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Does your child have diabetes? Here’s everything you need to know

The Kashmir Monitor

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Increased thirst and frequent urination, extreme hunger, weight loss, fatigue, blurred vision, and frequent behavioural changes — have you noticed any of these symptoms in your child? If yes, then you should get them screened for diabetes. While there is no nationwide registry or any consolidated official data on the prevalence of diabetes among children in India, the incidence is high.
“Type 1 diabetes is one the most common endocrine illness. The incidence of childhood diabetes is on the rise worldwide with a reported increase of two to five per cent per year,” says Dr Sumit Gupta, consultant pediatric at Columbia Asia Hospital.
The Diabetes Atlas 2017 estimates that there are 128,500 children and adolescents with diabetes in India. According to a study published in the Indian Journal of Endocrinology and Metabolism, it is estimated that India is home to about 97,700 children with type 1 diabetes mellitus. The actual figures might be higher since a lot of cases might not be reported or fail to get diagnosed.
Dr Ashutosh Goyal, senior consultant – endocrinology and diabetes, Paras Hospitals, Gurgaon, confirms that there has been a rise in type 1 diabetes incidence across the world. “In fact, there has been an increase in the incidence of auto immune conditions in general; type 1 diabetes is an auto immune condition itself. Autoimmunity of the pancreatic ß-cells results in a situation where the body stops producing required amount of insulin. Auto immune diseases are mostly genetic. However, environmental factors play a critical role in activating those genes and causing full fledged disease in an individual,” he shares.
According to him, a variety of theories are used to explain this rise in incidence of auto immune diseases. One of the most commonly cited theories is the hygiene theory which blames our increased penchant towards creating super hygienic and sanitised environments.
“Evidence shows that exposure to a variety of microbes and pathogens during early childhood acts as a protective factor against type 1 diabetes. Less exposure to a wide variety of microbes and pathogens is associated with an increase in allergic conditions as well as auto immune conditions. Apart from this, other environmental factors such as exposure to toxins in our food chain, environmental pollution etc are all believed to play a role,” he adds.
Some of the most common red flags of the condition include increased urination, weight loss and infections. However, children at risk can also be identified by getting a screening before its onset. Delayed diagnosis leads to Diabetic Ketoacidosis, a life threatening condition.
“Diabetes in children can develop at any age but usually it shows after one year of age. Given the autoimmune nature of the disease, the condition cannot be prevented. The most common form of diabetes in children is Type 1 diabetes. However, increased childhood obesity has resulted in increased prevalence of Type 2 diabetes due to insulin resistance,” says Dr Anurag Bajpai, consultant pediatric and adolescent endocrinology, Fortis Memorial Research Institute, Gurgaon.
So, like adults, do children also need to be injected with insulin?
“Yes,” says Dr Gupta, adding that insulin is the only treatment available for type 1 diabetes. Concurring, Dr Goyal says, “Type 1 diabetes in children is a condition in which your child’s body no longer produces an important hormone (insulin). Your child needs insulin to survive, so you’ll have to replace the missing insulin by injecting it in his/her body. These kids need multiple injections daily.”
Besides insulin, certain lifestyle changes, regular physical activity and healthy eating help in control of childhood diabetes, says Dr Bajpai. Suggesting a diet which includes carbohydrates from fruits, vegetables, whole grains, legumes, low fat milk and light fibres, Dr Gupta points out that the child’s school should also be prepared to handle the situation.
“It is very important to make your child aware of of the condition since it is a disease that requires significant lifestyle modification. Until and unless, a child takes initiative of leading a healthy life, none of the external factors can help him/her to control the disorder. A child with this condition need extensive counseling sessions to educate him/her about the condition and the need for leading healthy lifestyles,” suggests Dr Goyal.
“Parents themselves need in-depth education about the disease and its management to be able to guide their child. Parents must talk to the child in an age-appropriate way and offer him/her confidence in his/her ability to manage the disease. They should be taught that diabetes doesn’t mean the end of the world. It only means that with a little effort and good lifestyles, they can lead healthy and productive lives. Give them examples of celebrities living with this condition such as Wasim Akram, Sonam Kapoor, Nick Jonas, among others. Answer all their questions patiently pertaining to diabetes. Make sure that the child doesn’t get too much bothered about the disorder and feel sorry about it,” he says.


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Health

Hepatitis A Causes and Symptoms

The Kashmir Monitor

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Generally speaking, hepatitis A is more common in parts of the planet that are developing. It’s for the fact that sanitation and food handling practices are by and large poor. However, medical experts say that living in developed countries can also put you at risk of having hepatitis A, but it’s really a rare occurrence.

Just like what’s mentioned earlier, hepatitis A is caused by the hepatitis A virus or HAV. It can be spread around by someone who has hepatitis A because he or she is a carrier of the virus behind it. It is said that a person with hepatitis A is most infectious about 2 weeks before he or she begins to experience signs and symptoms.

Here are some of the ways that hepatitis A is spread around:

 

Consumption of food that is prepared by a person who has hepatitis A. This is most especially true if he or she has not properly washed his or her hands.

Drinking of water that is contaminated with the hepatitis A virus.

Intake of raw or undercooked seafood obtained from contaminated water.

Close contact with someone who has hepatitis A. This includes having sexual intercourse with an infected person, especially when the rectal or anal area has been touched with the fingers, mouth or tongue.

Using illegal drugs, especially when paraphernalia contaminated with the hepatitis A virus are used.

Symptoms

Medical experts say that it may take a while before the various signs and symptoms associated with hepatitis A show up. They say that someone may experience them about 4 weeks after getting infected. It’s even possible for someone with hepatitis A to not experience any sign and symptom at all.

Some of the initial signs and symptoms of hepatitis A include:

Tiredness and malaise
Achy muscles and joints
Pain in the upper right section of the abdomen
Loss of appetite
Mild fever
Headaches
Sore throat
Diarrhea or constipation
Hives or raised rash that’s itchy

These initial signs and symptoms associated with hepatitis A can last anywhere from a few days only to a couple of weeks. Afterwards, as the infection of the liver progresses, the following may be experienced by the individual:

Jaundice, which is the yellowing of the skin as well as the whites of the eyes (sclera)

Pale colored stools
Dark colored urine
Skin itching

Tenderness and swelling of the upper right section of the abdomen

Although it rarely happens, hepatitis A can cause liver failure. When such develops, the person who is infected may experience severe vomiting, frequent bruising, bleeding of the nose and gums, drowsiness and confusion.

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Health

Busting myths around blood donation

The Kashmir Monitor

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As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

Contrary to the myth about blood donations making a person weak or anaemic, the body replenishes the lost blood in a matter of a few days, say experts.

“A healthy bone marrow makes a constant supply of red cells, plasma and platelets, so there is no question of becoming weak, much less anaemic. It is a myth and should not deter people from donating blood,” says Dr RK Singal, chairman, internal medicine department, BLK super-speciality Hospital.

 

The donors can give either whole blood or specific blood components, as there is sophisticated equipment available these days that extract relevant components from blood and the rest of the blood can be transfused back to the donor.

As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

About 65% of India’s population is young and if this section donates blood regularly, chances of the country facing blood shortage will be remote. Hence, there is all the more reason for people, especially youngsters, to come forward and be regular blood donors.

How to prepare

Have enough fruit juice and water in the night and morning before you donate

Have a full meal 3 hours before donation; never on an empty stomach

Have some rest for about 10-15 minutes after donation

Have some snacks or a juice with high sugar content after donation

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Health

Erectile dysfunction’s connection with lifestyle

The Kashmir Monitor

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By Dr Anjani Kumar Agrawal

healthy-lifestyle-can-reverse-effects-of-hypertensionAll over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED).

All over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED). From my research, I have found a strong link between ED and stress. Other major causes include smoking, drinking, diabetes, hypertension or high blood pressure and cholesterol levels. My advice to these patients is — do not get even more stressed over this situation. Instead, focus on taking the right medication and making some changes to your lifestyle, so you can once again enjoy a satisfactory sexual life.

 

DIAGNOSIS OF ED

We normally diagnose ED and its underlying causes by asking the patient a few questions about his medical and sexual history. This is sometimes done by sharing a questionnaire with the patient. The questions that we ask are designed to help us understand the cause of ED in the particular patient.

We also do a physical exam, ask for certain blood tests to rule out other medical conditions responsible for erectile dysfunction, and recommend imaging tests (if required) to determine whether the person is physically able to have an erection or not.

SHORT-TERM SOLUTION, LONG-TERM CURE

Underlying medical conditions such as diabetes, hypertension and hypercholesterolaemia (high cholesterol levels) can cause ED. In these cases, ED can be reversed once the patient starts treatment.

In my experience, many men suffer from ED because of work stress, family pressure and anxiety. So, changes in lifestyle with regular exercise, yoga, abstaining from alcohol and smoking, and proper counselling help in treating ED. Along with this, medicines for ED are usually prescribed for about 3 to 6 months by which time lifestyle changes start to take effect and the patient is physically and mentally healthier, which helps resolve the problem.

An estimated 16% to 25% of men experience ED at some point in their lives. I would urge them not to be embarrassed about it. Seek medical help from a urologist or andrologist; get the necessary advice/medication; and go on to enjoy a healthy, fulfilling sexual life.

The author of this article is Dr Anjani Kumar Agrawal, head, andrology, department of urology sciences, Max Smart Super Speciality Hospital, Saket

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