Tag Archives: pediatric doctor vasundhara

New to Nursery ? Helping kids adjust to school

school kids

New Season of School has started in most schools in India. Lots of parents must be sending their little angels to big school for the first time. Most parents and kids would be excited and many would be nervous.

Few tips regarding our young kids while sending them to school for the first time:

  • Get them mentally prepared. Tell them positive things about school. Your kids should be excited to go to school rather than being scared or apprehensive about it.
  • Tell them you are just around the corner and will come whenever needed. And during school hours their teachers will take care of them.
  • Separation Anxiety is integral part of development which needs to dealt with patiently. Separation anxiety in kids
  • BREAKFAST is the most important meal of the day. Make sure that your child as well as you have it together in the morning. A healthy breakfast will boost your immunity as well bonding with your kids.
  • Encourage them and support them at every step.
  • Talk to your child; try to spend quality time with your kids. LISTEN to them rather and ask them open-ended questions.
  • Let them open up to you. They might not be able to express things well and might be emphasizing on very small things which you might find not important. But remember, for them these small things might be more important than you think. And it will encourage them to share more important things with you once they grow up.
  • Show them that you are listening intently. Maintain eye to eye contact with them as they talk.
  • Talking daily and discussing things as a daily routine will help you tackle BULLYING in school as well.
  • Educate kids regarding Good touch and Bad touch to guard them against Sexual harassment. Discuss with kids regularly and ask them to talk to you whenever anyone touches them in private parts. 

    Prevent Against Sexual abuse in Children

  •  Most important is to go with the flow and do not worry too much. Have faith in your abilities.
  • Try to inculcate good habits in your kids and always lead by example.

 

Feel free to contact your child specialist or MAYA CLINIC, regarding any queries

regards

Dr Rahul Varma

Potty-Training-Toilets

When is the right time to start Toilet training in children?

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Training the children for toilet is a big issue for parents. It is perceived as a big developmental milestone. But the real problem starts when we start comparing our kids with others. Every child has different pace of developing milestones. And few accidents regarding Susu (Urine) and potty (Stool) once in a while should be dealt with patiently. Compassionate and encouraging attitude towards toddlers will help us better, than showing frustration and anger.

What is the age when our baby will be ready?

  • First action which suggests that your baby is ready to train is when baby start to tell you while doing susu or soon after that before you take notice. And when baby is praised for telling the same, they will soon be telling you before doing.
  • Most babies should be ready by 2 years but some may take time until they turn 3.
  • Girls are ready earlier than boys of similar age
  • Control over susu comes before potty
  • Other features which indicates that your baby is ready for toilet training are
    • Telling you that his nappy is wet
    • Pulling at wet or dirty nappies
    • Baby does not want to wear nappies any longer
    • Shows interest in others using toilet

  Potty-Training-Toilets

Patience is the Key to success in this case too. Most problems arise when we start too early or we want our baby to be trained before certain major event in our life. eg arrival of 3nd baby, family marriage, long planned vacation, before going to play school. If we try to put pressure on child it will only worsen the case and increase your frustration levels.

How to train your baby

  • Teach your child meaning of words needed to define urine, stool, dry, wet , it’s coming. Choose words you are comfortable with eg susu, potty, wet (geela), dry (suukha), etc. Clear words and constantly same words to be used by everyone at home will make it easier for baby.
  • Need to have thing with you which are needed like toilet seat (different types are there, choose which ever you are comfortable with), footstool near the seat so that baby can climb up, proper lighting in the area, something to hold on while sitting on toilet seat so that baby will feel safe and relaxed.
  • Keep the area safe. Keep toilet cleaner, household cleaner and other toiletries out of range of children.
  • Talk to your child, if you are comfortable you can let your baby go along with you and tell them all the steps you are doing like cleaning flushing etc.
  • Learn the signal which baby gives before, keep your toilet ready (because your baby won’t be able to hold on for long), loose cloths which can be easily removed.

potty-training-readiness

Few important things you need to know:

  • Never start toilet training when something new is happening and child is trying to adapt. eg change of home, grandparents leaving home, arrival of 2nd baby, you are very stressed out etc
  • Give your child time to get familiar with stuff in toilet (so that they are not scared). Eg let him touch the toilet seat, feel it.
  • Encourage an appreciate child’s behavior and things when they tell in time. Hug them or cuddle them and say something like “You are good baby”. And always support them if they do in their pants.
  • Never embarrass or punish your Child. It will only worsen the situation.
  • Remember it is very difficult skill to learn for child and it will take time. The more you support your child easier it will be for them.
  • Hygiene: Girls should be taught to wipe front towards back to avoid chances of getting the potty into vagina and Boys should be taught to shake penis after susu to get rid of any drops.
  • Teach your child to wash hand every time and also assist them in early stages of cleaning.

 

“Toilet training works best when there is no pressure for either the parent or the child”.

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  • If you are stressed out or getting angry seeing that your baby is not learning, it is best to leave it for few days and do not pressurize your child. Punishment will never help.
  • Some baby will hide at some weird place and do susu or potty. Like behind the sofa, or curtain or cupboard. You need to be patient and support them and no Punishment.
  • Most babies will make a mess after doing potty; they may soil their hands and spread it. Do not punish them but also do not pretend to be happy about it. Child should know that it is not good in non threatening way.
  • Constipation can make things worse as doing potty becomes painful and child try to avoid passing stool and is afraid to sit on potty seat. Give warm bath, it may relax the muscles.
  • If a child who has been dry, start to wet again then look for causes of stress or visit a doctor to rule out urinary infection. Features suggestive of urinary infection include:
    • Increased frequency, pain during susu
    • Blood in susu

Consult a doctor if even after age of 4 years child is wetting pants to rule out Urinary infection, bladder abnormalities like Vesico ureteral reflux and behavioral issues like BED-WETTING.

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To Summaries

  • Toilet training is not easy and child needs your support during this difficult phase to learn this new skill.
  • Go slowly at your child’s pace,not as per your need or wish.
  • Praise child at every step and encourage him/her.
  • Do not get dishearten by few accidents (susu & potty) after child had been dry.
  • Punishment has no place in toilet training.

 

Regards

Dr Rahul Varma

Fever, chills, headache during rainy Season? It could be Leptospirosis!

 

 Fever, chills, headache during rainy Season? It could be Leptospirosis!

 02-leptospirosis2

Leptospirosis is most common zoonotic (Spreading from animals) disease worldwide. It is still widely overlooked and under reported.

Without treatment, Leptospirosis can lead to kidney damage, meningitis (inflammation of the membrane around the brain and spinal cord), liver failure, respiratory distress, and even death.

It spreads via urine of infected animals which can get into water and soil and survive there for weeks.

 Leptospira_interrogans_strain_RGA_01

Animal which commonly causes this disease are cattles, rodents, dogs, horses, pigs etc. Animals might be asymptomatic and continue to excrete the bacteria into environment.

EID_Leptospirosis_AcsB_1

It Spread to Human via

  • contact with urine (or other body fluids except saliva) from infected animals
  •  Ingestion of contaminated food or water
  • Direct contact over cut or wound (eg splash of infected water over eyes, nose or broken skin & mucus membrane)

 

Symptoms

Leptospirosis has a wide range of symptoms which could be similar to other illness as well. But common ones are:

leptospirosis

  • High fever, with or without chills
  • Headache
  • Muscle aches, body ache
  • Vomiting
  • Jaundice (yellow skin and eyes)
  • Red eyes
  • Abdominal Pain, Diarrhea
  • Rash

Incubation period ranges from2 days to 4 weeks. Can occur in 2 phases: 1st with acute febrile illness followed by more severe involving multi organ dysfunction “Weil’s Disease”

 model_lepto

Who is at Risk?

  • Occupational hazard eg farmers, mine workers, sewer workers, slaughterhouse workers, veterinarians and animal caretakers
  • Recreational hazard eg swimming in contaminated water , camping outdoor sports. More common in tropical and temperate climate
  • Incidence of Leptospirosis infection among urban children appears to be increasing.

 lepto-infection

How to diagnose?

It is completely curable if diagnosed early and treatment started on time.

Consult your doctor immediately. Doctor will order few tests which may include dark field microscopy, Culture, leptospirosis Serolgy (IgG& IgM) and PCR.

How to manage?

Avoid self medication

Leptospirosis is treated with antibiotics, such as doxycycline or penicillin, which should be given early in the course of the disease. It should be taken only after consulting doctor, in appropriate doses and for proper duration.

Intravenous antibiotics may be required for persons with more severe symptoms.

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How we can prevent it?

  • Clean Water (boiled, RO )
  • Protective gears: while swimming
  • Protective clothing or footwear
  • Cover your would properly and avoid contact with contaminated water, taking shower in monsoon rain, going to river banks
  • Take care of pets. Consult vet doc
  • Clean your home regularly of rats and other animals

For further reading click on the link below

http://www.searo.who.int/entity/emerging_diseases/topics/Communicable_Diseases_Surveillance_and_response_CDS_leptospirosis-Fact_Sheet.pdf?ua=1

Feel free to discuss with your doctor or call us at MAYA CLINIC. we will be happy to respond back.

Regards

Dr Rahul Varma

 

Typhoid Fever (mayaclinic.in)

Typhoid Fever: things we should know

 

 

Typhoid Fever (mayaclinic.in)

 

Typhoid Fever is so commonly heard off in our country. (I think most common as well as most over diagnosed disease in India).

typhoid

Cause: It is caused by bacteria called Salmonella Typhi (S.Typhi) typically living in humans and are shed through a person’s feces (poop) or urine (pee). Bacteria get into blood and spreads quickly inside leading to high grade fever within a week or two.

Without treatment, typhoid fever may last a month or more and become very serious, even life-threatening. Even after treatment during recovery phase a person can transmit this disease to others.

  food infected

Cause of Spread: 

  • Due to unclean water intake, unhygienic food and poor sanitation facilities.
  • Drinking water (and other drinks) and eating food handled by someone who has typhoid or is still a carrier.
  • Infected people can pass it on to others by touching them with unwashed hands.
  • Contaminated water by sewage, more so in area with poor sanitation and inadequate water treatment

Typhoid fever is named after a lady called typhoid mary who was suffering from this disease and used to serve food in USA leading to epidemic of this disease in that area.

tm                       typhoid-mary-article  

Symptoms: Severity depends upon vaccination status, age, general health etc

ss

  • Mild to High grade Fever
  • Stomach pain
  • Body pain, weakness
  • Diarrhea or constipation
  • Poor appetite
  • Reddish spotted rash

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Complications

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Complications: Intestinal perforation (rare)

 

Diagnosis:

Salmonella_typhimurium- gram negative bacilli under high magnification of 15000 X

  • History and examination
  • Blood tests :
    • Typhi Dot IgM: during first few days of fever
    • Widal test: after 5 days of fever (It gives false report before that). Unfortunately this test is most misused test in India. And many false positives reports are given by various labs even on first day of illness.
    • Blood Culture is gold standard: But in most cases antibiotics have been started early so yield of this test is low. And beside it is costly, so many quacks start treatment rather than testing. This treatment is often incomplete and in inadequate doses leading to drug resistance and disease recurrence.

child_with_fever  

Treatment:

  • Antibiotics: important to give for proper duration and in adequate doses. Please do not stop medicine on your own once child starts feeling better after 2- 3 days.
  • Some Cases might not respond to oral medication and need for Intravenous medication along with fluids might arise.

Plant for treating Typhoid Fever

Stopping the Spread

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Prevent the spread to others: Wash hands regularly. People with typhoid fever should avoid preparing food. Children should stay away from school until doctor certifies them to join back school.

How to prevent Infection

travel_clinic_vaccinations 

Vaccination: It is Available and routinely given around 2 years of age and every 3 years after that. Even if your child is vaccinated (Vaccine is not 100% effective and loses its effectiveness over time)

  • Sanitize water.
  • Cook all food.
  • Avoid raw food.
  • Wash hands frequently

handwashingposter

Feel free to contact your child doctor for any queries or contact us at MAYA CLINIC.

Regards

Dr Rahul Varma

” Healthy Kids, Happy Family”