The most effective prevention against diseases

Returning to this blog after several months, I found, happily, that people continue to visit my blog as before. I decided to re-enter the world of advising lay people and this entry is a step in that direction. 

Most readers would agree that there are many measures to prevent diseases; some include making major changes in life-style, some involve taking expensive vaccines or medicines; some involve relocating oneself from a harmful environment, and still others call for expensive investigations to detect the harbingers of an illness that is yet to affect you. However, the most beneficial and most inexpensive method to thwart diseases - specially infective illnesses, which are a significant cause of illness and death all over the world - is correct hand-washing. 

As doctors, we all do it countless numbers of times every day during our busy office practice. Surgeons wash their hands so thoroughly that they sometimes spend minutes on this pre-op preparation. It stands to reason, therefore, that the medical fraternity is convinced that hand-washing is extremely important. The reason is simple: our bodies are colonised by billions of bacteria, some harmless, but many, the cause of skin infections as well as more deadly internal infections that have the potential to kill. 

About 2.2 million children under the age of 5 die each year from diarrheal diseases and pneumonia, the top two killers of young children around the world. Handwashing is not only simple and inexpensive, but remarkably, handwashing with soap can dramatically cut the number of young children who get sick. Handwashing with soap could protect about 1 out of every 3 young children who get sick with diarrhea and almost 1 out of 6 young children with respiratory infections like pneumonia. Although people around the world clean their hands with water, very few use soap to wash their hands. Washing hands with soap removes germs much more effectively. (From: http://www.cdc.gov/Features/GlobalHandwashing/)

The Center for Diseases Control, USA has several articles on hand-washing, and THIS ARTICLE forms the important backdrop. THIS ONE is the one that details when and how hand-washing must be done. Be sure to click on the "Show me the Science" link on the left to better understand the rationale behind hand-washing. 

I hope this entry helps you to understand how important this simple method of disease prevention is. Be blessed.

Antibiotic abuse

Most parents and care-givers expect the doctor to prescribe an antibiotic whenever they take their child to the doctor for symptoms of cough and cold, a runny nose or a sore throat. In fact, during my practice, I had to face their (the patents') angry glances when I told them that the antibiotic was not only unnecessary, but likely to produce harm than good.

The CDC calls the misuse/overuse/abuse of antibiotics as one of the greatest scourges of the modern world. The reason for this is simple to understand.

The first thing to know is that most common infective illnesses are caused either by bacteria or by viruses. While bacteria are life forms and when attacked by antibiotics, are likely to get killed, viruses are pure genetic material that multiply inside human cells and thus cause illness. Treating a bacterial illness with an antibiotic may make sense if the child has been seen by a qualified doctor; managing a viral illness with the same kind of medicine is useless as viruses are not "life" forms in the way we understand life.

Well, then, you might ask, why all this hullabaloo over using antibiotics for viral illness? The reasons are twofold. The first is that antibiotic overuse may create an environment inside your body that makes bacteria get used to those antibiotics ... so that you need stronger and stronger antibiotic agents the next time you have the same illnesses that needed simpler antibiotics the last time around.

In addition to this problem of antibiotic resistant germs making their home in your body temple, there is one other major problem caused by the ill-advised use of antibiotics, which is the occurrence of SIDE EFFECTS.  As antibiotics are medicines, they can produce side-effects as varied as rashes, loose motions, fever, vomiting, body aches and so on. These side-effects are usually temporary, but can drain the little ones' energy and cause problems that may need a consultation with the HIGHER specialist. 

Thus, my advise to you all is this: try and resist an antibiotic prescription, and if you do need it, or think you need it, re-visit the child's doctor for him/her to endorse the need for it; use the entire course without interruption (usually, antibiotics are used for a fixed duration of between 6-10 days, but there are a few which are only needed to be given for 3 days, and some that are needed for longer than 10 days. The last bit of advice is to never keep the unused portion of a liquid antibiotic for future use as such antibiotics lose potency beyond the specified storage period of about 3-7 days.

An additional bit of caution: never use antibiotics prescribed for your friend/cousin/neighbour's child. This is simply disastrous.

I hope this post has helped to clarify the position about the captioned topic. Thank you for reading.

How to raise a genius child

I am posting this because of a personal request by Ms. Allison Morris to share this with the readers of this blog. I do not entirely endorse the point of view expressed by the site, because I believe bringing up a well-rounded child may be important, but should not be the only goal for parents. It is rather more important not to pressure the child at a tender age and let him/her grow at his/her natural pace. However, here is the link to the site:

http://www.onlinepsychologydegree.net/raise-a-genius

Do go through the site and post your comments below in the comments section.

How to Wean the infant off frequent Night-time feeds

Many parents have approached me with this very common problem faced by them: the baby has grown beyond her first birthday, and is still waking up the mother for breast feeds or top feeds almost three or more times during the night.

The problem is accentuated by the fact that many middle-class families have working mothers who need the rest at night time. Being woken up by an irritable, fretful child can be very taxing for both the parents and sometimes even the older children in the house or the grand-parents in case of an extended family.

Such a problem needs to be first understood from the child's perspective. The child wakes up her mother not because she is really hungry, but because she is habituated to fall asleep while suckling or needs to suckle every few hours. It is important to remember that mother's milk is no longer very nutritious by the time more than a year has passed in the age of the baby. If the mother does not discipline the child at this age, the problem may not go away until the child has grown older, much older.

So, how does one go about it? Imagine that a child is waking her mother up four times in the night: at 11, then 1, then 4 and finally at 6 a.m. When she wakes up at 11 p.m., feed her immediately. At 1 a.m., let the child cry for 5-6 minutes and then feed her. Ditto at 4 a.m. At 6 a.m., feed her immediately. The next night, the child will learn to wake at about 5-10 minutes past 1 a. m. Delay this feed by 5 more minutes the next night, and so on till one feed (the 6 a.m. one), gets pushed on to the morning. Repeat this till both the night feeds have been eliminated.

The following two changes may help prevent frequent wakings AND development of the urge to demand night time feeds: the first is letting the baby sleep in her own separate bed/cot/.crib from mid-infancy; the second is having a separate baby room so that the baby learns from early on (say from around the age of 10-11 months) to sleep alone. 

I hope the above write-up helps my readers.

On the face of it, the words "let the baby cry" may sound inhuman or cruel, but, believe me, there is no other alternative. People have tried giving sleeping medication or even opium to the baby ... but surely you aren't going to try that, are you?