MILES TO READ B4 I SLEEP: April 2025

Thursday, 3 April 2025

Wednesday, 2 April 2025

AT SOURCE NO SUBJECT OBJECT SPLIT

Tuesday, 1 April 2025

a 5 KLESAS

The Five Kleshas (afflictions or obstacles) in Yoga Philosophy come from Patanjali’s Yoga Sutras and are considered the root causes of human suffering. They are:

Avidya (Ignorance) – The fundamental misunderstanding of reality, leading to attachment and suffering. It is the root of all other kleshas.
Asmita (Ego or "I-ness") – The identification with the self as separate from everything else, creating a sense of individuality that can lead to pride, insecurity, and attachment.
Raga (Attachment) – The craving for pleasure, possessions, and experiences, which leads to suffering when they are lost or unattainable.
Dvesha (Aversion) – The opposite of attachment, this is the rejection or avoidance of pain, discomfort, or unpleasant experiences, which also causes suffering.
Abhinivesha (Fear of Death or Clinging to Life) – The deep-rooted fear of change and the unknown, often manifesting as an attachment to life itself, even when it causes suffering.

Overcoming these kleshas through self-awareness, meditation, and detachment is a key goal in yoga and spiritual practice. Do you relate to any of these in your own experiences? 😊

A “Everything I perceive is a magical lie

A This is a dream? Well maybe a nightmare - suffering is everywhere

We live in the mind of THE ONE ☝🏿”

"The infinite is incomprehensible." Ahh, the existential paradox

A DC

Here are some inspiring quotes from Deepak Chopra:

“The highest levels of performance come to people who are centered, intuitive, creative, and reflective.”
“You must find the place inside yourself where nothing is impossible.”
“The way you think, the way you behave, the way you eat, can influence your life by 30 to 50 years.”
“In the midst of movement and chaos, keep stillness inside of you.”
“The most creative act you will ever undertake is the act of creating yourself.”
“Every great change is preceded by chaos.”
“Walk with those seeking truth… run from those who think they’ve found it.”
“The best use of imagination is creativity. The worst use of imagination is anxiety.”
“You alone are the judge of your worth, and your goal is to discover infinite worth in yourself.”
“Nothing is more important than reconnecting with your bliss. Nothing is as rich. Nothing is more real.”

Do any of these resonate with you? 😊

LPR X HABIT COUGH

Here’s a pediatric wisdom pearl on LPR causing habit cough, . I'll include:
✅ Key points on LPR & habit cough
✅ A simple diagnostic approach
✅ Treatment strategies

Pediatric Wisdom Pearl: Laryngopharyngeal Reflux (LPR) & Habit Cough

🔹 LPR Overview

Reflux of gastric contents into the larynx & pharynx
Common in children with GERD, but can occur without heartburn
Symptoms: Chronic throat clearing, hoarseness, dry cough, globus sensation

🔹 Link to Habit Cough

Chronic throat irritation from LPR can trigger a persistent cough
Over time, the cough becomes a learned response (habit cough)
Key Features of Habit Cough:
- Dry, barking, or honking cough
- Absent during sleep
- No response to typical cough treatments
- Often resolves with distraction or suggestion therapy

🔹 Diagnostic Clues

Clinical history & symptom pattern
24-hour pH monitoring or impedance testing (if needed)
Consider trial of reflux treatment if suspicion is high

🔹 Management Approach ✅ LPR Management

Acid suppression (PPI or H2 blocker trial)
Alginate therapy
Lifestyle changes (elevating head, avoiding acidic/spicy foods, no late-night meals) ✅ Behavioral Therapy for Habit Cough
Suggestion therapy (e.g., "Your cough will stop now")
Distraction techniques (breathing exercises, chewing gum, hydration)
Speech therapy in refractory cases ✅ Supportive Care
Humidification, hydration, throat lozenges
Reassurance to family—habit cough is benign and reversible

📌 Take-Home Message: LPR-induced cough can evolve into a habit cough. A combined approach of reflux management and behavioral therapy leads to resolution! 💡

“Brevity is the soul of wit.” William Shakespeare, "Hamlet"

Summary: The Buddha’s Teachings on Awareness & Thought

✅ Illumination, Not Repression – The Buddha’s teachings focus on awareness and understanding, rather than suppressing thoughts or emotions.

✅ Steady Awareness – When awareness is calm and unentangled, it remains untouched by thoughts as they arise and fade.

✅ Non-Identification with Thoughts – The goal is not to eliminate thinking but to detach from it, recognizing that thoughts are temporary and not the self.

✅ Freedom from Mental Turmoil – By observing thoughts without attachment, one cultivates inner peace and clarity.

✅ Practical Mindfulness – Applying this principle in daily life encourages self-awareness, emotional balance, and wisdom.

Would you like this framed as a meditation practice or a practical guide? 😊

UVC UAC DURN - UVC can stay for 10 to 14 days, some stretch for a few more days. With rapid escalation of feeding regime, most don't stay this long. UAC is even removed much earlier

UVC can stay for 10 to 14 days, some stretch for a few more days. With rapid escalation of feeding regime, most don't stay this long. UAC is even removed much earlier

Summary: Gomati Mantra

1. Overview

Ancient Vedic mantra associated with spiritual purification and atonement.
Named after "Gomati", linked to cows ("go" in Sanskrit) and their sacred status in Hinduism.
Primarily used in Prayaschitta (expiation rituals) for atoning sins, especially cow slaughter (gohatya).

2. Cultural & Spiritual Significance

Mentioned in Dharmashastras and texts by Shatatapa on ethical duties.
Aims to cleanse spiritual and moral impurities (dosha) caused by unethical actions.
Aligns with Dharma (righteous conduct) and cosmic balance.

3. Key Benefits

✅ Spiritual Purification: Neutralizes negative karma.
✅ Restores Harmony: Helps rebalance after ethical disturbances.
✅ Moral Atonement: Reinforces moral responsibility and mindfulness.
✅ Psychological Relief: Helps release guilt and cultivate inner peace.
✅ Karmic Cleansing: Aids in spiritual progress through sincere repentance.
✅ Divine Connection: Links practitioners to higher energies of mercy and forgiveness.

4. Symbolism

Cows as Earth & Life Symbols: Represents sustenance, non-violence, and abundance.
Purification & Renewal: Signifies the power of self-correction through repentance.
Dharma & Accountability: Encourages respect for life and responsibility for actions.

5. Rituals & Traditional Use

Often recited during sacred purification rites, including bathing in the Ganges/Gomati River.
Gomati Chakra (sacred stone) is sometimes used alongside the mantra for added protection.
Less commonly known than Gayatri Mantra, but holds importance in traditional Hindu expiatory rituals.

6. Modern-Day Relevance

🌱 Environmental & Animal Welfare: Promotes ethical treatment of animals.
🧘 Mindfulness & Ethical Growth: Encourages intentional, responsible living.
😌 Mental Well-Being: Helps reduce anxiety through meditation and chanting.
🙏 Accessible Spiritual Practice: Can be integrated into daily meditation as japa (repetition).

Would you like a mantra text or pronunciation guide as well? 😊

FFFF

The fight, flight, freeze, and fawn responses are the body's automatic reactions to stress, trauma, or perceived danger. These responses originate from the autonomic nervous system and are shaped by individual experiences, especially in cases of repeated trauma.

1. Fight Response 🥊 (Confronting the Threat)

The body prepares to defend itself against the perceived danger.
Adrenaline surges, muscles tense, and aggression or assertiveness increases.
Common signs:
- Anger, irritation, or rage
- Confrontation, arguing, or physical aggression
- Controlling or dominating behavior
- A sense of power and resistance to threats

✅ Adaptive Example: Standing up to a bully
❌ Maladaptive Example: Uncontrollable aggression in non-threatening situations

2. Flight Response 🏃‍♂️ (Escaping the Threat)

The body prioritizes getting away from danger.
Heart rate increases, legs feel restless, and the mind focuses on escape routes.
Common signs:
- Anxiety, restlessness, or panic
- Avoidance of conflict or uncomfortable situations
- Overworking or excessive busyness
- Feeling trapped or wanting to run away

✅ Adaptive Example: Running from a dangerous animal
❌ Maladaptive Example: Avoiding all difficult conversations due to fear

3. Freeze Response 🧊 (Becoming Still & Unresponsive)

The body shuts down instead of fighting or fleeing.
This happens when the brain perceives escape or defense as impossible.
Common signs:
- Feeling numb, dissociated, or "zoned out"
- Inability to speak or move
- Holding breath or feeling disconnected from reality
- Procrastination or difficulty making decisions

✅ Adaptive Example: Staying still to avoid detection by a predator
❌ Maladaptive Example: Freezing under stress during a simple conversation

4. Fawn Response 🤝 (People-Pleasing to Stay Safe)

The body tries to appease the threat to avoid harm.
This response is common in trauma survivors, especially those with a history of abuse or neglect.
Common signs:
- Difficulty saying "no"
- Prioritizing others' needs over your own
- Fear of conflict or rejection
- Over-apologizing and seeking approval

✅ Adaptive Example: Calming down an angry person to prevent escalation
❌ Maladaptive Example: Staying in toxic relationships due to fear of abandonment

Which Response is Most Common?

People may switch between these responses based on context, past experiences, and personality.
Some may default to one response more often due to childhood trauma or chronic stress.

Do you relate to one of these responses more than the others? Would you like coping strategies for a specific one? 😊

P NN BRST ABSCESS

Neonatal Breast Abscess – Summary & Management

1. Overview

A localized infection in the breast tissue of neonates, usually caused by Staphylococcus aureus (often MRSA).
Most commonly affects full-term neonates within the first 2-4 weeks of life.
Can be unilateral or rarely bilateral.

2. Clinical Features

☐ Swelling, erythema, and warmth over the affected breast
☐ Tender, fluctuant mass (suggestive of abscess formation)
☐ Fever (rare) – Most cases are afebrile
☐ Purulent nipple discharge (in some cases)

3. Differential Diagnosis

Neonatal mastitis (infection without abscess formation)
Physiologic neonatal breast hypertrophy (due to maternal hormones)
Galactocele (benign milk-filled cyst)

4. Investigations

☐ Clinical diagnosis – Based on examination
☐ Ultrasound (if needed) – To confirm abscess, differentiate from galactocele
☐ Aspiration for culture – If drainage is performed
☐ CBC, CRP (if systemic signs present) – To assess inflammation

5. Management Approach

A. Antibiotic Therapy (for mastitis or small abscess <1cm)

Empirical oral antibiotics targeting Staph aureus (including MRSA):
- Cephalexin (for MSSA) OR
- Clindamycin or Trimethoprim-Sulfamethoxazole (TMP-SMX) (for MRSA risk)
Duration: 7–10 days

B. Drainage (for larger abscesses >1cm or worsening symptoms)

Needle aspiration preferred over incision and drainage (I&D)
Repeat aspiration if abscess persists
Surgical drainage if aspiration fails or large abscess with necrosis

6. Prognosis & Follow-Up

Most cases resolve with early antibiotics and/or drainage.
Follow-up in 2–3 days to assess response.
Avoid excessive manipulation/massage, as it can worsen the infection.

Would you like a flowchart for management?

PCT X YI SEPSIS

A recent study published in Pediatrics (March 2025, Vol. 155, e2024069507) by Marom et al. evaluated the effectiveness of procalcitonin (PCT) and other inflammatory markers in identifying invasive bacterial infections (IBIs) in febrile infants aged 60 days or younger. citeturn0search0

Key Findings:

Procalcitonin as a Predictor: Elevated PCT levels were significantly associated with IBIs, suggesting PCT is a reliable biomarker for early detection in young febrile infants.
Comparison with Other Markers: While traditional markers like C-reactive protein (CRP) and white blood cell count (WBC) are commonly used, PCT demonstrated superior specificity and sensitivity in detecting IBIs.
Clinical Implications: Incorporating PCT measurements into the evaluation of febrile infants may enhance diagnostic accuracy, potentially reducing unnecessary interventions and hospitalizations.

These findings support the integration of PCT testing into clinical protocols for managing febrile infants, aiming to improve outcomes through timely and accurate identification of serious bacterial infections.