RECENT POSTS

About BLK Pediatric Practice

The concept of this E-platform “Pediatric Practice” is brain child of Dr. S. C. Arya, Emeritus Consultant Pediatrician, who is also its editor.Dr. S. C. Arya, has been a practicing pediatrician in Delhi for more than 50 years and was instrumental in the development of Centre for Child Health at…Continue reading “About BLK Pediatric Practice”

PERINEAL RASH…

Seborrheic Perineal Dermatitis

1 Aug 202116 Jul 2021

It is an inflammatory skin disease, commonly affecting the napkin area of infants. It is characterized by sharply demarcated salmon-coloured, scaly plaques that involve the groins. The scaling is greasy and…

Candidial Dermatitis…

Candidial Diaper Rash

29 Jul 202116 Jul 2021

Candidial diaper rash is seen in children on broad spectrum antibiotic therapy or infected with oral thrush or sometimes with acute diarrhea. It is caused by Candida albicans. It is diagnosed clinically and…

PERINEAL RASH…

Primary irritant contact Dermatitis

25 Jul 202116 Jul 2021

Initial Post: What Causes a Perineal rash ? Previous Post : General Treatment approach to any Perineal Rash Primary Irritant Contact dermatitis, also referred to as Napkin Dermatits, is the…

Diaper dermatitis…

Treatment approach to a Perineal Rash

22 Jul 202116 Jul 2021

Previous Post: What Causes a Perineal rash ? Following tis ABCDE pneumonic will ensure that all aspects are covered for any Perineal Rash or Diaper Dermatitis in addition to the…

PERINEAL RASH…

Perineal Rash in Infancy

18 Jul 202116 Jul 2021

What causes a Perineal Rash in Infants ? Perineal rash in infants is basically a descriptive phenotype for multiple dermatoses that may affect the anogenital skin of an infant. It can…

BONE AND JOINT DISORDERS…

Transient Synovitis of Hip Joint

15 Jul 202113 Jul 2021

Transient (toxic) synovitis of the hip presents as a limp or a painful hip or pain in the knee (referred pain). It typically affects boys between 3 to 8 years…

Mountain Sickness…

Management of High Altitude Illness(Acute mountain sickness)

11 Jul 20212 Jul 2021

Previous Post Preventive measures for High Altitude Illness Initial Post What is High Altitude Illness Mild headaches can be treated conservatively with paracetamol or ibuprofen.Use ondansetron for vomiting.Supplemental oxygen (if…

Mountain Sickness…

Preventive measures for High Altitude Illness

8 Jul 20212 Jul 2021

Continued from previous post What is High Altitude Illness Gradual ascent - Avoid going directly from low altitude to more than 9,000 ft (2,750 m) sleeping altitude in 1 day. Once…

Mountain Sickness…

High Altitude Illness(HLI)- Acute mountain sickness (AMS)

4 Jul 20214 Jul 2021

Acute mountain sickness (AMS) is the most common and benign form of high altitude illness (HAI). The risk of AMS depends upon individual susceptibility, the rate of ascent and the elevation…

Supporting a child with Dyslexia

1 Jul 202125 Jun 2021

Previous post: Learning Disabilities- Role of Teachers & Parents Initial Post : Learning Disabilities - The Spectrum Dyslexia impedes fluency in reading and writing activities. Most children with Dyslexia have…

Language and Learning Disabilities…

Learning Disabilities – Role of Parents & Teachers

27 Jun 202125 Jun 2021

Previous post: Learning Disabilities- Understanding the spectrum Primary caregivers or parents and Teachers, both have a big role to play in identification of children facing challenges so that a timely…

Language and Learning Disabilities…

Learning Disabilities – Understanding the spectrum

24 Jun 202125 Jun 2021

“Learning disabilities are a generic term that refers to a heterogeneous group of disorder manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning, or…

GROWTH DEVELOPMENT AND BEHAVIOR…

Puberty – Early vs Delayed

20 Jun 202118 Jun 2021

When it is a Precocious / Early puberty –Girls- if pubertal signs (breast development) are seen before 8 years of age.Boys- if pubertal signs (increase in testicular volume) are seen…

Body Mass Index…

Interpreting Body Mass Index BMI

17 Jun 202116 Jun 2021

WHO recommends using BMI as an index of being overweight or obese. BMI Correlates well with risk of obesity related medical complications.BMI = Weight (kg)/ Height (m2)It is Important to use Age…

Diabetes mellitus…

Diabetic Keto-acidosis- Practice points

13 Jun 202112 Jun 2021

DIAGNOSIS OF DIABETIC KETOACIDOSIS- DKA Blood Glucose >200mg/dlBlood pH <7.3Bicarbonate <15 mmol/LKetones present in blood/urineIf you diagnose a child with DKA – refer to a higher center (preferably with PICU…

INFECTIOUS DISEASES…

MIS-C Panel Discussion IAP Delhi- West

IAP Delhi-West organised a Panel Discussion on 9th June, 2021 which eminent panelists, including Dr Rachna Sharma, Head Pediatric Intensive Care at BLK Centre of Child health. The panel discussion…

Diabetes mellitus…

Diagnostic criteria for Pre-diabetes and Diabetes Mellitus in children

6 Jun 202130 May 2021

DiagnosisFasting Glucosemg/dlPostprandial Random or Post-OGTT Glucose mg/dlHBA1c%Normal70-99<140</=5.6Pre-diabetes100-125140-1995.7-6.4Diabetes mellitus>/=126>/=200>/=6.5OGTT- Oral Glucose Tolerance Test

Reactive arthritis…

Reactive Arthritis

3 Jun 202130 May 2021

It is an inflammatory joint disease which is caused by an extraarticular infection. However, there is absence of bacteria in the joint. Reactive arthritis usually occurs one to four weeks…

Paroxysmal Non Epileptic Events…

Spasmus nutans

30 May 202129 May 2021

Spasmus nutans is a triad of head tremor, nystagmus and torticollis. The condition usually begins in infancy (3-8 months)The head tremors are slow, can be horizontal or vertical. The nystagmus…

Gratification disorder…

Gratification disorder or infantile masturbation

27 May 202129 May 2021

Gratification disorder also known as infantile masturbation is a self-stimulating pleasure behaviour of the child. It occurs between the ages of 3 months and 5 years. It may be observed…

Head Nodding…

Head nodding

23 May 202122 May 2021

Head nodding without accompanying nystagmus can occur as paroxysmal events in older infants and toddlers These head movements can be lateral (“no-no”), vertical (“yes-yes”), or oblique. The episodes may occur…

Paroxysmal Non Epileptic Events…

Sandifer syndrome

16 May 202115 May 2021

Sandifer syndrome is a movement disorder that comprises paroxysmal retrocollis(extension of neck) and opisthotonus(arching/extension of trunk) posturing with tonic deviation of neck in early child hood due to gastroesophageal reflux. The child has preserved…

Benign paroxysmal torticollis…

Benign paroxysmal torticollis

13 May 202112 May 2021

It is characterised by episodes of head tilt to one side for a few hours or days. The torticollis may occur without any associated symptoms or may be accompanied by…

Benign myoclonus of infancy…

Benign myoclonus of infancy

9 May 20219 May 2021

Benign myoclonus of early infancy is characterized by episodes of myoclonic spasms involving flexion of the trunk, neck, and extremities in a manner resembling the infantile spasms of West syndrome. The…

Paroxysmal Non Epileptic Events…

Shuddering attacks

6 May 20215 May 2021

Shuddering episodes are characterized by periods of rapid tremor of the head, shoulders, and arms that resemble shivering. It is often accompanied by facial grimacing with preserved consciousness Onset is in infancy…

Breath Holding Spells…

Breath Holding spells

2 May 202130 Apr 2021

Breath Holding Spells (BHS) usually occur between the ages of 6 months and 5 years in children; but may start as early as first month of life. The frequency of…

Breastfeeding…

Lactation professionals in India: COVID 2021 response

30 Apr 202130 Apr 2021

Dr SHACCHEE BAWEJA, Lactation Consultant at BLK and president of ALPI (Association of Lactation Professionals India) conducted a QnA session with BeginEd India for Healthcare professionals involved in care of…

Benign sleep myoclonus…

Benign sleep myoclonus

29 Apr 202127 Apr 2021

It is characterized by repetitive myoclonic jerks occurring during sleep which are typically in the distal more than proximal limbs, and more prominent in the upper than the lower extremities.It…

Jitteriness

25 Apr 202125 Apr 2021

It is the most common non-epileptic movement disorder in neonatal period.Generalized symmetric, rhythmic movements of chin and/or extremities that resemble tremor. It is stimulus sensitive; increased with crying. It can be precipitated…

Paroxysmal Non Epileptic Events…

Paroxysmal Non Epileptic Events- PNEE

22 Apr 202129 May 2021

Paroxysmal non epileptic events in childhood mimic epilepsy and evoke lot of anxiety amongst parents and family members. These events sometimes end up in getting extensive diagnostic work up and…

Infantile colic…

Management of Infantile Colic

18 Apr 202113 Apr 2021

Previous Post: Evaluation of an Infantile Colic Infantile colic is a benign self limited condition. There is no proven therapy for it. Parental reassurance is the main measure to manage…

Infantile colic…

Evaluation of infant with suspected colic

15 Apr 202113 Apr 2021

Previous Post: What causes an Infantile Colic Infantile colic is a diagnosis of exclusion Thorough history and physical examination to rule out underlying organic disorders and to determine the need…

Infantile colic…

What causes an Infantile Colic

11 Apr 202113 Apr 2021

Previous Post: What is Infantile Colic What exactly results in a colic, still remains a medical dilemma but few hypotheses have been proposed by researchers, which include- Poor feeding technique…

Infantile colic…

What is Infantile colic

8 Apr 20218 Apr 2021

Infantile colic is a benign, self-limited process in which a healthy infant has paroxysms of inconsolable crying. The standard diagnostic criteria—known as the “rule of three” crying more than three hours…

Recommendations for Vitamin D doses

4 Apr 202131 Mar 2021

Previous Post: Vitamin D - Food Facts Dose recommendations for Vitamin D by Indian Academy of Paediatrics are as follows- Ages/GroupsPreventionTolerable upper limitTreatment of insufficiencyTreatment with Bulk Doses(oral route preferred)Premature…

Vitamin D–Food facts

1 Apr 202131 Mar 2021

Previous Post: Vitamin D - Practice Points Breastfed babies from birth to 1 year of age should be given a daily Vitamin D supplements as the mother herself is likely…

Vitamin D-Few Practice points

28 Mar 202131 Mar 2021

What are Normal Vitamin D levels Normal ranges of Vitamin D(25 Hydroxy Vitamin D) levels in blood as per IAP Classification are classified as - Sufficient: >20ng/ml (50 nmol/L)Insufficient: 12-20ng/ml (30-50 nmol/L)Deficient: <12ng/ml…

Hypertension…

How to use BP reference charts for children

25 Mar 202119 Mar 2021

Previous Post: How to define hypertension in children For defining hypertension child’s blood pressure needs to be compared with reference charts for that age and height centile. The reference charts…

Hypertension…

How to define hypertension in children?

21 Mar 202119 Mar 2021

Previous Post: Measurement of BP - DOs & DONTs Trained health care professionals in the office setting should make a diagnosis of Hypertension in a child or adolescent who has…

Hypertension…

Measuring the blood pressure- Dos & DONTs

18 Mar 202116 Mar 2021

Previous Post: How to select correct cuff size for measuring blood pressure Besides a circadian variation in blood pressures, a lot of other factors may affect blood pressure measurement like…

Hypertension…

How to select correct cuff size for measuring blood pressure

14 Mar 202114 Mar 2021

Previous Post: Techniques to measure a BP Visual check system by any one of three criteria: Bladder width at least 40–50% of the arm circumferenceBladder length at least 80–100% of…

Hypertension…

Techniques to Measure Blood pressure

11 Mar 20219 Mar 2021

Previous Post: When to measure a Blood Pressure in Children Auscultation by Sphygmomanometer and stethoscope is the “Gold standard”. The BP reference charts are based on auscultatory BP measurement with mercury…

Neonatal Cholestasis…

Management of Cholestasis

7 Mar 20217 Mar 2021

Continued from Previous Post: Role of HIDA Scan in Cholestasis Treatment of neonatal cholestasis depends on underlying etiology. Biliary atresia needs early Kasai porto-enterostomy, before the age of 3 monthsGalactosemia…

Neonatal Cholestasis…

Role of HIDA scan in Neonatal Cholestasis

4 Mar 20214 Mar 2021

Continued from Previous Post: Investigations in Neonatal Cholestatsis Routine use of HIDA scan should be discouraged in all cases of neonatal cholestasis. Infant with neonatal cholestasis with pale stool (abnormal…

Neonatal Cholestasis…

Investigations in Neonatal Cholestasis

28 Feb 20214 Mar 2021

Continued from Previous Post: When to suspect Neonatal Cholestasis While evaluating a child with neonatal cholestasis, the most important priority is to exclude biliary atresia and causes like galactosemia which…

Neonatal Cholestasis…

Neonatal Cholestasis- when to suspect

25 Feb 20214 Mar 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…

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