Tag Archives: Pediatrician Ghaziabad

Urinary infection in children: what need to be done?

uti

  Definition of urinary tract infection (UTI) is  growth of significant number of organisms of single species  in urine sample along with Symptoms. ( First aid for urinary pain in children. )

Types of UTI and common symptoms

Simple UTI: mild fever, irritable, Pain during urination, increased frequency and urgency

Complicated UTI: High grade fever, vomiting, stomache, dehydration and toxic looking child

Symptoms present less often are: heamturia, voiding issues, bed wetting , failure to thrive may also be present

 

Risk factors:    Girl child , poor hygiene, Vesicoureteral reflux (VUR), Voiding dysfunction, obstruction in urinary tract

Urine collection: mid stream clean catch sample gives most accurate report in home settings

Urine routine , microscopy s/o UTI: pus cells in urine sample, along with positive nitrate and leucocyte esterase .

Gold standard test is urine culture.. as its report takes aroung 48 hours to come, we can start antibiotics after sending urine sample for culture in consultation with doctor and wait for culture report for further plan of action.

Treatment:

Plenty of fluids, oral antibiotics and other supportive care as advised by your doctor

Plan of action as per age ( preferably in consultation with pediatric nephrologist)

  • Less than 1 years: Ultrasound, MCU and DMSA scan
  • 1-5 years of age: ultrasound and DMSA, ( if DMSA is abnormal than MCU to be done)
  • More than 5 years: Ultrasound only ( if abnormal  further work up)

In high risk cases ,we might need prophylaxis to prevent repeated episode of urinary infection.

Whenever in doubt consult pediatric nephrologists

Regards

Dr Rahul Varma

How should I manage Diaper Rash in my baby?

 Diaper rash

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rash

I think virtually every parent must have faced this problem once in their babies at some point of time. Diaper rash basically develops due to direct contact of skin with moist surface or soiled diaper. It develops mostly in genital area, perianal area, thigh folds and buttocks.

Diaper rash (mayaclinic.in)

Causes of Diaper Rash:

  1. If potty soiled diaper is left for too long.
  2. If wet diaper is kept for too long a period.
  3. Allergic reaction to diaper material, soaps or baby wipes
  4. Too much moisture
  5. Too much rubbing of skin while cleaning or too much friction from diaper if put very tightly on baby.
  6. Bacterial infection, yeast infections

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Once the rash has started developing and skin is damaged, there are more chances of developing infections like bacterial, fungal or yeast.

Babies who are breast fed have less chance of diaper rashes.

More common when baby is having diarrhea, baby on antibiotics, recent change in dietary habits like starting with solid foods. If babies are not kept clean or dry for long periods.

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Steps to manage/ prevent Diaper rash:

  • Keep area as clean and as dry as possible.
  • Pat dry; the area rather than rubbing. Allow it dry fully before putting on diaper.
  • Use oil based barrier like Vaseline petroleum jelly, coconut oil etc.
  • Keep diaper area dry for as long as possible. Best is to avoid use of diaper during day keep it open to dry air.
  • If temperature of room is ambient, try to keep baby in open without nappies, so that rashes can air dry.
  • Change diaper more frequently
  • Avoid wiping with alcohol based wipes, use soft cotton washcloth.
  • Apply thick layer of any Zinc based ointment like Siloderm etc. Or any napirash cream available. Important is to put a thick layer and it is not necessary to completely remove the whole cream on next diaper change.
  • Most important thing to remember is that heavy rubbing or scrubbing is only going to damage it more.
  • Wrap the diaper as loose as possible (too tight diaper can prevent proper air circulation is there and wet or soiled parts do not rub against the skin too much).
  • Avoid use of Steroid based creams as far as possible (unless until recommended by your child doctor, as they can harm your baby).

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When Consult your child doctor (Pediatrician) if

  • Pus filled blister or sores appear near rashes
  • Rashes are not improving
  • They are getting worse even after taking all the precautions.
  • Baby has fever along with rashes
  • Rashes all over the body

home-remedies-for-diaper-rash

Various home remedies available for Diaper rash treatment are listed in the below mentioned link.

http://www.top10homeremedies.com/home-remedies/home-remedies-diaper-rash.html

 

Regards

Dr Rahul Varma

What is the right breast pump for lactating mother?

 

(Source Indus parenting site)

Direct breast feeding is the best option, but sometimes due to medical conditions or working mothers need to express breast milk.

When nursing mothers need to express breast milk; it can be done manually (as it had been done traditionally for long time) or you can use breast pumps (mechanical stuff which has become fashionable in recent years to make the process more comfortable and easy).

From a baby’s point of view; baby needs clean hygienically expressed milk, whichever methods suits you, it is up to you. Whether you express it manually or use manual breast pumps or electric breast pump.

 

breast pump

As a new mother, you might have prepared a list of ‘things to do.’ You might have even stuck to this list that mostly reads, “Feed, clean, bathe, repeat.” But now it’s time to go back to the corporate jungle and claw your way back up the ladder. And if that’s the plan then you are probably in the market looking for a breast pump.

Since there are many kinds of breast pumps, you will have to select the one that you feel would work best for you. Which means that this type should keep the milk flowing and prevent clogged ducts or breast infection.

When exactly do I go for a breast pump

So on your next visit to the gynaecologist, you may be advised to buy it way before you actually plan to use it; which means almost a month or so before you head back to work or plan to introduce the bottle. Dr Ragini Agarwal, surgery and cosmetic gynaecologist, W Hospital by Pratiksha, Gurgaon, explains, “New mums who are about to resume work or need to stimulate lactation because of low milk supply, or to relieve engorgement (a painful condition whereby the breasts are overfull) urgently need a breast pump.”

You can also consider buying a breast pump for the following reasons:

  • The baby needs extra breastmilk as a ‘top-up feed’ following a breastfeed
  • The baby is in the nursery and, therefore, separated from the mother
  • The mother is forced to wean due to the infant’s death
  • You wish to maintain or increase milk production
  • To pump exclusively if the new mother is hospitalised after birth
  • If the mother cannot nurse for physical reasons such as a cleft palate
  • The baby may not be able to suckle well at the breast

In case you are planning to use a breast pump soon after delivery, experts advise that its best to start pumping within three to four weeks of delivery. Dr Geetika Gangwani, lactation consultant, Mamma Mia, Fortis, Delhi, says, “Each mother and baby is different, so the need to express milk will be very individualistic.

For instance, mothers whose babies are in the NICU soon after birth, need to start expressing using a breast pump within six hours of their delivery. Whereas some mothers only express once they go back to work and a few might not need to express at all.”

So how do you select a breast pump? Before heading out to the market, ask yourself two questions. First, what are the different types of breast pumps. Second, how safe is it for you as well as your baby?

Continue reading to know more about the types of breast pumps and their safety norms

Should you invest in a manual, an electric or a double breast pump? If you’re looking to buy one, then address these questions before your purchase

breast pump

Types of breast pump

Let’s begin with the first question. There are many models of breast pumps in the market, but they are primarily categorised into two types- electric and manual.

  • Manual breast pumps: They are operated by squeezing or pulling a handle in a repetitive fashion. This allows the user to directly control the pressure and the frequency of milk expression. Manual breast pumps are small and inexpensive and are, therefore, easy to use. They also come with many accessories such as breast shell, a pump membrane (this helps in maintaining the suction and is vital for pump functioning) and tubing (this connects the mechanical apparatus to the collecting bottle).
    Cost: They can cost anything between ? 200 and ? 3,000. “But they require significant effort and can be tiring because the user provides all the power. They also allow for only one breast to be pumped at a time,” says Dr Priyanka Mehta, senior gyneacologist, ePsyClinic.com, Delhi.
  • Electric breast pumps: They are ideal if a mother pumps daily. They are larger than manual pumps, but portable models are also available in the market. These are also divided between hospital grade and personal use pumps. While hospital grade pumps are larger and intended for multiple users, personal use pumps are smaller and generally intended for a single user.
    Cost: A high-quality, electric pump costs anything between ? 3,500 and ? 7,000. “These will help you express your milk most efficiently. You could also opt for a double breast pumps that pumps both breasts at same time and can cost up to ? 20,000,” says Dr Mehta.

A word of caution: Try to keep your hands off the piston type or the bicycle horn pump (they can damage breast tissue and harbour bacteria in the suction bulb) or the rubber bulb (they can also harbour harmful bacteria) from the range of manual breast pumps in the market.

Now how do you decide which type is best for you. Dr Gangwani explains why this is not a question to worry about. “Successfully expressing breastmilk is an art that mothers usually master over time. Research shows that electrical breast pumps along with massaging the breast gives maximum output.

When choosing a pump, please keep in mind the frequency of its use. If you plan to pump at least three to four times per week, an electrical pump is recommended. If the frequency is lesser, then you could use a manual pump or hand express as well,” she says.

Safety notes while buying a breast pump

The second question you must address is the safety of a breast pump. Because quality breast pumps don’t come cheap, you might consider borrowing it from a friend or buying a cheaper version. That’s a complete ‘no-no.’

Breastmilk can carry bacteria and viruses of hepatitis and HIV, and they can contaminate the pump. Also, in some cases an exclusive pump for your own personal use can be unsafe because the milk can get into its internal parts. However, pumps that are originally designed for more than one mother are still safer. You can try rental and hospital pumps, they are usually cleaned properly and are sterile.

“Dr Gagnwani says, “In addition, mothers can also try manual breast pumps. Apart from being less expensive they are also easy to clean and portable, making them a safe option.”

While you weigh in all of these options, also keep in mind a few other things:

  • If you have chosen a double breast pump, seal the unused side. If you avoid this practice, it can reduce the pump’s suction and reduce milk production.
  • Wisely choose the breast shields. Your nipple should not run along its chamber, you can hurt your breast this way.
  • If you are to feed within a few hours, take out all the parts and separately clean them with a mild soap and warm water.

Buying a breast pump can be tough, especially when you are a new mother. So to make things easy, first understand the types and functioning of the pumps you may have finalised for yourself and then read the safety precautions for their use. All this information will not only help you but also help another confused new mum who may turn to you for some advise.

bully (mayaclinic.in)

How to stop bullying in Children?

bully (mayaclinic.in)

Bullying is so commonly seen among children these days. We need to take a strong stand against bullying. It can ruin someone’s entire life; it can damage self esteem of a child.

Good thing is that people in the community have started recognizing it and lots of efforts are being made at different levels to prevent bullying.

what is bullying

Few basic strategies which can help in preventing Bullying of your child are:

  • Discuss and talk about it: Discuss with your children and family about this topic of bullying. Share your experience, may be your child will open up easily after it. Praise your kids, if he/ she open up and provide unconditional love and support to them.
  • Consult with School Staff: Discuss with teachers and counselors at school regarding their policies on bullying and how do they tackle it, if a case arises.
  • Remove the bait: If bullying is occurring due to a money which child carry for lunch or any fancy gadget which your child is carrying; then stop it. Remove anything which your kids think is the root cause of bullying. Never shy away from discussing with school teacher.
  • Have a Buddy for your child: Having a safety buddy with whom your kid feel safe will be a good option. Tell your child to have a buddy with them; whenever they think the bully may strike like in school bus, washrooms, empty corridors etc.
  • Try to Ignore and keep calm: Bully feel satisfied if they see you getting frustrated and irritated; it gives them a high. If you do not react to bullies, it takes away the basic pleasure for which bully is doing it. SO your child’s best chance is to ask the bully to stop it and walk away from there. And if needed report to appropriate person/authority soon after.
  • Do not try to battle it out on your own: Many a times you might need to involve the parents of the bully. But do it in presence a counselor who can mediate.
  • Be confident; bullies don’t like people who are not afraid.

bullying stop  stop bullying 2

Discussion and supporting your child through this tough phase is the key. Spending quality time with your child will help them to open up with you.

Feel free to talk to your pediatrician or child psychologist regarding this issue.

Bullying 1

 

Regards

Dr Rahul Varma

 

 

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Injury prevention and Safety in children

Injury Prevention in Children

Every day around 1000 children die worldwide. Most of these deaths can be prevented by taking simple injury prevention measures. Huge number of children becomes seriously injured for life. In developing countries like ours where we lose so many children to infectious diseases; it adds to the mortality burden of country. More than 90% of these injuries are unintentional.

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Common Causes:

RTA ( road traffic accidents), fall from height, burns, poisoning, drowning are the main causes of death in children due to injuries.

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Road traffic accidents (RTA)

It is the leading cause worldwide. various methods which can help in preventing these deaths are Proper use of seat belts and child restrainer devices , wearing helmets, driving and walking in designated lanes, driving within speed limits and to avoid drunken driving.

Fall:

Fall from beds are very common and most baby survive with only bruises and scratches. But still more than 100 children die daily due to fall from height. Many of these deaths can be avoided by using well fitted window panels, child proofing doors and windows and play areas.

Burn:

Burn injuries from hot water or flames are commonly seen in young children. Preventive measures which can help are smoke alarms, temperature regulators, using fire crackers under supervision of adults.

Poisoning:

Another common cause of death in young children is poisoning. Daily numerous calls are received by poison cell. Accidental poisoning can be prevented by child proofing cabinets, keeping toilet cleaner out of reach of children, keeping kerosene oil safely and all the medicines away from children.

Drowning

Drowning is another cause of death in coastal areas. But many small children can drown head down in buckets or bathtub.So to prevent these deaths, we need to store water only in closed container and keep tub empty.

Poverty

Children living in poor economical conditions are more likely to be living in unsafe environment. They might be living close to road with high traffic, poor and unstable construction, illegal electricity connection etc.

child-injury

 

Prevention

Child deaths have decreased significantly over last decade (in western countries) due to following measures:

  • Enforcing laws for child safety like having child proof cabinet for storage of medicines and floor cleaners etc.
  • Structural modification in public places like proper railing for child safety in stairs, well fitted windows, fencing around pools, life guards etc.
  • Public awareness campaigns
  • Better emergency care
  • Proper storage of flammable objects
  • Parental guidance
  • Better disaster management

 1child

In India major issue is with enforcing laws rather than making them. Authorities should be more vigilant and we should also know our social responsibility.

Right to safety

All children have the right to a safe environment and deserve protection from injury. With proper awareness, environmental modifications and good emergency care, it can be achieved.

 

Regards

Dr Rahul Varma

 

Smartphones and Tablets are not meant for babies; they interfere with optimum brain development. Read on to know more

mayaclinic-smarthphone -baby

Smartphones and tablets are not meant for babies (< 2 years)

In today’s environment we all can see small babies and toddlers playing with phones. Whether you are at mall, driving in car, waiting somewhere , smartphones have become like babysitter for many parents. Parents feel excited to see their small babies handling touch screen phones so efficiently. Touch screen smartphones with their great picture quality, colorful images and good sounds appeals to babies. But are they really good for optimum brain development for young kids?

Answer:

Till now there is NO research done to know the connection between infant learning and smartphones. For older children with use of interactive elements it may help in learning concepts such as sequencing and cause and effect relations. But for small babies who are still in very young age of brain development, it’s long term effect is not known.

 baby-on-smartphone

Recommendations:

All the doctors are of the opinion to reduce screen time for small babies. Screen time includes time spent on TV, videos, laptops, phones etc. American Academy of Pediatrics (AAP) has made a clear stance that “NO screen time for kids less than 2 years”. Main reason being association of Language learning delays, poor reading skills and short term memory are seen more often in children with more screen time.

Facts:

Children learn better from real life experiences rather than screen time. It is more so if activities involve moving and doing. Various surveys and studies show that on an average 12-month-old baby is exposed to up to 2 hours of screen time a day.

Young age (< 2 years) is very critical for learning of new concepts. Most of the learning involve 3 dimensional Sensory- motor experiences which cannot be replicated on a 2 dimensional screen. Active play involves better hand – eye coordination , fine motor skill development.

Example:  Compare a ball in real life and a ball on Screen.

Infants are still developing concept of 3 dimensional vision. For a small baby  watching on screen a BALL is just a flat, shaded circle. In real life if we roll a ball across floor it proceeds in a single motions and gradually slows and stops finally. But on Screen same action cannot be done; it will be broken up. Small babies may stare at bright colors and motions on screen but their brain is not capable of making sense or meaning out of these amazing pictures. By  the age 2 years brain has developed enough and baby can understand things better. Due to all this confusion it is better to avoid screen time in small babies.

After a certain age technology and screen time can be used judicially for better interactive teaching. Older children can do lot more and screen time can help them in understanding concept better along with reading from textbook. But not for very small babies.

Another excuse which most parents give is that there baby will never eat food if we take phones out of there life. Just to remind them that before invention of smart phone kids used to eat well.  And Honestly speaking we have started spending more time on social networking like facebook and whats app which have lead to more exposure in children. Because it’s we who cannot live without phone rather then kids.

Regards

Dr Rahul varma

 

 

You can save a life by giving Hands-only CPR !

 

  CPR (mayaclinic.in)

“Anyone can learn CPR and everyone should”

  • Sudden cardiac arrest is one of the leading causes of death worldwide. Many of these lost lives can be saved if a person nearby knew how to do CPR (cardiopulmonary resuscitation) or simply hands- only CPR.
  • You will be surprised to know that it is easy to perform and can be done by anyone. There is no need for any knowledge reading science i.e.  it can be done even by an illiterates . It just need strong will on your part to know it.
  • Sudden cardiac arrest is not the same as a heart attack.
  1. Sudden cardiac arrest occurs when electrical impulses in the heart become rapid or chaotic, which causes the heart to suddenly stop beating.
  2. A heart attack occurs when the blood supply to part of the heart muscle is blocked. A heart attack may cause cardiac arrest.

 hands-only-cpr

Reasons why you should know it

  • It saves many lives should be a good enough reason for you to learn it. Chances of a person surviving a sudden cardiac arrest increase significantly if CPR is started early. Effective bystander CPR provided immediately after sudden cardiac arrest can double or triple a victim’s chance of survival, but unfortunately very few cardiac arrest victims get CPR from a bystander in India.
  • More than 80% of heart attack occurs at home, so chances are you will be saving a person’s life that you love. Put very simply: The life you save with CPR is mostly likely to be someone you love.
  • CPR is not done by many due to various concerns like doing harm to person, doing harm to oneself, reason of hygiene, chances of getting infected or getting into legal hassles. But once you know the proper technique you will realize, you can only do well to a dying person without risking your health. Don’t be afraid; your actions can only help.
  •  Giving mouth to mouth resuscitation is not necessary: Most common reason why people are afraid of giving CPR is that they might have to give mouth to mouth breath. Guidelines in 2010 changed which clearly says that without formal training you should attempt hands-only CPR.  I strongly feel, all of us should know how to do chest compression even without mouth breathing. In many adults hands-only CPR has been found to be equally effective. (Although in children it is different and reasons of sudden cardiac arrest are different)
  • Hand-only CPR is very easy to learn: It can be easily performed
  • Unnecessary deaths can be prevented which occur due to poor response to cardiac emergency.
  • You can learn how to give Hands-Only CPR by watching a simple one-minute video at heart.org/cpr. (In India, call 102 instead of 911)

cpr

Once you have learned CPR, You can teach others too. Give 5 people you care about the power to save lives by equipping them to act quickly in a crisis.

Don’t be afraid; your actions can only help.

mayaclinic.in

If you see an unresponsive adult who is not breathing, call 102(call for help from others nearby) and push hard and fast on the center of the chest.

But before starting CPR make sure your life is not in danger (eg. No moving vehicle nearby, no chances of accident)

SEE A VIDEO, SAVE A LIFE
You can prepare yourself to act in an emergency by simply viewing the Hands-Only™ CPR instructional video(In India, call 102 instead of 911)

correct posture while CPR

The American Heart Association has recommended Hands-Only  CPR for adults since 2008.

Feel free to contact any nearby hospital to learn CPR.

Regards

Dr Rahul Varma

 

Sleep_hygiene

My baby not sleeping well at night? what to do.

Sleep Hygiene for children

Sleep_hygiene

 

To put child to sleep might be a big task for some of the parents. Young kids and children always are interested in playful activities and making them sleep on time might be difficult for many parents. Children have different sleeping time in different phases of life. The total duration of sleep decreases as child grows older.

YourChildsSleep_graphic

Following are the things which you can do so that your baby sleeps well. And it will also prevent development of sleep disorders later.

 little-girl-sleeping-(mayaclinic.in)

  1. Set bedtime and bedtime routine for your children. It will help adjust their body clock and they will be better prepared mentally and prevent development of sleep disorders.
  2. Bedtime and wake up time should be same on school and non school nights. Change in schedule is very common over weekends as children are allowed late nights by many parents. It is always better to follow a fixed pattern. Body adapts well to it.
  3. Hour before bed time should be quiet time. An hour prior to sleep should be winding up time and preparing to sleep in quiet and comfortable environment. Best time to sit back and discuss with your children regarding day’s activity or best is story telling time.   Father Watching His Infant Sleep
  4. Do not send your child hungry to bed. If child is empty stomach it will hamper proper sleep. So a light meal before sleep is best in order to avoid child waking up at middle of night.
  5. Avoid products with caffeine for few hours prior to sleep. It can delay the sleep. Avoid too much of liquid intake few hours prior to sleep. It can increase the urge to pass urine during night and disturb the sleep. It is more important in children with bed wetting issues.
  6. Outdoor Physical activity daily. Regular physical exercise is not only important for growth and development of child but also for to induce proper sleep.  sleeping child
  7. Bedtime quiet and dark. Bright light or loud music and disturb initiation of sleep. It is best to have night lamp or dim light in case your child is afraid of dark.
  8. Comfortable temperature. Ambient temperature is needed for good sound sleep. But if the temperature is too cold or too hot it will interfere with proper sleep.
  9. Bedroom only for sleeping, not for time out or punishment. Bedroom should be meant for sleeping only and all the other playful activities should be done in other room.
  10. No TV in bedroom.  TV / laptop/ computers are absolute no for bedroom. It distracts children a lot and prevents them to go to sleep.

 sleep hygiene 2

 Just to summaries about all the steps in one photo, read the below info-graphic.

10-tips-for-better-sleep

If we do not follow proper sleep hygiene steps for children, it can increase the chances of Sleep disorders like sleep terror, insomnia, parasomnia etc. Various sleep disorder we will discuss later in other article.

 

Regards

Dr Rahul Varma

“Healthy kids, Happy Family”

 

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

 

nose bleed (mayaclinic.in)

How to manage child with nose bleed (Epistaxis) ?

 

Epistaxis (Nosebleed): What to do?

nose bleed (mayaclinic.in)

 

One of the most frightening sites for a parent is to see their child bleed from nose. But you can rest assure that in most cases it is not serious. Most of them can be treated at home.

 nosebleed

It occurs due to bleeding from small vessels of nose. It happens as a result of break in the tissue lining of nose (mostly in front part or “anterior” of nose).

 Epistaxis Management        images

Cause:

  • Irritation and lack of moisture in the nasal membrane
  • Dry air or warm air can lead to crusting of membrane inside nose and it may cause itching which can lead to scratching or nose picking. It in turn leads to bleeding.
  • Allergic conditions and cold
  • Repeated nose blowing
  • Excessive use of antihistamines and Decongestant medicines can also lead to it.
  • Serious causes: Head Injury
  • Bleeding disorders

 t3

In some cases bleeding can occur from posterior part of nose which can be dangerous. It leads to flow of blood down the back of throat.

Frequent or long time bleeding if occurs; you should consult doctor.

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What can be done at home?

 t 1 

t2

 

  • Do not Panic and remain Calm
  • Make your child sit in your lap and tilt his or her head slightly forward.
  • Gently pinch nose with clean cloth.
  • Keep applying pressure on nose for about 10 minutes. If we stop too soon bleeding may start again
  • If child is leaning back, it may cause blood to flow down the throat which may in turn cause gagging, coughing or vomiting.
  • Discourage child to blow nose, picking, rubbing.
  • Ice pack on forehead might help.

  t4

When to call doctor?

  • Frequent nose bleed
  • Long time duration of bleeding or difficult to control bleeding
  • Foreign body in nose
  • Bleeding from any other site as well
  • Associated symptoms like fever, rashes etc
  • Easy bruising tendency
  • Medication: recently added or long term

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Urgent Attention needed if:

  • Bleeding is heavy
  • Associated with weakness or dizziness
  • Head injury or history of fall
  • Bleeding continues after two attempts of applying pressure for 10 minutes each

 m1

 

Prevention:

  • Avoid nose picking (Keep finger nails trimmed most of the time)
  • Use saline nasal spray frequently during illness
  • Vaporizer or steam helps
  • Protective gears while playing or driving to prevent injury

 

Even after taking all the precautions, sometimes child starts bleeding without any obvious reason. So do not panic as most of them are harmless and can be stopped easily.

Discuss with your doctor (Child specialist/ ENT specialist) or contact us at Maya Clinic.

 

Regards

Dr Rahul Varma

” Healthy Kids, Happy Family”