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“A handful of worms were pooped out after taking medication”, said her Mom.
After Mom's general check-up, she unconcernedly said that lately her daughter, 13 years old (looked as if she was 18 because of her strong genes) sleeps all day long and lazy most of the time, while otherwise, she’s healthy and well. I came across this Afridi family while working as a primary doctor in a rural setup.
Though having a pretty fair complexion, her daughter still seemed pale to me. I got concerned and started asking questions, reaching to an unexpected conclusion. Her mom then mentioned that she loves eating plain ice like anything, and then other questions were if she drools saliva at night or chews her cuff/clothes/eating mud, scratching back, etc. period or any bleeding issues? The only positive thing was the drooling of saliva at night making her pillow all wet.
These correlations of tiredness, being pale, eating ice, & drooling saliva were all pointing towards Iron deficiency caused by worms.
In rural areas especially developing countries, we have limited resources so we mostly diagnose or treat by clinical judgment, unless their’s something alarming to refer.
I started her on deworming medication along with Iron supplement & multivitamins.
