Best Way To Treat Fever In Children

Let us imagine a scenario: It is 4 in the morning. You are fast asleep and suddenly you hear the discomforting cries of your child. You sense that something is wrong and you immediately rush to the other room. As soon as you touch him, you realize that the child's body is burning up like a furnace? You immediately rush to get your thermometer and the figures on it do not make for a good reading - 102 degrees F. Panic dulls your response rate. Your first reaction is to call the doctor. It might be the right thing to do in some rare cases, but in most cases experts advise differently.

Stay Calm

The most important thing is for you to stay calm and relax and realize that it is still well within your hand to take care of the child. First things first, fever is not your enemy. Rather, it is body's way of telling you that your immune system is fighting alien elements in your body. Children of the age group 0 to 3 almost always face high temperatures at some point in their nascent lives.

The Need of the Hour

How you should go about it depends on your child's age and thermometer's readings. If your child is a newborn or is less than 3 months old and reading is above 100.4 degrees, then you must call the doctor at once.

Between 3 to 6 months, temperature threshold is 101 degrees F, while 103 degrees F is usually the limit for children older than 6 months. But, if the child is showing alarming symptoms such as body ache, fatigue, and diarrhoea, along with the high temperature of 101 degrees F or 102 degrees F, then you should consider calling the doctor on a priority basis.

Take the Hints - Be Wary of the Symptoms

Keeping an eye out on the symptoms is extremely important. If your child has a running nose and low-grade fever (99-100 degrees F), then he might be suffering from a bout of common cold. Vomiting and diarrhoea usually indicate stomach virus. For children with weak immune system or at higher risk than others, it is advisable to consult a doctor.

A 24 hours rest is generally advised in flu, till the patient is fever free without taking any antibiotics. Ailments like an earache, sore throat or discomfort in peeing should be brought to the notice of doctor as it might indicate soar throat, UTI or ear infection, all of which require antibiotic treatments. Certain signs warrant an immediate medical attention. Discomfort in breathing along with constant crying, difficulty in walking, unusual rashes and purple looking spots demand that he be taken to the E.R. right away.

The most important thing is to complete the treatment course diligently and let the fever run its course as it may actually aid the body in building immunity against the fever causing germs and fight them. One must remember that being calm and relaxed at taxing times go a long way in helping you take right decisions and treating fever in children is all about patience and right decisions.

Best Way To Treat Fever In Children

The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).

The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.

If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.

Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.

If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.

Once the conservative treatment fails:

Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.

Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.

Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

LESI: Lumbar Epidural Steroid Injection

Indicated in   Acute radicular pain due to irritation or inflammation.

Symptomatic herniated disc with failed conservative therapy
Acute exacerbation of discogenic pain or pain of spinal stenosis
Neoplastic infiltration of roots
Epidural fibrosis
Chronic LBP with acute radicular symptoms
Epidural- lumbar injection
ESI Treatment Plan

Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.

SNRB- Selective Nerve Root Block 

Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if

There is minimal or no radiological finding.
Multilevel imaging abnormalities
Equivocal neurological examination finding or discrepancy between clinical & radiological signs
Postop patient with unexplainable or recurrent pain
Combined canal & lateral recess stenosis.
To find out the pathological dermatome for more invasive procedures, if needed
Intradiscal Procedures 

Provocative Discography - Coupled with CT

A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.

Percutaneous Disc Decompression (PDD)

After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed

Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.

Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.

Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)

A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.

Procedures That Can Help Treat Slip Disc & Sciatica!

Female infertility is considered as the inability of conceiving. As per WHO it is described as the inability to be pregnant, maintain and carry forward a pregnancy to its full term. It is often of two types:

    Primary Infertility: This is the inability to give birth to a baby either due to the inability to become pregnant or maintain a pregnancy, which includes stillborn and miscarriage.
    Secondary Infertility: This refers to the inability to give birth when there is already a live birth or the woman was pregnant.

The causes of infertility can vary from being acquired or genetic. However, following factors are largely responsible for infertility:

    Genetic: Some genes can lead to mutation leading to infertility like, in case of BMP15 gene there is a hypergonadotrophic ovarian failure which causes infertility.
    Acquired: This is caused by factors like age, smoking, sexually transmitted diseases, obesity, body weight, eating disorders, diseases like diabetes, thrombophilia and also radiation and chemotherapy.

The treatment for infertility usually depends on the cause, age, duration of time for which a person has been infertile and preference of the patient. Infertility is believed to be a complex disorder and the treatment involves a huge amount of physical, financial and psychological commitments. All this also requires a lot of time. Some women might need just a minimum of two therapies to attain fertility while others might require different treatment before they can conceive.

Treatment is largely aimed to restore the fertility either by means of medication and surgery or help in reproduction with the help of some procedures.

Fertility Restoration through medication

This is the main treatment for women who are infertile because of ovulation disorders. These drugs include:

    Gonadotropins: These are injected to stimulate the ovaries. Drugs like Menopur, Repronex, Follistim AQ, Gonal-F, Bravelle restore the production of eggs, while Ovidrel and Pregnyl are used for maturing the eggs and for their release.
    Clomiphene citrate: This is taken orally and stimulates ovulation by releasing more Follicle Stimulating Hormone and Luteinizing Hormone from the pituitary gland.
    Metformin: This is used in females who have PCOS and also when insulin resistance plays a major role in infertility.
    Bromocriptine: Used when the infertility is caused due to excess prolactin production.
    Letrozole: This also induces ovulation

Fertility Restoration through surgery

Surgical procedures can amend the problem of infertility. However, these treatments are very rare these days owing to the success of other fertility treatments. These include:

    Tubal ligation reversal surgery: In case a tubal ligation has been performed it can be reversed by reconnecting the tubes again through surgery.
    Hysteroscopic surgery: This corrects or removes the abnormalities that cause infertility. This surgery can correct the shape of the uterus, remove endometrial polyps and improve chance of getting pregnant.
    Tubal surgeries: In case of blocked fallopian tubes laproscopic surgery can be performed to dilate the tubes, removed blockages or create a new opening.

Assistance in Reproduction through techniques

The most common used techniques for reproduction assistance are:

    Intrauterine insemination or IUI: In this about million healthy sperms are put in the uterus at the time of ovulation.
    Assisted reproductive technology: In this mature eggs are retrieved from a woman and this is then fertilized with sperms in a dish in the lab. Once the fertilization is done the embryo is placed in the uterus for further development. IVF is the most common and effective assisted reproductive technology. This procedure takes place over weeks with several blood tests and hormone injections.

Dealing with infertility is not easy and can be emotionally and physically draining. To cope with the various tests and treatments of infertility one should be fully prepared, eat a healthy diet, exercise reach out for help and support of family and friends and look for other options like a donor egg, adoption or no children.

Treatments of Infertility

Roti vs. Rice- What should you have your meals with?

The nutritional conflict between rice and roti is age-old, as primary staples of every Indian cuisine.  White rice and wheat chapattis are both infused with considerable amounts of protein, calorie, fat as well as fibre. This overlap makes it tougher to choose just one as an accompaniment with your meals.
The health-conscious can take a sigh of relief with this list of effective benefits of the two. Let’s pit them against each other!

#1: If you opt for a lighter meal…Choose rice!
Boiled white rice is easier to chew and digest as it is low in fibres. For those with issues of diarrhoea, colitis, an upset stomach or morning sickness, rice is a favourable choice. If you are suffering from chronic gastrointestinal distress, rice is recommended for you.
Tip- You can consume a bowl of steamed rice with sautéed vegetables for a wholesome meal!

#2: If you are looking for muscle growth…Choose roti!
Rotis is the best food accompaniment for vegan and vegetarian bodybuilders. At home, you can mix variants of whole grains to harness the benefits of calcium and other minerals. Wheat chapattis made of whole grain consist of complex carbohydrates that boost your energy.
Tip- For reducing your portions, have two servings of roti (without ghee) with a large bowl of home-cooked yellow dal.

#3: If you have a heart condition… Choose rice!
For you to keep your heart healthy, the consumption of rice is vital. Brown as well as white rice is full of fibres and high in magnesium, niacin, phosphorus that can prevent heart problems.  Rice helps you in lowering bad cholesterol levels.
Tip- Substitute your regular white rice in the khichdi or biryani recipe with brown rice. (Contains fibrous bran and germ layer)

#4: If you want to feel fuller… Choose roti!
For weight watchers, who want the feeling of satiety for longer period should include rotis in their meal. Wheat rotis take longer to digest which helps in maintaining blood sugar levels. This quality also makes it a good alternative for diabetic individuals. Wheat rotis are nutritious and contain vitamins B1, B2, B3, B6 and B9 that help in keeping you strong.
Tip- While kneading the wheat dough for the rotis, you can add soya powder to increase its protein content.
To escape the dilemma of choosing between these two healthy and tasty staple sides, try switching to whole-wheat rotis and brown rice. Savour both, guilt-free!

If you would like to consult with me privately, please click on 'Consult'.

 Roti vs. Rice- What should you have your meals with?

Stroke is a medical condition in which the flow of blood towards the brain is poor and causes the death of certain cells. There are two common types of stroke: 

1. Ischemic- due to lack of blood flow
2. Hemorrhagic- due to bleeding

Signs and symptoms of stroke 

Problems with movement
Inability to feel  on one side of the body
Problems understanding or in speech
Vertigo
Loss of vision
Difficulty in carrying out everyday activities
Role of Physiotherapy for Patients with Stroke

The main focus of physiotherapy is to help you use your arms and legs to regain as much strength and movement as possible. 
If you have one-sided paralysis, correct positioning is important to prevent spasm or injury.
It helps you to sit up as this will help you avoid blood clots in your legs, improve your breathing and help you recover quickly.
If you are unable to move, you may be given chest physiotherapy to keep your lungs free of infection.
What does a Physiotherapist do?

A physiotherapist advises you on how you should be positioned when lying or sitting, and how often you need to be moved.
Motivates you to be actively involved in your physiotherapy sessions to help you relearn normal patterns of movement
Decides when you should begin to start walking and what equipment is needed to move or support you
Provides therapy to strengthen your limbs and teach you how to move again as independently as possible
Takes care of the fact that no complications should arise and you have a smooth recovery.
Treatment Techniques:

Strength Training: It is evident that strength training can improve upper-limb strength and function without increasing tone or pain in individuals with stroke.
Gaming: Goal orientated computer gaming has proven to significantly reduce upper limb impairment in stroke survivors.
Virtual Reality: Virtual reality training has been shown to be effective in restoring upper limb motor impairments and motor-related functional abilities.
Mirror Therapy: Mirror therapy has been shown to have a beneficial effect on motor control and function compared to conventional therapy.
Robot-Assisted Therapy: It has been shown to have a beneficial effect on motor recovery and function.
In the upper extremity with severe impairment and/or poor prognosis for recovery, Chedoke McMaster Stroke Assessment (CMSA) of Arm and Hand < Stage 4) treatment should focus on maintaining a comfortable, pain-free, mobile arm and hand. Engage in repetitive and intense use of novel tasks that challenge the stroke survivor to acquire necessary motor skills to use the involved upper limb during functional tasks and activities. Engage in motor-learning training including the use of imagery.

Stroke - How Physiotherapy Can Help With It?

As per medical studies, bipolar disorder is a personality disorder that is said to affect millions of people around the world, as per medical studies. Extreme mood swings that take a person from a state of euphoria to depression can be called bipolar disorder. While we all go through phases of the same, the patients who suffer from this disorder will usually show a persistent swing or shift between varying moods. The severe shifts will lead to difficulties when it comes to managing one's everyday affairs in a normal manner. The symptoms and signs are also characterised by the phases and mood swings that the patient may be going through. 
Read on to know more about the signs and symptoms of bipolar disorder.

1. Mania: One of the extremes in mood swings experienced by the patient includes extreme euphoria or mania for no apparent, or life altering reason. Feeling overly happy and enthusiastic are the basic symptoms of this phase.

2. Impulsive: The patient can end up feeling elated for a prolonged period of time, with extreme restlessness and impulsive behaviour. They may also end up getting agitated and edgy. This is usually characterised by fidgety behaviour and when the patient speaks too fast. The patient may speak too fast due to racing thoughts which overtake his or her speech and actions.

3. Confidence: In this stage, the patient may also display extraordinary confidence, which may not necessarily be backed by reality. In reality, things may be very different in terms of opportunities, skills, people and other such factors. During this mania phase, the patient may also indulge in risky behaviour that gives an adrenaline rush like gambling and having sexual intercourse with multiple partners. This usually happens when the patient is bolstered by a sudden surge of unfounded confidence.

4. Depression: This is the other end of the spectrum for these patients. When the mania abates, it gives to way to extreme depression and even anxiety.

5. Withdrawal: The patient usually tends to isolate himself or herself from the rest of the family and social circle for a prolonged period, refusing to meet anyone on a normal basis. They also avoid contact with people whom they meet every day, which can have an adverse effect on their work and the rest of the aspects of their lives.

6. Memory and Concentration: In this phase, the patient can also experience difficulty in remembering important things and concentrating on tasks. The patient may also be preoccupied with a number of things which can prevent him or her from making proper decisions. Slow speech and lack of energy may follow as a result of such preoccupation. Preoccupation with death is a common symptom of this phase.

Symptoms of Bipolar Disorder

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