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What are the signs of learning disorders in children?
What are the signs of learning disorders in children?
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Has difficulty following understanding instructions |
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Has difficulty remembering what is told just now |
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Reading, writing, maths skills problems |
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Has difficulty distinguishing right from left, e.g. confusing '25' with '52' or 'b' with 'd' or 'on' with 'no' |
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Lacks co-ordination - in walking, sports, holding a pencil, tying a shoelace |
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Can not understand concepts of time, is confused by yesterday, tomorrow |
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Loses or misplaces homework, notebooks or items. |
What are the signs for ADHD in children?
What are the signs for ADHD in children?
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difficulty organizing work |
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is easily distracted |
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makes careless, impulsive errors |
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frequently disrupts the class |
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has difficulty awaiting his turn in a group |
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appears to be inattentive to instructions |
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fails to follow parents' requests |
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gets easily bored of a game and hardly finishes it |
What are the signs of a depressed child?
What are the signs of a depressed child?
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Persistent sadness |
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Lack of enjoyment in favorite activities |
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Increased activity or irritability |
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Persistent physical complaints like headaches and stomachaches |
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Frequent absences from school |
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Poor academic performance |
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Persistent boredom, low energy, poor concentration |
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Eating or sleeping pattern changes |
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Spending more time alone |
What are the signs of panic disorder?
What are the signs of panic disorder?
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Panic attacks are usually classified as being part of panic disorder if they occur more than once and are accompanied by at least four of the following symptoms: |
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Sweating |
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Shortness of breath |
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Heart beating very rapidly |
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Chest pain |
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Feeling unsteady |
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Choking or smothering sensations |
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Numbness or tingling |
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Hot or cold flashes |
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Faintness |
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Trembling or shaking |
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Nausea or stomach pains |
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Feelings of unreality |
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Fears of losing control, dying, or "going crazy" |
What are the signs of Obsessive-Compulsive Disorder?
What are the signs of Obsessive-Compulsive Disorder?
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Obsessions
Obsessions are constant, intrusive, unwanted thoughts that cause distressing emotions such as anxiety or disgust. People experiencing obsessions recognize that these persistent images are a product of their own mind and are excessive or unreasonable. Yet, these intrusive thoughts cannot be settled by logic or reasoning. For example, some people may constantly fear bringing harm or injury to themselves or others or worry that they could violate social norms by swearing or making sexual advances. Others worry about germs and contamination.
Most people quickly become accustomed to an experience that only appears to be a threat. After repeated exposure to it, they eventually no longer feel threatened by it. People with OCD continue to experience these anxious feelings of threat and do not realize that the "threat" might be minuscule. Over the course of several months, these feelings develop into an obsession that becomes a threat on its own. Often, people with OCD find that repeated behaviors (rituals) decrease their concern, and so they feel compelled to repeat them in order to reduce their discomfort.
Compulsions
Compulsions are urges to do something to lessen discomfort, usually discomfort that is caused by an obsession. Rituals are the behaviors in which people engage in response to a compulsion. In the most severe cases, a constant repetition of rituals may fill the day, making a normal routine impossible. Compounding the anguish these rituals cause is the knowledge that the compulsions are irrational. |
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Cleaning - Provoked by the fear that real or imagined germs, dirt, or chemicals will "contaminate" them, some spend hours and hours washing themselves or cleaning their surroundings. |
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Repeating - To dispel anxiety, some utter a name, phrase, or behavior several times. They know these repetitions won't actually guard against injury but fear harm will occur if they don't do it. |
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Completing - People with this compulsion must perform a series of complicated behaviors in an exact order or repeat them again and again until they are done perfectly. |
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Checking - The fear of harming oneself or others by forgetting to lock the door or turn off the gas stove develops into the ritual of checking. Others repeatedly retrace routes they drive to be sure they haven't hit anyone or caused any accidents. |
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Being meticulous - While neatness and tidiness don't signify a disorder, some individuals with OCD develop an overwhelming concern about where things go on a desk or the appearance of a room. |
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Avoiding - Compulsive avoiders stay away from the cause of their anxiety and anything related to it. One patient became so anxious about chocolate that she avoided not only the candy but also anything else that was brown. |
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Hoarding - One of the less common compulsions, hoarding involves the constant collection of useless items. People with this compulsion may collect anything - scraps, newspapers, clothing, containers, cans, stones, garbage, even excrement - to the point that rooms are filled, doorways are blocked, and health hazards develop. |
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Slowness - Also a rather uncommon compulsion that strikes mostly men, this compulsion causes people to do certain tasks very, very slowly. |
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Other compulsion - Other varieties of compulsions include excessive and ritualized praying, counting, and list making. |
What is Interventional Neuroradiology or Endovascular Neurosurgery?
What is Interventional Neuroradiology or Endovascular Neurosurgery?
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| Interventional Neuroradiology (Endovascular Neurosurgery) is a medical speciality in which minimally invasive diagnostic and therapeutic procedures for cerebrovascular disorders are performed under radiological guidance. It is somewhat similar to the treatment carried out in the heart by cardiologists, such as angioplasty or stent placement. In these procedures, very thin catheters or wires are placed through blood vessels in groin and are navigated in the blood vessels to the site of the abnormal vessels. This is followed by diagnostic or therapeutic procedures. These procedures are done instead of open surgery and in some cases to supplement the conventional surgery. |
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Advantages of Endovascular Neurosurgery: |
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ensures minimal injury to normal brain |
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fewer complications, better outcome |
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ensures shorter hospital stay |
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enables treatment of diseases that could not be treated in the past |
What is Minimally Invasive Spine Surgery (MISS)?
What is Minimally Invasive Spine Surgery (MISS)?
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| Minimally Invasive Spine Surgery is an emerging area, which is both exciting and full of promise. It involves performing surgery on the spinal cord and the vertebral column using minimally invasive techniques. The major advantages of this technique over conventional spine surgery are: |
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Minimally Invasive Spine Surgery is safer and offers a much shorter recovery time compared to conventional spine surgery. It leads to less post-operative complications as well. |
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Secondly, in Minimally Invasive Surgery a tunnel is made through your back muscles by sequential dilatation to permit access to the spine by the surgeon. This leads to minimal tissue damage and less pain. In a conventional surgery, all the muscles are stripped off the vertebrae. |
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The operative scar in Minimally Invasive Surgery consists of one or more small scars measuring up to an inch versus a single large long scar of conventional surgery. |
How is MISS performed?
How is MISS performed?
Minimally Invasive Spine Surgery also known as 'keyhole surgery' uses a thin telescope like instrument known as endoscope, which is inserted through small incisions. The endoscope is connected to a tiny video camera, which projects the inside view of patient's body onto television screens in the operating room.
Small surgical instruments are then passed through one or more additional half-inch incisions. These incisions are covered with surgical tapes and after a few months are hardly visible.
There is a new technique called 'percutaneous vertebroplasty', for relieving pain due to collapsed vertebrae, wherein only a needle is placed, under guidance, into the fractured vertebrae for injection of the bone cement.
Can all patients with spine problems benefit from this technique?
Can all patients with spine problems benefit from this technique?
MISS is not appropriate for all patients, every patient is evaluated individually and advised accordingly. If your physician recommends a more traditional open approach then it does not mean that recovery time is going to be very long or painful. You should educate yourself about all the surgical options available to you, discuss these options with your physician and then rely on him to choose the best option for you that he is comfortable performing.
When is MISS mostly used?
When is MISS mostly used?
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| MISS is mostly used for: |
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slipped or prolapsed discs |
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spinal fusion, which is often performed on degenerative discs, trauma and spondylolisthesis (one vertebra slips over another) |
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deformity corrections, such as for scoliosis |
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removal of herniated and prolapsed discs |
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pain due to collapsed vertebrae |
What are the advantages of MISS?
What are the advantages of MISS?
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| There are numerous advantages of MISS, vis-vis open surgery: |
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quicker and accurate diagnosis |
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faster recovery with shorter hospital stay |
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minimal tissue damage, hence less pain |
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minimal post-operative infections |
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precise surgical technique can be performed |
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minimal scarring |
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no residual weakness |
When can I get back to work?
When can I get back to work?
You are usually allowed to go home the next day, except in cases of more advanced procedures that may require three or four days of hospital stay. You can get back to routine activities in 5 days and to work in 10 days.
What is brain tumour?
What is brain tumour?
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| A brain tumour is an abnormal growth of tissue inside the skull. Although there are many types of brain tumours, they fit into one of two categories: |
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benign tumours - they are non-cancerous in nature |
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malignant tumours - they are cancerous in nature |
| A tumour that originates in the brain is called a primary tumour. Both benign and malignant brain tumours can be primary in nature. A malignant brain tumour that is caused by the spread of cancer cells from another area of the body is a metastatic tumour. |
What is benign tumour?
What is benign tumour?
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| A non-cancerous tumour must be evaluated closely to determine whether it is close to vital structures such as blood vessels, nerves or the brain stem. Tumours that are near the vital structures may be partially or completely surgically removed and/or treated with radiation therapy, gamma knife therapy or chemotherapy. |
| Tumours that are not located near vital structures and that are in a surgically accessible area are often treated by surgical removal. Benign tumours that are slow growing and difficult to surgically access, or are not causing significant symptoms, may be monitored by MRI or CT scans on a regular basis. This form of treatment is called observation. |
What is malignant tumour?
What is malignant tumour?
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| It is important to determine if a malignant tumour is primary or metastatic in nature. The tumour size, type and location is important information in planning the optimal treatment. If the tumour is located near vital structures or is difficult to surgically access, chemotherapy or radiation therapy may be considered instead of surgery. |
| Malignant tumours may be partially or completely removed surgically. Many times chemotherapy or radiation therapy is performed, in addition to surgery, to ensure that remaining tumour cells do not re-grow at a slower rate. |
What is metastatic tumour?
What is metastatic tumour?
The original source (primary site) of metastatic brain tumours is often the lung, breast, kidney, colon or a metastatic melanoma. Metastatic brain tumours may cause symptoms in some patients before the primary site is diagnosed.
If the tumour is metastatic and the primary source is unknown, extensive testing is performed to determine the location of the primary cancer and other possible metastases. The primary source of metastatic tumour is able to be determined in approximately 90% of the patients.
What are the symptoms and treatment of metastatic tumour?
What are the symptoms and treatment of metastatic tumour?
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| Symptoms - The type and severity of symptoms depends upon the tumour size, type and location. Other factors that influence the symptoms include: the patient's age, overall health, emotional status, medications, previous & current treatment. Some of the more common symptoms include: |
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headache |
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nausea and vomiting |
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seizures |
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weakness |
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vision problems |
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confusion |
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difficulty with memory or ability to understand |
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decreased level of consciousness |
Diagnosis - The size, location, shape and appearance of the tumour on an MRI or CT scan can often aid in determining the type of tumour. If the tumour type is unable to be determined by an MRI or CT scan, a biopsy may be performed.
Treatment - Treatment depends on a variety of factors, some of which include: |
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The age of the patient at the time of the diagnosis |
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The overall health of the individual |
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The type, size, location and characteristics of the tumour cells and blood vessels |
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Observation - Monitoring slow growing, benign (non-cancerous) tumours. |
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Biopsy - surgical removal of a small piece of the tumour to determine the type of tumour. |
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Partial surgical removal of tumour - when the tumour cannot be reached, involves vital areas of the brain or the surgery would cause a significant risk to the patient |
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Complete surgical removal of the tumour. |
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Endovascular Surgery - Embolisation of blood vessels in preparation for surgery or direct delivery of chemotherapy to the tumour. |
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Radiation Therapy - In radiation therapy, ionizing radiation and particles are used in the treatment of malignant neoplasms. A therapeutic dose is delivered to the area. Sophisticated electronic techniques have been developed to deliver the radiation at one angle and then to rotate the source so that the dose to the overlying and adjacent normal tissue is minimized. |
What are the conditions for which Endovascular Neurosurgery is used?
What are the conditions for which Endovascular Neurosurgery is used?
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| Endovascular Neurosurgery is performed for the following conditions : |
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Intracranial Aneurysms - Aneurysms are focal swelling of blood vessels, which can burst and cause bleeding in the brain. Endovascular coiling can treat these aneurysms, thus avoiding open surgery. |
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Angioplasty or Stent Placement - This procedure is done to treat stenosis in arteries of brain (including c a r o t i d , v e r t e b r a l , intracranial arteries). Many cases of stroke occur due to stenosis (narrowing) in arteries leading to the brain. They can be treated noninvasively by endovascular route with an angioplasty or stenting procedure. |
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Stroke or Brain attack, including Intra - Arterial Thrombolysis Acute stroke or brain attack usually occurs due to blockage of arteries of the brain. Appropriate patients can be treated by placing a micro catheter at the site of blockage followed by administration of thrombolytic drugs, which dissolve the blocking material. |
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Arteriovenous Malformation - Arteriovenous malformations (AVMs) of brain are malformed blood vessels, which can cause intracranial bleeding (bleeding in brain), seizures and headache. AVMs can be treated by injecting "glue" through a microcatheter placed precisely into these abnormal blood vessels. |
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Tumour Embolisation - One of the major problems in surgical removal of intracranial tumour is bleeding during the surgery. Interventional neuroradiologist can help the surgeon by preoperative endovascular occlusion of the blood vessels supplying the tumour. This will reduce the bleeding and facilitate the surgery. |
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Cerebral or Spinal Angiography - DSA (digital subtraction angiography) is considered as the 'gold standard' investigation to diagnose diseases of blood vessels. |
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Vertebroplasty - With age bones become weak and collapse of bones (vertebrae) in the spine is one of the major causes of severe back pain in the elderly. Vertebroplasty is a revolutionary treatment in which "bone cement" is injected through a needle placed into the broken bone so as to stabilize the vertebra and to reduce the pain. |
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Percutaneous Sclerotherapy - Many superficial vascular malformations such as Haemangioma (malformation of blood vessels) or Lymphangiomas (malformation of lymphs) can be treated by puncturing through a needle, followed by injection of "Sclerosant Material" which causes obliteration of the malformation. |
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