Pulmonary Function Tests or PFTs are a set of tests that are used to determine, measure or observe the functioning of the lungs. The most common pulmonary function tests used are spirometry, gas diffusion, and lung plethysmography. 

Highlights of pulmonary function tests

A spirometry test is used to measure the amount of air inhaled and exhaled. It also measures the amount of time taken to complete a respiration cycle.
A lung plethysmography measures the amount of air in the lungs after the patient has taken a deep breath. It also measures the amount of air that remains in the lungs after the patient has exhaled as much air as possible.
What does a Pulmonary Function Test measure?
Pulmonary function tests would not only check how well the person is breathing but also how effectively the lungs are able to conduct oxygen to the rest of the body. In addition to air flow, these tests would measure the size and volume of the lung and lung diffusion.

These tests can also be used to measure

Total Lung Capacity   the amount of air present in the lungs after breathing in deeply
Forced Vital Capacity   the amount of air that can be exhaled after breathing in deeply
Minute Volume   the amount of air exhaled per minute
Vital Capacity   the total volume of air that can be breathed out after inhaling as much as possible
Tidal Volume   the amount of air inhaled or exhaled when breathing normally
Maximum voluntary ventilation   the amount of air that can be inhaled and exhaled in one minute
Functional Residual Capacity   the amount of air that remains in the lungs when breathing normally
Forced Expiratory Flow   the flow or volume of air during an exhalation
Peak Expiratory Flow Rate   the rate at which a person can exhale
When are Pulmonary Function Tests recommended?
A physician might recommend a patient undergo a PFT as part of a routine physical check-up. This test would be advised if the patient is experiencing any symptoms associated with lung problems or disorders such as asthma, respiratory infections, chronic obstructive pulmonary disease, COPD. A doctor would also use these tests to monitor and check whether a certain treatment prescribed for a lung disease or condition is working effectively.

Pulmonary function tests are safe as they are non-invasive but it is important to follow the instructions of the doctor or technician before, after and during the test. It is important to make your doctor aware of any surgeries, respiratory infections, chest pains or heart attacks that you might have experienced before the test. If you are taking any medications you might need to follow the advice of the doctor as to whether you can take them before the test.

Your doctor would also advice you on how to prepare for the test such as not eating a large meal, avoiding caffeine and wearing loose-fitting clothes. If you have any doubts, concerns or queries discuss them with your doctor.

Pulmonary Function Tests - Why Is It Required?

Is bedwetting a regular feature in your child? Has this been continuing for a long time and is making you concerned? Nocturnal enuresis is the condition in which a child passes urine when he sleeps at night, unknowingly. It is referred to as bedwetting or nightwetting in Ayurveda. Shayyamutra is the Ayurvedic name of this condition in which shayya refers to sleeping, and mutra means urine.

Ayurvedic guidelines and remedies

You must ensure that your child is getting sufficient sleep. A proper sleep schedule will make it easier for him to wake up when his bladder is full and he needs to urinate.
The bowel must be kept clear to prevent thread worms from troubling at night. They account for being an important cause for bedwetting.
Your child should abstain from food items such as green gram, potato, tea, chocolates, coffee, and spicy foods producing gas.
You must make sure that your child does not drink any liquid right before going to sleep. On the contrary, his bladder should be emptied before going to bed.
Bladder stretching exercises should be undertaken, which are effective for the management of bedwetting in children.
In children who experience bedwetting in spite of being grown up, the reason is usually stress. Stress may occur from various causes and it is important to bring your child s stress under control. For this, he should undertake yoga, mindful meditation, and other relaxation techniques.
There are various Ayurvedic home remedies, which are ideal for managing bedwetting in children. Some of them are as follows:

Fry one spoon of coriander seeds until it turns brown. Mix one teaspoon each of sesame seeds, babul gum, and pomegranate flowers and make a fine powder out of the ingredients. Add crystal sugar to the mixture and give this to your child before bedtime regularly.
Give half a cup of milk and Sarshapa in a powdered state to your child before he/she goes to sleep at night.
Ayurvedic remedies used for curing bedwetting in children aim at strengthening your nervous system and your urinary tract. Vishatinduka vati, Chandraprabha vati, and Shilajitwaadi vati are common Ayurvedic medicines used for treating bedwetting.
Deworming should be carried out for the infestation of intestinal worms, which may provide relief to your child.
Several medicinal herbs are also used for the Ayurvedic treatment of bedwetting. They include bimbi, kataka, amalaki, hareetaki, haridra, khadira, and a lot more.
It is recommended for you to consult an Ayurvedic practitioner before following any Ayurvedic remedy for your child for treating bedwetting. A doctor would prescribe the best remedies after diagnosing your child properly.

Bed Wetting in Children - How Ayurveda Remedies Can Help!

A genetic disorder, Down s Syndrome is caused due to extra genetic material during cell division. It is the faulty arrangement of chromosomes which results in the Down s Syndrome. It approximately affects one in 800 births around the world, across a wide spectrum of race, gender, region, and socio-economy. Since it is a naturally occurring condition whose underlying cause cannot be controlled or regulated, there is nothing one can do to undo this condition. Instead, people with Down s Syndrome, because they are generally socially and intellectually underdeveloped, are equipped with learnings and interventions related to life-skills from very early in life and striving towards making them independent. Various therapies can be incorporated for improving the overall quality of life of the people born with Down s Syndrome.

Occupational Therapy and Down s Syndrome -

Development of motor skills is delayed in the children born with Down s Syndrome. This is due to their certain physical characteristics like low muscle tone (hypotonia), loose ligaments or ligamentous laxity making the joints extra flexible, and decreased strength.

The aim of the Occupational Therapy for children born with Down s Syndrome is to facilitate or enable the development of movement patterns optimally, as against accelerating the rate of development which is a general assumption. It helps in achieving developmental milestones in an efficient manner. Occupational Therapy hence helps children in developing a good or correct posture, aligning their foot properly for proper balance and movement, improving their walking pattern, and helping them generally through developing fine and gross motor skills for carrying out daily activities.

Moreover, Occupational Therapy helps in teaching self-care skills like getting dressed, eating, toileting writing, using a computer, etc. For teenagers, Occupational Therapy helps in identifying suitable skills, careers, jobs, and vocations to match with strengths, capabilities, and interests. Sensory integration activities help in teaching the child to produce an appropriate response to any situation, and in developing attention and concentration.

Occupational Therapy Assessment -

Children with Down s Syndrome have delayed gross and fine motor skills, and lack basic cognitive and communication skills among many other issues they face due to their condition. Occupational Therapy addresses all these shortcomings of development for comprehensive management of the disease.

Occupational Therapy checks the sensorimotor components like muscular tone, strength, endurance, coordination, balance, range of motion, hand function, and posture. It also checks the perceptual and cognitive components like memory, attention, figure-ground, and directionality. For checking social skills, areas like peer relationship, verbal and non- verbal communication, and group interaction are assessed.

According to the assessment results, intervention strategies and fun activities are devised for the child to promote optimal function of motor senses.

Take Away -

Down s Syndrome cannot be cured but can be managed through methods like Occupational Therapy which helps in teaching basic life skills for making the patients confident and independent to face the world on their own.

Down Syndrome - Know How Occupational Therapy Can Help!

Being a mother is the greatest gift to womankind. With the most amazing feeling of being a mother, comes big challenges and responsibilities. The first and foremost being, keeping the baby safe and healthy. Providing babies their best start begins with breastfeeding. Doctors around the world recommend exclusive breastfeeding to begin within the first hour of a baby s life and continue until six months.

A mother s milk has no substitute. It is packed with amazing nutritional benefits, the absence of which can lead children at risk of malnutrition and various diseases. Breast milk is often being termed as complete food with added antibodies, enzymes, hormones and fatty acids extremely vital for a delicate immune system of an infant. Babies build their immunity in the first few years of their life and breast milk is critical to developing immunity.
UNICEF working on child s rights and well-being world over promotes breastfeeding schemes across many countries. 

According to UNICEF reports, a non-breast fed child is 14 times likely to die within first six months than an exclusively breastfed child. An estimated 8,20,000 children under the age of five could be saved each year with increased breastfeeding. However, Only 38% of infants globally are breastfed. Looking at India s state, Malnutrition continues to be one of the greatest challenges. One cost effective, safe and smart intervention to curb malnutrition and decrease infant mortality is breastfeeding.

Let s now look at the benefits of breast milk for infants and mothers:

Breast milk is found to reduce the risk of respiratory tract infections, diarrhea, asthma, food allergies, leukemia, diabetes and celiac disease.
Psychologists have long established the positive effects of mother s touch in the emotional development of babies. In addition to this, breastfeed has positive effects on child s cognitive development.
Breastfeeding has amazing benefits for mothers. It is found to aid weight loss post pregnancy. It promotes better uterus shrinkage and delays menstruation. Lactating mothers naturally avoid pregnancy till they breastfeed. It reduces the risk of breast cancer, cardiovascular disease and rheumatoid arthritis later in life.
Considering the benefits of this super natural milk, many countries have now adopted an international code of marketing of breast-milk substitutes. The code promotes breastfeeding and restricts marketing of infant formula milk. India along with many other countries signed it.
India has also begun with a baby friendly hospital initiative where hospitals educate new mothers regarding breast feeding and strictly discourage infant formulas wherever possible. The myth of feeding newborn babies with honey, water, sugar does more harm than good. Thus, it is vital to exclusively breastfeed the baby at least for six months before introducing other foods. 

Ensure your child s right to a healthy life through breastfeeding!

Breastfeeding - Its Benefits for both Mother and Baby

Iron is an essential nutrient and mineral that is required by adults and children alike. Iron helps move oxygen from the lungs to the rest of the body and helps muscles store and use oxygen. It is especially important for children because it aids development and prevents anaemia. Untreated iron deficiency in children can cause physical and mental delays. It can lead to less healthy red blood cells in the child's blood stream which will cause a delay in the growth of physical and mental faculties.

Risk factors for iron deficiency in children

Infants and children at highest risk of iron deficiency include:

Babies who are born prematurely or have a low birth weight
Babies who drink cow's milk before age 1
Breast-fed babies who aren't given complementary foods containing iron after age 6 months
Babies who drink formula that isn't fortified with iron
Children ages 1 to 5 who drink more than 24 ounces (710 milliliters) of cow's milk, goat's milk or soy milk a day
Children who have certain health conditions, such as chronic infections or restricted diets
Children ages 1 to 5 who have been exposed to lead
Adolescent girls also are at higher risk of iron deficiency because their bodies lose iron during menstruation.
Symptoms of iron deficiency anaemia

The signs and symptoms of iron deficiency anaemia in children may include:

Pale skin
Fatigue or weakness
Slow cognitive and social development
Inflammation of the tongue
Difficulty maintaining body temperature
Increased likelihood of infections
Unusual cravings for non-nutritive substances, such as ice, dirt or pure starch
Prevent iron deficiency in children

Take steps to prevent iron deficiency in your child by paying attention to his or her diet. For example:

Breast-feed or use iron-fortified formula. Breast-feeding until your child is age 1 is recommended. If you don't breast-feed, use iron-fortified infant formula.
Encourage a balanced diet. When you begin serving your baby solids, typically between ages 4 months and 6 months, feed him or her foods with added iron, such as iron-fortified baby cereal. For older children, good sources of iron include red meat, chicken, fish, beans and dark green leafy vegetables. Between ages 1 and 5, don't allow your child to drink more than 24 ounces (710 milliliters) of milk a day.
Enhance absorption. Vitamin C helps promote the absorption of dietary iron. You can help your child absorb iron by offering foods rich in vitamin C, such as melon, strawberries, kiwi, broccoli, tomatoes and potatoes.
Consider iron supplements. If your baby was born prematurely or with a low birth weight or you're breast-feeding a baby older than 4 months and he or she isn't eating two or more servings a day of iron-rich foods, talk to your child's doctor about oral iron supplements.
Make sure that you watch out for the tell tale signs of iron deficiency and take the necessary precautions to avoid the same. If you wish to discuss about any specific child related problem, you can consult a specilized pediatrician and ask a free question.

Iron Deficiency In Children

Upon reaching adolescence, children's bodies undergo several changes and so do their minds. It is then that their minds are most, as well as least impressionable. And the daunting question regarding the upbringing of an adolescent is how to treat their constantly changing behavior?

Here are some of the tantrums adolescents more commonly throw, and what should ideally be your approach to it:

Your child seems to hate you: It is very common for a phase of emotional exclusionism to prevail between 16-17 years of age approximately. And the worst thing you could do is heighten that emotion by returning the hatred. Make sure you're firm against any extremely unacceptable behavior, but at the same time, show them that you're there for them no matter what.
Electronic devices become the center of their attention: Whenever you want to have an earnest conversation with your children, their attention seems to be drawn solely to their phones and computers. They feel the need to be connected to their friends and all times. Ways to monitor that are by setting limit to the maximum hours spent on devices or making them pay their own bills, which will make them more responsible rather than splurging unnecessarily. Also, if your child is not entirely secluded from the family, it is probably best not to interfere all the time.
Ignoring the curfew: Your kids often stay out later than the set limit. But it is quite possible that your curfew is unreasonable when compared to other parents' curfew. Find out what the average time limit is; it may prevent your child from bearing a grudge against you. In case they still fail to respect your curfew, make sure you spill out to them what the consequences can be, like being grounded for a week. However, in certain cases, your child may be spending time doing nothing constructive, but away from home. There may be something else going on, find out what that is.
Being friends with the wrong people: Sometimes it might happen that you think some children do not have a good influence on your child, but you cannot say that directly because adolescents tend to get very defensive about their choice of friends. Unless the adolescent is doing something harmful with the friend, like using drugs, let him exercise his choice. Otherwise, don't hesitate from seeking professional help to counsel your child.
Being over-dramatic: Every emotion is heightened in your child and you cannot tell them that what they are whining or being overjoyed about are trivial, because that's their prime focus then. Let them realize on their own how irrational they sound or else you may risk spoiling your relation with them.

Behavioral Problems in Adolescents

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