Please guide me for premature closure of sutures. As in no repertory this symptom is given.

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Asad Parvez Qureshi<br />Kamal Laboratories Pakistan,<br />Sukho Distt. Rawalpindi,<br />Pakistan.

it is almost certain that there will be material that should have been discharged.
There are two ways of dealing with this

A - Use Silica 6x frequently for two weeks , the anticipated result would be to break the wound open - temporarily - to effect a discharge.

B . Use Hepar Sul which is an absorbent and will upload the rubbish into the disposal system of the body to be discharged with urine and stool.

It could be that brain is not developing, due to which the FONTANELLES close too early.
Dear Paskey, What kind of fluid could be which has been retained?

__________________
Asad Parvez Qureshi<br />Kamal Laboratories Pakistan,<br />Sukho Distt. Rawalpindi,<br />Pakistan.

mainly water -- assume you are now talking about hydrocephalus and the subject is a baby.

Whilst Hep Sul may still be apropriate Kent said that Natrum Sulph is useful in disposing of water that is surplus .. while Nat mur assists in the uptake of water.

Often the cause of hdrocephalus is VCCINATION -- if this is so then Thuja and Variolinum should be considered

From the annals of orthodoxy the following may be of interest --

The Programmable Adult Codman Hakim Valve is Useful Even in Very Small Children with Hydrocephalus - A 7-Year Retrospective Study with Special Focus on Cost/Benefit Analysis -.

Arnell K, Eriksson E, Olsen L.

Department of Paediatric Surgery, University Children's Hospital, Uppsala, Sweden. Kai.Arnell@surgsci.uu.se.

INTRODUCTION: Ventriculo-peritoneal shunting is the most commonly used method for the treatment of paediatric hydrocephalus. The programmable valve with the ability to adjust the opening pressure non-invasively has made it easier to find exactly the right opening pressure for each child and reduce the risk of over- or under-drainage. The aim of this investigation was to study our clinical experience with the adult Codman Hakim programmable valve in children, with reference to complications and economic impact. METHODS: A seven-year retrospective study of 122 hydrocephalic children (aged from children born prematurely to 15 years old) shunted with the adult Codman Hakim programmable valve was performed. RESULTS: The programmable valve was the first shunt in 76 children and in 14 after prior ventricular drainage. The remaining 46 had different non-programmable systems as their first shunt. The most common reason for changing to a programmable valve was over-drainage. With the programmable valve, catheter-related complications, e.g. proximal (36 %) or distal obstructions (30 %), were the main reasons for surgical revision. Non-invasive pressure adjustment was performed in 73 % of the children. Among the children with the programmable valve as their first shunt, 57 (75 %) were adjusted, 12 (21 %) had severe symptoms of over-drainage and would have required urgent surgical change of the valve if it had not been adjustable. A resetting of the opening pressure after MRI was found in 38 % and accidental resetting occurred in 4 %. Programmable valves are about twice as expensive as non-programmable valves. We estimated the increased cost of the valve and compared it with the savings from a reduction in the number of re-operations. The total cost for the programmable valve (as the primary shunt) in our study was less than that for expected re-operations due to over- or under-drainage when using non-programmable valves. CONCLUSION: The programmable valve was easy to handle; only one size was required and the adjustment made it possible to achieve an optimal intraventricular pressure with a lower total cost, reduced hospital stay as well as an increased quality of life for the children.

It's not the hydrosephlus but the size of the head is smaller then the age and with the growth of child the brain it is not growing. I think this could be due to the prmature closue of fontanells, I could hardly find any open or bulging space on the head of 8 months old baby. The same is the case with his elder brother.

__________________
Asad Parvez Qureshi<br />Kamal Laboratories Pakistan,<br />Sukho Distt. Rawalpindi,<br />Pakistan.