NOVEL CORONA VIRUS COVID-19… VITAMIN C : How Important in Viral illnesses? 9 Jul 20209 Jul 2020 Vitamin C is an essential micronutrient for humans, with pleiotropic functions related to its potent antioxidant and a cofactor for a family of biosynthetic and gene regulatory enzymes. Vitamin C…
Breastfeeding… Infant Feeding Decisions in times of COVID Pandemic 5 Jul 20203 Jul 2020 With COVID cases on the rise in last 3 months in India, challenges are faced when a pediatrician encounters a situation where a family/mother is panicked and confused about feeding…
Dermatitis… Sanitizer Induced Hand Dermatitis 2 Jul 202029 Jun 2020 Hand dermatitis is a common condition involving inflammation of the skin on the hands. It occurs when the skin becomes irritated in response to a “trigger,” such as contact with…
NEONATAL RESUSCITATION PROGRAM NRP… Neonatal Resuscitation in COVID Times 28 Jun 202027 Jun 2020 COVID pandemic is going to stay for a while now and now all medical community is geared to handle it. This also, brings challenges to our colleagues or neonatologists, who…
Dermatitis… Perioral dermatitis 25 Jun 202029 Jun 2020 Perioral dermatitis in children typically presents as multiple small flesh-colored or erythematous inflamed papules or micronodules around the mouth, nose and eyes. The age ranges from 7 months to 13…
Foreign Body Aspiration… Foreign body Aspiration in children 21 Jun 202020 Jun 2020 We all have encountered clinical scenarios of classical presentation of a toddler coming after some foreign body aspiration. But clinical dilemma arises when we do not get a classical history…
Cognitive Behaviour therapy CBT… Psychosomatic disorders in children & Cognitive Behaviour Therapy-CBT 18 Jun 202015 Jun 2020 Psychosomatic disorders consist of clinical symptoms with no underlying organic pathology. Most common symptoms observed in children are abdominal pain, headaches, difficulty in breathing, chest pain, fatigue, excessive worry about health. Most symptoms…
Respiratory Distress Syndrome… Surfactant Replacement Therapy 14 Jun 202014 Jun 2020 Dera Readers, Dr Kumar Ankur, Neonatologist, has nicely sumed up the current practice guidelines on use of Surfactant in neonatology. Please click below to view the video presentation https://youtu.be/i2ZkFi-dxEQ
INFECTIOUS DISEASES… How long a COVID positive case can be infective? 11 Jun 202010 Jun 2020 To address this not so easy question we need to first understand the concept of Cycle Threshold (CT) in RT-PCR for COVID CT is the number of replication cycles required…
Adoption… ADOPTION, FOSTER CARE AND KINSHIP CARE 7 Jun 2020 Adoption is act of lawfully assuming the parental rights and responsibilities of a child under the age of 18 irrevocably. Adopted children become full members of their adopted family and have the…
Immunological Disorders… Periodic Fever Aphthous Stomatitis Pharyngitis Adenitis Syndrome PFAPA Part 2 4 Jun 202031 May 2020 Continued from previous post…(Clinical Symptoms & Diagnosis click to read) WHEN IT IS NOT PFAPA Patients should be evaluated for the following features since the presence of any of them…
Immunological Disorders… Periodic Fever Aphthous Stomatitis Pharyngitis Adenitis – PFAPA Syndrome: Part 1 31 May 202031 May 2020 PFAPA is a common autoinflammatory syndrome in childhood. The onset is usually before 5 years of age and attacks typically cease by 10 years of age in most patients, though a minority…
VACCINATIONS… Vaccination in immunocompromised children: Part 2 28 May 202022 May 2020 There may be certain situations where even immunocompromised need to be given vaccines, even if a suboptimal immune response is expected… Mammalian bites & Rabies Thorough wound management and antisepsis…
VACCINATIONS… Vaccination in immunocompromised children: Part 1 24 May 202024 May 2020 IAP has guidelines for vaccination of children in situations, where a child is considered to be immunocompromised and an appropriate immune response to a vaccine is not mounted. These scenarios…
BONE AND JOINT DISORDERS… Scoliosis- What a pediatrician should know 21 May 202020 May 2020 Scoliosis of greater than 10 degrees is relatively common (incidence 1-2%), but progression to ≥ 25 degrees and the need for treatment is rare.Examination findings of uneven shoulders/Scapulae level, Rib Hump, Uneven…
IAP VACCINE GUIDELINES… IAP VACCINE GUIDELINES BOOKLET 2018-2019 with corrections 20 May 202020 May 2020 CLICK the LINK to Download the booklet released with corrections in May 2020. List of corrections is added in the END of booklet
Breastfeeding… NRP Guidelines during the COVID-19 Pandemic 17 May 202016 May 2020 Resuscitation of neonate preferably to be done in a physically separate room adjacent to delivery room. However, If not feasible due to logistic issues then resuscitation trolley should be physically…
Migraine… Preventive therapy for migraine in children 14 May 202014 May 2020 Indication to start preventive therapy Preventive therapy should be restricted to those children whose experience Headache frequency atleast one headache/week or more than three headaches /monthProlonged and severe headaches, even…
Migraine… Migraine: Acute Management & Complimentary therapies 10 May 202014 May 2020 Drugs for use in the Acute Management DrugDoseRemarksAnalgesicsOralUse should be restricted to three headaches/week to prevent analgesic rebound headacheAcetaminophen15mg/kg/dose q4-6hrlyIbuprofen10mg/kg/dose q6hrlyNaproxen sodium5-7mg/kg q8-12hrlyTriptans (5-HT1 receptor agonists)Oral, Subcutaneous and IntranasalRestrict uses to 6…
Migraine… How to manage Migraine 7 May 20201 May 2020 There are five main domains of management of Migraine which are as follows: Headache education: Patient and family members should be reassured that there is no serious underlying disorder. It is helpful for…
Migraine… Diagnosing Migraine without aura 3 May 20207 May 2020 ICHD3 diagnostic criteria for migraine without aura are- At least five attacks fulfilling criteria 2-4Headache attacks lasting 4-72 hr (untreated or unsuccessfully treated a,b)Headache has at least two of the following…
Headaches… When to ask for neuro imaging in recurrent headaches 30 Apr 202012 Apr 2020 The American academy of neurology (2002) recommends: Routine neuroimaging study is not indicated in children with recurrent headaches and normal neurological examination. It is indicated in children who have: Abnormal…
Headaches… Evaluating Headaches in Pediatric Patients 26 Apr 202026 Apr 2020 Headaches are common complaints in the Pediatric office practice. Although headaches are usually not associated with serious medical conditions but a careful clinical assessment is necessary to identify specific clues…
Battery Ingestion… Accidental Battery Ingestion 23 Apr 202012 Apr 2020 It is crucial to remove any accidental battery ingested in gastro-intestinal tract as soon as possible as degradation of battery may lead to caustic injury. The risk is highest if…
Gluten Sensitive Enteropathy (Celiac Disease)… Celiac Disease- A Brief Update 19 Apr 202012 Apr 2020 Celiac disease (CD) is an autoimmune disease that is caused by interaction of gluten in genetically predisposed individuals. Diagnosis of Celiac Disease Testing for total IgA and TGA-IgA as initial…
INFECTIOUS DISEASES… Understanding the Laboratory Testing for novel Corona Virus Disease (COVID-19) 16 Apr 202012 Apr 2020 The purpose of this write up is to clarify certain aspects of laboratory testing for Corona Virus. There are two basic methodologies applied to test for the novel Corona virus…
INFECTIOUS DISEASES… Management of Tick Exposure 12 Apr 202020 Mar 2020 Use fine tipped tweezers to grasp the tick as close as possible. Pull upwards with steady even pressure, don’t twist or jerk the tick. Ticks should neither be removed nor be…
INFECTIOUS DISEASES… Rickettesial Disease 9 Apr 202020 Mar 2020 Suspect Rickettsial disease in any sick child with prolonged fever without any specific focus or obvious etiology. Check history of travel, look for eschar (a crusty necrotic lesion with or…
Phimosis… Phimosis 5 Apr 202023 Mar 2020 Phimosis is inability to retract prepuce. Prepuce of new born is non retractile. At the age of 3 years upto 10% remain non-retractile and at age 16 years, only 1% have a…
Balanoposthitis… Balanoposthitis 2 Apr 202018 Mar 2020 Balanoposthitis (inflammation of the glans and the foreskin) is a frequent condition seen in the clinic. Usually caused by external irritation from soaps, antiseptic washing solutions or repeated retraction of…
INFECTIOUS DISEASES… Donning & Doffing of Personal Protective Equipment(PPE) 30 Mar 2020 https://youtu.be/Vanmj0MsKN0 Donning & Doffing of Personal Protective Equipment- PPE, A very informative Demo Video by efforts from Infectious Diseases Team of AIIMS, Delhi. Many of us who are in a…
NEPHROLOGY… Management of relapses of nephrotic syndrome 29 Mar 202017 Mar 2020 Recurrence of proteinuria more than 3+/4+ by dipstick testing, for 3 consecutive days with swelling constitutes a relapse. Prednisolone is given @ 2 mg/kg/day till urine protein is negative/trace for…
NEPHROLOGY… Diagnosis & Management of First Episode of nephrotic syndrome 26 Mar 202017 Mar 2020 Nephrotic syndrome is diagnosed in a child with Edema: usually starts as periorbital puffiness with variable degree of generalized body swelling.Heavy proteinuria: defined as urine dipstick protein 3+/4+ or spot…
Breastfeeding… Breastfeeding in the times of Novel Coronavirus Pandemic 23 Mar 2020 If it was important before, it has become even more important now! Yes you guessed it right! I am talking about breastfeeding during the novel Corona virus pandemic. It is…
Screening, Anticipatory Guidance and Counseling… Energy drinks are not safe for kid 22 Mar 202017 Mar 2020 Energy drinks are often confused with sports drinks, but they are actually quite different. Energy drinks contain sugar, caffeine, plant extracts such as guarana, herbs such as ginseng, as well as…
ALLERGIC DISORDERS… Antihistaminics in Urticaria 19 Mar 202011 Mar 2020 Depending on the duration of clinical symptoms (the time since the first episode of urticarial wheals), urticaria can be classified as acute (up to 6 weeks) or chronic (over 6 weeks). In acute urticaria second-generation antihistamines are the first choice. For refractory cases, use a combination of H1 and H2…
Anti-histaminics… Antihistaminics in pediatric practice 15 Mar 202011 Mar 2020 Histamine influence immunoregulation of the acute and chronic inflammatory response through 4 different types of receptors, called H1, H2, H3, and H4. Drugs classified in the first generation of antihistamines (“classical” antihistamines) are classified as first generation, include chlorpheniramine, diphenhydramine, promethazine, and hydroxyzine. They are sedating and necessitate multiple daily doses because of relatively short half-lives. The second…
Urinary Tract Infections… Imaging studies after first episode of urinary tract infection (UTI) 12 Mar 20209 Mar 2020 Ultrasound kidneys is recommended in all cases with UTI irrespective of age. Dimercaptosuccinic acid scan (DMSA) should only be done after 3 to 4 months of treatment to detect renal…
INFECTIOUS DISEASES… Laboratory testing of Novel Corona Virus (SARS-CoV-2) 8 Mar 20203 Mar 2020 Testing for Novel Corona virus (SARS-CoV-2) is done by detection Viral RNA detection by PCR Techniques Existing Multiplex PCR kits with respiratory virus panels, such as those manufactured by Biofire…
INFECTIOUS DISEASES… Preventive measures for COVID-19 5 Mar 20203 Mar 2020 Information for Public The best way to prevent infection is to avoid being exposed to this virus and to prevent spread of virus in community from the infected person. Following…
INFECTIOUS DISEASES… Case definitions for surveillance of Novel Coronavirus Disease, COVID-19 1 Mar 20203 Mar 2020 The Novel Corona Virus also refered to as SARS-CoV-2 causes the disease referred to as Corona Virus disease 2019 or COVID-19 The case definitions have been issued by WHO and are…
INFECTIOUS DISEASES… SWINE FLU H1N1 MANAGEMENT 27 Feb 2020 Patients with Flu like illnesses with mild fever, sore throat, diarrhoea and vomiting do not need any testing and should be treated symptomatically and followed as outpatients. They do not…
INFECTIOUS DISEASES… Current guidelines for Rabies Immunoglobulin or Human Monoclonal Antibody use 23 Feb 202023 Feb 2020 RIG provides passive immunization and is administered only once, as soon as possible after the initiation of PEP and not beyond day 7 after the first dose of vaccine. Equine Rabies…
INFECTIOUS DISEASES… Current WHO guidelines on Rabies Vaccine 20 Feb 2020 IAP Advisory Committee on Vaccines & Immunization(ACVIP) endorses the new schedule suggested by WHO in 2018 as below- Pre-exposure prophylaxis (Pre-EP) is recommended in the following two situations. • Children exposed to pets in home. …
INFECTIOUS DISEASES… Rabies – Post Exposure Prophylaxis of the Vaccinated 16 Feb 202016 Feb 2020 In a rabies endemic country like India where there is sustained dog-to-dog transmission, every warm blooded animal bite is suspected as a potentially rabid animal bite. As rabies is practically 100% fatal, even…
INFECTIOUS DISEASES… Mammalian Bites and Rabies : Interesting Facts 13 Feb 202012 Feb 2020 Vaccination status of the biting animal Although unvaccinated animals are more likely to transmit rabies, vaccinated animals can also do so if the vaccination of the biting animal was ineffective…
Autistic Spectrum Disorder… Red Flag signs to pick up a child with autism early 9 Feb 20209 Feb 2020 The red flags indicating at risk for early autism which can be obtained from history/ observation of the child: By 8 months of age poor eye contact and joint attention. For normally…
Kawasaki Disease… How long to give Aspirin in Kawasaki Disease 2 Feb 202027 Jan 2020 Administration of moderate dose ASA (ASPRIN*) (30–50 mg/kg/d) is given until the patient is afebrile and after Low-dose ASA (3–5 mg/kg/d) is continued as guided by Z scores on ECHO as follows- Z score < 2.0 (No coronary abnormality)…
Anti-histaminics… Commonly used anti-histaminics 15 Mar 201911 Mar 2020 First-generation H(1)-antihistaminesBrand Name with ConcentrationOral dosesHydroxyzineSyrups Atarax, Hicope (10mg/5ml)Drops Atarax, Hicope (6mg/ml).Tab Atarax (10mg, 25mg)1-2 mg/kg/day q 6 hrly oral.(Lower doses for Rhinitis, Higher dose as anti-allergic) 6 months–6 years initially 5–15…
