Children and their common medical issues
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CHILDREN AND THEIR COMMON MEDICAL ISSUES What are the most commonly sold O-T-C drugs to children? What are the most commonly formulated dosage forms for children? Why do children visit a paediatrician? Key words: birth rate, natal death rate, incubator, breast feeding, congenital disorders, genetic disorders, children’s ailments, infectious diseases, vaccination, meningitis, encephalitis, impairment, disability, handicap, congenital cardiovascular defect, juvenile arthritis, integration into school, mental retardation, orthopaedic problems, dislocation of the hip, idiopathic scoliosis, allergies, atopic eczema, Down syndrome, chronic asthma, pulmonary fibrosis, cerebral palsy, diabetes, the onset of puberty Some disorders and impairments of children can develop before birth, some of them during birth and other during their life. Serious illness in children is now rare indeveloped countries, whereas fifty years ago, many children were permanently handicapped from infectious diseases. Rheumatic fever caused severe heart disease in small children. Poliomyelitis caused paralysis of the arms, legs and even the chest. Tuberculosis was a very common disease in children, too. Better hygiene and antibiotics have made these diseases rare in the developed world, although they have made still major health problems indeveloping countries. Because children are healthier, the paediatrician’s role has changed. The main causes of long-term illness in children in developed countries today areeczema(which affects 10% of children),asthma(5%),squint(3%),congenital physical handicap (2%),epilepsy (0.8%), anddiabetes(0.4%).Canceroccurs in only 0.03% of children. Today, paediatricians treat minor illnesses most of the time. They examine normal children regularly so that they can detect serious illness at a very early stage. Congenital and genetic disorders of the musculoskeletal system include a broad spectrum of abnormalities. Among congenital disorders that effect bones, joints or muscles, some are apparent at birth, such asachondroplasia. Others are present at birth but not recognized until later, such as some forms of osteogenesis imperfecta and conditions like multiple epiphyseal dysplasia that become apparent only with growth. Other disorders may also involve other body system, as inDown syndrome. Abnormalities may result for instance from a defect in the original 46 chromosomes. DOWN SYNDROME (TRISOMY OR MONGOLISM) The prevalence of this disorder increases with maternal age. Patients with Down syndrome manifest varying degrees of mental retardation. They typically have stubby hands, slanted eyes, ... They often suffer from cardiac and gastrointestinal abnormalities. Spontaneous dislocation of the hip occurs between 2 and 4 years of age in almost 5 percent of children with Down syndrome. Their hips are usually hypermobile and dislocations often reduce spontaneously. These dislocations are not painful. However, if this condition is persistent and remains untreated, affective patients become less active and displacement may become fixed. Non-operative methods generally are not effective. Patellofemoral instability occurs in about 5 percent of Down patients. It may cause frequent falling and limited ambulation. These people can suffer from changes in gait, spasticity, weakness, bowel and bladder dysfunction and other disorders. Foetal alcohol syndrome A clear association has been established between maternal alcohol abuse and foetal damage. Children with foetal alcohol syndrome start small and stay small, remaining below normal height and weight throughout life. Many are misdiagnosed as having cerebral palsy because of mental retardation, hypotonia or hypertonia and delayed motor milestones. Approximately half of all these children have orthopaedic problems. Ten percent have dislocation of the hip. Other joints have restricted motion, most marked in the elbows and fingers. Congenital spinal deformities, including scoliosis, occur in the cervical, thoracic or lumbar spine. Haemophilia is a sex-linked disorder characterized by a deficiency in the activity of antihaemophilic globulin factor VIII. In severely affected patients spontaneous bleeding occurs. The most affected joints are the ankles, knees and elbows. Maintaining a career, social life and physical fitness requires knowledge of the treatment and prevention of bleeding episodes. Intramuscular injections and drugs that interfere with platelets function, such as aspirin, should be avoided. All patients should carry a card containing their diagnosis and blood group. Congenital musculartorticollisor “ wry neck “ results in the head being tilted toward the affected side, with the chin rotated to the opposite side and slightly raised. The most significant problem with congenital muscular torticollis is asymmetry of the face and skull. In a case of suitable treatment during the first year of life - stretching of the effected muscle is effective treatment for most patients. Surgical release of the muscle is generally recommended for children over one year of age with persistent, significant restriction of motion. MENTAL RETARDATION Mental retardation is a disorder in which a person’s overall intellectual functioning is well below average, with an intelligence quotient (IQ) around 70 or less. Individuals with mental retardation also have a significantly impaired ability to cope with common life demands and lack some daily living skills expected of people in their age group and culture. The impairment may interfere with learning, communication, self-care, independent living, social interaction, play, work, and safety. Mental retardation appears in childhood, before age 18. About 1 percent of the general population has mental retardation. Mental retardation is slightly more common in males than in females. Mental health specialists have defined four degrees of severity of mental retardation based on IQ score. These are: mild retardation (IQ range 50 – 55 to abou