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Nocturnal enuresis commonly called bedwetting or sleepwetting is involuntary urination while asleep after the age at which bladder control usually occurs. Nocturnal enuresis is considered primary (PNE) when a child has not yet had a prolonged period of being the cry. Secondary nocturnal enuresis(SNE) is when a child or adult beings wetting again after having stayed dry.

Most bedwetting is a developmental delay, not an emotional problem or physical illness. Only a small percentage(5% to 10%) or bedwetting cases are caused by specific medical situations bedwetting is frequently associated with a family history of the condition.

Bedwetting children and adults can suffer emotional stress or psychological injury if they feel shamed by the condition. Treatment guidelines recommend that the physician counsel the parents, warning about psychological damage caused by pressure, shaming, or punishment for a condition children cannot control. Bedwetting is the most common childhood complaint. Most girls stay dry by age six and most boys stay dry by age seven. By ten years old 95% of children are dry at night. Studies place adult bedwetting rates at between 0.5% to 2.3%.

The bladder is a muscular receptacle, or holding container, for urine. It expands as urine enters and then contracts to push the urine out. In a person with normal bladder control, nerves in the bladder wall send a message to the brain when the bladder is full, the brain then sends a message back to the bladder to keep it from automatically emptying until the person is ready to go to the bathroom. But people with nocturnal enuresis have a problem that causes them to urine involuntarily at night.

What causes Enuresis?

They do have some theories though, on what may contribute to someone developing the condition:

Hormonal Problems:

A hormonal called antidiuretic hormone, or ADH, causes the body to produce less urine at night. But some people's bodies don't make enough ADH, which means their bodies may produce too much urine while they're sleeping.

Bladder problems:

In some people with enuresis, too many muscle spasms can prevent the bladder from holding a normal amount of urine. Some teens and adults also have relatively small bladders that can't hold a large volume of urine.


Teens with enuresis often have a parent who had the same problem at about the same age. A scientist has identified specific genes that cause enuresis.

Sleep problems:

Some teens may sleep so deeply that they don't wake up when they need to urine.


using caffeine causes a person to urinate urine more.

Medical conditions:

medical conditions that can trigger secondary enuresis include diabetes, urinary tract abnormalities (problems with the structure of a person's urinary tract), constipation, and urinary tract infections. Spinal cord trauma, such as severe stretching of the spinal cord resulting from a fall, sports injury, auto accident, or another event may also play a role in enuresis, although this is rare.

Psychological problems:

Some experts believe that stress can be associated with enuresis. It's not uncommon to feel stressed out during the teenage years, and things such as divorce, the death of a friend or family member, a move to a new town and adapting to a new school and social environment, or family tension can feel overwhelming.

Doctors don't know exactly why, but more than twice as many guys as girls have enuresis. It is often seen in combination with ADHD.

Classification of bedwetting:

Primary nocturnal enuresis:

Primary nocturnal enuresis is the most common form of bedwetting. Bedwetting counts as a disorder once a child is old enough to stay dry, but continues either to average at least two wet nights a week with no long periods of dryness or to not sleep dry without being taken to the toilet by another person.

Secondary nocturnal enuresis:

Secondary enuresis occurs after the patient goes through an extended period of dryness at night (roughly six months or more) and then reverts to nighttime wetting. Secondary enuresis can be caused by emotional stress or a medical condition, such as bladder infection.

Psychological definition:

Psychological may use a definition from the American Psychiatric Association's DSM-IV defining nocturnal enuresis as report urination into bed or clothes, occurring per week or more for at least three consecutive months in a child at least years of age and not due to either a drug side effect or a medical condition. Even if the case does not meet these criteria, the DSM-IV definition allows psychologists to diagnose nocturnal enuresis if the wetting causes the patient clinically significant distress.

The homeopathic remedy for Nocturnal enuresis:


Is useful when involuntary urination is worse in winter and better in summer. It is also for children who tend to wet their pants when they cough or sneeze or even laugh.


Is very beneficial in the case where along with the bedwetting problem child depicts symptoms of worm manifestations irritation of the nose, causing constant symptoms desire to pick, or press into it, extreme ill humor, heightened irritability and most commonly gritting teeth during sleep.


It is found to be an excellent remedy for bed wetting in children. Its action is mainly on the urinary bladder. Painful urination. Constant nocturnal bedwetting. The urine looks cloudy. Enuresis with dreams and nightmares.


Enuresis in the first part of the night with dreams as if urinating in the urinals. Otherwise also must hurry when the desire comes or the urine escapes. It is especially useful in heavy sleepers who wet the bed in the first sleep.


The child needing this homeopathic remedy has involuntary urination during sleep during which he or she may pass enormous quantities of clear urine. They can also have red sand in their urine. The typical lycopodium patient craves sweets, likes hot drinks and has aggravations from 4-8 pm fo many complaints.


Nocturnal enuresis a general remedy.


The child requiring this remedy often suffers from urine discharges that are involuntary. The urine can dribble while sitting or walking and at night in bed (according to the older authors particular in young girls). The typical child needing the homeopathic remedy Pulsatilla is often changeable and fickle and can be a bit weepy. They tend to love fuss and company.


Use it when the well-selected remedies fail to act. Bedwetting of psoric patients. Wets the bed especially during full moon.

Secale cor:

Enuresis in old people due to enlargement of prostate glands.


Enuresis in sickly girls during the first sleep. Urine is very offensive.

Verbascum thaps:

Nocturnal enuresis of long standing.

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Scope of Homeopathy Treatment in Asthma
Asthma is one of the most common health problems affecting around 2 crores of people in India and around 33 crores in whole world level. The death and disability from asthma is seen more in children from the age group 2-14. In asthma the bronchial tubes or air ways get affected. There is a cascade of bio reaction that occurs in the air tubes or respiratory tract of an asthma affected person. The lungs play the major role for gas exchange in our body. Each and every cell of our body gets their oxygen to stay alive. The air goes through the nasal passage and air tubes and reaches at lungs where it absorbs to the blood and finally goes to every cell. When you breath sending oxygen to your whole body and releasing carbon dioxide from the body. The whole function of air exchange is carried out by the respiratory system. The respiratory system consists of different parts or segments those takes the active part in respiratory function. The respiratory function starts from the nose or nostrils and end at lungs.
The pathophysiology of asthma can be explaned as in 2 process –
1) bronchial inflammation,
2) broncho constriction

The bronchial inflammation – in everyday life we exposes thousands of foreign substances which are very minute in size and invisible to naked eyes. Those floats in airs and when we ingest them go inside our body and makes their way into the bronchial passage. The WBC or white blood corpuscles are one component of the complex immune system. There are 5 types of WBC neutrophile, eosinophile, basophile, Lymphocytes, monocytes. Among them the lymphocytes plays a major role in allergic reaction. The lymphocyte are divided into 2 types – the T lymphocytes or ‘T cells’ , the B lymphocytes or ‘B cells’. The T cells and B cells travel everywhere in our body passing through the blood vessels. Their role is to recognize a foreign particles present in the body and then to attack them. When they reach in bronchial airways the T lymphocytes check each and every cell to confirm it whether it is a safe cell or a foreign cell. When the T lymphocytes find a foreign cell then release some chemicals called cytokines. Those cytokines activate the B lymphocytes to convert plasma cell. The plasma cell produces one antibody, IgE anti body that moves and attach to the IgE receptor of mast cell present on the mast cell surface. The mast cells are the specialized cells distributed in various body parts of our body like over skin, inside the respiratory tract, inside the GI tract etc. Those mast cells contains some tiny protein granules called the histamines.
When an antigen or allergen get inside our body and reach in our air space it attached to the IgE antibody of mast cell. When the antigen and antibody unites the mast cell releases its histamines to the surrounding spaces. Those histamines have the pro inflammatory properties. So when they attach to the epithelial cells of bronchial tube with its H1 receptor that present on every cell surface the inflammation starts. So this causes the inflammation of bronchial airways. Due to the btronchial inflammation there is also mucus secretion around the areas.

Bronchial constriction – the bronchial inflammation causes the thickening of the mucous lining of the air tubes and in addition to that over secretion of mucus from the hyperactive mucus glands makes the bronchial spaces narrower and that causes bronchial constriction.
Besides that when there is an inflammation in the bronchial mucous lining the afferent nerves ending of the parasympathetic nerve fiber present in the bronchial airways sends some impulses to the vagus center of the brain stem and then down the vagal efferent pathway to again reach the bronchial small airways and secrets acetylcholine from the nerve ending that stimulate the smooth muscles fibers surrounding the bronchial tubes to be tighten more and more that result bronchial constriction and broncho spasm.

Homeopathy treatment for asthma –
The homeopathy treatment helps to treat the asthma in 2 ways – It controls the acute asthmatic condition by both oral medicines and homeopathy nebulizer (Dr Satapathy’s homeo nebulizer).The acute symptoms of asthma like coughing, chest tightness, wheezing sound, shortness of breath are immediately required to control as quick as possible so the person can breathe freely. There are many homeopathy medicines when selected as per the totality of symptoms of the person can able to control the acute asthma symptoms effectively and rapidly. The medicines for acute symptoms can be given repeatedly even 30 minutes to hour interval till the symptoms are not getting fully recovered. There is no specific medicine for any specific health issues in homeopathy. One medicine can be given in different health problem when the symptoms of the diseased person are fully matched homeopathically with the medicinal symptoms. For example a severe dry cough which worsen on lying posture with gagging or vomiting, suffocative sensation and more cough after drinking cold water can be given one homeopathy medicine ‘spongia’, another person with same dry severe cough but get relief after drinking little cold water will be given another medicine ‘cuprum met’. So here for the same health problem of cough there is two different medicines in which one get relief from tsaking cold water but another get worse, which is the key characteristic symptoms to select the specific homeopathy medicines. Similarly in all asthma symptoms that may be cough or wheezing sound or tightness of chest the medicines are not same for each individual symptom. The selection of medicines is totally depend upon the symptoms of the patient. But it is hundred percentages true that homeopathy has effective medicines for all acute symptoms. If the correct medicine with accurate potency is given it give immediate relieve to the disease. So besides the diagnosis of disease the diagnosis of medicine is highly essential to cure one disease in homeopathy. Unlike other therapist a homeopath has dual responsibility i.e. to diagnosis the disease and then to diagnosis the remedy. But at the same time the mother tincture form of homeopathy medicines have specific effect on a specific health problem like Justecea adathoda mother tincture is generally given for dry cough whatever the characterized symptom present. But the specific homeopathy remedy is generally given in raw form i.e. in mother tincture form or in very lower potency. The alkaloid or active principle of each and every homeopathy medicine has some key therapeutic property. In this regards homeopathic nebulizer developed by Dr.Satapathy do act in same principle and is given to all asthma patients as a common supplementary treatment to control the severity of asthmatic situation. With all the indicated homeopathic acute remedies, Dr.satapathy’s homeo nebulizer offers a rapid and long lasting relief to the acute symptoms of the asthma.
The control of the acute symptoms of the asthma won’t give a long lasting relief. It is the management of acute symptoms for a time period. Because though the symptoms can be well managed by the acute homeopathic remedies for a limited time period , but there is chance of reappearance of asthma symptoms if the patient again being exposed to the triggers. It is because the person’s immune system is still in hyperactive state so whenever he get exposed towards any allergens the symptoms again reappear. The immune system of an asthmatic person is very sensitized to many allergens and when get contact with them develop the asthmatic symptoms. Just to control the symptoms will not cure the asthma in a long term basis because his hypersensitive immune system again will react adversely when again get expose to the same allergen. So for a long term cure it is highly required to modify the hypersensitive immune system of the asthmatic person to a normal functioning immune system. A proper constitutional homeopathy medicines basing upon the homeopathy way of case history taken which covers the common clinical symptoms with their modalities , physical general symptoms, mental general symptoms, miasmatic back ground, past history of any health issues either physical or psychological background, family history of any diseases, if all those taken into consideration then the constitutional homeopathy medicine comes from those symptom similarities basis is the specific medicine for that particular person. If that medicine is given for a considerable time it will help to modify the hypersensitive immune system to normal functioning immune system. This type of homeopathy treatment is called as classical homeopathy treatment. From my 24 years of clinical experience I feel both acute homeopathy treatment along with classical approach of treatment is much more beneficial than alone acute treatment or alone classical treatment.
In spite of that there are many factors those also put bad impact on the immune system and convert its healthy functioning nature to hypersensitive nature. Factors that affect the immune systems are faulty life style, faulty food habits, lack of physical activities, constantly staying in a overstressed condition, side effects of various chemical drugs, obesity, smoking, rise of pollution, suppression of any skin disease, hereditary condition and so many life style changes also responsible for making our immune system hyperactive. So with homeopathy treatment a healthy life style, healthy food habits, healthy mind set up is mostly desirable to cure asthma permanently and forever.

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Understanding Cerebral Palsy
सेरेब्रल पाल्सी अथवा प्रामस्तिष्क घात मुख्यतः मस्तिष्क पर किसी प्रकार की चोट अथवा असामान्य विकार की वजह से शिशुओ मे होती है . यह एक नॉन प्रोग्रेसिव डिसॉर्डर है जिसमे मस्तिष्क का जो भाग शतिग्रस्त हुआ है वह समय के साथ वैसा हे रहता है एवम आगे उसका षरन नही होता है.

भारत मे एक हज़ार लाईव बर्थ मे से ३ % शिशुओ मे c.P होता है और संपूर्ण भारत मे २५ लाख से ज़्यादा CP मामले वर्तमान समय मे है.

सेरेब्रल पॉल्ज़ी के लक्षण:

१. सीबरल पॉल्ज़ी से पीड़ित शिशु का शारीरिक विकास सामान्य बच्चो की अपेक्षा विलंब से होता है
२. ६ माह की आयु तक सोशल स्माइल नही देते
३. ध्वनि के प्रति प्रतिक्रिया व्यक्त नही करते
४. ८ माह के होने पर भी सिर और गर्दन नही संभाल पाते
५. हाथों और पैरो की मांसपेशिया अत्यधिक कड़क अथवा ढीली होती है
६. हाथों की मुट्ठी कसी हुई रहती है
७. हाथों की पकड़ कमजोर होती है
८. १२ माह का होने पर भी बच्चा स्वयं अपने शरीर का संतुलन नही बना पता
९. रीढ़ की हड्डी आगे की और झुकी हुई होती है, बच्चा आगे की और झुककर बैठता है
१०. पैर तिरछे प्रतीत होते है

Dr. Pooja Pathak

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Understanding Dyslexia (learning disability)

Diagnosis of Dyslexia is based on signs/symptoms related to reading/ learning n academic performance of the children.

डिस्लेक्सिया के कुछ प्रमुख लक्षण :

देर से बोलना सीखना,
नए शब्दों को सीखने/बोलने में दिक्कत,
कविताएं सुनाने में अटकना,
वाणी अस्पष्ट होना.

अपनी आयु के समान बच्चो से पढ़ाई में पिछड़ना,
स्पेलिंग (शब्दार्थ) लिखते समय गलती करना,
लिखावट (हैंड-राइटिंग) अस्पष्ट होना,
सुनी गई बात को समझने और रिप्लाय (उत्तर) देने में परेशानी,
त्वरित निर्देशों को समझ नही पाना,
किसी भी क्रिया को करने की प्रक्रिया स्टेप बाए स्टेप फॉलो नही कर पाना.

By applying specific therapeutic strategies and special education techniques,children with Dyslexia can lead a normal productive life.

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Attention deficit hyperactivity disorder (ADHD) is a common behavioral disorder that affects an estimated 8% to 10% of school-age children. Boys are about three times more likely than girls to be diagnosed with it. Kids with attention deficit hyperactivity disorder (adhd act without thinking, are hyperactive, and have trouble focusing. Of course, all kids (especially younger ones) act this way at times, particularly when they're anxious or excited. But the difference with attention deficit hyperactivity disorder (ADHD is that symptoms are present over a longer period of time. They impair a child's ability to function socially, academically, and at home. Three primary characteristics of Attention deficit hyperactivity disorder (ADHD The three primary characteristics of Attention deficit hyperactivity disorder (ADHD are inattention, hyperactivity, and impulsivity. The signs and symptoms a child with attention deficit disorder has depends on which characteristics predominate.

Children with Attention deficit hyperactivity disorder (ADHD may be:
Inattentive, but not hyperactive or impulsive.
Hyperactive and impulsive, but able to pay attention.
Inattentive, hyperactive, and impulsive (the most common form of
Attention deficit hyperactivity disorder (ADHD . Children who only have inattentive symptoms of Attention deficit hyperactivity disorder (ADHD are often overlooked, since they’re not disruptive. However, the symptoms of inattention have consequences: getting in hot water with parents and teachers for not following directions; underperforming in school; or clashing with other kids over not playing by the rules.
Inattentive signs and symptoms of ADHD
It is not the children with ADHD which can’t pay attention: when they’re doing things they enjoy or hearing about topics in which they’re interested, they have no trouble focusing and staying on task. But when the task is repetitive or boring, they quickly tune out. Staying on track is another common problem. Children with ADHD often bounce from task to task without completing any of them, or skip necessary steps in procedures. Organizing their school work and their time is harder for them than it is for most children. Kids with ADHD also have trouble concentrating if there are things going on around them; they usually need a calm, quiet environment in order to stay focused.

Symptoms of inattention in children:
Doesn’t pay attention to details
Makes careless mistakes
Has trouble staying focused; is easily distracted
Appears not to listen when spoken to
Has difficulty remembering things and following instructions
Has trouble staying organized, planning ahead, and finishing projects
Gets bored with a task before it’s completed
Frequently loses or misplaces homework, books, toys, or other items
Hyperactive signs and symptoms of ADHD
The most obvious sign of ADHD is hyperactivity. While many children are naturally quite active, kids with hyperactive symptoms of attention deficit disorder are always moving. They may try to do several things at once, bouncing around from one activity to the next. Even when forced to sit still which can be very difficult for them their foot is tapping, their leg is shaking, or their fingers are drumming. Symptoms of hyperactivity in children:
Constantly fidgets and squirms
Often leaves his or her seat in situations where sitting quietly is expected
Moves around constantly, often runs or climbs inappropriately
Talks excessively
Has difficulty playing quietly or relaxing
Is always “on the go,” as if driven by a motor
May have a quick temper or a “short fuse”
Impulsive signs and symptoms of ADHD
The impulsivity of children with ADHD can cause problems with self-control. Because they censor themselves less than other kids do, they’ll interrupt conversations, invade other people’s space, ask irrelevant questions in class, make tactless observations, and ask overly personal questions. Instructions like “Be patient” and “Just wait a little while” are twice as hard for children with ADHD to follow as they are for other youngsters. Children with impulsive signs and symptoms of ADHD also tend to be moody and to overreact emotionally. As a result, others may start to view the child as disrespectful, weird, or needy. Symptoms of impulsivity in children:
Acts without thinking
Blurts out answers in class without waiting to be called on or hear the whole question
Can’t wait for his or her turn in line or in games
Says the wrong thing at the wrong time
Often interrupts others
Intrudes on other people’s conversations or games
Inability to keep powerful emotions in check, resulting in angry outbursts or temper tantrums
Guesses, rather than taking time to solve a problem
Medical causes of ADHD
The specific causes of ADHD are not known. There are, however, a number of factors that may contribute to, or exacerbate ADHD. They include genetics, diet and the social and physical environments.

Genetics Twin studies indicate that the disorder is highly heritable and that genetics are a factor in about 75 percent of all cases. Researchers believe that a large majority of ADHD cases arise from a combination of various genes, many of which affect dopamine transporters.

Environmental Twin studies to date have suggested that approximately 9 to 20 percent of the variance in hyperactive-impulsive-inattentive behavior or ADHD symptoms can be attributed to nonshared environmental (nongenetic) factors. Environmental factors implicated include alcohol and tobacco smoke exposure during pregnancy and environmental exposure to lead in very early life.

Complications during pregnancy and birth Complications during pregnancy and birth, including premature birth, might also play a role. ADHD patients have been observed to have higher than average rates of head injuries. Infections during pregnancy, at birth, and in early childhood are linked to an increased risk of developing ADHD. and streptococcal bacterial infection.

Insecticides The organophosphate insecticide chlorpyrifos, which is used on some fruits and vegetables, with delays in learning rates, reduced physical coordination, and behavioral problems in children, especially ADHD..

Social The World Health Organisation states that the diagnosis of ADHD can represent family dysfunction or inadequacies in the educational system rather than individual psychopathology. Other researchers believe that relationships with caregivers have a profound effect on attentional and self-regulatory abilities.

Homeopathic treatment of ADHD is constitutional taking a more holistic look at the individual. Every disease is considered as a Mind-Body process where your personality traits are as important as your physical symptoms thus taking into account diet, lifestyle, personality, surroundings and emotional factors. Natural remedies are used to successfully treat the symptoms, helping the person to heal and to reach a state of balance and health. The natural approach is also safe with no side effects. This is very important, especially in the case of children, because of the frequent side effects of prescription drugs and the risk of addiction. Homeopathy offers a wider range of options that conventional medicine.

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Diarrhoeal Illness in Children
Diarrhea management in children
Passage of 3 or more loose stools in 24 hours period is considered diarrhea. A change in consistency and frequency of stool pattern is noticed by parents. It is estimated that on average a child under 5 years of age will have approximately 3.2 episodes of diarrhea per year. The loss of liquids caused by diarrhea can lead to dehydration and disturbances in body electrolytes which may require medical treatment.
What causes diarrhea in children?
Gastrointestinal tract infections – Mostly Viral, also bacterial and protozoal are the cause of diarrhea. Many a times there may be a non-infectious cause of diarrhea (antibiotic induced, lactose intolerance, etc.)
Additional complaints
Child having diarrhea can also have Vomiting, Fever, Abdominal Pain and Decreased Appetite.
What can parents do at home?
ORS (Oral rehydration solution) should be started for child having loose motions. Parents can also start with home available fluids like dal water, sugar-salt solution (Half teaspoon salt+ 8 teaspoon sugar added to a liter of clean 1 liter water). Parents should consult doctor urgently if:
1. Child is becoming very sleepy or irritable
2. Child is having multiple vomiting and is not able to drink ORS
3. Eyes of child look sunken into the orbit.
4. Child is passing blood in stools
Medical management of diarrhea:
World Health Organization emphasizes on 3 points in management of any acute childhood diarrhea. These are ORS, Feeding and Zinc supplementation. Since most of diarrhea episodes are due to viral infections most children recover with ORS and Zinc therapy. Feeding should not be stopped during diarrhea. Doctor examines the child to look for any dehydration (decrease in body water), rule out possible bacterial cause of diarrhea (which might require antibiotics), other causes of loose motions (transitional stooling in newborns, increased gastro colic reflex, toddlers diarrhea etc.). Antibiotics are not required for every case of diarrhea. Stool or blood tests are not required usually but doctor may decide to perform some tests if diarrhea gets prolonged to more than 2 weeks and in some other conditions.
How to Prevent Diarrhea:
1. Hand washing - after playing outdoors, after going to toilets, before having meals.
2. Prevent eating out at places that seem to have doubtful hygiene standards.
3. Exclusive breast feeding for first 6 months of life prevents diarrhoea episodes in young infants; Bottle feeds can prolong a diarrhoea episode and can be a cause of recurrent loose motions in a child
4. Vaccine: Vaccine to prevent diarrhea caused by Rotavirus is available.

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Cold And Cough in Children
Cold and Cough in Children – The common facts
Most of the hospital visits by parents of children, especially younger ones, are for complaints of cold and cough. Parents are usually concerned because of accompanying fever in most of cases. Majority of these episodes of illness are VIRAL in origin and as such medical treatment is symptomatic and no antibiotic is required.
Cold is a VIRAL illness in which symptoms of running nose and blocked nose are common. The first symptom is often sore or scratchy throat, followed by blocked nose and finally runny nose. Around 1/3 cases of cold are associated with cough. Other complaints like fever, headache, body ache and tiredness can also occur. Usually episode of cold and cough lasts about 1 week and 10% cases may last for 2 weeks. Colds occur year –round , but more common in August- October and April- May due to increased activity of RHINOVIRUS. Other viruses like RSV can cause cold between December to April.
Young children (up to 3-4 years of life) have average of 6-8 colds per year and 15% children have at up to 12 cold episodes per year i.e. one per month. The cold episodes decrease with age and by adulthood average of 2-3 episodes per year are reported. Parents should seek medical opinion early if following complaints occur:
1. Child refuses to drink anything for long period of time.
2. Change in behavior of child- either very sleepy or very irritable.
3. Difficulty in breathing.
Antibiotics are not effective in treating colds. They may be necessary if the cold is complicated by a bacterial infection, like an ear infection, pneumonia, or sinusitis. Inappropriate use of antibiotics can lead to the development of antibiotic resistance, and can possibly lead to side effects, such as an allergic reaction.
Simple hygiene measures can help to prevent infection with the viruses that cause colds. Hand washing prevent the spread of infection. Hands should be wet with water and plain soap, and rubbed together for 15 to 30 seconds. Alcohol-based hand rubs are a good alternative for disinfecting hands if a sink is not available. It may be difficult or impossible to completely avoid people who are ill, although parents should try to limit direct contact.
Some parents ascribe cause of cold to food items like curd, fruits and rice. These are food myths and have no scientific rationale. As previously mentioned young children can have one episode of cold every 1 to 1 ½ months in first few years of life and they are not related to weak immunity. Children who are bottle fed have more chances of getting colds, ear infections and diarrhea episodes. Exclusive breast feeding in first 6 months of life protects little ones from catching frequent infections.

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An easier method of rehydration in children
An Easier Management Of Dehydration In Children

- Prof. Vd. M. P. Prabhudesai
M. F. A. M., A. V. P.
- Vd. Mrs. M. M. Prabhudesai
B. A. M. S. (Mumbai)
Sawantwadi, Dist.- Sindhudurga. Pin - 416510


When we decided to leave Mumbai and settle in Konkan area of Maharashtra, we had certain ideas in our minds. Present study is a humble effort towards one of our ideas, i.e. to make low-cost effective remedies available to poor, needy rural people.
There are many traditional remedies prevalent in our area, which we could know while discussing with traditional birth-attendants and traditional healers, in our area. We heard them telling that patent bregma (i.e. Talu) in infants has an exceptional capacity of absorption and this route may be used in treating dehydration in them. Out of various methods practiced in our area, one is to apply absorbent cotton soaked in breast-milk to patent bregma of dehydrated infants, repeatedly, till the patient recovers.
In February 1989, we got chance to try this method in a dehydrated baby, 28 days old, in which all the available methods for dehydration, including i.v. Infusion, were failed. Along with loose motions it had vomiting as well. It parents were very poor and due to lack of conveyance (only two S.T. buses out in a day) they were unable to shift the child to Govt. Hospital, which is only 30 Kms. from our place. As the parents showed full faith in us we decided to try this simple method. Being encouraged by the favorable results in the patients we tried this method successfully in 33 babies till the end of September 1989.
When we presented the case study in Third International Congress in Traditional Asian Medicine at Mumbai, in January 1990, we received many letters of encouragement and after a personal scientific communication we decided to modify this method a little, because of which we could cover children up to 6 years of age, which is supposed to be the high-risk age group.
In this modification we tried and advised massage to the whole body of the patients with naturally available milk (i.e. cow's, buffalo's, or breast) and milk-soaked cotton-swab was applied to the patent bregmas of younger babies, as well.
An attempt is being made here with positive treatment to present our practical experience during these efforts.

Selection of patient:

During initial trial we selected dehydrated babies up to the age of 1½ year, i.e. before ossification of anterior fontanelle (i.e. with patent bregma); but for modified experiment we preferred children up to 6 years of age, who were suffering from dehydration.
Till now only 72 cases are on record (including 33 cases of initial trial) as the village that we have chosen for service to rural people has total population not exceeding one thousand five hundred only and secondly, it is very difficult to convince the illiterate parents to allow us this unusual experiment on their severely ill children.
We have omitted the children with vomiting of cerebral origin and with fourth degree dehydration.
Thus, for selection of children in this experiment we applied two main criteria as follows-
1. Age of the child under trial should not be more than 6 years; and
2. The child under trial should be dehydrated.

In our initial study we applied absorbent cotton-swab soaked in naturally available milk to patent bregmas of dehydrated babies and before it could become dry, it was replaced by another swab. This was repeated till applied swab remained wet approximately more than one minute.
In the modified method, all children under trial were massaged with naturally available milk, all over the body till its rate of disappearance was markedly diminished and their skin regained its normal luster and elasticity. This procedure was also followed in younger babies with patent bregmas.
As for as possible we preferred breast-milk to apply at Talu in babies with patent bregma and for massage we used any of the naturally available milk.
We omitted re constituted milk for this particular study, which is not easily available in our area.
Especially the children with severe and repeated vomiting were stopped all oral feeds.

The work is going on, but for the purpose of communication, the group of 33 babies of our initial trial (i.e. group one) and the groups of 39 children of our modified experiment (i.e. group two) are being analyzed. The number of patients is comparatively less; as many of the outpatients have not appeared again for follow up examination.
Our observations are as follows-
1. Immediate observation after applying milk-soaked cotton-swab to Talu of dehydrated babies was that the swab becomes dry after some time.
2. Similarly after massaging the whole body with natural milk, it was disappeared in the skin.
3. Both above observations clearly indicate absorption of milk through skin and anterior fontanelle (i.e. Talu) and the rate of absorption was found to be equally proportional to the degree of dehydration.
4. Signs of rehydration were seen in babies under trial, within ten to thirty minutes depending upon degree of dehydration.
5. The milk applied over whole body of the baby, turned into a whitish layer as the signs of dehydration got reduced & we thought this was the marker to assume that dehydration Is under control.

Table showing age-wise classification

Age of patient Male Female
Group One
1. Less than one month
2. Between 1 to 2 months
3. Between 2 to 6 months
4. Between 6 months to 1 year
5. Between 1 to 1½ years
Total 21 12

Group Two
1. Less than 6 months
2. 6 months to 1½ years
3. 1½ years to 3 years
4. 3 years to 6 years 6
3 3
Total 22 17

Table showing degree of dehydration

No Degree Group One Group Two
Male Female Male Female
3. First
Third 11
3 3
7 11
4 2
Total 21 12 22 17

Table showing symptom-wise classification

Group Symptom
Only loose motions Loose motions with vomiting

2. Male Female Male Female
16 8
10 5
6 4
Total 32 18 11 11

Discussion and Conclusion:
According to W.H.O., dehydration is supposed to be No. 1 killer in children less than 6 years of age. So especially in areas where communication or expertise is not available, a simple method to manage dehydration is very much desired. Naturally and easily available substance like milk (cow's, buffalo's or goat's or breast) when properly used especially in remote rural areas can avert the risk and provide relief to patient and parents.
Established ways for rehydartion, at times, fail for lacking in getting proper (and cheaper) route. In attempt to find a route (especially intravenous) aseptic precautions are not that meticulously followed. So the risk of infection is much more and disastrous, on background of dehydrated stage. So more substitute mean and method utilized to compensate the risk will be very much appreciated.
So an attempt was done to try this positive drug, non-blind schedule of scrutiny. The single or double blind pattern was not desired in the emergency situation of dehydration. Placebo or otherwise intervention could not be thought of both ethically and by social circumstances.

This simple method for rehydration has following advantages:

1. This method is very simple and safe. The material required for management is easily and naturally available, almost everywhere and the risk of excess-dosage is not there.
2. It can be tried at home, thus may save many man-hours of parents, anxiously strained and wasted during hospitalization of their child, for i.v. infusion. Even non-earning domestic member of the family can carry out this method at home.
3. It will help to minimize the risk of probable introduction of infectious (like virus B hepatitis, aids etc.) through i.v. route or i.v. infusion fluids, especially where the social and professional meticulosity for asepsis is less.
4. This, being almost a no-cost remedy, will bring down the total cost of treatment, especially desirable in developing countries, like India.
5. Mother's scientifically health-valuable breast-milk, which is otherwise shunted out with psychologically painful stimuli, in case of severely vomiting child; is used in this method. So the mother is satisfied to see her breast-milk is utilized for her baby, & not wasted.
Additionally, it may prevent problem breast-abscess risk.
6. This method is definitely more useful than present O.R.S., especially so in children with total rejection of any oral intake.
7. As it covers the major risk-age-group dying by dehydration, it will be an additional support to M.C.H. scheme to deal with the killer No.1 of children.

We are quite aware of this positive non-double-blind management's limitations. It may have lesser scientific weightage. But the fact remains that within the situation, with limited economic and social aspects, at remote and least communicable areas; especially in rainy season and quality of professional skill and care unavailable, the report has golden merits.
While summing up we wish "best of health to all"

सर्वेऽत्र सुखिनः सन्तु सर्वे सन्तु निरामयाः।
सर्वे भद्राणि पश्यन्तु मा कश्चित् दुःखभाग्भवेत॥

This paper was presented in-
1. Third International Conference on Yoga and Ayurveda (IASTAM) at Mumbai in January 1990
2. Fourth World Congress on Ayurveda at Bangalore in December 1991.

- Prof. Vd. M. P. Prabhudesai
- Vd. (Mrs.) M. M. Prabhudesai
Dhanvatari Ayurvedic Panchakarma Chikitsalaya
Sawantwadi, Dist. - Sindhudurga.
Maharashtra, Pin- 416 510.
Mobile - 9422435323, 9423884321
E-Mail: -

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Phimosis is a commonly diagnosed problem in the Pediatric age group. But unfortunately, more often than not, it is overdiagnosed. Most of the children who are referred to us for surgical correction for phimosis do not need so. A degree of adhesion of the prepucial skin to the glans is natural and expected. The wrong step is manually retracting the prepuce which is often advised by the physicians. This causes small often microscopic tears in the inner prepucial skin which later on causes scarring and true shortening of the prepucial skin. There are many ointments available which help in adhesiolysis of the physiological prepucial adhesion.

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Loss of organ
A mentally retarded boy staying in a orphanage was bought to me with a scrotal swelling. The boy is 14 years old. He looks disturbed because of pain although he was not able to speak. I examined him and found that his scrotum was swollen and very tender.
The ultrasound showed that his testes had rotated and there was no blood supply – meaning it was already dead. His caretaker says its swollen since 5 days. Poor fellow. A normal boy would have come immediately with such a swelling. His mental retardation and absence of parents had led him to loose his organ.
I had to take him up for surgery. On opening his scrotum his testes was totally dead. There was nothing that i could do for an organ that had lost its blood supply for 5 days! In normal circumstances such surgeries taken up immediately after the onset of swelling can save the testes. Most of the times I have observed that if parents are prompt and bring their child in emergency, the testes can be salvaged. If its late, the testes is lost for ever.
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