Friday, 19 March 2010

Ear Wax … it good or bad for your child?

Many parents ask ‘which is the best way to remove the wax from the ear?’

Actual question should be 'Do you really need to remove the wax in the ear??'

First of all wax has some protective function in our ears. Wax lubricates the ear canal and prevents drying of the skin. It also helps in cleaning along with the jaw movements. Some literature suggests that the wax protects from some of the infections. So, it is not all that bad!

However excess wax or impacted wax may result in impaired hearing.

You do not need to clear the wax from your child’s ear routinely. One should attempt to remove the wax only if it is giving you problems. If in doubt get your child’s ear checked. For most cases softening the wax with olive oil or almond oil is enough to move the wax. Well impacted wax may have to be removed by a procedure called ‘syringing’ by your doctor. Other commercial preparations may be available in some countries to soften the ear wax. Using cotton buds is not advisable. These buds may push the wax further in.

A little wax in your child’s ear? Let it be ….relax.

Does your child suffer from ear infection?

Most of you may have come across children screaming with ear ache. The most common cause of ear ache in children is ear infection. The short tube (eustacian tube) in their ear which gets blocked easily makes them susceptible to ear infection. Infection of the middle ear, known as ‘otitis media’ in medical language is very common in children. About 1 in 4 children suffer from ear infection at some time during their first 10 years. There are different types of ear infection. The two most common types are discussed here.

1. The commonest presentation is a child presenting with fever, earache and irritability. This may be preceded by respiratory tract infection such as cold or cough. Younger children may pull their ears. These symptoms are suggestive of ‘acute ear infection (otitis media)’. In severe cases ear drum (tympanic membrane) may perforate and there will be discharge of pus into the ear canal which parents may notice.
Diagnosis is based on these symptoms and when your doctor looks into the child’s ear with an instrument called ‘otoscope’, ear drum may look red and bulging.

Treatment: Most of the time ear infection resolves on its own. Pain can be treated with simple medicines such as paracetamol. Some cases may need antibiotics. If you are prescribed antibiotics please complete full 5 day course. Incomplete course of antibiotics may lead to further complications.

2. Glue ear: This condition is not associated with ear ache. Glue ear is very common in children. Normally children present with reduced hearing capacity. Sometimes the child’s written performance is much better than the oral performance and this comes to the attention of teachers in school indicating the possibility of hearing problem.

Most of the time glue ear resolves on its own. Children who are > 3 years or who have a speech/ language/ developmental problem should be seen by ENT specialists. These children may need adenoidectomy or ‘grommet’ insertion.

School age children with suspicion of hearing problem should have their hearing accurately assessed by what is known as ‘audiometry’.

IMPORTANT: When the child has ear ache DO NOT put oil into the ear.

If you are concerned about your child’s hearing do seek medical opinion. He may be suffering from a treatable condition.

Type I Diabetes- Treatment

Type I diabetes can not be cured, but can be kept under control. INSULIN is the only treatment for this type of diabetes. Together with insulin, diet and exercise play an important part in the management of diabetes.

Insulin: As mentioned in the previous posts insulin is a hormone secreted by pancreas and it is lacking in patients with diabetes. These patients can be given insulin in the form of injections to control their blood sugar. If swallowed, our stomach will simply digest insulin. Therefore it has to be given in the form of injection. In the past, insulin was derived from animals such as cows and pigs. Currently, human insulin is available in the market. It is much safer to use this type of insulin. Various types of insulin are available. Depending on the timing of the onset, peak and duration of their action, they are classified as short acting, intermediate acting and long acting insulin. In addition there are rapidly acting and slow acting insulin analogues. Availability of various forms of insulin gives more flexibility to how we treat diabetes. Insulin injections can be given using various devices.

Simplest and cost effective way is to inject using a needle and a syringe.

                                A little more expensive device but easy to use is ‘insulin pens’.


Insulin can also be given using a pump. Pumps are very expensive, but give flexibility to the patients.

Using each of these devices requires a lot of guidance and education and details will be explained in future posts.

Diet: Diet plays a very important role in controlling your diabetes. Never skip your meals, especially if you have taken your insulin. Always follow your meal plan according to the advice given by your dietician.

Physical Activity: Physical activity improves the action of insulin and helps to keep the blood sugars low.

Thus, treatment of diabetes involves a combination of insulin treatment and patient education.

Remember, insulin should be used as advised. Improper use of insulin could be dangerous.