Rajath Profile picture
Sep 24, 2020 9 tweets 4 min read Read on X
Dr Barrington draws attention to this well written open access commentary #MedTwitter #Neonatology #Disability #QoL A good life cannot be predicted from a brain scan!
Neonatologists often stare at seeming disasters early in the life of a newborn. Parents are distraught and ask how the road ahead would be? We are tempted to carry out tests and scans, lean on our personal experience and give our opinion: This itself has consequences 2/n
Research in keeping with the World Health Organization’s definition of QoL (a child or parent’s perception of their life) shows that disability severity has little relationship to life quality 3/n
“..Parents often hear this when you try and ‘prognosticate’ QoL for a sick neonate based on scans and tests.

‘If your child survives, they will have a bad life, and by extension you will too’.4/n
Further.. “poor QoL prognosis hampered or delayed parents’ ability to see, or invest in, their child’s happiness and acceptance by others”. So we not only ‘label the child’ we also influence the way the parents may cope and enable themselves and their child 5/n
Emotional well‐being, peer interactions, parental adaptation, and community support are much more powerful predictors of whether a child is likely to grow up to have a good life 6/n
Personal Reflection: 1. choose your words carefully, they are heard! 2. Tests = poor black & white snap shots 3. Families need a kinder society for their kids to succeed - exert influence in that sphere. 4. Never take away ‘hope’ from anyone unless you are absolutely certain n/n
onlinelibrary.wiley.com/doi/full/10.11… not only a must read for #Neonatologists #Obstetricians but for anyone who has a stake in society that we are building for the future.

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More from @FoolzWizdom

May 11
📍Our perception of #Health and Disease is filled with myths and if you put #Diet into this equation, you spawn an entire mythology, fake expertise, scare mongering, businesses, and needless deprivation of joys of just enjoying your food
📍These #myths are culturally so deeply ingrained in India, even qualified doctors and nutritionists perpetuate them, even depriving kids of ice creams and fruits they crave for by irrational prescriptive diets
Although a tough nut to crack, I will try to shatter these myths 👇
📍Cold foods or cool drinks ≠ coughs and colds:
Coughs, colds are usually viral illness or respiratory allergies. Chilled juice or icecream does not make you catch a cold. Neither does avoiding them help you recover faster. Warm liquids soothe your throat but they don’t ‘heal’
Read 13 tweets
Mar 8, 2023
#Adenovirus in Children: Recent surge
Adenovirus causes mild infections mostly in children
Outbreaks of ‘Madras eye/pink eye’, clusters of seasonal respiratory illness are not unusual
Severe illness with adenovirus has been rare

After a build up over 3mo we now see a surge
Parents should look out for:
Sudden onset high fever with chills
Headache and throat pain
Nausea and vomiting
Red eyes and red throat
Poor response to fever medications
Excessive tiredness
Burning sensation during urination
This infection is more of an inconvenience than a cause of concern
As a rule, kids get better in 5-6 days, very few need short hospitalisation to stay hydrated
Severe and unusual presentations needing ICU care (pneumonia or multi-organ involvement) are exceptionally rare
Read 6 tweets
Jul 12, 2022
#CSection conundrum 1/n

As a neonatologist I shall delve into short & long term effects on the child a bit later on.
For today, the question I am looking into is ‘will > C section = < maternal and neonatal mortality’ adjusted and not adjusted to Human developmental Index (HDI)
#Csection and #MMR and #NMR 2/n
WHO recommends an ideal rate of 15% at a population level. Less than this, mums and babies are at risk, more it will veer towards unnecessary sections.
Does this hold good when we look into pooled country wise data?
When adjusted to HDI, especially amongst developing countries there is ⬆️ risk of maternal deaths when C section rates are below 10%. But the correlation (higher C section - lower mortality) irons out pretty rapidly beyond 10% for MMR and 20% for NMR 3/n
Read 8 tweets
Aug 13, 2021
I am further convinced that Twitter at least is not the place where we can further the cause of general welfare. Some of us will note the blind spot we have to numerous privileges we have. But, we still have to give the best for ourselves and our kids. We have no choice.
So we make points that clearly lay out - we can’t escape the race, we work hard. We find lateral entry points for others a great disadvantage.The label of our own privileges: class, caste, IQ, merit is a burden if anything.I don’t see why anyone should have a problem with that.
The other side is now cogently arguing need for equitable opportunities and representation in the society. This would be for the common good, but at individual cost. There may be a point in that merit alone will not bring social justice. Do we have the right means to that end?
Read 7 tweets
Aug 12, 2021
Finally read Prashanth’s editorial. Not easy or comfortable read. Not easy also because we all have inherent biases. The flow of thoughts are complex and the sentences are long. One drifts to one’s own life events rather than read author’s reflections, hence maybe a bit lost 1/n
Basic premise is to question the merit of meritocracy. But meritocracy exists very patchily in our society. The ladder to climb to a better social standing, affluence, influence if only was professional college, degrees, high paying jobs the equation would have been simpler.
Most ‘merit student’ doctors, academically excel, train well and work for 💰 but have a smaller sphere of influence in my opinion. We end up securing our place that’s mentally challenging plus financially rewarding.
Read 7 tweets
Jun 4, 2021
Doesn't make sense at all, but somehow feel compelled to.
What could it be due to?
1. It is Ok to hit someone:
Physical retribution for perceived wrong has been acceptable in our society (thrashing in schools/police with lathi/spanking kids for eg)
2. Bipolar perception of the profession:
Noble profession - not a job that should pay the bills (expecting anything in return for job well done makes it less noble)
Doctors deified (can perform miracles, bring back from dead) + vilified (fleece patients, take cuts, looters)
3. How dare they make money?
We celebrate young techies, IITians making big money: they are meant to.
Doctors - no!: It is ok if they make some, but we really don't like them making a lot
An entrepreneur hitting gold - must be a genius
A doctor well off - must be fleecing
Read 17 tweets

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