Valvar aortic stenosis, commonly called aortic stenosis, is a disorder which occurs when the aortic valve of the heart becomes narrow. The narrowing of the valve prevents its full opening, and hence, blood flow from the heart to the aorta is restricted. When the aortic valve gets obstructed, the heart has to exert much more effort to pump the blood. The heart muscles get weakened as a result. This condition is more common in children.

Diagnosis of valvar aortic stenosis-
Before diagnosis, we should know about the symptoms of valvar aortic stenosis in children. They include:

 Feeling breathless
 Angina or chest pain with a feeling of pressure or tightness
 Syncope of fainting
 Palpitations and enhanced heartbeats
 A steady decline in regular activities and energy levels
 Fatigue due to little exertion
 Not gaining weight
 Poor eating patterns
 Problems in breathing

The wall of the left ventricle also thickens muscularly, and the thick wall occupies more space in the lower chamber of the heart and hence, the room for adequate blood supply is reduced. This may lead to heart failure.

Echocardiogram-
The initial test that is recommended for patients with symptoms of valvar aortic stenosis is doppler echocardiography. This test enables the doctor to estimate the aortic valve region, peak or mean transvalvular gradients and the maximum aortic velocity. These primary measures are required to assess the severity of the disease. Echocardiography provides important information on the valve function, left ventricular filling pressure and disruptions in other valves.

Other major tests which help in the diagnosis of valvar aortic stenosis include:
 Mri or magnetic resonance imaging, which provides images of internal body structures with great detail.
 Ct scan or computed tomography where three-dimensional images are extracted.
 Chest x ray
 Cardiac catheterization where a dye is used to highlight blockages, if any, in the heart.

Treatment-
Usually, there are no medicines for fixing valvar aortic stenosis as the disease is not reversible. Medicines can be used to treat the problems, which are caused by the condition.

Replacement of the damaged valve by surgery is the best treatment for valvar aortic stenosis. The surgery performed is called valvuloplasty. This is a cardioscopic surgery where a tube with a small balloon is inserted into a vein. The tube is guided into the heart, and the balloon is inflated. The balloon and tube are removed after the valve is opened. The damaged valve is replaced by mechanical valve or the valve of a cow or pig by an open-heart surgery.

Valvar aortic stenosis is a severe heart condition in children, and the only permanent remedy for this disease is a valve replacement surgery.

Diagnosis and Treatment of Valvar Aortic Stenosis in Children

It is no longer so surprising to read about alarming air pollution levels in our cities. On more than one occasion, these levels have risen above the danger levels. For some people, this may simply create an annoying fog that makes it difficult to see. For others, it can cause serious health issues. Air pollution is one of the most common reasons for the growing instances of asthma and allergies. Children are most susceptible to such diseases caused by air pollution.

Asthma and Allergies
Asthma can affect children even before their fifth birthday and the condition is characterized by breathlessness caused by a constriction of the airways. While the root cause of asthma is unknown, it is usually seen that asthmatic patients are more sensitive to others to particles in the air such as pollutants, dander, dust, smoke etc. Thus, the airways construct as a reaction to these allergens. Changes in the weather, a sudden cold draft or the flu can also aggravate asthma.

Can you Protect Your Children from Asthma?
Wheezing, panting, finding it difficult to breathe and a persistent cough are some of the signs of asthma. If you notice these symptoms, you must consult a doctor immediately. At home, here are a few things you could do.

Avoid exposing your children to smoke: Do not smoke around your children or allow others to smoke around them. If you cannot give up the habit, wear a smoking jacket when you smoke and take this off before you play with your children. When you ll go out, drive with the windows up so that your child does not inhale exhaust smoke. Set your air conditioner to circulate air within the car itself.
Dust often: Try and keep your home as dust free as possible. Use a wet cloth to clean so that the dust does not fly in the air. Wash all your bed linen once a week. Carpets and rugs should be vacuumed regularly or dusted outside. It may also be a good idea to invest in dust mite impermeable covers for your child s mattress and pillows.
Keep your Pets clean: If you share your home with pets, bathe them once a week and brush them daily. Do not let them climb on to the furniture or your beds. Also, avoid having their toys lie on your beds.
Wear a face mask: Try and time your child s outdoor activities when the pollution levels are low. Buy yourself and your child a face mask that will filter the air they breathe in. These should be worn whenever they play outdoors.
These simple steps could help your child be healthier and can prevent asthma and other such allergic reactions.

Increasing Asthma & Allergy In Children - What Should You Do?

Whooping Cough (another name for Pertussis) can be termed as an infection to the respiratory system caused by the bacterium Bordetella Pertussis (B. pertussis). It generally affects infants (below one year of age) and who have not yet been immunized; also kids between 11 to 18 years of age whose immunity graphs are on a downward spiral.

What are the Signs and Symptoms?
Initially, whooping cough produces signs and symptoms that may just seem to overlap with those exhibited during the average cough and cold; mild coughing, sneezing, runny nose, low fever, etc. These persist for about a week or two and then slowly, there is the onset of the dry, irritating cough which again turns to prolonged coughing spells. The child s face may seem flushed with a purple hue. The child may also vomit or make the distinctive whooping sound at the end of one such spell. Breathing difficulty can be another issue.

What is the Diagnosis?
The doctor performs an initial check-up followed by tests of mucus sample from the nose or throat. The mucus is checked for the presence of the Bordetella pertussis bacteria. To make a more thorough diagnosis, a blood test is also advisable.

What is the Treatment?
Hospitalisation might be required in case of acute distress. Respiratory support may also be provided if required. If there is intense dehydration, intravenous (IV) fluids may also be administered. As this disease is on account of a bacterial infection, antibiotics will be needed. But these will just treat the immediate effects and the cough cannot be completely done away with.
What can be the Possible Complications?

The possible immediate complications include:

Brain Damage
Pneumonia
Convulsion
Haemorrhaging in the brain
What can be the Prevention?
Vaccination is needed in order to prevent whooping cough. The vaccines are advised to be administered at the age of two months, four months and six months respectively. The 1st booster dose is to be given at 16 to 18 months age and 2nd booster dose is given on 5 year completion of age. An optional booster may be given at 10 year age.

Whooping Cough in Kids - How It Can Be Treated?

Hearing loss is not something limited to elderly men or elderly women only. This is something that can affect any adult at any stage of life. The good news is that it can be managed. Today, there are a number of hearing aids that can help improve hearing ability. These aids allow an individual who has lost part of his or her hearing to live a normal life. For best results, hearing loss should be arrested in its early stages.

Here are a few signs you should look out for.

Muffled Speech: When you hear people talk, their speech should be clearly identifiable. If you hear muffled noises that you have to interpret as words, it could be a sign of hearing loss.
Difficulty understanding words: The human ear has the ability to separate conversational sounds from ambient noise. However, in some cases where the inner ear is damaged, a person might find it difficult to separate the two. In such cases, the person might not be able to understand words clearly as they get confused with background noise. This is a sign that must never be taken lightly.
Feeling the need to ask people to repeat themselves: Once in a while if you find yourself asking another person to repeat what he or she said, there is nothing to worry. However, if this becomes a regular occurrence and happens with many people, then the fault lies in your hearing. Thus, if you notice yourself needing to ask people to repeat themselves or talk slowly, consult a hearing specialist.
Increasing the volume of the radio or television: As children, we are taught that playing music or watching TV at a very high volume can damage the ears. The radio, television and other such appliances should be played at a volume where the information being relayed is clearly audible and people can have a conversation alongside without needing to shout. If you find yourself having to increase the volume constantly, it could be a sign of hearing loss.
Withdrawing from conversations: As hearing loss is aggravated, people begin to feel conscious of having to ask others around them to repeat themselves or talk slowly. This can make them withdraw from a conversation and other social situations. In many cases, the simple reason for avoiding a party could be the discomfort of not being able to hear the other person clearly in a conversation.
 All hearing problems can be better handled by proper investigation, different test, sign and symptoms of the patient, which are carried by a specialist of hearing, called as AUDIOLOGIST, who can look your hearing problems, plan out treatment plan, rehabilitation pre and post etc. Audiologist will definitely help you hear again. 

Common Signs Of Hearing Problems In Adults!

Lactose intolerance is a condition wherein you are not able to digest lactose, which is a sugar found in milk. Other foods that contain lactose include cheese and ice-cream. Inadequate production of the lactase enzyme in children causes lactose intolerance. This enzyme is produced in the intestine that helps in the digestion of lactose.


Lactose intolerance is often confused with milk intolerance. The symptoms are similar but they do not share the same cause. Milk allergy is an adverse reaction towards milk and it is a problem of the immune system, whereas lactose intolerance involves the digestive system.


Symptoms-
The symptoms of lactose intolerance are:
Bloating; on consumption of milk over a period of time
Diarrhea is also very common
Stomach pain
Nausea


Diagnosis-
It is self -diagnosable; just strike out foods containing lactose from your child s diet and see if the symptoms get better with time. If the symptoms happen to fade away gradually, then it certainly must ve been lactose intolerance.
However, it can be tricky as many non-dairy products also contain lactose.
If the child is lactose intolerant, then he/she might have to undergo a lactose breath test. This is used to test the levels of hydrogen in the child s breath after the child consumes a lactose solution. Usually, hydrogen levels are low in one s breath. However, if the lactose solution is not digested properly, then it will lead to a temporary increase in the levels of hydrogen in the breath, thus indicating lactose intolerance.


Treatment-
This disorder does not have a cure; so in case your child has lactose intolerance, you need to adjust his/her diet accordingly. Over-the-counter lactase is also available that helps in digesting lactose based foods. You can also go for the  lactose- free  milk variety for your child.


Lactose Intolerance in Kids

Attention deficit/hyperactivity disorder (ADHD) is among the most common neurobehavioral disorders presenting for treatment in children and adolescents. ADHD is often chronic with prominent symptoms and impairment spanning into adulthood. ADHD is often associated with co-occurring disorders including disruptive, mood, anxiety, and substance abuse. The diagnosis of ADHD is clinically established by review of symptoms and impairment. The biological underpinning of the disorder is supported by genetic, neuroimaging, neurochemistry and neuropsychological data. Consideration of all aspects of an individual s life needs to be considered in the diagnosis and treatment of ADHD. 

Multimodal treatment includes educational, family, and individual support. Psychotherapy alone and in combination with medication is helpful for ADHD and comorbid problems. Pharmacotherapy including stimulants, noradrenergic agents, alpha agonists, and antidepressants plays a fundamental role in the long-term management of ADHD across the lifespan. 

The management of ADHD includes consideration of two major areas: non-pharmacological (educational remediation, individual and family psychotherapy) and pharmacotherapy. 

I personally support Psychotherapy. Specialized educational planning based on the child s difficulties is necessary in a majority of cases. Since learning disorders co-occur in one-third of ADHD youth, ADHD individuals should be screened and appropriate individualised educational plans developed. Educational adjustments should be considered in individuals with ADHD with difficulties in behavioral or academic performance. Increased structure, predictable routine, learning aids, resource room time, and checked homework are among typical educational considerations in these individuals. Similar modifications in the home environment should be undertaken to optimize the ability to complete homework. For youth, frequent parental communication with the school about the child s progress is essential. 

Symptoms in children and teenagers 

The symptoms of ADHD in children and teenagers are well defined, and they're usually noticeable before the age of six. They occur in more than one situation, such as at home and at school. The main signs of each behavioural problem are detailed below:

Inattentiveness: having a short attention span and being easily distracted making careless mistakes   for example, in schoolwork appearing forgetful or losing things being unable to stick at tasks that are tedious or time-consuming appearing to be unable to listen to or carry out instructions constantly changing activity or task having difficulty organising tasks 
Hyperactivity and impulsiveness: being unable to sit still, especially in calm or quiet surroundings constantly fidgeting being unable to concentrate on tasks excessive physical movement excessive talking being unable to wait their turn acting without thinking interrupting conversations little or no sense of danger 
These symptoms can cause significant problems in a child's life, such as underachievement at school, poor social interaction with other children and adults, and problems with discipline. 

Related conditions in children and teenagers 

Although not always the case, some children may also have signs of other problems or conditions alongside ADHD, such as: 

anxiety disorder   which causes your child to worry and be nervous much of the time; it may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness 
oppositional defiant disorder (ODD)   this is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers 
conduct disorder   this often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals 
depression 
sleep problems   finding it difficult to get to sleep at night, and having irregular sleeping patterns 
autistic spectrum disorder (ASD)   this affects social interaction, communication, interests and behaviour 
epilepsy   a condition that affects the brain and causes repeated fits or seizures 
Tourette s syndrome   a condition of the nervous system, characterised by a combination of involuntary noises and movements called tics 
learning difficulties   such as dyslexia Symptoms in adults In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD. 
ADHD is a developmental disorder; it's believed that it can't develop in adults without it first appearing during childhood. But it's known that symptoms of ADHD often persist from childhood into a person's teenage years, and then adulthood. Any additional problems or conditions experienced by children with ADHD, such as depression or dyslexia, may also continue into adulthood. By the age of 25, an estimated 15% of people diagnosed with ADHD as children still have a full range of symptoms, and 65% still have some symptoms that affect their daily lives. The symptoms in children and teenagers, which are listed above, is sometimes also applied to adults with possible ADHD. But some specialists say that the way in which inattentiveness, hyperactivity and impulsiveness affect adults can be very different from the way they affect children. For example, hyperactivity tends to decrease in adults, while inattentiveness tends to get worse as the pressure of adult life increases. Adult symptoms of ADHD also tend to be far more subtle than childhood symptoms. 

Some specialists have suggested the following list of symptoms associated with ADHD in adults: 

carelessness and lack of attention to detail 
continually starting new tasks before finishing old ones 
poor organisational skills 
inability to focus or prioritise 
continually losing or misplacing things 
forgetfulness 
restlessness and edginess 
difficulty keeping quiet and speaking out of turn 
blurting out responses and often interrupting others 
mood swings, irritability and a quick temper 
inability to deal with stress 
extreme impatience 
taking risks in activities, often with little or no regard for personal safety or the safety of others   for example, driving dangerously 
Additional problems in adults with ADHD As with ADHD in children and teenagers, ADHD in adults can occur alongside several related problems or conditions. One of the most common conditions is depression. Other conditions that adults may have alongside ADHD include: 

personality disorders   conditions in which an individual differs significantly from an average person, in terms of how they think, perceive, feel or relate to others 
bipolar disorder   a condition that affects your moods, which can swing from one extreme to another 
obsessive-compulsive disorder (OCD)   a condition that causes obsessive thoughts and compulsive behaviour 
The behavioural problems associated with ADHD can also cause problems such as difficulties with relationships, social interaction, drugs and crime. Some adults with ADHD find it hard to find and stay in a job. If you notice any of the above in your child or yourself , it is worth making the effort and spending some time and money to have your child and or yourself assessed on a priority basis as ADHD causes neural changes in the brain. 

Attention Deficit Hyperactivity Disorder (ADHD) - A Guide!

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