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Worms in kids

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Few of my friends are always  worried about their child's growth. Natasha always keeps me asking why her daughter is not gaining weight and why she falls sick again and again.  The worms are parasites which feed off the host’s body and eventually result in malnutrition, affecting the healthy growth of the child.  Worms may get entry into abdomen and create health problems .          Though all age groups can get worms, kids are more susceptible. Worms in abdomen can affect the appetite and ultimately growth of a child. When a child is not eating properly we assume he is showing tantrums or too busy in playing and ignore it but it can be worms those are troubling the stomach. When to suspect worms? Itchy bottom, which is usually worse at night Redness around the bottom area Restlessness due to itching Difficulty in falling asleep Visible worms – small, white and 8-13 mm long (often mistaken for bits of toilet paper!) ...
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Diabetes in pregnancy

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Diabetes is a disease in which your blood sugar is too high. When the diabetes is first diagnosed during pregnancy then it is called Gestational diabetes.

 There are 3 types of diabetes:
1) Type 1- This is early age onset and insulin dependent.
2) Type-2- This is late age onset and non-insulin dependent
3)Gestational diabetes

 Who is at risk to develop gestational diabetes?
  • Family history of diabetes
  • Age above 30 yrs
  • Obesity
  • Having a previous birth of overweight baby (4kg or more)






If you have diabetes even before pregnancy...

 Whether you are trying to conceive or already pregnant , treating diabetes during pregnancy is a key to health of both baby and you.

 Pre-conceptinal councelling is very important for you .


  • Diabetologist, nutritionist and obstetrician should jointly see a diabetic woman .
  • Frequent blood glucose should be checked and self monitoring is required.
  • Healthy controlled diet, exercise and if required medicines should form a combination plan .
  • Regular check ups with your obstetrician for high blood pressure and the baby's growth will prevent complications.
  • When a woman with diabetes is pregnant, her blood sugar can undergo many fluctuations because of the hormones associated with pregnancy.
  • It is important to achieve tight control of blood sugar levels when planning a pregnancy to avoid complications


 Effect of diabetes on baby:

1) Congenital malformation: Baby's organs such as brain, heart, kidney start forming in first trimester, so high blood sugars in this early stage can lead to birth defects such as septal defect in heart, certain kidney problems etc.

2) Macrosomia In this condition the baby grows too big and can make the vaginal delivery difficult.

 3)Due to big baby, labour may be prolonged leading to birth injuries.

 4) The newborn may face hypoglycaemia soon after birth due to high insulin levels in blood.

 5) Some other problems may include jaundice, respiratory distress, unexplained fetal death etc.

 Effect of diabetes on pregnancy:

 1) Preterm labour: This may happen due to more chances of infection or polyhydramnios (Excess liquor around fetus)

 2) There are more chances of infections, more commonly urinary tract infection.

 3) Pre-eclampsia : It is a condition characterised by hypertension, protein in urine and with or without oedema. Uncontrolled diabetes can increase the possibility to lead to pre-eclampsia.

 4) Polyhydramnios- The liquor around the fetus can be too much leading to pressure symptoms.

 5) Recurrent spontaneous abortion may be associated with uncontrolled diabetes.

 Effect on labour:

 1) There can be prolonged labour due to big baby or a need of caesarian section.

 2) Perineal injuries can happen in the normal delivery of a big baby.

 3) Postpartum haemorrhage

 Management:

 1) The patient needs more frequent antenatal supervisions with periodic check ups of blood sugar.








2) The control of high blood sugar is done by diet, exercise( aerobics, brisk walking) and with or without insulin, as per your doctor feels requirement for you.


3) According to your medical condition, your doctor will decide about the mode of delivery normal or caesarian.





















Can you develop diabetes in future?

1) If you have good control over blood sugar, after delivery you can recover from it. 
2) Nearly 50% of women with Gestational diabetes mellitus can develop diabetes over a follow up period of 5-20 years.
3) Recurrence risk in subsequent pregnancy is more than 50% 

Can your baby develop diabetes?

  • Babies born to mothers with diabetes are not born with diabetes.
  • Baby must be closely watched for hypoglycaemia after birth until it's body adjusts to the amount of insulin it makes.
  • Chances of having a diabetic child is about 6% when only father is diabetic ,it rises to 20% if both the parents are diabetic.

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