Coughing is a common problem of the respiratory tract and often indicates a deeper problem. It can be very irritating and can affect eating habits and socialization. A cough which persists for more than 4 weeks is believed to be chronic in nature. Tuberculosis (TB) is the most common cause of chronic cough in India. TB is an airborne bacterial infection caused by the organism - 'Mycobacterium tuberculosis', that primarily affects the lungs, although other organs and tissues may be involved. Cardinal features are: 

Chronic cough with or without sputum.
Fever more in the night time. 
Poor appetite. 
Unintentional weight loss. 
Read on to know about other common causes of chronic cough and how to manage them.

Allergies: People with allergies usually have a chronic cough, which gets aggravated when exposed to the allergens such as pollen or environmental dust. Staying away from allergen provides relief. Antihistamines are also useful, which most people detected with allergies keep in handy. Inhalers might be required, if there is associated congestion or shortness of breath.
Asthma: This is a very common chronic condition, caused by inflammation and swelling of the lungs, in addition to wheezing and shortness of breath. Asthma patients often suffer from a chronic cough. An asthma attack usually happens during the night or early morning, and is triggered by colds, cigarette smoke, air pollutants or allergens, which can even include certain foods. Most asthmatics usually carry their steroids, inhalers, and bronchodilators, as the onset of attack can be unpredictable.
Bronchitis: This condition of inflammation of the bronchial region is very common among smokers and among the elderly. There is excessive mucus accumulation, which the body tries to clear via coughing. The lungs are weakened and therefore, the coughing is painful.
Gastroesophageal reflux disease (GERD): This is a problem of the digestive system, but regurgitation of food into the airway induces cough. GERD is a chronic issue and so most people also end up with a chronic cough. It is worse with sitting up than with sitting down. Treatment includes H2 blockers to suppress acid production and dietary changes including small, frequent meals and avoiding spicy food items.
Upper airway cough syndrome: There could be multiple problems in the upper airway, which leads to a constant postnasal drip. Here, there is constant dripping of the sputum into the air passage, which can lead to a chronic cough whenever there is impaired air flow. This can be caused by various forms of chronic sinusitis and rhinitis. People diagnosed with this condition usually resort to antihistamines and decongestants for relief.
Other causes: There are a number of other causes as noted below. Smoking, tuberculosis, congestive heart failure, pertussis or whooping cough, foreign body in the airway, cancer in the airway passage, chronic aspiration of foods, etc. can all lead to chronic cough.
The key is to identify the reason that is causing the chronic cough. Most people who are diagnosed are educated to handle it and carry the required medications including steroids, bronchodilators, and inhalers.

Suffering from Chronic Cough - How to Manage it?

Puberty is a time when a girl's body begins to define itself in more womanly terms. This is the start of a process that will usher in decades of sexual activeness and child bearing years. The changes that a girl goes through during this period can be quite challenging with a play of hormones as well as physical changes, such as growth of hair in private parts and the development of breasts, among various other changes. When these changes come at an early age, it can be all the more challenging to cope and comprehend the process. The onset of early puberty is something that is becoming more and more common with girls between the age bracket of 12 &amp; 13. How can you help deal with early puberty? Here's a list of tips!

1. Self-Image: One of the most important side effects of early puberty remains one's image of the self, as this phase in life is characterised by the most dramatic physical changes that can leave a lifelong effect on the girl's mind. The reinforcement of positive self-image to help the girl grow more comfortable in her skin despite the wide array of feedback she may be getting from sources outside the home, will help in creating a positive impact on a lifelong basis.

2. Doubts: This is a time when the child goes through a number of doubts regarding looks and appearance as well as how well she may be able to cope with the onset of the new process. As parents, the best thing to do is to let the child explore this terrain even as you remain firmly in the background for hand holding when the child asks for it. This will help the girl become even more confident to take life's decision more efficiently and seriously.

3. Talking About It: The best thing to do is to talk things out. Once you start seeing the changes in the girl's appearance by way of hair growth and sudden sprouting of breasts and height, it is important to understand that puberty may be close by. So have a talk about menstrual cycles and the changes that the child will be seeing soon. This will help in mentally preparing the child and giving her the leeway to ask questions that you can answer over a period of time.

4. Opposite Sex: It would also be beneficial to discuss the changes in the behaviour of boys towards her, as this will help her blossom into a more confident lady in the years to come.

Remember to love and support your child through this important milestone of her life, as the way you reach can have a lasting impact on her.

How to Deal with Early Puberty

Child nutrition from age 6 months to 5 years Growth and development of a child depends on the nourishment received by the child right from birth. Healthy diet and proper eating habits are essential to be inculcated in a child as early as possible. A balanced diet given to the child at the earliest provides all nutrients required for adequate growth and development. Nutritional value of every food item introduced in the child s diet should be gauged prior and then given to the child. 

Nutritional requirement of children varies in accordance to the age group. It is necessary that the parents should have knowledge about the age-specific requirements of the diet, which will benefit the child in their growing years. 

Following is the ideal child nutrition ranging from the age group of 6 months to 5 years. 

1. 6 months to 12 months

A. Right from the birth of a newborn child, it is necessary to begin breastfeeding for the baby. It should begin within an hour of the child s birth. It is the ideal way of providing proper nutrition to the child. 

B. Breastfeeding is beneficial by providing nourishment and also by improving the immunity of the baby. 

C. From birth to 6 months, only breastfeeding is advised. It is a critical source of nutrition for the child even during illness. 

D. After the baby turns 6 months old, solid food can be introduced in the child s diet.

E. Breastfeeding can be continued and supplemented with other food items.

F. Usually, fruit juices are introduced first in the diet.

G. Feeding bottle should be avoided and the child should be fed with a spoon and cup. Proper hygiene and good handling of the food is required. 

H. It is necessary to wipe the gums and developing teeth clean with a wet gauge to prevent any decay that can be caused by sticking of the food on the teeth surfaces fed to the child.

2. 1 year to 3 years

A. Children in this age group can tell when they feel full after feeding. It is necessary to listen to their demand for food and also avoid overfeeding children.

B. This age group requires children to eat all types of nutrients, so parents should focus on providing a variety of food items to replenish their child s nutritional requirements.

C. Children in this age group require fat-rich foods and should be given dairy products for calcium requirements.

D. Processed foods should not be given to children in this age. Calories intake should be monitored to the optimum level. 

E. Since children at this age are involved in activities like walking, running around and playing it is essential to keep feeding them at regular intervals to maintain the energy levels of their bodies.

3. 3 years to 5 years.

A. Children belonging to this age group require to eat a well-balanced, nutrient rich diet. 

B. Grains should be included on a routine basis. They provide the child with carbohydrates, fibers and minerals. All these nutrients provide energy to the child s body. 

C. Inclusion of whole wheat grains provides fibers in adequate quantity. 

D. Refined foods should be avoided, whole grain breads should be included in the diet. 

E. Fruit intake should be increased, as they are an important source of various vitamins. Fresh fruit should always be preferred over juices for growing children. 

F. Sugar intake should be kept to a minimum quantity, since refined sugars do more harm to the child s health than any good. 

G. Vegetables should form a considerably greater part of the child s daily diet, with the inclusion of a variety of vegetables. 

H. Protein sources of food include meat, poultry, pulses, beans and nuts. Along with protein, these food items also provide iron, zinc and minerals to the body. 

Apart from the above specified food items, daily intake of milk is necessary for children of growing age. It provides the body with sufficient calcium to facilitate bone growth in growing children. Also, nuts like walnuts, almonds, cashews are advised to be given to the children daily.

Nutrition Tips For Children From Age 6 Months To 5 Years!

Fluoride products for the teeth have immense importance in dentistry. Fluoride is one such chemical, the balance of which is highly required for strong and healthy teeth. However, there is an optimum amount of fluoride needed for teeth. Anything lesser than that or greater than that can cause harm and serious teeth and gum problems and tooth decay. The best option, therefore, is to get a fluoride based toothpaste or mouthwash, which will keep on providing the teeth with the optimum quantity of its daily dose of fluoride.

The benefits of fluoride products
Before delving into the types of fluoride products available, let's have a look at the benefits of fluoride on teeth. Fluorides actually save the teeth from dental caries. It happens such that fluoride makes a certain mineral bonding on the teeth which is called fluorapatite. This is not normally found in human teeth, but when teeth damage is done, then to heal it fast this compound is needed to repair the damages. This adds to the mineral bonding in the teeth and strengthens the teeth.  

The fluoride products
The various fluoride based products, which you may use are as follows:

1. Fluoridated water: Fluoridating water is a simple process where the optimum amount of fluoride is mixed with drinking water so that drinking the water automatically keeps on adding fluoride to the body and keeps in contact with teeth. This therapy alone is enough and needs no more therapies generally. But not all water reserves contain this, and it's not possible to add fluorides to all water reserves. That is why the other fluoride treatments are needed.

2. Fluoride toothpaste: This is one of the most common forms for fluoride treatments. Every common daily use toothpaste contains a 0.22 to 0.312 percent of fluoride, and this is highly beneficial to the teeth for healing of decay and fast repairs. It lets the teeth get stronger. 

3. Mouth Rinses: Fluoride mouth rinses are an option. The sodium fluorides commonly used in the rinses are used in small amounts in the product which is used just like toothpaste and washed off.

4. Fluoride foams and gels: The foam and gel are used when the teeth of the child or adult are under high risk of cavities. The foam or gel is rubbed on the teeth, and kept for a while and then washed off. The typical application time is 30 minutes. 

5. Varnishes: The fluoride varnishes are just like gels, and they are also used on the tooth surface similarly. It's the choice of the dentist or patient as to which one they want to go with. Besides, these slow fluoride releasing devices, medical supplements and lozenges are also there, which slowly release the optimum amount of fluorides to keep the teeth strong and healing.

Use of Fluoride Products for Teeth

The appendix is a small, finger-shaped pouch attached to the large intestine in the right belly area. It is a vestigial organ as it has no specific role to play in humans, but the organ is still seen, though in a very small size compared to the earlier living beings in the evolutionary chain. Acutely inflamed appendix is the most common cause leading to it removal, often seen in the ages of 10 to 19.

Causes: the appendix gets infected by two main reasons - general infection in the abdomen that reaches the appendix or blockage of the appendix leading to inflammation and swelling within it. The appendix is a blind pouch, and there is a good chance for its blockage from food particles, lymphatic tissue, or even sometimes feces. Some of the potential risk factors for appendicitis include a diet low in fiber, high in sugar, gut flora, and family history.

Symptoms/diagnosis: in adults, the appendicitis has very characteristic symptoms including acute pain in the right upper part of the belly associated with fever and vomiting. However, in children, the pain may not be as tell-tale a sign but is still quite diagnostic of appendicitis. However, presence of the following symptoms together is surely indicative of appendicitis.
1. Right abdominal pain, especially rebound tenderness, where pressure placed in the right upper part of the belly and released leads to excruciating pain.
2. Fever, nausea, and vomiting
3. Abdominal fullness or bloating
4. Elevated white blood count (as with most infections)
Additionally, the younger the child, the symptoms are not very clear, but ultrasound will confirm the diagnosis. The inflamed, enlarged appendix will be visible on the images and could be surrounded by free fluid. Ct scan also can be considered if required to confirm the diagnosis.

Treatment: as noted above, children present with symptoms that do not pinpoint to appendicitis. Treatment usually takes two routes:

If diagnosed as appendicitis before rupture, then surgical removal is the best method to contain its symptoms. Other symptoms like fever and nausea and vomiting usually subside a couple of days after the surgery.
If the appendicitis goes unnoticed and ruptures, then the intestinal cavity can get infected, which is called peritonitis. Earlier, the preferred approach was to control the infection and then go for removal. However, lately, removing the appendix followed by antibiotics to control the infection is the preferred approach.
The prognosis and recovery from appendicitis is very good. Deaths have occurred only in very small infants, where they are not able to pinpoint the area and therefore it can go undiagnosed, leading to rupture and subsequent death.

Early identification is the key to proper identification, immediate treatment, and complete recovery from appendicitis.

Appendicitis in Children

Hearing is one of the five senses that you or anyone else relies on for communication and a whole host of other things. Among the five senses, touch, smell, taste, hearing and sight, it is often hearing, which is the most easily affected. You don't have to be a senior citizen to experience hearing loss as it is quite common among younger people as well. This problem is also getting widespread with each passing day.

Before coping with hearing loss, the first job is to detect it
If you have a hunch that you or any of your loved ones is suffering from hearing loss, it is important that you get it diagnosed. Some of the common symptoms of hearing loss will be:

 Hearing difficulties while talking to someone over the phone
 Straining to hear conversations with family members or friends in household situations 
 People usually need to repeat what they talk to you with a louder voice
 You often hear complaints that you keep the tv too loud.
 In crowded situations, such as family gatherings or a restaurant, you have problems listening to people.

Although this condition tends to affect senior citizens, an increasing trend shows younger people i. E. People mostly in their 40 and 50s and even younger than that suffer from this condition.

How to deal with hearing loss?
Some of the options to deal with hearing loss are mentioned below.

 Once diagnosed with hearing problems, change your ways of communication: if you or your loved ones have been diagnosed with hearing problems, it is important that both adjust your ways to deal with the problem. Rather than getting angry at the other for not being able to communicate effectively, develop and strategize ways to make communication less problematic and erratic.
 Cochlear implants: this is a newer technology, which has gained popularity in the past decade or so. These are directly implanted into the inner ear and are designed to bypass the damaged areas of the ear and directly stimulate the auditory nerve. These have become very popular, although, are not a replacement of natural hearing. It is only prescribed for people who have severe hearing loss or are deaf.
 Hearing aids: although selecting a hearing aid is difficult as the patient needs to be comfortable, once selected it is one of the best solutions for the hearing impaired. The functionality of these devices can be extended with the hearing assistive technology or hat devices that can focus the audio waves depending on the situations and give a more tailored approach for every individual's needs.

Dealing With Hearing Loss

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