-Based Eloquence-Based Medicine ‘The more senior the physician, 2. 4. Vehemence-Based Providence-Based Medicine the less important the evidence!’ ‘A‘Fear sense of Despair ‘Smooth (Restricted tongue, of Litigation Sartorial to Surgeons) elegance ‘Decision ‘Substitution may of best volume be left as “Clinical Experience” is defined And Leads Verbal to over eloquence investigate are Makes the physician feel helpless In the For hands Evidence!’ of Almighty!’ ‘Making the same mistakes ‘He will Powerful And let his over Substitutes’ scalpel treat!’ speak! ’ And do nothing!’ With increasing confidence over an impressive number of years’
- Slides: 25