6 Categories of Sleep Disorders

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Catching sufficient sleep every day / night, is important for the physical and emotional well being of our body. Sleep is not about resting our body or taking a break from whatever we are doing, but sleep plays a vital part in helping our body to recover from the daily toll on our bodies, after our day’s activities. It also helps us recover from illnesses and injury. Insufficient sleep over a span of time is an indication of diabetes, heart diseases, obesity and depression.
If a person is stricken with a sleep disorder then this affects the person’s ability to get sufficient restful sleep during the night. 

Causes for Sleep Disorders 

According to the statistics put together after a 7 year research, about 70% of the population in India, are affected by sleep related problems. Some of the sleep disruptions may be because of changes occurring due to biological processes in the body, like aging or diseases that are associated with pain or mental health ailments, such as anxiety and depression.  

When the circadian rhythm in our biological clocks is disturbed because of working late shifts or because of jet lag, it scrambles the sleep cycle or if in the habit of taking long naps during the day, then this once again disrupts the sleep cycle. 

Types of Sleep Disorders

There are 6 different categories of sleep disorders.  

Insomnias - this condition occurs when, you experience daytime fatigue, the morning after your night of sleep, when you have trouble falling asleep or staying asleep. An occasional night of disturbed sleep or staying up too late does not mean that you have insomnia. However, at least 30-35% of older adults complain of this disorder and in many cases insomnia occurs in age groups where there is stress, medical and mental health problems. 

Hypersomnia – this is a group of sleep related disorders. A person with hypersomnia is prone to excessive sleeping and will fall asleep anywhere and anytime, which could endanger the person having such a disorder. 

• Narcolepsy is a form of hypersomnia where the patient has a lifelong sleeping disorder. In this disorder, sudden potential for sudden attacks of the need to sleep will affect and impact the patient’s life.
• Kleine- Levin Syndrome is an episode or series of sleep patterns where the patient will experience sleepiness and will sleep for durations. The duration of sleep may occur anywhere from 2 days to a week and it can occur several times in a year.
• Idiopathic Insomnia – the cause for this type of insomnia is still unknown. It causes the patient to sleep anywhere from 12 to 14 hours in a day and involves a daily period of an uncontrollable need to sleep.
• Long sleepers who sleep longer than those in their age group need their daily dose of 10 to 12 hours of sleep. This actually is a good quality of sleep. But when a long sleeper does not get adequate amount of sleep they tend to be sleepy which impacts the quality of their life. 

Sleep Movement Disorder – Restless legs syndrome, Periodic limb movement, Leg cramps while sleeping and sleep rhythm movement are all conditions that cause sleep disorder. 

Circadian Rhythm – occurs when there is a disturbance in the regular sleep-wake patterns of an individual. For example travelers who have jet lag, or individuals working late night shifts.

Parasomnias involves a group of experiences or events occurring as the person is falling asleep, or during sleep or while waking up. The individual may appear to be knowingly doing whatever they are doing, but in reality have no memory or realization that they are actually involved in the act. For example a sleepwalker will be still sleeping but may be walking around, but will wake up elsewhere not knowing how they got there. 

This article has just touched the tip of the iceberg with reference to sleep disorders. There is much more to this than meets the eye. There will be more articles on this disorder from our neuro specialists, with frequent updates. So tune into our monthly newsletter to keep abreast of the medical developments at Kauvery Hospital. 

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How to keep your baby safe at home

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Safety of the Baby - Your Top Priority!
The littlest feet make the biggest footprints in our hearts….

When it comes to your precious baby, safety always takes the first position. So it is imperative that we plan ahead and take precautionary measures to keep this bundle of joy happy, healthy and above all safe! Here are some pointers that will help you to simplify this vital task of addressing your baby’s safety.

• Time to install a playpen: Once the baby moves out of the warmth of the mother’s arms, the next safest place will be a play pen. It’s a great way to keep your baby off danger zone while you are busy in the kitchen, checking your mail, unpacking a shopping bag, popping to the loo or taking a shower. The play pen should be sufficiently padded to avoid contact with sharp edges

• Keeping the tiny fingers safe: The house should be scanned for potential hazards from the baby’s level of reach. All the electrical sockets need to be covered, multipurpose latches to be fixed, door slam guards to be attached and corner protectors to be placed in every corner.

• Carbon Monoxide detector to be installed: Fumes have no colour or odour and we need a detector to alert us on any kind of gas leaks. Carbon monoxide affects babies and children more quickly than adults. So it is essential to have a detector at home.

• Smoke Alarm: Every floor of your house may require a smoke alarm and ensure that the batteries are always charged.

• Safety gate for the stairs: It’s advisable to keep the stairs nice and clear to avoid tripping and falling and a stair gate can be used to avoid nasty tumbles when your little one tries to explore greater heights!

• No guessing when it comes to Temperature:  Maintain an optimum temperature of 16-20 degree Celsius in your baby’s nursery so she/he doesn’t get too cold or hot. A room thermometer will be of great help and don’t forget to pick up one for the bath tub too. When you run your baby’s bath ensure that you run cold water first and then add hot water gradually to be on the safe side.

• Hazardous materials out of reach: Our little explorers go on a biting spree…where they tend to taste everything that comes their way.  So medicines and cleaning products should be kept out of reach and under lock and key. The kitchen and bathroom cupboards and drawers should be latched always.

• Safe Sleep habits: Mortality rate of babies are seen high especially when babies are asleep. Crib safety is very important. Avoid pillows or blankets that might choke the baby during sleep. Bare is best.

• Never place a baby on a sofa, waterbed, soft mattresses or other soft surfaces to sleep as it could increase risk. 

Remember -Never to leave your baby unattended. With more mobility of the baby comes more responsibility from your end. Keep Safe always!


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Guide to parents of autistic children

It’s not easy to raise a child. Especially so, in this current day and age. This post is mainly for parents who have discovered that their child is Autistic.

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Autism is a condition and not a disease and as a parent, you need to give your child all the support that is required. Autistic children have difficulties in communicating or interacting with others. No parent is ready to accept the fact that his child is autistic and often gets frightened not knowing what to do next. Autism, unlike many other conditions, is not something that your child can “grow out of”. There are many techniques to help the child learn skills to cope up with this condition. 

What Do You Need To Do As Parents?

• Try to start the treatment the moment you suspect some problem with your child. Don’t wait for him/her to grow out of it (nevertheless, do not be paranoid about every small thing your kid does or doesn’t do). Seek a Specialist’s advice as soon as possible.

• Learn all there is to know about Autism and the difficulties your child might face while growing up.

• Try to understand what your child wants. Although it might be very difficult never get irritated with your kid and end up expressing anger by scolding. Always be calm with the child.
• Do not give up hope on your child and jump to conclusions as to how your child’s life is going to be.

Connecting With Your Child.

Autistic children will have a hard time adapting to different environments and they may tend to behave differently at different places. The best thing that you can do to help out is to try and make your child have a consistent behaviour at all places. These kids will learn more when they have an organized schedule that involves various activities.
Kids love to be praised and rewarded with something they love. A small gesture like giving a piece of candy or applauding when your child does something correctly can go a long way in boosting the morale. Positive reinforcement is what your child needs to boost the confidence level. Make your child feel extra special. 

Understanding Your Child.

You need to know the strengths and weaknesses of your child. Try to understand why your child is behaving in a particular way without getting impatient. Know the skills your child possesses and try to incorporate new skills in the daily routine one step at a time.
Finally, remember that whatever treatment your child undergoes, your support is paramount for success. Your child should feel comfortable around you and should trust you enough to rely on you completely. 

Identify A Special School

Your child needs a specialist to identify his or her levels of disability. Some autistic children need part-time rehabilitation for some particular disability but can still cope in a mainstream school. Some autistic children may not be able to cope up in mainstream schools because they need special personalized care. Find a good special school with different activities for your child and interact regularly with the instructors and take their guidance and assistance.
Remember these children do not have any disease. They just see the world in a different way. 

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Paediatric Cardiac Surgery

Dr. Prashanth Shah, Paediatric Cardiologist, Kauvery Hospital talks about the various types of cardiac complications in children. 80 to 90% of patients lead a normal life after surgery. The timing of surgery and good teamwork is important. There is an option of minimally invasive cardiac surgery so that no apparent scars are visible. In Kauvery we have performed more than 2000 complex surgeries successfully. Frequent cold and cough, low weight gain and bluish colour of tongue are symptoms to look for in babies with cardiac problems. 

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My child is 7 and wets his bed. Should I be worried?

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Some children are slow to train their bladder and take up to 5 years to have dry nights. But bed wetting incidents in children over the age of 5 need the doctor’s help. It may be due to emotional stress or genetic factors or infections or just a small bladder. Whatever it is this can be treated. 

Treatment options include Bladder training, Medicines and Moisture alarms (where alarm bells will sound when the bed starts getting wet. It helps the child to wake up to use the bathroom) 

Some useful steps for parents to help the bedwetting child: 

a. Make sure the child drinks enough water during the day so that he does not drink too much in the evening to make up. 

b. Bladder Training: Delay the child by 10 to 15 minutes to use the restroom, so that the bladder learns to control. 

c. Avoid giving the child cola or caffeine especially at nights

d. Encourage the habit of emptying bladder before going to bed

e. Bedwetting is not the child’s fault. So avoid scolding or blaming the child. 


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Uranus - Bottom Clinic at Kauvery Hospital

Don’t just sit around in Pain. Get to the Bottom of it.

Do you suffer from? Painful defecation | Constipation | Bleeding per anus | Mass per anus | Pus discharge at anus | Rectal prolapse | Fecal incontinence | Perineal itching

Trust experienced Proctologists at Kauvery to correctly diagnose and treat your rectal health issues. If you have symptoms like rectal itching, pain, bleeding or any other unusual symptoms, don’t waste precious time waiting. Uranus - Bottom clinic offers treatment for a wide variety of health problems like piles, fissures, fistulas, tumours.

Dr. Jyothi Basu, Senior Proctologist at Kauvery Hospital, talks about various treatments available at Kauvery's Bottom Clinic "Uranus".

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Has your child been vaccinated yet?

Vaccines are a godsend to mankind. Diseases that killed multitudes of people can now be prevented by a few harmless dosages of vaccines.

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What are vaccines?

Vaccines consist of weakened or dead antigens (microbes) that cause a particular disease that is introduced into the body. These trigger a small immune response and when the disease affects the body next time, the body will fight it without any difficulty.

Vaccinating your baby

Vaccinating your child is a process that goes on till your child is about 15 years old. Vaccinations need to be given at periodic intervals, some varying between a few months and some between few years because the antibodies require time to get used to the new antigens introduced into the body.

Certain vaccines are introduced immediately after your baby is born because eliminating devastating diseases like polio at the earliest is best for your child.

Why is vaccination important?

Although all of the epidemics like polio, diphtheria, and measles have been eradicated, a few cases have been found to have the above-mentioned diseases, and if your child isn’t vaccinated, the infectious agent is bound to attack and cause disastrous effects on your child’s body. Some diseases that killed thousands of children have been eliminated completely and others are close to extinction due to safe and effective vaccines.

Vaccinating your child can save huge medical expenses in the future. The government provides vaccination for polio and other diseases that are available free of any charge in many places. Doing this, will save many lives and save a lot of money because we all know that “prevention is better than cure”. 

Vaccinating your child is not only for his/her betterment but for the betterment of the family, neighbors and the community as a whole. If your child gets a contagious disease, chances are that the whole neighborhood contracts the disease. This would create a local outbreak that might cause more damage than one might usually imagine.

If a major outbreak occurs, the economy of the city or state would drop in large numbers (now you wouldn’t want to be the cause of that, would you?). The advantage of vaccination would also be economic benefits because the country would be saving up on imported medicines to treat the outbreak, thereby spending the saved money on things necessary for the country’s development.

Vaccination Schedule

To be fully resistant to certain diseases, children should be given all doses of the recommended vaccines at the correct intervals. A schedule is followed for vaccinating the kids and the pediatrician should be consulted regularly.

The schedule should be followed strictly and it is the parents’ duty to ensure that their child gets vaccinated at correct intervals of time. Failure to follow up on multiple dosages of a particular vaccine would render the initial steps fruitless.

So now that you know the importance of vaccines, it is imperative that your baby gets vaccinated starting from birth. Vaccinate your baby to enjoy healthy days ahead.

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Vaccinations for adults and senior citizens

Dr. Ashwin Subramaniam, Consultant Internal Medicine and Diabetology talks about the types of vaccinations which avoid infections in adults.

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Is your child getting hyperactive due to eating sweet goodies?

You must have seen children at birthday parties arriving as gentle, polite humans and transform into uncontrollable little devils after the goodies are eaten. 

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The general belief is that giving too much sugar to children in the form of sweets, candies, colas and cakes makes them hyperactive. It is partly true. 

What happens to a child when sugar is consumed? The sugar is processed soon and enters the bloodstream. This causes a surge in blood sugar followed by a slump which makes the child tired and sluggish, therefore cranky. 

To avoid this to happen, the parent has to control portion sizes of cookies and cake or dilute the fruit juice. Craving more can be curbed by giving nuts, cheese, vegetable sticks or something healthier. 

Giving sweets occasionally say once a week is a good goal. The biscuits and fruit juices in the lunch box can be replaced with healthier options like Sundal, Paneer Frankies or Cheese toast on wheat bread. There are so many healthy options and myriad ways to make food look attractive for kids to take interest and eat. 

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Vitamin D Deficiency Causes Osteomalacia and Rickets

Fragile and soft bones in the human skeletal system is a sign of Osteomalacia disorder in adults and Rickets in children. Osteomalacia and Rickets occur when the mineralization of the skeleton is defective and inadequate. This generally develops when the amounts of Vitamin D are insufficient in the diet or more often because of the body’s inability to absorb and metabolize Vitamin D, which is an important ingredient that helps in the absorption of calcium, and which is also needed for the bones and teeth to stay strong and healthy. Deficiency of calcium and phosphorous is also a reason for Osteomalacia or Rickets.

In children, Rickets is easily detectable as the disorder tends to cause pronounced skeletal deformities. In adults Osteomalacia is difficult to diagnose as it is difficult to differentiate it from osteoporosis. In some people who have soft bones due to the deficiency of Vitamin D, repeated pressure on these bones may cause fractures or minor deformities.  

Causes

There are several reasons (as detailed below) why, Osteomalacia and Rickets disorders happen.

• In adults - when the intestines are unable to efficiently absorb and process Vitamin D
• When disorders of any other organs such as liver, kidneys and the skin occur, and when these organs are unable to synthesize Vitamin D, consequently this causes Osteomalacia
• When there is a deficiency of Vitamin D in the diet, especially in infants exclusively breast-fed and in the elderly. Vitamin D can be supplied in the diet through fortified cereals and dairy products
• When there is inadequate exposure to sunlight, this results in inadequate production of natural Vitamin D, by the skin
• When there is an abnormal reduction of alkalinity or occurance of chronic acidosis, in the blood, caused by renal failure 
• When complications due to Hemodialysis occur or because of chronic renal failure
• When there is any interference with the normal metabolism of Vitamin D, such as administration of some anticonvulsant medications that are used to treat epilepsy
• When the blood contains low levels of phosphorous (hypophosphatemia), which is caused by rare hereditary disorders. Sometimes Hypophosphatemia may be caused by continuous use of antacids that are non-absorbent 

Symptoms

There are several symptoms that help identify Osteomalacia and Rickets, which include:

• Continuous pain in the bones of the arms, spine, hips and legs
• A waddling gait accompanied by weakness of the muscles
• Unidentifiable reasons for fractures and deformities of the bones occurring
• A rare form of disorder that occurs when the calcium levels in the body are low, which cause painful cramps or spasms in the feet, hands and face
• Bowed legs, a waddling gait, pot belly, and disturbed growth in children affected by Rickets
• Abnormal heart rhythms, deformities of skeletal / skull, knock knees, Pigeon chest (protruding chest), numbness of extremities and around the mouth, impaired growth (short stature), dental deformities, delayed formation of teeth, teeth defects, excessive cavities, sleeping disorders, poor tone and development of muscles, and delayed walking in children 

Preventing Osteomalacia and Rickets

Intake of adequate amounts of fortified, dietary Vitamin D, (such as mushrooms, dairy products -milk, curd / yoghurt and cheese, oil and fat laden fish, egg yolks, soy milk, fortified cereals, and cod liver oil) and from naturally available sunlight, will help prevent deficiency of Vitamin D.

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Treatment

Osteomalacia caused by Vitamin D deficiency can be cured generally in 6 months. Rickets can be arrested in children, though the deformities will be permanent. Rickets is very common in underdeveloped countries.  

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Common Urological Diseases which affect youngsters and elders

Dr. Jeevagan, Senior Urologist talks about common urological diseases affecting youngsters and adults. He also discusses about management of urinary stones and enlarged prostate.

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Nutrition for your Baby

What’s Best for the Baby?

Food is one major source that nourishes the body, making one healthy and strong. Infant nutrition is important for ensuring right development, preventing illness and maximizing cognitive skills and mental capacities. No other developmental stage calls for such strong attention towards nutrition. But which food is best for the baby?

A Mother’s Concern

Nourishing your baby with the right kind of food can be the biggest concern for a mother. If you are a nursing mother, then you may believe that your child gets all the necessary nourishment through the mother’s milk. It may be true if you watch your own diet and ensure that it is well balanced with micronutrients such as vitamins, minerals and phytonutrients. A typical modern diet composed of sugar products, white flour, additives and commercial fats and oils which do not build or nourish will obviously result in mother’s milk lacking in quality nutrients. Good quality proteins, fats and complex carbohydrate rich diet will be the perfect nutrition for a nursing mother and eventually her baby. It is strongly recommended that a baby is nourished with mother’s milk at least for a minimum period of 8-12 months. This is essential to build resistance and for various other vital purposes.

Bottom line,every woman will breast feed in a perfect world with perfect nourishment. But regrettably, that perfect world is a far off dream. What would mothers with low milk supply do? What if the mother is unwell or what if the baby is adopted? Fortunately it is possible to prepare wholesome baby formula at home, devoid of chemicals and artificial additives, though it may not come as a perfect substitute for mother’s milk.

Supplementary Diet for your Baby

An infant requires a full spectrum of nutrients during the first year of life, which only mother’s milk can provide. But when it is no longer a sole source of nutrition, then here are a few options that you can look at.

• At four months, egg yolk can be introduced. It is found to be rich in cholesterol, choline and other brain nourishing food. A pinch of salt will supply a variety of trace elements too.

• Cod liver oil, an excellent source of omega-3 fatty acids, DHA, EPA, Vit D and A can be introduced slowly starting with ¼ teaspoon mixed with fresh orange juice.

• If the baby seems hungrier, then a mashed ripe banana can be added to the diet. It has a rich supply of amylase enzyme that helps to digest carbohydrates.

• After six months pureed meat can be introduced to add iron, zinc and protein in the diet.

• By eight months to one year the baby can be introduced to a variety of homemade foods, one at a time going easy on the cereals as they may develop allergies, not having the enzymes to handle it.

• Say no to juice, soy foods, margarine, shortening and commercial dairy products in the first few months.

• Cereal gruels can be added on completion of one year.

Maximize your baby’s health with minimum efforts at home.

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Breast Feeding- The Best Diet For Your Baby!

“While Breastfeeding may not seem the right choice for every parent, it is the Best choice for every Baby” - Amy Spangler.

WHY BREASTFEEDING?
A newborn baby has only three demands. The warmth felt while being nestled in the mother’s arm…life sustaining liquid food in the form of mother’s milk and security in the knowledge of her presence. Breastfeeding satisfies all these three needs. One must realize that a mother’s feed is anytime better than a baby formula, however tall the claims may be and the thirty years of technology cannot replace or surpass the three million years of nature’s evolution.
Scientific literature has concrete evidence that exclusive breastfeeding for the first six months of a life cut down under-five child mortality by 13-15%. There cannot be more compelling reasons for breastfeeding the baby.
Apart from all the benefits to the baby in the form of rich nourishment and total protection through a tough immune system, there is a package of benefits to the nursing mothers as well.
• Reduces the risk of ovarian cancer
• Increases post-partum weight loss
• Reduces risk of breast cancer
• Prolongs lactational Amenorrhea
• Reduces cardiovascular risk
• Decreases Visceral Adiposity
• Reduces type 2 diabetes risk

WHAT MAKES IT SPECIAL?
It is quite difficult to list out all the properties and ingredients of mother’s milk. But it has been found that the nutrient content is consistently maintained. It includes the nutrients in the mother’s bloodstream along with the bodily stores. It contains an optimal balance of proteins, sugar, water and fat required for a baby’s growth and development. It also enhances biochemical reactions in the infant allowing the hormones, enzymes, growth factors and immune system to defend against infections. The polyunsaturated fatty acids in the milk help in normal neural and retinal development. Lactation involves usage of 500 calories per day which helps the mother to lose weight after delivery.
The first milk produced during the first few days of childbirth is called colostrum. It is more concentrated and easy to digest than mature milk. Its laxative property allows easy bowel movements, thus preventing Jaundice in the infant by expelling excess bilirubin through the stools. It also seals the gastrointestinal tract from foreign substances which may be passed on from sensitive food that the mother might have consumed.

REMINDERS TO LACTATING MOTHERS:
• Alcoholic beverages and smoking can be avoided during this period to avoid subjecting the infant to potential risks however minimal they may seem.
• Confer with lactation consultants for necessary advice and support in case of uncertainties.
• Nursing mothers should start nursing typically within one hour of birth. Skin to skin contact also called Kangaroo care should be established to make subsequent feeding significantly easier.
• Be aware of the Baby’s feeding intervals and quantity required as per the infant’s stomach capacity.
• Try different positions and find out the preference to a particular position to avoid ineffective feeding which could lead to infant health concerns.

Remember moms, “Breastfeeding isn’t just about Milk…It’s also about Love”

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