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Fat child is not
healthy Ethical issues in medical research Foot pain can lead to weight gain Dental cavities near gums Health Notes
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Fat child is not
healthy The children with many layers of fats, “chubby looking,” have been considered as healthy and beautiful by parents and their family friends. With the result, an epidemic of obesity is in the offing among pre-school and school-going children. These children will suffer from several serious ailments as they grow. The American Academy of paediatrics has issued a new report on lipid screening and cardiovascular health in children, a report that has taken on new urgency due to subsequent increased risks of type-2 diabetes mellitus, hypertension, cardiovascular disease and several other health risks. By their misplaced affection the parents and relatives are pushing the vulnerable children to have deadly diseases in future. A fat child is not a healthy child at any age, and this must be clear to all.
The recommendations For children or adolescents at a higher risk of cardiovascular disease or with elevated low-density lipoprotein (LDL)-cholesterol levels, changes in the diet based on nutritional counselling and other lifestyle modifications are also recommended. For overweight or obese paediatric patients with high triglyceride levels or low high-density lipoprotein (HDL)-cholesterol levels, weight management is the primary treatment, and includes improvement in the diet with nutritional counselling and increased physical activity. Screening should take place after two years of age, but no later than 10 years of age. For those with no risk factors, treatment with medicines should be used if LDL-cholesterol levels are persistently higher than 190 mg/dL. Although the initial goal is to lower LDL-cholesterol to levels < 160 mg/dL, targets as low as 110 mg/dL, is warranted when there is a family history with other risk factors - obesity, diabetes, mellitus, the metabolic syndrome and other higher-risk situations. Love your child with the following advice:
The writer, a senior eye specialist, has many medical books to his credit.
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Ethical issues in medical research Research with human subjects is an important tool for the development of evidence-based modern medicine. However, there is sometimes the risk of the protection of the human participants, when the researcher is focussed only on the successful outcome. The passion for success can also result in the coercion of human subjects to participate in the research. Another important aspect is misrepresentation or incomplete information of the medical facts to the patients in getting their consent signed for their participation in the research. In World War II, Nazi physicians performed medical experiments of injections of live viruses on prisoners, forceful immersion of people in ice water and compelling prisoners to ingest poison. In 1946, the War Crimes Tribunal at Nuremberg probed this and pronounced punishment against 16 of such physicians/ administrators, including death sentence to seven of them. There are a number of international ethical codes that act as guiding factors for facilitating an ethical research. The World War-II Nazi episode of prisoners led to emergence of the first international code of research ethics named as Nuremberg Code. This code has acted as a basis for all the subsequent codes of ethics that emerged later on. Under this code, a set of 10 directives were issued in order to satisfy moral, ethical and legal concepts in the conduct of human subject research. There has been numerous examples where the teacher conducted the research on the students of the class taught by him and the employer conducted research on the employees under his administrative control. It was felt that due to the factor of obligation the students and the employees in such a situation feel coerced to participate in the research. This resulted in the introduction of another recent code of international ethics issued by the US Department of Health and Human Services (HHS) and followed almost all over the world is based on three basic principles of ethics: Respect for persons, beneficience, and justice. In addition to almost all the points of the Nuremberg Code, it has advocated for taking special precautions while dealing with vulnerable groups that include prisoners, mentally challenged, children, economically or socially disadvantaged, students of a class taught by the investigator and the employees under the direct control of the investigator. It has also recommended that every institution should constitute an institutional review board (IRB) which will permit, oversee and review all the research activities being undertaken in the institution. It should ensure that the aim of every reseach should be clear and well defined. Human beings should not be used solely as a means to an end. Every research proposal should be able to clearly demonstrate the benefits overweighing the risks. The role of the IRB is not only limited to the clearance of the reseach proposals, rather it is meant to monitor the progress of the research at regular intervals to satisfy that there is no deviation from ethical standards even during the research project. If it happens to be so, the IRB is empowered to stop further tests for the research. The research on the human subjects is very sensitive and critical issue. The public at large and the researcher both should be well aware of the pros and cons of the project. There should not be any obligation or coercion for the participatnt to get enrolled for the research. The relationship between the researcher and the human participants should be based on honesty, trust and respect. The writer is Associate Professor, Department of Orthopaedics, Government Medical College and Hospital, Chandigarh.
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Foot pain can lead to weight gain Individuals suffering from lower limb problems like pain in the feet and the knees are generally advised to avoid walking, running, etc. This inactivity in turn leads to obesity (gaining weight) although there may be alleviation of pain. Obesity in turn may lead to other complications like diabetes, hypertension and aggravation of knee and ankle joint problems. Foot pain is an extremely common problem experienced by most individuals at some stage in their life. Walking exerts pressure around one and a half times the body weight whereas running increases this pressure around three to four times the body weight. Foot injuries cause pain which entails strain, heel pain (plantar fascitis), tendoachilles, corns, blisters, etc. Foot pain affects both men and women but women suffer more due to their light bone structure and wearing narrow toe and high heel shoes. Feet are designed to provide the balance and strength during walking/ running even over uneven surfaces. When high heels are worn there is alteration in bio-mechanics of the lower limbs obstructing normal functioning. Pain under the heel occurring early in the morning while getting out of the bed or after a prolonged rest can be due to "plantar fascitis". The heel is attached to the foot by a strong ligament, i.e. plantar fascia. In individuals suffering from "plantar fascitis" there is inflammation of this fascia causing pain. "Achilles’ tendonitis" is also a painful and debilitating condition in which agonising pain is experienced on the back of the heel in the morning or post-exercise. Achilles tendon connects the calf muscles to the heel bone. Pain under the heel and Achilles tendonitis are conditions caused due to obesity, lack of flexibility of calf muscles, wearing worn-out shoes, flat / high arch feet and a sudden increase in training intensity. Treatment * Rest to the affected foot and avoidance of weight-bearing activities. In cases where pain intensifies on walking/ running, aerobic activity could be shifted to cycling/ swimming where excessive pressure is not exerted on the foot/ knee. * Ultrasound followed by deep-friction massage to alleviate pain. * Wearing a heel pad takes off some of the strain. * Weight reduction. * Using sports shoes (with more cushion/ flexibility and raised heel). Exercises Calf stretch: Standing with both extended hands on the wall, placing one-leg in front of the other; bend the front leg without raising the heel of the back leg. Stretch will be felt at the back of the calf muscle. Staying for a count of 10 change to the alternate leg, repeating two to three times a day. Towel curls: Placing a small towel on the floor and continue curling it repeatedly using toes. Self-stretch: While sitting, place a foot on the opposite knee, put all five toes into extension. Hold for 15 seconds. Repeat this five times. Rear foot pain should not be ignored and treatment sought immediately, otherwise it can lead to restriction of aerobic activities. Sedentary lifestyle may lead to weight gain, complicating the problems further. The result would be a prolonged period for treating the core cause. The writer runs his Pain Management Clinic in Chandigarh. Email: chadha_r2003@yahoo.co.in
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Dental cavities near gums These are peculiar types of cavities in the teeth which appear where the tooth meets the gum. These can get accidentally discovered while running one’s finger or nail on the teeth. If these are overlooked they become large, and may be noticed as a ditch near the gums while viewing one’s teeth in the mirror. These cut/groove cavities in the teeth normally do not occur in children, but are quite often seen in the adult and older population. These cavities can also cause sensitivity, and when you report to the dentist with this problem, he tells you that this sensitivity may be due to the presence of cervical cavities/ gum line cavities in your teeth. Generally these cavities are present on the outer surfaces — buccal and facial sides of the teeth. Sometimes, such cavities are also seen on the lingual surface — tooth surfaces facing the tongue. Generally, these cavities are clean, without any discolouration. These may show brown/black staining. Often these cavities are partially hidden and some times even completely hidden under the gum. The gum grows on the tooth because of irritation due to the accumulation of the food particles in these not-so-easily cleanable grooves. The natural convex contour of the teeth deflects the food from the direct impingement on the gums during eating. The chewing of food massages the gum and keeps it healthy. With the development of these cavities near the gum the normal contour of the tooth surface is lost and the food impinges on the gums leading to gum disease. How do these cavities
develop? Where the tooth and the gum meet, it marks the meeting of the outer covering of the crown of the tooth i.e., enamel with the cementum that covers the outer surface of the root. Their meeting place — junction — is very thin. Due to the different forces exerted on the teeth, there is an indirect force — abfraction — delivery to this junction resulting in a little breach at this meeting place of the outer coverings of the crown and the root. This ditch/ groove/cut in turn becomes a reservoir /catchment area for the bacteria — dental plaque — to grow. Being a groove, it does not get cleaned with tooth brushing. The bacteria present in this breached retentive area react with the sugar we take and produce acid. It slightly erodes the underlying dentine the second layer of the hard structure of the tooth leading to the deepening of the initial small groove and gradually leading to the development of a large cavity. So, basically, these erosion/gum-line cavities result from the accumulation of dental plaque and their interaction with the sugar that you eat in these breached areas. How to prevent the gum line cavities? The occurrence of these cavities can be prevented by: i) Consciously keeping a gap (about 2-3 mm) between the teeth of the upper and lower jaws. This will prevent exerting undue forces on the teeth at all times. ii) Thoroughly cleaning the teeth particularly at these areas so that no dental plaque is left. iii) Restricting the intake of sugar or sugary items to not more than three times a day. iv) If you have a habit of grinding your teeth at night, you can ask your dentist to give you a night guard. It is made up of a flexible material, and is worn at night. If not treated on time, these cavities go bigger and bigger and will involve the nerves and the blood vessels located in the tooth and can cause pain. The line of treatment The gum line cavities, not involving the pulp, as and when detected, can and should be filled with tooth-colour material — composite filling material. This filling material comes in different shades of white, and if the filling is properly carried out it is indistinguishable from the tooth. If the filling is appropriately carried out, flushed with the tooth, particularly towards the gum margin and the above stated preventive measures are taken care of, the filled tooth will work and last like a natural tooth. In case the cavity has gone deep and the nerves are involved, root canal treatment followed by the restoration of the cavity with composite material is carried out. The writer, who heads the Dental Department, The Apollo Clinic, Chandigarh, is a former Head, Oral Health Sciences Centre, PGI, Chandigarh. Email: chawlahs
@gmail.com
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Health Notes WASHINGTON: A new study has found that tributyltin, a ubiquitous pollutant that has a potent effect on gene activity, could be promoting obesity. Tributyltin is used in antifouling paints for boats, as a wood and textile preservative, and as a pesticide on high-value food crops, among many other applications. The chemical affects sensitive receptors in the cells of animals, from water fleas to humans, at very low concentrations — a thousand times lower than pollutants that are known to interfere with sexual development of wildlife species. Tributyltin and its relatives are highly toxic to mollusks, causing female snails to develop male sexual characteristics, and it bioaccumulates in fish and shellfish.
— ANI Lower childhood IQ linked to adult mental disorders
Lower IQ was also linked to psychiatric disorders that were more persistent and an increased risk of having two or more diagnoses at age 32. The study participants were members of the Dunedin Multidisciplinary Health and Development Study, a cohort of children born in 1972-1973 in Dunedin, New Zealand. At the initial assessment at age 3, the study had 1,037 children. The participants were also interviewed and tested on their overall health and behavior at ages 5, 7, 9, 11, 13, 15, 18, 21, 26 and at age 32, when 96 per cent of the original cohort participated. IQs were assessed at ages 7, 9 and 11.
— ANI Exercise may reduce age-related brain changes
WASHINGTON: Exercise can help prevent age-related brain changes in older adults, suggests a new study. In the study, researchers at the University of North Carolina (UNC) - Chapel Hill found that older adults who exercise regularly show increased cerebral blood flow and a greater number of small blood vessels in the brain. “Our results show that exercise may reduce age-related changes in brain vasculature and blood flow,” said presenter Feraz Rahman, currently a medical student at Jefferson Medical College in Philadelphia. “Other studies have shown that exercise prevents cognitive decline in the elderly. The blood vessel and flow differences may be one reason,” Rahman added.
— ANI Cosmetics during pregnancy ‘increase birth defect risk’
MELBOURNE: Pregnant woman have been warned against the use of cosmetics, for they could lead to birth defects. The warning follows a study, which found that women exposed to high levels of hair spray during pregnancy were twice as likely to have babies born with a urinary tract defect. It encouraged calls for a new European cosmetics labelling system that would mark out some products as off-limits to mothers-to-be. The French Government declared last week considering such a labelling system for cosmetics.
— ANI |
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Traditionally, Indian parents have been rather liberal in feeding their children with foods of various kinds; whether or not the child is hungry. In fact, this has been the only way of showing affection to young children; sweets, pizzas, eggs, nuts and so on.
WASHINGTON:
In a new, long-term study, researchers at Harvard School of Public Health (HSPH) found that children with lower IQs showed an increased risk of developing psychiatric disorders as adults, including schizophrenia, depression and generalized anxiety disorder.