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Bridging the cleft gap Worried over weight, British teenagers skip breakfast Shorter breaks better than long break
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Bridging the cleft gap Little Shiva was born with a severe cleft lip and palate in a poor, rural area of northern India. His father was a labourer who earned less than Rs 50 a day. Shiva's illiterate parents did not know that clefts can be repaired until they came across an advertisement in the local newspaper about a Smile Train clinic in a nearby town. Getting operated when he was young saved Shiva from many years of pain and suffering. Luckily, he will never develop any kind of speech impediment that is often impossible to correct in children who have their clefts repaired much later in life. Every year, approximately 35, 000 babies are born with a cleft defect in India. More than 50 per cent of these children do not get treatment because they do not know that the problem can be fully corrected or are too poor. There are more than 10 lakh cases of untreated cleft defects in India. This has become a significant healthcare problem in India. Added to the problem are the inequalities in access to and quality of cleft care between the urban and rural areas.
Birth defect
The word cleft means a gap or split between two things. Cleft lip and cleft palate are birth defects. The lips and palate form between the period of four to 12 weeks when the baby is in the womb. The lips develop between four and seven weeks and the palate develops between seven and 12 weeks. If there is any adverse effect on the development of the child during this period, then the lip or palate remains un-united. A cleft occurs when certain midline soft tissues do not fuse together during the development of the foetus. Clefts can involve the lip, the roof of the mouth (palate), and the soft tissue in the back of the mouth. Cleft lips come in a broad range of severity and disfigurement. Some can be as slight as a notch in the red part of the upper lip. Others manifest as a severe cleft lip with the total separation of the lip all the way up into the nose. A cleft palate is when the roof of a baby's mouth has not joined fully, leaving a gap. These can range from a tiny little hole at the back and in the roof of the mouth to a major cavity that runs all the way from the front to the back of the mouth.
Scenario in India
In North and East India, one out of 700 children is born with the problem of cleft. But the problem is not the incidence of cleft but the prevalence of the disorder. There are many social myths associated with it. The most common is that if a pregnant woman chops vegetables during a lunar or solar eclipse then the child is born with a deformed face. Huge backlogs of un-treated cleft patients are there in North India and East India as compared to South India. The states of Bihar, Jharkhand, Chhattisgarh, West Bengal and Orissa are the most affected with the highest prevalence of unrepaired clefts. The lack of expertise, facilities and resources are some of the reasons behind the problem. The problem is being addressed by reaching out to patients in the rural parts of the country to provide treatment. Though 'normal' in every other sense, because of the facial deformity, children born with cleft defects are condemned to grow up as social outcasts and objects of ridicule. Many children afflicted with clefts, especially girls, are killed at birth or abandoned. Orphanages have many children with cleft defects. Even when they are allowed to live, their families are ashamed of them, other children ridicule them and many schools may not accept them. If these affected children manage to get basic education, they cannot find jobs, or get married.
What causes a cleft?
The exact cause of a cleft lip and palate is unknown. It is a multi-genic disorder wherein the combined expression of these multiple genes affects the development of face. Studies in North India found deficiency of Vitamin B12 and folic acid in a large number of mothers of cleft patients. Other reasons factors such as drug and alcohol use, smoking, maternal illness and infections. A woman is at a higher risk of having a baby with a cleft if she is a teenager or over 35 years old and has been exposed to teratogens, which include medications, infectious diseases and environmental agents that can disrupt the normal development of a foetus. Another study showed that a gene called Methylenetetrahydrofolatereductase gets affected and results in a high concentration homocysteic acid, which is toxic to the cells. Research says females are more tolerant to high concentration of homocysteine as compared to males. Therefore, males have a 2.5 times higher incidence of cleft than females. Hospital statistics reveal that parents bring the girl child for the treatment of cleft at a younger age than they do for boys as they are more worried about the facial looks of their girl child as compared to a boy child.
Problems
Untreated clefts lead to a host of problems — both physical and psychological:
Mothers are often unable to breastfeed babies who suffer from a cleft lip and palate as the baby is unable to create the required suction pressure while feeding. A top feed is often insufficient and deficient in nutrition, as a result a number of babies with a cleft do not survive due to poor nutrition. Statistically, the expected life span of a person with an untreated cleft is 14 years less than the national average. Cleft of the palate causes poor speech development. These children may take longer to talk and when they do, they may talk slower than most children, have a nasal intonation, and may find it hard to pronounce certain words. If a child with a cleft palate is operated late, speech therapy is often needed to help eliminate any speech impediments.
Solution
Most clefts can be completely corrected with a simple surgical procedure that could take as little as 45 minute and cost as little as Rs 12,000. Mothers can learn and use some simple techniques to give proper feed to babies with a cleft palate and ensure proper nutrition. The World Health Organisation (WHO) recognised that non-communicable diseases, including birth defects cause significant infant mortality and childhood morbidity in 2008. In fact, cleft lip and palate has been included in their Global Burden of Disease (GBD) initiative.
Cost of a smile
z SmileTrain is a non-profit organisation dedicated to help millions of children who suffer from cleft lip and palate by providing free surgery for them. Smile Train not only makes quality cleft lip and palate surgery available across India, it provides it completely free of cost to anyone who needs it. Since 2000, Smile Train has sponsored over 325,000 safe, quality surgeries across India. The NGO’s efforts have been well documented in a documentary Smile Pinky. The documentary won an Oscar in 2008. The protagonist of the film, Pinki, was also operated for a cleft lip by doctors working with SmileTrain. To honour NGO’s efforts, Pinki was invited to toss the coin at this year’s Wimbledon men’s finals.To ensure safety and efficacy of the procedures, doctors and healthcare professionals in India are trained and educated in the latest in cleft surgery and related care. Smile Train works only with local doctors and hospitals in India, helping them treat children in their own communities. Interested patients can get details about all SmileTrain treatment centres on the following website http://www.smiletrainindia.org/tc_frameset.htm —
The writer is Director and Chief of Plastic Surgery, GS Memorial Hospital. He operated on Pinki, who was documented in the Oscar winning documentary ‘Smile Pinki’. |
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Worried over weight, British teenagers skip breakfast
London: A British study has found children as young as 10 being unhappy for their weight. Since they feel they need to shed weight, one in six teenagers is skipping their morning meals. A report by the Schools Health Education Unit says, two-thirds of 14 and 15-year-old girls wanted to be slimmer. One in five of the group have no lunch along with 14 per cent of 13-year-old girls. The study said young people become more concerned about their weight as they grow up and are increasingly likely to skip breakfast or lunch as they get older, Daily Mail reported. The study, questioned over 68,000 10 to 15-year-olds, and found nearly two-thirds (63 per cent) of girls (aged 14 and 15) say they would like to lose weight, along with more than half (54 per cent) of those (aged 12 and 13). The report also questioned pupils about their eating habits. Around one in six (17 per cent) 14 and 15-year-old girls, and more than one in 10 (11 per cent) boys of the same age did not eat breakfast. Others only had a drink for breakfast. Laura Sharp, a nutritionist for the Children's Food Trust, said: "These are very worrying findings — all pupils, whatever their age, need to start the day with breakfast if they're going to be able to focus in class. Research shows a clear link between eating breakfast and children's attainment at school. What's particularly worrying is that girls and boys are skipping meals at a time when their bodies are changing fast and they're particularly in need of good nourishment," she added. —
IANS |
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Shorter breaks better than long break
Washington: A new study suggests that a long vacation may not be best to mentally rejuvenate and de-stress. "Although vacations rank fairly low on the list of stressors, they combine elements like travel, sleep disruption and food changes that can themselves be stressful," said Christopher Robinson, University of Alabama, Birmingham Department of Psychology. Research has shown that people who were about to go on vacation were happier — evidence that anticipation of a break is a mental perk. Tips to maximise the short-term increase of happiness vacations provide include: Shorter trips throughout the year instead of only one long vacation. Spontaneous weekend getaways. A morning off after an evening out to extend the break. Whether it is hiking or camping, a relaxed family game night, golf, going to the beach or getting a baby sitter and having an evening out with one's partner or friends, Robinson encouraged fitting in regular mental health breaks. "I find that regularly taking time to sit around a fire pit with friends helps me de-stress far better than involved vacations with tons of planning," Robinson said.
— ANI
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Want to get fit? Chuck your cell phone Left-handers are better decision makers Islamabad:
A new research has suggested that being a left hander could make you a better decision maker than a right-handed person. According to BBC health, scientists at Abertay University in Dundee have found that left-handed people are more likely to take their time over unfamiliar tasks and think about the consequences, the Daily Times reported. The study, which included 100 persons — 50 left-handers and 50 right-handers — to complete a task on a computer, suggested that many objects and activities in daily life are designed for right-handed people, forcing the left-hander to think more and thus making them better decision makers. — Agencies |
Little Shiva was born with a severe cleft lip and palate in a poor, rural area of northern India. His father was a labourer who earned less than Rs 50 a day. Shiva's illiterate parents did not know that clefts can be repaired until they came across an advertisement in the local newspaper about a Smile Train clinic in a nearby town.
New York: