Dr. Deepak Sharan media
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Here is a selection of my articles/interviews on paediatric orthopaedics and school health:

Articles on backpack safety

  1. Lighter bags make happier children
    Expert Speak
    Bangalore, The Times of India, August 21st, 2005

  2. Weighty matter: Heavy bags make schooling a burden for city children
    Author: Shilpa Bala
    Bangalore, The Indian Express, August 6th, 2005

  3. Backs pack up under the weight
    Author: Vinita A Shetty
    Bangalore, The Times of India, May 24th, 2005

  4. Heavy school bags cause musculoskeletal disorders: Study
    Kochi, Daily Excelsior, August 13th, 2004

  5. Beating the backpack blues
    Author: Dr Deepak Sharan
    Bangalore, The Times of India, July 24th, 2004

  6. Sharing the child's burden
    Author: Dr Deepak Sharan
    Bangalore, The Times of India, July 17th, 2004

  7. The school's role in backpack safety
    Author: Dr Deepak Sharan
    Bangalore, The Times of India, July 10th, 2004

  8. The art of carryng backpacks
    Author: Dr Deepak Sharan
    Bangalore, The Times of India, July 3rd, 2004

  9. How to choose a backpack
    Author: Dr Deepak Sharan
    Bangalore, The Times of India, June 26th, 2004

  10. Backpacks cause bad backs
    Author: Dr Deepak Sharan
    Bangalore, The Times of India, June 19th, 2004

  11. School Blues: Backpack to bad back
    Author: Shilpa Bala
    Bangalore, Vijay Times, June 8th, 2004

  12. 'Heavy backpacks affecting children'
    By Staff Reporter
    Bangalore, The Hindu, July 5, 2003

  13. Save your child's back
    Author: Kanak Hirani Nautiyal
    Bangalore Times, The Times of India, May 26, 2003

  14. Pack that schoolbag, lighten that load!
    Author: Shilpa Sebastian R.
    Bangalore, The Hindu, July 10, 2003

  15. The Hindu NIE workshop today
    Bangalore, The Hindu, July 4, 2003

  16. Backpacks Make for Bad Backs
    Author: Seth Swift
    Easterneronline.com (USA), October 23, 2002

  17. Weighed down
    Author: Panchalee Thakur
    Bangalore Times, The Times of India, October 11, 2002

  18. Schoolbag stress
    Author: Asha Chowdary
    Bangalore Times, The Times of India, June 27, 2002


Articles on other aspects of Paediatric/General Orthopaedics:

  1. Recoup: A rehab centre for corporates
    Bangalore, The New Indian Express, April 24, 2006
    http://www.newindpress.com/NewsItems.asp?ID=IE120060424033545&Topic=&Title=Bangalore&Page= s

  2. How's your metatarsal, Mike?
    Author: Ruma Singh
    Bangalore Times, The Times of India, April 28, 2006

  3. Fast Forward (Mobile Matters)
    Times News Network
    Bangalore, The Times of India, July 17, 2005

  4. X treme fashion: dangerously edgy
    By Asha Chowdary
    Bangalore Times, The Times of India, March 24, 2005

  5. New surgical procedure to treat cerebral palsy
    By Shyama Rajagopal
    Kochi, The Hindu, October 31, 2004
    http://www.hindu.com/2004/10/31/stories/2004103115880300.htm or READ HERE

  6. Workshop on cerebral palsy
    By Staff Reporter
    Kochi, The Hindu, October 19, 2004
    http://www.epilepsy.com/newsfeed/pr_1098192604.html or READ HERE

  7. Seminar on developmental pediatrics
    By Staff Reporter
    Bangalore, The New Indian Express, November 24, 2003

  8. Help for children with cerebral palsy
    By Staff Reporter
    Bangalore, The Hindu, November 24, 2003

  9. Rehabilitate cerebral palsy patients
    Author: Paawana Poonacha
    Bangalore, The Times of India, November 22, 2003

  10. Battle that bulge
    Author: Kanak Hirani Nautiyal
    Bangalore Times, The Times of India, November 1, 2003

  11. Exposure to computers may hamper child's growth
    Author: Sahana Charan
    Bangalore, The Hindu, July 7, 2003

  12. Quack, quack: beware of 'docs'
    Author: Paawana Poonacha
    Bangalore, The Times of India, March 27, 2003

  13. 'Handicapped' on medical certificate
    Author: Paawana Poonacha
    Bangalore, The Times of India, March 11, 2003

  14. 'Rs. 40 cr. a month for schemes for the disabled'
    Bangalore, The Hindu, January 22, 2003

  15. Obesity: Kids at Health Risk
    Author: Kanak Hirani
    Bangalore Times, The Times of India, August 23, 2002

  16. Talk shop for issues in adolescence
    Author: Kanak Hirani
    Bangalore Times, The Times of India, November 12, 2001

  17. Rage Spills Over Into Sporting Arenas
    Author: Asha Chowdary
    Bangalore Times, The Times of India, July 27, 2001

  18. Good posture projects confidence
    Author: Dr. Deepak Sharan
    Bangalore Times, The Times of India, May 24, 2001


I have also been interviewed by VOICES on All India Radio, Bangalore (on Rehabilitative Surgery for Locomotor Disabilities: July, 2002), E-TV, Bangalore (on Backpacks and Postural Problems in Indian School Children: telecast during national news on January 9, 2003 and Bangalore news on January 10, 2003; and on Cerebral Palsy on November 22, 2003), and India Vision, Kochi (on Cerebral Palsy on October 22, 2004).

To read my RSI/MSD educational columns in the World's topmost English Newspaper CLICK HERE


Good posture projects confidence
Author: Dr. Deepak Sharan
Bangalore Times, The Times of India, May 24, 2001

"Stand up straight!" "Pull your shoulders back!" "Stop slouching" As children, some of us were reprimanded to maintain good posture. Yet we were seldom taught effective ways to accomplish this. Most of us remain blissfully unaware of the harmful consequences of postural neglect.

As we start to grow older and worry, our posture deteriorates. We have a series of reflexes throughout the body that support us against the force of gravity and naturally co-ordinates our movements. Inappropriate muscular tension creates an interference with these reflexes and many of us end up moving in ways that are awkward and inefficient.

The consequences of poor posture can be seen all around us: stiff necks, shoulders hunched forward or pulled tightly back, restricted breathing, and tightness in the thighs, legs and ankles. The result is headaches, neckaches, backaches, and sciatica.

So what is 'good' posture? Posture is essentially the position of the body in space. The correct posture is one in which the body segments are balanced in the position of optimal alignment and maximum support, with full pain-free movement with a minimum of energy expenditure. The key to this low-tension position is balance: your upper torso and head are balanced over the mid-torso and lower back so that they rest on top of one another and don't require muscle tension to hold things in place.

Nature has aligned us so our center of gravity falls through our body and moves through specific bony landmarks: Earlobe over the middle of the shoulders, over the hip joint, and over a point about an inch in front of the ankle joint. In the correct position, your spine has the natural curvature, your chest is 'open', meaning that they are centered on the plane of the torso. With correct muscle flexibilities and strength balances, proper posture can be maintained without conscious effort. However, when you are fatigued or stressed, you tend to revert to your relaxed posture and alignment. You will then fatigue even more quickly and perform less efficiently.

But how is poor or faulty posture developed? Children stand or sit in a hunched over position for a variety of reasons: habitually; psychological factors, especially low self-esteem (adolescent girls may slouch to hide developing breasts), laziness, to irritate their parents, or to express their growing independence; muscle spasm; respiratory conditions; excess weight; and high-heeled shoes/boots, tight clothing and wide belts.

Poor posture often worsens during the adolescent growth spurt, when a child may assume a more pronounced round back. Other common postural problems are when the spine curves inward, slouching and side-to-side curving. The aggravating cause of a significant number of modern injuries related to posture is computer use, which will be discussed in a subsequent column.

Many think straightening up is important only for appearances. Although good posture does project confidence, strength and poise, it is important because it contributes to our health and capabilities. An awareness campaign to promote the importance of good posture in students is the need of the hour, and is an important activity of "Open Door". Good postural habits must be instilled at an early age. Get your school or college to organize lecture-demonstrations in Postural Correction. Treatment of postural problems includes individualized assessment, exercises and practice. A special method called Alexander Technique is popular in the west, though largely unheard of in India. Muscle relaxation techniques, biofeedback, manipulation, massage and stretching exercises are also used to relieve pain and muscle tension. Regular non-jarring exercises, such as swimming, and maintaining high levels of activity are recommended. Appropriate supportive furniture (e.g., firm beds and chairs) may be required. Posture can be improved, and the sooner the better. Pulling back into alignment may feel awkward and uncomfortable at first, but we adjust to it quickly.

You can let your posture get worse and suffer the consequences, or you can improve it NOW. The choice is yours.


Rage Spills Over Into Sporting Arenas
Author: Asha Chowdary
Bangalore Times, The Times of India, July 27, 2001

Fury, as in a fire in the chest and a burn in the gut, is no longer restricted to high pressure work areas or bad roads. In a malady now on the rise in the city, anger is erupting on the sports field, not always during a national level match but even during friendly club events. Sports rage, as the disorder is often termed, has led to grave injuries caused by a moment of fury or fleeting carelessness.

Today, anything can precipitate a physical attack- losing a match or even anger spilling over from an earlier grudge. Whatever the cause, the victims who suffer, do so in silence, often too scared to even tell their doctors what caused the mishap.

"We are always trying to find excuses for this," says Malini N (name changed) who was deliberately injured during a badminton match and is now suffering from a serious eye wound. "In my case, I was playing badminton with this club member who was annoyed by women being included in the club. In a moment of anger, he smashed the shuttlecock with unnecessary force and it hit my eye. I was rushed to the hospital with a haemorrhage in my eye and though that was treated in some weeks, a cataract has developed and I now suffer from blurred vision. I now require an operation that can cost over Rs. 40,000."

According to Malini, these events happen all the time, but most people do not bring them to light. "I had a friend who had her contact lens smashed, another person had his eyelids crushed in a club match. I don't see why we should be the target of someone else's personal angst."

"People will do anything to win," says national level hockey player, Ashish Ballal. "In some matches, a lot of people get hurt because some of them begin hitting each other on the field. You see, in an important match, you train a lot and you want to taste success. Sometimes in hockey, a person can be hooking you and your blood pressure shoots up and you react in anger. I've seen it happen. One of my teammates had to have several stitches and I have had some bruises myself. The frustration levels and the desire to win is definitely on the increase."

Dr. Hemanth Kalyan, consultant in orthopaedic surgery and sports medicine at Lakeside Medical Centre says, "This usually happens in the informal level of sports. In the interschool hockey match, I once saw a student who scored a goal being hit with a hockey stick and the bones of his wrist were damaged. Only education, protective gear and healthy sporting attitudes can help in any sport."

Dr. M Venu, senior registrar, orthopaedics, at HOSMAT says, " There has been an increase in injuries due to foul play. People have come to me with knee injuries and severe bleeding, especially after a football match. The amount of competition is on the increase which could be reason behind this." Dr. Deepak Sharan, head of pediatric orthopaedics department, Bangalore Children's Hospital adds, "Pent up emotions and hidden psychological problems can surface during a game. In many countries, there are sports counsellors who can help out."

In foreign countries, sports rage extends to parents and coaches who often resort to violence on the sports field. Press accounts describe a youngster actually beaten to death and others who were viciously beaten. Many countries are even enacting laws increasing penalties for sports violence and to curb sports rage.


Obesity: Kids at Health Risk
Author: Kanak Hirani
Bangalore Times, The Times of India, August 23, 2002

A five-minute run tires him out. He can put away two packets of chocolate at a go. He feels drowsy in school and has low self-esteem. His cholesterol is high and he complains of frequent backaches.

If this sounds like a description of your child, it's possible that he counts among the 20 per cent of students who suffer from obesity.

A recent study by doctors from the Bangalore Children's hospital (BCH), showed 20 per cent of pre-school children surveyed to be suffering from obesity. Of that, five per cent were at risk of cardiac diseases.

Dr. Nandini Mundkur, CEO, BCH says this survey is just an indication of increasing obesity among young children. Right from the time they're in the womb, babies are at risk. However, signs of obesity can be detected from the age of three.

"Factors like breast-feeding, nutrition, exercise and eating habits play an important role," says Dr. Mundkur. She adds that exercise isn't on the agenda of either parents or schools. "How many schools insist that their students exercise every morning? How many children eat healthy meals? Schools conduct health camps but don't focus on these issues. It's essential that every child should have an annual health check up. They should be taught that they are responsible for their body."

Obesity can hinder a child's development in various ways: They are at the risk of heart diseases, orthopaedic and joint problems. "Obese children also get isolated and are called names. Their weight makes it impossible for them to participate in sports and they get tired fast," adds Dr. Mundkur.

Children and adolescents with obesity keep Dr. Deepak Sharan active professionally. "I've just seen an obese 12-year-old with slipped capital femoral epiphysis (the head of the femur slips away from the rest of the femur)," says the head, department of pediatric orthopaedics and rehabilitation, BCH.

He explains that the tensile strength of bone and cartilage in children doesn't adapt well to excess loading due to being overweight, causing a variety of orthopaedic and joint problems.

Dr. Kavita Bhat, pediatric endocrinologist, Manipal Hospital and BCH says, "Up to 60 per cent of the children who are checked for obesity have elevated cholesterol as young as four to five years. Sometimes, obese children snore a lot at night, causing respiratory problems and hindering their performance in school."

You can check if your child is obese by finding out his Body Mass Index, by calculating his weight in kg divided by height (squared) in metres. A BMI of over 29 indicates obesity and a BMI between 20 to 25 is ideal. The Bangalore Children's Hospital also has an obesity clinic with a panel of doctors at their Rajarajeshwarinagar center on Monday mornings, and at their Malleswaram center on Wednesday mornings from 10 am to 1 pm. For details call 8600252 or 3347794, or email bchrc@vsnl.com.


Backpacks Make for Bad Backs
Author: Seth Swift
October 23, 2002
Easterneronline.com (USA), October 23, 2002

Recent studies have shown that backpacks, especially in adolescents, may be the cause of an increase in cases of bad backs. Some results of students shouldering a load that at times exceeds a quarter of their bodyweight are chronic back, neck, and shoulder pain. In a way, it's almost like a perpetual pregnancy that students wear on their back for five to eight hours a day, five days a week, in excess of nine months a year for upwards of 18 years. As students, we practically live out of our backpacks.

While backpacks may be an improvement over the hand held book satchels of the past as far as organization and such are concerned, it may be that the cons outweigh the pros.

This is not just an American phenomenon either. In India, Dr. Deepak Sharan, who is the head of the Department of Pediatric Orthopedics & Rehabilitation at Bangalore Children's Hospital, has documented cases of people with back pain that he believes are related to the use of backpacks. "The immediate result of carrying too much unbalanced weight for too long is muscle soreness and strained ligaments. Backpacks lead to restricted movement of the spine and alter the fluid content of discs." This makes backpack wearers prime targets for herniated discs and arthritic spines later in life.
The imbalance in one's center of gravity created by lugging the books around on one's back is one of the easiest things that can be corrected, according to some. One way to counteract this imbalance is to carry the load higher on the back, because, according to Dr. Randolph Trowbridge, who specializes in the science and medicine of biomechanics, "The shape of our backs makes it easier to carry a load there."

With some people, however, this piece of advice does not mesh with their own personal experience. Tim Wooddy, a graduate student in the History and High Tech Communications programs, said, "The weight in a backpack is going down, so the bottom vertebrae are taking (the brunt of) the load. That's why the military uses backpacks (that rest) low on the backs. It's pretty effective."

Another way to help counteract the center of gravity created by too many books in a backpack is by rearranging the books. Researchers recommend that students pack the heavier items nearest to the back, and when they do pack the items do it so the weight is evenly distributed. That way the weight doesn't shift to one side and place even more stress on just one side of the spine.

One thing for students to beware of is that the weight of the backpack should not exceed 10-15 percent of one's bodyweight. The number and weight of books is not something most students have much control over, since books regularly weigh 5-7 pounds, but some doctors recommend carrying a book or two in your arms if the weight exceeds the maximum safe weight.

One petite sophomore student, who prefers to remain anonymous, remarked, "I never knew that (too much weight) could be so bad for your back. I always wondered why my back always hurt."
Students should also beware of the saddlebag single strap backpacks. The major problem with these is that it puts all the weight and stress on one side only and doesn't distribute it. Another thing to be wary of is only wearing one strap of a backpack. This can cause even more undue stress on one's back and, besides, is a remnant of the ultra crappy 1980s.
The backpacks that have numerous compartments for storage can be a good investment for students. According to researchers, this allows for a more even distribution of the weight. Students should avoid overpacking their backpack. Instead of bringing the kitchen sink, first find out whether it is really needed in class that day. Wide shoulder straps and backpacks made of lighter material are also recommended.

A useful tip that Dr. Sharan gives to backpack wearers is that, "If the backpack forces the wearer to move forward to carry (it), it's overloaded." He also stresses that postural problems "Do not go away with time if nothing is done about them. Remember," he said, "as the twig is bent, so grows the tree."

Wooddy remarks of backpacks and their users, "Backpacks are designed for light loads, but still people pack 20-30 pounds in there. This is unhealthy because most people aren't fit enough (to carry that load)." The president of Jansport was not available for comment for this issue.


'Rs. 40 cr. a month for schemes for the disabled'
Bangalore, The Hindu, January 22, 2003

Doctors and government officials met here on Tuesday to try correct the handicaps in the State's disabled care system. The programme, organized by the Commissionerate for Persons with Disabilities, had doctors from Bangalore Children's Hospital (BCH) addressing orthopaedic surgeons from government hospitals state-wide.

The Assistant Commissioner from the Commissionerate, B.C. Pradeep Kumar, regretted that very few parents or doctors knew that the State Government gave a maximum of Rs. 15,000 for corrective surgeries.The money was given regardless of the level of disability or the age of the disabled person, but was subject to income levels-for children of parents below poverty level who earned less than Rs. 24,000 a year.

"The State Government spends Rs. 40 crore a month on pensions and other schemes for disabled people," he said. The money could be better used on post-operative care, etc.

The BCH doctors - Nandini Mundkur and Deepak Sharan - asked government doctors not to give "permanent" disability certificates for children below five. "Such a certificate will hamper the child for life," Dr. Mundkur pointed out. Besides, without proper counselling, parents would prefer to let children remain disabled, as corrective surgery would cut off government aid. If the parents are in the below poverty line category, a disabled child gets Rs. 125 a month for life.

Dr. Sharan spoke of identifying patients for surgery. "For cerebral palsy, most doctors warn against surgery. But lower limb surgery can be successful for children between four and six years while those between six and eight years can have upper limb surgery," he said. Doctors had to operate only in cases where benefits outweighed the risks, he stressed.

The government doctors said they worked in severely understaffed hospitals (one nurse for three wards) with ill-equipped operating theatres. "Though the government has said that those with 45 per cent disability need only one ID, disabled people come asking for certificates for job applications, travel concessions, pension, etc.," the doctors said. Mr. Kumar said the commissionerate would organize another workshop to discuss assessment of disability. Those who wanted to know more about the corrective surgery scheme can contact the District Disability Welfare Officer or the commissionerate (phone: 548 2639/41) or Mr. Kumar (phone: 548 2659).


Doctors inept to treat disabled
Author: Paawana Poonacha
Bangalore, Sunday Times, February 2, 2003

An estimated eight million disabled persons in Karnataka need to undergo surgeries to correct/reduce deformities resulting from polio, cerebral palsy, limb deformities and post burns contractures. But sadly, government orthopaedic surgeons with postgraduate qualifications are not "technically skilled or adequately exposed" to conduct these corrective surgeries, a recent study by the State Commissionerate of Disabilities found out.

This is certainly bad news for those with locomotor disabilities. Though the Karnataka government has allocated Rs. 15,000 per person per year for surgical correction of locomotor disability, there are no good surgeons or hospitals available to see the project through. As of today, surgeries are conducted in just a couple of hospitals and most rural patients do not have access to them.

"The government incurs an expense of Rs. 36 crore, just to provide maintenance allowance to the disabled. Of this, Rs. 12 crore could be saved if the disabled undergo corrective surgeries," Chief Resource Person, State Corrective Surgery Scheme for Locomotor Disabilities, Dr. Deepak Sharan, said.
Another discouraging trend is that some of the disabled, who underwent surgeries for free at camps, have been crippled due to complications caused by the lack of technical expertise. "Therefore, most disabled believe that it is better to suffer disability than face complications of a failed surgery," Dr. Sharan says.

Ironically, locomotor disability is handled by the Department for the Welfare of Disabled under Women and Child Welfare, with absolutely no involvement of the health department.

At a recent orientation program for government orthopaedic surgeons, willing doctors were given a comprehensive training programme at all regional levels by the health department, before being asked to carry out corrective surgeries independently.

The Commissionerate of Persons with Disabilities, which conducted the programme, has a long list of recommendations, including a multi-disciplinary team approach, on-the-spot assessment and documentation, and expert postoperative care.

"Rajasthan has earmarked Rs. 7 crore for such surgeries and set a target of 25,000 cases for 2002-03. The state Health department too should launch a drive in setting targets and earmarking budgets to this exercise," Assistant Commissioner (Disabilities) B.C. Pradeep Kumar said.


‘Handicapped’ on medical certificate
Author: Paawana Poonacha
Bangalore, The Times of India, March 11, 2003

Shocking but true. An estimated 25 lakh disabled persons in the state do not possess medical certificates conforming to GOI guidelines to avail of benefits of various schemes. Reason: Doctors are unaware of the procedure to issue such certificates as no one possesses the copy of guidelines.

In a letter to Chief Minister S.M. Krishna last week, the Union Ministry for Social Justice and Empowerment directed the government to take immediate steps to set up a medical board to issue certificates as per guidelines.

“Unfortunately, the health department has not yet circulated copies of the guidelines to government hospitals to issue medical certificates as required under the Disabilities Act,” laments Assistant Commissioner for Disabilities, B.C. Pradeep Kumar.

While there is alarming rise in number of cases before courts where the disabled weren’t provided GOI-approved medical certificates, large-scale discrepancies have been noticed in issuing certificates.

As a result, a very negligible section of the disabled have so far availed of concessions for reservation in employment, education, allotment of houses and sites, issuance of bus passes, travel tickets, etc. All those who suffer from any kind of disability beyond 40 per cent are entitled to receive certificates.

At a recently held orientation programme on corrective surgery, orthopaedic surgeons felt the reasons for lack of interest to receive guidelines to issue certificates was the procedure was exhaustive and time consuming.

“The guidelines to issue certificates run into 100 pages. The one-day camps being organized by the Department of the Welfare of the Disabled expects surgeons to issue certificates to about 2,000 disabled in a spa of a few hours,” doctors complained, adding that calculations to find out whether patients suffer from 40 per cent disability was complicated.

Software. Two Bangalore-based Orthopaedics- Dr. Prabhakar Murthy, medical superintendent of Bangalore Children’s Hospital, and Dr. Deepak Sharan, HOD, Pediatric Orthopaedics and Rehabilitation- have been asked to evolve a software package to simplify the procedure for issue of certificates.


Quack, quack: beware of ‘docs’
Author: Paawana Poonacha
Bangalore, The Times of India, March 27, 2003

"I'll get to the root of your problem and swear painless, speedy treatment," a quack operating near Shantinagar assured anxious parents of nine-month-old Arfa K. who recently suffered a dislocated elbow. Several sessions of massage, applications of splints and herbal pastes followed, but the trauma only increased.

A week later, the infant’s upper limb swelled up like a balloon and she went into a coma. Doctors attending on Arfa drained out half a litre of pus from the elbow. She had also developed septic arthritis of the hips requiring another surgery.

In another case reported recently, doctors found a girl of the same age suffering from septicemia and septic arthritis of the hip because of "branding" (using hot iron rods) treatment administered by quacks.

Following conducting a series of assessment camps, Karnataka's Corrective Surgery Programme for Locomotor Disability, has reported a sudden rise in the popularity of quacks in the city.

Incidents where "fixing the bones" by quacks and delay in proper treatment by a couple of weeks, has led to a lifetime of disability. In extreme cases limbs have even had to be amputated.

"Orthopaedic Surgeons encounter numerous limb deformities resulting from failed folk healing and bone-setting," the report reads. Quacks are found to be operating in the by lanes of Shivajinagar, Kalasipalya, Yashwantpur, Cubbon Park and surrounding areas.

"Injudicious massage for injuries around the elbow leads to stiffness because of extra bone formation or to joint instability due to ligament damage following forcible manipulation. This is in addition to the risks of infection, gangrene (due to damage of blood supply), deformities or fractures that fail to join," warns Dr. Deepak Sharan, chief Resource Person, State Corrective Surgery Programme.

"Many educated and well-to-do people rationalise such treatment by stating that disciplines such as Osteopathy and Chiropractic, based on manipulation of spine and joints, are very popular in the west. Unfortunately, native practitioners undergo no systematic training and ply obscure techniques secretly handed down the ages. They have no knowledge of anatomy and they can damage nerves and blood vessels by blind manipulation," Dr. Sharan feels.

Although both children described above, made complete recoveries from a life-threatening condition, parents admitted that they sought the help of quacks due to poverty. Radhika Mandal, a charitable organisation has sponsored over 20 successful operations, including these two cases, in the last one year.



Save your child's back
Author: Kanak Hirani Nautiyal
Bangalore Times, The Times of India, May 26, 2003

Forget about how it looks and don't choose the pink schoolbag with the Mickey Mouse. When you buy a bag for your child this year, make sure that when he packs it with his books, it's easy on his back.
Ideally, a child shouldn't carry a bag more than 10 per cent of his or her body weight. And there's a good reason. The top of the shoulder where the straps of a backpack rest is rich in nerves and blood vessels that serve much of the rest of the body- head, arms and hands, neck and back.

Excessive weight of a backpack can lead to several health problems for a child.

Seema Shah's son Manek who weighs 22 kg carries at least five kg to school. "I feel my poor boy has developed a hunch because he carries such a heavy bag. He has to carry all his textbooks and notebooks to school every day," she says.

Sseema says that she'd rather buy a sensible school bag that's easy on her son's shoulders, he won't let her. "Kids also want their bags to be fun." She suggests that schools can make things simple and have a cupboard where the students can store their textbooks. According to Dr Deepak Sharan, department of pediatric orthopaedics and rehabilitation, Bangalore Children's Hospital (BCH), next month BCH is conducting a workshop for children, teachers and parents titled Kids, Computers and Backpacks. "We have a visiting US faculty for this workshop. I believe that we need a forum to address this issue where everyone can take a concrete decision."

In schools like the Gear Foundation, things are different. According to their head, M Srinivas, children do not carry bags weighing more than a kg. "They leave most of their books in school. They only carry a small file with some papers and a comment card for the parents. Most children in other schools carry 200 page notebooks when they need just one or two pages," he says.

Ravi Ladha, local distributor for Genius bags, says since the past two years his company has manufactured bags that are easy on a child's shoulder and back. "The Orthofit bag remains on the shoulder and doesn't shiftthe stress on the vertebral column. It also fits against the curve of the back as it has been ergonomically designed." Ladha says another bag, Orthogrip, has good padding, shape and grip so that the bag straps don't dig into the skin. "Since the bag weight is a serious issue we also have school bags with trolleys," he adds.

If your child is buckling under his school bag, this is how he or she may feel: an aching in the shoulders, neck and back; tingling in the arms, wrist and hands, especially at night; noticeable imbalances in posture, including tilting of the head and neck to one side and an uneven gait; frequent headaches and poor voice quality.

Weight and watch

o Use a knapsack with well-padded straps and use both straps when carrying the knapsack
o Buy a knapsack with several compartments to better distribute the weight
o Pack heavier items near the top of the pack. That way, the legs are carrying most of the weight. Heavy items packed at the bottom of the pack put more stress on the back
o Both straps should be worn across the shoulders and upper back to equalize the weight

Back to links.


'Heavy backpacks affecting children'
By Staff Reporter
Bangalore, The Hindu, July 5, 2003

Backpacks, bad postures, and computers can do enough harm to children if proper care is not taken while carrying bags to school and while working on the computer, according to experts from Bangalore Children's Hospital.

Speakers at a workshop on "Kids, backpacks and computers," organized by The Hindu under the Newspaper in Education (NIE) programme and Bangalore Children's Hospital here on Friday expressed concern over the fact hat most schoolchildren suffered from backaches, neck pains, and other musculoskeletal problems due to heavy backpacks and bad sitting postures. Around 300 children from 16 schools in Bangalore, 35 teachers, and 45 parents participated in the programme, which also discussed computer-related injuries (CRI) in children. Nandini Mundkur, Paediatrician, Bangalore Children's Hospital, stressed the need for schoolchildren to be seated in the correct posture in the classroom. She said chairs in the classroom should be of the appropriate size according to the age of the child. Students should rest their backs on the seat and the feet should touch the ground while seated.

"Schoolchildren are posed with the problem of carrying bulky backpacks to schools, and Indian students are not alone in facing this problem," Shruthi R. Iyer, Researcher from Houston, said.

According to a study conducted by her, around 49 percent of the Indian students complain of pain in the upper back, lower back, neck, and shoulders. She said there was a need to implement "pain prevention screening" in schools so that children were not subjected to the torture of carrying heavy backpacks.

Deepak Sharan, Orthopaedic Surgeon, said a lot of IT professionals suffered from CRI or repetitive strain injury (RSI), which was caused due to bad postures while sitting in front of the monitor. Children were at a high risk of developing CRI or RSI, which might cripple them at a later stage, he cautioned.

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Rehabilitate cerebral palsy patients
Author: Paawana Poonacha
Bangalore, The Times of India, November 22, 2003

What does it take to bite, chew and swallow food or what synchronises our speech as we breathe? Ask thew country's estimated 40-80 lakh children suffering from cerebral palsy (CP), a disorder causing lack of control over one's movements.

The disorder causes inter-connected disabilities due to a 'minor problem' in the brain, which could occur before, during or after birth.

Even as there are signs of phasing out polio, CP is emerging as the most common disability in the country, health experts warn.

As there is no complete cure for CP, multiple corrective surgeries and neuro rehabilitation can help patients lead a better life, a concept doctors in India are largely unaware of, they say. A report compiled for the Bangalore Children's Hospital for the state health department states that 75 per cent out of 1000 cases of locomotory disabilities evaluated in 2002-03 were found to be that of CP.

In a residential school for the disabled in Tumkur, 90 per cent of the children were found to be suffering from it. None were ambulant with or without locomotory assistive devices and many were bed-bound or wheelchair-bound.

"Most children had the potential to walk but despite promise of government funding, parents of these patients refuse to seek adequate treatment," says Dr Deepak Sharan, HoD, pediatric orthopaedics and rehabilitation, Bangalore Children's Hospital, who conducted the study.
According to him, a common advice given by most doctors is that nothing can be done medically for these children.

"Many CP patients are bluntly referred to physiotherapists who are not equipped to handle CP patients with disabilities like speech, vision, swallowing, epilepsy, mental retardation, behavioral and learning disabilities," he says.

Shortage of medical professionals trained in rehabilitation trends seems to be the reason why treatment of CP patients is lagging behind in India. "There are corrective surgeries based on current international recommendations which have shown encouraging results," says Dr Sharan.

Neuro rehabilitation of CP patients is equally dismal, if not worse, says, Dr A.S. Hegde, HoD, neurosurgery at Satya Sai Hospital. "NIMHANS offers neuro rehabilitation, while Vittal Medical College in Vellore, Armed Forces Medical College at Pune, Dr Ahluwalia's Institute of Rehabilitation at Delhi and St. John's Hospital at Bangalore offer succour to CP patients on both neuro and ortho fronts," Dr Hegde details.

Ajay Vijayaraghavan (photo) before and after surgery. On Saturday, Ajay and 30 other CP patients who have been operated upon by Dr Deepak Sharan, will have a get-together at Bangalore Children's Hospital to set up a support group.

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Heavy school bags cause musculoskeletal disorders: Study
Kochi, Daily Excelsior, August 13th, 2004

KOCHI, Aug 12: Three out of four computer professionals in India develop musculoskeletal disorders after working continously on computers and history of most of these cases are traced to their school days, a study by the Indian Academy of Paediatrics Shows. According to the survey conducted among 3,500 professionals at Bangalore alone, 75 per cent of them reported disorders and the academy was now on a massive drive to collect data from across the country. For most of them, the disorder began from their school days when they had to carry heavy backpacks, according to Dr Deepak Sharan who has been on an intense campaign for the last two years to reduce the load of school bags.

Dr Deepak, who is the head of the Department of Paediatric Orthopaedics at Bangalore Children’s Hospital and Research Centre, was in the city to conduct study among the students, parents and others. "If the current trend persists, it will be a rarity to find a pain-free adult when the present generation of school children grows up to enter the work force," he warned. According to a study in 2001, which is the only one available on Indian students, 50 per cent of them were tested positive for chronic pain due to carrying heavy backpacks. "Half of them go through a severe episode of pain at least once before they enter adulthood," he poined. Adolescents with back, neck and shoulder pain were at increased risk of experiencing chronic musculoskeletal pain, he said citing different studies abroad. "All this will have a serious impact on the productivity and thereby the economy of the nation," Dr Deepak said.

The academy had launched a national-level drive to collect data on the ill-effects of heavy backpacks and is into a campaign across the country to get the weight of bags reduced, national executive member Dr Sachidananda Kamath said. As per their findings, carrying of backpacks would change the centre of gravity in the body and would affect stability. It causes the body to lean forward and baseline oxygen consumption increases. Tiredness or muscle fatigue, swelling, pain in the head or neck, back or shoulders, muscle spasms or stiffness, numbness, curved or rounded back and altered gait could be some of the results of carrying heavy baggage. The academy had also come out with some suggestions to the schools, parents and the manufacturers of bags in this regard. The cochin chapter had recently made some schools accept their suggestions, including bags with less weight. (UNI)

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Workshop on cerebral palsy
By Staff Reporter
Kochi, The Hindu, October 19, 2004

The high cost of new technologies in medicine prevents ordinary people access to modern medical treatment, said the District Collector, A.P.M. Mohammed Hanish. Inaugurating a free surgical workshop for managing cerebral palsy in children, Mr. Hanish said it was difficult for the Government to evolve welfare schemes in the health sector because of the lack of funds. But the Government would ensure an environment for such enterprises to flourish.

The Bangalore-based expert in orthopaedics and rehabilitation, Deepak Sharan, will lead the four-day surgical camp at the Welcare Hospital. Organised by the Adarsh Institute for Cerebral Palsy and Childhood Development Disorders, the camp will select about six children below 15 years for surgery. According to the organisers, the surgery would help children with cerebral palsy to a great extent in going about their daily activities without external help.

At the inaugural function, paediatrician Abraham K. Paul, vice-chairman (Tech.) of Adarsh, introduced the team which would conduct the surgery and take follow-up action. The technical director of Adarsh, S. Ramakrishnan, welcomed the gathering. Senior orthopaedic surgeon, Sudheer Thomas, and the director of Adarsh, P.N. Narayanan, spoke on the occasion. Paediatrician Sachidananda Kamath proposed a vote of thanks.

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New surgical procedure to treat cerebral palsy
By Shyama Rajagopal
Kochi, The Hindu, October 31, 2004

There is no programme yet to manage cerebral palsy in spite of the fact it accounts for the maximum number of cases of disability in the country, said Deepak Sharan, Bangalore-based consultant in Orthopaedics and Rehabilitation. Talking to The Hindu here, Dr. Sharan said there were no parameters to measure disability in a person. Disability certificates were issued quite arbitrarily, he said. Many a time, it was noticed that disability of a person measured at one centre differed with the result from another centre, he said.

Setting parameters

Dr. Sharan, who is consultant to the Union Ministry of Social Justice and Empowerment and also the Disability Commissioner of Karnataka, said the Government had appointed a team of specialists, including developmental paediatricians, paediatric neurosurgeon, paediatric orthopaedic surgeon, physio therapist, occupational therapist and other specialists, to set parameters to define disability. The Childhood Disability Group of the Indian Academy of Paediatricians would provide the basic structure to define disability and provide a measuring yardstick. The Government also has plans to modify the definition of cerebral palsy, said Dr. Sharan, who is part of a five-member expert committee on cerebral palsy and autism under the Union Ministry. There are about 5-8 million people in the country afflicted with cerebral palsy, he said. The Spastic Society of India and other NGOs provided more of vocational training to cerebral palsy-afflicted children. Medical treatment of cerebral palsy was non-existent, he said.

He said the perception of an attack of cerebral palsy had been linked to difficult labours. But, now the theory has been extended to say that a child with disabilities could also lead to difficult labours, he added. The incidence of cerebral palsy has been measured at 2-2.5 out of 1,000 births. At a disability screening camp held in Bangalore in 2002-03, it was found that out of 1,000 disabled cases, 75 per cent of locomotor disabilities were due to cerebral palsy.

Advanced surgery

Conventional methods of correcting cerebral palsy through surgery were not generally successful, said Dr. Sharan, who has a Fellowship in Paediatric Orthopaedics from the U.K. and is also a member of the American Academy for Cerebral Palsy and Developmental Medicine. According to him, a poorly done operation is worse than no operation at all. After a five-year training in the U.K. in the most advanced technique in managing cerebral palsy called Orthopaedic Selective Spasticity Control Surgery (OSSCS) using an advanced computer aided three-dimensional analysis of muscle function, Dr. Sharan has performed about 45 surgeries in the last three years in Bangalore, all of which have boosted his confidence to make available such surgery to more people. OSSCS is not a technique but a principle devised by the Japanese orthopaedic surgeon, Takashi Matsuo, explains Dr. Sharan. About 30 muscles are involved in taking one step. In the case of a cerebral palsy-afflicted person, a few muscles fail to function. All the dysfunctional muscles in a limb need to be identified and should be corrected in a single operation, he said. It also reduces the trauma of going through a number of surgeries, he said.

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