I thought to myself that let me educate my countryman with a new approach.
Instead of telling the "dos" and "donts",let me just inform them about the consequences of in-sanitation. We know that majority of killer diseases like diarrhea, dysentery,typhoid,hepatitis, malaria, dengue, tuberculosis,measles ,swine flu, diphtheria,polio, tetanus etc are infectious diseases and all of them are preventable by our own efforts even at individual levels.
The prevention of all of them starts as soon as the baby is conceived.Taking two doses of tetanus vaccine during pregnancy and a safe institutional delivery will prevent neonatal tetanus which certainly is a very cheap prevention of this killer disease.Later in childhood and also in adult life regular immunisation will prevent it throughout life.
Starting mothers milk soon after birth and exclusive breast feeding for at least 6months of life will prevent diarrhea and dysentery.our insanitary habits of introducing bottle feeding out of fashion and many other unjust reasons is killing so many due to diarrhea!Even those who survive are surviving at high cost to individuals and community. Doctors often prescribe antibiotics and many other medicines which are in fact detrimental. Injudicious use of antibiotics is a major concern in drug resistence besides the economic factors and health hazards.
Another insanitation results from giving apple ,anar and palak juice to the baby . one can imagine theunhygeinic method of making these unnecessary juices which no baby needs.
The disease producing microbes are all over in our atmosphere due to our dirty habits. The indiscriminate disposal of human and animal excreta,the waste from homes , the leftover organic and inorganic matter in front of shops, homes ,after sabzi mandis, the fecal contamination of leaking pipes ,the un flushed excreta of blocked toilets, the ditches with stagnant water etc are store houses for germs like hepatitis, typhoid , shigella , ecoli , many parasites which the naked eyes can not see but they are in the air every where clinging to us looking for opportunity to invade us for their survival. The result is all the above diseases. Diarrheas , hepatitis , typhoid , dysentery are waterborne, malaria and dengue are also indirectly waterborne as the mosquitoes survive in stagnant water.
Typhoid is due to , dirty fingers , dirty fluids and flies which survive on feces .look at the cost of treatment of typhoid ,germs are getting resistant. The vaccine is available but how many parents do it regularly? Indiscriminate spitting and similar dirty habits spread the germs of tuberculosis. BCG vaccine at birth prevents tuberculosis to some extent.
Hepatitis of many varieties is waterborne and comes in epidemics killing so many. For some forms we have the preventive vaccines which also has to start right from birth.
Even HIV AIDS can be termed as disease of in sanitation of mind.
Why create diseases threw our dirty habits then research for cure and prevention?
ARISE AWAKE and dream no more fight in sanitation on war footing to save the human misery and economic burden.
Thursday, January 6, 2011
Wednesday, April 7, 2010
Thalassemia minor.
I came across a few people who were diagnosed as thalassemia minor since their childhood but did not know the implications of this diagnosis. Now they are in their process of settling in life.
They have to be put wise or else it could be disastrous.
Any mild anemia can be due to Thalassemia minor and can not be detected unless tested for.
In India commonest anemia is nutrition deficiency anemia therefore doctors put the child on iron without any tests. If the underlying disease is thalassemia than iron load can be dangerous rather than improving the anemia.
The test for this condition is hemoglobin electrophoresis which is easily available.
If found to be having this condition , one should not take iron and MOST IMPORTANT IS NOT TO MARRY A PARTNER WITH THALASSEMIA MINOR. OTHERWISE CHILDREN BORN OF SUCH PARENTS WILL SUFFER FROM THALLESIMIA MAJOR . Thallasemia major is a very serious condition , where child can not live without weekly blood transfusions and methods of bringing out iron overload from the body.
The best is to go in for tests rather than matching Janam patri before marriage.
mind you this condition is pretty common in certain parts of world including Punjab in India.
They have to be put wise or else it could be disastrous.
Any mild anemia can be due to Thalassemia minor and can not be detected unless tested for.
In India commonest anemia is nutrition deficiency anemia therefore doctors put the child on iron without any tests. If the underlying disease is thalassemia than iron load can be dangerous rather than improving the anemia.
The test for this condition is hemoglobin electrophoresis which is easily available.
If found to be having this condition , one should not take iron and MOST IMPORTANT IS NOT TO MARRY A PARTNER WITH THALASSEMIA MINOR. OTHERWISE CHILDREN BORN OF SUCH PARENTS WILL SUFFER FROM THALLESIMIA MAJOR . Thallasemia major is a very serious condition , where child can not live without weekly blood transfusions and methods of bringing out iron overload from the body.
The best is to go in for tests rather than matching Janam patri before marriage.
mind you this condition is pretty common in certain parts of world including Punjab in India.
Tuesday, January 5, 2010
Vaccinations for children in first year of life..
BCG vaccination should be given at birth , it is to prevent Tuberculosis. It can be given at any age if it is missed at birth. in two months it will be followed by a scar. If not , it needs re vaccination.
Polio drops are also administered at birth and are given at 6 week onwards in five doses one month apart in the first year of life. inject able polio is also available which can also be administered from 6 weeks onward along with oral polio.
Polio does not have cure , it results in crippling , but the prevention is simple and effective.
DPT vaccination protects against Diphthria , Whooping cough , and Tetanus. This is injected intra muscularly three times along with polio.
This is available as a pentavalent vaccine also in which polio and hepatitis vaccinations are also combined in the same injection. by this a single shot gives protection against 5 diseases. Diphthria is a serious disease affecting heart muscle , breathing muscles and is rapidly progressive towards death. So is Tetanus , a disease resulting into muscular paralysis and death. Whooping cough too is full of dreaded complications.
Hepatitis B vaccination is also administered at birth , after one month and after 6 months of the first dose. This protects against the dreaded life threatening Hepatitis B disease of the liver.
At 9 months of age Measles vaccination is given intramuscular , to prevent measles which is a contagious disease and is a biggest killer in first year of life in malnourished children. These vaccinations have to be followed with boosters in next few years or else the immunity will be lost. I shall deal with further vaccinations in my next blog. PREVENT DISEASES BY TIMELY VACCINATIONS.
Polio drops are also administered at birth and are given at 6 week onwards in five doses one month apart in the first year of life. inject able polio is also available which can also be administered from 6 weeks onward along with oral polio.
Polio does not have cure , it results in crippling , but the prevention is simple and effective.
DPT vaccination protects against Diphthria , Whooping cough , and Tetanus. This is injected intra muscularly three times along with polio.
This is available as a pentavalent vaccine also in which polio and hepatitis vaccinations are also combined in the same injection. by this a single shot gives protection against 5 diseases. Diphthria is a serious disease affecting heart muscle , breathing muscles and is rapidly progressive towards death. So is Tetanus , a disease resulting into muscular paralysis and death. Whooping cough too is full of dreaded complications.
Hepatitis B vaccination is also administered at birth , after one month and after 6 months of the first dose. This protects against the dreaded life threatening Hepatitis B disease of the liver.
At 9 months of age Measles vaccination is given intramuscular , to prevent measles which is a contagious disease and is a biggest killer in first year of life in malnourished children. These vaccinations have to be followed with boosters in next few years or else the immunity will be lost. I shall deal with further vaccinations in my next blog. PREVENT DISEASES BY TIMELY VACCINATIONS.
Friday, September 25, 2009
Practical Issues in health of children .
I published " tips for parents to deal with anemia" in health education section of widely circulated news paper in North India.
To my surprise , the problem of Anemia is common even in children of doctors, even the doctor mothers! The reason being their inability to convince their elders in the family ,to do things which they consider as scientific , who are the care takers for their children when they are away for work.
There are many emails from such doctors asking me to suggest to them how to deal with this problem .
I did not ever imagine that financial independence and even post graduate education of women could not empower them to do the right things for their own children.
The children of pediatrician mothers are wearing charms and are putting black spot on cheek to ward of evil and are visiting temple for measles to be over !
How should we transform education into everyday practice , is the real issue rather than making people just literate!
Health education for children needs to convince grand parents and other care takers on the scientific approach. There are many issues but at present I am too shocked to address the problem fully.
To my surprise , the problem of Anemia is common even in children of doctors, even the doctor mothers! The reason being their inability to convince their elders in the family ,to do things which they consider as scientific , who are the care takers for their children when they are away for work.
There are many emails from such doctors asking me to suggest to them how to deal with this problem .
I did not ever imagine that financial independence and even post graduate education of women could not empower them to do the right things for their own children.
The children of pediatrician mothers are wearing charms and are putting black spot on cheek to ward of evil and are visiting temple for measles to be over !
How should we transform education into everyday practice , is the real issue rather than making people just literate!
Health education for children needs to convince grand parents and other care takers on the scientific approach. There are many issues but at present I am too shocked to address the problem fully.
Tuesday, August 25, 2009
Anemia in Children: Tips for Parents
ANEMIA IN CHILDREN , WHAT SHOULD PARENTS DO?
National Family Health Survey reported that about 80% children are anemic even in the grain producing states Punjab and Haryana. We need new strategies to save children from this significant morbidity.
Anemia is a state of low hemoglobin in the body, the causes can be many.
The most common is iron deficiency . A normal weight new born is born with sufficient stores of iron to last him first 6 months of life if all goes well with him.
. In India majority of children are born low birth weight and premature for which mother,s malnutrition is also one of the important factor.
Such children have low stores of iron and they need supplementation of iron surely from the age of 2 weeks. The iron of human milk is better absorbed than other milks.
Mothers milk must be continued in all infants for innumerable scientific advantages to the baby as well as mother.
The home made food appropriate for the age of the baby should be supplemented. Parents often do not accept the fact that grains and pulses have more iron and other nutrients, these need to be given rather than the top feeding of diluted milk by bottle. Bottle feeding even in best circumstances result into several maladies the most dangerous being diarrhea which forms the vicious cycle with malnutrition and anemia.
In the first year of life most babies visit for Well baby checkup and or at least five times for vaccinations.Doctors can always detect anemia and take corrective measures if vigilant
. What parents do not realize is that they do not take advise on anemia seriously. They feel that it is just a tonic which is prescribed which they give irregularly and stop at their own inconvenience. Anemia has to be realized by parents and doctors as a disease , the treatment has to be given with calculated doses , expected hemoglobin rise is calculated and the treatment would continue for additional 3 months even after the hemoglobin is appropriate. This is in order to replenish the stores in the body.
The careful pediatricians have a side lab in their clinics where hemoglobin can be assessed just in 10 minutes with just a prick and the treatment is evidence based. Parents don't have to make additional trips from clinic to the lab for the results and revisits for the prescription based on same results.
In the second year of life child has to gain just 2kg of weight therefore his requirements are not as much as he needed in the first year to become 10kg from the 3kg at birth.
There is a natural reduction in food consumption pattern but parents expect children to eat more all the time and " chalo dudh to pee lo atleast , nahin peena padega" They insist on milk all the time filling the little stomach of children with milk rather than grain based food, do force feeding , the nutritional requirement becomes a perpetual struggle between the two , children are learning denial and at times the force feeding becomes an attention seeking device. These wrong trends can continue throughout resulting into undernourishment and anemia.
As young as 2 go to school, which is surely a form of child abuse by parents ,separation anxiety and stress of discipline even if it is a play school is a subject requiring a national attention , can also result in malnutrition due to several factors even though they are fed in the school.
The school going children are always in a rush in the morning . Its a sight to see parents holding a half finished glass of milk even on bus stand. Its universal that all children go to school without proper breakfast.Its also a scientific fact that breakfast should be like a king and early so that brain gets glucose for proper function. The first meal of child is in the school in the break at 11am which is too little for several things including food. The schools have started insisting on healthy food but the reality is different. Parents ought to be educated and in turn educate children that food is mainly for nutrition , enjoyment is a state of mind. A child who breaks fast at 11am , is again confronted by parents forcing food at 2 after the school. The class 8 onward children are again at a rush at this time for forced tut ions by overambitious parents. Its a hard fact that even younger children and children from weaker section of society are going for tut ions.
Children are perpetually in fabricated indoors from home to school to tuition to television , video games , computer even though it is essential.
Such circumstances result into low immunity making them susceptible to ailments resulting in low utilization of iron due to stress of infections.
when majority of children go to school without breakfast , why can the first period not be devoted to eating the food brought from home rather than waiting till 11am. thus children would surely be hungry at 2pm after school .
Parents find it difficult to tackle the food fad ism of children . It is the parents who unknowingly are responsible for such habits in children besides the peer pressure of course. Now a days in well to do homes it is a common sight on the dinning table that instead of appreciating the flavor and presentation of food it is the " not for me " attitude of mothers which children are facing at each meal. Imitation of finicky attitude is child's natural reaction. Thus they also learn to be choosy. Dieting means eating balanced food and utilizing it by sports and active life style rather that becoming the couch potatoes. Undernourishment is low as well as overweight. even obese children could be anemic.
Parents ought to realize that children at all ages need balanced diet , especially so during the period of growth spurts till adolescent age. It is these healthy teens who will be healthy mothers and would not produce low birth weight newborns breaking the cycle of nutritional anemia.
In the name of nutrition and exercise young children are going to gyms rather than playing outdoors and are consuming protein powders prescribed by trainers which is a wrong trend and must be stopped.
Iron deficiency even without anemia results in fatigue , restlessness , poor attention span , learning disabilities , poor arithmetic and linguistic abilities , irritability , hyperactivity and pica ( tendency to eat mud and other abnormal objects).
There is a myth prevalent in parents that mud eating is due to deficiency of calcium , they resort to self prescribing and injections for this by self style doctors.
The fact is this that the iron deficiency is an easily preventable disorder by partnership of parents and doctors. The iron administered in oral form is best absorbed and corrects anemia effectively , inject-able iron is not needed in general.
Anemia is prevalent in spite of ongoing strategies of nation , its time to make new strategies.A lot can be achived by partnership of parents and doctors.
National Family Health Survey reported that about 80% children are anemic even in the grain producing states Punjab and Haryana. We need new strategies to save children from this significant morbidity.
Anemia is a state of low hemoglobin in the body, the causes can be many.
The most common is iron deficiency . A normal weight new born is born with sufficient stores of iron to last him first 6 months of life if all goes well with him.
. In India majority of children are born low birth weight and premature for which mother,s malnutrition is also one of the important factor.
Such children have low stores of iron and they need supplementation of iron surely from the age of 2 weeks. The iron of human milk is better absorbed than other milks.
Mothers milk must be continued in all infants for innumerable scientific advantages to the baby as well as mother.
The home made food appropriate for the age of the baby should be supplemented. Parents often do not accept the fact that grains and pulses have more iron and other nutrients, these need to be given rather than the top feeding of diluted milk by bottle. Bottle feeding even in best circumstances result into several maladies the most dangerous being diarrhea which forms the vicious cycle with malnutrition and anemia.
In the first year of life most babies visit for Well baby checkup and or at least five times for vaccinations.Doctors can always detect anemia and take corrective measures if vigilant
. What parents do not realize is that they do not take advise on anemia seriously. They feel that it is just a tonic which is prescribed which they give irregularly and stop at their own inconvenience. Anemia has to be realized by parents and doctors as a disease , the treatment has to be given with calculated doses , expected hemoglobin rise is calculated and the treatment would continue for additional 3 months even after the hemoglobin is appropriate. This is in order to replenish the stores in the body.
The careful pediatricians have a side lab in their clinics where hemoglobin can be assessed just in 10 minutes with just a prick and the treatment is evidence based. Parents don't have to make additional trips from clinic to the lab for the results and revisits for the prescription based on same results.
In the second year of life child has to gain just 2kg of weight therefore his requirements are not as much as he needed in the first year to become 10kg from the 3kg at birth.
There is a natural reduction in food consumption pattern but parents expect children to eat more all the time and " chalo dudh to pee lo atleast , nahin peena padega" They insist on milk all the time filling the little stomach of children with milk rather than grain based food, do force feeding , the nutritional requirement becomes a perpetual struggle between the two , children are learning denial and at times the force feeding becomes an attention seeking device. These wrong trends can continue throughout resulting into undernourishment and anemia.
As young as 2 go to school, which is surely a form of child abuse by parents ,separation anxiety and stress of discipline even if it is a play school is a subject requiring a national attention , can also result in malnutrition due to several factors even though they are fed in the school.
The school going children are always in a rush in the morning . Its a sight to see parents holding a half finished glass of milk even on bus stand. Its universal that all children go to school without proper breakfast.Its also a scientific fact that breakfast should be like a king and early so that brain gets glucose for proper function. The first meal of child is in the school in the break at 11am which is too little for several things including food. The schools have started insisting on healthy food but the reality is different. Parents ought to be educated and in turn educate children that food is mainly for nutrition , enjoyment is a state of mind. A child who breaks fast at 11am , is again confronted by parents forcing food at 2 after the school. The class 8 onward children are again at a rush at this time for forced tut ions by overambitious parents. Its a hard fact that even younger children and children from weaker section of society are going for tut ions.
Children are perpetually in fabricated indoors from home to school to tuition to television , video games , computer even though it is essential.
Such circumstances result into low immunity making them susceptible to ailments resulting in low utilization of iron due to stress of infections.
when majority of children go to school without breakfast , why can the first period not be devoted to eating the food brought from home rather than waiting till 11am. thus children would surely be hungry at 2pm after school .
Parents find it difficult to tackle the food fad ism of children . It is the parents who unknowingly are responsible for such habits in children besides the peer pressure of course. Now a days in well to do homes it is a common sight on the dinning table that instead of appreciating the flavor and presentation of food it is the " not for me " attitude of mothers which children are facing at each meal. Imitation of finicky attitude is child's natural reaction. Thus they also learn to be choosy. Dieting means eating balanced food and utilizing it by sports and active life style rather that becoming the couch potatoes. Undernourishment is low as well as overweight. even obese children could be anemic.
Parents ought to realize that children at all ages need balanced diet , especially so during the period of growth spurts till adolescent age. It is these healthy teens who will be healthy mothers and would not produce low birth weight newborns breaking the cycle of nutritional anemia.
In the name of nutrition and exercise young children are going to gyms rather than playing outdoors and are consuming protein powders prescribed by trainers which is a wrong trend and must be stopped.
Iron deficiency even without anemia results in fatigue , restlessness , poor attention span , learning disabilities , poor arithmetic and linguistic abilities , irritability , hyperactivity and pica ( tendency to eat mud and other abnormal objects).
There is a myth prevalent in parents that mud eating is due to deficiency of calcium , they resort to self prescribing and injections for this by self style doctors.
The fact is this that the iron deficiency is an easily preventable disorder by partnership of parents and doctors. The iron administered in oral form is best absorbed and corrects anemia effectively , inject-able iron is not needed in general.
Anemia is prevalent in spite of ongoing strategies of nation , its time to make new strategies.A lot can be achived by partnership of parents and doctors.
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