Clinical Kaumarabhritya

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Item Code: IHL098
Author: Dr. Prem ShankerUpadhyay
Publisher: Chaukhambha Visvabharati
Edition: 2010
ISBN: 9788190987127
Pages: 182
Cover: Paperback
Other Details 8.5 Inch X 5.5 Inch
Weight 200 gm
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Book Description


To protect, nurture and fondle once own procreation is an intense desire of every living being. The human, one of the most developed creation of the mother nature has made all efforts to have a healthy, beautiful progeny endewed with all the best qualities. It is but natural to find relevant reference in earliest available written literature i.e. ‘Vedas’ full of knowledge of all the subjects known till to day including about progeny and its health.

Medicine in Vedic era was magicoreligious, where-in prayers were offered to God Aswinis to make the foetus intelligent, agni for making it strong, deities for safe delivery and sky, earth, sun and air etc. to give pleasure and tenderness to it. This description in an insinuation that it was known during those days that intelligence and strength of the foetus, the future man can be modified during intrauterine life, safe delivery is important for future and entire atmosphere influences not only health of foetus and child, but also can help in eradication of certain diseases, as the cough involving each and every part of the body and tuberculosis (yaksma) are said to be cured by nutritive diet (havi) and living in hill or forest areas, the areas having fresh air and abundant sun-rays cures these and other diseases also.

Breast feeding was started after first feed of somarasa an ambrosia by goddess Aditi, the mother of god Indra, probably to inhance immunity and also to test normalcy of gastrointestinal tract. Mother’s lap was considered most comfortable to the child because it offers psychological impetus to the newborn besides being suitable in temperature.

Certain concepts and rituals practiced today seem to have descended from vedic period i.e. concept of first eruption of upper teeth is fatal for parents and pacification to ward-off evil effect, as well as tonsure ceremony to provide better eye-sight, longevity and good health etc. Besides these all the details about clothes, immunoinhansive and nutritive food, piercing of ear (Karna vedhana) and seizure by grahi, yatudhani etc. simulating graham of ayurveda are referred in Vedic literature.

Literature on medicine descended from Vedas to ayurveda, classics of which are most systematized description of medicine with method of teaching/training in theory and practice in most scientific way with the then available tools. Its division in eight branches is based exclusively for its application in practice i.e. preventive, protective, rehabilitative and curative care.

Maharsi Susruta the surgeon has unequivocally emphasized the importance of knowledge of theory and practice both in the worlds that the one possessing knowledge of only theory or practical is like a bird with only one wing thus can not fly, one who is expert in both and intelligent can accomplish his object.

In ayurpveda subject is most systematized and practical Kaumarabhrtya on the eight branches of ayurveda though initially included aspects related to health of child in entirety i.e. Obstetrics, Gynaecology also besides neonatalogy and paediatrics etc., yet today with more emphasis on specialization, Kaumarabhrtya is principally concerned with subject related to the health of the child.

In ayurveda acute dearth of clinical oriented books specially of Kamarabhrtya is existing even today, inspite of such a long time for its systematized education as a distinct speciality. Dr. Upadhyaya an yongue teacher, researcher and clinician has fulfilled the gap to certain extent with his book ‘Clinical kaumarabhritya’ which is according to present curriculum of graduate standard education. To make subject intelligible, he has divided the book in eleven chapters covering the subject from the time of birth of neonate and has included even emergency procedures; explanation of subject through tables and diagrams has increased acceptability specially to novices.

I am sure that it would be a boon to all those associated with care of children more so to the novices entering the field.

I congratulate Dr. P.S. Upadhyaya and wish that he continues his journey in the survice of goddess Saraswati besides accomplishing his duties towards students and born nationals.

About the Author

Dr. P.S. Upadhyay S/o Sri Ram Tej Upadhyay and Smt. Dropati Devi MD (Ay.) Ph.D., Lecturer, Department of Kaumarbhritya, Govt. Ayurvedic College and Hospital, Atarra (Banda) U.P. born on 5th Jan. 1974 at Sultanpur Dist. (U.P.). He has completed B.A.M.S. from Lucknow University, M.D. (Ay.) and Ph.D. from Banaras Hindu University, Varanasi, was senior resident at Institute of Medical Sciences, BHU from 2006-2009. He was elected as District Instructor of Neonatal Resuscitation Programme for year 2009-2011 by Indian Academy of Pediatric in Varanasi. He has published five papers, presented two paper in International seminar and three seminar/conference. He is member of all India Ayurvedic specialist (P.G.) association, Life Member of Bhartiya Sangyaharak Association and Vishwa Ayurveda Parisad. He is skilled in management of neonatal and pediatric disorders.

About the Book

My effort embedded in this book is based on revised syllabus (year 2010) by Central Council of Indian Medicine, New Delhi. It covers the practical (clinical) part of the Kaumarbhritya subject having 100 marks. The matter embedded in this book collected from, Brahattariya, Laghuttriye, books of Neonatology, modern pediatric and my clinical practical experiences, which was taught by my teacher during residency period. The main topics covered in this book are examination and Care of newborn, Navjat Shishu Prana- Pratyagaman, Immunization and Vaccine preventable diseases, panchakarma, pediatrie equipments including phototherapy, Intravenous fluid administration and blood sampling, emergency procedure like lumber puncture, bone marrow aspiration, thoracocentesis and abdominal paracentesis, umbilical cord care technique, feeding in children, emergency medicine with normal laboratory values and proforma of Neonatal/pediatric case record. This book will be help full for MD (Ay) Kaumarbhritya scholars, students of PG diploma in Kaumarbhritya, Practioners in field of Kaumarbhritya, B.A.M.S. students and MD (Ay) intrance examination.


If a child has suffering from birth asphysia/disease, he faces many problems. If he did not have such problems then he is healthy. It is possible when he has protected by anyway. It is best thought that “Prevention is Better than Cure” but it is concerned mostly for preventive aspect. A diseased child, with parent seek doctor to treat the disease. In this view a small effort has made to provide the knowledge for prevention/treatment of infant & children along with the proper caring, proper immunization. Morbindity & mortality of infant & children (below 14 years) is very high in India with reference to other developing country. This text contains care of new born, Immunization, neonatal resuscitation, vaccine preventable diseases, emergency procedure & equipments. The efforts embedded in this book is based on opinion of my teacher Dr. B.M. Singh, Head Department of Kaumarabhritya and Dr. Sangeeta Gehlot, Head Department of Kriyasharir, Faculity of Ayurveda, IMS, BHU, Varanasi. I hope this book will be helpful for BAMS students, M.D (Ay) scholars student of P.G. diploma and Practioners in field of Kaumarbhritya. Any suggestions to improve this book will be grateful acknowledged.




Chapter   Page No.
1 Examination and Care of Newborn 3-23
  History and Physical Examination of the Newborn 3
  Maternal history 3
  Current pregnancy 3
  Perinatal history 4
  Past obstetric history 4
  Drug history 5
  Family history 5
  Routine physical examination of the neonate 5
  Physical examination of the neonate 5
  Neurological examination 7
  Neonatal reflexes 7
  Moro reflex 8
  Rooting and sucking reflex 8
  Assessment of Gestational Age 8
  New Ballard Score 9
  Physical Maturity 9
  Neuromuscular maturity 9
  Apgar Score 14
  Care of Normal Newborn 15
  Components of neonatal care 15
  Preparation for delivery 15
  Immediate care at birth 16
  Care after birth 16
  Essential postnatal care 17
  Home messages for care of normal newborn 18
  Normal variations of newborns 19
  Milia 19
  Mongolian blue spots 19
  Erythema toxicum 19
  Peeling skin 20
  Epstein’s pearls 20
  Regurgitation and vomiting 20
  Failure to pass meconium and urine 21
  Disorders due to transplacental passage of maternal hormones 22
  Mastitis neonatorum 22
  Vaginal bleeding 22
  Mucoid vaginal secretions 23
2. Navjat Shishu Prana-Pratyagaman (Neonatal Resuscitation) 24-34
  ABC’s of Resuscitation 24
  Basic resuscitation 24
  Anticipation of need for Resuscitation 25
  Ante partum factors 25
  Intra partum factors 26
  Equipments & Medicines for Resuscitation 26
  Positive pressure ventilation 27
  Care after successful resuscitation 29
  Assessment and timely recognition of the problem 29
  Advanced Resuscitation 29
  Endotracheal intubation 29
  Chest compressions 30
  Ayurvedic Approach of Navjat Shishu 32
  Prana-Pratyagamana 33
3. Immunization and Vaccine preventable Diseases 35-66
  Immunobiologics 35
  Vaccine 35
  Toxoid 35
  Immunoglobulin 36
  Antitoxin 36
  Vaccination 36
  Vaccine contents 36
  Types of vaccines 37
  Cold chain 37
  Immunization schendue 39
  National immunization/universal immunization programme 39
  IAP immunization schedule 39
  Vaccination schedule in adolescents 40
  Combination vaccines 41
  Vaccination in HIV/AIDS Positive Patients 41
  Vaccination schedule of an unimmunized child 42
  Immunization schedule for travelers 43
  Newer vaccines 43
  Adverse events following immunization 46
  Details of particular vaccines 48
  Vaccine Preventable Diseases 58
4 Panchkarma 67-83
  Purva karma 67
  Pradhan karma 67
  Paschat karma 67
  Preparatory procedure of Purvakarma 67
  Snehana Karma 67
  Procedure of snehana karma 68
  Determination of kalawadhi 69
  Determination of dose 69
  Dietetic management prior to snehana 69
  Anupana in snehapana 70
  Observation after snehapana 70
  Feature of sneha jirna 70
  Feature of samyak snehana 70
  Feature of asnigdha snehana 70
  Acute complication of snehapana 70
  Chronic complication of snehapana 70
  Post-snehana regiman 70
  Scientific approach of snehana 71
  Svedana (Dudation) Karma 71
  Type of svedana by Kashyap 72
  Scientific approach of Svedana 73
  Indication of Svedana 74
  Contraindication of Svedana 74
  Feature of asamyaka Svedana 74
  Feature of smayaka Svedana 74
  Feature of ati Svedan 74
  Post svedana regimen 74
  Vamana Karma 74
  Indication of Vamana karma 75
  Contraindication of Vamana karma 75
  Procedure of Vamana 75
  Criteria of effective Vamana 75
  Features of samyaka Vamana 76
  Features of asamyaka Vamana 76
  Features of excessive Vamana 76
  Complications of Vamana 76
  Virechana Karma 76
  Pharmacodynamic properties of Virechana drugs 76
  Indications of Virechana karma 76
  Contraindication of Virechana karma 77
  Procedure of Virechana 77
  Determination of Drug Doses in Virechana 77
  Criteria of effective Virechana 77
  Features of samyak Virechana 77
  Features of ayoga Virechana 78
  Feature of atiyoga Virechana 78
  Complications of Virechana 78
  Vasti Karma 78
  Classification of Vasti 78
  Indications of Asthapana Vasti 79
  Contraindications of Asthapana Vasti 79
  Indications of Anuvasana Vasti 79
  Contraindications of Anuvasana Vasti 79
  Features of asamayak Vasti 79
  Features of asamayak Vasti 79
  Features of excess Vasti 79
  Sirovirechana Karma 79
  Classification of Nasya 80
  Indications of Nasya Karma 80
  Contraindication of Nasya Karma 80
  Age at which Nasya can be given 80
  Determination of doses in Nasya karma 80
  Features of adequate Nasya 81
  Features of inadequate Nasya 81
  Features of excessive Nasya 81
  Advantages of adequate Nasya karma 81
  Scope and importance of Pancha karma 81
  Pachan Karma 81
5 Pediatric Equipments 84-91
  Phototherapy 84
  Indication for phototherapy 84
  Machanism of phototherapy 85
  Methadology for phototherapy 86
  Monitoring during and after phototherapy 87
  Contraindications for phototherapy 87
  Intensive phototherapy 87
  Continuous/intermittent phototherapy 87
  Intensive phototherapy 87
  Contraindications for phototherapy 87
  Intensive phototherapy 87
  Continuous/intermittent phototherapy 87
  Home Phototherapy 88
  Sunlight Treatment of Jaundice 88
  Side effects of phototherapy 88
  Overhead Radiant warmer 89
  Constructional detail of Overhead Radiant warmer 89
  Purpose of Overhead Radiant warmer 89
  Key function in Overhead Radiant warmer 90
  Display and Buzzer function in Overhead Radiant warmer 90
  Special Resuscitation equipments & Medicines 90
6 Intravenous - Fluid and Blood Sampling 92-102
  Indication of Intravenous - Fluid administration 92
  Quantity of fluid in Neonates 92
  Quantity of fluid in Infant and children 93
  Deficit fluid 93
  On going loss 94
  Maintenance fluid 94
  Quantity of maintenance fluid based on age of child 95
  Quantity of maintenance fluid based on weight of child 95
  Rate of administration 95
  Blood Sampling 96
  Femoral blood sampling 96
  Venous canulation/puncture 98
  Intra osseous (IO) infusion 100
  Indications of Intra osseous Infusion 100
  Contraindications of Intra osseous Infusion 100
  Steps of Intra osseous Infusion 101
  Complication of Intra osseous Infusion 102
7 Emergency Procedures 103-113
  Lumbar Puncture 103
  Indications for Lumbar Puncture 103
  Contraindications of Lumbar Puncture 103
  Procedure of Lumbar Puncture 103
  Complications of Lumbar Puncture 104
  Bone marrow aspiration 104
  Indication of Bone marrow aspiration 105
  Contraindication of Bone marrow aspiration 105
  Equipment & drugs for Bone marrow aspiration 105
  Procedure/Usual sites of Bone marrow aspiration 106
  Complications of Bone marrow aspiration 106
  Thoracocentesis/Intercostal Drainage 106
  Indication of Thoracocentesis 107
  Contraindications of Thoracocentesis 107
  Position and Site of Thoracocentesis 107
  Methods of Thoracocentesis 107
  Post procedure management of Thoracocentesis 108
  Complications of Thoracocentesis 109
  Abdominal paracentesis 109
  Cord Care Technique 111
  Delivery room procedure 111
  Method of cord care in Samhita granth 113
8 Feeding in children 114-122
  Objectives of Infant and Young Child Feeding 114
  Norms for Infant and Young Child Feeding 114
  Early Initiation of Breastfeeding 114
  Value of Colostrum 115
  Exclusive breastfeeding 115
  Counselling for breastfeeding during pregnancy 115
  Complementary Feeding 115
  First food for the baby 116
  Traditional foods for infants 116
  Protective foods 116
  Ten steps to successful breastfeeding 117
  Problems in breast feeding 117
  Inverted nipples 118
  Sore nipple 118
  Breast engorgement 118
  Breast abscess 119
  No enough milk 119
  Method of breast feeding 119
  Stana-Pana Vidhi (Method of Breast Feeding) 120
  Objective of the IMS Act 121
  The IMS Act-Main Points 121
9 Common Medicine 123-132
10 Normal Laboratory Value 133-140
11 Neonatal Case Record/Pediatric Case Record 141-148
  References 149
  Index 151

Sample Pages

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