FORM 2

THE PATENT ACT 1970

(39 OF 1970)

&

THE PATENTS RULES  2003

COMPLETE SPECIFICATION

(See SECTION 10  RULE 13)

1.TITLE OF THE INVENTION :

TRAINING KIT OF WEIGHT ADJUSTABLE MANNEQUINS AND CUSTOMISED NEONATAL GROWTH MONITORING CHARTS
2.APPLICANT

NAME : KRISHNA INSTITUTE OF MEDICAL SCIENCES

NATIONALITY: DEEMED TO BE UNIVERSITY DECLARED
U/S 3 OF UGC ACT  1956 VIDE
NOTIFICATION NO. F.9-15 / 2001 – U-3 OF
THE MINISTRY OF HUMAN RESOURCES
DEVELOPMENT  GOVT.OF INDIA

ADDRESS : KRISHNA INSTITUTE OF MEDICAL SCIENCES 
NEAR DHEBEWADI ROAD  MALKAPUR  KARAD
MAHARASHTRA  INDIA

3.PREAMBLE TO THE DESCRIPTION
PROVISIONAL

N / A COMPLETE

The following Specification particularly describes the nature of this invention and the manner in which it is to be performed :

4. TECHINICAL FIELD

The present invention relates to medical sciences and more particularly to the field of paediatrics wherein the Birth Weight Specific Colour Coded (BWSCC) Daily Neonatal Growth Monitoring Charts and weight adjustable Mannequins are devised which will help in training of the health workers in weighing baby  use of charts and subsequently use of the BWSCC Daily Neonatal Growth monitoring Charts in the field and take appropriate action using colour coding.
5. BACKGROUND
Infant mortality is decreasing but there is no significant reduction in neonatal mortality. Janani Suraksha Yojana (JSY) is being implemented for encouraging women to accept institutional deliveries. At present it is estimated that 90% of the deliveries in Maharashtra are Hospital/health centre deliveries. “Navjat Shishu Suraksha Karyakram (NSSK) is being implemented all over Maharashtra to improve and render standardised new born care immediately after birth. UNICEF has been providing support and expertise for training of birth attendants at all levels. All these initiatives are expected to reduce the mortality of the new born within 48 hours of birth.

Birth weight of the baby is one of the most important parameters to judge the growth of the foetus in the uterus and is related to survival of the baby in neonatal period. By knowing the birth weight the baby can be categorized into different weight groups. At present majority of deliveries in rural areas take place in primary health canters or private hospitals with facility of weighing of the baby.

Under Reproductive and Child Health Programme (RCH) II and Integrated Management of Neonatal and Childhood Illness (IMNCI) programmes the health workers are expected to undertake home visits to provide Maternal and Child health care after discharge of mother and baby from the institution. Growth monitoring is one of the best objective parameter to know baby’s well-being. The paediatricians can compute the expected weight on a given day by knowledge of birth weight and using mathematical formulae or percentile charts. Such computation of expected weights is difficult for health workers. At present there are no daily growth monitoring charts available for health workers to monitor the growth of the neonate. Existing growth monitoring charts are based on weekly or monthly growth monitoring pattern and hence cannot be used for daily growth monitoring during neonatal period. To bridge this gap the Birth Weight Specific Colour Coded Daily Neonatal Growth Monitoring Charts are prepared for health workers. All health workers are not well conversant with the weighing of the baby. If they have to undertake growth monitoring  they have to weigh the baby  plot the weight against the day after birth on which the weight was actually taken  in the growth monitoring chart; interpret the existing weight in relation to expected weight and take appropriate action to provide optimum neonatal care to the baby. At present there is no training kit or mannequins available for this purpose.

6. SUMMARY
Hence a TRAINING KIT OF WEIGHT ADJUSTABLE MANNEQUINS AND CUSTOMISED NEONATAL GROWTH MONITORING CHARTS is a training kit for health workers consisting of four patterns of neonatal growth monitoring charts and four mannequins corresponding to four birth weight groups  namely Group I – 1000gm to 1499gm  Group II 1500gm to 1999gm  Group III 2000gm to 2499gms  Group IV – 2500gm and above. With the help of this kit any health worker can be trained to accurately weigh the mannequin  plot the weight at the appropriate day after birth  interpret the growth of the baby as satisfactory  less satisfactory or unsatisfactory corresponding to green  yellow and pink coloured zones on the growth monitoring charts and take recommended action of continued care at home (Green Zone)  supervised care at home (Yellow Zone) or referral for specialist care (Pink Zone).
Graph 1 is used for birth weight group I. On X axis the day of birth is indicated as day 0 and 28 days thereafter as day 1 to 28. On Y axis an arrow is put at birth weight where the “Birth Weight (A) ?” is to be entered. Then 25gms are to be added to the birth weight and written on each bold blue line above the arrow of the birth weight and 25gms are to be subtracted from the birth weight and written on each bold blue line below the arrow of the birth weight. Now the growth monitoring chart is ready for monitoring the growth of a baby of desired birth weight from Group I of 1000gm to 1499gm (Pattern I).

Graph 1

Similarly Pattern II (Group II and Graph 2 of 1500gms-1999gms birth weight) & Pattern III (Group III and Graph 3 of 2000gms-2499gms birth weight) & Pattern IV (Group IV and Graph 4 of 2500gms + birth weight). Thus ‘Neonatal Growth Monitoring Charts’ can be custom made for any birth weight after selecting the pattern for afore said patterns depending on the birth weight of the baby to be monitored.

Graph 2

Graph 3

Graph 4

While constructing currently prepared Birth Weight Specific Colour Coded Daily Neonatal Growth Monitoring Charts magnitude  duration and velocity of weight change for respective 4 birth weight groups from earlier research work and figures quoted in slandered paediatric books are used. Since daily weight change is largely dependent on birth weight of the baby  for the four afore said birth weight groups the mean birth weight value for each birth weight group has been taken for compilation of expected growth curve line e.g. for 1000gm to 1499gm (Group I)  the expected growth curve has been drawn using 1250gm as mean birth weight value of the group and weight changes applicable to that birth weight. Similarly the mean birth weight values of 1750gm  2250gm and 2750gm have been used for constructing expected growth curves for Group II  III and IV respectively. A parallel arbitrary line to this expected growth curve line has been drawn to demarcate unsatisfactory growth by lesser than 50gm  75gm  100gm and 125gm for I to IV birth weight groups (Graphs 1 2 3 and 4). These unsatisfactory growth curve lines in all the four patterns of birth weight groups roughly indicate failure of growth of babies for 2½ to 3 days from birth.
The colour coding used is green as indicating satisfactory growth  yellow indicating less than satisfactory growth between expected growth curve line and unsatisfactory growth curve line and pink colour indicating growth below unsatisfactory growth curve line. (Refer to I to IV patterns of growth curves  Graphs 1- 4 corresponding to I to IV Birth Weight Groups).
To enable the health workers to weigh a baby and plot the weights serially on the neonatal growth monitoring chart  a set of four weight adjustable mannequins has been prepared. The base line weights of these four mannequins have been adjusted exactly to 1000gm  1500gm 2000gm and 2500gms respectively to correspond to the minimum birth weight of corresponding four birth weight groups of the ‘Birth Weight Specific Colour Coded Growth Monitoring Charts’ (Pattern I to IV)
In order to make the mannequin weigh exactly equal to these minimum value of the groups  a metallic block of required weight is put in the weight box which has been put in the space created at the backside of each mannequin. Thus the mannequins are made to weigh the minimum weight of the four birth weight groups identified for the four growth patterns depicted in the four patterns of the growth curves (Pattern I to IV). Henceforth called as ‘Baseline weights of the mannequins’.
Metallic rings each weighing 25gm are used to achieve the weight corresponding to the desired birth weight of a baby in the given birth weight group. This could be achieved by adding required number of rings to the weight box of that mannequin. By this procedure the weight of the mannequins can be made to correspond with any birth weight from 1000gm or above e.g. if the baseline weight of the mannequin is 2000 and the health worker is to be tested for birth weight of 2200gm  then 6 rings of 25gm are to be added to the weight box of the mannequin so as to make that mannequin weigh 2200gm. Corresponding to the desired birth weight to be tested henceforth call as ‘Desired Base line Birth Weight of the mannequin’.
Now to make the mannequin mimic the growth pattern of the baby with a given birth weight  required number of rings  each weighing 25gm are put in a string around the neck of the mannequin to make it weight equal to the desired weight on a particular day after birth e.g. If the weight of baby on 10th day has been 2400gm whose birth weight has been 2200gm  then after achieving weight of 2200gm  then after achieving weight of 2200gm as ‘Desired Base Line Birth Weight of the mannequin’ by adding four rings in the weight box of the mannequin with baseline weight of 2000gm  a string containing 8 rings is put around the neck of the mannequin to get 2400gm weight. Thus a baby of any weight can be mimicked by adjusting the weights in the weight box and the string around the neck of the mannequin prepared for the concerned birth weight group.
Thus the mannequins are used to simulate a baby and health workers are trained to weigh the mannequins of any given weight accurately. Which can be objectively tested on a standard weighing machine with 25gm least count.
Now the health workers are given examples of different weights on different days after birth and the health workers are taught to put the weight accurately on the growth charts  after identifying the correct pattern from the four patterns of growth charts. The health workers are trained to correctly mark the ‘x’ weight on n th day of birth.
Now the interpretation of the graph is taught to the health workers. The birth weight specific daily growth monitoring charts are colour coded and if the weight of the simulation mannequin on given day falls in green colour the baby is doing well  in yellow colour  it indicates less than satisfactory growth between expected growth curve line and unsatisfactory growth curve line. And if it is in pink colour  it indicates unsatisfactory growth.
This set of weight adjustable four mannequins along with the four patterns of growth curves make a ‘Training Kit’ using which any health worker can be taught  the basic skills of weighing of the baby  monitoring of the growth of a neonate on the ‘Birth Weight Specific Colour Coded Daily Neonatal Growth Monitoring Charts’  interpret the growth chart by use of colour coding and take appropriate action.
It is the concept of customised design of growth monitoring charts and customised changeable weights of the mannequins which is important. Using the same principle any variant in the kit for any other age group. It is flexibility and adaptability to the given situation which makes it unique.
Although visit schedule is fixed for the health workers under RCH II and IMNCI programme  the actual day of visit and schedule day of visit may change due to holiday or some other reason. The growth monitoring charts being designed for the daily monitoring they can be used on any day. Thus making them applicable to be used on the day of visit by the health worker from birth to 28th days of life.
Being a daily growth monitoring chart  growth of a neonate can be monitored on any day between birth to 28th days of life.
7. BRIEF DESCRIPTION OF DRAWINGS:
Fig. 1 is a front view of four mannequins corresponding to four birth weight
groups.
Fig. 2 is a back view of a mannequin showing space for keeping the weight box.
Fig. 3 is weight box.
Fig. 4 is Metallic rings threaded in a string.

8.DETAILS DESCRIPTION OF DRAWINGS:
Fig. 1 Front view of Mannequin. Smallest to biggest mannequins (1  2  3 and 4) are arranged to depict birth weight groups I to IV – namely 1000gm – 1499gm  1500gm -1999gm  2000gm – 2499gm  2500gm +.
Fig. 2 Back view of a mannequin (5) depicts space for keeping weight box (6).
Fig. 3. Weight box (6) contains a metallic block (7) for adjusting the baseline weight of the mannequin i.e. exactly making the minimum weight of the four birth weight groups namely 1000gm  1500gm  2000gm and 2500gm respectively. The weight box 6 also has a space for keeping rings of 25gms each (8)
Fig. 4. A string (9) with rings (8) for adding the weight to the Desired Baseline Weight of the mannequins to achieve the requisite weight of the mannequins.

9.I claim

1. The TRAINING KIT OF WEIGHT ADJUSTABLE MANNEQUINS AND CUSTOMISED NEONATAL GROWTH MONITORING CHARTS is used for training of all health workers regarding growth monitoring  to weigh the mannequin accurately  to choose appropriate growth monitoring charts (Pattern I to IV) for a given birth weight  to prepare a customised growth chart for a given birth weight of a baby  to put given weight at the appropriate place on the growth monitoring chart  to interpret the growth of the baby as satisfactory  less satisfactory or unsatisfactory corresponding to green  yellow and pink coloured zones on the growth monitoring charts and take recommended action of continued care at home (Green Zone)  supervised care at home (Yellow Zone) or referral for specialist care ( Pink Zone) by use of colour coding and to enable the health workers to use the neonatal growth monitoring charts in practice.

Dated this 19th Day of November  2012

DR.M.V.GHORPADE
(REGISTRAR)
FOR KRISHNA INSTITUTE OF MEDICAL SCIENCES

To
The Controller of Patents 
The patent office 
At Mumbai – 400 037

10.ABSTRACT OF THE INVENTION

TRAINING KIT OF WEIGHT ADJUSTABLE MANNEQUINS AND CUSTOMISED NEONATAL GROWTH MONITORING CHARTS is a training kit for health workers consisting of four patterns of neonatal growth monitoring charts and four mannequins corresponding to four birth weight groups  namely Group I – 1000gm to 1499gm  Group II 1500gm to 1999gm  Group III 2000gm to 2499gms  Group IV – 2500gm and above. With the help of this kit any health worker can be trained to accurately weigh the mannequin  plot the weight at the appropriate day after birth  interpret the growth of the baby as satisfactory  less satisfactory or unsatisfactory corresponding to green  yellow and pink coloured zones on the growth monitoring charts and take recommended action of continued care at home (Green Zone)  supervised care at home (Yellow Zone) or referral for specialist care ( Pink Zone).

DR.M.V.GHORPADE
(REGISTRAR)
FOR KRISHNA INSTITUTE OF MEDICAL SCIENCES