Child and Public Health Physician
A worried mother stopped her three-year-old son from attending the day care centre because he developed a runny nose (catarrh) which had been on since his enrolment three weeks ago.
The mum claimed to have been frequenting hospital twice weekly since school resumption. She was confused and did not know the way out of the quagmire.
According to her, other children in the centre also have catarrh and could probably have been the source of her son’s infection.
A second incident happened in a preschool; the proprietress, in trying to save a dying child, had to ride on commercial motorcycle (okada) for the first time in her life to get a five-year-old boy who convulsed repeatedly in school to the emergency centre.
The school was found wanting as there were no first aid materials, no school nurse or teacher designated to be in charge of pupils’ health and no certified first aiders in the school. The school was sued for negligence and was suspended by the regulatory body till they would have the basic requirements (first aid box, life-saving gadgets and first aider) in the school.
Kindly call parents, carry them along, get consents for interventions when things go wrong.
Searching for the right daycare centre for the preschool age group may be a difficult task. Keeping the children healthy while in school is even tougher because as they start daycare, they are welcomed by germs that can cause an array of health issues such as ear infections, colds, coughs, sore throats, runny noses, fever, vomiting, and diarrhea, among others.
Suggestion for caregivers and managers of day care centres
The following are needed for an excellent healthy living among kids in the daycare settings:
- Pre-entrance screening by qualified medical personnel: This will help to detect cases like communicable diseases, developmental delays. Also disorders like sickle cell and autism can be picked at an early stage.
- Cleanliness: The centres should be cleaned each day with safe, non-toxic cleaning products. Cleaning supplies must be locked safely out of reach of the children. Child care providers should clean toys each evening and sanitise them throughout the day to prevent the spread of germs.
- Hand washing: Encourage children to wash their hands throughout the day. There should also be teaching, demonstrations, songs, practice and lessons about hygiene. Caregivers must lead by examples; nannies and teachers should do hand washing as often as possible.
- Medication: There must strict policies for administering medication to the children, ensuring that the medications are safe and are protected. Based on new research about healthy practices for infants and toddlers, a doctor’s note should be given for any medication, prescription or over the counter, given to a child under two years to ensure safety.
- Child protection (safety and security), CCTV (Hidden cameras) should be an essential component of a good day care centre; this will allow the day care managers to monitor staff, children, visitors, and parents. Mothers who may be suspicious of wrongdoing on the child can request for playback. Electrical appliances, boiling rings, flasks and other hot instruments should be put away.
- Dedicated, friendly caregivers and nannies who are trained in child development, early childhood education or related fields should be employed to take care of the children. All staff members are to be trained in first aid and cardiopulmonary resuscitation (CPR).
- Caregivers, nannies, and food vendors should be screen annually for communicable diseases. They should do chest X-rays, stool tests, mantoux, typhoid screening, among others, annually to prevent the spread of communicable diseases from caregiver to the kids.
- Parents are to keep their children at home should they suffer any of the following: Diarrhea ( frequent watery stools more than thrice a day), vomiting (after two consecutive bouts), temperature of 38 C or over, earache, severe headache or stiffness in the neck, persistent cough, lice, chickenpox, measles, mumps, meningitis, impetigo (skin infection), pneumonia (cough, fast breathing and fever).
- Day care centres should have a special room that may also serve as a school sick bay. The services of a school nurse may be needed to render first aid.
- Harmful practices like force-feeding, using sedatives for children, sucking the nostrils of infants with mouth should be avoided.
In conclusion, children in these centres are more likely to catch infections than kids who do not attend day care. Children who go to day care centres are often around other kids who may be sick. However, being around a large number of germs in the centres may improve children’s immunity. Also due to the alarming rates of child abuse in the country, children should be protected from the male workers (male guards, security, drivers, among others) to prevent child sexual abuse.
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How Kourtney Kardashian Became Known For Kooky Health Advice – Refinery29
The 40-year-old Kardashian sister is known for living a strictly organic, gluten-free, non- GMO, vegan, dairy-free, ketognic, existence. While there are some funny vintage Keeping Up With The Kardashians clips of Kourtney working out casually or shaking a giant plastic salad container, her full-on wellness obsession began around the time that she had Mason. “I feel like once I had Mason, I just became more aware,” she told Refinery29 in 2016. “And then once you learn information, you can’t really make it go away.”
DOH issues health tips for devotees going on Visita Iglesia – INQUIRER.net
MANILA, Philippines — The Department of Health (DOH) issued on Thursday health tips for people who will visit churches during the Holy Week.
In a Facebook post, the DOH advised devotees to bring umbrellas, wear comfortable clothes, and to drink enough water.
Below are the Health department’s tips for Holy Week observers. /cbb
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Tips for better bowel control – Harvard Health – Harvard Health
Try simple measures first, like using a fiber supplement and treating underlying conditions.
Nobody wants to talk about or even imagine it. But loss of bowel control — known as fecal incontinence — is a problem for millions of adults in the United States, especially women.
“It becomes more common with age. It’s socially isolating and takes away your dignity. You live in fear that you have stool in your pants and people can smell it. Some people won’t even tell their doctors about it,” says Dr. Kyle Staller, a gastroenterologist at Harvard-affiliated Massachusetts General Hospital.
Symptoms and causes
Feces can leak out of the rectum accidentally — in liquid form or as solid stool — for a number of reasons. One is that age tends to weaken muscles, including the anal sphincter (the muscle that holds in feces until you’re ready for a bowel movement).
Damage to nerves or muscles can also lead to fecal incontinence. You may experience damage from rectal surgery, inflammatory bowel disease, multiple sclerosis, stroke, childbirth, or diabetes, for example.
Fecal incontinence can be an effect of chronic diarrhea from conditions such as irritable bowel disease. Impacted stool due to constipation can also cause fecal incontinence.
And sometimes, fecal incontinence is the result of an attempt to thwart constipation. “Older people frequently take laxatives and stool softeners because they’re worried about constipation. That creates loose stool. If age has weakened the muscles of the anal sphincter, fecal incontinence can occur,” says explains Dr. Jennifer Irani, a gastrointestinal surgeon with Harvard-affiliated Brigham and Women’s Hospital.
Try this at home
Both experts suggest trying simple fixes for fecal incontinence before seeking treatment from a doctor.
You can cut back on stool softeners and laxatives, if those are causing the problem. Or you can bulk up your stool (so it’s easier to hold on to) with an over-the-counter fiber capsule or a powder that you can add to a drink or food. Examples include Metamucil, Citrucel, FiberCon or Benefiber.
“Fiber won’t constipate you,” Dr. Irani says. “The rectum is smart and can sense bulkiness. When you have more sensation, you have more time to get to the bathroom,” she says.
You can also try bulking your stool with dietary fiber. Legumes such as beans and lentils are a go-to source. For example, a cup of canned low-sodium black beans has about 17 grams of fiber. A cup of cooked lentils has about 16 grams of fiber.
Taking a nonprescription antidiarrheal medication such as loperamide (Imodium) can work if you have incontinence with diarrhea. “It’s okay to take it every day under supervision, but it won’t work if you have a weakened sphincter,” Dr. Staller points out.
Pelvic floor exercises (Kegel exercises) may also help reduce fecal incontinence. These involve contracting (squeezing) the anal sphincter several times per day or whenever you feel fullness in the rectum. “Pelvic floor physical therapy will help, but it won’t always solve the problem. Also, you have to do the exercises every day or it doesn’t work,” Dr. Irani notes.
Pads that you tuck into your underwear or adult diapers can offer security when you have fecal incontinence. But pads and diapers can irritate the skin, as can a bowel movement that’s been near your skin for too long. Using a barrier cream such as zinc oxide can help protect the skin.
Dietary fiber linked to a lower risk for fecal incontinence
When fecal incontinence strikes, increasing your dietary fiber with foods like legumes can help get you back to normal. And a Harvard-led study published last September in Gastroenterology suggests that eating a high-fiber diet over the long term is associated with a lower risk for developing fecal incontinence in older women.
Researchers looked at questionnaire responses from more than 58,000 women who were followed for more than 20 years. Women in the study who ate the most fiber (25 grams per day) had an 18% lower risk for fecal incontinence, compared with women who ate the least amount of fiber (13.5 grams per day). The study is observational and doesn’t prove that eating fiber prevents fecal incontinence. But it’s reasonable that it should. “There are so many reasons why fiber can be helpful. It may help ward off heart disease and diabetes. A reduced risk for fecal incontinence adds another potential benefit,” says Dr. Kyle Staller, the lead author of the study and a gastroenterologist at Harvard-affiliated Massachusetts General Hospital.
When simple fixes aren’t making a difference, it may be time to see your primary care physician or a specialist. You can expect a specialist to take a full medical history and conduct a digital rectal exam (feeling the inside of the anus with a gloved finger to assess how tight the anal sphincter is).
Further testing to look for damage to the anal canal, sphincter, or lower colon may include
anoscopy (insertion of a small, short scope into the anal canal)
sigmoidoscopy (insertion of a flexible viewing tube to examine the sigmoid or lower colon)
anal ultrasound (using sound waves to look at the sphincter structure)
anal manometry (insertion of a catheter and balloon to measure anal sphincter strength).
Often, treatment of an underlying bowel condition, such as impacted stool or chronic diarrhea, solves the problem. “It’s much easier to fix a bowel disturbance than it is to tighten up the sphincter,” Dr. Staller says.
Beyond that, there are only a few treatment options for older adults whose fecal incontinence does not respond to simple measures.
One option is called sacral nerve stimulation. “It’s like a pacemaker for your anus,” Dr. Irani explains. “We implant wires into the sacral nerve in the spine to stimulate the sphincter muscle to contract. What’s key is that it will only work if incontinence involves solid stool, not liquid stool. Also, you have to be able to operate an external device and participate in your care.”
The other option is surgery to create a colostomy, bringing the end of the large intestine through a special opening in the abdomen so that it drains into an attached bag. “People rarely choose this option. They’d rather wear an adult diaper. But people who choose surgery seem to get their freedom back. They just empty the bag when it gets full,” Dr. Irani says. “Colostomy is especially helpful for people who are in a wheelchair and can’t get to the bathroom frequently,” Dr. Staller adds.
A ray of hope
Most people don’t have to resort to drastic measures like surgery. Bulking stool through diet or with fiber powders usually solves or greatly reduces the problem. But if that’s not working for you, don’t suffer in silence. Your doctor may be able to help.
“Just talking about it with someone who knows what you’re going through is a real benefit,” Dr. Staller says. “You may not be able to get rid of fecal incontinence, but you may be able to eliminate 50% of the episodes and many of the accidents you have. And we know that even one accident feels like it’s too many.”
Image: © GregorBister/Getty Images
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