Thursday, April 14, 2011

Rice Khichu


Ingredients 
 1 cup Rice Flour
 ½ tsp Green Chillies (chopped)
 ¼ tsp Chilli Powder
 1 tbsp Fresh Coriander (finely chopped)
 ½ tsp Cumin Seeds (jeera)
 ¼ tsp Soda-Bi-Carbonate
 A pinch of Hing (asafoetida)
 2 tbsp Oil
 Salt to taste
 Preparation Time
    

 Method
  • Take a wide vessel (handi) and put 2 ½ cups of water in it.
  • Put it over the flame and bring it to boil.
  • Now add chilli powder, cumin seeds, soda-bi-carb, green chillies, salt and a pinch of hing into it.
  • Mix well and let it boil for few minutes.
  • Now slowly add rice flour and keep stirring so that no lumps are formed.
  • Cover the vessel with a lid and cook for 10 more minutes.
  • Now put oil and coriander and mix it properly.
  • Serve hot Rice Khichu with papad.

Bed Wetting in Children

Bed-wetting is a condition that affects children worldwide. Bed-wetting is a subject that parents usually avoid discussing with anyone. They may be ashamed to admit that their child still cannot control his bladder. However, bed-wetting in children, and even teenagers, is a common occurrence.

Bed-wetting (sleep-wetting or 'nocturnal enuresis') is a term given to the uncontrolled passing of urine while a person is asleep. It affects people of all ages, but is usually seen in young children, until the age of six. Male children are usually affected by it.

Bed-wetting can occur due to a number of reasons. It can be hereditary or it can be due to any anatomical/physical causes, psychological causes or due to any external stress.

Effects of bed-wetting on children:

Bed-wetting is not physically painful, but such children might suffer from emotional problems. This is largely due to the stigma associated with bed-wetting. Punishing or teasing the child will only harm his/her self esteem and make more difficult for the child to stop bed-wetting.

Bed-wetting also prevents children from attending certain social activities involving sleepovers and overnight trips. Children who are unable to join in these gatherings may find themselves missing out on spending quality time with their peers for no fault of theirs and thus, they start suffering from psychological distress.

Ways to stop bed-wetting in children:

The first thing to remember is that bed-wetting is an involuntary response. A child does not deliberately wet the bed. Almost all children wet their bed till their bodies learn to control their bladder. Thus, bedwetting until the age of five or six is perceived to be a common occurrence and is usually not considered a problem.

There are some steps parents can take to minimize a child's chances of bed-wetting. The simplest way is to limit a child's fluid intake a few hours before bedtime. Also, encourage the child to visit the toilet before he goes to sleep. If necessary, wake him up once during the night so that he can empty his bladder. Bed-wetting usually increases with a drop in temperature, so make sure the child is dressed in warm clothing. The child can be made to wear diapers to reduce his embarrassment and prevent him from making a mess. In severe cases of bed-wetting, it is better to consult a doctor to detect the underlying cause.

Bed-wetting is not a disease. It is simply an unfortunate condition that affects children not just physically, but mentally as well. However, it can be easily cured and in most cases, the best healer is time.

Fatigue/Stress


Delivery may be a natural process, but along with it each mother experience stress and tiredness to different degrees. Recovering from delivery may take some time. The length of labor hours and the rest you had before delivery are important factors that decide the degree of tiredness.
If the delivery was without complication then sooner will be your recovery. Stress and anxiety after delivery is very common. The main reason being decreased hormonal level. Every woman has a feeling that being a new mother, is a very big responsibility and a   challenging task. This is not wrong but you need to remember that taking someone’s help is not wrong. Remember the following to cope-up with stress.
1. Feeling exhausted is not sin, take some rest.
2. Sleep is necessary not only for your baby but also for you.
3. Being anxious is ok but don’t do anything in hurry.
4. Remember you need energy to take care of yourself and your baby so eating small meals at intervals would be more useful.
5. Take someone’s help in taking care of a child. Take advice from any elder.
6. Your child needs your attention so does your own body. Do simple exercise and try to lose body weight that has been put during your pregnancy time.

Dental Fillings


Dental caries is the biggest problem in every age group. Dental caries is not only due to intake of more sweets, it can be due to several reasons like:
• Improper Brushing
• Irregular teeth
• Irregular gaps in between the teeth
• Bad oral habits
• Improper Oral hygiene

Based upon the area of dental caries cavities are classified by G.V black as follows:
• Class 1 cavity - Caries is present on occlusal portion and buccal or lingual pits.
• Class 2 cavity - Caries present on posterior interproximal area.
• Class 3 cavity - Caries present in anterior interproximal area.
• Class 4 cavity - Caries present in anterior interproximal including the incisor area.
• Class 5 cavity - Caries present on gingival at facial or lingual area.
• Class 6 cavity - Caries present on cusp tip.
Whenever we go to Dentist for dental fillings, we always tell Dentist that filling should not be visible. Eventually, we opt for tooth colored fillings. Types of dental fillings available are:
1. Silver Filling or metal Filling or Amalgam fillings.
2. Tooth colored filling or white filling or Composite resin fillings.

Advantages of Silver Filling:
1. Silver filling is the strongest filling ever known
2. It is less technique specific
3. It has tolerant to moisture present in oral cavity while placing the filling in tooth.
4. It does not get discolored while coming in contact with food ingredients such as Tamarind.
5. It takes time to get hard, for this reason it can be packed easily even in larger cavities.
6. It is inexpensive and versatile Filling.

Disadvantages of Silver Filling:
1. It contains mercury which is still in question that whether the use of silver fillings should continue or not.
2. Amalgam filling cannot be used in Anterior or front teeth due to its color.
3. Amalgam filling requires more space to get filled in tooth. In this case, Dentist sometime has to even cut healthy tooth while preparing the cavity.
Advantages of Tooth colored Fillings:
1. Tooth colored fillings can easily be used in anterior teeth or front teeth because of its color.
2. These fillings contain fluoride which does not allow carious lesion to proceed further and hence prevents further damage.
3. It can be completed in Single visit.
4. It does not cause tooth sensitivity.

Disadvantages of Tooth colored Fillings:
1. These fillings are very technique sensitivity. While doing tooth colored filling, if moisture comes in contact they lose half of its strength.
2. Tooth colored fillings get discolored if comes in frequent contact with food ingredients like tamarind.
3. It is expensive, and not recommended on tooth bearing heavy occlusion forces.
4. These fillings shrink with time which allows the micro leakage of food particles beneath the cavity. This is the main reason of dental caries beneath the cavity.
Post Dental Filling Prevention Measures:
1. Avoid tea, coffee for 1 or 2 days.
2. Avoid intake of food which requires hard chewing like mutton, chicken especially when filling is done in front tooth.
3. Avoid sticky food like chewing gum and sweets for 1 day.
4. Do not prick any instrument in filled tooth.

Frequently Asked Questions:
Is silver filling advisable for all teeth?
Silver filling is recommended in posterior (back) teeth. In case of anterior (front) teeth white fillings are recommended.
Is local anesthesia required prior to filling procedure?
Local anesthesia is not required in fillings, but in some cases if the tooth is sensitive and patient is quite apprehensive then anesthesia is must.
Does Tooth colored fillings harm the oral tissues?
No, White fillings don’t harm any of the oral tissues.
Is Mercury present in Silver filling safe?
No, mercury used in silver fillings is still in question. Some dentist do not recommend silver filling in any situation, but some are still using. Mercury if swallowed can cause mercury toxicity.
Why tooth colored fillings take more time?
Tooth colored fillings are more technique specific hence require more time.

After filling if pain starts in tooth then what is the treatment?
Sometimes due to deep carious lesion Dentist has to make deep cavity. In case of deep cavities dentist always gives a lining of medicament (which allows the formation of secondary dentin) beneath the filling and wait for 3 weeks. If patients complain of pain after 3 weeks, then RCT is recommended.

Bell's Palsy


Bell's palsy is defined as a sudden paralysis on one side of face. It is common in individuals residing in cold countries.
Common causes:
  • Inflammation of facial nerve
  • Infection in oral cavity
  • Hereditary
  • TMJ disorder
  • Tumors
  • Autoimmune disease
  • Smoking
  • Ear infection
  • Facial trauma
  • Cold or flu
Symptoms:
  •  Dry eye
  •  Corner of the mouth droop
  •  Frequency of tears decreases
  •  Patient is not able to speak and smile properly
  •  Numbness or weakness on one side of mouth
  •  Patient is not able to close eye and mouth properly.
Treatment:
In many cases Bell’s palsy get resolved in few weeks. Massage of facial muscle, eye drops and the treatment of underlying cause can treat Bell's palsy. Eyes should be covered as eye is not closing properly so to prevent the chances of infection in open eye is more.

Sunday, April 10, 2011

Breastfeeding


Breastfeeding Introduction
Human milk is widely recognized as the optimal source of nutrition for all infants. Breast milk promotes development of the infant's immune system and meets the nutritional requirements of an infant until approximately six months of age, when complementary foods and fluids are usually added to its diet.
There are many women who choose not to breastfeed. The possible reasons may include embarrassment, lack of knowledge about the benefits of breast milk, belief that formula is equal to breast milk, and myths about the "ease" of formula feeding compared to breastfeeding.
However, breastfeeding has got a lot of benefits not only for the mother but also for the child. For the following reasons, it is recommended that the mother breastfeeds the baby for at least 6 months without the formula food. And partial breastfeeding with formula food is recommended for the next 6 months.
Benefits of breastfeeding
For infants:
• Better digestive tract function and protection from digestive tract infections, such as vomiting and diarrhea.
• A reduced risk of respiratory infections, ear infections, and wheezing.
• Some studies suggest that breastfeeding reduces the risk of obesity, cardiovascular disease, and autoimmune diseases, such as type 1 diabetes mellitus.

For women:
Compared to mothers who feed formula, women who breastfeed experience:
• Reduced blood loss after childbirth as a result of a hormone, oxytocin, which is released into the mother's bloodstream while breastfeeding.
• Reduced levels of stress as a result of several hormones released during breastfeeding.
• Increased weight loss after pregnancy (if breastfeeding continues for at least six months).
• Decreased risk of breast cancer.

For family:
Families who breastfeed experience:
• Reduced infant feeding costs by cutting down the cost of infant formula and associated supplies.
• Reduced costs related to healthcare, including doctor's visits, hospital costs, and lost time from work. Infants who are breastfed are less likely to become ill and less likely to be hospitalized, reducing the potential costs and anxieties of caring for an ill child.
When to start breastfeeding
Breastfeeding should begin within the first few hours of delivery, if possible, by allowing the baby to rest or nurse, skin-to-skin, on the mother's chest. During this time, most infants are alert and interested in nursing.
In some situations, the infant or the mother must be separated for several hours or even days after delivery. Pumping the breasts and then storing the milk for use is recommended to stimulate production of breast milk; this can be started optimally within the first 12 hours after delivery.
In the first few days after delivery, the woman produces a small amount of yellowish milk called colostrum. Colostrum is rich in nutrients and provides all the calories a baby needs for the first few days.
Women should not worry when only small amounts of colostrum are normally produced. Infants are born with an excess of fluid and sugar stores that they are able to use as the woman's milk supply increases.
It is normal to produce small amounts of milk in the beginning. With continued frequent breastfeeding, the amount of mature milk produced will increase within two or three days. Infants normally lose weight during the first few days of life and gradually regain this weight by two weeks after delivery.
Positioning during breastfeeding
A woman may use one of the several positions to hold her infant while breastfeeding. There is no such "best" position for every infant and woman; the best position is one that is comfortable for the woman and allows the infant to latch-on, suckle, and swallow easily. A woman may have several preferred positions depending upon the baby's size, the baby or mother's medical condition(s), and feeding location.
 In all positions, the baby should not require turning his or her head to nurse; the baby's nose should be aligned with the mother's nipple. Turning the head in any direction makes it more difficult to coordinate suckling and swallowing, and can potentially make it more difficult for the baby to latch correctly.
Pillows or nursing supports can help to ensure that both the woman and the infant are comfortable. When the mother is sitting in a chair, a foot stool is helpful in supporting the infant's weight and preventing fatigue in the mother's arms, shoulders, and neck.
Latch On
‘Latching on’ refers to the infant's formation of a tight seal around the nipple and most of the breast areola with his or her mouth. A correct latch-on allows the infant to obtain an adequate amount of milk and helps to prevent nipple soreness and trauma. Signs of a good latch-on include:
• The top and bottom lips should be open to at least 120 degree angle.
• The lower lip (and, to some extent, the upper lip) should be turned outward against the breast.
• The chin should be touching the breast while the nose should be close to the breast.
• The cheeks should be full.
• The tongue should extend over the lower lip during latch-on and remain below the areola during nursing. This is visible if the lower lip is pulled away.
When an infant is latched correctly, the woman may feel discomfort for the first few seconds, which should then decrease. Continuous discomfort may be a sign of a poor latch-on. To prevent further pain or nipple trauma, the woman should insert her clean finger into the infant's mouth to break the seal. The infant can then be repositioned and assisted with latch-on again.
Signs of poor latch-on include:
• The upper and lower lips are touching at the corners of the mouth.
• The cheeks are sunken.
• Clicking sounds are heard, corresponding to breaking suction.
• The tongue is not visible below the nipple (if the lower lip is pulled down).
• The nipple is creased after nursing.
An infant must be able to suckle and swallow correctly to consume an adequate amount of milk. It should be possible to hear the infant swallow. The infant's jaw should move quickly to start the flow of milk, with a swallow heard after every one to three jaw movements.
Frequency and Length of Breastfeeding
Women are encouraged to attempt breastfeeding as soon as the infant begins to show signs of hunger. Early signs of hunger include awakening, searching for the breast or sucking on the hands, lips, or tongue. Most infants do not cry until they are very hungry; waiting to breastfeed until an infant cries is not good for its health.
In the first 1 to 2 weeks, most infants breastfeed 8 to 12 times per day. Some infants need breastfeed frequently, as often as every 30 to 60 minutes, while others will have to be awakened and encouraged to nurse. A baby may be awakened by changing the diaper or tickling the feet.
Caring for an infant can be an exhausting experience. The length of time an infant needs to finish breastfeeding varies, especially in the first few weeks after delivery from as little as five minutes to 20 minutes or more. It is recommended that the infant be allowed to actively breastfeed for as long as desired. "Active" breastfeeding denotes that the infant is regularly suckling and swallowing.
Most infants signal that they are finished nursing by releasing the nipple and relaxing the facial muscles and hands. Some infants younger than 2 to 3 months often fall asleep during nursing, even before they are finished. In this case, they should be awakened and encouraged to finish nursing. After finishing one breast, offer the other side with the understanding that the infant (especially an older infant) may not be interested.
The baby’s urine, stool and weight should be monitored regularly in order to analyze how well the breastfeeding is going on in the initial days.
When not to breastfeed:
In rare cases, a woman's breasts may be incapable of providing a sufficient amount of breast milk.
Breastfeeding is not recommended for women or infants with the following conditions:
• Women who are HIV positive
• Women with human T-cell lymphotropic virus type I or II (HTLV)
• Women being treated with chemotherapy or radiation therapy
• Women who abuse drugs or alcohol
• Women with herpes simplex lesions on the breasts (ok to breastfeed if one breast has no lesions)
• Infants with classic galactosemia (galactose 1-phosphate uridyltransferase deficiency).
Breastfeeding is encouraged for women or infants with the following conditions:
• Women with hepatitis (A, B, or C)
• Women with past or current cytomegalovirus (CMV) infection
• Infants who develop jaundice.
Common Breastfeeding Problems:
Breastfeeding a healthy infant is often accompanied by different challenges. These challenges when combined with the normal anxieties of parenting a newborn infant can be difficult to deal with.
Problems associated with breastfeeding cause distress, mild discomfort or significant pain because of which many women stop breastfeeding after a few weeks. However, these problems can be treated effectively, allowing the woman to continue breastfeeding, which benefits her and her infant's health.
Some of the common breastfeeding problems are discussed as follows.
• Breast Engorgement
Engorgement refers to swelling within the breast tissue, which can be painful. Engorged breasts become firm, flushed, warm to the touch, and feel as if they are throbbing. Some women develop a slight fever.
The best treatment for engorgement is to empty the breasts frequently and completely by breastfeeding.  If the breasts are engorged, expressing milk by hand or breast pump can help to soften the areola and allow the baby to latch on more easily. However, it is important to avoid over stimulating the breasts with hand and/or pump expression because this could worsen engorgement.
• Sore or Painful Nipples
The nipples normally become more sensitive during pregnancy, with the greatest sensitivity occurring around the fourth day after delivery. "Normal" nipple soreness occurs for the first 30 to 60 seconds of breastfeeding, but then improves.
This can also happen due to the baby sucking the nipple and not the breast as a result of bad positioning. In such a case, dislodge the baby by inserting the finger gently into his/her mouth to break the grip. Reposition the breast, so that the breast and not just the nipple go inside the baby’s mouth. Try different positions. Express milk and rub it on the nipples as this will help in healing. Use the less sore side to feed the baby.
• Thrush that does not Heal
White marks or sore nipples that don’t seem to heal are known as thrush. It can appear when either the mother or the baby have taken a course of antibiotics or may appear without any particular reason. In such a case, antibiotic treatment is required.
• Lumps in the Breast
Free movement of milk is stopped because of a block in some duct of the breast. This can happen because of a wrong sleeping position, sitting for a few hours with the seat belt across the breast or a tight bra. Massaging the area or using warm compress on the area helps to dissolve the lump. If possible, position the baby in such a way that his/her jaw is near the lump, so he/she can feed and help in dissolving the lump. Feed from the sore side, if it doesn't work express milk from the breast.
• Inflamed, Red Areas on the Breast
Inflamed, read areas on the breast accompanied with flu symptoms like temperature, aches, sore breast that is full is the indication of a condition is known as Mastitis. Mastitis is an inflammation of the breast when milk leaks into the breast tissue. In such a case, rest as much as possible, but continue to feed the baby, starting with the sore side. Use of warm and cold compress will reduce the swelling. If there is no improvement, consult the doctor.
• Bloody Nipple Discharge
A small percentage of women have bloody nipple discharge in the first few days after delivery, resulting in bright red or rusty colored colostrum. The condition is because of an increase in blood vessels in the breast ducts during pregnancy and typically resolves within a few days. It is not necessary to stop nursing or to substitute infant formula if blood is seen in the colostrum or breast milk, although a doctor consultation is required.
If the condition is not resolved within few days, then a doctor consultation and proper examination of the breast is required. This is important because, in rare cases, blood in the breast milk is a sign of breast cancer.
Blood may also appear in breast milk as a result of cracks in the nipple, trauma to the breast, or other conditions. Blood is often detected because the infant's stool becomes bloody. The color of the milk can range from pale pink to bright red. In any case, consult the doctor.
• Nipple Color Changes
Women who have Raynaud phenomenon or unusual cold sensitivity may develop a narrowing of the blood vessels of the nipple related to breastfeeding. This can cause the nipple to become painful and whitened (blanched) during, immediately after, and between feedings. Some women have a two-part color change (white and blue) while others have a three-color change (white, blue, and red).
Blanching or whitening can also occur as a result of nipple compression due to poor positioning and latch-on, and can be addressed by adjusting the position of nursing and latch-on. It can be managed by:
• Increasing the air temperature and wearing warm clothing. Reusable wool breast pads may be helpful.
• Applying a warm compress just before and after nursing.
• Stop smoking.
• Avoid medications that constrict blood vessels (e.g., pseudoephedrine, a decongestant).
A baby may refuse to be fed on the breast in case of:
• A change in the taste of milk because of a change in diet or medication.
• Because of using nipple cream.
• Because of stopping the use nipple shields.
• Because of undergoing dental treatment. or
• Because of the starting of the mother’s menstrual cycle.