Dr. Roshini Ambat

Highlights

1. Expert medical consensus from panel of senior and experienced doctors who manage neuromuscular disorders.
2. Intervention plan by multidisciplinary rehabilitation team

Experts in our panel

Pediatric neurologists

Dr P.A. Muhammed Kunju MBBS,DCH,MD(Pediatrics),DM(Neurology)
Dr Kalpana D MD (Pediatrics), DM(Neurology)

Pediatric orthopedician

Dr Vinod Krishnan. D.Ortho, DNB, Fellowship in pediatric neuromuscular disorders(Australia).

Rehabilitation physician

Dr Lakshmi Nair , MD (Physical Medicine and Rehabilitation), Specialist training in neurorehabilitation(Australia)

Developmental pediatrician

Dr Reeba Ann Daniel, MD, DNB(Pediatrics), Fellowship in Developmental and Behavioural Pediatrics

Our Team of interventionists include pediatric physiotherapist, occupational therapist and speech therapist.

Clinic on all 2nd Tuesday of the month

For appointments contact – 0471-2941562 / 2941000 (9am to 4pm)

Research projects of Neonatology submitted to NBE / IAP / NNF / Kerala University

Dear Medical Professional

The scope and expertise of our unit is to provide a level of care and services with advanced supports like high frequency ventilation and inhaled Nitric oxide therapy, peritoneal dialysis, parenteral nutrition etc.. for sick neonates. This includes years of experience in the care of neonates at thresholds of viability (23-25 weeks gestation). We are strongly committed to interdisciplinary involvement with Perinatology, High risk obstetrics, Pediatric Surgery, Laryngology, Retinal specialists, Pediatric Cardiology, Pediatric neurology, Pediatric Endocrinology.

Early parent participation in decision making as well as daily care processes is the crux of our unit. The dedicated Follow up services protocol- “Blue book” (which is now being practised in many other units) has been in place with a structured protocol for several years.

We believe that relentless improvement comes with academic endeavours and continuing education. Hence the commitment to teaching and training. We have been running the superspecialty DNB Neonatology program and Fellowships in Neonatology since 2008. Academic work includes involvement in clinical investigative research with a focus on translating science into better ways to deliver care and improve outcomes.
Our mission includes striving to quality improvement – not just in patient care, but also satisfaction of parents, staff and fellows. This includes extensive contributions to clinical research, national and international neonatal practice guidelines.

Microbiology: (Bacteriology, TB Culture, Mycology, Serology& Molecular testing)

Unique features are:

• Chip based RT PCR for COVID 19
• HCV Quantitative PCR in GeneXpert
• TB Culture and sensitivity tests in MGIT
• GeneXpert for detection of Mycobacterium Tuberculosis (MTB) & Rifampicin resistance.
• GeneXpert for Carba-R detection
• Immunofluorescence & Immunoblot testing for Neuro immunological diseases (only private centre in South Kerala)
• Biofire Micro array (multiplex PCR for meningitis, respiratory, gastro intestinal panels)
• Immunofluorescence, Immunoblot & ELISA testing for auto immune diseases

Equipment:

• VITROS 3600 & VITROS ECI
• Biomerieuxvidas
• Euroimmun 2P ELISA analyzer
• Vitek-2 Compact
• BACT/ALERT 3D
• BiofireMicro array
• Cepheid GeneXpert
• MGIT – BD Diagnostics
• Truenat Extractor &Analyzer
• Plexmat

Contact number – 0471-304100: 1145/1180

Histopathology and Cytopathology (Pathology)

Services offered:

Histopathology
This division provides

• Diagnostic surgical pathology services including:
  • On small biopsies like Renal biopsies, Transplant related biopsies, Endoscopic biopsies from gastro intestinal tract, naso pharyngeal tract, bronchoscopic biopsies including US guided endobronchial biopsy [EBUS], image guided trucut biopsy from internal organs and deep-seated soft tissue.
• Strong oncopathology:
  1. Providing frozen section for intra operative diagnosis and for marginclearance.
  2. Reporting protocol as stipulated in AJCC Cancer staging Manual, latest edition for grading and staging of surgical oncology specimens. (Eg: Mastectomy, Colectomy, Gastrectomy, Whipples, Lobectomy – lung, liver, thyroid, Nephrectomy, Panhysterectomy, Hemimandibulectomy, Bone resections etc).
  3. Immunohistochemistry back up in Oncopathology especially to provide diagnosis in Lymphomas, in detecting unknown primaries and in sub typing of carcinomas and soft tissue tumours. The division has IHC antibodies of about 85 numbers.
• Direct immune florescence, and routine H&E for Renal and Skin biopsies
• Fetal Autopsies done by pathologists and reported.

Equipments:

ASP 300S Closed Tissue processor, Leica Embedding machine, Cryostat for performing frozen section, Automated IHC stainer (Leica Bondmax)

Contact number – 0471-304100: 1125/1193

Hematology

Hematology, Clinical Pathology and Coagulation offers routine and special investigations of blood and body fluids to aid in the diagnosis of several medical conditions and in evaluating anemia, leukemia and coagulations disorders.

Peripheral blood smear and bone marrow smear examination done using routine stains and also by using special stains like Perl’s, PAS or Cytochemistry wherever applicable (eg: leukemia, myelodysplastic syndrome).

Equipment:

• Beckmen Coulter for doing Complete Blood Count
• Amax Destiny for Coagulation studies
• Automated analyzer by Beckman coulter for urine chemistry and microscopy.

Contact number – 0471-304100: 1262/1242

Biochemistry

Besides all routine biochemistry parameters, unique features are availability of rare tests like

• Osmolality measurement
• Sweat chloride analysis by pilocarpine ionotophoresis for cystic fibrosis screening
• Lead reference laboratory for Lead quantitation.
• Drug assays of Tacrolimus, Digoxin, Vancomycin, Phenytoin, Valproic acid
• First trimester screening (FTS)

Equipment:

• Cobas 8000 –Fully software controlled Modular analyzer
• Fully automated chemistry analyzer Cobas C 501
• Fully automated immunoassay analyzer E 411
• Biomerieuxvidas -immunology analyzer
• D-100 & D10Biorad for quantitative estimation of HbA1c,
• WaproOsmomat for osmolality measurement.
• Leadcare II for quantitative detectionof Lead poisoning
• Nanoduct for neonatal sweat chloride analysis.

Contact number – 0471-304100: 1246/1265

Knowing the routines

Breastmilk is best- Every normal newborn is helped to breastfeed right at birth and establish skin to skin contact with the mother.
Lactation experts counsel each and every family.
Written handouts about breast feeding are available.
Your baby would be examined by a Neonatologist at least twice a day
Newborn screening is done for:

• Congenital Hypothyroidism
• Congenital Adrenal Hyperplasia
• Hearing defects
• Congenital cyanotic heart disease
• Neonatal jaundice
• Neonatal anthropometry (growth assessments)

Jaundice screening involves clinical examination, transcutaneous bilirubin assessments and blood tests. Detailed follow up plans are communicated to you before discharge.
Vaccinations according to the latest recommendations are administered

Follow up of normal and high risk neonates

Our consultants are available in the out patient services every day of the week.
We are proud of our High risk follow up program with dedicated Developmental Pediatrician, developmental therapists to assess and help babies.

Teaching and training

We have been training Fellows and Superspecialists in the field since …..under the auspices of National Board of Examinations, Indian Academy of Pediatrics and National Neonatology Forum. More than 45 doctors have completed their training programs and are practising successfully all over the world. We believe that continuous education and experience are what makes our team strive to get better and better.

Parent participation

“Love is the chain whereby to bind a child to its parents”
 
Abraham Lincoln

We believe that parents play a vital role in a baby’s recovery to health. Hence we have no visitation restriction for parents 24X7, communicate every plan and event with you, and involve parents in care processes right from the start.

Postnatal classes

No doubt or query is silly!
We understand that as parents , you want to do all the right things for their baby, and thus you have many doubts about several things that may seem minor. We conduct daily education sessions on normal newborn care and feel it would benefit you if one class is attended before you go home.

At delivery

Be rest assured, that every delivery (even those expected to have no complications whatsoever) are attended by trained Pediatricians who are well versed in Newborn resuscitation. The baby is examined at birth itself to help those who need immediate help.

Getting prepared:

Apart from “medical check ups” for our pregnant mothers, we conduct “Antenatal education sessions”. These are detailed and interactive; conducted by many specialists including Senior obstetricians, Senior nursing staff, dieticians, physiotherapists and Neonatologists. We enjoy talking to you and listening to your queries, and are quite sure you would too… especially when you get to meet other families who are awaiting the arrival of their “bundle of joy”.

Dear parents/ grandparents/ family of a newly born

The birth of a baby is undoubtedly the most precious and happiest moment in our lives. When all goes well through pregnancy and your baby is expected to be born soon, here are some important facts that would help …
We at KIMS work as a team – the Obstetrics and Perinatology department with the Department of Neonatology.

Speech and Language Therapy

Speech and language therapy is the treatment for individuals with speech and language disorders. It will help to improve speech, language, communication, articulation, fluency and feeding skills in individuals with difficulties. We provide with effective individual sessions which include 45 minutes of therapy for the child and 15 minutes of parental counseling and training . Each sessions are individually tailored to the child’s needs and specific goals are taken for the betterment of the child. The session are completely transparent and the parents are involved in each session as they are also the crucial member during the intervention

Speech and language therapy Service are Provided children with

• Speech & Language Delay
• Speech Sound Disorder (Clarity Issues)
• Stuttering
• Autism
• Hearing Impairment
• Cleft Lip And Palate
• Apraxia Of Speech
• Global Developmental Delay
• Multiple Disability (Cerebral Palsy, Downs Syndromes)
• Mental Retardation (MR)

Learning Enhancement Programme

Poor scholastic achievement of children is a major concern for parents, teachers and the children, themselves in this present day of competitive world. An unrecognized and unresolved educational backwardness can cause lifelong impact on the child and the family. KIMS Learning Enhancement Centre helps in understanding the cause of the learning difficulties and gives systematic training to overcome it and become successful learners. We believe that every child has the ability to learn and succeed given the correct training and environment .We train children to develop thinking skills and langue skills to become competent and confident learners.

Who will benefit

• Children with Specific Learning Disabilities – Dyslexia, Dysgraphia, Dyscalculia
• Children with learning difficulties due to varied causes like langue delays, inadequate training and inattention
• Slow learners who may need differential instruction to acquire academic skills

Our Techniques

Orton – Gillingham multi sensory teaching strategies
Kansas University Satrategic Instruction Model (SIM)
NILD Education Therapy (National Institute for Learning Development)
RxDiscovery Math programme –
Rx for Discovery Reading
Instrumental Enrichment Programme (FIE)

Programmes and Therapies

Remedial Educational Training Programme – A programme for children with learning disabilities and learning difficulties using Internationally acclaimed techniques .It is tailor made programme for the needs of each child . It is a one to one session for one and half hours , minimum weekly twice aimed at building up basic academic skills like reading , spelling , writing , reading comprehension , language, and maths using multi sensory techniques . We aim at making children independent learners who can learn effectively .Along with the child training, we also equip parents to teach them by education then in the basic methods of teaching .

Online Remedial Educational Training program – As Remedial education is a specialized training available in limited centers in major cities , we provide online training for children who are residing in other districts or suburbs for whom it is not feasible to come for direct sessions to the hospital .

Education therapy – In this one on one therapy , an educational therapist will work with the child to overcome the learning challenges by strengthening the core skills like perception , cognition , emotional regulation and academic .This in turn will help the child to improve their ability to think, reason, and process information effectively . The goal of education therapy is to help children develop tools of independent learning in classroom and in life.

Study skills correction programme – Knowledge of effective study skills make meaningful and effective learners. We equip the children to understand the concepts, organize it meaningfully, retrieve information using efficient memory techniques, and present it effectively using specialized techniques and strategies.

Academic support and training for school dropouts – We provide guidance and training for children who had discontinued formal schooling, to appear for secondary and senior secondary examination conducted by the NIOS – National Institute of Open Schooling.

Attention Training Progamme and Behavior Management Programe – Difficulties in sustaining attention, , Hyperactivity ,Poor Impulse control and poor anger management may have many detrimental effects in the child’s academic and social life .This programme is aimed at training children improve concentration , academic skills and behavior and to become better functioning individuals .

Life skill training for slow learners /Intellectual disability – We provide tailor made training for young adult who are not equipped to live independently, with basic literacy training , interpersonal communication skills ,daily living activities , time and money management skills.