Monthly Archives: September 2014

You can save a life by giving Hands-only CPR !

 

  CPR (mayaclinic.in)

“Anyone can learn CPR and everyone should”

  • Sudden cardiac arrest is one of the leading causes of death worldwide. Many of these lost lives can be saved if a person nearby knew how to do CPR (cardiopulmonary resuscitation) or simply hands- only CPR.
  • You will be surprised to know that it is easy to perform and can be done by anyone. There is no need for any knowledge reading science i.e.  it can be done even by an illiterates . It just need strong will on your part to know it.
  • Sudden cardiac arrest is not the same as a heart attack.
  1. Sudden cardiac arrest occurs when electrical impulses in the heart become rapid or chaotic, which causes the heart to suddenly stop beating.
  2. A heart attack occurs when the blood supply to part of the heart muscle is blocked. A heart attack may cause cardiac arrest.

 hands-only-cpr

Reasons why you should know it

  • It saves many lives should be a good enough reason for you to learn it. Chances of a person surviving a sudden cardiac arrest increase significantly if CPR is started early. Effective bystander CPR provided immediately after sudden cardiac arrest can double or triple a victim’s chance of survival, but unfortunately very few cardiac arrest victims get CPR from a bystander in India.
  • More than 80% of heart attack occurs at home, so chances are you will be saving a person’s life that you love. Put very simply: The life you save with CPR is mostly likely to be someone you love.
  • CPR is not done by many due to various concerns like doing harm to person, doing harm to oneself, reason of hygiene, chances of getting infected or getting into legal hassles. But once you know the proper technique you will realize, you can only do well to a dying person without risking your health. Don’t be afraid; your actions can only help.
  •  Giving mouth to mouth resuscitation is not necessary: Most common reason why people are afraid of giving CPR is that they might have to give mouth to mouth breath. Guidelines in 2010 changed which clearly says that without formal training you should attempt hands-only CPR.  I strongly feel, all of us should know how to do chest compression even without mouth breathing. In many adults hands-only CPR has been found to be equally effective. (Although in children it is different and reasons of sudden cardiac arrest are different)
  • Hand-only CPR is very easy to learn: It can be easily performed
  • Unnecessary deaths can be prevented which occur due to poor response to cardiac emergency.
  • You can learn how to give Hands-Only CPR by watching a simple one-minute video at heart.org/cpr. (In India, call 102 instead of 911)

cpr

Once you have learned CPR, You can teach others too. Give 5 people you care about the power to save lives by equipping them to act quickly in a crisis.

Don’t be afraid; your actions can only help.

mayaclinic.in

If you see an unresponsive adult who is not breathing, call 102(call for help from others nearby) and push hard and fast on the center of the chest.

But before starting CPR make sure your life is not in danger (eg. No moving vehicle nearby, no chances of accident)

SEE A VIDEO, SAVE A LIFE
You can prepare yourself to act in an emergency by simply viewing the Hands-Only™ CPR instructional video(In India, call 102 instead of 911)

correct posture while CPR

The American Heart Association has recommended Hands-Only  CPR for adults since 2008.

Feel free to contact any nearby hospital to learn CPR.

Regards

Dr Rahul Varma

 

Congenital Hypothyriodism

Can my child have thyroid related problem at birth? YES, read on.

Congenital Hypothyroidism (CH)

Congenital Hypothyriodism    

Hypothyroidism is condition in which thyroid gland does not produce thyroid hormone in sufficient quantity. And if this condition is present right from birth, it is called Congenital Hypothyroidism (CH).

Congenital Hypothyroidism (CH) is most common preventable cause of Mental retardation in children.

It is also known as Cretinism, Endemic Cretinism (Iodine Deficiency), Congenital Myxedema.

Hypothyroidism is usually an age related change seen in older people, especially ladies. However its incidence is on a rise in younger population too.

physiology of CH

Newborn babies are also vulnerable; more so because there are no specific symptoms which can lead to early diagnosis. Because of this reason most of the private hospitals are now doing cord blood testing (Newborn Screening) to rule out thyroid related illnesses.

Good news for parents is that it can be diagnosed easily by testing (Newborn screening) and can be treated comfortable; so that child can live a normal life just like any other baby.

Hypothyroid in children

Signs and symptoms

Most of the children are asymptomatic (due to trans-placental transfer of maternal thyroid hormones)

If symptomatic; then following are the features

  • Prolong Jaundice during first few weeks of life (earliest sign)
  • During first month of life there is feeding difficulties (Sluggishness , sometimes even choking spells during nursing)
  • Lack of interest, Somnolence (sleepy all the time), large head size (due to myxedema).
  • Breathing difficulties due to large protruded tongue, also noisy breathing, nasal obstruction
  • During 1st year of life babies are sleepy all the time, have poor appetite, cries very little and sluggish most of the time.
  • Large protruded abdomen mostly has umbilical hernia.
  • A puffy appearance to the face. Dull looking
  • Cold to touch and mottled skin, edema of genital region and extremities
  • Constipation not responding to treatment
  • Poor muscle tone
  • Anemia can be there
  • Developmental delay
  • Slow heart rate

CH-mayaclinic

In children and teenage it can lead to

  • Poor growth leading to in short stature
  • Delayed eruption of teeth
  • Delayed puberty
  • Poor mental development

anatomy of thyroid gland

Thyroid gland is a butterfly- shaped organ at base of the neck.

 Hypothyroid

Causes:

  • Absent (agenesis) or (abnormal location) ectopic in location or underdeveloped
  • Genetic causes:  about 15% of cases are thought to be inherited
  • Iodine deficiency in mothers
  • Use of anti thyroid medicines in mothers

 Diagnosis: It is done by newborn screening in most cases

newborn screening

 Management:

  • Hormone replacement is the treatment (Safe and easy in children too)
  • L-thyroxine tablets are small and can be crushed into food or dissolved into a small amount of formula, juice or other liquid. No liquid formulation is available.    thyroid_treatment
  • Child specialist along with Pediatric Endocrinologist will treat children with thyroid or any other hormonal problems
  • Treatment to be started as soon as diagnosis made; since damage to brain once done can never be reversed
  • Overdosing of L-thyroxine in children can lead to
    • Faster heart rate
    • Loose motions
    • Poor sleep
    • Shakiness or tremors
    •  Soy-based formulas and Iron supplements can reduce the absorption of thyroid hormone.
    • Regular monitoring of child every few months
    • Developmental assessment

Congenital Hypothyroidism, before and after treatment (mayaclinic.in)

FAQ

Q. My child is too small? What if I do not treat my child?

Ans. It can lead to Mental retardation and developmental delay in children. Damage once done can never be reversed.

Q. Is it genetic disease?

Ans. About 15% cases are inherited and genetic counseling need to be done. Genetic testing can be done using blood sample.

Q. What are the tests need to be done to confirm it?

Ans.  If newborn screening is positive:

  • then blood tests are repeated after 72 hours of life which includes TSH, T4,T3.
  • Thyroid Ultrasound and Scan need to be done in certain cases

diagnosis of CH

Q. Can it be diagnosed during pregnancy?

Ans. NO

Q. Can elder siblings also have it?

Ans. If elder siblings are growing well, healthy and developmentally normal. Most likely the answer is NO.

For Any queries related thyroid disease or you want to discuss any other health related issues feel free to contact MAYA CLINIC. Or discuss with your child specialist.

Regards

Dr Rahul Varma

 

Sleep_hygiene

My baby not sleeping well at night? what to do.

Sleep Hygiene for children

Sleep_hygiene

 

To put child to sleep might be a big task for some of the parents. Young kids and children always are interested in playful activities and making them sleep on time might be difficult for many parents. Children have different sleeping time in different phases of life. The total duration of sleep decreases as child grows older.

YourChildsSleep_graphic

Following are the things which you can do so that your baby sleeps well. And it will also prevent development of sleep disorders later.

 little-girl-sleeping-(mayaclinic.in)

  1. Set bedtime and bedtime routine for your children. It will help adjust their body clock and they will be better prepared mentally and prevent development of sleep disorders.
  2. Bedtime and wake up time should be same on school and non school nights. Change in schedule is very common over weekends as children are allowed late nights by many parents. It is always better to follow a fixed pattern. Body adapts well to it.
  3. Hour before bed time should be quiet time. An hour prior to sleep should be winding up time and preparing to sleep in quiet and comfortable environment. Best time to sit back and discuss with your children regarding day’s activity or best is story telling time.   Father Watching His Infant Sleep
  4. Do not send your child hungry to bed. If child is empty stomach it will hamper proper sleep. So a light meal before sleep is best in order to avoid child waking up at middle of night.
  5. Avoid products with caffeine for few hours prior to sleep. It can delay the sleep. Avoid too much of liquid intake few hours prior to sleep. It can increase the urge to pass urine during night and disturb the sleep. It is more important in children with bed wetting issues.
  6. Outdoor Physical activity daily. Regular physical exercise is not only important for growth and development of child but also for to induce proper sleep.  sleeping child
  7. Bedtime quiet and dark. Bright light or loud music and disturb initiation of sleep. It is best to have night lamp or dim light in case your child is afraid of dark.
  8. Comfortable temperature. Ambient temperature is needed for good sound sleep. But if the temperature is too cold or too hot it will interfere with proper sleep.
  9. Bedroom only for sleeping, not for time out or punishment. Bedroom should be meant for sleeping only and all the other playful activities should be done in other room.
  10. No TV in bedroom.  TV / laptop/ computers are absolute no for bedroom. It distracts children a lot and prevents them to go to sleep.

 sleep hygiene 2

 Just to summaries about all the steps in one photo, read the below info-graphic.

10-tips-for-better-sleep

If we do not follow proper sleep hygiene steps for children, it can increase the chances of Sleep disorders like sleep terror, insomnia, parasomnia etc. Various sleep disorder we will discuss later in other article.

 

Regards

Dr Rahul Varma

“Healthy kids, Happy Family”

 

Fever, chills, headache during rainy Season? It could be Leptospirosis!

 

 Fever, chills, headache during rainy Season? It could be Leptospirosis!

 02-leptospirosis2

Leptospirosis is most common zoonotic (Spreading from animals) disease worldwide. It is still widely overlooked and under reported.

Without treatment, Leptospirosis can lead to kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, respiratory distress, and even death.

It spreads via urine of infected animals which can get into water and soil and survive there for weeks.

 Leptospira_interrogans_strain_RGA_01

Animal which commonly causes this disease are cattles, rodents, dogs, horses, pigs etc. Animals might be asymptomatic and continue to excrete the bacteria into environment.

EID_Leptospirosis_AcsB_1

It Spread to Human via

  • contact with urine (or other body fluids except saliva) from infected animals
  •  Ingestion of contaminated food or water
  • Direct contact over cut or wound (eg splash of infected water over eyes, nose or broken skin & mucus membrane)

 

Symptoms

Leptospirosis has a wide range of symptoms which could be similar to other illness as well. But common ones are:

leptospirosis

  • High fever, with or without chills
  • Headache
  • Muscle aches, body ache
  • Vomiting
  • Jaundice (yellow skin and eyes)
  • Red eyes
  • Abdominal Pain, Diarrhea
  • Rash

Incubation period ranges from2 days to 4 weeks. Can occur in 2 phases: 1st with acute febrile illness followed by more severe involving multi organ dysfunction “Weil’s Disease”

 model_lepto

Who is at Risk?

  • Occupational hazard eg farmers, mine workers, sewer workers, slaughterhouse workers, veterinarians and animal caretakers
  • Recreational hazard eg swimming in contaminated water , camping outdoor sports. More common in tropical and temperate climate
  • Incidence of Leptospirosis infection among urban children appears to be increasing.

 lepto-infection

How to diagnose?

It is completely curable if diagnosed early and treatment started on time.

Consult your doctor immediately. Doctor will order few tests which may include dark field microscopy, Culture, leptospirosis Serolgy (IgG& IgM) and PCR.

How to manage?

Avoid self medication

Leptospirosis is treated with antibiotics, such as doxycycline or penicillin, which should be given early in the course of the disease. It should be taken only after consulting doctor, in appropriate doses and for proper duration.

Intravenous antibiotics may be required for persons with more severe symptoms.

 1

How we can prevent it?

  • Clean Water (boiled, RO )
  • Protective gears: while swimming
  • Protective clothing or footwear
  • Cover your would properly and avoid contact with contaminated water, taking shower in monsoon rain, going to river banks
  • Take care of pets. Consult vet doc
  • Clean your home regularly of rats and other animals

For further reading click on the link below

http://www.searo.who.int/entity/emerging_diseases/topics/Communicable_Diseases_Surveillance_and_response_CDS_leptospirosis-Fact_Sheet.pdf?ua=1

Feel free to discuss with your doctor or call us at MAYA CLINIC. we will be happy to respond back.

Regards

Dr Rahul Varma