HEALTH & FITNESS

How to help children get sound sleep
It is ideal when a child goes to sleep without much difficulty, sleeps deeply and soundly throughout the night without waking up, and is refreshed and active the next morning. Good sleep means good physical and mental health.

Low back pain: change your lifestyle
Low back pain occurs due to various reasons and is not always due to muscle strain or prolapsed disc as is widely believed.

Ageing and ‘attrition’ of teeth
There are mainly three conditions that lead to the loss of teeth as you age: (i) dental caries, (ii) gum disease and (iii) wearing down of teeth, which dentists refer to as “attrition”.

Health Notes

Stem cell breakthrough may offer possible cures for diabetes
Scientists find new origin for a critical immune response
Broccoli, cabbage can help fight skin cancer

 

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How to help children get sound sleep
Dr Vivek Sharma

It is ideal when a child goes to sleep without much difficulty, sleeps deeply and soundly throughout the night without waking up, and is refreshed and active the next morning. Good sleep means good physical and mental health.

But in some children insomnias (meaning difficulty in falling or staying asleep) are common and frequently brought to attention.

Frequent night awakening

It is a common sleep problem particularly in children aged between six months and
four years.

These children are also more likely to have behavioural problems during the day, particularly tantrums.

Factors precipitating night awakening

1. Difficult temperament

2. Neuro-developmental problems

3. Maternal depression

4. Family stress

5. Parental responses such as night-time feeding and co-sleeping

6. Non-adaptive sleep associations — a child cannot recreate himself for falling asleep while feeding. These children would not settle to bed until the sleep associations were recreated by care-givers.

Examples of non-adaptive sleep associations

Falling asleep while breast-feeding or bottle-feeding

While being held by a parent

Asleep outside the bedroom and being brought into the bedroom asleep

Asleep with a pacifier that the child cannot put back in his/her month

Difficulty settling into bed

It is a very common problem. It starts in the pre-school age and by the elementary school age (5-12 yrs.) it becomes the most frequent sleep problem.

It often correlates with the time that a child moves from a crib to bed and is not easily contained.

Developmentally, it corresponds to the time that the child is exerting his/her independence from the primary care giver.

Delayed sleep phase syndrome

It refers to a shifting of the biological sleep clock forward. The child/adolescent falls asleep late and wakes up late in the morning.

How parents can help these children

Structured bed-time routine

Teaching a child to fall asleep alone on a bed

Decreasing night-time breast-feeding/ bottle-feeding

Praising “good” night-time behaviour

Prevention of unnecessary night awakening

Teaching the child how to fall asleep alone (chair-sitting routine)

Resetting the circadian clock — For children who have moved the bed-time and awakening time forward by two to four hours the parent should be counselled to move the awakening time in the morning earlier by 15 minutes to half an hour every day until the desired rising time is reached. This can be followed in a few days’ time by moving the bed-time earlier.

Medication is rarely used in children who are developing normally. It can be considered in children with neuro-developmental disorders resistant to behavioural management. Medication is considered a second line approach and should be used in conjunction with a behavioural intervention programme.

Children’s sleep habits and sleep comforts are very much influenced by their parents’ approach to bringing them up.

The writer is a Consultant Paediatrician, Rungta Hospital, Jaipur. Email: drvivek_sharma@rediffmail.com.

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Low back pain: change your lifestyle
Dr Ravinder Chadha

Low back pain occurs due to various reasons and is not always due to muscle strain or prolapsed disc as is widely believed.

Middle-aged and elderly individuals suffer from lumbar canal stenosis, which is the cause for low back pain.

The size of the lumbar canal decreases from 15 mm-20 mm to 10 mm or less.

Individuals with chronic low back pain are more prone to suffering from lumbar canal stenosis. As lumbar canal stenosis progresses slowly, the diagnose is delayed.

Such individuals experience pain in the back and legs with numbness and weakness.

However, this should be differentiated from a condition that is called vascular
claudication (where pain occurs in the buttocks and lower extremities with a
decreased pulse rate).

Pain due to lumbar canal stenosis is exaggerated on standing and walking, and alleviated on rest/sitting whereas pain after disc prolapse or muscle strain increases while bending forward or on prolonged sitting. More men suffer from this condition than women.

An MRI examination of the lumbar spine demonstrates narrowing of the lumbar canal with the compression of the nerve roots, herniated discs, facet joints and soft tissue structures.

Symptoms

Pain which increases during walking/ prolonged standing and is alleviated on sitting and bending forward.

Experiencing of stooped posture while walking.

Leg fatigue, numbness and weakness as though the extremities are giving up.

Symptoms could initiate from the feet spreading towards the legs or sometimes vice versa.

Experiencing cramps or sensation of restlessness in legs, especially at night.

Treatment

The aim of the treatment is to relieve the above mentioned symptoms and this includes:

Maintain a healthy body-weight, which would help relieve symptoms and also slow down the progression of the disease.

As individuals with canal stenosis often experience pain while walking and hence change their aerobic activity from walking to cycling.

Medicines to relieve pain.

If the above mentioned measures are not successful, an epidural steroid injection may be recommended.

Exercises: These exercises, if undertaken on a regular basis, go a long way in relieving symptoms.

Both knees to chest: Lying on back with knees bent, pull both knees towards the chest. Holding for a count of five, return slowly. Repeat 10 times.

Hamstring stretch: Lying on the back, raise one leg at about 90 degrees and pull it by holding the thigh. Holding for a count of 15, repeat three times thus experiencing a stretch on the back of the thigh.

Modified sit-ups: Lying on the back with knees flexed, keeping the feet on the floor, and crossing the arms across the chest. Instead of sitting up straight, move forward alternately towards the left and right knee. Repeat this 10-15 times.

Lumbar canal stenosis individuals may improve their quality of life by making various lifestyle changes. Incorporating aerobic activities, undertaking appropriate exercises and reducing weight go a long way in preventing agonising pain and also surgery of the spine.

The writer runs a pain management clinic in Chandigarh E-mail: chadha_r2003@yahoo.co.in.

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Ageing and ‘attrition’ of teeth
Dr H.S. Chawla

There are mainly three conditions that lead to the loss of teeth as you age: (i) dental caries, (ii) gum disease and (iii) wearing down of teeth, which dentists refer to as “attrition”.

Dental caries and gum disease begin quite early in life, but are preventable to a large extent. This requires the following steps: (i) proper brushing right from a young age, (ii) fluoride toothpaste incorporated as soon as the child learns to spit, (iii) intake of sugar in any form, even in very small amounts, is restricted to not more than three times a day, and (iv) eating - whether sweet or non-sweet — restricted to not more than five times a day.

The third factor, wearing down/attrition of teeth is considered normal. But in many individuals this is seen to be excessive. The reason for marked attrition is the grinding of teeth at night and/or during daytime.

Most people who grind their teeth are not aware of this habit. Sometimes your partner’s complaint of a peculiar sound of grinding teeth coming from you at night makes you aware of this habit. Daytime grinding does not come to one’s notice.

Abnormal attrition of teeth

Normally, teeth do attrite with the passage of time, a process which is beneficial for dentition. But habitual grinding of teeth during the day, night or at both times leads to excessive attrition, far more than normal.

It can even occur at a relatively early age. This leads to the shortening of tooth height: the teeth look small.

The grinding of teeth is also one of the causes for the development of cavities in the teeth near the gum-line. This abnormal grinding is detrimental to teeth.

If left unchecked

With the progression of excessive grinding, first the outer hard covering of the teeth - the enamel - wears down.

This exposes the yellow hue of the inner layer - dentine --- of the tooth. The teeth become smaller in size and may become sensitive to heat and cold.

If no treatment is sought, the nerves (pulp) of the tooth become exposed to the
saliva of the mouth.

The involved tooth is likely to pain, and would require root canal treatment.

Another problem associated with the shortening of teeth is that the chin has to travel up to meet the grinding surface of the upper teeth.

This leads to the shortening of the vertical dimension of the face, which results
in the deepening of the fold of skin on the face, in turn leading to the early
appearance of wrinkles.

The way to ascertain if you are a daytime teeth grinder is to observe, at different times of the day, whether your teeth of the upper and lower jaws are in contact while at rest, i.e., are these touching each other?

If so, it is likely that you are a daytime grinder and a candidate for excessive attrition with advancing age.

Similarly, you may be a night-time grinder if you find that your upper and lower teeth are in contact on waking up in the morning or any time at night.

How to prevent daytime grinding of teeth?

It is easy to check the habit of daytime grinding. To achieve this, you should inculcate the habit of consciously keeping a gap of 2-4 mm between the upper and lower teeth all the time when not chewing.

Prevention of nighttime grinding

You should wear a night guard. It is made up of a soft plastic, more or less see-through kind of material. It is custom made for your teeth by your dentist.

It is worn at night and it keeps a gap between the upper and lower teeth, thus preventing the teeth of the upper and lower jaws from coming directly into contact with each other.

You can also mend the habit of night grinding by repeatedly telling yourself to keep a gap of 2-4 mm between teeth before sleeping and each time you find teeth in contact when you wake up in the morning or any time at night.

Can worn-out teeth be reconstructed?

Even if your teeth have already worn down, they can be built up and reconstructed back to normal.

It restores the vertical height of the face and gives a lift up to the face. It is a technical method and your dentist can guide you.

Treatment should be sought as early as possible to prevent the loss of teeth.

The writer, Head of the Dental Department, The Apollo Clinic, Chandigarh, is Permanent Visiting Professor, The University of Leeds, U.K. Email: chawlahs@gmail.com.

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Health Notes
Stem cell breakthrough may offer possible cures for diabetes

London: Scientists have reached a step closer to developing potential treatments for devastating diseases, including spinal cord injury, macular degeneration, diabetes and Parkinson’s disease, thanks to a new method of
creating stem cells discovered by researchers at Mount
Sinai Hospital in Canada.

The researchers say that their study accelerates stem cell technology, and provides a road map for new clinical approaches to regenerative medicine. — ANI

Scientists find new origin for a critical immune response

London: Researchers at the Duke University Medical Center say that an immune system response, key to the first stages of fighting off viruses and harmful bacteria, has an entirely different origin than what has been thought to date.

“This finding will have important implications in vaccine science and autoimmune disease therapy development,” Nature magazine quoted, Dr Michael Gunn, an immunologist and cardiologist at Duke, as saying. — ANI

Broccoli, cabbage can help fight skin cancer

Washington: A new study, conducted on mice, has found that compounds extracted from green vegetables like broccoli and cabbage could be a potent drug against melanoma, a type of skin cancer.

The study found that these compounds, when combined with selenium, target tumours more safely and effectively than conventional therapy.

“There are currently no drugs to target the proteins that trigger melanoma,” said Gavin Robertson, associate professor of pharmacology, pathology and dermatology, Penn State College of Medicine. — ANI

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