La Importancia de Tomar Agua

Como todos sabemos, el agua es parte fundamental en nuestra vida diaria, y está presente en nuestras vidas y donde menos lo pensamos, y sobre todo con significados diferentes para cada uno. Como por ejemplo, para los químicos es un compuesto estable formado por 2 átomos de hidrogeno y 1 de oxígeno, uno de los estados de la materia que puede estar en varios estados como sólido, líquido y gaseoso; para los geólogos constituye que el 71% de la tierra está conformado por agua, y claro, en el ser humano constituye al menos dos terceras partes de esta. En definitiva, el agua es importante para nuestro funcionamiento, es como el aceite del carro que necesitamos para que cada una de nuestras células funcione en su más óptima tarea. La ausencia de agua siempre ha estado asociada con la desaparición de los seres vivos, es por lo que se dice que “el agua es indispensable para la vida del ser humano”. Es el principal termo regular del organismo, permite conseguir un equilibrio de temperaturas en todo el cuerpo. Nuestro organismo, y de cualquier otro ser vivo, necesita agua para funcionar normalmente, puesto que tanto las reacciones bioquímicas como el transporte adecuado de las sustancias tiene lugar en solución acuosa.

Como sabemos el agua es incolora y su color es el resultado de fenómenos de difusión, absorción y sobre todo, reflexión/refracción de la luz que penetra la superficie marina y oceánica.

Se dice que un feto humano a los tres días contiene un 94% de agua y que cuando se convierte en bebé alcanza el 75 % de agua, siendo en la vejez la menor cantidad de agua que es del 65%. La sangre contiene un 83 %, los músculos un 76% y el cerebro un 75%. Los huesos, que quizás a priori podrían parecer carentes de agua, están formados por un 22% de agua. Por todos estos datos, es fácil darse cuenta de la importancia que tiene el agua para el organismo.

El organismo, cada día pierde una media de dos litros de agua al día entre la respiración y la traspiración de la piel y la orina. Es por ello que los médicos aconsejan beber hasta dos litros de agua diarios, o aportarlos en la dieta ya sea con frutas o con vegetales que contengan gran cantidad de agua.

La sed aparece en el organismo cuando se pierde el 2 % del agua, lo que equivale a un litro de agua. Tras perder el 10 %, lo que equivale a 5 o 6 litros, se sufren alucinaciones y la piel se contrae. A partir del 15 %, 8 o 9 litros se puede morir.

El agua es importante para el organismo ya que actúa en la fabricación de las células, ayuda en los jugos digestivos, participa en las señales eléctricas entre músculos, transporta la sangre y elimina los desechos y los filtra a través de los riñones.

En condiciones normales, un ser humano cada día pierde unos dos litros de agua entre el sudor, la respiración, la orina y las defecaciones, y estos dos litros deben ser recuperados cada día, ya sea ingiriendo agua, refrescos,  fruta, alimentos acuosos, etc. Lo lamentable y triste es que al gua está al alcance de nuestra mano, en cada una de las casas, siempre existe un grifo del que poder beber, pero aun así, la mayoría de las personas del primer mundo, sufren de lo que se suele denominar “deshidratación crónica” ya que no beben el líquido suficiente, y luego se quejan de cansancio general. Tan solo bebiendo un poco más de agua cada día podría solucionarse.

El cerebro humano, está compuesto de un 95 % de agua, la sangre de un 82%, y los pulmones de un 90% de agua. Es por ello, que apenas una disminución de un 2% en la composición de nuestro cuerpo puede causar ya los primeros síntomas de deshidratación, como son la perdida momentánea de la memoria, problemas con las matemáticas, dificultad en enfocar la mirada en objetos o letras pequeñas, etc…

Un déficit de agua del 4% acarrea dolores de cabeza, irritabilidad, somnolencia y graves dificultades de concentración. Si alcanzamos un 10% de pérdida de peso corporal debido a la deshidratación, podemos perder la vida.

Un mantenimiento diario del agua que consumimos puede ser un papel clave en la prevención de enfermedades. Por ejemplo, beber 8 vasos de agua al día, en caso de no tomar frutas y otros alimentos acuosos, puede reducir el riesgo de cáncer de colon en un 45 % y el de vejiga en un 50%. El agua puede también ser beneficiosa en la prevención y cura de muchos tipos de enfermedades y dolencias que afectan a muchos sistemas del ser humano.

Dado que el agua es un componente tan importante para nuestra fisiología, debemos tener en cuenta tanto la cantidad como la calidad del agua que tomamos. El agua debe ser siempre potable, limpia, libre de contaminantes. Pero no todo es beber agua, es importante recordar que para mejorar su salud, conviene el ejercicio regular, una alimentación equilibrada y una actitud positiva ante la vida. Nos sorprenderíamos de saber de la propia capacidad natural que tiene el ser humano para curarse a sí mismo, así que ayudémoslo y ahora mismo tomemos un vaso de agua.

Dra Karla Monterrosa, NPH El Salvador

More stories on the importance of water at:https://www.nph.org/ws/page.php?path=homes/honduras/children/CleanWater.php

Club Foot or Foot Zambo

Club Foot, also called Foot Zambo, is a congenital malformation in which the affected foot, could be one or both, appears to have been rotated internally to the ankle. Often times it appears as if the person is walking on their ankles. It is a birth defect in which the foot is crooked or inverted inwards and downwards, resembling a golf club. Without treatment, affected people experience pain, discomfort and difficulty in mobility.

Before and After

Causes:·

  • Studies indicate that tendons have much denser tissues and equally more cells and less lax tissue than normal tissues. Therefore the ligaments and muscles are too tense to allow a correct placement of the bones with a simple manipulation.
  • Genetic or familial
  • Mechanical cause due to lack of space for the formation of the fetus during pregnancy
  • Neuromuscular diseases

Diagnosis:

In some cases, it is usually possible to visualize the malformation in the ultrasound study of the fetus at 20 weeks of gestation. The diagnosis is confirmed after birth, observing the shape of the foot down (equine) and inside (varus), and checking that by manipulation, not able to obtain a normal position.

Treatment:

There are two methods of treatment:·”French Method of Physical Therapy”: Use the fixation to maintain the correct posture. Foot manipulations begin within one to two weeks of birth.·

“Ponseti Method”: Consists of performing soft manipulations to obtain the best possible alignment with the plaster bandage. This pattern is repeated every week with complete correction of the deformity is achieved except the tipped position. At this point a small intervention should be performed, percutaneous Achilles tendon lengthening, with local anesthesia and no hospitalization is needed.

NPH case:

A seven year old boy living in one of NPH homes arrived in 2015 having difficulty walking. The diagnosis was obvious “Congenital Bilateral Club Foot”. The doctor from the NPH clinic consulted with several specialists in the country and abroad. After careful consideration of the case, the medical staff local and international decided to go for the conservative approach known as the Ponseti Method, before going with painful and invasive surgeries. After 10 months of weekly work changing the cast and physical therapy,  the patient was ready for minor surgery, elongation of the Achilles Tendon. After eight days he was dismissed from the hospital and has follow up with physical therapy. The treatment of club foot should start right away after birth. This boy was so lucky to arrive to NPH and get treatment since otherwise he would continue living on the streets and forever being the center for jokes and mocking.

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PIE EQUINO VARO bilateral congénito, También llamado: Pie Zambo, es una malformación congénita, en la cual este aparece en punta (equino), y con la planta girada hacia adentro (varo).

Es un defecto de nacimiento, en el que el pie se encuentra torcido o invertido hacia adentro y hacia abajo, semejando un palo de golf. Sin tratamiento, las personas afectadas frecuentemente aparentan caminar apoyados en sus tobillos

Causas:

  • Los estudios indican que los tendones tienen tejidos muchos más densos e igualmente más células y menos tejido laxos, que los tejidos normales. Por tanto los ligamentos y músculos están demasiados tensos para permitir una correcta colocación de los huesos con una simple manipulación.
  • Genética o familiar
  • Causa mecánica por falta de espacio para la formación del feto durante el embarazo.
  • Enfermedades neuromusculares.

Diagnostico:

En algunas ocasiones suele ser posible la visualización de la malformación en el estudio ecográfico del feto en las 20 semanas de gestación.

El diagnostico se confirma tras el nacimiento, observando la forma del pie hacia abajo (equino) y adentro (varo), y comprobando que por manipulación no somos capaces de obtener una posición normal.

Tratamiento:

Existen básicamente dos métodos de tratamiento:

“Método francés de fisioterapia”: Usa la fijación para mantener la postura correcta. Las manipulaciones del pie comienzan en una o dos semanas de nacidos.

“Método Ponseti”: Consiste en la realización de manipulaciones suaves hasta obtener la mejor alineación posible con el vendaje de yeso, esta pauta se repite cada semana, se consigue la corrección completa de la deformidad excepto la posición de puntillas. En este punto se debe realizar una pequeña intervención, alargamiento percutáneo del tendón de Aquiles, se realiza con anestesia local y no necesita hospitalización.

Este es el caso el niño de 7 años de edad quien ingreso en el 2015, con pie Equino Varo, este fue llevado con varios Especialistas, quienes ofrecían operaciones en los pies del niño, pero el tercer Traumatólogo lo refirió a Managua al Hospital de Especialidades de niños.

El niño, fue valorado por el especialista en Traumatología del hospital infantil, quien inicio un tratamiento conservador, según Método Ponseti, en Enero del 2016 y termino después de 10 meses , en Octubre del 2016 , fechas en la que ya le realizaron una cirugía de elongación del tendón de Aquiles. Fue dado de alta a los 8 días ya con sus pies alineados y continuidad por parte de Fisioterapia.

El niño ha tenido una buena evolución, sigue con sus actividades normales.

Foto de su llegada a NPH antes del tratamiento 2015

Dra Silvia Echaverry , Medico NPH Nicaragua and Julia Spettel, NPHI RMC Nicaragua, El Salvador, Peru and Bolivia

May is Mental Health Awareness Month

May is Mental Health Awareness Month and the first week of the month is dedicated to create children’s mental health awareness.

  • Mental Health is an important and integral part of the adolescents’ wellbeing.
  • Mental Health is not simply the presence or absence of symptoms. It includes general feeling and functioning, as well as having resilience when facing a setback.
  • Adolescence is a time where mental health disorders first appear.
  • Two- thirds of adults with psychiatric problems began between the ages of 15-25.
  • Most adolescents enjoy a positive mental health development, though more than a third of this group have experienced or currently are experiencing anxiety, depression symptoms or a debilitating mental health disorder.
  • Everyone feels worried or anxiety at times; adolescents experience strong emotions as part of their normal development but when symptoms persist for more than two weeks and interfere with their daily lives, it can be a warning sign for the adults caregivers.
  • Suicide deaths (usually prompted by a mental health disorder) globally surpass vehicle accidents at the age of 10-14, and is the second leading cause of death among 15-24 year olds.
  • Mental health support starts at the home, school and at the health professional office (physician or psychologist).
  • Adolescents should have access to Mental Health services breaking the barriers of stigma, ignorance and misunderstanding.

The maturation process in adolescents to adults is through changes and development, facing issues that most of them will overcome.

Key aspects in their development to empower youths:

  • Healthy relationships with peers and caring adults
  • Helping them to build a positive mental health & physical health habits as they grow and change
  • Coping, resilience, good judgment for good/right decisions
  • Healthy eating habits, exercise, preventing substance abuse
  • Inform and educate on reproductive health and teen pregnancy
  • Substance use and abuse 

Ways to support

  • Caring adults
  • Clinical prevention
  • Crisis intervention
  • Education

For all adults and peers living with adolescents or teenagers and according to the NIMH (National Institute of mental health – US) a child or teen might need help if they:

  • Often feel very angry or very worried
  • Have difficulty sleeping or eating
  • Are unable to enjoy pleasurable activities they used to enjoy
  • Isolate themselves and avoid social interactions
  • Feel grief for a long time after a loss or death
  • Use alcohol, tobacco, or other drugs
  • Exercise, diet, and/or binge eat obsessively
  • Hurt other people or destroy property
  • Have low or no energy
  • Feel like they can’t control their emotions
  • Have thoughts of suicide
  • Harm themselves (e.g., burning or cutting their skin)
  • Think their mind is being controlled or is out of control
  • Hear voices

At NPH a comprehensive assessment physical, developmental and psychological is given upon entrance and is monitored and followed up by the clinic staff (doctor and psychologist) if there is a mental health diagnosis. This helps to prevent future complications.

Most NPH children experience some sort of PTSD , because of their background before entering NPH and if they had suffered violence, abuse of any type of abandonment and neglect.

Around 2% need to have consultation with external specialists and have psychiatric treatment.

NPH uses an interdisciplinary team including physician, psychologist, occupational therapist, art therapist and physical therapist to support children.

NPHI Medical Services

Data from

US department of health and Human Services

NIH National Institute of Health

MGMH Movement for Global Mental Health

Today is World Malaria Day!

MOSQUITO-TRANSMITTED DISEASES
Countries where NPH works have a high prevalence of high-impact diseases, especially during the rainy season. Cleaning surroundings in our community is important to prevent the breeding sites of mosquitoes. Any collection of water is a threat for disease incubation. Fumigation and mosquito nets are necessary to prevent infectious, transmitted diseases such as zika, chikungunya, dengue or malaria.

The NPHI Medical Services team and local clinics work hard to apply our mission statement to our daily work: striving to reach an optimum health and wellbeing for children to live as healthy as possible. The success relies on the close cooperation between the Medical Services team and local staff, and establishing collaborative partnerships with local public health facilities and other NGOs.

Chikunguya in the Dominican Republic

The fever caused by the Chikunguya virus represents a new problem for the Ministry of Health in the Dominican Republic. Chikunguya began in February 2014, but before in December 2013, the Pan-American Health Organization, alerted the countries of the region of Americas. This disease for the first time affected the Dominican Republic, a very susceptible population, since it is transmitted by the mosquito Aedes aegypti. This type of mosquito is present in the entire country, which is the reason why a great number of cases were presented.

The origin of the word Chikunguya comes from the African language Makonde, which means: to bend by pain.

It is transmitted through the mosquito bite that can also produce dengue and yellow fever. This mosquito is easily recognized because it has a white circular stripe on the legs. When these mosquitoes bite a person with Chikunguya the transmission cycle starts.

Symptoms.

  • Sudden high fever, accompanied by multiple bilateral or symmetrical pains of variable intensity. In some cases the pain is so intense that it produces functional disability.
  • After a few days, a pruritic macular rash may occur.
  • Other: headache, diffuse back pain, myalgia, nausea, vomiting and conjunctivitis.

Subacute and chronic symptoms can occur from days, months or even years from the onset of symptoms. The main manifestation is arthritis.

Among the atypical manifestations of Chikunguya is neurological, ocular, cardiovascular, dermatological, renal, damage among others.

Among the complications described associated with Chikunguya:

  • Respiratory failure
  • Cardiovascular decompensation
  • Meningoencephalitis
  • Acute hepatitis

Severe cutaneous manifestations:

  • Shock and bullous lesions

The majority of these manifestations are observed in patients over 65 years of age and in children younger than one year and in patients with chronic diseases, diabetes, lupus among others.

The diagnosis is basically clinical, starting from the definition of the case suspected and family, community or work contact with other cases.

The differential diagnosis should be made with disease prevalent in the country, dengue, for the following reasons:

  • They are viruses transmitted by the same vector
  • Clinical manifestations are similar

Among the differential diagnoses with other diseases :

  1. Leptospirosis
  2. Malaria
  3. Childhood exanthematic diseases
  4. HIV infection
  5. Infectious mononucleosis

Measures to prevent are:

  1. Avoid conserving water in containers outside, tanks of deposits or water for domestic use
  2. Avoid accumulating garbage among others

If you have symptoms, go to your nearest health center for care and treatment.

Contributed by: Dr. Maria Reyes

Family and Community Doctor, NPH Dominican Republic

 

Today is World Health Day!

The impact of NPH’s healthcare in developing countries is significant. We not only provide comprehensive care for the children living in NPH homes, but also for patients from the community and children attending NPH schools. NPH clinics support these students by providing: annual medical exams, nutrition, vision and hearing screening, dental care, immunizations, deworming twice a year, supporting and finding solutions for special cases identified during screening, health education, and therapies according to availability.

See or amazing statistics below or check out our videos in honor of World Health Day at:

NPH Healthcare
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St. Damien Pediatric Hospital

The Common Ear Infection


The most common infections among NPH children, like in any other environment, are upper respiratory infections, and among them, ear infections or otitis which is a very frequent condition

An ear infection happens when a bacterial or viral infection affects the middle ear. Most ear infections happen when a child has previously had a cold for a few days.

Middle ear infections are also called otitis media. They are very common, especially in children between 6 months and 3 years of age. They are usually not serious and aren’t contagious, though can be painful because the inflammation and fluid buildup.

Ear infections can be chronic or acute. Acute ear infections are painful but don’t last more than a few days. Chronic ear infections they can recur many times. Chronic ear infections can cause permanent damage to the middle and inner ear and loss hearing.

Viruses or bacteria cause middle ear infections. Germs travel from the back of the throat when the Eustachian tube is swollen from a cold, causing infection in the middle ear. In some cases, children with an ear infection may also have fluid draining from the ear.

Some groups are more prone to have ear infections:

  • Children less than 5 years old, because they have shorter Eustachian tubes.
  • Children who attend daycare, because they tend to have more colds.
  • Babies who are being bottle fed, especially if they swallow milk while lying too flat, it can enter the Eustachian tube and increases the risk of an ear infection.

Symtoms:

  • unexplained fever
  • trouble sleeping
  • tug or pull at their ears
  • difficulty hearing quiet sounds.