Archive for the ‘General health’ Category

BLEEDING DISORDERS – REAL PROBLEM

Tuesday, May 12th, 2009

A doctor is often faced with a parent who is concerned that his or her child seems to bleed or bruise easily and there is said to be a relative with a bleeding tendency.

In the past, tests to check whether there was some serious underlying disorder were somewhat complicated.

Doctors now know that a thorough history of the child, how the problem has presented itself, plus a history of the family, can give most of the clues.

A few simple blood tests as well, should be enough for the family doctor to be able to reassure the parents that no real problem exists.

True haemophilia or haemophilia A, which was present among many descendants of Queen Victoria, is due to an absence of factor VIII in the blood. This deficiency is inherited, but is sex linked. It is carried by females and may appear in their sons.

Haemophilia B, or Christmas disease, is due to a lack of factor IX and is also sex linked in inheritance.

Correct diagnosis as to whether a bleeding disorder is present, will lead to the proper treatment if it is needed.

Purpura is a form of bleeding tendency which, in most cases, is acquired rather than inherited, and is usually temporary.

*13/71/1*

PIGEON TOES IN CHILDREN: SIGNS AND SYMPTOMS, HOME CARE, ETC

Tuesday, April 28th, 2009

Signs and symptoms

The turning in of the toes is easy to see; if the condition persists, it should be brought to the doctor’s attention. You can do a preliminary test for an adductovarus deformity of the foot by laying a straightedge along the outer border of the child’s foot. If the outer border of the foot is not absolutely straight from the heel to the little toe, the child has adductovarus deformity. To discern tibial torsion, place the infant or child on his or her back with the legs straight out, kneecaps pointed upward, and feet at right angles to the lower legs. If the toes point toward the midline instead of straight up, the child may have tibial torsion.

Femoral torsion or anteversion usually does not appear until age four or five; from then on it gradually worsens. It can be detected by rotating the thighs at the hip joint. If the thighs make a larger arc internally than externally the child has femoral torsion.

Home care

By three months of age, your infant will prefer to sleep with the toes directed outward. This position is normal and should be encouraged. When the child is old enough to sit upright, the feet should be straight or turned outward. Until 18 to 24 months, your toddler usually will walk with one or both feet turned outward; this gives the child a wider base and better balance, and is normal. A tendency to toe in after three months of age should be called to your doctor’s attention.

Precautions

• An uncorrected adductovarus deformity makes it very difficult to fit the child’s shoes properly; this may eventually lead to the child developing a skewed foot and bunions in adolescence or adulthood.

• A child who sits on the floor a lot should be taught to sit cross-legged, not on his or her haunches with the toes directed outward.

• Corrective orthopedic shoes should be prescribed only by a medical professional, never by a shoe salesperson.

• Most minor cases of pigeon toes correct themselves. Nevertheless, let a doctor judge if the condition is minor or not.

Medical treatment

Your doctor will observe the child while he or she stands and walks both with and without shoes. The feet, the lower and upper legs, and the rotation of the hips will be examined. If necessary, your doctor will instruct you in massaging your child’s feet to correct mild toeing-in. If this massage does not correct the condition by the time the child is three or four months old, your doctor will order specific kinds of shoes or plaster casts. To correct tibial torsion, the doctor may prescribe a splint that holds the feet outwardly rotated while the child sleeps. In the case of femoral anteversion the doctor may not start treatment until your child is a teenager. If the condition has not corrected itself by that time, surgery on the thigh bones may be necessary.

*166/84/5*

PREVENTIVE MEDECINE: PREVENTION OF INSOMNIA

Thursday, April 23rd, 2009

•    Any painful condition should be properly treated, and the cause cured if at all possible. If it can’t be adequately treated pain-killers should be taken before retiring, to ensure that you get adequate rest and sleep. All pains seem to be worse if you are tired so getting good sleep helps reduce the pain the following day.

Acute, feverish illnesses can usually be coped with fairly successfully. Drink plenty of fluids and take an aspirin to reduce the fever if it is keeping you awake. This kind of insomnia is usually very short-lived (only a night or two) and does not often cause much of a problem.

•    Never drink tea, coffee, cocoa or cola drinks in the three or four hours before you go to bed.

•     Take 100 mg of vitamin  complex. Some people need extra vitamin B1 to cure their sleeplessness. Taking  vitamins (and especially vitamin B3) too late in the day can have a stimulant effect and keep you awake. Take the  complex at 4.00 p.m. at the latest.

Zinc should be taken at a dose of 25-50 mg daily; and a combination of calcium 1-2000 mg and magnesium 500-1000 mg last thing at night. The essential amino-acid tryptophan 1000 mg can also be a useful dietary supplement, especially if depression is the cause of insomnia.

•     Never go to bed on a full stomach. Allow an hour or two to pass before retiring after a large meal. Wind, nausea and indigestion prevent millions of people from getting off to sleep and only a proportion can be helped with antacids. For many people the combination of alcohol and a large meal is the problem-try leaving out alcohol when you go out late in the evening. On the other side of the coin are those who lay awake hungry with their stomach rumbling. Have a snack of cereal or biscuits, perhaps a hot milk drink, just before retiring.

•     Apart from dietary restrictions on those foods which can be found by trial and error to cause nightmares and night terrors in children, there is little that can be done to prevent these events. Sometimes the child is obviously disturbed when awake and may well benefit from professional psychological help. Many children of troubled (for example, divorcing or separated) families sleep poorly and have frequent dreams and night terrors. Prevention starts with looking carefully at the child’s waking day. A few children are terrified by science-fiction characters and things they have seen on TV-common sense can sort out most of these problems.

•    It is helpful to relax before going to bed rather than expecting to sleep immediately, after a hectic physical, emotional or mental event. A hot bath can stimulate rather than relax-a tepid shower is probably better. Sitting down and listening to the radio, watching TV or reading a book are good ways of switching off from the demands of the day.

I have mentioned that excessive exercise before going to bed is detrimental to sleep, so is exercise a promoter of sleep at all? The answer is definitely yes, but it has to be the right type of exercise and taken at the right time. Regular exercise is essential for vibrant health and most people sleep better if they have had at least some exercise during the day. The best exercise before bed is a brief walk. Certain yoga postures are said to encourage sleep and some people find that a period of relaxation, including deep breathing exercises, helps relax them too.

*186/72/5*