Milestones
You can try to read revise and remember them 20 times and you’ll forget them 25 times.
But for gross motor milestones - a simple stick figure can help you figure out everything.
See the stick figure given below. Just remember - 3,6,9,12.
3 months - Neck control
6 months - Trunk control - Sit with Support
9 months - Knee Control - Stand with Support.
12 months - Feet control - walk with support.
A child would be able to stand with support only once it gains ability to sit without support.
So sit without support comes one month earlier - at 8 months.
Similarly- you’ll only be able to walk with support - once you’re able to stand independently.
Hence, stand independently comes at 11-12 months.
In Toto, this becomes
3 - NECK control
6 - Sit with support. (Trunk control)
8 months (9-1) month - Sit without support
9 - Stand with support (knee control)
11 months (12-1) - Stand independently
12 - Walk with support. (Feet control)
That’s it - you’ll now never forget Gross motor milestones for 1st year.
Take a deep breath. You’ll see your abdomen moves out and so does your chest. Why ? Diaphragm goes down - lungs expand and diaphragm going down causes abdomen to go out.
Whenever there is a respiratory pathology - the lungs won’t expand as fully while the diaphragm contracts.
The diaphragm contraction pushes abdomen while chest doesn’t move.
This causes the lag between abdomen and chest movement. When lag becomes significant- abdomen is put, chest is not - when chest expands - abdomen goes back - creating see saw.
And why do we do this?
Let me know how pull you know about respiratory distress in preterm.
You can have a newborn with normal saturation and HR actually tiring himself out before it’s too late.
You Need an examination finding allowing what interventions do be done .
Low Silverman Anderson - 02
4-6 - CPAP
> 7 - intubate ASAP.
And even on 02 and CPAP- it helps - whether the distress is improving or not.
If the scores go down on CPAP/02 - it’s working - if not - it’s not.
A formula and a Venn diagram used to classify liver injury based on the ratio of two liver enzymes, Alanine Aminotransferase (ALT) and Alkaline Phosphatase (ALP), to their respective upper limits of normal (ULN).
*** R-value.
A hepatocellular injury is indicated by an R-value greater than 5.
A cholestatic injury is indicated by an R-value less than 2.
A mixed pattern of injury is indicated by an R-value between 2 and 5.
https://t.co/C3CnRrzNus
The mechanisms by which ammonia and potassium levels influence hepatic encephalopathy (HE).
How a decrease in potassium (K+) leads to an increase in ammonia, which can then enter the central nervous system (CNS) through active transport and passive diffusion, ultimately leading to hepatic encephalopathy.
https://t.co/Ao7AjHjfYc