|HEALTH & FITNESS|
Binge at bedtime to
Soft drinks make
designs nanocell to kill cancer
Diarrhoea a major
threat to children’s health
Acute diarrhoea remains a great public health problem in developing countries. The morbidity and mortality is still very high. Better understanding of the problem and its management in time has helped to control it to a great extent. The poor standards of hygiene and sanitation, lack of breast feeding and nutritional education, malnutrition, illiteracy and ignorance important predisposing factors in children.
The treatment of acute diarrhoea should start immediately at home. This consists of oral rehydration therapy (ORT) and the continuation of nutrition in the child.
Oral rehydration therapy
Parents can give plain tap water, salt and sugar solution (two finger-pinch of salt plus one teaspoonfull of sugar plus one glass of water), shikangabi, rice water, lassi, coconut water, etc, available at home. In case the oral rehydration solution (ORS) packet is available at home, this can be used. Dissolve this in one litre of water and give around 50-100 ml for every loose stool. This is called Plan-A according to WHO recommendations.
These fluids will prevent the dehydration to occur. Mothers should be asked to continue the feeding of children with diet whatever child was being given before the onset of diarrhoea. Diet has a very important role to prevent PEM in the child. Infants should get breast-feeding during diarrhoea. Don’t withhold diet during diarrhoeal illness; rather try to give more to compensate the losses.
When there is some dehydration this shows that the child needs ORS 75ml/kg over 4-6 hours till he/she is well hydrated and passes urine. This is called Plan-B according to WHO guidelines. Subsequently, for further losses 50-100 ml ORS can be given to prevent further dehydration to occur. ORT should be given preferably with spoon and katori so that whatever goes inside, gets absorbed. ORS should not be given in large volume. This may induce vomiting.
As soon as hydration is achieved, ORS with low sodium can be continued depending upon the stool loss alongwith the normal diet whatever the child was taking before. Injudicious intake of ORS can lead to osmotic diarrhoea and in this situation ORS can become a dehydrating fluid. Use only when it is really needed.
Due to severe diarrhoea and poor intake, a child can develop severe dehydration and a shock state. This is the situation where isotonic IV fluids upto 100ml/kg can be given fast to replenish the deficit fluids. This is called Plan-C. This is only possible in hospital settings. After the deficit correction, the orally ORS 50-100 ml per stool can be continued to prevent further dehydration.
Every treating physician should follow the slogan of "Treat Diarrhoea with Diet" and pass the resolution to follow it religiously. Dietary manipulation depend upon the age of the child, pre-illness feeding pattern, pre-illness weight, duration of illness and type of infection and dehydration. Breast-fed infant should get breast-feeding continuously. If cereals have been introduced then cereal and pulse-rich diet alongwith curd or yoghurt should be given till the diarrhoea settles. It is palatable and better tolerated.
There is not much role for an indiscriminate use of antibiotics in acute diarrhoea. However, there are certain definite indications to use antimicrobial agents.
Traditional practices to be avoided
Antimotility and anti-spasmodic agents should not be given during acute diarrhoea. They prevent the natural clearance of infection rather predispose to paralytic ileus and more infection. Lomotil, loperamide and other antispasmodic drugs are banned to be used in diarrhoea in children. Stool-binding agents like pectin and kaolin are not of much help. They give false sense of security and prolong the infection. These agents are now banned for use in paediatric patients. There is no role for bowel rest in acute diarrhoea.
Steroids should never be used in acute diarrhoea. It is very rare to use IV fluids. All types of dehydrations can be managed with ORT. IV fluids are indicated in certain situations like severe dehydration, shock, persistent vomiting, paralytic illeus, septicemic child, pyomeningitis, raised intracranial tension due to cerebral thrombosis, intususception, etc. Antimicrobial agents should never be used indiscriminately. These help in prolongation of diarrhoea. Bottle-feeding should be discouraged as far as humanly possible.
It is a very good habit to wash the hands with soap and water. This can avoid commonly-acquired bacterial infections. Proper hand-washing is mandatory after defecation and cleaning the bottoms of infants and younger children and also before eating, cooking and serving food. The nails of the children should be trimmed twice a week. Drinking water should be clean and properly chlorinated. It should be free from any fecal contamination and rainy water.
Continuous tap water supply is preferred provided there is no leakage of water. Proper disposal of fecal matter takes care of most of the diarrhoeal diseases. Use of sanitary latrines is quite helpful in this regard. Eating of out and rotten fruits, kept in open should be avoided.
Flies help in spreading the various enteric infections. Proper sanitation of surroundings will take care of the fly menace. Promotion of personal, food and domestic hygiene is very important. Exclusively breast-fed infants do not suffer from diarrhoea. Breast milk acts as "Aseptic paint" in GIT hence prevents the enteric infections. Promotion of exclusive breast-feeding for 4-6 months of life will improve the health of the baby to fight against any infection. This prevents the occurrence of bacterial infection during early infancy.
Proper weaning with cereals at the age of four months under proper hygienic conditions is very important, as the needs of the baby go on increasing. Cereals and pulses will meet with the needs subsequently and keep the baby healthy to fight against any diarrhoeal illness. Low birth babies are more prone to enteric infections due to the non-availability of breast-feeding. So, proper antenatal care, nutritional education of mothers and encouragement for breast-feeding have a great role to play to prevent diarrhoea in low birth-weight babies.
So, diarrhoea is a nutritional problem and leads to dehydration and malnutrition.
The writer is Additional Professor and Chief, Division of Paediatric Gasteroenterology, PGI, Chandigarh.
London: A new study published in the Lancet and conducted at the National Institute on Ageing in Baltimore suggests that a binge before bedtime could be the key to losing weight.
According to Daily Mail, the ‘blowout’ diet not only lowers blood pressure butt also protects against heart disease and strokes. American neuroscientist Dr Mark Mattson has tested the regime on rats and is now looking at what happens when humans fast by day and feast in the evening.
In his experiments, rats were starved one day and allowed to gorge the next. They lost weight and lived longer than rats which were allowed to eat as and when they liked.
The rats lost weight after eating up to 40 per cent less food. They also had lower blood pressure, clearer arteries and a lower risk of developing diabetes.
The study also showed the blowout diet can protect against cancer and conditions such as Alzheimer’s. "Our basic metabolism was set up when we were hunter-gatherers," he explained. The pattern would be a mixture of feast and famine. Maybe we’d go several days without food, then splurge when a supply was found. — ANI
Washington: A new study conducted by researchers at the University of Cincinnati suggests that drinking large amounts of beverages containing fructose adds body fat, and might explain why sweetening with fructose could be even worse than using other sweeteners.
The team led by Matthias Tschvp allowed mice to freely consume either water, fructose sweetened water or soft drinks. They found increased body fat in the mice that drank the fructose-sweetened water and soft drinks — despite that fact that these animals decreased the amount of calories they consumed from solid food.
It suggests that the total amount of calories consumed when fructose is added to diets may not be the only explanation for weight gain. Instead, consuming fructose appears to affect metabolic rate in a way that favours fat storage.
All the mice began the study at an average weight of 39 grams. Those consuming the fructose-sweetened water showed significant weight gain over the course of the study, with an average final weight of 48 grams — compared with averages below 44 grams for the other groups — and had about 90 per cent more body fat than the mice that consumed water only.
Total caloric intake was lower in the mice that consumed the fructose-sweetened water than in the other groups, except for the control animals provided with water only.
"We were surprised to see that mice actually ate less when exposed to fructose-sweetened beverages, and therefore didn’t consume more overall calories. Nevertheless, they gained significantly more body fat within a few weeks," Tschvp added. — ANI
Washington: Researchers at the Massachusetts Institute of Technology have designed a dual-chamber, double-acting, drug-packing "nanocell" proved effective and safe, with prolonged survival, against two distinct forms of cancers, melanoma and Lewis lung cancer in mice.
The team led by Ram Sasisekharan loaded the outer membrane of the nanocell with an anti-angiogenic drug and the inner balloon with chemotherapy agents. A "stealth" surface chemistry allows the nanocells to evade the immune system, while their size (200 nanometers) makes them preferentially taken into the tumour. They are small enough to pass through tumour vessels, but too large for the pores of normal vessels.
Once the nanocell is inside the tumour, its outer membrane disintegrates, rapidly deploying the anti-angiogenic drug. The blood vessels feeding the tumour then collapse, trapping the loaded nanoparticle in the tumour, where it slowly releases the chemotherapy.
The team tested this model in mice. The double-loaded nanocell shrank the tumour, stopped angiogenesis and avoided systemic toxicity much better than other treatment and delivery variations. The nanocell worked better against melanoma than lung cancer, indicating the need to tweak the design for different cancers. — ANI
You rub and rub your
eyes, but they won’t stop itching. When you look in the mirror, they
are red and puffy with a lot of discharge. What’s going on? Do you
have a strange sickness? No, you have a common problem called
Conjunctivitis is the most common eye problem children can have. It is an inflammation of the conjunctiva, the clear membrane that covers the white part of the eye and lines the inner surface of the eyelids. Many people know the more common name for conjunctivitis- pink eye/eye flu.
Conjunctivitis/Eye Flu is very common in the rainy season because the bacteria tend to grow much faster in hot and humid environment.
Types of conjunctivitis:
1. Infectious conjunctivitis is usually caused by either bacteria or viruses.
2. Allergic conjunctivitis occurs more frequently among children with allergic conditions such as hay fever/asthama.
3. Irritant conjunctivitis can be caused by chemicals such as those in chlorine (chlorinated water in swimming tank) and soaps or air pollutants such as smoke and fumes.
Signs and symptoms
The different types of conjunctivitis can have different symptoms. In addition, symptoms may vary from child to child or person to person.
Is it contagious?
All types of infectious conjunctivitis are contagious and can spread from one eye to the other by touching the eyes.
The infectious organisms can also spread through coughing and sneezing. In addition, certain viruses spread in the summer time when children swim in contaminated water or share contaminated towels.
Allergic and irritant conjunctivitis is not contagious.
Can it be prevented?
To prevent infectious conjunctivitis, teach your child to wash his or her hands often with warm water and soap. Children also should not share eye drops, tissues, eye makeup, wash cloths, towels, or pillow cases with other people.
How long does it last?
Bacterial conjunctivitis lasts about a week. Viral conjunctivitis and the resulting inflammation can last two weeks or sometimes even longer.
How is it treated?
Medical treatment for most cases of bacterial conjunctivitis consists of prescription antibiotic drops or ointment for the eyes. The medication is usually given for about one week. Although viral infections typically do not require antibiotics, your doctor might treat a suspected case of viral conjunctivitis with eye drops or ointment to prevent an additional bacterial infection or because it might be difficult to determine whether the infection is caused by a bacterium or a virus.
To make your child comfortable during a bout of conjunctivitis, you can offer cool or warm compresses and crocin or ibuprofen, if necessary. Parents can clean the edges of the infected eye carefully with warm water and gauze or cotton balls. This technique can also be used to remove the crusts of dried discharge that may cause the eyelids to stick together when the child wakes up in the morning.
The Writer is Chairman and Medical Director, Centre for Sight, New Delhi.
Called enuresis in medical terminology and "shayya mootra" in ayurvedic parlance, bedwetting is the unintentional or involuntary discharge of urine during sleep. Most of the children between the age of three to five years begin to stay dry at night, but the time when they are physically and emotionally ready to control their bladder varies. By the age of 10, enuresis affects about 3 to 5 per cent of children with boys suffering more than girls. In very rare cases, bedwetting is reported to have continued even after attaining puberty.
Though a number of factors are considered responsible for enuresis, no one knows what are its definite reasons. Ranging from a smaller bladder resulting due to the developmental delay to poor muscle control and from excessive formation of urine to certain hormonal imbalances, experts have been busy finding the exact reason of bedwetting. Sometime psycholoical reasons like emotional insecurity such as birth of a sibling, death in the family, parental disharmony and loneliness and fear of school or studies are also counted as possible reasons for prolonged episodes of bedwetting.
Enuresis in general doesn’t result in any other long-term problem except causing a sense of guilt and embarrassment to the child. This problem is often confounded when parents, instead of finding a solution, start punishing the child. Humiliated by frustrated parents and teased by friends and relatives, the child usually develops low self-esteem and other psychological complexes. In less educated families and lower strata of society, specially in the case of the girl child cases of bed-wetting are more often mishandled.
Occasional bed-wetting should not be considered a disease. Most of the children gradually outgrow this problem without any treatment. If bedwetting is frequent, regular and occurs even during the day, it should be tackled not only medically but at other levels also. Initially, applying psychotherapy is the best option as it yields good results where no other physical or physiological reasons are found to be present.
A child’s psychological deprivations and disturbances should be properly handled. He should be taught to urinate before going to bed and avoid taking liquids after dinner. Excessive use of aerated drinks and juices and too much viewing of TV should also be discouraged. Parents’ attempt to motivate and encourage the child not to wet the bed accompanied by positive enforcement like praising and rewarding him for staying dry also help resolve the condition. At no point should the child be scolded or insulted for a thing which is not under his control.
Unless there are pressing reasons like infections of the urinary tract, medications should be started only if the child is more than five years of age. Thread worms are also an important reason for bed-wetting and to counter it the child should be trained to maintain hygiene and keep his bowels regular and clear. Bladder stretching exercises like holding urine a little longer during the day and practising repeated starting and stopping of the stream at the toilet bowl also help in some cases.
While treating enuresis, Ayurveda aims at using the medicines which strengthen the neuro-muscular functioning of the bladder. Chandra Prabha Vati, Bahumootrantak Rasa, Indra Vati, Tarkeshwar Rasa and Brahmi Vati are some of the classic medicines which really help. One should always remember that right parental care and support is the most important thing which not only restores confidence of the child but also facilitates fast recovery from bedwetting.
The writer is a Ludhiana-based senior ayurvedic physician.