Neonatal Cholestasis… Neonatal Cholestasis- when to suspect 25 Feb 202124 Feb 2021 Neonatal cholestasis is defined as jaundice with high color urine staining diaper in an infant within first 3 months of life. The common causes of neonatal cholestasis are – 1) Extra…
Laboratory Tests… Antinuclear Antibody-ANA 18 Feb 202118 Feb 2021 Antinuclear antibodies(ANA) are autoantibodies which recognize cellular antigens found predominantly(although not exclusively), in the cell nucleus. A positive ANA of 1:160 or more is highly suggestive of autoimmune diseases such…
PEDIATRIC DRUG THERAPY… Proton Pump Inhibitors 14 Feb 202112 Feb 2021 Proton pump inhibitors (PPIs) are substituted 2-pyridyl methyl sulfinyl benzimidazoles that inhibit the final common pathway in gastric acid secretion in the apical membrane of parietal cells regardless of the…
Hematopoietic Stem Cell Transplantation(HSCT)… Guidelines for Umbilical Cord Blood Banking 11 Feb 202110 Feb 2021 Umbilical cord blood can be safely collected from the placenta without any harm to baby or mother, however cord blood collection is not advisable in complicated deliveries. Private Cord banking…
THE EAR… Tympanometry 7 Feb 20214 Feb 2021 Tympanometry is a technique used to look at the function of the middle ear. It is NOT a hearing test. It is a test used together with otoscopy and audiometry…
Defects in Carbohydrate Metabolism… Galactosemia 4 Feb 20212 Feb 2021 Galactosemia is a rare autosomal recessive inborn error of galactose metabolism. Galactosemia should be suspected in a neonate who has persistent unexplained jaundice with poor feeding and weight gain. Such…
Human Immunodeficiency Virus(HIV)… Diagnosis of HIV infection in Infants and Children 31 Jan 202131 Jan 2021 Maternal HIV antibodies usually persist for nearly 9- 12 months in the infant. In some children, they may persist for as long as 18 months. Following table shows the various…
Breastfeeding… Feeding guidelines for infant born to HIV positive mother 28 Jan 202128 Jan 2021 Breastfeeding (BF) does carry a risk of transmission of HIV infection from HIV infected mothers to their infants. However, with use of maternal Anti Retro Viral (ARV) Drugs, the chances…
Human Immunodeficiency Virus(HIV)… ARV prophylaxis in Infant born to a HIV positive mother 24 Jan 202127 Jan 2021 Scenario 1: Infant ARV prophylaxis when mother has not been taking Nevirapine during pregnancy Infants are to be given daily Nevirapine (NVP) from birth for 6 weeks regardless of the mode…
The Endocrine System… Turner Syndrome 21 Jan 202120 Jan 2021 When parents of a girl child have concerns of a short stature or/and pubertal delay, always consider Turner syndrome as one of the possibilities. Besides a thorough physical Examination and doing a SMR…
PEDIATRIC DRUG THERAPY… Choosing a Topical Steroid 17 Jan 202116 Jan 2021 The prescribing physician should know about the classification of Topical steroids. GRADECLASSEXAMPLES1Very high potency Clobetasol propionate, Halobetasol prop2High potency Betamethasone dipropionate, Diflorasone 3Medium potency ointmentMometasone / Fluticasone ointments 4Medium potency creamsMometasone / Fluticasone creams 5Lower medium Hydrocortisone butyrate 0.1%6Low…
Diseases of the Blood… Hemophagocytic Lymphohistiocytosis (HLH) 14 Jan 202111 Jan 2021 Hemophagocytic lymphohistiocytosis is a terminology that is being encountered frequently in the past few years. It is a pathological entity where uncontrolled inflammation results in activation of lymphocytes. Activated T…
Henoch Scholein Purpura… Henoch Scholein Purpura 10 Jan 202110 Jan 2021 It is the most common primary systemic vasculitis in children. Diagnosis requires the presence of purpura or petechiae with lower limb predominance with one of the following four- Abdominal pain Arthritis…
Acute Pancreatitis… Acute Pancreatitis 7 Jan 20217 Jan 2021 Acute pancreatitis (AP) is not a rare disease in children and adolescents and should be considered during the differential diagnosis of acute abdominal pain. It may be life-threatening if it is…
Bronchoscopy… Tracheo-bronchial Foreign Body Extraction in children 3 Jan 202129 Dec 2020 Removal of foreign bodies from the child’s airways can be done either by a flexible bronchoscope or a rigid bronchoscope. Most usual foreign bodies like peanuts, almonds, other nuts and seeds…
Primary Teeth… ARE PRIMARY TEETH REALLY THAT IMPORTANT ?! 31 Dec 202030 Dec 2020 As a Pediatric Dentist, the most common question that I am asked is “Do baby teeth really require dental treatment?” Yes, it is true that primary/baby teeth are temporary and…
Appendicitis… Nonoperative management of Appendicitis 27 Dec 202026 Dec 2020 Appendectomy for an appendicitis presenting early remains the treatment of choice in majority of the cases but a minority of children can be considered for a Non Operative Management(NOM) if the…
Adolescent Medicine… Diagnosis and Management of PCOS 24 Dec 202023 Dec 2020 Continued from Previous post..What is PCOS Diagnosis According to Endocrine Society guidelines, diagnosis of PCOS is made by presence of clinical ± biochemical hyperandrogenism in the presence of persistent menstrual irregularity. Laboratory…
Adolescent Medicine… Polycystic ovary syndrome (PCOS) 20 Dec 202020 Dec 2020 Polycystic ovary syndrome (PCOS) is the most common endocrine condition affecting between 6–18% of adolescent girls It is associated with symptoms of hyperandrogenism (excess body hair (hirsutism), severe acne) and…
Diseases of the Blood… Iron chelation therapy in Thalassemia major 17 Dec 202016 Dec 2020 Continued from Previous Post on Assessment of Iron Overload in Thalassemia Goal of chelation therapy is to decrease tissue iron to a safe level and to minimise level of non-transferrin bound iron (NTBI)…
Diseases of the Blood… Assessment of iron overload in Thalassemia patients 13 Dec 202013 Dec 2020 An inevitable complication of regular blood transfusions in a Thalassemia major is iron overload. Assessment of iron overload by serum ferritin is widely used, relatively easy to perform and most acceptable, but…
The Digestive System… Importance of frequency, colour and consistency of stool in first few months 10 Dec 202010 Dec 2020 The child usually passes stool (meconeum)at the time of delivery. By end of 48 hours 99% of newborns would have passed stool, failing which the child should be investigated. In the first…
Hypertension… When should one measure a blood pressure in children? 6 Dec 20206 Dec 2020 Blood pressure (BP) should be measured annually in children and adolescents 3 years onwards. BP should be checked in all children and adolescents 3 years onwards at every health encounter…
IAP VACCINE GUIDELINES… IAP vaccination update 2020 3 Dec 20203 Dec 2020 The updates e-published byIndian Academy of Pediatrics (IAP) Advisory Committee on Vaccines and Immunization Practices (ACVIP) on 29th November 2020 issue new recommendations especially for IPV, IIV & Varicella vaccines apart from…
Congenital Heart Disease… Screening for Critical Congential Cyanotic Heart Disease in a newborn 29 Nov 202029 Nov 2020 In first 48 hours, many cyanotic congenital heart diseases can be easily missed. To avoid that, we must assess saturations before discharging the child - at least in one upper and one lower…
Urodynamic Study UDS… Scope of a Pediatric Urodynamic Study (UDS) 26 Nov 202024 Nov 2020 Pediatric urodynamics study (UDS) is a group of tests done for the assessment of how well the child’s bladder is functioning. The study measures following physiological functions- The functions of…
Evaluation of Renal Disease… Can hematuria result in anemia or proteinuria 19 Nov 202018 Nov 2020 Usually even gross hematuria doesn’t result in significant blood loss, except in case of trauma. 1 ml of blood in 1000 ml urine is sufficient to cause red discoloration of…
Evaluation of Renal Disease… Evaluating a child with “RED URINE” 15 Nov 202015 Nov 2020 All cases of red urine are not due to hematuria. Ask - History of fever, dysuria, rash, joint pain etc. If asymptomatic ask history of ingestion of beet-root, food colouring…
Hematopoietic Stem Cell Transplantation(HSCT)… Types of bone marrow transplants & finding a suitable donor for BMT 12 Nov 202012 Nov 2020 Continued from previous post..... There are two main types of transplants – Autologous and Allogenic. Autologous Transplants: This means that the bone marrow or stem cells used for the transplant…
Hematopoietic Stem Cell Transplantation(HSCT)… What is a stem cell (bone marrow) transplant 8 Nov 202011 Nov 2020 A stem cell transplant is more commonly known as a bone marrow transplant (BMT). The reason we use different terms is that in the past the stem cells were obtained…
Anti-Epileptic Drugs… Valproate 5 Nov 2020 Valproate is a commonly used as well as abused anti-epileptic drug. It is a broad- spectrum anti-epileptic which means that it is effective in nearly all types of seizures viz-…
Immunological Disorders… When to suspect A Primary Immunodeficiency 1 Nov 2020 Primary immunodeficiencies are to be suspected in any patient with Unusual susceptibility for infections, Severe or early onset autoimmunity and Susceptibility to malignancies. Initially only patients with susceptibility towards infections were evaluated…
Beyond Clinical Pediatrics… Understanding Standards & Certifications of Masks/Respirators 29 Oct 202028 Oct 2020 With the novel coronavirus outbreak globally, all of us as doctors are concerned about our safety and many of us would need to answer same to our patients. Masks vs…
VACCINATIONS… Hepatitis-B Vaccine Non-responder 25 Oct 202023 Oct 2020 Approximately 5-10% of people do not develop protective antibodies even after the completion of the hepatitis B vaccine series. This is confirmed with anti-HBs titers measured at least 4 weeks after the…
Evaluation of Renal Disease… Urine calcium creatinine ratio & Hypercalciuria 22 Oct 202021 Oct 2020 Calcium creatinine ratio on spot urine sample is a good screening test for hypercalciuria. A ratio of >0.8 mg/mg in children below 6 months , >0.6 mg/mg in children 6-12…
Neonatal Seizures… Neonatal Seizures Part 1 18 Oct 202018 Oct 2020 New born period witnesses a wide variety of seizures or seizure syndromes. The neonatal brain has certain characteristics that makes it prone to generate seizures and also due to these…
Child Abuse… Child Abuse 15 Oct 202015 Oct 2020 Child physical abuse is defined by WHO as that which results in actual or potential harm. Various forms of child abuse are common in all societies. 25-50 % of the world’s children report…
ADHD… Managing Attention Deficit Hyperactivity Disorder 11 Oct 202011 Oct 2020 If a child is diagnosed with ADHD (hyperactivity, along with impulsivity and inattention), it is important to know that ADHD can be successfully managed. The treatment options to manage ADHD are:…
ADHD… Distinguishing an energetic child from Attention Deficit Hyperactivity Disorder 8 Oct 20207 Oct 2020 If a child is energetic and has difficulty sitting still, there is likelihood he may be displaying some signs of ADHD however if the child is able to control his/her…
Seizures… Seizure Classification 4 Oct 20203 Oct 2020 The dilemma of classifying a seizure is a common scenario in our clinical practices. The entire management of seizures in follow up can change if initial classification is not correct.…
Autistic Spectrum Disorder… M-CHAT-R – A Good Screening tool for Autism Spectrum Disorder(ASD) 1 Oct 20201 Oct 2020 Modified checklist for Autism in toddlers, known as MCHAT ( R) is freely available online and can be used in age group 16-30 months to screen for ASD. It is…
Diagnostic Modalities… Conducting a Pediatric Echocardiography- Determining the Situs 27 Sep 202026 Sep 2020 A basic knowledge of performing a pediatric ECHO is always a bonus to any pediatrician dealing with new-borns. With a basic knowledge, one might not be able to make complex…
Dermatitis… Tacrolimus 24 Sep 202024 Sep 2020 Topical calcineurin inhibitors (Tacrolimus/Pimecrolimus) are complex macrolide compounds and selectively inhibit cytokine transcription in activated T-cells Tacrolimus is used in chronic extensive atopic dermatitis as steroid sparing agent. Unlike Topical steroids,…
Neonatal Adaptation Syndrome… Neonatal Adaptation Syndrome 20 Sep 202020 Sep 2020 Neonatal abstinence syndrome (NAS) is a result of the sudden discontinuation of fetal exposure to drugs that were used or abused by the mother during pregnancy. NAS leads to a constellation of…
Developmental delay… Red-Flag Signs for Early Detection of Developmental Delay 17 Sep 202017 Sep 2020 In our daily practice, we do not spend enough time to pick up developmental delay in the child. At times we are not sure of our observation and we don’t…
CRITICAL CARE… Umbilical Lines- Practice Pearls 13 Sep 202012 Sep 2020 Placing an Umbilical line is now a common procedure carried in any NICU setup and every Neonatologist is well versed with this. Behind the art of placing a successful Umbilical…
BIPAP… BI-PAP use in a Pediatric Intensive Care Unit 6 Sep 20206 Sep 2020 Non invasive ventilation is a safe and effective option for many acute as well as chronic medical Conditions in Pediatric population. Use of Bipap as a non invasive mode of…
