Medical Questions & Answers » Health Articles

ADHD Disorder in Children

medicalquestions — Mon, 15 Jun 2009 06:00:22 +0000

My 7-year-old is a very active boy – extremely so, I would say. He cannot sit still for moment and is often in trouble at school. According to his teacher, his restlessness is disturbing the rest of the class. My neighbor says he may be suffering from something called ADHD, and medication will help him quiet down. I personally feel my son just happens to be more energetic than most boys of his age, and his boredom threshold may be lower. However the complaints from school make me anxious. How do I get my son to behave the way he’s expected to in the classroom? What distinguishes ADHD from regular naughtiness?
Children with ADHD (Attention Deficit Hyperactivity Disorder) often display inattention and impulsiveness besides hyperactivity. An expert must make the diagnosis before any medication is given to the child. Once the diagnosis of ADHD is made, these children can be helped with proper management and may do reasonably well in school and later in life. There are Pediatric Neurologists in the Child Trust Hospital in Chennai to whom you can show your son. They’ll help you decide whether your child has ADHD or “regular naughtiness”.

I was operated for prostatis seven years back, but since the last two years I’ m having difficulty in passing urine completely. The doctor found that there was a stricture, which was removed with an operation. I was prescribed “Contiflow” and “Uritone” for two months without much improvement. Then for three weeks I was put on catheter and after that I was advised to do self catherization, which I am still continuing. Now doctors say that I have a neurogenic bladder for which there is no treatment. Is there any treatment for this? Will Botox help?
Your neuropathic bladder can be corrected. You need to get a URODYNAMIC evaluation done and then consult your urologist. Botox is used for overactive bladder and not for your condition. Your bladder is probably hypotonic and you may need Tab Urotone 1 tablet three times a day.

Height Growth of Children

medicalquestions — Tue, 09 Jun 2009 06:00:16 +0000

My son is 19 years old. For almost 3 years now his height has not increased. He is 5′6″. There is no one in our family who is taller than that. I want to ask you
1. Are there any chances that his height can increase now?
2. If yes, at the most to what extent?
3. Are the products advertised on TV, like Yoko and other syrups, useful?
4. What are the exercises he should do to gain height and what should he eat (being a vegetarian)?

1. There are no chances of increase in height now, by natural process.
2. With surgical methods, viz., the Illizarow technique, height can be boosted, but the risks of complications are high, it is time consuming and also very costly. I would not advise it at all. This is only for your information.
3. The products promoted on TV are mere advertising hoaxes. They are not proven, non scientific and fraught with risks.
4. There are no exercises that can increase his height at this age. During the growth period, viz., up to 18 years in boys, participating in games and sports coupled with high protein intake helps add an inch or two.

My children are 46″ and 40″ in height respectively. My own is 5′1 “. I want their height to be more than mine at least. Kindly clarify:
1. Whether their growth is normal.
2. Is there any medicine to increase the height without causing any side effects/adverse effect?
3. I have heard of growth hormones, but do not know how to administer such drugs. Please advice on the above.
Your children’s height is less than the average of kids of that age. Though exceptions are seen, height of children is mainly dependent on that of parents. Tonics and vitamins are of no use in such cases. If you want to consider the growth hormone option, you must consult a pediatric endocrinologist, who will ask for certain tests and then decide whether these drugs should be given to your children or not.

Know The Heart at Risk

medicalquestions — Thu, 04 Jun 2009 06:00:54 +0000

I’m 23-years-old. I’ve been smoking for the past 8 years. I cannot resist it. Please advise me on how I can kick the habit and also reduce its ill effects.
You have smoked long enough to last a lifetime, and it appears you have indeed become a nicotine addict. While it’s true that all that smoking may have affected your vital organs like the heart and lungs, remember, it is never too late to quit. You can begin your smoking cessation program immediately. To successfully kick the habit you must not only prepare yourself mentally but also take practical steps that’ll ease the process. For example:
(1) Avoid being put in the presence of tobacco – be it people who smoke or places that allow smoking;
(2) Plan for all those times when you will feel the urge to smoke – before dinner, after dinner, in the loo, at work. How do you intend to keep your hands, mouth and brain busy when they’re not in the thrall of nicotine?
(3) When you get the urge to smoke talk to a friend or relative. Yoga and Pranayama will also help.
(4) Resort to nicotine gums to overcome the craving, but use only for short periods.
It’s usually best to quit cold turkey but follow whatever method that works best for you. Finally remember that even though you may fall off the wagon and go back to smoking, don’t castigate yourself for having failed in your attempt. All successful quitters tried many times before they kicked the habit for good. Staying away from nicotine is the only way to avoid its dangers but you may give antioxidants and vitamin pills a try.

I am 57 years old male, 5′6″ height, 30½” waist, weighing 51 kg with normal Blood Pressure and Blood Sugar level, pure vegetarian, non smoker and limited tea taker. I am fully active and healthy. However my LDL cholesterol (232 MG/DL) and Total cholesterol (318 MG/DL) figures are very high. Kindly explain my chances of developing CAD (Coronary Artery Disease) and what I can do to prevent it.
You appear to have hypercholesterolemia. Deranged lipid profiles are one of the factors which predispose to coronary artery disease. However, you are not overweight, non-hypertensive, and non-diabetic. And while a deranged lipid profile marginally increases your risk of heart attack, correcting the levels would help in reducing it. I would suggest that you avoid saturated fats like ghee and butter and also fried foods. A heart healthy diet includes plenty of whole grains, vegetables, fruit and good fats (peanut, olive, mustard oils). Tea, by the way, is good for the ticker. Exercise can also help boost your HDL “good” cholesterol levels. Finally, ask your cardiologist about cholesterol-lowering medications like statins.

Genital Herpes & Ross River fever

medicalquestions — Wed, 03 Jun 2009 06:00:05 +0000

My grandson suffers severely from a recurrent blistering rash across his face that I believe are cold sores. I have read that there is a drug to cure herpes infections. Will this drug work on cold sores as well as genital herpes?
Zovirax (aciclovir) was the first effective antiviral drug ever developed. It is expensive, but also very effective in controlling infection by all forms of the herpes virus. There are several newer drugs that also act in this way.
The herpes virus causes cold sores, genital sores, shingles and chickenpox.
The drug has been used for some years to control genital herpes and shingles, but cases of severe cold sores can also be prevented and controlled by the drug. Because chickenpox is a self-limiting disease, it is only used to treat this disease in patients who have an inadequate immune system.
Zovirax can be used in a low dose long term to prevent infection, or at a high dose for a short time to settle an acute infection.
The government subsidises the cost of the drug under very strict guidelines. If your grandson falls outside these guidelines, be prepared for a very large bill from the pharmacist.

My daughter’s best friend has Ross River fever. I am worried that she could catch it too. What is this fever, and how do you catch it?
Ross River fever is caused by a virus-like germ that attacks the connective tissue of the body. It is transmitted from one person to the next by mosquitoes. When the mosquito bites an infected person, the germ enters the mosquito with the blood, and is injected back into the next person the mosquito bites, infecting them also.
The patient suffers from fevers, muscle aches, arthritis and headaches, and is very tired. It may last for a couple of weeks or a couple of months. There is no cure available. The only form of prevention is the liberal use of insect repellents, screening houses and long sleeves.
The disease is more common in north Queensland and the Northern Territory, but may occur anywhere in Australia that mosquitoes occur.

Tetanus – Its Causes and Treatment

medicalquestions — Sat, 23 May 2009 06:00:56 +0000

What causes tetanus? Is it a serious disease? Why do doctors insist on jabbing everyone who has a cut with a tetanus shot?
A bacteria called Clostridium tetani can live quite harmlessly in the gut of many animals, particularly horses. When it passes out of their bodies in faeces it forms a hard microscopic cyst which then contaminates the soil and waits for a chance to return to active life. The bacteria can remain inactive for many years until it enters a cut or wound in the dirt of dust that may be around when the tissues are exposed.
Once it has infected a cut, it starts multiplying and produces a chemical which is absorbed into the bloodstream and spreads throughout the body. This chemical (a toxin) attacks the small muscles used for chewing our food, making it difficult to open the mouth. Thus the common name for tetanus is lockjaw. The toxin gradually attacks larger and larger muscles, irritating them and causing them to go into severe spasm.
These spasms are similar to the cramps you may experience in your leg at night, except they are more severe and can attack every muscle in your body. The patient remains conscious throughout the disease, but eventually the muscles which control breathing and the heart are affected, and the patient dies.
There are very few effective treatments for tetanus, because although the bacteria may be killed, the toxin remains in the body. Tetanus can be prevented by vaccination, but it cannot be cured.

Should an adult man have a mumps vaccine if he has never had the disease?
Yes. Children should have a mumps vaccine at one and five years of age, so it is now an uncommon condition, but if an adult catches the disease, it is usually more severe than in a child.
If an adult (man or woman) has not had mumps, a vaccine that has minimal side effects is available to give life-long protection. Most general practitioners would carry a supply of this vaccine, and so it is a very simple matter to obtain protection.
Mumps seems to have the unfortunate ability to strike just before your annual holidays or at some other vital time, so for this reason alone it is worthwhile being protected. In addition, the testes of men and ovaries of women may be affected by a severe case of mumps. This complication is not common, but may lead to sterility in both men and women.

Vaccination for Whoping Cough

medicalquestions — Sat, 23 May 2009 06:00:16 +0000

Should I give my baby the diphtheria, whooping cough and tetanus vaccinations, or are the side effects dangerous?
All children should receive the full course of vaccines to protect them against these serious diseases unless there are very good medical grounds not to use them.
Unfortunately, some parents through ignorance or ill-informed advice are not vaccinating their children, and the diseases of whooping cough and diphtheria are increasing in the community.
Tetanus is always with us, and is potentially able to infect any wound. All three diseases may be fatal, may cause brain damage and may cause chronic ill health.
The risk of vaccination is infinitesimal, and when compared to the potential side effects of any one of these diseases, it is a far preferable course of action. Another person (adult or child) only has to breathe the infecting germs in the direction of your child and he or she may catch one of these dread diseases. Please vaccinate your child now!

I have never heard of any child catching whooping cough, but my doctor is insisting that my baby has this vaccine. Is whooping cough vaccination still necessary?
There is no treatment available to cure this distressing disease, but it may be completely prevented. Even so, increasingly large numbers of children are being left unprotected because their parents forget to obtain the necessary course of injections, or are poorly informed.
Whooping cough is not a disease of the past. Hundreds of Australian children contract the disease every year, and many of them die or are left as invalids. The bacteria that causes the infection is widespread in the community, and adults may have the disease and consider it merely a cold. Only in young children is the disease severe, and it is therefore important to start vaccinations as early as possible.
The vaccination against whooping cough is invatiably combined with those for tetanus and diphtheria, and is given at two, four, six and 18 months of age. This triple vaccine has minimal side effects, and the most common ones are a slight fever for 6 to 24 hours after the needle, and sometimes prolonged crying. Any other risks are minimal, and certainly far rarer than the serious complications of any of these three diseases.
If the child has a fever or other illness, the vaccination may be delayed for a few days until he or she has recovered. The only children who should not be vaccinated are those with febrile convulsions, a history of epilepsy and allergies to certain elements of the vaccine.

Klinefelter syndrome – A Hereditary Problem?

medicalquestions — Wed, 13 May 2009 06:00:13 +0000

I have been told that a cousin has Klinefelter syndrome. Is this an hereditary problem that I should be worried about in my family?
One in every 500 males is afflicted with Klinefelter’s syndrome. It is named after Harry Fitch Klinefelter, who practised as a physician in Baltimore, USA, until the 1990s. He described a condition in which males have very small testes and penis, develop small breasts, have scanty body hair and are impotent. These men are always sterile.
The syndrome is caused by an abnormality in the chromosomes that govern the activity of every cell. At the moment of conception when the sperm fuses with the egg, the chromosomes from the mother and father of these men combine incorrectly with two X chromosomes and one Y being present (XXY) instead of one of each (XY). Because every cell in the body is affected by the abnormal chromosomes, no cure is possible.
Testosterone (male hormone) tablets or injections can be given to improve the general body shape and impotence of the man, but the infertility cannot be corrected. Plastic surgery to remove the breasts is sometimes necessary.
Please be assured there is absolutely no chance of the condition being present in your family, as it is an error of fertilisation, not an inherited condition.

I have had pins and needles in my arms for years on and off. Sometimes my arms really ache. It can’t be the arthritis my doctor says it is because I am only 28 years old. Do you have any ideas?
Naffziger syndrome, which has numerous other names including cervical rib syndrome, scalenus anticus syndrome and thoracic outlet obstruction, is the diagnosis that springs to mind.
Patients with this problem have an additional rib present in lower neck above normal first rib. Nerves and arteries can be compressed between the extra cervical rib and the scalenus anticus muscle in the neck. This is a congenital (present since conception) problem.
The syndrome causes abnormal pressure on ulnar nerve then pain and pins and needles sensation in the arm and hand, muscular weakness of small hand muscles, and altered sensation in the forearm and hands. In severe cases patients have cold blue hands, and reduced pulsation and blood flow in the radial and ulnar arteries in the arm.
The diagnosis can be confirmed by an X-ray of the neck, which shows the extra rib.
Treatment involves rest, neck traction, and sometimes surgical excision of extra rib. Without treatment, symptoms are slowly progressive, but there is a good result from surgery.

About Carpal Tunnel Syndrome

medicalquestions — Tue, 12 May 2009 06:00:53 +0000

Would you please write something about carpal tunnel syndrome? My doctor tells me that this is the cause of my hand problems.
Carpal tunnel syndrome is a form of repetitive strain injury to the wrist. It is caused by the excessive compression of the arteries, veins and nerves that supply the hand as they pass through the carpal tunnel in the wrist. This tunnel is shaped like a letter ‘D’ lying on its side and consists of an arch of small bones which is held in place by a band of fibrous tissue. If the ligaments become slack, the arch will flatten, and the nerves, arteries and tendons within the tunnel will become compressed. It is far more common in women and in those undertaking repetitive tasks or using vibrating tools and in pregnancy.
The symptoms include numbness, tingling, pain and weakness in the hand. The diagnosis is made by x-rays of the wrist, and studies to measure the rate of nerve conduction in the area confirm the diagnosis.
Treatment involves splinting the wrist, fluid tablets to reduce swelling, nonsteroidal anti-inflammatory medications, and occasionally injections of steroids into the wrist. Most patients will eventually require minor surgery to release the pressure.
The main complication is permanent damage to the structures in the wrist and hand if the syndrome is not treated.
The operation normally gives a life-long cure.

My mother is paralysed from the waist down with Guillain-Barre syndrome. She has diarrhoea, pins and needles and feels cold. Will her condition ever improve?
The Guillain-Barre syndrome is fortunately rare, and often follows a stress to the body such as an infection, surgery, vaccination or injury. Its exact cause is unknown.
The symptoms vary significantly from one patient to another, but include weakness of the legs and/or arms, paralysis of some facial muscles to cause grimacing, pain in various nerves, pins and needles sensation, poor control of bladder and bowel and abnormalities in heart rhythm and breathing.
The disease is difficult to diagnose, as there are no specific tests that will confirm its presence.
It is uncommon for patients to die from the condition, and most make a good recovery over many months, but as many as 20% are left with some long-term disability. Numerous treatments have been tried, but none are generally successful in all patients. The main form of care is good nursing in hospital during the worst stages, then at home for the months that recovery will take. Physiotherapy is often beneficial in maintaining limb movement.
Unfortunately, it is impossible to predict the outcome in any individual, but patience may be rewarded with recovery, often after nearly all hope has gone.

Treatment of Chronic Fatigue Syndrome

medicalquestions — Tue, 12 May 2009 06:00:13 +0000

I have chronic fatigue syndrome, and wonder what treatment you would prescribe, as many doctors maintain there is nothing that can be done for it.
Medical science is constantly advancing, discovering more about the body and its interactions with the environment and diseases. Unfortunately, we are a long way from knowing all the answers about what is an extraordinarily complex biochemical machine that can have its equilibrium disturbed by everything from cancer and infection to stress and allergies.
There are no tests that can confirm a diagnosis of chronic fatigue syndrome. Everything in the sufferer appears completely normal except for the fact that they are so tired that they cannot perform their normal daily activities. It is therefore a diagnosis of exclusion, and some doctors claim it is purely psychiatric, but after seeing some of my own patients suffer, I am sure that there is something more to it—the question is what?
Because we don’t know what causes chronic fatigue syndrome, we don’t know how to treat it. There are as many theories and treatments as there are doctors, and every alternative therapist from osteopaths to naturopaths seems to claim that they can cure the problem. I know of nothing that works. The medical press is constantly full of trial results, letters, case reports and anecdotes from doctors, but nothing conclusive has yet come to light. What we do know is that most victims do fully recover, but this may take many years.
Some patients are affected more than others by the condition, not only because they are more tired, but because in desperation they have spent large amounts of money from their already depleted reserves in trying exotic and expensive cures that are promised by charlatans. If there was anything that could be proved to work, the medical profession would be delighted to use it, but because the condition eventually cures itself, any treatment that is being used at that time will be credited with the benefits. Antidepressant and antiinflammatory medications seem to be the best options currently available.

My mother has just been diagnosed as having Cushing’s syndrome. What causes Cushing’s syndrome? Is it serious?
Cushing’s syndrome occurs when an excess amount of steroids (such as cortisone) are given to a patient, or a gland becomes overactive to produce steroids within the body. The glands involved are the pituitary, which is in the middle of your brain, and the adrenals which sit on top of your kidneys.
The syndrome may cause obesity, skin markings, headaches, weakness, bone pain and other diverse symptoms.
Steroids are very useful in controlling a wide range of diseases from asthma to arthritis and skin disorders, but they must be used judiciously to avoid complications.

Myalgic Encephalomyelitis Syndrome

medicalquestions — Mon, 11 May 2009 06:00:48 +0000

I have been diagnosed as having myalgic encephalomyelitis. Can you explain this disease for me?
Myalgic encephalomyelitis (ME or chronic fatigue syndrome) is one of a number of diseases categorised as post-viral syndromes. No-one can fully explain the condition, because these syndromes have only recently been recognised and remarkably little is known about them.
It appears that in some people, a viral infection such as influenza is followed by a chronic inflammation of many organs of the body. It is rather like a prolonged dose of the flu, but without the runny nose and fever—just aches and pains and tiredness.
The symptoms of ME vary dramatically from one patient to another, and there are no specific blood or other tests to make the diagnosis. This makes the task for doctors very difficult, and explains why some of these people have at times been described as malingerers.
Symptoms can include arthritis, muscle pains, headaches, nausea, vomiting, diarrhoea, skin rashes, abdominal cramps, depression, mood changes and severe tiredness. A wide range of treatments have been tried to help these people, but all are experimental and there are none that I could justifiably mention here.
Most people have the disease for many months or a few years, and it then slowly fades away, but in the meantime the victim has lost job, career, pride, money and possibly family. The only other point of note is that women are affected five times more than men.

My son aged 30 years has been diagnosed as having chronic fatigue syndrome. What causes this, and is there anything that can be done to help him, as he is very depressed and always tired?
Chronic fatigue syndrome is a chronic condition may affect anyone, as it is thought to be caused by a virus. It may start as a flu-like illness that recurs several times until it becomes constant. The patient is tired all the time, every muscle in the body aches constantly, a severe headache occurs, skin rashes can develop, and there may be weakness of the arms and legs. It is like having the worst possible case of influenza, but without the runny nose and cough, and without improving for many years. It is far more common in women than in men.
Unfortunately there are no miracle cures available, but antidepressants, anti-inflammatory and other drugs may be helpful. There are also a few new medications being used on an experimental basis by some specialist physicians.