Ask Dr. Rachna Pande

Dear Doctor, my 19-month-old child seems to have an abnormal heart beat. Originally, I was less concerned because I thought it would clear with age. Unfortunately it has increased, what could be the problem?

Dear Doctor,

For about one week now, my eyes have been itching, could this be a problem with the glasses I am using?

 

Sandrine

 

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Dear Sandrine,

Itching of the eyes is a common problem that can arise from many causes. It is good to become suspicious of your eyeglasses. Eye gasses of any type should be comfortable and able to improve one’s vision.

If the number of glasses has changed over years, the vision may not be very clear. It is said that when vision is even slightly hazy, a person tends to rub his eyes frequently, to see more clearly. In this process, there is a high risk of eyes getting infected, causing itching, redness, pain or discharge.

Loose or very tight fitting glasses could also impair vision while sometimes materials used in making eye glasses can cause itching as an allergic reaction.

There may also be causes unrelated to glasses which bring about itching of the eyes. Infections or inflammation of any layer of the eyes can cause itching. Under such circumstances, there would be associated redness, pain, itching and discharge from eyes.

Sometimes, itching of eyes commonly occurs due to exposure to dust, smoke, fumes or droughts of dry air. Being allergic to any substance present in the atmosphere or that applied as cosmetic on the eyes or face can also manifest as itching.

Any old trauma within the eyes may cause itching as it heals.

If you are using eyeglasses for a long time, it is advisable to get the number rechecked again as it may change with time. Also people need to ensure that the glasses remain clean always.

In cases of an allergy, anti-histamines formulated, as drops in the eyes are useful although when signs of infection become very obvious, the infection should be treated with suitable antibiotics.

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Dear Doctor,

My 19-month-old child seems to have an abnormal heart beat. Originally, I was less concerned because I thought it would clear with age. Unfortunately it has increased, what could be the problem?

Mugwaneza

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Dear Mugwaneza,

You have not specified, whether the abnormal heartbeats are occasional or persistent. Is it just a very fast or very slow heart rate or are you worried that it is irregular?

Well, an infant or toddler can have an arrhythmia (irregular heart beat) due to fever or excess physical activity. Crying or playing can also lead to fast and sometimes irregular heart beat among toddlers. But in such a situation, it subsides with the reduction in fever or when the baby stops that activity and rests.

A very small child may be having sinus arrhythmia, where the heart beat becomes slightly irregular with breathing and gets slower with inspiration. This is a benign condition that should not make you restless.

At times, an infant may have just few extra beats (ectopic beats) with no apparent cause, but the heartbeat will feel irregular although there may be a genetic predisposition.

Smoking in the vicinity of a child may cause damage to the heart of the child eventually leading to an irregular heartbeat. Some drugs like those used to treat cold and allergy or use of caffeine, can cause arrhythmia in a child.

Infections of the heart, can affect the heart muscle or valves, leading to an irregular heartbeat. The infection can be viral and subsides without treatment. It can be bacterial like tuberculosis or rarely fungal.

Electrolyte imbalance in the body caused due to poor feeding, diarrhea and or vomiting can lead to an irregular heartbeat. But again this subsides with treatment of underlying cause.

A baby may be born with some defect in the valves of the heart or the partitions separating the chambers of the heart. Here irregular heart beat could be associated with breathlessness on exertion, fainting, becoming blue after crying, paleness, early fatigue, one or more of these symptoms.

Use of alcohol and or tobacco during pregnancy, predisposes the child to such defects. Fortunately, all of these could be diagnosed easily and cured with suitable antibiotics.

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Dear Doctor,

I really feel bad about my weight. I am thinking about laxatives because when I exercise, nothing seems to change. Is there a better alternative?

Amos

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Dear Amos,

With routine use of laxatives one can lose weight but this is the most unhealthy way. Laxatives act by enhancing bowel movements and are normally used as a remedy for constipation. Occasionally a laxative may be used for some medical intervention like keeping bowels empty before a surgery or some procedure. But I must warn that regular use is extremely harmful. The first risk associated with laxatives is a diarrhea. While losing weight, there may be loss of fluid and electrolytes from the body making one feel tired and exhausted with muscular cramps. Severe cases may need hospitalization for intravenous perfusions.

With this, there is lack of absorption of necessary nutrients in the gut since most of them are also removed with frequent stool. Gradually this condition will push one to become malnourished and more prone to infections.

Recurrent diarrhea can damage the protective coverings of the rectum and anus leading to rectal bleeding. Using laxatives regularly can dilate the large bowel and make it more sluggish, a problem which increases with age. The bowels tend to get habituated to laxatives and this may impair natural regular bowel movement. Gradually increasing dose of the laxative has to be used, increasing the risks as well.

It is better to reduce weight in a healthy manner. To keep a normal body weight, it is important to consume calories as per the needs of the body. This depends on one’s height, weight, gender and level of physical activity. Calories consumed should be in form of healthy foods, like fish, fresh fruits and vegetables, low fat milk products. Avoid alcohol, sodas, junk food and extreme snacking in between meals. Regular exercise is definitely useful in reducing calories. Recommendation is to exercise at least for 30 minutes, a minimum 3 times per week, but if it is daily, it would be more beneficial. Studies say that exercising once in morning and then sitting throughout the day, as with desk workers is also not healthy and adds on to the body fat. 

In between sitting for long hours, a person should walk about or even jog lightly for 15-20 minutes possibly in the work place. Regular yoga is useful in reducing weight as well as for controlling the mind. This helps one to avoid other risk factors contributing to obesity.

Along with other risk factors for obesity, hereditary factors also cause irreversible obesity. But one can adopt other healthy measures for reducing weight, instead of laxatives.

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