Search Results for: health

Maternity Benefits :A Topic No One Wants to Talk About

By Dr.Amrita Basu(MBBS,MS) on January 8, 2018 22

Motherhood a profession?A job? A vocation?A blessing?
It’s all and some more.Mothers have the most profound effect on the child.It’s not me, but psychologists who say this.Children need their moms.
But families need to sustain themselves too.
SAHM is a luxury many can’t afford.

What society forgets is that everyone has a mother.Mother’s bring up nations, their leaders, their army men, their entrepreneur’s, everyone!If a nation continues to ignore the sacrifice women make to bring up the future citizen of the world you are missing the point.

My story

When I became a mommy my life underwent a 180 degree reset.I wanted to do everything I always wanted to do, but my first priority shifted from own happiness to baby’s health and happiness.

It’s a miracle how mothers across time and geographical borders want the same for their child

But I had another little bug to take care of.This bug was inside my brain.The weird nonstop talking part which wouldn’t let me give up trying.
The education and learning I have received.What kind of example will I set if I dont practice what I talked about ?
About being able to support me financially and socially.

It seemed impossible that I could continue having a career while I brought up the little one.

God intervened.
My Job as a medical teacher was God sent.
It’s flexible and helps both of us juggle baby work housework and professional duties without hair tearing worries.

When my baby was born, I was not in a Government service.I received no paid maternity leave.In fact at a job interview, an interviewer asked me about my plans for family planning!That gave me a jolt.That’s strange and discriminatory but stranger things happen.

Now things hopefully are changing.Laws are being made but are you aware of them?

I share a few of the key changes in the Indian Maternity Benefit Amendment bill and how it will affect you.

Ministry of Labour and Employment, Government of India
Key points in the MB Amendment Acts

Increased paid maternity leave (from the existing 12 weeks to 26 weeks).But for third or more pregnancy it is still 12 weeks
Work from home options.After the 26 weeks leave and depend on nature of work an agreement with the employer.
Option for adoptive mothers.Up to 12 weeks of leave from the day of adoption.
Creche benefits.Mandatory with up to 4 visits allowed during work hours.
The responsibility of the employer to educate the employee about her rights.

Some other countries with good Maternity benefits are:

Germany: Has sensible and kind rules for pregnant, nursing, mothers and also for child care benefits.
Canada and Norway allow 50 weeks and 44 weeks respectively as paid maternity leave.
The United Kingdom has excellent maternity benefits with up to 52 weeks leave.
But not so good in the USA.I was surprised to know they have the lowest levels of leave for mothers in the industrialized part of the world!

My thoughts :

Why would any country want a brain drain of successful, hardworking creative sincere women workforce ?

Women bring essential soft skills to a workplace which no man can.

A society which doesn’t appreciate women can never truly progress.

How can governments across the world deprive such a large section of the population to the right to a livelihood?

Do not think you cannot be financially independent without a job.You can do the same as an entrepreneur.

[bctt tweet=”When the going gets tough, you will discover superpowers!” username=”misra_amrita”]

You just have to believe.That’s my Word of the year.

You may have to work harder but you will be stronger.

Additional ideas and resources(will be updated)

Have a skill?Use Skillshare Udemy, Teachable, Etsy, Instamojo, to share your course, class and digital products. LinkedIn to network and create a professional circle.

Check out Inkwellteam an extraorservice force for global flexible work options connecting businesses with accomplished women !

Did you get maternity benefits?How do you think the Government can help families more?

Write in the comments below!

Writing this for #MondayMommyMoments.

This week the #MondayMommyMoments prompt is :

A Mother deserves the highest salary !-Manushi Chhillar (Miss India 2017)

Your thoughts on this. Tell us the good, bad and the ugly.We want to know!

Read our rules: MondayMommyMoments and Supermom rules

Link up by submitting your URL through the button below.

13 Cool Facts About Water which No One Tells You

By Dr.Amrita Basu(MBBS,MS) on January 7, 2018 16

Drink water?Why?How will water benefit you?Why should you drink water?How much water is enough?How to drink more water?13 Cool facts about water which no one tells you is the one post you must bookmark to remember why you need to drink more water.

What I must tell you at the beginning:

Water is a miracle fluid.Oxygen and water are essentials for life.If you think drinking tea, coffee, juices will take care of your water needs, stop kidding yourself.

About water, a lot of varied information will fly.I want to help you know the truth from the myths!

Content breakdown:

13 Cool Facts About Water which No One Tells You
What are the factors which will determine your water needs
How do you know you are drinking enough water?
How to drink more water?
How to make your child drink more water?
Listen to the podcast
Watch the video

13 Cool Facts About Water which No One Tells You

1)Drink 500 ml water half an hour before each meal.This will not only help you meet daily water goals but also help you lose excess weight.

2)Suffering from acidity and GERD?Drinking water helps in this too.

3)Water when replacing sugar-laden calorie-heavy drinks help you cut down on extra calories.With obesity a rising epidemic, you can’t afford to ignore this.

4)Physical activity and cognitive function are both improved with good hydration.Important especially in athletes and children to drink adequate water on a daily basis.

5)Older people . may experience delirium and dementia with dehydration.Since their thirst sensation is often altered It’s important for the elderly to drink adequate water.

6)The most obvious effect is on your gut health.If you don’t visit the loo regularly for your morning calls its something you need to think about.Constipation is not cool.A healthy bowel makes a healthy person.

7)Your kidney is crucial in managing your body’s water balance and blood pressure..Your kidney also needs water to filter the toxins from your blood which gets excreted in urine.

No water and this filtration system get strained and urine is decreased and is high-colored.

8)Drink water to prevent a headache and be happy.

Mood swings, irritability, and headache triggers are common signs of low water intake.Lack of adequate water may act as a trigger for migraines.

9)Water intake helps to increase concentration and cognition in children.

10)Adequate water intake reduces urinary tract infection.

11)Water intake has a strong preventive action against kidney and urinary stone formation.

12)It also reduces hypertension, fatal coronary heart diseases, venous thromboembolism.It keeps your cardiovascular system healthy.

13)Water has an effect on your gut health .If you don’t visit the loo regularly for your morning calls, its something you need to think about.Constipation is not cool.A healthy bowel makes a healthy person.This evidence needs more corroboration though.But I think you already know the truth about this.

What are the factors which will determine your water needs

Your general health status .how healthy you are.During fevers, disease states, water need may be increased.

Environment
In the hot climate you will need more water to meet your hydration needs.
Exercise: High BMR states and increase in physical activity means you sweat more and your body needs more water.
Pregnancy or breastfeeding status .Both these physiologic states need good hydration

Water has a lot of actions other than just hydration.Its range of goodness makes it the right thing to add to your new year health goals.

How do you know you are drinking enough water?

You will not be thirsty
You will have great energy.
Your urine will be light colored.
You will be making all your cells happy.

How to drink more water?

Carry your own cool water bottle.Have fruit infusion water.Not fruit juice, or drinks.
Eat plenty of fruits and veggies.They contain a lot of water and can help fulfill your water needs along with nutrition needs.

How to make your child drink more water?

Drink water with them.The best way to teach them is by setting an example.
Make drinking water fun using a sipper or a straw.
Include plenty of fruits and veggies in their diet.
Have a water drinking challenge every day, with the loser having to do whatever the winner says.

Listen to the podcast summarizing the main points.

Written as a part of #ChatterPrompts’

13 Cool Facts About Water which No One Tells You

References:

Water-deprivation headache: a new headache with two variants.
Blau JN, Kell CA, Sperling JM
Headache. 2004 Jan; 44(1):79-83.Pubmed
Water, Hydration and Health
Barry M. Popkin, Kristen E. D’Anci, and Irwin H. Rosenberg Pubmed
Harrison Textbook of Internal Medicine

SBI Computer Security #Cybersecurity

By Dr.Amrita Basu(MBBS,MS) on January 5, 2018 43

When I came to Malda in 2013, the only bank with which I had net banking facility enabled, was State Bank of India. We bought our home, our mutual funds, insurances everything using online banking facility. Strictly trusting the secure network provided by SBI and safe internet habits, I kept my money safe and sanity intact.

Even now when I want money transferred to my bank, or want to transfer money the bank that comes to my mind is my SBI account. There are many reasons.But most importantly I have a 17-year -old relationship with State Bank of India.They provide a secure environment and good service. In today’s world until and unless you have access to safe and secure net-banking facility many of your financial transactions will become cumbersome.Cybersafety is a serious matter.

There are definite best practices which you must follow while banking online:

Number one: Always use a secure internet connection for accessing your bank. For this, your home network on your laptop or home computer is best. Have internet security installed on all your home and office devices.Not just anti-virus, you need a complete solution to keep your computer safe.

Never click unknown links from your phone or from your laptop.

Avoid downloading apps and software on your phone which wants you to override your phone or laptop security. The last two are ways by which hackers get malware downloaded on your phone.Remember its your phone,y our laptop,y our digital home.So keep it safe.

When you use debit cards:

Remember your PIN.
Remember to keep changing it regularly. Make it complex and test your brain. It’s better you don’t write it down in random places.
Avoid giving your card to any service person.Go to the payment counter yourself while shopping, visiting restaurants or shops. This habit keeps you safe.
Make your PIN complicated; so that people can’t easily make it out.Do not share it with anyone.
Do not use card for payment purpose while using Free wifi at airport, coffee shops, or any other open public internet connections,
Never discuss Mother’s maiden name or your pet name with anyone.These are common questions used for resetting passwords and should be guarded.

Be careful about Vishing calls! The bank personnel will never call you to confirm any account related information through phone.

Internet banking precautions:

Always use secure connections. Don’t fall for free wifi. Use only secure channels.
Keep strong password and keep changing periodically.
Make it complex using a capital letter, small letters, numbers, and symbols. You can use the virtual keyboard for additional security.
Make the password inspirational so that you can remember.
OTP, CVV, Password should never be shared with anyone .
Register your mobile number, so that you get the SMS for online transactions on time.
Set proper and minimal amounts for beneficiaries.
Review your account statements regularly.
While on the roads you need to drive safe .while online you need to remember safe usage of IT .
Be smart, be secure, keep your money safe.

Mobile Baking with SBI:

Mobile banking with SBI is very popular. But like every other bank, the Mobile banking SBI app needs usage with care.
When you use third-party apps you are trusting unknown people with sensitive information.
Free apps when they gain access to your banking data and phone information can cause major security breaches.

What are your tips to keep your banking safe online? Share in the comments below.

NOSEBLEED in Kids: 3 THINGS YOU NEED TO KNOW(+A home care checklist download)

By Dr.Amrita Basu(MBBS,MS) on January 4, 2018 13

Nosebleed in children are worrying.Causes may be many and management of pediatric nose bleeds can be tricky .Read about nose bleed in adults here .

As a parent, it’s heartbreaking and you feel terribly upset.

It’s actually very common.

And not as worrying as it looks.

As an ENT surgeon nosebleed are some of the most frequent emergencies we attend.

The most important advice in cases involving children is rarely medicine.

I felt a little info about first aid home care for nosebleed would be useful.

Why does it happen?

Most often it’s due to nose picking.

Nose picking is easily the most common reason for nosebleed in children.

Luckily nosebleed in children are hardly ever life threatening.

But just knowing the why is not good enough .

Parents need to be aware of danger signs.

The signs below show when you need to visit the emergency.

#IMPORTANT TIP 1

THE DANGER SIGNS WHICH YOU SHOULD KNOW

Massive nosebleed which cause difficulty breathing
Massive nosebleed , which doesn’t stop even after the home-care described below.
You find nosebleed has made your child pale, tired or disoriented.
Nosebleed occur repeatedly, often and in very large amount without any trauma
Child has undergone a recent nasal surgery
Child has some tumour in the nose

Doctors will focus more on the child’s breathing and hemodynamic stability ,than the nosebleed.

This means the child might need intravenous fluid support, blood transfusion, moist oxygen inhalation

Identification of the site and cause of nosebleed, is of importance only after making the child stable.

WHAT CAUSES NOSEBLEED

IN CHILDREN:

Blowing the nose very hard
Injury to your child’s nose during playing
Broken bones
Temperature and humidity changes make the inside of your child’s nose become dry.
Juvenile nasopharyngeal angiofibroma

WHAT COULD BE THE CAUSE OF FREQUENT NOSEBLEED IN CHILDREN?

Mostly systemic causes

Bleeding disorders,coagulopathies:Haemophilia A, B, Factor IX deficiency(Von Willebrand disease)
Leukemia
Hereditary Haemorrhagic telangiectasia(HHT)

A study had found at least 1 episode of nosebleed occur

In 30% children less than 5 years
56% children aged 6 to 10 year
Children younger than two years rarely have nosebleed.

Child abuse is another worrying cause of recurrent nosebleed in children.

That’s a potential red flag for healthcare providers.

50% Adults with nose bleeding has the history of nosebleed during childhood.

#IMPORTANT THING NO.2

WHAT IS THE BEST WAY TO STOP A NOSEBLEED AT HOME?

stop nose bleed at home:first aid — **Stop nose bleed :first aid**

How to stop Nose bleed

Make your child sit down and bend forward and pinch the soft part of their nose.

Make your child breathe gently through the mouth
Do this for at least 5 minutes.Most nosebleed stop by a maximum of 10 minutes of pinching the nose this way
Bending in front, helps to drain blood down the nose and prevents trickling to the back of the throat .Trickle to the back of throat can cause vomiting and more bleeding.
You should pinch just above the nostrils
Place an ice pack on the bridge of your child’s nose
Avoid nose blowing
You can apply antibiotic ointment, petroleum jelly,nasal drop.

ANTERIOR EPISTAXIS

Nosebleed in children most commonly occurs from the front part of the nose.

This is known as anterior epistaxis.If its not controlled at home you might need to visit, the emergency of your nearest hospital.

Little's area is the commonest site of anterior nose bleed in children — Little’s area is the commonest site of anterior nose bleed in children

WHAT OTHER WAYS WILL THE DOCTOR STOP THE NASAL BLEEDING

CAUTERY

Chemical cautery – silver nitrate, TCA
Electric cautery
Laser photocoagulation
Indication – if bleeding site is identified by noting
- Active bleeding
- An eschar
- Prominent vessel

CHEMICAL CAUTERY

Agent – silver nitrate commonly used

Anaesthesia – LA

4% lidocaine within adrenaline or 4% lidocaine with 0.5 phenylephrine or by 10% cocaine

TECHNIQUE

Circumferentially around the bleeding site and then the real offending bleeding vessel

Disadvantage –

Repeated cauterization required
Ulceration or septal perforation

ELECTRIC CAUTERY

Indication active arterial bleed not controlled by silver nitrate
Bipolar cautery preferred over unipolar cautery
If aggressively performed a hole may be formed in the septum
For posterior bleeding , it has to be stopped using a 30° endoscope and cautery
In children – cautery should be used under GA.

CARE AFTER CAUTERY

Local antibiotic ointment x 10 days
Avoid nose blowing/ picking
To keep the mouth open while sneezing

ANTERIOR PACKING

INDICATION

If cautery is not possible
If obvious site can not be identified
If bleeding not controlled by cautery.
Mechanism
- Adequate pressure to the bleeding site
- Thrombosis of bleeding
Anaesthesia LA/GA

MATERIAL USED

Absorbable substance
- Oxidized cellulose
- Gelatin sponge
- Surgicel

INDICATION

In bleeding disorders
Hereditary telangiectasia

Mechanism of action:All the absorbable packs help the blood to clot .They give a matrix for the platelets and fibrin particles interlinks. This way the bleeding from the nasal cavity can be stopped

ADVANTAGE

Dissolves spontaneously
Trauma of pack removal eliminated

MEROCEL PACK: This is in between an Absorbable nasal pack and ribbon gauze.This is made of biocompatible , polyvinyl alcohol sponge material which helps to stop bleeding .It has a very high-capacity for absorption .

Provides a mild pressure and tamponade effect after insertion in the nasal cavity .This tamponade effect helps to stop the bleeding.

It may be kept for upto 5 days , but under antibiotic cover.

Advantage:

Highly hydrophilic and can absorb blood upto 21 times its volume
Soft , compressible, easy to insert
Very little trauma during insertion and removal
Easy to cut and shape according to size of nasal cavity

Disadvantage:

It’s expensive.

Nasal bleeding which needs high tamponade effect to stop , may not be controlled

RIBBON GAUGE PACK

Impregnated with antibiotic and vaseline.

– Layered placement of the pack filling

COMPLICATION OF ANP

DURING PACKING

Vasovagal attack
Blind packing aggravates bleeding ,as the friable mucosa is traumatized.
Pushed into throat

WHILE PACK IS PREVENTION IN THE NASAL CAVITY

Epiphora, or watering of eye
Secondary sinusitis.Infection of the sinuses.
Anosmia, sleep apnea
Toxic shock syndrome

DURING REMOVAL OF PACK

Vasovagal attack
Further bleeding

Posterior nosebleeds:

Originate toward the back of the nasal passage, near the throat.Occurs mostly in elderly as hypertensive epistaxis.

Posterior nosebleeds are less common than an anterior nosebleed. But they can be serious and can cause a lot of blood loss. Children do not usually get posterior nosebleeds.

But if it does occur, they can be serious .Posterior epistaxis can cause significant blood loss and collapse.

In children it can occur following trauma to nose.

This causes the nasal bone to break and injury to the sphenopalatine artery .This sphenopalatine artery at the back of the nose can cause profuse bleeding.Thus is a serious emergency and needs urgent medical intervention.

HOW CAN FREQUENT NOSEBLEED IN CHILDREN BE MANAGED?

Consultation with your doctor is important in case of frequent nosebleed.

Careful history: Generally there is the history of prolonged bleeding after minor trauma, teeth extraction etc.

The child may be having other signs of frequent bleeding:

Pinpoint bleeding spots under the skin (purpura)
Repeated bruising
Swollen painful joints
Bleeding from other places, blood in urine, blood in stool

Investigation:

Complete haemogram
BT, CT, platelet count
Prothrombin time/Activated Partial Thrombosis tin Time
Hess’s test, factor VIII and IX assay

Treatment:

Treat the cause
Stop bleeding
Cautery is contraindicated

#IMPORTANT THING NO.3

NOSEBLEED PREVENTION

If your child gets nosebleeds frequently.After a full checkup if you find its due to nasal crusts and nosepicking.

There are a few things which you can do to help stop nasal crusting.

The less the crust, less will be the childs tendency to pick his/her nose.

Te following measures will help reduce drying and crusting.This in turn will significantly decrease the nose picking and the chances of getting a nosebleed:

Use a humidifier in your bedroom while sleeping, especially when the air is very dry.
Keep your child’s nose moist using a saline nasal spray.
Teach your child to stop picking his/her nose, clip their fingernails to avoid injury.
Explaining to your child about the possibility of a doctors visit ,with nose bleed may help them not to pick their nose.

I hope you found this post helpful.

Please share and help another parent.They will thank you for this.

Tracheostomy Care in Children:What you need to know(+A handy guide for download)

By Dr.Amrita Basu(MBBS,MS) on January 4, 2018 14

Tracheostomy Care in children

A distinctly serious topic.But a necessary one.

I realized this when working as a resident in Safdarjung Hospital New Delhi, many caregivers would often ask persistent questions regarding home care.

All children may not be fit for home care.

But for those who are otherwise alright, home environment often speeds up their recovery to a tube free life.

What is tracheostomy?

Tracheostomy is an opening made in the anterior wall of the breathing tube or trachea.

For children the opening is generally a slit in the tracheal cartilage and the cartilage itself is never removed.

It’s a life-saving procedure.

What are the indications of tracheostomy in children?

Indication for Pediatric tracheostomy

To relieve upper airway obstruction(most common)
To prevent complication of prolonged ventilation
To reduce anatomical dead space
Allow suction toilet of trachea

Indication of upper airway obstruction potentially requiring tracheostomy

Nose, Nasopharynx, oropharynx, base of tongue:

Choanel atresia
Macroglossia
Treacher Collins/Goldenhar Syndrome
Cystic hygroma

Supraglottis and glottis:

Supraglottic cyst
Vocal cord palsy
Physical trauma

Subglottis trachea:

Tracheomalacia
High tracheal stenosis

Conditions which may require prolonged ventilation

Failure of control over breathing
Chest wall dysfunction
Disorders of Lung parenchyma
Large Airway disease
Central sleep apnea (Ondine’s curse)
Thoracic dystrophy
Bronchopulmonary dysplasia
Tracheobronchomalacia.

The serious nature of the conditions which require tracheostomy will give you an idea, about why this procedure helps to save lives. is only done when all other conservative options fail.

Itis only done when all other conservative options fail.

[wysija_form id=”16″]

So what should parents and caregivers of children living with tracheostomy know?

1)Acceptance

I know it’s difficult to watch a child breathing through a tube.

You wonder why innocent children have to suffer.

But that tube will help the child live healthier.

Always remember when condition improves , tracheostomy is a totally reversible procedure , with little morbidity.

[Tweet theme=”basic-white”]Having faith and hope is must[/Tweet]

Acceptance of a tracheostomized child is important. As your child breathes and feeds better , your unconditional love and support will help him/her accept the tube and live healthier.

As your child breathes and feeds better , your unconditional love and support will help him/her accept the tube and live healthier.

2)Suctioning the tracheostomy Tube

The suction catheter should not be passed more than 1cm beyond tube tip to avoid tracheal damage.

With time , secretions become less.

Then you need to suction less frequently.

Humidification of inspired air by using nebulizer & tracheostomy mask helps to prevent excessive drying and irritation of trachea.

The suction should be made to suck some clean water after every tracheostomy Tube suction and kept clean.

The suction tube should be changed regularly.

The frequency of change ideally should be every 2 to 3 days , but will depend on the condition of child.

TRACHEOSTOMY TUBE CARE IN CHILDREN HANDY GUIDE — TRACHEOSTOMY TUBE CARE IN CHILDREN: HANDY GUIDE

[emaillocker id=104350][/emaillocker]

3)Supervision and sleeping

Baby with a new tracheostomy should be sleeping near parent.

This helps in becoming familiar with the sounds she makes and to determine the frequency of suctioning.

It’s good to keep a child monitor next to the child at all times.

4)Change of tube

First change of tube is always done by a doctor.

Then after you can learn to change tube under supervision by a trained healthcare worker.

This makes you confident and keeps you aware about potential hazards.

When you come home the tube may be changed weekly if no cheat infection present.
If the child has Chest infection then it’s better you change tube, every 2-3 days
Never change tube at home alone.Always 2 caregivers should be present during the change of tracheostomy Tube.
In hot humid climate, it’s better to change the Tracheostomy Tube tape daily.One side at a time should be changed by 1 caregiver while the other caregiver holds the tube in place
Always wash your hand with soap and water before touching the tube.
Before insertion of fresh tracheostomy tube, lubrication with xylocaine jelly helps to lessen the irritation.

5)Bathing

Swimming is not allowed.

The bath should always be supervised even for older children.

Better not to use an overhead shower.

A handheld shower or bucket -mug technique works best.

6)School

If the child has no other problem, regular schooling should be continued.

But it’s important for the teachers, healthcare workers, and school authorities to be aware of the condition, potential hazard, and emergency management procedure.

7)Discipline

When we are ill we are pampered.

But as the child gets better it’s best to treat him /her as you would any other child.

Discipline and all other activities should be like a normal child.

You should encourage him /her to participate in activities as far as possible (discuss with your doctor if your child’s special condition has any restrictions ).

Dress the tracheostomy Tube with a nice scarf to avoid unpleasant curiosity and help your child feel like the other little ones.

8)Speech and Language development

An assessment by a speech therapist early helps you plan better.

Tracheostomy tube with a speaking valve is a must.

Encourage both verbal and nonverbal means of communication with your child.

9)Travel

Wherever child goes, a suction pump must go.

Suction pump

Spare tracheostomy Tube

Tape

Xylocaine jelly

Suction catheter

Syringe

Saline

Scissors

10)Equipment needed for Home care of Tracheostomy tube

Tracheostomy Tube
Suction catheter
Suction pump 3

a)Permanent at home

b)portable suction pump for travel

c)Manual: in case of power disruption, malfunction, regular cleaning and service of pump

11)Skin Care:

Keep the tape clean and dry at all times
Every day put a clean soft piece of gauze tucked between the skin of the neck and the side flanges of the tube.
This gauze should be changed as soon as it gets wet
Clean the skin around the tracheostomy opening with a gauze soaked (and rinsed dry) in mild antiseptic solution, keeping in mind to make the skin dry afterward.

12 )Requirement for children at home with tracheostomy

Caregiver : At least 2 responsible adults
The environment at home: Adequate space, heating, cooling, humidifying facility.Having a telephone and access to transportation.
Healthcare Support system:

District Nurse

Community pediatrician

General Physician

Hospital nearby

Community support

Having a child with a tracheostomy is a big challenge.

But if your child is otherwise healthy and you are willing to learn .

You can take care of a tracheostomy at home.

But every case is unique and the best guide to your child’s conditions is your doctor.

Stay informed and stay healthy.

Disclaimer :

The information provided here is strictly for the purpose of helping you live better and not to be confused with professional medical advice which is only given after professional consultation.

EAR PIERCING : DON’T DO IT WITHOUT READING THIS!

By Dr.Amrita Basu(MBBS,MS) on January 4, 2018 6

Ear Piercing has been popular from time immemorial. Piercings, at all levels of the pinna, is popular even now. Sometimes even the tragus is pierced. I am an ENT surgeon and this is a public service post.

Previously seen in rural, but now more among the urban population than before. So what’s the worry?
Traditionally single piercing of the ear lobule’s fleshy part caused little problem.P roper aseptic precautions in the right setup were all that was needed!
But piercing of the cartilaginous part often brings with it multiple problems.

Problems of Piercing in cartilaginous part

perichondritis (inflammation of cartilage )
hypertrophic scar
keloids
sometimes even necrosis of the cartilage
the collapse of the pinna.

The problems of inflammation, infection hypertrophic scar, keloid can occur also in the lobular part.

EAR PIERCING:Dont do it without reading this

Signs of infection of Pinna after piercing
Pain, redness, swelling, discharge.

If piercing can cause these problems both in the ear lobules and cartilaginous part, then why the precaution for cartilage piercing?

The deformity produced in the cartilaginous part is greater and often more severe. Add to it the sensitive nature of cartilage and the prominent site of your ear.This piercing may give you the kind of “look” which is more than what you bargained for!

So what should you know before you go for an Ear Piercing?

1) Avoid piercing of the cartilage of your ear.

2)Go for Ear Piercing in the fleshy lower part(lobe)

3)Ensure Aseptic measures are being taken care of.

The doctor or the piercing clinic representative should be using sterile gloves.

Sterile instruments should be used. Cleaning the ear lobules with betadine solution,

Cleaning the ear lobules with betadine solution, spirit is recommended.

4)If you have a history of a thick raised scar forming in regions with cuts and scars…
AVOID EAR PIERCING especially if you are still in your growing years!

What material should you use while choosing earrings?
Gold, Silver, Platinum, Titanium, stainless steel non-reacting, neutral pure metal.Ring or stud with no ridging. This is important because imitation alloys and even white gold (it contains nickel along with gold )can cause a foreign body reaction.

Inflammation, infections, and allergic reaction predisposes to hypertrophic scar and keloid formation.

Can pain during piercing be reduced?
Yes, it’s possible by topical application of a local anesthetic agent preferably 15 to 20 min before the procedure.

Who can do ear piercing?

ENT surgeon and dermatologist can both pierce the ear aseptically with due precautions. But all of them may not be doing it. Often piercing clinics are the only option and, in that case, you have to use your sensibility to choose the best option!

What is the care required after Ear piercing?

1)Keep the ear-piercing clean.
After washing hand with soap and water clean the ear lobules with cotton wool dipped in antiseptic solution, twice a day.
2)Rotate the earring in its hole slowly to avoid the build-up of debris.
3)Keep the region dry.
4)Look out for signs of infection. Infection and allergic reactions make the chance of hypertrophic scar, and keloid formation more likely.
5)Don’t try to change the ear-ring/stud before 6 weeks after Ear piercing.
6)Continue wearing ear-ring continuously for 6 months as otherwise the tract will not form and the piercing may close.

What to do for foreign body reaction to ear-ring?

A granulomatous inflammation due to foreign body reaction may manifest as an itchy, reddish, nodular lesion at the site of the piercing. Taking out the offending object followed by steroid ointment application in proper concentration helps cure the condition in most cases
More aggressive lesions may need intralesional (within the swelling) steroid injections and sometimes even excision. Keep in mind to avoid further piercing at least 6 months after this event and ideally till the growing age of the person is over.

What is Keloid and why you should be careful?

Some people may have an aggressive response of skin repair after surgical nonsurgical trauma to the skin.
It’s characterized by elevated itchy scars after even minor skin lacerations. This occurs due to an over-enthusiastic, poorly regulated proliferation of the cells responsible for skin repair and is mediated by the individual immune system.
The problem with people with this problem going for Ear Piercing is they will develop unsightly nodular lesions on the pinna which are often very difficult to get rid of completely.

Best treatment options for Keloid

Steroid treatment
Steroid-containing creams and ointment. May work for small lesions. Helps to flatten the lesion and decreases itchiness. Often regains to original size after stoppage of cream.

For both hypertrophic scar and keloid:
The serial weekly course of intralesional steroid injection helps decrease the itching, and redness and decreases the size of the lesion. The main reason steroids work is they decrease the hyper-reactivity of the scar-forming tissues. A prolonged treatment up to 6 to 7 weeks may be needed in some cases.

Pros of this treatment:

Maybe done in an outpatient setting.
Not expensive
Less morbidity

Cons of this treatment:

A high level of patient motivation and compliance is needed for weekly pricking with a needle.
There’s often loose extra skin left at the site of lesion, which looks unsightly.
Smaller lesions respond better.

Surgical excision followed by steroid injection at the base of the lesion location.
This mode of treatment actually gives good results in most cases, especially for large keloids.
The principle of surgical excision for best result in keloid is to give the surgical incision within 1cm of the external border of the lesion. This avoids the involvement of further area of skin.
After excision of the bulk of the keloid intralesional steroid injection is given at the base of the lesion to inhibit further proliferation of fibroblasts. This steroid injection is again repeated weekly till about 6 to 7 weeks for best results.

Laser surgery is also another method of excision. But not much difference in results has been seen compared to regular surgery.
The results for surgery alone are not very good. But surgery along with steroid injection gives quite a good result in the majority of small to medium-sized keloid. Results may, however, vary according to the size of the Keloid and patient profile.

Radiotherapy along with Surgery
Radiotherapy is a definite a last resort.
It’s used only in case of highly disfiguring keloids resistant to other types if treatment.
An important thing to remember is if you have a tendency to keloid formation, you should definitely avoid repeat piercings and all nonsurgical types of skin trauma.You should also tell your doctor about this before all surgical treatment.

What’s the Ideal age for skin piercing in Children?

This is a somewhat controversial area. Though there’s no set age for Ear Piercing. It’s better to get it done when the child is able to actively help take care of the ear-piercing site and ear-ring. About 6 to 10 years is a good age when the child is able to understand the process and will be actively interested.

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So pierce your ear or your child’s ear, do it with due precautions. Did you get your ears pierced? Do you plan to get your ears pierced?

Comment below to let me know what problems(if any ) you have faced when you got your ears pierced when you got your ears pierced.

Ear piercing image by Stuart Miles at freedigitalphotos.net

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