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Allergy & Asthma care

AllForKids now offers Specialized Allergy and Asthma Care for Children and Adults

By appointment only, please call ahead on 0484-645 2772/649 2772 .

Vaccination Services

AllForKids provides all age appropriate vaccinations.

Our Vaccine Reminder service reminds you of upcoming vaccinations by e-mail or SMS.

KidsDoc Monthly Newsletter from AllForKids
October 2008, Vol-1, Issue-10

By Dr. M.Vijayalakshmi M.D(Peds), M.D(USA), FAAP, DAA

 

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Periodic Health Alerts/News items of local interest:

AllForKids is proud to announce a weekly Alert/News Service on its web site which brings you updated health information including disease alerts and local health trends. Please visit www.allforkidsindia.com and click on the Alert pop up to see this week's alert and alerts/news from past weeks.

Loud Sounds and Hearing Loss in Children and Adolescents – why you should watch out for the music listening habits of your child

Parents should be worried when their children and adolescents listen to loud music frequently from their iPods and other personal listening devices.

Hearing loud noises for a period of time can cause temporary or permanent hearing loss. It depends on the person, it depends on how long you're listening, and it depends on the level at which you're setting your iPod or other device.

Earphone

People listening to music at loud volumes on personal stereo sets (iPods, other MP3 players and Walkmans) might, without knowing it, be damaging their hearing.

That's the conclusion of a recent studies which tested the noise volume many people were experiencing from their personal stereo players (PSPs) and compared them to a benchmark level considered safe.

How loud is safe?

Our ears didn't evolve to cope with loud noises. Sustained loud noises damage our delicate hearing mechanisms - and the damage is permanent.

How much noise is damaging? That depends on how loud the noise is, and how long it lasts. The maximum noise exposure allowed in the workplace for example, according to occupational health and safety laws, is no more than 85 decibels over a period of 8 hours a day, five days a week.

How loud is 85 decibels? It's the equivalent of someone shouting at you from two meters away. A rock concert or a disco can get up to 110 decibels (sound power doubles every 3 decibels - so 110 decibels is over 200 times the safe level)

But what about music through headphones? Research shows that most people had noise exposures less than the recommended levels. But around 25 per cent of users had daily noise exposures higher than the recommended level.

Ear damage: When we hear a sound, it's actually a sound wave transmitted through air, picked up by the eardrum, and transmitted by tiny bones in the middle ear into vibrations in the fluid in a tiny organ in the inner ear called the cochlea. Sound frequencies excite tiny hairs in the cochlea - different frequencies excite hairs in different places - and these are converted to electrical impulses to be interpreted by the brain as sounds. Excessive vibrations from loud sounds damages these hairs and impairs hearing.

One of the problems is the damage isn't immediately noticeable. It's only when we get cumulative damage over long periods of time that we begin to notice hearing loss.

People who have noise-related damage may have more profound hearing loss when they're old. Over the age of 70, one in two or three people will have significant hearing loss simply due to old age - especially in the high frequencies - 4000 Hertz and up.

So the message is, make sure if you listen to personal stereo sets you don't turn them up too loud.

How loud is too loud? There's no rule of thumb about numbers and volume controls, they're all different and you can't measure decibel levels from them. But as a general rule - when you're wearing the headphones you should be able to hear a person talking a meter away. If you can't, then the music volume is too loud.

So don't turn it up for long periods or, if you have turned it up, when you come out of the noisy environment into a quieter one, remember to turn it down again.

Safety of Toys

Parents should be wary of the cheap toys particularly the Chinese toys in the local markets in Kerala as many of them uses paint which have high content of lead. Loose paint can cause children to ingest lead when they bite the toys or put their hands in their mouths.

Lead poisoning (also known as saturnism, plumbism, or painter's colic) is a medical condition caused by increased levels of the metal lead in the blood. Lead may cause irreversible neurological damage as well as renal disease, cardiovascular effects, and reproductive toxicity

For more information about the effect of lead on children please visit the following link on our website: http://www.allforkidsindia.com/allforkids/Resources/lead.aspx

Disease Focus – Whooping Cough( Pertussis)

Content Source: Centers for Disease Control and Prevention

WhoopingCough

Pertussis, also known as whooping cough, is a highly contagious disease caused by the bacterium Bordetella pertussis; it derived its name from the characteristic severe hacking cough followed by intake of breath that sounds like "whoop"; a similar, milder disease is caused by B. parapertussis. Although many medical sources describe the whoop as "high-pitched", this is generally the case with infected babies and children only, not adults.

Worldwide, there are 30–50 million pertussis cases and about 300,000 deaths per year. Despite generally high coverage with the DTP and DTaP vaccines, pertussis is one of the leading causes of vaccine-preventable deaths world-wide. Most deaths occur in young infants who are either unvaccinated or incompletely vaccinated; three doses of the vaccine are necessary for complete protection against pertussis. Ninety percent of all cases occur in the developing world. Children tend to catch it more than adults.

Symptoms:

After a two day incubation period, pertussis in infants and young children is characterized initially by mild respiratory infection symptoms such as coughing, sneezing, and runny nose (catarrhal stage). After one to two weeks, the cough changes character, with an increase of coughing followed by an inspiratory "barking" sound (paroxysmal stage). Coughing fits may be followed by vomiting due to the sheer violence of the fit. In severe cases, the vomiting induced by coughing fits can lead to malnutrition and dehydration. The fits that do occur on their own can also be triggered by yawning, stretching, laughing or yelling. Triggering fits gradually diminish over one to two months during the convalescent stage. Other complications of the disease include pneumonia, encephalitis, pulmonary hypertension, and secondary bacterial superinfection.

Transmission:

Transmission Occurs through direct contact with discharges from respiratory mucous membranes of infected persons.

Treatment:

Treatment with an effective antibiotic (erythromycin or azithromycin) shortens the infectious period but does not generally alter the outcome of the disease; however, when treatment is initiated during the catarrhal stage, symptoms may be less severe. Close contacts who receive appropriate antibiotics (chemoprophylaxis) during the 7–21 day incubation period may be protected from developing symptomatic disease. Close contacts are defined as anyone coming into contact with the respiratory secretions of an infected person in the 21 days before or after the infected person's cough began.

All About Diabetes

Content Source: Centers for Disease Control and Prevention

Am I or my child at Risk for Type 2 Diabetes?

Taking Steps to Lower Your Risk of Getting Diabetes

Diabetes

Diabetes is a disease in which blood glucose levels are above normal. People with diabetes have problems converting food to energy. After a meal, food is broken down into a sugar called glucose, which is carried by the blood to cells throughout the body. Cells use the hormone insulin, made in the pancreas, to help them process blood glucose into energy.

Types of Diabetes

The three main kinds of diabetes are type 1, type 2, and gestational diabetes.

Type 1 Diabetes

Type 1 diabetes, formerly called juvenile diabetes or insulin-dependent diabetes, is usually first diagnosed in children, teenagers, or young adults. In this form of diabetes, the beta cells of the pancreas no longer make insulin because the body’s immune system has attacked and destroyed them. Treatment for type 1 diabetes includes taking insulin shots or using an insulin pump, making wise food choices, exercising regularly, controlling blood pressure and cholesterol, and taking aspirin daily—for some.

Type 2 Diabetes

Type 2 diabetes, formerly called adult-onset or noninsulin-dependent diabetes, is the most common form of diabetes. People can develop type 2 diabetes at any age, even during childhood. This form of diabetes usually begins with insulin resistance, a condition in which fat, muscle, and liver cells do not use insulin properly. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in response to meals. People who are overweight and inactive are more likely to develop type 2 diabetes. Treatment includes taking diabetes medicines, making wise food choices, exercising regularly, controlling blood pressure and cholesterol, and taking aspirin daily—for some.

Gestational Diabetes

Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually goes away after the baby is born, a woman who has had gestational diabetes is more likely to develop type 2 diabetes later in life. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin.

What is type 2 diabetes?

People develop type 2 diabetes because the cells in the muscles, liver, and fat do not use insulin properly. Eventually, the pancreas cannot make enough insulin for the body’s needs. As a result, the amount of glucose in the blood increases while the cells are starved of energy. Over the years, high blood glucose damages nerves and blood vessels, leading to complications such as heart disease, stroke, blindness, kidney disease, nerve problems, gum infections, and amputation.

Can type 2 diabetes be prevented?

Research has demonstrated that people at risk for type 2 diabetes can prevent or delay developing type 2 diabetes by losing a little weight. The results of the Diabetes Prevention Program (DPP) showed that moderate diet changes and physical activity can delay and prevent type 2 diabetes.

Research has showed that people through lifestyle change can reduce their risk of getting type 2 diabetes by upto 60 percent.

What are the signs and symptoms of type 2 diabetes?

Many have no signs or symptoms. Symptoms can also be so mild that you might not even notice them. Some people have symptoms but do not suspect diabetes.

Symptoms include

  • increased thirst
  • increased hunger
  • fatigue
  • increased urination, especially at night
  • weight loss
  • blurred vision
  • sores that do not heal

Many people do not find out they have the disease until they have diabetes complications, such as blurry vision or heart trouble. If you find out early that you have diabetes, then you can get treatment to prevent damage to the body.

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Should I be tested for diabetes?

Anyone 45 years old or older should consider getting tested for diabetes. If you are 45 or older and overweight, getting tested is strongly recommended. If you are younger than 45, overweight, and have one or more of the risk factors,you should consider getting tested. Ask your doctor for a fasting blood glucose test or an oral glucose tolerance test. Your doctor will tell you if you have normal blood glucose, pre-diabetes, or diabetes.

What does having pre-diabetes mean?

Pre-diabetes means your blood glucose is higher than normal but lower than the diabetes range. It also means you are at risk for getting type 2 diabetes and heart disease. However, you can reduce the risk of getting diabetes and even return to normal blood glucose levels with modest weight loss and moderate physical activity. If you are told you have pre-diabetes, have your blood glucose checked again in 1 to 2 years.

Besides being older and overweight, what other factors increase my risk for type 2 diabetes?

To find out your risk for type 2 diabetes, check each item that applies to you.

  • I have a parent, brother, or sister with diabetes.
  • I have had gestational diabetes, or I gave birth to at least one baby weighing more than 9 pounds.
  • My blood pressure is 140/90 mm Hg or higher, or I have been told that I have high blood pressure.
  • My cholesterol levels are not normal. My HDL cholesterol—“good” cholesterol—is below 35 mg/dL, or my triglyceride level is above 250 mg/dL.
  • I am fairly inactive. I exercise fewer than three times a week.
  • On previous testing, I had impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).
  • I have other clinical conditions associated with insulin resistance, such as acanthosis nigricans.
  • I have a history of cardiovascular disease.

The more items you checked, the higher your risk.

How can I reduce my risk?

You can do a lot to lower your chances of getting diabetes. Exercising regularly, reducing fat and calorie intake, and losing a little weight can help you reduce your risk of developing type 2 diabetes. Lowering blood pressure and cholesterol levels also helps you stay healthy.

If you are overweight then take these steps:

  • Reach and maintain a reasonable body weight.
  • Make wise food choices most of the time.
  • Be physically active every day.

If you are fairly inactive then take this step:

  • Be physically active every day.

If your blood pressure is too high then take these steps:

  • Reach and maintain a reasonable body weight.
  • Make wise food choices most of the time.
  • Reduce your intake of sodium and alcohol.
  • Be physically active every day
  • Talk with your doctor about whether you need medicine to control your blood pressure.

If your cholesterol or triglyceride levels are too high then take these steps:

  • Make wise food choices most of the time.
  • Be physically active every day.
  • Talk with your doctor about whether you need medicine to control your cholesterol levels

Making Changes to Lower My Risk

Making big changes in your life is hard, especially if you are faced with more than one change. You can make it easier by taking these steps:

  • Make a plan to change behavior.
  • Decide exactly what you will do and when you will do it.
  • Plan what you need to get ready.
  • Think about what might prevent you from reaching your goals.
  • Find family and friends who will support and encourage you.
  • Decide how you will reward yourself when you do what you have planned.

Your doctor, a dietitian, or a counselor can help you make a plan. Consider making changes to lower your risk of diabetes.

Reach and Maintain a Reasonable Body Weight

Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. Excess body weight can also cause high blood pressure.

Body mass index (BMI) is a measure of body weight relative to height. You can use BMI to see whether you are underweight,normal weight,overweight,or obese. Visit www.allforkdsindia.com/resources/index.aspx to find what your BMI is.

If you are overweight or obese, choose sensible ways to get in shape.

  • Avoid crash diets. Instead, eat less of the foods you usually have. Limit the amount of fat you eat.
  • Increase your physical activity. Aim for at least 30 minutes of exercise most days of the week.
  • Set a reasonable weight-loss goal, such as losing 1 pound a week. Aim for a long-term goal of losing 5 to 7 percent of your total body weight.

Make Wise Food Choices Most of the Time

What you eat has a big impact on your health. By making wise food choices, you can help control your body weight, blood pressure, and cholesterol.

  • Take a look at the serving sizes of the foods you eat. Reduce serving sizes of main courses such as meat, desserts, and foods high in fat. Increase the amount of fruits and vegetables.
  • Limit your fat intake to about 25 percent of your total calories. For example, if your food choices add up to about 2,000 calories a day, try to eat no more than 56 grams of fat. Your doctor or a dietitian can help you figure out how much fat to have. You can also check food labels for fat content.
  • Limit your sodium intake to less than 2,300 mg—about 1 teaspoon of salt—each day.
  • Talk with your doctor about whether you may drink alcoholic beverages. If you choose to drink alcoholic beverages, limit your intake to one drink—for women—or two drinks—for men—per day.
  • You may also wish to reduce the number of calories you have each day.
  • Your doctor or dietitian can help you with a meal plan that emphasizes weight loss.
  • Keep a food and exercise log. Write down what you eat, how much you exercise—anything that helps keep you on track.
  • When you meet your goal, reward yourself with a nonfood item or activity, like watching a movie.

Be Physically Active Every Day

Regular exercise tackles several risk factors at once. It helps you lose weight, keeps your cholesterol and blood pressure under control, and helps your body use insulin. If you are not very active, you should start slowly. Talk with your doctor first about what kinds of exercise would be safe for you. Make a plan to increase your activity level toward the goal of being active at least 30 minutes a day most days of the week.

Choose activities you enjoy. Some ways to work extra activity into your daily routine include the following:

  • Take the stairs rather than an elevator or escalator.
  • Park at the far end of the parking lot and walk.
  • Get off the bus a few stops early and walk the rest of the way.
  • Walk or bicycle whenever you can.

Take Your Prescribed Medications

Some people need medication to help control their blood pressure or cholesterol levels. If you do, take your medicines as directed. Ask your doctor about medicines to prevent type 2 diabetes.

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Pediatric and Adolescent Clinic
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