washing hands

Firm with worms

---

Your Health - Dr. Gita Mathaiwww.telegraphindia.com/1170220/jsp/knowhow/story_136680.jsp

---

• 

Quite often, families that come to me complain that the children have "worms". They usually base the diagnosis on poor or perverted appetite (pica) and perianal itching, especially at night. Some actually see small white worms in the stool. This is not surprising as soil-transmitted worm infestation affects 50 per cent of our population! Practising something as basic as washing our hands and feet, regularly and properly, can save us and our children from such infections.

In fact, infectious agents cause over 60 per cent of diseases in India; 90 per cent of these can be prevented by hand washing. This is particularly true of respiratory illnesses such as the common cold, diarrhoea, parasitic infestations, influenza, and even serious illness like jaundice, typhoid and meningitis.

Germs (bacteria and viruses) enter our houses all the time - we carry them in from the road, our workplace and the children carry some in when they return from school or play. Germs cling to our hands when we go to the toilet, or touch mud or dust. Worms enter our bodies through our bare feet if they come into contact with contaminated soil. Pets - particularly cats, dogs and birds - harbour mites, parasites, bacteria and viruses, which cause diseases.

Sneezing and coughing ejects particles containing viruses and bacteria into the air. These eventually settle on walls, furniture and dust. People carrying germs can touch surfaces like walls, lift doors and banisters accidentally and contaminate them. As and when we touch these articles, the germs can enter our bodies. And they are always carried by our hands.

So washing the hands is an easy preventive measure, if performed correctly. Always use soap and scrub your hands well because soap destroys the cell walls of micro-organisms and the scrubbing dislodges and removes germs.

Washing hands after using the toilet may seem like elementary hygiene, yet a recent survey showed that only 67 per cent of Indians questioned actually washed their hands with soap. The reasons sited were many: Scarcity of running water or any water at all, lack of a toilet or absence of plumbing.

Doctors who do not wash their hands after examining each patient on their hospital rounds are liable to transmit infections from the first few patients to all the rest. This cross infection occurs in 5-15 per cent of hospitalised patients. The people most likely to suffer are young children, the elderly, and the immunocompromised (those suffering from cancer and HIV). They come to hospital with one illness and eventually have to stay much longer as they develop complications of other hospital-acquired infections. These are more severe, caused by super-resistant bugs and can be fatal.

The habit of washing hands has to be inculcated in children from a young age. Hands must be washed

• before eating

• after using the toilet

• after playing

• after touching pets and

• feet must be washed if you have been outside barefoot.

There is an urban myth -the 30-second rule - which states that if food falls on the ground and is picked up within 30 seconds, it is unlikely to be contaminated or cause disease. This is untrue, even if the floor is shiny.

Houses should be mopped regularly with disinfectant solution. Banisters and other surfaces that are touched by a lot of hands should also be wiped down. Sunshine is God's natural, non-chemical disinfectant gifted to us freely. We need to use it to dry our clothes, and allow it to enter our homes to maintain a germ-free environment.

HANDY TIPS

The correct way to wash your hands:

• Wet your hands thoroughly and then apply soap
• Rub your hands vigorously together and scrub the entire hand for at least 15 seconds.
• Rinse well and then dry your hands.
• If no water is available, use hand sanitizer. Take 3ml of the liquid and rub it all over both hands.

Dr Gita Mathai is a paediatrician and author of Staying Healthy in Modern India.
Mail your questions to yourhealthgm@ yahoo.co.in

https://www.telegraphindia.com/1170130/jsp/knowhow/story_132934.jsp to eat or not

o eat or not to eat

---

Your Health - Dr. Gita Mathai

---

• 

We need nourishment to survive. Our body signals to us when we need food, our stomachs rumble when we feel hungry and, if the deprivation has been prolonged, we may even feel "faint" - signalling that blood sugar levels are falling.

An empty stomach secretes a chemical called ghrelin. This stimulates the appetite centre in the hypothalamus (a part of the brain). Unfortunately, even when you do not really require food, seeing the photo of a delicious-looking dish or actual food (say, in a shop window) or the tantalising smell of cooking can trigger the release of the hunger hormone, ghrelin. That why the fast food and aerated beverage advertisements on TV are so successful.

The message conveyed by ghrelin is often irresistible. People eat even when they are not really hungry. This is because ghrelin also works on "reward centres" in our brain, the same sites that are stimulated by alcohol, tobacco and addictive drugs like cocaine. So whenever we eat, we feel good and mood is elevated. That means the next time someone says they are addicted to chocolate, you'd better believe them.

The biochemical signals for appetite and satiety are complex. As hunger causes the blood sugar levels to drop, the pancreas releases glucagon, and the brain releases neuropeptide Y. As soon as we eat, and the blood sugar levels go up, our fat cells produce leptin and our brain proopiomelanocortin (POMC) - both appetite inhibitors. Some of these signals reach the brain via the nervous system and the blood carries others there. If we listen to our bodies, at this point we should theoretically stop eating.

Unfortunately there is a time lag in the signals and our response to them. By the time we realise and respond, it may already be too late and we have overeaten. This is particularly true of sugary snacks made from refined flour as they are digested rapidly. Plants and fruits take longer to digest. The chances of overeating are therefore reduced.

Children have well formed appetite centres practically from birth. If overfed (very easy to do with artificial feeds), the infant may refuse to feed or regurgitate. As the child becomes older, there may be a mismatch between how much the parent feels the child should eat and the amount actually consumed. If we make a fist with our hand (at any age), that is roughly the size of the stomach. Based on that, it is possible to calculate how much a child can be expected to eat.

Out of love and affection, we can force-feed children. Then their appetite centres get reset (sometimes permanently) at higher levels. Also, by giving fast food, there is a mismatch between amount consumed, caloric intake and requirement. This is clearly seen in our present day epidemic of childhood obesity.

Some children are picky eaters and will not eat the healthy food placed in front of them. Mealtimes become contentious and stress-filled. To avoid this

♦ Do not substitute milk or snacks for meals

♦ Do not begin or end the day with milk

♦ Do not put the child to bed with a feeding bottle

♦ A child over the age of 1 needs only 400ml of undiluted milk per day.

In the case of adults, loss of appetite may occur normally because of smoking, increasing age, pregnancy or thyroid disorders. If there is no obvious reason for loss of appetite, investigations need to be done.

There is really no safe drug that can be used long term for appetite suppression and weight loss. Eating food slowly, savouring it, increasing consumption of fruit and vegetables, cutting off snacks and exercising regularly is the only proven path to follow.

Dr Gita Mathai is a paediatrician and author of Staying Healthy in Modern India. Mail your questions to yourhealthgm@ yahoo.co.in