Thursday, July 30, 2009

My screaming son

Cover of "Baby and Child"Cover of Baby and Child

Question by Samantha

My son turned three in May. He is a fast learner, picking up words quickly and forming sentences. However, he has a problem. He always screams for attention when he is frustrated. He will carry on until his face turns red and the veins in his throat become visible. As he has been doing this since the age of two, his voice is now husky from the screaming. I have tried to stop him but to no avail. Is there anything else I can do?

Sometimes, a child shouts to get attention.
Reply from Dr Phuah Huan Kee, Neuro Paediatrician, Singapore Baby and Child - A Healthway Medical Specialist Practice

Sometimes, a child shouts to get attention or to vocalise his frustrations. But for this to occur so frequently that his voice becomes hoarse is unusual.

You may need to find out why he is doing that.

One reason could be that he's learnt he could get his way by "raising his voice". Family members, for example, may give in to his demands when he screams.

Sometimes, this sort of behaviour can be found in children who are impulsive and hyperactive. I would suggest that you consult your family doctor or paediatrician. They can decide whether a referral to an occupational therapist or a psychologist is needed.

The information provided above is for your general knowledge only. You should seek medical advice or treatment for your condition. Email questions to

From TODAY, Health – Tuesday, 28-Jul-2009

Expectant women more at risk?

A pregnant woman
A pregnant woman (Photo credit: Wikipedia)

LONDON - Pregnant women who get Influenza A (H1N1) are at least four times as likely to be hospitalised as other people with the virus, a new study says.

While experts do not know if pregnant women are more susceptible to getting H1N1, they say that once pregnant women are infected, they have a higher risk of complications.

Researchers at the United States Centres for Disease Control and Prevention (CDC) analysed the first 34 US cases, including six deaths, of H1N1 in pregnant women from April to mid-June.

They concluded that expectant women suspected of having H1N1 should be given Tamiflu as soon as possible, even before tests confirm the diagnosis.

The experts also recommended that they should be among the first in line when a vaccine is ready.

The study was published online yesterday in the medical journal Lancet.

Lead researcher Denise Jamieson from the US CDC, said the agency does not recommend any special precautions for pregnant women to avoid catching the flu virus.

But if they do catch the virus, doctors need to act fast, preferably within 48 hours of developing symptoms.

Of the six fatal cases in the Lancet study, nearly all had viral pneumonia before experiencing acute respiratory problems, and were put on ventilators before they died.

Aside from one woman who had asthma and another who was obese, the pregnant women were essentially healthy, said Ms Jamieson. AP

From TODAY, World – Thursday, 30-Jul-2009

Wednesday, July 29, 2009

Get enough sleep

Sleepy men in Tehran, IranImage via Wikipedia

Lack of rest ups ghrelin, a 'hunger hormone' that stimulates one's appetite

Eveline Gan

THE benefits of a good night's sleep go beyond improving your concentration and overall well-being. Researchers have found that it is also good for your waistline.

Those who consistently fail to get enough sleep may experience weight gain, according to findings presented at Sleep 2009 in Seattle last month. The annual meeting of the Associated Professional Sleep Societies is attended by doctors, researchers and healthcare professionals.

A study on 92 healthy adults conducted by University of Pennsylvania found that those who had less than the average amount of sleep gained an average of 1.3kg during the 11-day experiment.

Another study on 1,000 volunteers conducted by Stanford University in California found that those who slept less than eight hours a night had higher levels of body fat. Those who reportedly slept the least weighed the most.

The findings are hardly surprisingly, since inadequate sleep affects the hormones that help control our appetite and metabolism, said local sleep specialist Dr Lim Li Ling.

According to Dr Lim, who is the director of Sleep Disorders Unit at Singapore General Hospital, sleep deprivation is "a stressful state which alters our body's hormonal environment".

Getting a good night's rest may also be good for your waistline.
Lack of sleep decreases the level of leptin, a hormone that makes one feel full after eating. It also increases the level ghrelin, a "hunger hormone" that stimulates one's appetite. This results in overeating and weight gain, said Dr Lim.

"People who don't get enough sleep may also feel tired and exercise less," she added.

For those who have less sleep because they stay up late, eating habits such as bingeing on calorie-laden foods to stay awake may be the reason behind the weight gain, said Ms Lim Su Lin, chief dietitian and senior manager at National University Hospital's dietetics department.

"To stay awake, they may resort to drinking high-sugar, caffeinated beverages or munching on tidbits," said Ms Lim. They may pile on the pounds as a result.

To control your appetite through the day, Ms Lim recommended sticking to three main meals a day at fixed times, and including fibre to your meals.

Fibre, which can be found in vegetables, fruits and whole grains, makes you feel full and thus deters snacking. Starting the day with a wholesome breakfast can also help you avoid binge eating later in the day.

For another group of people, the problem may be more serious than weight gain.

A substantial number of Singaporeans suffer from sleep disorders. Dr Lim estimated that 10 to 30 per cent of the local population have insomnia and up to 15 per cent have obstructive sleep apnea (OSA).

OSA is a condition where a person's upper airways are blocked during sleep. "When breathing is interrupted during sleep, the quality of sleep is affected," she said. Poor sleep is known to be as detrimental as lack of sleep.

So what constitutes a good night's sleep?

"It is simply one from which we wake up naturally (without an alarm clock), feeling refreshed, alert and able to function at peak mental performance," said Dr Lim. A person who sleeps well would not need to nap in the middle of the day.

The amount of sleep a person requires varies with age. According to Dr Lim, newborns may need as much as 16 to 20 hours, spread throughout the day, while young children should get 9 to 10 hours and teenagers, 8 to 9.5 hours.

Adults require 6 to 10 hours of sleep.

"Although some people take pride in getting by with very little sleep, most people who get fewer than five to six hours daily are probably not getting enough," said Dr Lim.

How to achieve a good night's rest
A guide to a good night's sleep - by Dr Lim Li Ling, director of Sleep Disorders Unit at Singapore General Hospital.

  • Try to go to bed and wake up at around the same time. Our sleep-wake patterns are regulated by an internal "clock" that dictates when we feel sleepy. When our daily activities synchronise with our internal clocks, we will naturally sleep better.
  • If you can't fall asleep within 15 to 20 minutes, leave the bedroom and do something relaxing, such as reading or listening to soft music. You should only return to bed when you feel sleepy again, however long it takes.
  • If you have insomnia, you should not read, watch TV or work in bed. Associating the bed with other types of activities, especially if they are stimulating, will make it harder to fall asleep.
  • Avoid caffeine - a stimulant that can stay in your body for over 10 hours - and stimulating activities close to bedtime. Stimulating activities include vigorous exercise, intense work and exciting TV programmes.
  • Long afternoon naps make it difficult for us to fall asleep at night and should be avoided.
  • A daily ritual to help us relax at the end of the day is a good lead-up to sleep. This can take the form of a taking a warm bath, dimming the lights, reading quietly or listening to soft music.
From TODAY, Business – Monday, 27-Jul-2009Reblog this post [with Zemanta]

H1N1: Two more people in ICU

Well, this is yesterday's news, but it is still noteworthy that H1N1 cases leading to death is mostly on pneumonia issue… so those on the high-risk group, take note, and beware.

TWO more people warded in intensive care have been diagnosed with the H1N1 virus.

One, a 45-year-old woman with a history of myasthenia gravis (a neuromuscular disease), went to the National University Hospital emergency department on Monday after experiencing breathing difficulty and four days of fever.

She was admitted directly to the ICU with a diagnosis of severe pneumonia and respiratory failure. Laboratory tests confirmed she has H1N1.

She was on ventilator support and critically ill, the Health Ministry said last night.

The second patient, a 25-year-old woman with a history of asthma, sought treatment at Tan Tock Seng Hospital's emergency department on Tuesday. She had three days of shortness of breath, cough and sore throat. She was subsequently transferred to the ICU for closer monitoring, and tests confirmed she had H1N1.

In all, 102 H1N1 cases are currently hospitalised, 12 of them in intensive care.

From TODAY, Home – Wednesday, 29-Jul-2009

Is this a waiting game?

None - This image is in the public domain and ...Image via Wikipedia

But I thought that the normal body temperature, if taken from the mouth or the armpit, is 37.7C and below. Fever starts from 37.8C up, is that right? Or did that change when H1N1 came?

Letter from David Soh Poh Huat

IT SADDENS me when I read about H1N1 cases in the intensive care units - it seems that nothing much can be done to prevent deaths from occurring.

We have all been told to expect a peak in the number of H1N1 cases and the only thing to do seems to be to wait for the vaccine, which is expected to be available in few months. Are we playing a "waiting game" with the virus?

A member of my family recently had a temperature reading of 37.4°C and went to a clinic near our home. It was a certified Pandemic Preparedness Clinic but although the counter has a glass panel, the staff were not wearing masks and did not take the patient's temperature when she registered. The doctor she saw said she had the flu.

Over the next three or so days, my family member's temperature was between 37.1°C-37.2°C. Subsequently she revisited the clinic, where another doctor said she did not have the flu, as only a reading of 37.5°C would be considered a fever.

So are we taking H1N1 seriously or lightly? We should not just focus on people with underlying medical conditions. There is publicity about the virus on television but I feel more can be done. Maybe posters should be put up in public places and schools cautioning people what to look out for, such as what to do if one's temperature exceeds a certain range, et cetera, and when to return to the doctor if the fever persists.

H1N1 is here to stay, so besides embracing it gracefully, more needs to be done to counter it.

From TODAY, Voices – Wednesday, 29-Jul-2009