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Healthwatch

Concussion In Children: What To Know And Do

Concussion is one of the most common injuries to the brain, affecting about two million children and teens every year. It is a particular kind of injury that happens when a blow to the head or somewhere else on the body makes the brain move back and forth within the skull.

It's possible to get a concussion after what might seem like a minor injury, like a forceful push from behind, or a collision between two players in a football or soccer game.

What are the signs and symptoms of concussion?

Because the injury may not seem that significant from the outside, it's important to know the symptoms of a concussion. There are many different possible symptoms, including

passing out (this could be a sign of a more serious brain injury)

headache

dizziness

changes in vision

feeling bothered by light or noise

confusion or feeling disoriented

memory problems (such as difficulty remembering details of the injury) or difficulty concentrating

balance or coordination problems

mood changes.

Some of these are visible to others and some are felt by the person with the concussion. That's why it's important to know the signs and to ask all the right questions of a child who has had an injury.

Sometimes the symptoms might not be apparent right away, but show up in the days following the injury. The CDC's Heads Up website has lots of great information about how to recognize a concussion.

How can further harm to the brain be avoided?

The main reason it's important to recognize a possible concussion early is that the worst thing you can do after getting a concussion is get another one. The brain is vulnerable after a concussion; if it is injured again, the symptoms can be longer lasting — or even permanent, as in cases of chronic traumatic encephalopathy (CTE), a condition that has been seen in football players and others who have repeated head injuries.

If there is a chance that a child has had a concussion during a sports competition, they must stop playing — and get medical attention. It's important to get medical attention any time there is concern about a possible concussion, both to be sure there isn't a more serious brain injury, and to do a good assessment of the symptoms, so that they can be monitored over time. There are some screening questionnaires that are used by doctors that can be used again in the days and weeks after the concussion to see how the child is improving.

What helps children recover after a concussion?

Experts have struggled with figuring out how to protect the brain after a concussion. For a long time, the recommendation was to rest and do very little at all. This meant not doing any exercise, not going to school, not even reading or watching television. As symptoms improved, the restrictions were lifted gradually.

Over time, though, research showed that not only was this much rest not necessary, it was counterproductive. It turns out that getting kids back into their daily lives, and back into being active, is safe and leads to quicker recovery. Experts still recommend rest and then moving gradually back into activities, but the guidelines are no longer as strict as they once were.

One important note: A medical professional should guide decisions to move from rest to light activity, and then gradually from there to moderate and then regular activities based on how the child is doing. This step-by-step process may extend for days, weeks, or longer, depending on what the child needs. Parents, coaches, and schools can help support a child or teen as they return to school and return to activities and sports.

Some children will be able to get back into regular activities quickly. But for others it can take weeks or even months. Schools and sports trainers should work with children to support them in their recovery. Some children develop post-concussive syndromes with headache, fatigue, and other symptoms. This is rare but can be very disabling.

How can parents help prevent concussions?

It's not always possible to prevent concussions, but there are things that parents can do:

Be sure that children use seat belts and other appropriate restraints in the car.

Have clear safety rules and supervise children when they are playing, especially if they are riding bikes or climbing in trees or on play structures.

Since at least half of concussions happen during sports, it's important that teams and coaches follow safety rules. Coaches should teach techniques and skills to avoid dangerous collisions and other injuries. Talk to your child's coaches about what they are doing to keep players safe. While helmets can prevent many head injuries, they don't prevent concussions.

Source: Harvard Health Publishing

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Healthwatch

Ever Hear Of Tonsil Stones?

Recently, a friend asked me about tonsil stones. He has sore throats several times a year, which are instantly relieved by gargling to remove them. When I told him I thought tonsil stones were pretty rare, he asked: "Are you sure about that? My ear, nose, and throat doctor says they're common as rocks." (Get it? stones? rocks?)

It turns out, my friend and his doctor are on to something. Tonsil stones are surprisingly common and often quite annoying. Here's what to know and do.

What are tonsil stones?

Tonsil stones (medical term: tonsilloliths) are small white or yellow deposits on the tonsils. They develop when bacteria, saliva, food particles, and debris from cells lining the mouth get trapped in tiny indentations called crypts.

They vary considerably between people, including:

Size. They may be so small that you can't see them with the naked eye. Or they may grow to the size of gravel or, rarely, much larger.

Consistency. They're often soft but may calcify, becoming hard as a rock. Hence, the name.

How long they last. Tonsil stones can last days to weeks, or may persist far longer before they break up and fall out.

How often they occur. New tonsilloliths may appear several times each month or just once or twice a year.

While they're more likely to form if you have poor oral hygiene, good oral hygiene doesn't provide complete protection. Even those who brush, floss, and see their dentists regularly can develop tonsil stones.

How common are tonsil stones?

You've heard of kidney stones and gallstones, right? Clearly, those conditions are better known than tonsil stones. Yet tonsil stones are far more common: studies suggest that up to 40% of the population have them. Fortunately, unlike kidney stones and gallstones, tonsil stones are usually harmless.

What are the symptoms of tonsil stones?

Often people have no symptoms. In fact, if tonsil stones are small enough, you may not even know you have them. When tonsil stones do cause symptoms, the most common ones are:

sore throat, or an irritation that feels as though something is stuck in the throat

bad breath

cough

discomfort with swallowing

throat infections.

Who gets tonsil stones?

Anyone who has tonsils can get them. However, some people are more likely than others to form tonsil stones, including those who

have tonsils with lots of indentations and irregular surfaces rather than a smooth surface

smoke

drink lots of sugary beverages

have poor oral hygiene

have a family history of tonsil stones.

How are tonsil stones treated?

That depends on whether you have symptoms and how severe the symptoms are.

If you have no symptoms, tonsil stones may require no treatment.

If you do have symptoms, gargling with salt water or removing tonsil stones with a cotton swab or a water flosser usually helps. Avoid trying to remove them with sharp, firm objects like a toothpick or a pen, as that can damage your throat or tonsils.

If your tonsils are inflamed, swollen, or infected, your doctor may prescribe antibiotics or anti-inflammatory medications.

Is surgery ever necessary?

Occasionally, surgery may be warranted. It's generally reserved for people with severe symptoms or frequent infections who don't improve with the measures mentioned above.

Surgical options are:

tonsillectomy, which is removing the tonsils

cryptolysis, which uses laser, electrical current, or radio waves to smooth the deep indentations in tonsils that allow stones to form.

Can tonsil stones be prevented?

Yes, there are ways to reduce the risk that tonsil stones will recur. Experts recommend the following:

Brush your teeth and tongue regularly (at least twice a day: in the morning and before sleep).

Floss regularly.

Gargle with salt water after eating.

Eliminate foods and drinks that contain a lot of sugar, which feeds bacteria that can help stones form.

Don't smoke, because smoking irritates and inflames tonsils, which can encourage stone formation. The same may apply to vaping, though there is limited research to rely upon.

The bottom line

Considering how common tonsil stones are and how bothersome they can be, it seems strange that they aren't more well known. Maybe that's because they often get better on their own, or people figure out how to deal with them without needing medical attention.

I hope you aren't one of the many millions of people bothered by tonsil stones. But if you are, it's good to know that they're generally harmless and can be readily treated and prevented.

Now that you know more about them, feel free to spread the word: tonsil stones should be a secret no more.

Source: Harvard Health Publishing

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Healthwatch

Can You Strong-arm Diabetes?

There is a strong link between diabetes and fitness. Many studies have shown that people with type 2 diabetes lose more muscle mass and strength over time than people with normal blood sugars. This is thought to be a major reason why diabetes is associated with functional limitation, impaired mobility, and loss of independence. Studies have also shown that combining aerobic and resistance training can not only improve blood sugars in people who have diabetes, but can also prevent diabetes from developing.

For these reasons, scientists are very interested in the relationship between diabetes and fitness, teasing out the differences between muscle strength and cardiorespiratory fitness.

In a 2019 study published in the journal Mayo Clinic Proceedings, researchers looked at 4,681 adults, measured their muscle strength and cardiovascular fitness, and followed them over about eight years. Both upper and lower body muscle strength were measured using bench and leg presses at increasing loads, and participants were scored as having low, medium, or high strength based on the maximum weight lifted per kilogram of body weight.

They found that those with medium strength had a 32% reduced risk of developing diabetes than those with low strength. This is all fine and good and consistent with prior research. However, they did not see that those with high strength had any further reduction of diabetes risk. As a matter of fact, there was no association at all.

How could this be?

The authors focus largely on the also very important cardiorespiratory fitness factor. They point out that those participants with medium strength also tended to have good cardiorespiratory fitness, with good correlation between the two. However, in the low and high strength groups, it was a bit of a mix, with some people in the low strength group having high cardiorespiratory fitness, and vice versa. They point out that there may be added benefit to having both good muscle strength and good cardiorespiratory fitness, not just good muscle strength alone.

But another consideration is how things like strength and cardiorespiratory fitness are measured. It's important to note that just about every study looking at muscle strength uses a different method than this study. Hand grip strength is very common, for example. One large 2018 study of 8,208 Korean adults found that stronger hand grip strength was significantly associated with lower fasting blood sugars, HbA1c levels, and fasting insulin levels (all markers of prediabetes and diabetes). It's possible that hand grip is somehow a superior method of measuring strength than bench and leg press, or vice versa.

Maybe cardiorespiratory fitness is the more important factor after all?

This has been found to be particularly important in diabetes prevention. One large 2018 study out of Japan looked specifically at cardiorespiratory fitness (as measured by oxygen uptake while exercising on a cycle ergometer) in 7,804 men, and followed them over about 20 years, checking several times to see if anyone developed diabetes. They found that higher cardiorespiratory fitness was significantly associated with lower risk of developing diabetes at all follow-up periods. This is a pretty powerful association, though it would be good to do this study in women and in other ethnic groups.

Let's look at the big picture

Being in good overall shape, meaning having both decent muscle strength and cardiorespiratory fitness, is just good for you. Both can very likely lower your risk of developing diabetes, and even if you have diabetes, being fit can improve your blood sugars.

Follow me on Twitter @drmoniquetello

Resources

Association of Muscular Strength and Incidence of Type 2 Diabetes. Mayo Clinic Proceedings, March 11, 2019.

Accelerated Loss of Skeletal Muscle Strength in Older Adults with Type 2 Diabetes. Diabetes Care, June 2007.

Patients With Type 2 Diabetes Show a Greater Decline in Muscle Mass, Muscle Strength, and Functional Capacity With Aging. Journal of the American Medical Directors Association, August 2013.

Muscle dysfunction in type 2 diabetes: a major threat to patient's mobility and independence. Acta Diabetologica, December 2016.

Effects of Aerobic and Resistance Training on Hemoglobin A1c Levels in Patients with Type 2 Diabetes. JAMA, November 24, 2010.

Association between muscle strength and type 2 diabetes mellitus in adults in Korea. Medicine, June 2018.

Long-term Impact of Cardiorespiratory Fitness on Type 2 Diabetes Incidence: A Cohort Study of Japanese Men. Journal of Epidemiology, May 5, 2018.

Source: Harvard Health Publishing

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Instablog9ja

Findings In Power Sector Will Make You Cry – EFCC Chair Olukoyede

The Executive Chairman of the Economic and Financial Crimes Commission (EFCC), Ola Olukoyede, has revealed that the extent of corruption within the power sector is distressing enough to bring people to tears.

Olukoyede made the revelation during an oversight visit by the House of Representatives Committee on Financial Crimes to the EFCC’s headquarters in Abuja, on Tuesday, November 12.

“As we speak, we are grappling with electricity. If you see some of the investigations we are carrying out within the power sector, you will shed tears.

People were awarded contracts to supply electricity equipment. Instead of using what they call 9.0 guage, they will go and buy 5.0.

Every time you see the thing tripping off, the thing gets burnt, and all of that, it falters and it collapses. It’s part of our problems,” he said.

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God Stopped Naira From Falling To ₦10,000 Per Dollar Because Of Our Prayers — Pastor Adeboye

The General Overseer of the Redeemed Christian Church of God (RCCG), Pastor E.A. Adeboye, has stated that, without divine intervention, the exchange rate could have reached ₦10,000 for $1.

Speaking at the Special Holy Ghost Congress in Abuja, he attributed Nigeria’s financial struggles to its reliance on fuel imports and the ongoing issue of non-operational refineries.

According to him, “We need help, and it’s not human help; it’s divine help. Before our current president took office, we were aware that the root of our financial issues lay in the importation of petrol. Despite having oil, we continued to import petrol and waste billions on refineries that did not operate effectively.

When the president cancelled the subsidy on petrol imports, those who benefited from it became upset and created more problems.”

As the naira continued to decline rapidly, Adeboye said that he prayed and was grateful that others joined him in prayer.

“If God hadn’t intervened, $1 could have been worth N10,000 by now. This illustrates how much we need prayers,” he added.

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Senator Shuaibu Isa Lau’s Wife Reportedly Asks Police To Detain Skit Maker After He Criticised Her Husband Over Road Conditions

Police in Taraba State, reportedly following orders from Hajia Fatima Lau, the wife of Senator Shuaibu Isa Lau of Taraba North, arrested and detained skit maker Nafiu Hassan for several days, according to SaharaReporters.

Lau is a member of the Peoples Democratic Party (PDP) and the Deputy Senate Minority Leader.

Hassan had done a skit where he decried the deplorable condition of roads in the senatorial district. He said that many of the roads are now killing zones due to their bad state.

However, a source who spoke with the news outlet said: “Nafiu Hassan made a video about a month ago about bad roads and dilapidated health facilities in Taraba North. However, this video led to his arrest last Wednesday and he was detained till Sunday.

He was arrested by the police on the orders of the Senator’s wife. Nafiu was passing through the Senator’s street while the wife, Hajia Lau, was about to enter her residence in Old Commissioner Quarters in Jalingo.

So, she saw him and created a scene knowing he was the one that made a video about bad roads and dilapidated healthcare facilities in her husband’s village. She termed that as defamation of character and then ordered policemen attached to her to immediately arrest him. [SWIPE]

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