BEHAVIOUR PROBLEMS: HOW TO MANAGE?
Young children readily sense this reluctance, and invariably take advantage of these situations. Everyone has seen a parent in a supermarket struggling with one or several young children. Their demands get shriller by the minute, and the embattled parent usually gives in to whatever the demand is to avoid further embarrassment. This of course virtually guarantees that the same battle will take place next time.
You can minimise these situations by considering the following:
• Do not take your child shopping or visiting. This is obviously the last resort, but may be necessary at times to break a cycle.
• If he is good, praise him and give him the reward as promised.
• If he begins to misbehave, try ignoring him (the first rule of behaviour modification). If this is not possible, warn him (once only) that if he does not stop, you will take him straight home and he will go to his room for time-out.
• If he does not stop, carry out your threat immediately, without further discussion. Be consistent. If you do this several times, the child will quickly learn that to misbehave when out shopping inevitably has consequences, and the testing behaviour will likely stop or reduce significantly. The difficult thing, of course, is to carry out the threat, leaving your shopping right in the middle, or curtailing your visit to friends or family. If you are not prepared to do this, then do not threaten to do it.
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HEADACHE — MIGRAINE – GENERAL INFORMATION
One group of headaches is due to stimulation of pain-sensitive nerve endings in the wall of arteries of the brain or scalp. These are the vascular headaches. The arteries are dilated and this irritates the nerves and causes pain. Migraine is the best known of this group.
When a patient goes to a doctor with the complaint of headache, a proper history is most important. Only in a few cases of headache will there be any abnormal finding on examination or anything abnormal showing on tests.
One famous physician had a favorite saying: “Let me take the history and I will rely on the examination of the most inexperienced medical student.”
In most cases, the astute doctor can arrive at the correct diagnosis on the history alone, but a full medical examination is always necessary to exclude other illness.
X-rays of the skull may be taken and sometimes more invasive techniques, such as a lumbar puncture, where a needle is inserted into the spinal canal and fluid withdrawn for examination under the microscope, are used. Occasionally, air is injected into the fluid canals in the brain.
In a carotid angiogram, a radio-opaque dye is injected into the carotid artery in the neck and X-rays are taken as the dye flows through the arteries of the brain.
A newer, less invasive technique is the brain scan, where a radioactive substance is injected into a vein and its progress through the brain is monitored.
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MENORRHAGIA – LOSS OF BLOOD
Usually the loss of blood is only moderately heavy and, if this is so, one can usually wait and hope that the condition will resolve itself.
But if the bleeding is excessively prolonged then a curette is indicated.
The curette is not only diagnostic in the sense that the lining of the womb can be removed and examined under the microscope but if most of it is removed then it may cure the condition.
But if bleeding recurs at a later stage then a second curette may be necessary. If this treatment fails to control the problem then we may need to consider hysterectomy, or removal of the womb.
Fibroids are benign, that is non-cancerous tumors of muscle and fibrous tissue which develop in the womb. These may be single or multiple. In many cases they cause no symptoms but should one project into the cavity of the womb it may cause excessive bleeding.
Some women have difficulties coming to terms with the loss of the womb and see it as a loss of femininity.
But for women who really have no further use for this organ and which is causing considerable distress, operation comes as a welcome relief.
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BABY AND CHILDHOOD RESPIRATORY DISORDERS: PNEUMONIA
Pneumonia was once a serious disease in children, with a high mortality rate. It is still dangerous, but today, with a wide range of antibiotics available, the death rate has fallen precipitously and the results now are usually good.
But parents should never overlook the symptoms and should take immediate action if they occur. Pneumonia means the air-containing lung substance has become infected; and areas of lung tissue, normally spongy, become filled with fluid and discharge and may even become a solid mass. This reduces the area available for normal exchanges of oxygen and carbon dioxide. Unless relief is imminent, death may result either from suffocation or from the spread of the disease and toxic effects of the organisms involved.
Onset may be rapid, with a rising fever, chills in older children and probably bouts of shivers. Breathing becomes rapid. There may be a cough. Vomiting and diarrhoea may occur. There may be aches and pains and a stiff neck. In older children there may be severe pain present, particularly in the tummy region. Sometimes the sudden onset of symptoms, especially the fever, may lead to convulsions, which are very worrying to parents. There may be obvious breathing difficulty, and the child may grunt when breathing out. Nostrils may be dilated, cheeks flushed, lips possibly a bluish shade (indicating cyanosis).
Any infant or child with symptoms of this nature needs immediate expert medical care. Pneumonia may lead on from a simple upper respiratory tract infection, or it may come on suddenly with no relationship to a previous infection. Never forget that normal respiration is essential to good health and if it is in any way jeopardized, for whatever reason, medical help is vital.
Antibiotics have revolutionized treatment of serious lung infections and pneumonia. The sooner this is started the better. So our advice is prompt attention. See the doctor. Do not delay or waste time in trying self-medication. Time lost could spell disaster.
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BABY AND CHILDHOOD ILLNESSES: HEAD ROLLING, HEAD BANGING AND ROCKING
Towards the end of the first year many infants resort to strange habits, such as banging the head, rolling the head or rocking the head and body when lying in the cot. Often this is more common when they are tired and as they are about to fall asleep. Many finally drop off into slumber.
Some infants pull at their hair, others knock and bruise themselves, particularly their arms. It may be an indication of boredom, or relief from tension. It has been related to adults drumming a desk with their fingers, or tapping the floor with their toes, or making other rhythmical movements when under stress.
Some parents fear the child may be mentally defective, or that the child is masturbating.
Treatment
It is worth having the infant examined by the family doctor if fears are held for his mental state. If the child obviously relates well to others and is making satisfactory mental and physical progress for his age, mental disorders can usually be ruled out. Most cases tend to settle down. Simple methods to prevent the child from mechanically injuring himself are worthwhile, such as padding the sharp edges and corners of the cot. Sedative medication is often prescribed, but this gives only temporary respite and is virtually useless. Most cases settle down in due course as they become older, and the problem automatically vanishes.
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OATS
(Avena sativa)
This grain, common in the Western diet, has become fashionable in recent years for its bran’s ability to control cholestrol levels in the blood. It is the inositol in oat bran, a B-complex vitamin, which helps to increase the blood’s ratio of high density lipoproteins to the cholestrol-rich low density lipoproteins. While the miraculous properties of oat bran may have been exaggerated, a deficiency of inositol can certainly lead to a significant increase in blood cholestrol levels.
As a source of fibre, oat bran is considered superior to wheat bran as it will not scour the bowel. In cases of severe bowel irritation however, laxatives such as psyllium should be used instead.
Oats in their wholegrain and rolled forms are an excellent source of protein, Vitamin B1, calcium, iron and silicon. The aforementioned inositol also aids the body’s absorption of zinc. A tea made of oat straw is sometimes recommended for chest and skin complaints. The skin toning properties of oats are widely recognised and oatmeal is an ingredient in many natural facial scrubs and face packs.
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DEHYDRATION IN CHILDREN
Dehydration is a serious loss of body fluids. It occurs when the body is losing more fluids than it is taking in. When an excessive amount of body fluid is lost, the body loses the water, minerals, and salts contained in the fluid. Proper amounts of water, minerals, and salts are essential to health and to life.
Several conditions may cause the body to lose an excessive amount of water, minerals, and salts. Diarrhea, vomiting, and excessive sweating are common causes of dehydration. Illnesses that cause excessive breathing (such as asthma) may cause the child to lose water vapor from the lungs. Illnesses that cause excessive urination (such as diabetes) may also cause dehydration.
The smaller the child, the more quickly dehydration can develop. In young infants, dehydration occurs as rapidly as 12 to 24 hours after the start of any cause of dehydration (such as diarrhea or vomiting). A child who is not losing extra fluids will rarely become dehydrated simply by taking in fewer liquids. Except in young infants and in children with diabetes, the kidneys can compensate for a smaller intake of liquids. However, a small intake of liquids in a child who is also losing fluids causes dehydration to occur even more rapidly.
Signs and symptoms
Except in a child with diabetes, a sign of dehydration is a smaller output of urine. A young child who goes six to eight hours without urinating, or an older child who does not urinate for ten to 12 hours, may be dehydrated. Other signs of dehydration include sunken eyes; drowsiness; rapid or slow breathing; and depression (sinking in) of the soft spot in an infant’s skull. The membranes inside the mouth may feel dry when touched by a finger. The skin may feel less flexible than usual when pinched between the thumb and forefinger.
Home cake
If a child shows any symptoms of dehydration, call your doctor. If the child is vomiting, stop the vomiting first. With any condition that causes fluid loss (including prolonged high fever), you should encourage your child to drink extra fluids. The best liquids to give a child with increased fluid loss are commercial fluids that contain proper salts and sugar. Other good liquids are gelatin desserts (liquid or gelled); weak tea with sugar; ginger ale, colas, and other carbonated drinks. Plain water is less helpful. Milk products should be avoided.
Precautions
• Do not give undiluted skim milk and boiled whole milk to a child who is losing fluids. Their salt and mineral content is too great for the child to tolerate.
• If symptoms of dehydration develop, contact your doctor. The younger the child, the more urgent the situation. Diarrhea in infants can be very serious.
• The amount of urine output cannot help detect dehydration in a diabetic child.
Medical treatment
Your doctor will diagnose and treat the condition that is causing dehydration. Your child may be admitted to a hospital to be given intravenous fluids and salts. The child may be tested for the amounts of salts and minerals in the body.
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AGE EXTENDERS: HEALING HERBS
Protecting against aging. Sometimes it seems like everybody’s anti this or anti that. Well, that holds true for some herbal remedies, too. Grape seed, for example, is antioxidant. Oxidation is basically the body’s equivalent of rust, at the cellular level. It tears down, weakens, and ultimately kills cells that make up our skin and tissues-a process associated with aging and degenerative diseases. Antioxidants, which are found mainly in fruits and vegetables, help counter the cellular wear and tear. How much grape seed should you use? Follow the instructions on the label, says Dr. Tyler.
Ending constipation, reducing cholesterol, guarding against colon cancer. All you have to do is drink slime. That’s right. Nice, slimy psyllium in water. Take it flavored or unflavored. Take it as raw husks (which you’ll find at the health food store) or as ground-up seeds like those contained in the commercial preparation called Metamucil (which you’ll find in the supermarket, along with less-expensive generic versions). Use psyllium daily, says Dr. Tyler, with water and other liquids. Lots of liquid-that’s key. This bulking fiber, used daily or more often, gently pushes wastes through the intestinal tract. “It acts like a giant sponge going through the gut, swabbing it out. And it tends to remove carcinogens before they can have much effect,” Dr. Tyler says. As an extra added bonus, psyllium can cut cholesterol, too. For regularity, though, you have to use it, um, regularly. Follow the instructions on the label.
Feeling mote vital. Studies show that taking ginseng, along with a multivitamin, lifts spirits and, in general, makes a man feel better, Dr. Tyler says. It’s a tonic. Of the many products on the market, the concentration of ginsenosides may vary. Buy a standardized extract that contains 4 percent of the active ingredient ginsenosides, and follow the dosage on the label, he says.
An herb called Siberian ginseng, which really is not a member of the true ginseng family, works similarly, says Terry Willard, Ph.D., herbalist. Dr. Willard suggests taking from 500 to 1,000 milligrams of Siberian ginseng twice daily.
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PREVENTIVE MEDECINE: COPING WITH STRESS
A large number of people harbour negative feelings such as hate, distrust and resentment, sometimes holding on to grievances for years. These feelings work away inside them to make them ill even though the source of the problem is often someone else. Whilst serious grudges and really intransigent problems may need professional insights and expertise, many such negative emotions can be overcome by individuals themselves once they realize that they are doing themselves more harm than anyone else. The starting point is to realize that the past is done and gone and that nothing can undo what we have done. The aim should be to come to terms with what has happened and then try to make amends for it in some way. Often simply having the strength to say ’sorry’ after many years can lift a burden off your shoulders. Sometimes such feelings are best put down in writing rather than discussed face to face, or it may be better to open the door in writing and then meet to talk it out. Very few people can throw a heart-felt apology back in someone’s face and if time has healed the emotional wounds even a little then things can go very well from there. It was a wise man who said, ‘He who cannot forgive breaks the bridge over which he himself must pass’
The secret of all attitudes, beliefs and behaviour is to know yourself and to have insights into these facets of yourself. This can be very difficult but there are excellent books that can help. Perhaps one of the best is ‘I’m OK-You’re OK’ by Dr Thomas Harris. A few sessions with an insight-trained counselor of some kind can also be invaluable in opening doors for you which then alter the whole way you think in the future. It pays to listen to what good friends say too. There are few people who will be really honest with you in life and, ironically, your partner may not be the best person.
So many emotions, types of behaviour and beliefs are destructive and harmful to us that it is a shame that so little is said about all this in health education of all kinds. It should really be a major strand of preventive medicine-the benefits would be enormous. The burden on doctors would fall dramatically if they were trained to deal with their patients in this way-giving insights into their personalities as an explanation for their ill health. Alas, few doctors are capable of doing this and those that are have too little time to exploit their skills. Hopefully there will soon be a shift away from dealing with the obvious complaints to dealing with the underlying personality problems that produced them in the first place.
If you doubt the importance of the personality in illness and health, think of all the major diseases that we are heir to. Smoking, for example, has an enormous psychological component to it and most smokers won’t or can’t give up until they understand the underlying psychological mechanisms that make them do it. The problem with overeating is much the same. Both are oral pleasures for people who are arrested at the oral stage of their psychosexual development. Most VD is caused by promiscuous behaviour which could be prevented if the individuals concerned had insights into themselves and their actions. The majority of car crashes are in no way ‘accidental’ and neither are the thousands of unwanted pregnancies that occur each year. And so I could go on. And I haven’t even mentioned the obvious emotionally-based problems within marriages, families and working groups-all of which produce disease. The greatest tool of preventive medicine, then, is self-knowledge, and until our medical-care system comes to grips with this people will continue to injure and kill themselves quite unnecessarily.
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CAUTIONARY NOTE ON HERBS
Most herbs can be used safely over long periods in small amounts. However, care should be taken when using herbs that have a. cumulative effect.
Golden seal should not be taken over long periods of time because of its effect on the intestinal bacteria which can affect the absorption of Vitamin B. Lily of the valley and ephedra should not be used with persons who are suffering from a history of very high blood pressue. Comfrey and foxglove are cumulative and poisonous in large amounts.
When collecting wild herbs, know the herb that you are gathering. It is not difficult to incorrectly identify wild herbs. A good rule is that if you are not sure, do not use it.
Do not use essential oils in large doses as they are concentrated and may cause irritation in contact with the eyes or mucous membranes.
FORMS OF HERBAL PREPARATIONS
Infusions: Decoctions:
Percolation:
Made with the use of spirits where the herb cannot be heated or when the drug only gives up its principles to spirit. Are the most concentrated form of the drug. They are made by concentrating the chemicals in liquid by evaporation, high pressure. 28gm of drug = 28gm of liquid Are made by pouring boiling water over the herb and letting it stand for half an hour and then straining the liquid off. A decoction of the drug requires heat. Cold water is poured over the herb and then the mixture is boiled for twenty minutes, cooled and strained.
A very effective way of obtaining the fluid, soluble part of a drug. This is obtained by allowing the fluid to drip through the drug time and time again in a percolator, until nearly all the soluble matter is extracted from the drug.
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