Doctor’s blog

Hardness of water in simple terms is “the soap destroying power of water”. In other words if water is hard large amount of soap is required for producing lather while washing cloths.

Why hardness occurs in water?

Water becomes hard due mainly to four dissolved compounds namely calcium bicarbonate, magnesium bicarbonate, calcium sulphate and magnesium sulphate. If any one or more or all of these four are present in higher quantity the water becomes hard. There are also other compounds (like chlorides and nitrates of calcium, iron, aluminium and magnesium compounds, but they are generally present in small quantity and not significant) that can produce hardness of water, but they are not as important in producing hardness of water as the above mentioned four compounds.

How hardness in expressed?

Hardness of water is expressed as milli-equivalent/liter (mEq/l) and 1 mEq/l of hardness is equivalent to 50 milligrams of calcium carbonate in one liter of water or 50 PPM (parts per million) of calcium carbonate.

• Soft water: less than 1 mEq/l or less than 50 mgs of calcium carbonate/liter
• Moderately hard water: 1-3 mEq/l or 50-150 mgs of calcium carbonate/liter
• Hard water: 3-6 mEq/l or 151-300 mgs of calcium carbonate/liter
• Very hard water: more than 6 mEq/l or more than 300 mgs of calcium carbonate/liter.

Hardness of water is classified as carbonate and non-carbonate. Carbonate hardness is also called temporary hardness due to presence of bicarbonate of calcium or magnesium or both, which on long standing becomes soft due to evaporation of carbon dioxide from bicarbonate and settlement of calcium/magnesium. But non-carbonate hardness does not lose hardness on long standing (due to presence of calcium sulphate and magnesium sulphate) and called permanent hardness.

Deficiency of human growth hormone in children may lead to various problems. The problems of deficiency of human growth hormone in children are different from that seen in adults if there is deficiency of human growth hormone during adult life. The problems or clinical presentations of human growth hormone deficiency of growth hormone in children vary according to cause of the deficiency (like isolated deficiency, insensitivity to growth hormone, due to nutritional deficiency, Growth Hormone Releasing Hormone receptor mutation, psychological factors etc.).

The isolated human growth hormone deficiency is by far the commonest form of growth hormone deficiency. Isolated human growth hormone deficiency presents with typical symptoms and presentations that are different from other causes of growth hormone deficiency. The characteristic features of isolated growth hormone deficiency are short stature (for obvious reason of growth hormone deficiency growth is subnormal), increased percentage of fats, high pitched voice, small size penis etc. There is increased chance to develop hypoglycemia (low blood sugar level in blood) which is mainly due to unopposed or very minimal opposition to the action of insulin.

The cause of isolated human growth hormone deficiency is generally unknown, but in approximately one third of the cases of isolated human growth hormone deficiency there is genetical predisposition, which is transmitted as autosomal dominant, autosomal recessive, or X-linked.

In approximately 10% of cases of isolated human growth hormone in children there is mutation (may be point mutation) of respective genes.