00:00I am telling you that there are 7-8 patients in a month.
00:04What do you think about this?
00:12The first thing is inflammatory bowel disease.
00:16One is called Crohn's disease.
00:23Indeterminate colitis is one of the two features.
00:28And the fourth is the IBD.
00:30We are seeing the 4 types of kids in IBD.
00:33Why are they growing up?
00:35The first part of the genetic, the monogenic is a small part.
00:39The first part is now, there is no difference.
00:42The other three types are growing up.
00:45Why are they growing up?
00:47We are seeing about 7-8 patients per year.
00:52In 2001, when I came to this department as a faculty,
00:56we were seeing 7-8 patients.
00:58And now we are seeing more in 8-10 months.
01:03This is the same phenomenon in Western world.
01:07In the Western world, there was a period between the 70s, 80s and 90s,
01:14and there was a lot of IBD diagnosed.
01:16Now, they are going to negative because possibly,
01:18the incidence is less of them because they have changed their lifestyle.
01:23Now, we are going to peak in Hindustan.
01:25In Hindustan, we are seeing more in Hindustan.
01:28We are seeing more in Hindustan.
01:30Especially, we are seeing a lot of children.
01:32Children means 0-18.
01:34We are seeing very IBD.
01:36So, for example, I cannot tell you 100% full-proof.
01:41But possibly, the basic cause of IBD,
01:45there are 3-4 things.
01:47In the same way, the teeth of the toxin,
01:49there are bad bacteria,
01:50and these bad bacteria are damaged by intestinal lining.
01:53to damage the bacteria from bad bacteria and other things like diet, environmental pollutants or deep fried food can also
02:08happen.
02:09But the basic issue is that when these bacteria are damaged by the immune system,
02:14then the immune system which is the work of the police to save the disease is caused by the disease.
02:24So, environmental triggers including diet and pollution and bad bacteria in the gut.
02:33Now, what is controllable, environmental pollution is obviously controllable, diet is controllable,
02:38it's important that you don't eat your children's junk. We didn't eat this junk because my children are about 25
02:44-30 years old.
02:46We didn't eat it. But it's now that it's fashion that you have to give a price and motivate something.
02:52So, this is bad possibly, one.
02:57Two is obviously the pollution that we are all talking about, the air quality is so bad in especially cities
03:06that may have a rule.
03:08The third thing that is avoidable for children, especially as a pediatrician, pediatric gastroenterologist, which play a role is,
03:17one is mode of delivery.
03:19That means, how the child is born.
03:21Because the gut bacteria, their composition starts from birth.
03:28So, the child is born in cesarean.
03:31That is not a good idea.
03:32Cesarean should be in the same case, which is necessary.
03:40So, these are bad.
03:44Possibly, they may have a long-term infection.
03:46The other thing that is wrong with parents.
03:49Antibiotics.
03:50The child is taken to a local pediatric patient.
03:53They are taken to a local pediatric patient.
03:54They are taken to a local pediatric patient.
03:55They are taken to a local pediatric patient.
03:56Antibiotics also destroy the healthy bacteria and give rise to bad bacteria in the gut, which will again cause or
04:02contribute to IBD.
04:04In the long run.
04:05Third thing is, use of proton pump inhibitors.
04:09Pate may dard ho ta hai.
04:11Adult gastroenterologist ka, then I have taken to a local pediatric patient.
04:15But every pediatrician should know, ki, bina baat pe, pate ke dard ke liye, proton pump inhibitor nahi de na
04:24hai.
04:24Yaise maine aap ko bata ya, ki, meri opi d mein kooi bhi doctor ki juret nahi hai, ki, bina
04:31baat pe, proton pump inhibitor de.
04:33Because humi pata hai, ki, ye bhi acid, acid is good for the body.
04:37Jo, johi hotha hai pate ka, wo pachan shakti badaata hai, number one.
04:42Number two, wo humari, joe bacteria, unko bhi sahih rakta hai.
04:47To humi acid ko hi khatam kar deenge, toh color cheese ho ghi na.
04:51Toh this is another thing wrong that possibly parents are doing, we as doctors are possibly doing,
04:57and that is why we are seein literally explosion of IBD, pediatric IBD ki baat.
05:02Matlab ki, ji joo humi ne describe ki aya, hi sari.
05:05So possibly those are the reasons. Maybe I have missed a few. But broadly these are the things which contribute.
05:12Unhealthy lifestyle is another thing. Sedentary.
05:14The kids don't go to play with their children. It's bad.
05:18Because you know all these things, the Indian roots are time to play, time to eat.
05:25I mean those things have gone away.
05:26Stress is enough for children. Stress itself.
05:29We know that the stress can become a cause of flare.
05:35Now the IBD disease can become a cause of flare.
05:38Some of them are strong and some of them are strong.
05:41Now when they are strong, we are identifying triggers for children.
05:47Every child has different triggers.
05:49Some of them are junk food.
05:51After 2-3 days, 4 days, a week after flare.
05:55The other thing is stress.
05:58Some of them have a flare for the exam.
06:02So these are the things that are kind of modifiable.
06:06One of the students who are going to the school is going to the inflammatory level.
06:13So what is that?
06:15It's very bad.
06:16The kids, as I was told, as I was told, the first public education program.
06:23One is mild to moderate, one is difficult to treat.
06:26As a gastroenterologist, we learn how to categorize.
06:30That this is a problem in the hole.
06:32And then we have problems in the hole.
06:35Now the difficult to treat is two types.
06:38One is difficult to treat is the same.
06:41One is difficult to treat.
06:43One is difficult to treat too.
06:43We can say, you can hope, pray, treat and support.
06:50Support is the biggest thing in those difficult to treat.
06:53The other is difficult to treat, because of the child's initial diagnosis,
07:07That is bad.
07:09So, there are some children that were actually difficult to treat.
07:14So, that is why we insist that it is so long,
07:18if any chronic disease has been exposed to the child's diagnosis,
07:22any specialist, especially if he is an adult specialist,
07:27then there are a number of pediatric asymptologists in India.
07:32There are some big cities.
07:34Second opinion is necessary.
07:36Don't take a life-long disease, blindly follow.
07:39So, if you follow and follow them,
07:40then you have knowledge from the correct quarters.
07:44Now, one more question is...
07:46No, I have a question.
07:49Some of the children are going to school.
07:53Some of the worst children.
07:54But all of them are now going to school.
07:56So, school educators also have to give knowledge.
08:01Don't be impatient.
08:02If a child hasn't done it, then what happened?
08:05Don't stress.
08:06Don't stress.
08:06If there's a child's exam,
08:08there are two kids from our family,
08:10who often do their exam,
08:12and they get tired.
08:13So, parents, teachers don't stress.
08:18For school, if there's no issue,
08:23After school, if there's no problem.
08:25If there are children like this,
08:25then they give them some extra study leave.
08:27They defer them the exam.
08:30They give them the opportunity to give them the exam.
08:32They give them the opportunity to give them the exam.
08:33Parents, children, and teachers,
08:36don't worry.
08:37Marks are not everything.
08:38Life is all about a lot of other things except marks.
08:42You know?
08:44Holistic approach.
08:45This is teachers' role.
08:48This is a great role.
08:49This is a great role.
08:49This is an IBD program.
08:50This is an IBD program.
08:50We can also educate them.
08:52So, teachers also know how to deal with chronic diseases.
08:55They should not unnecessarily
08:56get hurt and get away from school.
08:59These are all things.
09:00They don't have punishment.
09:01They don't have punishment for academic performance.
09:05They don't have punishment.
09:05Ma'am, season-wise go already.
09:07Is it winter or summers?
09:09In the IBD program there is nothing.
09:11At least some people have not observed anything.
09:13Yes.
09:14In certain years ago,
09:16many years ago,
09:17there was a lot of infections in the heat.
09:19There was a lot of infections in the heat.
09:20So, there were a lot of children in the heat.
09:22But I think as a whole,
09:24we have a standard of living in society.
09:27So, we are not seeing any phenomena.
09:29Now, the standard of living is high.
09:31Because of hygiene and hygiene,
09:32many people say that
09:33it is an IBD relationship.
09:35It is growing,
09:36possibly because of extra hygiene.
09:38Exactly.
09:39Thank you so much, Ma'am.
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