By O. Bandaro. Eckerd College. 2019.
These will include the following: (a) The room should be of an appropriate size and in an acceptable condition before installation takes place purchase suhagra 100mg. Particular care should be taken to ensure that the floor is sufficiently robust to support the equipment discount suhagra 100 mg otc. Floor loading details are provided in the supplier’s specification discount suhagra 100mg line, and local engineering staff should be consulted. An uninterrupted power supply system is essential for optimal utilization of the gamma camera system. The grounding of the equipment should be checked since this can be a source of electrical noise as well as being a potential hazard. Poor quality electric supply is recognized as a major reason for instrument malfunction and failure. Similarly, care should be taken that other radiation sources in the vicinity (X ray machines, linear accelerators or 60Co devices) do not contribute to the background. Acceptance tests The first crucial step after installation of the imaging equipment is the initial evaluation or acceptance testing. This includes not only confirmation that the instrument performs according to specifications, but also evaluation of performance under conditions that will be encountered in clinical practice. No instrument should be put into routine use unless it has been shown through acceptance testing to be performing optimally. Provided the equipment is operating according to specification and has been demonstrated to be safe, a limited number of patient studies should be performed as part of the acceptance procedure. Quantification of tests is essential in order to compare results with specifications and to provide baseline values for future comparison. Therefore it is recommended that the specialized instruments and software are provided by the company for the purpose of acceptance testing, and that the tests are carried out on-site by the company engineer, under supervision of the user. The user may chose to perform additional tests to confirm the operation of the equipment and may chose to use these results as a reference for future quality control. If necessary, the user should invite a competent expert to participate in the acceptance tests and the evaluation of the results. Warranty period The warranty period (usually one year) should be clearly defined in the purchasing documents. The warranty period is very useful in exposing possible failures of electronic components at an early stage. It is recommended that the warranty period should start only when the equipment has passed all acceptance tests. Equipment should be put into clinical use as soon as possible in order to optimize the warranty period. There must be a clear understanding between the supplier and the end user as to how the warranty period will be influenced if a major part of the system needs to be replaced during the warranty period. The company should perform regular services and preventative maintenance procedures during this period. Service contracts A service contract should be negotiated, to include labour and either no spare parts, spare parts excluding the crystal, or all spare parts. The price of the service contract usually varies between 2 and 10% of the purchase price of the imaging system. The supplier should make available a qualified person to perform prevent- ative maintenance and servicing on the camera (proof of adequate training should be provided). In the event of system failure, the maximum response time of the service engineer should be specified (two hours is a typical figure). The maximum acceptable downtime per year should also be specified (10% of available working days is suggested). A penalty clause should be added to the contract if the supplier does not meet all the requirements. The supplier should supply a checklist of what will be performed during the services for preventative maintenance. The service engineer should leave on-site a record of all tests and checks performed. It is recommended that quality control tests such as those for uniformity and spatial resolution be performed before each service and repeated after completion, to evaluate the effectiveness of the service. General considerations The main imaging device in nuclear medicine is the gamma camera based on a sodium iodide detector, developed originally in 1958 by H. Although there are rectilinear scanners still in use, these will not be discussed. Multidetector systems are normally constructed using multiple gamma cameras that improve the efficiency of detection. Designs using multiple small detectors rather than conventional gamma cameras are also not in widespread use. The addition of coincidence circuitry to the conventional dual head gamma camera allows it to be used for ‘positron imaging’ as discussed in a later section of this manual. The design of gamma cameras has improved dramatically over a long period, with current devices being very much digital systems rather than simply being interfaced to an acquisition computer. Over the years the performance of cameras has also improved; not only is their resolution, uniformity and count rate capability better but also, more importantly, their stability is improved. Although there have been various attempts to design specialized gamma camera systems for specific applications, in general the more successful designs are those that provide flexibility. In many centres, the camera is required for different applications and, at the time of purchase, it is often difficult to predict what the ultimate application may be. Provided this flexibility is maintained, a dual head system has the advantage of improved throughput, and the low likelihood of both heads having problems means that a single head can be available for continued operation, even when the second head is non-functioning. A dual head system also offers the possibility for dual photon imaging, as discussed elsewhere. It is this flexibility that has resulted in the dual head camera currently being the most popular system. Although more expensive than a single head system, the dual head system is cost effective in terms of both throughput and flexibility. The computer is now an integral part of any imaging system, and consideration of not only speed but also the range of available software, connectivity and ease of upgrade become important considerations. There has been a trend in recent years towards standard computer platforms that can keep abreast of developments more easily than the older manufacturer-specific systems. Even though these systems tend to lag behind the general release of systems software, they generally offer a wide range of available peripherals and general software (including free software). Although there is a wide selection of advanced clinical applications software, the ability to develop user defined applications, without the need for advanced programming skills, remains a requirement that is not always available. Confirmation of results arising from application software is the responsibility of the site concerned. Particular care needs to be taken to ensure that interpretation is correct for the population concerned (e. There are many accessories for gamma cameras, including some that reduce overall reliability. One example is automated collimator exchangers that do not permit manual override and therefore result in the system being inoperable in the event of malfunction. Although basic collimators have changed very little (except for construction), there is a range of specialized collimators now available including fanbeam and cone-beam collimators that provide improved efficiency as well as marginally improved resolution compared with that of parallel hole collimators.
The new school nutritionist has moved on far beyond the simple slogans of the old school and is now in a position to understand much more about the catalytic effect of a wide range of vitamins and minerals generic suhagra 100mg with visa. Doctors and Nutritional Medicine Because we are buy generic suhagra 100 mg on-line, on the whole buy genuine suhagra, what we eat, there are some doctors of the new school of nutrition who maintain that one of the very first tests which a doctor should carry out on patients is to measure their nutritional status. Those doctors who do not assess the nutritional status of their patients rarely take it into account during diagnosis. The training of orthodox doctors has consistently failed to take nutrition into account. Even when dealing with food-based problems such as allergy and intolerance, many orthodox doctors steer their way carefully through any discussion of nutrition. Some doctors would not consider it a part of their role to give patients authoritative advice on the consumption of certain foods. The idea of nutritional treatment conflicts with their training and the culture of modern medicine which has been largely shaped by pharmaceutical interests. The avoidance by orthodox practitioners of nutrition has meant that nutritional practice and advice have been relegated to a sub-professional area of health care which tends to be populated by more malleable, often female, ancillary workers: an area which tends to be dominated and controlled by the processed food, chemical and pharmaceutical companies. Gradually, they are losing any understanding of the biological effects of the drugs which they prescribe and the foodstuffs and chemicals which their patients consume. In a world in which doctors become detached from the basic skills of healing, issues of nutrition tend to be approached in only the crudest terms. Chapter Twelve Dr Stephen Davies: Nutritional Doctor I had no idea what it was, but I did know that the whole theoretical matrix upon which orthodox 1 medical care was based was fundamentally flawed. By the end of his first month in clinical practice, Dr Stephen Davies knew he was not happy with it. Twenty years later, he looks back on two experiences which explain this lack of affinity with orthodox medicine. Reviewing the first experience, which happened while he was working in a large London teaching hospital, he draws out two themes: that some orthodox doctors did not care for their patients in anything which might be vaguely termed a psychological manner and that even those doctors who did care seemed to be oblivious to the fact that medicine is as much about alleviating symptoms as looking for cures. Just as I arrived, the entourage of Consultant, Senior Registrar, Registrar, two Senior House Officers, two Housemen, the Senior Nursing Sister, three Staff Nurses, two Junior Nurses, and six Medical Students plus a couple of hangers on, were moving away from a bed. That experience, Four or five days after my first ward round, I was with a lovely physician, a rheumatologist; he was kind, caring and conscientious. In came a man in his early forties, a nurse holding him up under each arm-pit, and with a Zimmer frame. He had had juvenile rheumatoid arthritis and it had continued throughout his adult life. Since those days as a trainee doctor, Stephen Davies has revolutionised the way in which he conceives of and practises medicine. Like all those who bring about change, he has had to carve out a very personal direction, a course which led up many false paths and unproductive avenues. Now, in his forties, Davies is well established as a nutritional doctor who has built one of the most effective biological laboratories in the country. All the time, at my first hospital, I was on the verge of dropping out of medicine. Even then I saw that there was so much destructive-ness in medicine, that I did not feel comfortable being a party to. There is, in the history of his search, that kind of self-inquisition that is illustrated in the books of Hermann Hesse. Davies is a rigorous scientist and his laboratory provides the hard diagnostic information which enhances his eclectic, creative and personal approach to medicine. I got involved in Scientology for a period, in the early seventies, simply because I thought that there might be something in there of value. After graduating and failing to find a niche for himself in orthodox medicine, Davies took what was to turn out to be the most important step of his medical career. He was one of three doctors at a hospital in the south of Newfoundland, giving hospital care to a population of ten thousand. I saw a disease pattern which was completely different from that which I had seen in England. The people came from more or less the same genetic stock as the people I had seen in practice in England, so it was more than probable that their different medical condition had been affected environmentally. In the extremes of poverty, in areas where industrial food production, in this case fish canning, has laid waste natural communities and their cultures, medical lessons are sometimes easier to learn. The illnesses I saw were those associated with very poor communities, for example, a six year old child, having to have a complete upper and lower dental extraction because all the teeth were brown and eroded. There was a great deal of depression and a lot of high blood pressure amongst young men and young women. A lot of cardiovascular disease, a lot of young deaths, miscarriages and stillbirths. In 2,500 people, I saw an enormous amount of congenital malformations, the kind of cases that I would just not see in general practice in England. Davies concluded that diet was of major importance in shaping the pattern of illness which he saw. His observation of this community gave him a foundation upon which to build his future medical practice. There was a vast amount of drinking, Newfoundland has a very high intake of alcohol. They were also eating a lot of salted fish, which had very few vitamins left in it. Solutions offered by the doctor who worked in the town before Davies arrived had mainly been dependent upon the prescription of drugs. In his first six months, using vitamin B complex, he took more than 300 dependent people off psychotropic drugs prescribed by the previous doctor. He had only one treatment failure, and none of those who came off drugs went back on during the eighteen months he was there. Arriving back in England in 1977, Davies set about his quest through books and discussions with other doctors for an eclectic medical model. In the beginning, working from home, learning as it were from his patients, he charged £2 an hour. I use it in relation to pathological diagnosis, biochemical diagnosis and patient examination. The fundamental difference in the way I practise is that I do not have a blind adherence to drug therapy. Like many pioneers Stephen Davies wanted to set up some kind of institutional network which would support and further the ideas, research and clinical work which he was doing. The only real forum available at the time for nutritional practitioners was the British Society for Allergy and Environmental Medicine, which allowed Davies only 15 minutes a year at its conference and, at that time, had no interest in placing nutritional medicine on its agenda. In 1984, together with other doctors, he set up the British Society of Nutritional Medicine. In 1984, following a bequest from his recently deceased dentist father, Stephen Davies set up Biolab Medical Unit, with the help of a biochemist. Having a clinic and laboratory was to enable him to have control over testing and measuring the samples taken from his patients. Setting up the laboratory was a costly exercise, although it enabled him to work more cheaply and efficiently than if he were still having the tests done outside the practice.
The nucleated cell count is that result in impaired drainage and obstruction buy suhagra 100mg with mastercard, usually 2 buy generic suhagra from india,000/ L with a predominance ( 80%) leading to subungual edema buy cheap suhagra 100mg, periorbital edema, of lymphocytes. The growth and • A history of bronchiectasis, chronic bronchitis maintenance of these endometrial implants are (in a nonsmoker), chronic sinusitis, or recurrent dependent on the ovarian steroids; therefore, endo- pneumonias in association with a chronic pleu- metriosis occurs only in women of reproductive ral effusion or peripheral edema suggests the age or in those women who are receiving estrogen diagnosis. Endometriosis typically • Slow nail growth is the most consistent nail involves the pelvic structures, particularly the ﬁnding and is more common than yellow dis- ovaries, cul-de-sac, broad ligament, and uterosac- coloration of nails; women often cover their ral ligaments. There were 110 cases of thoracic • The diagnosis can be established when at least endometriosis reported in the English-language literature between 1966 and 1994. Catamenial pneumothorax occurred in 80 552 Pleural Pearls (Sahn) (73%) of 110 cases, catamenial hemothorax in 15 to earlier diagnosis and timely, speciﬁc therapy (14%), catamenial hemoptysis in 8 (7%), and lung with decreased morbidity. Movement of endometrial tissue from the peritoneal to pleural cavity can occur either The goals of treatment are twofold: eradication through congenital diaphragmatic defects, which or suppression of thoracic endometrial tissue and occur more commonly in the right diaphragm, or prevention of reseeding from the pelvis. Therefore, oral contraceptives, progestins, Clinical Presentation danazol, or gonadotropin-releasing hormone ana- logs have all been used to suppress ovulation. At presentation, the mean age of women with Unfortunately, ovulation suppression appears to thoracic endometriosis is 35 years (range, 19 to 54 be effective in less than half of the patients. Pleural implants, however, were abrasion, partial pleurectomy, and chemical found in 15% of patients who underwent thora- pleurodesis through a chest tube. However, even costomy or thoracotomy, whereas diaphragmatic with a successful pleurodesis, patients may still defects and/or parenchymal cysts or blebs were develop catamenial chest pain as long as endome- observed in 25% of patients. Recurrent Patients with thoracic endometriosis typically symptoms are presumably the result of cyclical have symptoms within 24 to 48 h of the onset of proliferation of the pleuropulmonary endometrial menstruation; however, catamenial symptoms may implants in response to ovarian estrogens. Chest pain is symptoms can be relieved by hysterectomy with the most common symptom, occurring in 90% of bilateral salpingo-oophorectomy but may recur if patients; dyspnea occurs in about 30%. Catamenial estrogen replacement therapy is initiated and dor- pneumothorax is almost exclusively (95%) a right- mant thoracic endometrial tissue is reactivated. Diagnosis Clinical Pearls The diagnosis should be considered in a woman of reproductive age who presents with a • Thoracic endometriosis is a clinical diagnosis pneumothorax (nonsmoker), hemothorax, hemop- in women who develop right-sided pneumo- tysis, or chest pain associated with menses. The onset of a bronchopleural ﬁstula, which may be dramatic, with acute fever, dyspnea, and References production of copious, mucopurulent sputum, not only heralds the disease but increases the risk of 1. Thoracic endometriosis syn- stitutional symptoms, such as fatigue and weight drome: new observations from an analysis of 110 loss, and also manifest low-grade fever and night cases. Visualization of mon site for empyema necessitatis is in the subcu- diaphragmatic fenestration associated with catame- taneous tissues of the chest wall; therefore, patients nial pneumothorax. Before the development of antituberculous medica- Chronic Tuberculous Empyema tions, Mycobacterium tuberculosis was the most common cause of empyema necessitatis. Defnition and Causes Radiographic Findings Chronic tuberculous empyema, an entity dis- tinct from and much less common than tuberculous The typical chest radiographic finding of pleural effusion, represents chronic, active infec- chronic tuberculous empyema is a moderate-to- tion of the pleural space. Chronic tuberculous large, loculated pleural effusion with pleural calci- empyema can occur in several settings: (1) progres- ﬁcation and enlargement of the overlying ribs due sion of the primary tuberculous effusion (usually to the chronic infectious process. In addition to tuberculous 554 Pleural Pearls (Sahn) empyema, the differential diagnosis of empyema serial, space-emptying thoracenteses and 24 necessitatis includes bacterial empyema, lung months of isoniazid, rifampin, and ethambutol. Thoracentesis was repeated bimonthly for the ﬁrst 2 months, monthly for 3 months, and less Pleural Fluid Analysis frequently as the fluid reaccumulated more slowly. Twenty-four months of therapy was cho- The deﬁnitive diagnosis of tuberculous empy- sen based on the rate of improvement of the ema is established at thoracentesis by finding 6 pleural ﬂuid by laboratory parameters. Surgical purulent ﬂuid that is smear positive for acid-fact options for chronic tuberculous empyema include bacilli and subsequently cultures M tuberculosis. Anaerobic and aerobic cul- • Much less common than tuberculous pleu- tures should be performed because, on occasion, ral effusion, tuberculous empyema represents there is concomitant bacterial and mycobacterial chronic, active infection in the pleural space. Several patients have been described in whom chemotherapy for tuberculous empyema was com- References plicated by progressive, acquired drug resistance. Chronic tuberculous of the agents into the empyema cavity because of empyema with bronchopleural ﬁstula resulting in a severely ﬁbrotic and calciﬁc pleura; it is possible treatment failure and progressive drug resistance. Non- Removal of the obstructing lesion generally results Hodgkin’s lymphoma of the pleural cavity devel- in rapid resolution (within days) of the effusion. The with back-diffusion of hydrogen ions as the failure of drug penetration and acquisition of drug ﬂuid passes from the retroperitoneal into the pleu- resistance in chronic tuberculous empyema. J Thorac Car- Chest Radiograph diovasc Surg 1990; 99:410–415 The chest radiograph should demonstrate a Urinothorax small-to-moderate effusion ipsilateral to the obstructed kidney; however, there are reports of Pleural effusions associated with renal disease bilateral and contralateral effusions. With rare exception, hydronephrosis with extravasation of fluid into the perirenal Diagnosis space appears to be a prerequisite for the develop- ment of a urinothorax. The diagnosis prostate cancer, posterior urethral valves, renal should be suspected in the setting of obstructive cysts, nephrolithiasis, surgical ureteral manipula- uropathy and can be conﬁrmed by thoracentesis tion, blunt kidney trauma, renal transplant, ileal demonstrating a pleural ﬂuid/serum creatinine conduit with ureteral obstruction, and bladder ratio 1. A ﬁstulous tract usually occurs • A urinothorax is typically an ipsilateral urine between the upper thoracic subarachnoid space collection in the pleural space due to obstruc- and the pleural space. Effusions range presence of contrast in the pleural space after from small to massive depending on the size and myelography conﬁrms the diagnosis in patients duration of the ﬁstula. An important laminectomy or thoracotomy, while 3 (16%) feature of the transudative effusion is that the total patients responded to chest tube drainage. Iatrogenic cerebro- sistence of the effusion as a result of hydrostatic spinal ﬂuid ﬁstula to the pleural cavity: case report imbalance; a concomitant, low-grade inﬂamma- and literature review. Radioisotope myelogra- hypothesis that plasma lipoproteins move into the phy in the detection of pleural-dural communica- pleural space bound to triglycerides. Neurosur- A literature review published in 1999 revealed gery 1990; 26:519–525 175 cases of cholesterol pleural effusions, with 78% in men (age range, 17 to 81 years). The major- Cholesterol Pleural Efusion ity of the cases were attributable to tuberculosis; rheumatoid pleurisy was a distant second in fre- A cholesterol pleural effusion, also referred to quency. Other causes include paragonimiasis, as a pseudochylous or chyliform effusion, is character- lung cancer, empyema, hemothorax, and trauma ized by a high lipid content that is not a conse- (Table 1). Decor- tication should be considered for the symptomatic The cardinal feature of these effusions is patient with restrictive physiology as long as the a high cholesterol concentration, which is inde- underlying lung is relatively normal. A cholesterol presence of an active inﬂammatory process would pleural effusion may be differentiated from a appear to make the prospect of successful decorti- cation less likely. These effu- • A cholesterol effusion is distinct from a chylo- sions also have been described as resembling thorax and is a consequence of chronic pleural “soft, white cheese” and “motor oil. When the cholesterol concentration is 200 mg/dL, • The diagnosis can be suspected by observing the most likely diagnosis is a cholesterol effusion, ﬂuid with a satin-like sheen and diagnosed if the regardless of the triglyceride levels. Differentiating a Cholesterol Effusion From Chylothorax* Condition Chylothorax Cholesterol Effusion Incidence Uncommon Rare Causes Lymphoma, trauma, surgery, lymphangioleiomyomatosis Lung entrapment; tuberculosis, rheumatoid arthritis, empyema Onset Acute to subacute Insidious; chronic course (years) Symptoms Dyspnea None; dyspnea Appearance Serous, milky, turbid, bloody Milky; satin-like sheen Pleural ﬂuid Protein-discordant exudate with 80% lymphocytes; Neutrophil-predominant exudate; cholesterol, analysis triglycerides 110 mg/dL 200 mg/dL; cholesterol/triglyceride ratio 1. This occurs more com- Spontaneous Bacterial Empyema monly on the right, as there are a greater number (Spontaneous Bacterial Pleuritis) of diaphragmatic defects compared with the left hemidiaphragm. In from pleural fluid of a cirrhotic patient with addition to case reports, there have been only two hepatic hydrothorax who has a neutrophil count retrospective series totaling 15 episodes and a 250/μL, similar to spontaneous bacterial perito- prospective study of 24 episodes. It can also be diagnosed if pleural tive trial, 120 patients with hepatic hydrothorax ﬂuid culture is negative and the pleural ﬂuid were hospitalized during a period of 4 years.
This interesting fnding needs to be verifed by a larger case-control The presence of a neurological defcit buy generic suhagra, as well as cerebral palsy cheap suhagra online mastercard, study with a longer follow up period cheap suhagra online amex. Thus, this study investigated the reasons for admission among people with Introduction/Background: The aim of this study is to evaluate the cerebral palsy in different age categories. Results: Eleven children were enrolled (median ous system, respiratory system, and gastrointestinal system were age, 9 years). Yusmido1 1Hospital Tengku Ampuan Afzan, Rehabilitation Medicine Depart- Introduction/Background: Study on correlation between quality of ment, Kuantan, Malaysia life (QoL) of family members of cerebral palsy children and bur- den of care. Material and Methods: Select 50 children with cerebral Introduction/Background: Chronic neuropathic foot ulcer is a palsy 50 cases of primary caregivers as experimental group, select common complication for spina bifda patients with bilateral tali- 50 normal children the main caregivers of 50 cases as control group, pes equinovarus due to insensate skin and abnormal ankle posi- The research is the investigative study using Zarit caregiver burden tion which can lead to more detrimental subsequences. Re- ing, limb amputation is the fnal option and can cause more dis- sults: The analysis on the relevancy about QoL and nursing burdens ability to patients. Material and Methods: A patient with lumbar to Primary family caregivers with cerebral palsy children shows: myelomeningocele and bilateral talipes equinovarus was assessed Care burden of the experimental group was higher than control group using Pediatric Quality of Life Inventory 4. Cerebral uate and compare quality of life pre transfemoral amputation and palsy children’s burden of primary family caregivers of nursing and post prosthesis restoration. Score was given to each items assessed QoL between eight dimensions are negatively correlated (p<0. The emotional func- 706 tioning score shows no different pre amputation and post prosthesis restoration with score of 0/20. The decision for amputation is formidable especially nent- they recognized them as changeable with possibility of pro- for a growing child, thus detailed discussions among healthcare gression. Conclusion: According to the results it can be concluded providers, parents and patients are crucial. Nicolae clinical value and has the potential to develop interventions that Robanescu”, Paediatric Physical and Rehabilitation Medicine, Bu- improve outcome. In this study, we present a preliminary feeding 3 and swallowing problems by identifying the responses for specifc charest, Romania, Emergency Teaching Hospital “Bagdasar Ar- questions. Material and Methods: Thirty-one children with cere- seni”, Physical and Rehabilitation Medicine, Bucharest, Romania bral palsy participated (17 boys, 14 girls). Results: showed that feeding and swallowing problems activity limitation, caused by brain non-progressive lesion during identifed are using a feeding tube 12. We observed a signifcantly Rehabilitation Medicine, Novi Sad, Serbia, 3Faculty of Medicine- (p<0. Because of different clinical expres- sion it required different and personalized approach in treatment 711 in habilitation and rehabilitation process. Children with impairment of intellectual capacities could not be connected with cerebral palsy will present selective loss of motor control, spastic- using wheel chairs and having problem with speech. Standard protocol in this area is passive observed one statistically signifcant correlation (p<0. Material and Methods: This study exam- ebral palsy, fnding its characteristics, and analyzing its causes. Introduction/Background: Botulinum toxin type A is licensed for the treatment of spasticity in children older than 2 years. On the other hand, equinus gait is the most common problem with spastic 714 cerebral palsy, which results in an unstable and ineffcient gait pat- tern. She begun to stand up with support, and her left equinus 1Hospital Sultan Ismail, Rehabilitation Medicine, Johor Bahru, foot had become conspicuous. At age eleven month, she was in- Malaysia jected botulinum toxin of 20 units into 5 area (adductor, gracilis, gastrocnemius and medial hamstrings) only one time, and long leg Introduction/Background: Background: Primary objective: To com- cast applied at the same time. Secondary objectives: To determine association of sev- problem, the limitation of her left ankle was improved and posi- eral factors eg. Material and Methods: Methods: This was a pro- motion of lower limbs was improved and her plantar sensitivity spective cross sectional study involving 99 children between the was reduced. Our study shows that use of night orthoses and use of Introduction/Background: To Analyze the clinical characteristics sedative medication eg. Material and Methods: This was a cross sectional study con- with protein-s defciency. Material and Methods: This is 16-month ducted in Pediatric Rehabilitation Clinic in University of Malaya old boy, born by forceps with a fetal distress. The child underwent a soft rehabilitation and past 6 weeks was documented to assess compliance. He took initially Baclofen, which was stopped because graphic and medical background data were obtained from caregiv- of convulsions. Spinal deformity is common in cerebral palsy and will result 718 in functional impairment and pain. The basic data including age, sex, and Gross Motor 1 Fudan University Huashan Hospital, Department of Rehabilita- Function Classifcation System were recorded. We retrospectively tion Medicine, Shanghai, China reviewed the radiographs to assess the progression of the scoliosis and analyze the factors related to the severity of scoliosis. Results: Introduction/Background: Transcutaneous electrical acupoint stim- There were 34 participants recruited in this study. During the four year follow up, there were respiratory diseases, pain and enhancing motor functions of stroke fve participants who have rapid progression of scoliotic curve. Those who have a spinal ercise was performed 40 minutes per day, 5 days per week in both curve above 40 degrees before age 12 years have higher risk of groups. Recently Mariko Taniguchi-Ikeda et al succeeded in vious, though without statistical signifcance (p=0. Material and Methods: We collected clinical data promoting motor functions in children with cerebral palsy. Fine and gross motor development of the blind babies are crucial in order to achieve maximum independence. Zhou3 Material and Methods: The longitudinal study compared the de- 1Kunming, China, 2Honghe University, Rehabilitation, Honghe, velopmental data concerning 9 motor skills of 11 blind children China, 3The Second Peoples Hospital of Honghe Prefecture, Reha- (retinopathy of prematurity) from Special Care Center “Speranta” bilitation, Yunnan, China Timisoara with age 2 months -3 years old, to a control group of sighted children at the same age. Objectives: to establish the age Introduction/Background: To explore the behavior and signifcance when they perform the milestones; to evaluate the motor behavior of distinctive neonate disposal during the Mang in the natural state. Results: The results the motor development of blind children tion were carried out to the Mang in China. Results: After 20 years was delayed in all the stages, but signifcant in 5 motor skills that trace and a cross-sectional investigation, none of children with cer- were examined (p<0. This delay shows the major importance ebral palsy or mental retardation and 1 case of children with suspi- of vision in motor development and in self-care skills, but also is cious mental problem were found. Conclusion: In the absence of modern medical means, Conclusion: Early intervention and individualized programs of the dispose of the neonates with distinctive method in the Mang is the physiotherapist for the achievement of maximum potential of to abandon therapies of “problem newborn” initiatively, which is to the child, a safe and an adequate stimulating environment, proper prevent the waste of resource in maximum. It is the unique choice handling could shorten the motor developmental delay and could of the Mang to follow the natural law for racial maintenance.