As a Pediatrician, part of my job is to give anticipatory guidance to parents on how to spend quality time with their child and what not to do. And one day I realized that I do many of the things I tell families not to do.
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Children Without Worms (CWW), an organization dedicated to the worldwide control of worm disease, performed a survey in five Nicaragua communities in 2005, and documented a prevalence rate for worms of 49%!
Constipation is the infrequent passage of hard, difficulty to pass stool – that is the standard definition. Now for what we really see:
Let’s say your practice went out of business tomorrow. Who would miss you? Who would be bummed that you weren’t there anymore?
Although there is a difference in the emphasis in private practice versus academic practice, one can grow as a physician in either setting. The reward however is also very different in each setting.
The CDC reports that malaria is present in only 6 of the 17 departments (sort of provinces) of Nicaragua. The 6 reported departments are located on both the Pacific and Atlantic coasts and in the interior. The absence of reports in the other 11 departments must be a reporting anomaly. Mosquitos do not acknowledge borders.
Acute injuries vary from sport to sport, but the lower extremity (the knee in particular) is one of the most common joints injured in the young and older athlete.
Li wrote: “I saw an article you posted about potential causes for excessive urination for children. One of the mentioned problems involved constipation. Do you have any advice on where I can find more info on ways to relieve this problem through diet? I was told build up of old stool is the cause of my child’s urinary problems.”
We often forget about improving things in our medical practices. We get comfortable and complacent. We often assume, we do a good job, no need to fix what isn’t broken. But time and time again, I’m reminded that there is always areas of improvement. I’m also reminded that on occasion, we don’t do things as good as I see them in my mind.
