Does learning to play a musical instrument make your child stronger in academics?

“Children who study music from an early age can do better at a range of subjects such as maths, science, arts and language. The earlier a child ... comes to grips with music, the more the brain growth will be influenced. It sets them up for life.” - Dr Richard Letts, Music Council of Australia

We would all have encountered the advice on how we should encourage (*force*) our children to learn a musical instrument (preferably piano or violin) so that they will do well academically. Many research findings support this popular notion. For me, I find it strange because my thoughts are that the hours spent on practising the musical instrument could have been the hours spent on memorising the names of the muscles and bones of the human body! How is it then possible for the child to do well academically?

I have two hypotheses.

Hypothesis 1

Children who are strong in academics are the ones who are able to learn a musical instrument. In the first instance, all children are enrolled in learning a musical instrument, those who have difficulty learning would have dropped out, leaving behind those who study music. And when you assess those who study music, you’ll find that they are also strong in academics. This brings to the question is it because I know how to play the piano (cause) therefore I am good at math (effect) or I am good at math (cause) therefore I can play the piano (effect)?

Hypothesis 2

Children who play music acquire skills that are relevant to be strong in academics. They learn:

• That there are rewards from hard work, practice and discipline;
• To memorize by repetition and recognise patterns;
• Time management.

Some children as young as 5 years old may have already experienced their first graded music exam, hence they have early exposure and experience to exams.

These two arguments put forth demonstrate the linkage and indirect benefits of learning to play a musical instrument. However, I do believe there is a direct benefit that is children who learn music from a young age might have improved auditory senses which might aid in learning languages as well as be attentive in class.

Is it okay to take reconstituted Curam that has been left outside the fridge for 10 hours?

My friend asked me this question the other day.

First of all, a little bit of background on the drug. Curam or Augmentin (both brand names for the antibiotic combination amoxicillin/clavulanate) is commonly handed to the patient in two ways:

1)       In a bottle of powder. The patient brings home the bottle, adds water up to the mark indicated on the bottle to make a suspension – this is known as reconstitution.

2)       In a bottle of reconstituted suspension. The pharmacist or clinic assistant first reconstitutes the drug before giving it to the patient.

In both instances, the reconstituted drug should be refrigerated (stored at 2°C to 8°C) as soon as practicable to maintain the efficacy (usefulness) of the drug (manufacturer’s recommendation) for the entire dosing regimen (5 to 7 days). The powder on the other hand can be stored under room conditions for as long as the expiry date allows.

Thus, it is fairly common to receive calls from a family – who had left the reconstituted suspension out on the kitchen counter overnight – asking if the drug can still be used or do they need to go to the clinic to get a new prescription/bottle. There is also the possibility that you’d be bringing along a reconstituted suspension for your sick child (who had no choice but to travel with you) and may take some time before you have access to a refrigerator. So, how long can it stay outside the fridge?

Several studies have been performed to compare the stability of the reconstituted suspension when stored out at room temperature. The findings of these studies were:

1)       For the brand Augmentin, when stored at room temperature (25°C), Amoxycillin maintained its efficacy (defined as at least 90% of its initial concentration) throughout the 7 days dosing regimen, while clavulate drops to 90% of its value by day 2.

2)       Different brands have different stability profiles (see figures 1 and 2).

3)       In general, amoxicillin maintained its efficacy even if it has been stored out at room temperature and at 40°C for as long as 24 hours. Clavulanate is less stable and there could be a 30% drop in potency within the first 24 hours when stored at 40°C.

Figure 1. Concentration of Amoxicillin of various brands when stored at room temperature 25 °C

Figure 2. Concentration of Clavulanate of various brands when stored at room temperature 25 °C

Would I give my child Curam/Augmentin after it has been left outside the fridge for 24 hours? It is probably okay to give because:

1)       The efficacy of Amoxicillin is still maintained for all brands

2)       Clavulanate’s effectiveness may have dropped 30% but clavulanate’s inclusion is to counter infections that resistant to amoxicillin and I view this as secondary

3)       I’d consider getting a new bottle / prescription the next practicable time depending on the severity of the illness.

Oh and one last thing, do reconstitute the amoxicillin/clavulanate combination drug with boiled-and-cooled tap water or distilled water to improve its stability. The drug is most stable when dissolved with soft water (no mineral water) at neutral pH (no alkaline water).

REFERENCES

1. J Clin Pharm Ther. 1994;19(5):313-5.
2. Journal of Chemical and Pharmaceutical Research, 2013, 5(5):293-296
3. International Journal of Pharmaceutical Science and Practice, 2014,03(01): 1-12
4. Journal of Applied Pharmaceutical Science , 2012, 02(01): 28-31
5. Acta Vet Hung. 2009;57(4):485-93