Saturday 27 September 2008

Muscular dystrophy

We say that a child has muscular dystrophy but in actual fact it is an umbrella term for many different diseases. The muscular dystrophies (MD) are a group of more than 30 genetic diseases characterized by progressive weakness and degeneration of the skeletal muscles that control movement. Some forms of MD are seen in infancy or childhood, while others may not appear until middle age or later. The disorders differ in terms of the distribution and extent of muscle weakness, age of onset, rate of progression, and pattern of inheritance.

Treatment
There is currently no specific treatment to stop or reverse any form of MD. Treatment may include physical therapy, respiratory therapy, speech therapy, orthopaedic appliances used for support, and corrective orthopaedic surgery. Drug therapy includes corticosteroids to slow muscle degeneration, anticonvulsants to control seizures and some muscle activity, immunosuppressant’s to delay some damage to dying muscle cells, and antibiotics to fight respiratory infections. Some individuals may benefit from occupational therapy and assistive technology. Some patients may need assisted ventilation to treat respiratory muscle weakness and a pacemaker for cardiac abnormalities.

Prognosis
The prognosis for people with MD varies according to the type and progression of the disorder. Some cases may be mild and progress very slowly over a normal lifespan, while others produce severe muscle weakness, functional disability, and loss of the ability to walk. Some children with MD die in infancy while others live into adulthood with only moderate disability.
For more information on this topic try Muscular Dystrophy Campaign at www.muscular-dystrophy.org

Monday 22 September 2008

Measles

There has been a noted increase in the number of cases of measles in recent years, this is thought to be as a result of parents deciding not to have their child immunised due to the controversy over the MMR vaccine.

Measles is caused by a virus that is spread by droplets. The virus is passed on through direct contact with someone who's infected, for example by touching or kissing them, or through breathing in contaminated air. It's fairly easy to catch if you haven't been vaccinated and come into contact with someone who has the infection, which is why epidemics often occurred among school children.

The infectious period is from four days before the rash to four days after it's appeared. Unfortunately, it's most infectious before the rash appears so people tend to spread the virus before they realise they have it, it is best to inform anyone who has been in contact with the child in this period that they have measles, as people of any age can get it.

It's most common among those aged between one and four, all children who have not been vaccinated are at risk from measles, and those who have problems with their immune system may have a more severe case of measles.

Symptoms
The symptoms take about ten to 14 days to develop after exposure to the virus, the early symptoms are like a cold, with runny nose, cough, conjunctivitis and fever, a few of days later, tiny white spots surrounded by red may develop on the inside lining of the cheeks, so they are difficult to see. The measles rash appears a day or two later, starting behind the ears or on the face and spreading down across the body.
It's a fine red rash which becomes blotchy and confluent, it fades after three to four days and should be completely gone after a week or so.

Complications
The infection isn't usually serious but there are potential complications that can be fatal, even for otherwise healthy children. These are rare but include otitis media, pneumonia, hepatitis, conjunctivitis and encephalitis (inflammation of the brain). Encephalitis or inflammation of the brain may develop a few days after the rash has appeared, and a quarter of those who get this complication will be left with brain damage and a devastating but extremely rare illness called sub acute sclerosing panencephalitis (SSPE). This progressive illness may develop many years after the first bout of measles and is eventually fatal. Fortunately, it's very rare, occurring in fewer than one in 100,000 cases.

Treatment
It is important to see your doctor to confirm the diagnosis as although rare, complications can be very dangerous. In most cases children may be treated at home with pain and fever-reducing syrups such as Calpol, always check it is the right product for your child age and they should be encouraged to drink fluids. Very rarely hospital treatment, with antiviral drugs, may be needed in more serious cases.

Wednesday 17 September 2008

Heat Rash

Heat rash takes the form of tiny blisters which appear in newborn babies. It's often caused by the sweat glands which are not fully developed in babies, and can become blocked if the baby is too hot. This is why heat rash is commonly seen in newborn babies during summer. It may also appear during a fever, or simply when a baby has been overdressed.

Symptoms
It takes the form of pinkish blebs or small blisters which usually appear over the face, neck and in skin folds, especially in the nappy area. If infected, they may become pus-filled, and you should seek medical advice.

Treatment
You can help by giving your child a luke warm bath, dressing them in light cotton clothing. The rash should disappear in two to three days. If your baby is scratching the spots, speak to your doctor or child health nurse about which creams may help.

Warning: Seek medical attention if

  • the spots become inflamed or pus-filled (yellow or green). This means that they have become infected, and need treatment
  • the rash lasts more than two to three days
  • in addition to having a rash, your baby is generally unwell, has a fever or is not feeding well
  • you are concerned

Tuesday 2 September 2008

Head Lice

Remember the nit nurse, thankfully those days of ritual humiliation and terror are gone but the down side is that if your child has head lice it may take a while before they notice, its a good idea to check every time you wash their hair those little buggers can arrive at any time.

Head lice often called nits unsurprisingly given the name like to live on heads, they are extremely common in children, often first noticed due to the presence of eggs in the child’s hair. they are spread from person to person by close contact, despite close attention to hygiene, the adult then lays egg in the next person’s hair which usually takes about a week to hatch, and the cycle begins again.

Symptoms
The first sign of head lice is usually itching the head, especially the nape of the neck and behind the ears. If you look closely at your child’s hair, you will see many small, white, oval-shaped eggs firmly attached to the root of the hair shaft, close to the scalp. The further away from the scalp, the longer the nit has been there (hair grows at the rate of 0.3 mm a day). The adult insects themselves move very quickly and are difficult to see unless you part the hair very quickly and you see one jump. There is no need to chase them, the fact that there are eggs are good enough evidence of their presence.

Treatment
There are many different types of Anti-lice shampoos that are available from the chemist without a prescription, they are simple to use and effective. If you do choose to use them then do so strictly according to instructions.

For a more natural cure try hair conditioner. Apply a very generous amount of conditioner to dampened hair, and rub into the scalp and along the hair shafts. Leave on for at least 15 minutes. You may place a shower cap over your child’s head while you are waiting. The action of the conditioner is to suffocate the lice, which then release their claws from the hair shaft or scalp. A fine-toothed lice comb can then be used to comb out the conditioner. Use a tissue or tap water in the sink to rinse the comb between strokes. You will often see lice bodies that you have combed out. It is said that this treatment needs to be repeated every 2-3 days for two weeks, but it is very effective. Remember that there is no need to shave or cut your child’s hair, the little lice have no preference as to length and for that matter age.

Lice are highly contagious, and can spread rapidly between families and between children in the same class. If you find lice in you child’s head check the whole family, and even if you do not see any eggs or lice, it may well be worthwhile to treat all other family members just in case. It is important to let the child’s creche, nursery or school know that your child has lice.

Clean and vacuum your child’s room, as well as any areas in which they have been playing. Soak all brushes and combs in anti-lice shampoo for several hours to disinfect them. Wash all bedding, blankets and clothes in hot water. Any item that can't be washed should be sealed in plastic bags for two to three weeks in order to kill the eggs. If your child is itching excessively and it interrupts their sleep or if sores develop on the scalp, and weep or spread then you need to see a doctor.

These little buggers are tricky so keep an eye out

Wednesday 27 August 2008

Eczema

the first thing to know about eczema is that it is a common condition in childhood it affects a fifth of the children in the UK, the good news on this statistic is that 75 % of those children grow out of it by puberty.

Causes
It is thought that eczema has a genetic basis and tends to run in families. It is often associated with other conditions such as asthma or hay fever. Children with eczema have dry, sensitive skin which is easily irritated by certain chemicals (such as soaps or bubble bath solution) and by contact with woollen or polyester garments. In some children and adults for that matter, diet seems to play a role in eczema, although it is often very difficult to find the offending food. Eczema is not contagious.

Symptoms
It is characterised by a very itchy, red rash, usually present in patches on the elbow creases and behind the knees, although it may occur on the face, neck, hands and feet almost anywhere.

In babies it usually starts with the cheeks then moves to the wrists,ankles, folds behind the knees and on the inside of elbows. The rash may develop cracks and weep or bleed, especially when the child scratches excessively because of the itch. the scratching can cause the area to get infected by bacteria, which enter the skin via the cracks. In between attacks of eczema, the skin looks thickened and dry. Eczema usually begins at some time during the childhood, often in the first few months of life. The main truiggers seem to be soap which dries the skin, dust mites and occasionally foods such as dairy, eggs and fish.

Treatment
Eczema cannot be cured. The key it living with the condition is to try to prevent severe flare-ups, the way to do that is to treat symptoms as soon as they appear. Eczema is worsened when the skin is dry, so oils and moisturising creams applied directly to the skin are helpful, as is the use of bath oils, all these things help to prevent the skin from becoming dry but be careful to only use products which are specially formulated to help with the condition or some non perfume products such as aqueous creams as perfumed products can aggravate the condition.

If your child is scratching at the rash, try putting cotton mittens on their hands at night, cut nails short and keep them clean. If their scratching becomes constant, see your doctor equally if the rash becomes infected, your doctor will probably recommend a short course of antibiotics.

If the eczema is servere your G.P. may prescribe steroid creams to help but always read the instructions very carefully and use as instructed, as this type of cream can lead to thinning of the skin.

What you can do to help
Try to dress your child in cotton clothes and more spercifically underwear as they are more comfortable for your child than woollens or synthetics, keep the child cool, as overheating can make the itch worse also avoid very hot baths or showers are also aggravating. Use creams after your childs bath to keep the skin supply and prevent it from drying. It maybe worth looking into food intolerances to see if the out breaks are linked to a food allergy

For more information try The National Eczema society at www.eczema.org

Friday 22 August 2008

Ear Infections

Ear infections are one of the most common illnesses in babies and young children. Most ear infections are middle ear infection, young children are more prone to these types of infections, because the tubes which connect the throat to the middle ear are softer and shorter. This means that germs can reach the middle ear more easily than in older children, whose tubes are longer and more vertical. In younger children the tubes are prone to getting blocked, so that there is less ventilation into the middle ear space.

Although they may cause fever and pain in the short-term, they usually get better with treatment and there are no long-term consequences.

Some children do have recurrent ear infections, for reasons that are still not clear, and these may lead to a condition known as ‘glue ear’ and can result in hearing loss. ‘Glue ear’ is the term used to describe the presence of thick, glue-like secretions in the middle ear. These are sometimes the consequence of repeated ear infections. Glue ear, very often affects the child’s hearing, which in turn may have an impact on the child’s speech development.

Ear infections in young children need to be seen promptly by a doctor and followed up to make sure that they don’t keep coming back.

Symptoms
The symptoms experienced depends on the age of the child, symptoms may include fever, irritability or drowsiness, loss of appetite, nausea or vomiting and sometimes diarrhoea, and headache. Younger children may tug their ear, or poke their finger inside. While sometimes ear infections are ‘silent’ and do not cause any specific symptoms, usually your child will complain of earache, or of a feeling of fullness or pressure in the ear. Babies may cry a lot and pull at the affected ear, especially at night when lying down. Some children may suffer severe and intense pain in their ear. Ear infections can cause a temporary decrease in hearing, so that some children may have noticeable partial deafness during ear infections. Occasionally the eardrum may rupture (perforated eardrum), with a thick and sometimes bloody discharge. This creates some relief of the pressure that has built up in the ear as a result of the infection, and eases the pain, do not panic the burst eardrum usually heals naturally.

Treatment
When an ear infection is diagnosed antibiotics are usually only given to babies and children who are very unwell, as symptoms of a middle ear infection usually get better without intervention within 24 hours. if you child is diagnosed with an ear infection an is prescribed antibiotics, even if the symptoms have improved always make sure that the child finishes the whole course of treatment, as stopping too soon could make the infection come back.

Your G.P. may tell you to give your child infant painkillers such as Calpol to help with the pain and bring down any fever

Many children who have recurrent ear infections, or a chronic infection (glue ear), may require the insertion of ventilating tubes (grommets) into the eardrum. This prevents fluid from building up behind the drum, and helps to preserve hearing. This is a very common procedure in childhood, and usually your child can be a day patient. Grommets usually fall out after 6-12 months, although sometimes special tubes are inserted which will stay in longer. Unfortunately in some children, grommets may need to be reinserted again if infections recur.