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hari-writes · 7 years ago

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Little Louis Dupain-Cheng - Chapter 2

Fandom: Miraculous Ladybug Pairings: Adrien/Marinette Summary: In the seven years since Hawk Moth’s defeat, much has changed. Adrien Agreste PhD returns to Paris and is reunited with his friends. Marinette has a degree in Fashion Design, a thriving boutique and a son, six-year-old Louis. Louis is like his mother in many ways, except for green eyes and a familiar smile… Will Adrien do the maths?

Read on A03 »»★«« Buy me a coffee?

Chapter 1

Une fille comme les autres

Marinette was a normal girl with a normal life.

She missed Tikki like crazy and often found herself checking her purse in the vague hope that she’d find the kwami there. The exhilaration of running over rooftops as Ladybug and the feeling of freedom was hard to replace, but the burden of being Ladybug had also been lifted. She was free from the worry of when and where Hawk Moth would strike again. She was able to start her life all over again.

Adrien’s absence in her life loomed large. She missed her partner and friend. She and Chloe bonded over their mutual pining for him. They both loved him, both had complicated histories with him and unique bonds to him. Together, they counselled each other through the gaps he left in their lives. She knew that the others video called him regularly, but she and he couldn’t get their schedules to match up. Instead, she emailed him. He always replied within a day and they found that this communication worked for them. It was easier to be honest in an email.

She and Chloe, Nino and Alya met often. They supported each other to deal with the aftermath of their battle with Hawk Moth. They toasted their kwamis and talked openly about their feelings. It helped, but she never stopped missing her other half.

»»★««

Fashion school was everything Marinette dreamed and more. She felt more inspired in the first few months at ESMOD than she’d been in the entire time she’d spent at lycée. There was so much around her to spark her creativity and she felt energised. She made new friends, shared ideas and sketches with classmates, and appreciated how her tutors spoke to her like they valued her opinion.

If this was adulthood, she liked it.

November began and the class were preparing for their first big project, a Christmas fashion show. All of them were working long hours, nobody more so than Marinette. She helped her parents in the bakery three mornings a week before school and worked on alterations and commissions in the evenings on top of school work. She was constantly exhausted.

It came as no surprise to anyone when she fainted in class.

“Mademoiselle, may I ask, when was your last period?” The doctor said, looking at something in his notes.

“Um, I can’t remember. August, I think. Middle-ish of the month? I don’t know, sorry.” Marinette had so much on her plate that she hadn’t even noticed that she’d skipped a couple of periods. If she had, she’d have put it down to stress of her new course and not eating properly. She had been feeling nauseated and tired since term started and she knew she hadn’t been taking care of herself like she should.

The doctor ran a few more tests. He came back into the room with a serious expression on his face. Marinette was worried.

“Am I ill, doctor?” She asked.

“No, not ill.” He said, “but I do have some news. You’re pregnant.”

“What?” She managed to say.

“You are roughly three months pregnant.” The doctor repeated.

“Oh. Shit.”

This was too much adulthood.

»»★««

“Vous êtes en état de grossesse, mademoiselle... Vous êtes enceinte de trois mois.”

The words the doctor spoke ran on a loop in her mind. If she was focussing on the positives, it had replaced the memory of that final battle with Hawk Moth in her nightmares and overwhelming panic had replaced the memory of the sorrow she felt when she saw Adrien’s face after his father was arrested.

It was difficult to be optimistic.

She had to go to the clinic for a scan to show how the baby was growing and to confirm the due date. She hadn’t known she was pregnant and now she was worried that she’d unwittingly harmed her baby.

Meanwhile, she had to decide how she was going to break the news to her parents and which of her friends she could trust with this knowledge.

Until the scan, it didn’t feel real. She didn’t feel pregnant, didn’t even know what pregnant was meant to feel like. The moment it struck her that she was growing a life in her belly happened as she lay on an exam table, bladder full to bursting, with cold gel on her stomach while a sonographer pressed an ultrasound probe over her, occasionally tapping on a keyboard or dragging a cursor over the screen.

“Here.” She pressed a few buttons on the keyboard. “This is your baby’s heartbeat.”

It was quick and strong. Her baby’s heartbeat. Her own heart stood still as she listened to the sound. Tears filled her eyes and she knew she was going to do everything she could to protect this tiny human being.

“You’ll be glad to know that the fetus is normal and healthy, maman,” The sonographer smiled. “Bébé is growing in line with your expected due date so you’re going to meet this little guy or girl around 17th May next year.”

She left the clinic, clutching her declaration de grossesse and scan photos like they were the most precious artefacts in the world. To her, they were. She arrived for her ultrasound a scared girl and left as a proud mother-to-be.

She needn’t have worried about telling her parents. They loved her unconditionally and were thrilled about becoming grandparents. They didn’t ask who the father was, but told her that she could talk about him when she was ready. She could see the disappointment in their eyes, and she knew they weren’t disappointed in her actions, but in the opportunities she might lose as a result of this new path her life was taking. They had sacrificed so much for her and she knew her tuition fees at ESMOD were a financial strain on them. She wasn’t going to let this baby be the end of their dreams for their daughter.

Her friends were equally as supportive, if less calm about it all.

Alya was ready to kill the father and refused to believe that Marinette didn’t know who he was. That was when she knew she made the right decision to shelter him from this. He might have been the biological father of her baby, but he had his own life to live and she had no right to throw this at him.

Chloe shrieked so loudly that Marinette wondered if the baby heard her. According to the baby book Nino bought her, the fetus starts to hear sounds at 18 weeks and this little bug was closer to 12, but Chloe was so shrill, Marinette thought it might be its first memory.

“You’re PREGNANT?!” Chloe wasn’t calming down any time soon.

“Yes, Chloe. And I need you to keep the news to yourself, please.” Marinette pleaded, “You know as well as I do that Adrien would come back to Paris if he found out I was knocked up.”

“But, you’re saying he’s not the father,” Chloe asked.

“Do you think that would stop him?” Marinette arched an eyebrow.

“No.” Chloe conceded. “He’s always had a bleeding heart. He would absolutely come back. Damnit. I hate lying to him, but I’m doing this to protect him, right?”

“Right.” Marinette agreed.

“Ok, now that’s cleared up, when can we go shopping for maternity clothes?” Chloe reached for her purse.

“We have to invite Alya,” Marinette warned her, “She’ll kill us both if she misses out on a baby-related shopping trip.”

»»★««

“I’m going to see Adrien next week, to take all his Christmas presents to him.” Nino told her at the start of December. “He’s going to show me around Cambridge and give me a tour of Cavendish Laboratory where he’s studying, apparently it’s really cool. Is there anything you want me to pass on from you?”“Sure. I knitted him a sweater. I can drop it to yours tomorrow if that suits?” Marinette checked her schedule.

“I was actually talking about mini-Marinette.” He rubbed her stomach. She was just starting to show and Nino was fascinated by her belly.

“No.” Marinette said, “Please, Nino. He’s doing so well over there, I can’t have him feeling like he needs to come and check on me.”

“Well, it’s not like he’s the father… is it?” Nino asked.

“If he was, would you be more or less likely to want him to know?” Marinette asked.

“Huh.” Nino thought deeply, “Less, I guess. You’re right, he’d drop everything, including his education, to be here and support you. Plus, it would bring up a whole mess of crap about his relationship with his own father, I’m sure.

“So, we don’t tell him, ok? Besides, I told you already, I don’t know who the father is. I was caught up in the post-Hawk-Moth-defeat-celebrations and got drunk. I couldn’t pick the guy out of a lineup. Just, don’t worry Adrien, please?” She repeated.

It felt like everyone she knew was most concerned with the identity of the father and unwilling to accept her insistence that she didn’t want anyone to know who he was so she’d formulated a story. She kept it vague and refused to give details, but nobody was buying it.

Nino definitely wasn’t convinced. He was 90% sure that Adrien was the father. Adrien was the only person that Marinette wanted to be around after the business with Hawk Moth/Gabriel went down. The pair were inseparable for the last two weeks of August. Marinette hadn’t been caught up in any celebrations that he knew of. If anything, she had been in mourning.

As Adrien’s best friend, he wanted to tell him, but Marinette was right, it would do more harm than good right now, especially since he didn’t know for sure. He knew he’d have to brace himself for repercussions when the truth finally did come out, but for now, he and Alya would be there for their friend and support her all they could as she entered the scary world of single parenthood.

She had distanced herself from most of her lycée friends, only keeping in touch with Alya, Nino and Chloe. All three were sworn to secrecy about her pregnancy and she knew she could trust each of them. They had practice in keeping secrets after all.

»»★««

Her tutors at ESMOD were amazing. It helped that she was top of her class and known to be a hard worker, but she knew she was lucky to get the support she did. She was permitted to turn in her final collection, stylebook and completed outfit early which meant she would be able to continue her course in the next academic year. She would have time off from when her baby was born in May until the start of September to bond with her baby and figure out her childcare situation before the next term began.

Her classmates were less supportive. The stigma of being a teenage parent was multiplied by the stigma of being a single parent and the majority of her class felt entitled to judge her harshly. Her ‘special treatment’ in finishing the year early added to the resentment many felt. She had a small group of friends who stood up for her, but even with them by her side, she could feel the judgement aimed at her from all sides.

These classmates thought they could bring her down, make her quit. They were the same classmates who were jealous of her position at top of the class. They had misjudged her. They didn’t know they were dealing with Ladybug.

It simply made her more determined.

»»★««

Mme. Coquet called her into her office on the last day before Christmas break.

“Miss Dupain-Cheng, I’m sure you know how much work you’ve got ahead of you next term so I want you to relax and enjoy your Christmas.” She told the student.

“Thank you, madame.” Marinette squeaked. She found the woman intimidating. Not in a scary-Gabriel-Agreste way, but in a this-woman-is-so stylish-and-talented-it-hurts way.

“I also wanted to let you know that I have pre-registered your child with an excellent creche a few streets from here. My children went there and I highly recommend it.“ Mme. Coquet continued.

“That’s so kind of you, but I don’t know if I can afford it...” Marinette started.

“Nonsense.” Her tutor interrupted. “You have immense promise, Marinette, and if I have to pay the fees myself, I will. However, you will find that most of the costs will be paid by the local authorities.”

“Wow. I don’t know how to thank you.” Marinette could feel tears welling up. Damn these pregnancy hormones!

“You can thank me by graduating this course with honours and starting your own world-changing fashion line. Okay?” the tutor smiled.

Marinette nodded. She was determined to pay this woman’s faith back to her in every way she could.

»»★««

On 25th May, one week and one day after her due date, Louis Thomas Dupain-Cheng was born. He weighed 2.8kg, had a scrunched up face, tiny hands and he was perfect.

As soon as Marinette held him in her arms, she knew he was going to change the world.

He had already changed hers for the better.

She felt the most overwhelming protective surge, greater than any she encountered as Ladybug. She wanted to give this little being everything she had. She stared into her son’s face, seeing herself and his father reflected in it. More than that, though, she saw the man he might become and all the opportunities she wanted to give him.

He was only a few minutes old and he had already stolen her heart.

She looked up at the scared and delighted faces of Nino and Alya. The pair had been with her in the delivery room for the birth; Nino held her hand and shouted encouraging words, while Marinette tried to stop Alya from getting in the midwife’s way as she filmed the birth. Three eighteen-year-olds had just successfully delivered a baby (with the help of a few medical professionals) and they were all falling in love with that baby.

“Can I?” Nino held out his arms.

“Of course, Uncle Nino.” Marinette carefully passed Louis to him, still covered in streaks of blood and whitish stuff that none of them wanted to know what it was.

“Hi, Louis, I’m your Uncle Nino.” He spoke gently. “I’m going to be here for you whenever you need me, ok? Me and Auntie Alya are going to be the coolest uncle and aunt you could wish for.”

“I’m sorry to interrupt, papa, but may I take your baby for weighing and I can get him cleaned up?” The midwife asked.

“Oh, I’m not… um, yeah, here you are.” He handed Louis to the midwife.

Nobody mentioned her mistake, they knew it was going to happen countless times over the years. The father was something they’d stopped discussing. Suddenly, he wasn’t important, Louis was.

Until.

»»★««

Marinette confessed all to Nino when the post-birth hormones hit. He happened to walk into the hospital room as she rained tears onto her son’s head.

“I’m sorry, Louis.” She repeated over and over.

“Mari! What’s wrong?” Nino asked, full of concern.

“He’s going to grow up without his father because of me.” She wept. “I chose to keep him out of the loop.”

“Oh, Marinette.” He stroked her hair, “You don’t have to, but do you want to tell me who he is?”

She looked at him, tearful, but resolute. She knew she could trust him, he was one of her oldest and most enduring friends. She had to unburden herself and although she knew she was just sharing the secret, it felt like a load was lifted to tell him the truth.

Nino went to the Mairie for the Déclaration de Naissance. The father’s name was compulsory and he was the only other person who had been at the birth who knew the truth about the father’s identity. He would have to make a declaration to establish paternity, should he wish to be recognised in the future, but Marinette was relieved that his name was at least on the birth certificate.

Marinette knew the next few years would be tough. She’d be juggling motherhood, a fashion design degree and internships. She had plans to launch her own business afterwards. She was going to have to work hard to achieve her dreams and she was glad she had such wonderful parents and friends to support her.

Louis was all the motivation she needed to pursue her future will determination.

She was doing it all for him now.

#ml fic #ml fanfic #ml fiction #adrienette #marinette x adrien #louis dupain-cheng #my writing #my fiction #my fic #a03 fic #Little Louis Dupain-Cheng

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juniperpublishers-oajnn-blog · 5 years ago

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Hydrocephalus in Sudan; Types, Management and Outcome

Authored by Mohammed Awad Elzain*

Abstract

The incidence of congenital hydrocephalus is still very high in Sudan. Most of the patients present late with large head and malnutrition, which make the management very difficult. Materials and method: This study is a retrospective review joining all children younger than 15 years of age who have been operated at the National Center for Neurological Sciences during the period from Aug 2011 to December 2013. The data obtained from a computerized data record system in the center and the patients were clinically assessed by the author when during follow up in the refer clinic. Results: Most patients lie in the age group (birth â€“ 3 months) 40.5%. The majority of the cases presented with large head 71.8%. Hydrocephalus secondary to Chiari II malformation represented the commonest etiology of congenital hydrocephalus (42.7%) while postmeningitic hydrocephalus was the commonest etiology of secondary hydrocephalus (82.1%). Fortunately 10.7% had shunt complications, but only 6% had early postoperative shunt infection. The commonly found associated congenital CNS anomaly was myelomeningocele (35.1%).

Folic acid and supplements were defective in 72.5% of the pregnant ladies who started to take the folic acid after the end of the first trimester. Four patients found to have problems during pregnancy, 2 of them had malaria, one PIH and one recurrent UTI, however none of the patient had FH of similar condition. Discussion: Most of the patients were from Khartoum and the central area (68.7%). This is followed by those from the Western part of Sudan (Darfur and Kordofan), as there is a lot of wars and refugees which has created nutritional impact on the ladies in the childbearing age As a result of the poor antenatal follow up and the illiteracy of most of the parents, most of the diagnoses were made late when they notice their baby’s head increasing. The presence of associated congenital anomalies makes the management much more difficult. Conclusion: Early detection and management of hydrocephalus should be considered by increasing the awareness of the medical professionals and the general populations. The use of strict meticulous aseptic technique during the operative procedure is crucial in preventing shunt infection and most other serious complications. The ventriculoperitoneal shunt procedure is not an easy one and should be performed by the most experienced neurosurgeon under the most optimum condition.

Keywords: Congenital hydrocephalus; Large head; Folic acid deficiency

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Introduction

Hydrocephalus is a common health problem that is associated with aggressive morbidity and mortality [1]. Different types of hydrocephalus may be managed with the placement of the ventriculoperotineal shunt, but the complications related to shunt placement should be identified and managed properly particularly in the first 5 years following shunt placement. A survey done by Albright A.L. in 2010 recruiting seven pediatric neurosurgeons proved that there is no standardized technique or shunt type to prevent shunt complications and the most important issue after shunt implantation is the patient follow up. It was also noticed that, none of the pediatric neurosurgeons operate on asymptomatic patient or do annual follow up images for shunted patients with hydrocephalus beyond 5 years [2].

The most annoying shunt complication is shunt infection which requires urgent shunt removal as the bacterial growth affects the shunt hardware [3]. However when the shunted patients develop meningitis, they should be managed the same as those who have meningitis without shunts and shunt removal here is controversial [3]. Shunt infection caused by coryenebacterium species represents a special challenge as it was found to be resistant to most antibiotics and requires shunt removal [4]. In cases of delayed shunt infections,Propionibacterium acnes is believed to be the causative agent and was also found to be very difficult to eradicate even with prolonged antibiotics therapy and also requires shunt removal [5]. Bayston R. suggested that the antibiotic impregnated shunts use may prevent this later type of shunt infections [6].

Brydon H.L. in his study emphasizes the fact that the high CSF protein content does not increase the risk for shunt infection [7]. However these findings are still theoretical and more studies are needed to confirm this. Furthermore, Brydon also published another study 2 years later stating that protein deposition in shunted patients is not the main cause for shunt obstruction [8].

Numerous advances were done to improve the shunt valve manufacturing starting from fixed pressure valves to programmable valves. However, the later have the problem that the valve pressure may be accidently changed upon exposure to a high magnetic power [9]. This problem has been solved with the provision of the ProGAV valve system and its efficiency was proved in the study done by Allin, D.M. in 2006 [9]. Two years later Allin D.M. discovered that Polaris valve may also overcome the problem of accidental re-adjustment and this has been evaluated at UK Shunt Evaluation Laboratory in Cambridge [10].

Shunt nephritis is another rare form of shunt complications and up to the year 1996 only 115 patients were reported in the literature11. This is a reversible form of renal disease caused by shunt infection and can be managed by either prescribing antibiotics only or by both shunt replacement and antibiotic treatment11. The CSF over-drainage upon changing from horizontal to vertical position ( Siphoning effect ) has been known as one of the shunt complication that necessitated the evolution of new shunt devices with anti-siphoning effect like Z flow hydrocephalus system and Diamond valve [12,13].

Silicon hypersensitivity, an immune response mediated towards the implanted silicone catheters has been also believed to increase the risk for shunt failure. Eymann has suggested the use of animal models to study that immune response in order to understand this phenomenon and to help in improving shunt system manufacturing [14,15]. Shunt obstruction is a common complication of shunt implantation that may be diagnosed clinically and confirmed by different imaging techniques. Due to the high dose of radiations associated with repeated CT brains, Goetz suggested the use of infrared-thermography a noninvasive tool to verify shunt patency and this was found to be sensitive in more than 85% of patients [16].

The nutritional status of the patients with hydrocephalus is an important overlooked factor that may have negative influence on shunt surgery. In India Jain G. found that the post-operative shunt complication rates were significantly higher in the poorly nourished children [17].

Most of the Sudanese children with hydrocephalus were malnourished this is due to fact that the incidence of congenitalhydrocephalus together with post meningitic type is still very high in Sudan. Beside that most of the patients present late with large heads this also lead to increase incidence of the complications associated with shunt placement which make the management much more difficult. Therefore we conducted this study to reflect and publish our experience in diagnosing and managing hydrocephalus in Sudan and to show the magnitude of the problem, there are no previous published studies discussing the problems of patients with hydrocephalus in Sudan.

This study is a retrospective review joining all children younger than 15 years of age who have been operated at the National Center for Neurological Sciences during the period from Aug 2011 to December 2013. The data obtained from a computerized data record system entered by the neurosurgical residents and a trained information technology person in the center. Data entered include that obtained from the file, while operative and postoperative data was obtained from the authors and the operating neurosurgeons and entered in the system immediately after surgery and during follow up in the referred clinics. The patients were regularly clinically and radiologically assessed by the authors over 3 years follow up period.

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Results

Sex distribution

The total number of the patients studied was 131 patients 81 of them were males (61.8%), and 50 patients (38.2%) were females (Table 1) (Figure 1).

Age distribution

The youngest patient operated was 15 days old and the oldest was 12 years old with average presentation at 1 year of age (Table 2.1).

When patients were ranked in groups, it was found that most of them were in the age groups from birth to 6 months (n=89/131, 68%) (Table 2.2) (Figure 2).

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Residence

Most of the patients in the series were from Khartoum and central areas around Khartoum (the capital of North Sudan) (n=90/131, 68.7%) (Table 3) (Figure 3).

Presentation with large head

Almost three quarters of patients (n=94/131, 71.8%) presented with larger head (more than 2 SD “98%” Head Circumference for age, one percentile for boys and one for girls) as their first presentation and as the first abnormality noticed with their parents (Table 4) (Figure 4).

Causes and types of hydrocephalus

Most of the children in this study were having hydrocephalus secondary to Chiari Type II malformation caused by their associated myelomeningocele (n=44, 33.6%) followed by those with congenital acquiductal stenosis (n=40/131, 30.5%). Secondary (acquired) hydrocephalus was mainly in a form of postmeningitic hydrocephalus , the diagnosis was made utilizing both clinical and radiological data using CT and MRI scans (n=20/131, 15.3%) (Table 5.1 & 5.2) (Figure 5.1 & 5.2).

Associated CNS congenital anomalies

We only mentioned here in this study the congenital CNS anomalies while the other non related congenital anomalies were not mentioned (Table 6).

Type of surgery done

Most of the patients were operated through posterior approach through Keen’s point using medium pressure (MP) valves and the ventricular catheters were placed at the occipital horn of the lateral ventricle. In some few cases like those with posterior fossa tumors the ventricular catheter was placed at the frontal horn of the lateral ventricle through Kocher’s point. The Y connecter in this study was used mainly for those with Dandy Walker variant in which the posterior fossa cyst was not communicating with the IV ventricle, the EVD was resorted to in patients where frank features of infection like pus or turbid CSF or hemorrhage were encountered during surgery in the stage of ventricular tapping .also cystoperitoneal shunt is patients with localized hydrocephalus . Dandy walker patients were treated with shunts with double ventricular catheters and Y shaped connection (Table 7) (Figure 6).

Intraoperative CSF opening pressure

The CSF opening pressure was assessed clinically intraoperatively upon tapping the ventricles and almost all of the patients were having high opening pressure (Table 8) (Figure 7).

Type of shunt used

Different types of shunt systems have been used in our center but Medtronic was the commonly used one for being supported for free for under 5 years kids by some non-governmental organizations (Table 9).

Shunt Complications

The complications encountered were in a form of infected CSF (4 patients), shunt exposure (4 patients), bloody CSF (2 patients, one of them had S.D.H. with I.V.H.) and shunt dysfunction (4 patients) (Table 10).

For the reason that shunt implantation is a lifelong commitment we considered all patients who improved after shunt procedure or during follow up within “improved” category. The late shunt complications after 3 years are not included in this study (Table 11) (Figure 8 & 9).

The improvement parameters

The improvement parameters used in this study were mainly clinical in a form of depressed Anterior fontanelle (AF) stoppage of CSF leak, Stoppage of Vomiting (V), lax AF (soft fontanelle neither bulging nor depressed), other parameters of improvement include improvement of developmental milestones whether mental or physical (Table 12) (Figure 10).

Antenatal Care (A.N.C.)

We divided the patients from thee antenatal care and tonics and vitamins supplement points of view into 3 main categories (Figure 11)

Patients with good antenatal care: Those are children of mothers who attended regularly ante natal care visits and who received the tonics from the early beginning of the pregnancy (the first month of pregnancy)

Patients with poor antenatal care: Those are children of mothers who did not attended regularly antenatal care visits and who started to receive the tonics after the end of the first trimester.

Patients without antenatal care: Those who did not attend antenatal care visits and/or who did not receive tonics throughout the pregnancy.

Pregnancy complications

Mothers of four patients were found to have problems during pregnancy, two of them had malaria, one has Pregnancy Induced Hypertension (PIH) and the last recurrent Urinary Tract Infection (UTI).

Family history of similar condition

None of the patients was found to have FH of similar condition.

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Discussion

The average age at presentation was Eleven months. This late presentation may be attributed to the lack of the neurosurgical services in the remote areas. The youngest child operated was Fifteen days old and the oldest was Twelve years old. However, most of the patients present between birth up to Three months, followed with those between Four to Six months and that is why most of the operated patients were children in the pre-school age. Male sex was the dominant, but this may not have very much significance in this study.

Most of the patients were from Khartoum and the central area because the national center for neurosciences beside the two other governmental centers and some other private centers are all in Khartoum. This is followed by those from the Western part of Sudan (Darfur and Kordofan) as these regions has the highest number of population in Sudan after Khartoum and the possibility of the effect of political conflicts and war refugees which has created nutritional and health impacts on the ladies in the childbearing age.

As a result of the poor antenatal follow up and the illiteracy the diagnosis was usually late and made only after the child head increases. That is why those who presented with large head were representing the majority of our patients. 78.6% percent of the patients were found to have congenital problems like Chiari malformation accompanying spina bifida followed by acquiductal stenosis, and in 17.6% it was postmeningitic type of hydrocephalus. Therefore the congenital etiology was on the top of the list followed with the infectious etiology and this can also justify the presentation with large head. Furthermore, most of the cases were young children and a many of them had large occipital horns and small frontal horn (colpocephaly) that is why we approached most of the patient through Keen’s point using fixed medium pressure valves despite the fact that the opening CSF pressure in the vast majority of patients intra-operatively was relatively high pressure. Although in the literature Sinha et al studied Tourty patients with pediatric hydrocephalus and they discovered that there is no difference in the outcome with low or medium pressure valves [18]. But still this point is not clear in treating hydrocephalus as logically high opening pressure hydrocephalus treated with placement of low pressure shunt may lead to Medtronic, BMI, Chabra and antibiotic impregnated shunts were all used with Medtronic being the most commonly used one as it was provided free for the patients with nongovernmental organizations.

Fortunately, we had an acceptable outcome as those who had shunt complications were only 10.7% and those with postoperative shunt infection were only 6.1%. This is because we adopted a rigid protocol to prevent shunt infection (short preoperative admission one night before surgery, and discharge two days after surgery, baby wash with soap the day before surgery, first operation in the day, few number of personnels in the room not more than 6, scrubbing with 2 different solutions, non touch technique and change of gloves upon shunt insertion and using 2 different types of antibiotics postoperatively). The final outcome was promising as most of the patients improved postoperatively. We used simple clinical assessment ways to primary assess the improvement like depressed Anterior fontanelle (AF) stoppage of CSF leak, relieve of headache (H/A), Stoppage of Vomiting (V), lax AF. The strongest parameter was lax or depressed AF.

The presence of associated congenital anomalies makes the management much more difficult. More than one third of the patients in this study were having associated myelomeningocele with few of them had other congenital CNS anomalies.

Most of the mothers (72.5%) of the affected children started to receive the folic acid after the end of the first trimester while considerable number of them did not receive any folic acid throughout the pregnancy. This may reflect the association of folic acid deficiency with the development of hydrocephalus. Only few of the mothers were found to have problems during pregnancy like malaria, PIH recurrent UTI. However, the association of these conditions with the development of hydrocephalus needs further studies to evaluate the pathogenesis and the correlations if any.

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Conclusion

Early detection and management of hydrocephalus, is associated with easy treatment and better outcome.

It is important to increase the awareness of the medical professionals and the general populations will decrease the overall incidence of hydrocephalus. Involvement of the general media is incredibly important.

The use of strict meticulous aseptic technique during the operative procedure is crucial in preventing shunt infection and most other serious complications. The ventriculoperitoneal shunt procedure is not an easy one and should be performed by the most experienced neurosurgeon under the most optimum condition.

The follow up of the patients should be adequate as those children might have long term complications and disabilities.

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Recommendations

Fortification of the wheat flour will help the ladies in childbearing age to have good maternal serum folic acid level. Otherwise the mothers should be taught the importance of taking folic acid early in the beginning of pregnancy. Proper antenatal care is mandatory for women in child bearing age specially who has history of child birth with CNS deformities the role of media medical education in this matter is so valuable. Adopting rigid national protocol to prevent shunt infection will be useful even in the presence of associated risk factors like malnutrition.

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saranimated-exercises · 6 years ago

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Character Bible

Steve Miller?

Steve is a regular boy in every respect except one. His head is that of a wasp.

He was born on the 22nd May 1995 to April and John Miller. The pair cannot have children naturally so opted to try IVF. Many of their friends had tried it and been very successful. Their experience, however panned out slightly differently to expected. There was no indication of anything wrong until their first Ultrasound scan. This displayed an anomaly with the head of the baby that they doctors could not explain. They ran multiple tests and found the baby was perfectly healthy and was still due on the expected date. They could not look at the baby properly until it was born. The mother also noted some odd stabbing sensations in her stomach during the pregnancy.

Once the baby was born the situation became clear. The child had the head of a wasp. The parents were baffled along with doctors as they had never seen this phenomenon before.

After months of investigations into the hospital, they found the IVF samples had been mixed with a gene-splicing experiment. The experiment was successful but they were unaware until the investigations was carried out.

As he grew up, he was often bullied about his obvious differences however he has full use of his mandibles. This means he can use them as a defensive weapon when being attacked. People started to leave him alone and he started to get media attention. He started to become more outgoing and more confident.

Wasps have a higher temporal resolution. This means they can think and see at a much higher speed than humans. This was passed on to Steve.

As he grew up, he had to make frequent trips to the hospital for check-ups and tests so he became very familiar with hospitals. He became fascinated by the hospitals and the machines they used. At school, he started to get fascinated by science and technology. He ended up passing his A-Levels at the age of 14 due to his faster cognitive ability. He then received a part-scholarship to Cambridge university studying medicine. The rest of the tuition and living during this time was funded by the IVF Clinic which caused his deformity.

He passed the 6 year course in just 2 years and became the world’s youngest doctor at 16 but could not practice until he was 18. In this time, he used some of the funds set aside by the IVF clinic to travel.

During this time, he met his future wife, Donna. They were both travelling through Shenzhen in China when they met. She comes from Richmond in London and went travelling as a gap year before University. When they got back she went to Cambridge also and studied the History of Art. She went on to become a Gallery Curator for the Tate Modern.

When he was old enough, Steve started working for the hospital that caused his deformity, aiming to improve the system and make sure this sort of thing didn’t happen again. In is late 20s he became the CEO of Rosie Hospital in Cambridge. This is quite a feat. Not only is he under 30, but rarely do doctors become CEOs of hospitals.

By 32 he had become the CEO of Cambridge University Hospitals which contains Rosie and Addenbrooke’s hospital.

#collaboration

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arunbeniwal-blog · 5 years ago

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Best IVF Centres in Ranchi | Aveta IVF Centre | Elawoman

Aveta IVF Centre

Aveta IVF Centre is known for housing experienced Gynecologists. Dr. Sonali N Tawde, a very much presumed Gynecologist, practices in Mumbai. Visit this medical health community for Gynecologists suggested by 71 patients.Aveta IVF Centre in Ranchi is a best player in the category Nursing Homes in the Ranchi. This notable establishment acts as a one-stop destination servicing clients both local and from other parts of Ranchi. Through the span of its voyage, this business has established a firm foothold in it's industry.

The conviction that consumer loyalty is as important as their items and administrations, have helped this establishment garner a vast base of clients, which continues to develop constantly. This business utilizes individuals that are dedicated towards their particular jobs and put in a great deal of exertion to achieve the normal vision and larger goals of the company. In the near future, this business aims to expand its line of items and administrations and cater to a larger customer base. In Ranchi, this establishment involves a prominent location in Booti. It is an easy task in commuting to this establishment as there are various methods of transport readily available.

Administrations advertised:

Aveta IVF Centre in Booti has an extensive variety of items and administrations to cater to the varied necessities of their clients. The staff at this establishment are respectful and incite at providing any assistance. They readily answer any inquiries or questions that you may have. Pay for the item or administration with ease by using any of the available methods of payment, such as Cash, Checks, Credit Card, Debit Cards. This establishment is functional from 00:00 - 23:59.

Sunita IVF Centre

Sunita IVF Centre has answer for the richness issues, such as past pelvic inflammatory disease (PID), irregular menstrual cycles, endometriosis, past tubal pregnancy, PCOS - polycystic ovary disorder, and so on. Here Dr. Sunita Jha Provides special care for the child mother.Sunita IVF Centre - Nursing Homes/Clinics/Hospitals of appointment benefit, blastocyst culture benefit and counseling administration in Ranchi, Jharkhand.

Treatment Procedure

After counseling Dr. Sunita Jha examins all the trial of both husband and spouse, and after that appropriate treatment process is started, and while the treatment is started in the supervision of the consultant, the patient have to visit regularly the IVF fixate in Ranchi on the following given date.

Special Care and Facilities for the Patients.

In our middle all the tests for the patients are available and laboratory for IVF treatment processed and Operation Theater is also available. With the accomplished medical team and specialists we are dedicated to gives you the effective treatment.

Egg Donation/Egg Sharing

As a leading IVF and egg donation focus in Ranchi, Jharkhand, we keep all the information about the giver such as abilities and qualification, hobbies and intrests, family history, age, eye shading, hair shading, weight, height and so forth Giver egg has its own importance in the IVF treatment and it is viewed as amazingly safe for conceptive medical technology.

Special Care and Facilities for the Patients.

In our inside all the tests for the patients are available and laboratory for IVF treatment process and Operation Theater is also available. With the accomplished medical team and specialists we are dedicated to gives you the effective treatment.

Intra Uterine Insemination

Intrauterine insemination (IUI) is a treatment procedure in IVF that contains insertion of male sperms inside a woman's uterus to enable fertilization. Dr. Sunita Jha, the IVF specialist in Jharkhand utilize IUI technique to increase the quantity of to increase the procedure of fertilization inside the uterus.

Special Care and Facilities for the Patients.

Almost all the medical trial of the patients are available in our laboratory for IVF treatment process with Operation Theater. Alongwith the accomplished medical team and specialists we are dedicated to gives you the effective treatment.

A H IVF and Infertility Research Centre Pvt Ltd ranchi

A H IVF and Infertility Research Centre Pvt Ltd ranchi is a Private incorporated on 28 September 2001. It is classified as Non-govt company and is enlisted at Registrar of Companies, Kolkata. Its authorized share capital is Rs. 1,500,000 and its paid up capital is Rs. 101,500.

It is inolved in Research and experimental advancement on natural sciences and engineering (NSE). [This class includes systematic creative work in the fields of research and advancement in natural sciences, medical sciences, agriculture and engineering and technology.If you a question in you mind related Best IVF Centres in Ranchi get answers from us at elawoman.com.A H IVF and Infertility Research Centre Pvt Ltd ranchi Annual General Meeting (AGM) was last held on 29 September 2017 and according to records from Ministry of Corporate Affairs (MCA), its balance sheet was last documented on 31 March 2017.

Chiefs of A.h. Ivf and Infertility Research Center Private Limited are Jaya Shree Bhattacharya, Aiyesha Fatima Husain, Sultan Syed Azhar Husain.They could convey the primary baby, Louise Joy Brown, using the technique of In-Vitro Fertilization also called IVF (or unnaturally conceived child), by which an egg is prepared outside the body and the developing life transfered back onto the uterus. Louise Joy Brown is today a mother herself, of a healthy young man that she has imagined naturally.

Dr. Jayashree Bhattacharya put in more than two decades in Britain as Senior Consultant Gynæcologist for the Bourn Hall Clinic, and Honorary Lecturer for the Department of Obstetrics and Gynæcology of Cambridge University.Our specialist will help you to solve your problem related IVF in Ranchi at elawoman.com.

She established the first IVF Center in Eastern India at the Institute of Reproductive Medicine in Kolkata, in 1990, and started the main unit of AHIIRC in 1998 in Ranchi, Jharkhand. Today, AHIIRC is available in Ranchi, New Delhi, Kolkata, Siliguri, Patna, Durgapur, Lucknow, Varanasi, Midnapur, and is probably the largest and best practice in India.get more about IVF in Ranchi can contact us at elawoman.com.

TECHNICS AND TECHNOLOGIES

Some richness issues are more easily treated than others. as a woman ages, her chances of getting pregnant go down while her danger of miscarriage goes up. your specialist may suggest that you skirt a portion of the means more youthful couples usually take. Unfortunately, chances of having a baby decrease with each passing year. It's important to understand that regardless of whether you are able to get pregnant, no treatment can guarantee a healthy baby. Then again, many advances in infertility have helped many couples have babies.

Before you start a 'venture', it is important to talk about how far you want to run with the treatments. For example, you may want to attempt medicine however would prefer not to have medical procedure. You may change your mind during your treatment, yet it's great to start with a clear idea of what you want your points of confinement to be.

The cost involved in the treatments for infertility can be costly. Whenever cost is a worry for you, don't hesitate to ask how much the medicines and systems cost. AHIIRC furnishes you with many alternatives from today's most advanced Assisted Reproductive.

Hill View Hospital

Hill View Hospital and Research focus is a quarter century old growing hospital in India, engaged in providing primary as well as tertiary healthcare administrations. It is a hospital that was established and managed by Dr. Vinod Priya with a mission and a passion for providing healthcare for the poor. At Hill View Hospital, the growth has been phenomenal.If you know more about Best IVF Clinic so you can click here below links.

From a 10-bed single specialty Institute facility focusing on gynecology, neonatology, Orthopedics, laparoscopic medical procedure, General Surgery, Urology has turned into a multi-specialty hospital comprising of 75 beds across the course of events. Our push to furnish quality health care with compassion has rewarded us with the honor of being the best healthcare supplier in Jharkhand.

With the administration situated Healthcare conveyance display, Hill View is geared to give financially savvy and convenient treatment. In spite of the intense rivalry and marketing by numerous commercial corporate organizations, Hill View has carved a niche for itself by garnering the best reputation amongst the local masses. Armed with the best.

Devkamal Hospital and Research Center

Devkamal Hospital and Research Center is a Multispeciality facility in Itki street, Ranchi. The hospital was found by Dr. Anant Sinha (prominent plastic specialist). The group at the center unequivocally has confidence in treating patients with incredible consideration. Administrations given by the center are DNA Fragmentation Test, Cardiology, Devkamal Hospital and Research Center is a perceived name in patient consideration. It was incepted in the year 2008. They are one of the notable Private Hospitals in Hehal. Supported with a dream to offer the best in patient consideration and outfitted with mechanically propelled human services offices, they are one of the up and coming names in the social insurance industry. Situated in , this hospital is effectively open by different methods for vehicle.

A group of well-prepared restorative staff, non-medicinal staff and experienced clinical professionals work nonstop to offer different administrations that incorporate Pathology Lab , Xray , Sonography , Ct Scan , Casualty , Blood Bank , I.c.c.u. , Cafeteria , Chemist , Ambulance Service , Std Facility , Fax Facility , Internet Facility , Health Checkup Scheme , National Insurance , New India Assurance , Icici Lombard , Bajaj Alliance , International Patient Health Plans , Credit Cards Accepted , Debit Cards Accepted.

For more information, Call Us : +91 – 8929020600

Visit Website : www.elawoman.com

Contact Form : https://www.elawoman.com/contact

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colorfulanchorkryptonite-blog · 6 years ago

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Dr. Fabian James Kurian | Elawoman

Dr. Fabian James Kurian

Dr. Fabian James Kurian is a renowned Obstetrician, Reproductive Endocrinologist and Infertility Specialist based in Johor Bahru, Malaysia. He specialized in Reproductive Medicine and IVF Treatment, Intrauterine insemination(IUI), In Vitro Fertilization(IVF), High-Risk Pregnancy Care and Infertility Assessment.

Dr. Fabian James Kurian has vast experience in infertility treatment and has treated many patients to date. He completed his MBBS with first class results and pursued Membership of Royal College of Obstetricians and Gynecologists from Cambridge University. He is a preferred choice of many patients looking for infertility treatment as he has an excellent track record of high success rate.

He also keeps himself updated with the latest advancements in medicine to incorporate in his practice. Patients from the neighboring states also visit the hospital as he provides treatments at the highest standards. He has a keen interest in IVF and has devoted himself to be an expert in the field. His great knowledge and experience in the field of fertility treatment made him one of the best IVF specialists in Malaysia.

Dr. Fabian James Kurian also attends various workshops conducted by various institutions. He is presently practicing as an infertility specialist at TMC Fertility Centre. TMC Fertility Centre is the top ranking IVF hospitals in Johor Bahru, Malaysia. Some of the services provided at the clinic are Laparoscopy Surgery, DNA Fragmentation Test, Donor Egg Program, Donor Sperm / Egg Program, Egg Freezing, Cryopreservation and Vitrification, Hysteroscopic Surgery and In Vitro Fertilization (IVF).

The clinic offers a pleasant atmosphere and has a well-maintained facility. With advanced technology and modern techniques, TMC Fertility Centre aims to provide the best medical facilities to the patients. The hospital houses a team of dedicated and trained doctors and paramedical staff who work round the clock to tackle any emergency situation. The hospitals meet all the parameters laid by the medical industry and ensure to provide the best treatment facilities.

Best IVF Doctors in Johor Bahru

Below are the Best IVF Doctors in Johor Bahru with options to book your first appointment FREE. Check Reviews, IVF Cost, IVF Success rates, Fees, Address, Contact Number for all treatments they offer. Find details to affordable test tube baby costs.

Dr. Tan Jui Seng

Dr. Tan Jui Seng is an acclaimed infertility specialist practicing in Johor Bahru, Malaysia. He is an expert in Minimally Invasive Surgery (MIS), such as Hysteroscopic and Laparoscopic Reproductive Surgeries, Fertility Treatment by Assisted Reproductive Technique (IUI, IVF & ICSI) for infertile couples. He has more than a decade of experience in infertility treatment and had treated more than 5,000 infertile couples to date.

Dr. Tan achieved the Johor’s First ICSI Fraternal Twin Babies born from Johor‘s first frozen and thawed Embryo Transfer Twin Pregnancy. He is devoted to providing extensive treatment facilities to help every childless couple realize their dream of parenthood. He completed his graduation and MD from the National University of Malaysia in 1990, with excellent results. He is also a proud Member of the Royal College of Obstetricians and Gynecologists, United Kingdom, 1996. Moreover, he trained in world-renowned hospitals under the guidance of highly experienced doctors.

Dr. Tan Jui Seng also attends various workshops and conferences to understand the latest advancements in medicine. He has also presented his research to various organizations. Moreover, he has received many awards and recognition from various institutions. Presently, he is practicing as an Infertility consultant at IVF Bridge Fertility Centre. IVF Bridge Fertility Centre is a well-established infertility clinic situated in Johor Bahru, Malaysia.

The hospital is ISO certified Class 7 hospital with neat and clean patient recovery rooms and well-maintained infrastructure. The treatment for the gynecological diseases like Vaginal Discharge and Itching, Early pregnancy problems, Vaginal Bleeding, Leg Pain, Menopause Clinic, Cramps During Periods, Painful Periods, Endometriosis, Polyps, Polycystic Ovarian Syndrome, Fibroids Treatment, Excessive Nausea and Vomiting are provided at the centre.

The medicinal, service and consultation services at the centre are provided with dedication, care and precision. From years of experience, learning, and research, the hospital has developed very effective management strategies for diagnosis and treatment to various ailments. Each of the medical specialists practicing at the hospital has over a decade of experience in their respective fields of expertise. It offers a nurturing, clean and healing environment to ensure the well-being of patients. Other facilities provided by the hospital include 24-hour service, ambulance services, and an in-house pharmacy.

IVF Bridge Fertility Centre

IVF Bridge Fertility Centre is an IVF and Gynecology Center situated in Johor Bahru, Malaysia. It is said to be one of the well-known Fertility Centers in the Southern region of Malaysia. It provides services like Clinical Consultation, Andrology Services, Freezing and Storage service (Cryopreservation), IVF Laboratory services, General Surgery, 3D/ 4D Ultrasound scans, In-Vitro Fertilization (IVF), Intrauterine Insemination (IUI), and Intracytoplasmic Sperm Injection (ICSI). The hospital is ISO certified Class 7 hospital with neat and clean patient recovery rooms. The staff at the hospital is very supportive.

The treatment for the gynecological diseases like Vaginal Discharge and Itching, Early pregnancy problems, Vaginal Bleeding, Leg Pain, Menopause Clinic, Cramps During Periods, Painful Periods, Endometriosis, Polyps, Polycystic Ovarian Syndrome, Fibroids Treatment, Excessive Nausea And Vomiting is provided at the centre. It is equipped with the latest technology and tools to help its patients in the best possible way. Dr. Tan Jui Seng is the Fertility specialist practicing at IVF Bridge Fertility Centre.

Dr. Mohanraj Krishnasamy

Dr. Mohanraj Krishnasamy is an infertility specialist who specializes in Infertility evaluation, Infertility treatments like IUI, IVF as well as Reproductive Medicine specialty. He graduated from University Science, Malaysia in 1991 and then went on to become member of MRCOG in the year 1998. Dr. Mohanraj has also undergone training in Kuala Lumpur General Hospital and Watford General Hospital. Presently, Dr. Mohanraj Krishnasamy is practicing at JSH Fertility Centre, Johor Bahru. For more information, visit elawoman.com.

JSH Fertility Centre

JSH Fertility Centre is an IVF and Gynecology Center and is located in Jalan Abdul Samad, Johor Bahru, Malaysia. It is a well-known hospital when it comes to infertility problems. The services and facilities provided by the hospital are DNA Fragmentation Test, Advanced Laparoscopy Surgery, In-Vitro Fertilization (IVF), Intrauterine Insemination (IUI), Reproductive Medicine, Intracytoplasmic Sperm Injection (ICSI), Sperm Retrieval Techniques like Microsurgical Epididymal Sperm Aspiration (MESA) and Testicular Sperm Aspiration (TESA), Freezing of Sperms/Embryos/Oocytes, Hysteroscopic Surgery, Donor Egg Program Egg Freezing, Semen Freezing, and Testicular Biopsy.

The hospital has well designed according to the ART guidelines given by the Health Ministry to ensure higher success rates. The centre believes in the quality of fresh air for the proper development of embryos. The consulting gynecologist at JSH Fertility Centre is Dr. Mohanraj Krishnasamy.

For more information, Call Us : +91 – 8929020600

Visit Website : Elawoman

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rovenzwilz-blog · 6 years ago

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scan in pregnancy

how much are 4d baby scan

A short History of the development of Ultrasound in Obstetrics and Gynecology

Dr. Joseph Woo

http://www.ob-ultrasound.net/history1.html

You'll remember that with the 2D scans before, you could have been asked to load up on water and fill your bladder. For these newer scans, you will simply be asked to help keep yourself hydrated in the couple weeks before your scan. This is because the fluid around your child is what makes it obvious the facts and gives the sonographer a clearer picture.

1.^ Hoskins, Peter; Martin, Kevin; Thrush, Abigail (2010). Diagnostic ultrasound : physics and equipment (2nd ed.). Cambridge, UK: Cambridge University Press. ISBN 978-0-521-75710-2.

2.Jump up ^ Health, Center for Devices and Radiological. "Medical Imaging - Ultrasound Imaging". www.fda.gov.

3.Jump up ^ "Real-Time 3-D Ultrasound Speeds Patient Recovery" (Press release). Mayo Clinic. July 13, 2007. Retrieved May 21, 2014.

4.Jump up ^ Feinglass NG, Clendenen SR, Torp KD, Wang RD, Castello R, Greengrass RA (July 2007). "Real-time three-dimensional ultrasound for continuous popliteal blockade: a case report and image description". Anesthesia and Analgesia. 105 (1): 272–4. doi:10.1213/01.ane.0000265439.02497.a7. PMID 17578987.

#scan for pregnancy

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scan4djanuarysale-blog · 6 years ago

Link

A short History of the development of Ultrasound in Obstetrics and Gynecology

Dr. Joseph Woo

http://www.ob-ultrasound.net/history1.html

1.^ Hoskins, Peter; Martin, Kevin; Thrush, Abigail (2010). Diagnostic ultrasound : physics and equipment (2nd ed.). Cambridge, UK: Cambridge University Press. ISBN 978-0-521-75710-2.

2.Jump up ^ Health, Center for Devices and Radiological. "Medical Imaging - Ultrasound Imaging". www.fda.gov.

3.Jump up ^ "Real-Time 3-D Ultrasound Speeds Patient Recovery" (Press release). Mayo Clinic. July 13, 2007. Retrieved May 21, 2014.

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luciusmalf1-blog · 6 years ago

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ultrasound of a baby

http://4dbabyscanwiltshire.webgarden.com/

We do Pregnancy scan, 3D 4D Ultrasound scan, Early Pregnancy scan Gender Scan, Dating Scan, Reassurance Scan, Growth Scan, Presentation Scan, Wellbeing Scan, 4D baby scan, Gynaecology scan, Ultrasound scan . We cover Oxford, Reading, Newbury, Oxfordshire, Berkshire, Wiltshire A short History of the development of Ultrasound in Obstetrics and Gynecology Dr. Joseph Woo http://www.ob-ultrasound.net/history1.html You'll remember that with the 2D scans before, you could have been asked to load up on water and fill your bladder. For these newer scans, you will simply be asked to help keep yourself hydrated in the couple weeks before your scan. This is because the fluid around your child is what makes it obvious the facts and gives the sonographer a clearer picture. 1.^ Hoskins, Peter; Martin, Kevin; Thrush, Abigail (2010). Diagnostic ultrasound : physics and equipment (2nd ed.). Cambridge, UK: Cambridge University Press. ISBN 978-0-521- 75710-2. 2.Jump up ^ Health, Center for Devices and Radiological. "Medical Imaging - Ultrasound Imaging". www.fda.gov. 3.Jump up ^ "Real-Time 3-D Ultrasound Speeds Patient Recovery" (Press release). Mayo Clinic. July 13, 2007. Retrieved May 21, 2014. 4.Jump up ^ Feinglass NG, Clendenen SR, Torp KD, Wang RD, Castello R, Greengrass RA (July 2007). "Real-time three-dimensional ultrasound for continuous popliteal blockade: a case report and image description". Anesthesia and Analgesia. 105 (1): 272–4. doi:10.1213/01.ane.0000265439.02497.a7. PMID 17578987.

#Gender scan

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cambridgehospital-blog · 6 years ago

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Special Precautions for Pregnant Woman - Belle Vue's Cambridge Hospital

Best Maternity Hospitals in Bangalore

10 important thing to know about your maternity for your first child:

The pregnancy test is positive? Well congratulations to you..!! Do you feel like you’re stepping into new land? Over the next nine months you can observe a lot of changes in your body and life.

Here is the list of 10 imperious things to know about your pregnancy, specifically if you going to be a first time mom. So, we've compiled a quick list to help you stay on the healthy side and how you can help yourself during your pregnancy. Following are the measures or tips that will make your pregnancy the most enjoyable and memorable part of life.

1. Consult your doctor on confirming the pregnancy:

Consult your doctor on confirmation of the pregnancy on the urine pregnancy test. The doctor may ask for a blood test called "Serum BHCG to re-confirm the pregnancy or may consider doing an ultrasound scan to check on your baby. This scan will also help ruling out twin pregnancy or an ectopic pregnancy. It also helps with identifying the baby's growth and heartbeat.

2. Find out which week you are in:

Consult your doctor to understand your week bump. It is important you understand your due date to take required measures till the maturation stage.

3. Do you have bleeding?

Once you confirmed your pregnancy if in-case you have any bleeding issue you could consult your doctor and understand the reasons and measures to be taken

4. Are you gaining too much weight?

Your weight increase depends on your body mass index. Once you have a positive sign of your pregnancy, gaining a few pounds is quiet normal. If you are overweight in your early stages or any stage of your trimester it is advised that you consult a dietitian. Eating right is important for the healthy development for you and your unborn child.

5. Know that some food items are off your menu

Your baby is still tiny and it is important you intake the right nutrients for you and your baby. There are some off limit food that you must avoid which includes alcohol, uncooked food, caffeine, canned food, street food and artificial sweeteners,. Your food habits can determine and build your immunity and strength to ensure your baby grows healthier.

6. Exercise Exercise Exercise!!

Exercise is usually advised from the second trimester after consulting with the doctor.

Child birth is a laborious process and requires a lot of energy. To elevate your energy and stamina it is important you dedicate few minutes or hours in exercise. Regular exercise will strengths your muscles and facilitate your delivery. The right workout and exercise daily shows significant support in the complete development of the child. It is also important to do regular Breathing exercises, squats and stretchers

7. Keep your content positive:

Keep your environment positive. Feel good about yourself and track all your happiness till delivery stage. Read a book, be yourself, meditate, prepare for parenting, get enough sleep, be happy, listen to music, get your partner to pamper you, go with the flow and do not stress too much.

8. Allocate time in educating yourself:

Read as much as possible about your pregnancy. Know the causes and symptoms and measures to be taken in case of emergency ensure to always visit your doctor. If you are a part of any groups and forums where information is exchanged, ask your doubts and quiries to your doctors and get it clarified.

9. Sort out your priorities:

Sort out your priorities and it is imperative that your partner and family support you during the pregnancy.

10. Choose the right place for your birthing:

It’s important you know where you would like to give birth to your child. Is there a right consultation give?? Are the doctors providing you accurate information?? Is the hygiene factor kept in mind?? Is the hospital or clinic in you close by surrounding of your house?? Ensure you take care of these factors for a comfortable delivery process

Bellevue’s Cambridge Hospital is a renowned hospital for mother and child care with over 35 years of quality service. We have a friendly staff catering to the various strata of the society, making birthing, diagnostics, treatments and care affordable for everybody.

Giving birth is one of the most challenging things a woman will ever do. The feeling of motherhood certainly involves a lot of joy and excitement, but it also brings responsibilities to raise your child as a parent. Its important time to time care is given to your baby and get the right tips on diet, fitness, lifestyle, health etc.

Know this mom’s.. you are the only one who can know what is best during birthing. Stay fit and healthy and ensure you meet your doctor on regular basis. If any signs of distress do not ignore take precautionary measures to avoid complications.

You are going to be a first time mom being anxious and nervous is quiet obvious but this is a new chapter of your life. A proper study and knowledge about birthing and visiting your doctors on regular basis will smoothen the process of your delivery. Once you conceive your entire life surrounds about experiencing every single minute. It is important you remain positive, calm and enjoy every moment of your special period.

We hope that these simple steps or points will help you sail through your pregnancy and make sure you are stress free from all the mis conceptions.

#best maternity hospital in bangalore gynaecologist in indiranagar bangalore best infertility hospital in bangalore best gynecologist in bang

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privateultrasoundscancambridge · 1 year ago

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Let the experts from the Private Baby Scan Clinic of Cambridge help you learn about the five benefits of pregnancy scans in Cambridge.

#private 4d baby scan cambridge #baby scan offers cambridge #gender scan clinic cambridge #fetal well being scan cambridge #ultrasound baby scan cambridge #private ultrasound scan cambridge #4d baby scan clinic cambridge #growth scan clinic cambridge #cambridge baby scan clinic #well being scan clinic cambridge

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rajpersaud · 7 years ago

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The Voices Within - Charles Fernyhough discusses hearing voices and inner speech with Dr Raj Persaud

The Voices Within

http://www.charlesfernyhough.com/tvw.html

The Voices Within is a book about the voices in our heads. It is published by Basic Books in the US and by Profile Books/Wellcome Collection in the UK.

The Voices Within was picked as a top neuroscience book of 2016 by Forbes and a science book of the year by the Observer and ABC. It was chosen as a top spring science book by Nature and selected as a summer reading pick in the Guardian and Times Higher Education. It was the subject of an essay-review in the New Yorker.

I spoke about the themes of the book on the Diane Rehm Show, and discussed them in this Q&A with The Atlantic. These pieces for TIME Ideas and the LA Times explore the benefits of talking to yourself. I spoke about these ideas on BBC Radio 4's Start the Week; you can listen again here. You can also see me speaking about the themes of the book in this talk for 5x15 and in this Royal Institution lecture. The book featured in a Guardian Books podcast. An abridged extract from the book was published by BBC Future.

Translation agreements have been concluded for German, Spanish, French, Turkish, Italian, Korean and simplified Chinese.

Order from the Guardian Bookshop, Hive.co.uk or Amazon.com.

'A lucid, authoritative survey of our current knowledge… The author’s investigations, at once scientific and humane, represent the discipline of psychology at its rare best.' Raymond Tallis, Wall Street Journal

'An intriguing and deeply humane book… particularly good when addressing the role of inner voices in creativity… In ‘The Voices Within’, [Fernyhough] has again rendered complicated mental experience without losing its human texture.' Casey Schwartz, New York Times Book Review

'Fernyhough’s book … provides enough science to ground the argument, but the real achievement here is the writing. The author is a psychologist and a novelist, and his prose has a narrative feel that separates it from most books on the psych shelf. The subject is one of the tough brain conundrums that’s far from settled; we’ll be trying to figure out the role of the inner voice long from now, but Fernyhough’s book is a readable take on what we know and where the questions may go next.' David DiSalvo, Forbes Brain Books of 2016.

'From explaining the hurdles of studying our internal dialogue to setting the record straight on schizophrenia and “hearing voices,” this book is a must-read for those seeking to understand the voices in their heads.' DiscoverMagazine

'Fernyhough has built up an interesting picture of inner speech and its functions… making a case for the role of inner speech in memory, sports performance, religious revelation, psychotherapy, and literary fiction.' The New Yorker

'This sophisticated and appealing work scrutinizes a tangled topic with aplomb and will leave readers permanently observing their own thought processes differently. Perfect for readers of Oliver Sacks and Malcolm Gladwell.' Booklist (starred review)

'After reading the book, I couldn’t help noticing my thoughts more closely—asking myself, Is this dialogic thinking? or What perspective was that voice taking?At one point, there’s mention of “the idea that, when we internalise dialogue, we internalise other people. Our brains, like our minds, are full of voices.” For me, at least for now, one of those voices is Fernyhough’s.' New York Magazine, The Science of Us

'Though the book is not about creativity per se, one of its highlights is its fascinating insight into the process of artistic creation, particularly writing. In another high point, the narrative gently prods readers into a wider and more empathetic view of pathologies such as aural hallucinations. Fernyhough's book is a valuable addition to the literature surrounding the unending human quest to understand the location—and the creation—of the self.' Publishers Weekly

'Fernyhough examines the phenomenon of "inner voices," which manifests in two broad components: the more or less ordinary business of talking to oneself and the more fraught existence of voices inside one's head... with much to say about how the brain works at the interface of thought and language.' Kirkus Reviews

'This expansive review offers a stimulating blend of theory, research, and insight on inner speech and voice hearing that will complement more prevalent behaviorist and biomedical perspectives.' Library Journal

'A book that will challenge some of our preconceptions about how we think and how "the voices within" may be plentiful, or infrequent, helpful or problematic and variable from person-to-person. This is a valuable book for those who want to understand one important aspect of our human mind.' New York Journal of Books

'Intriguingly challenges conventional assumptions about the self as unified and coherent, while also posing the question: how might that which we deem pathological be shaped by the mores of our times?' Christine Gross-Loh, Guardian summer reading picks.

'As enlightening as it is surprising… By entwining inner voice theories, research, and data into easy-to-digest literary, pop culture, and personal anecdotes, Fernyhough has (quite intentionally) crafted a book that reads like a novel but never strays from its carefully examined scientific foundation.' Kirkus Reviews author interview

'Charles Fernyhough isn't just a scholar and a scientist, he is also a novelist, and this book reflects his unusual combination of gifts. It is an engaging and humane exploration of the experience of voices in our heads, delving into the origin of these voices in children, their contribution to problem-solving, creativity, and religious experience, their role in madness, and much else. This is a beautifully written and fascinating work.' Paul Bloom, Professor of Psychology at Yale University, and author of Just Babies

'Perceptive, illuminating and humane.' Gavin Francis, author of Adventures in Human Being

'Fascinating and elegantly humane... [Fernyhough’s] book is refreshingly interdisciplinary in its insistence that philosophy and literature are going to be just as important investigative tools for this subject as clinical psychology and brain scan.' Steven Poole, Guardian

Fascinating… the book traces in detail (the footnotes are just as interesting as the text) the various attempts to pin down inner voices… an expert blend of the scientific and artistic.' Erica Wagner, New Statesman

'Persuasively unravels connections between the voices we hear inside and the words we say out loud... an elegantly written survey.' Nick Rennison, Sunday Times

'If Fernyhough is to be believed, there is a sense in which we are visited all the time by good or bad angels and it is the ability to question and discriminate that distinguishes creative thoughtfulness from madness... His book, The Voices Within, is the intriguing result of his research.' Salley Vickers, Observer

'Fascinating… thought provoking… intriguing… clear presentation of the slippery nature of both our inner and spoken worlds.' Suzanne O’Sullivan, Lancet

'Stimulating and fruitful... A fascinating tour d'horizon.' Mike Jay, Literary Review

'Profound and eloquent... an intriguing array of fresh findings and perspectives.' Douwe Draaisma, Nature

'Compelling… reassures those of us who worry that we have a chorus of voices jabbering in our heads.' Mail on Sunday

'This is a truly exceptional book for its scope, richness of detail and originality… a book that informs as well as provoking thought and reflection… It is quite simply a remarkable book.' British Journal of Psychiatry

'With its extensive illustrations of the creative effects of inner speech and voice-hearing, sane and mad, [The Voices Within] is a thought-provoking and engaging read.' Times Higher Education

'Fernyhough presents his work as a wide-ranging investigation, spanning psychological research – including the brain-plundering marvels of fMRI – as well as philosophy, spirituality, literature and the arts. If there’s a drawback to The Voices Within, it’s that it may make you spend even more of your waking hours listening to yourself think.' The Saturday Paper(Australia)

'Utterly fascinating... the main joy of Fernyhough’s book comes from watching him chase down the faintest conceptual ripples extending outward from the ideas he discusses.' The National (UAE)

'A surprisingly humanitarian approach to a necessarily human topic… a vital, illuminating, engaging exploration of the things that make us who we are.' Ilkley Gazette

'Most of us talk to ourselves. In fact, many people describe their thoughts as being like a conversation between the different voices of their consciousness. In his eye-opening new book, Charles Fernyhough explores this inner speech, revealing what purpose it serves, what it says about us, and what it can tell us about those who experience hallucinated voices.' BBC Science Focus

Biography

I was born in Chelmsford, Essex, in 1968, and educated at Brentwood School, Essex, and Queens’ College, Cambridge, where I read Natural Sciences.

I returned to Cambridge to study for a PhD in Developmental Psychology, which I was awarded in 1995.

My writing has been published in several anthologies, including New Writing 11 and New Writing 14, and my books have been translated into eleven languages.

Photo credit: Ben Gilbert/Wellcome Images

My awards include a Time to Write Award from the Northern Writers’ Awards and an Arts Council of England Grant for the Arts

I have taught creative writing, with a particular focus on psychological processes in reading and writing, in a variety of contexts around the UK, including a short course on Creative Writing and Psychology at Newcastle University. Between 2004 and 2006 I worked as a mentor on the British Council’s Crossing Borders project for African writers.

I have appeared at festivals in Barcelona, Sydney, Durham, Newcastle, Sheffield, Edinburgh, Hay-on-Wye, LSE, Wigtown and Bath.

I work as a part-time Professor of Psychology at Durham University, with interests in child development, memory and hallucinations.

photo credit, it’s Ben Gilbert/Wellcome Images

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