Congenital Torticollis… Congenital Torticollis: Management 29 Jan 202320 Jan 2023 Previous Post: Congenital torticollis- Diagnosis and Assessment Management of Congenital Torticollis Investigations Routine neck imaging is not recommended If a mass is present but not characteristic of SCM, ultrasound (US)…
Congenital Torticollis… Congenital Torticollis 22 Jan 202320 Jan 2023 Congenital torticollis is usually diagnosed within the first month of life. Diagnosis after 6 months is rare and other causes should be considered. There are 2 types: Muscular: Tightness of…
Human Immunodeficiency Virus(HIV)… Co-trimoxazole (CTX) Preventive Therapy (CPT) for HIV-Exposed/Infected infants and Children 11 Dec 20228 Dec 2022 Co-trimoxazole Preventive Therapy (CPT) protects the infant from Pneumocystis jiroveci pneumonia (PCP), toxoplasmosis and other bacterial diseases. It is the standard component of HIV care to reduce the morbidity and…
Congenital Heart Disease… Cyanotic Spell 4 Dec 202222 Nov 2022 Common precipitation events: Crying Defecation Fevers Dehydration Tachycardia (decreased filling time leads to reduced end diastolic volume) Medications (ACE inhibitors) Treatment: Sequentially, it should be followed as mentioned below:- First…
Congenital Heart Disease… Role of digoxin in Acyanotic Congenital Heart Disease(ACHD) 27 Nov 202222 Nov 2022 Digoxin is a drug indicated in heart failure associated with reduced heart function. Its role in heart failure secondary to left to right shunt lesions in acyanotic congenital heart disease(ACHD),…
ALLERGIC DISORDERS… Skin Prick Testing- when to plan 20 Nov 202215 Nov 2022 Indications for performing a Skin Prick Testing in children Allergic Rhino-sinusitis/conjunctivitis Seasonal rhinitis/conjunctivitis These children should be tested if not responding to the usual treatment Perennial rhinitis/conjunctivitis All cases should be tested as the…
Down's Syndrome… Down’s syndrome 13 Nov 20227 Nov 2022 Down syndrome is the most common chromosomal disorder reported in humans and the most common cause of Intellectual disability. Reported incidence is approximately 1 in 700 live newborns. Clinical diagnosis…
Developmental delay… Early child development – preventive pediatric office practices, an idea whose time has come 27 Oct 202226 Oct 2022 As the pediatric office practice is in for a change in paradigm, the early child development monitoring is an essential pillar of pediatric preventive health. Almost 43% of the under…
QUICK REFERENCES References & Guidelines 13 Oct 202211 Oct 2022 Dear Colleagues and all our readers and followers, In addition to our regular posts/blogs on small snippets useful for a general pediatrician in day to to day office practice, we…
PEDIATRIC DRUG THERAPY… Esomeprazole 18 Sep 202217 Sep 2022 Usage in Neonatal age group GERD Routine use is not recommended in preterm neonates Term and preterm neonates: Oral: 0.5 mg/kg/dose once daily. DURATION of therapy in symptomatic GERD : Guidelines…
Diseases of the Blood… Megaloblastic anemia treatment pearls 11 Sep 20228 Sep 2022 Vitamin B12 supplementation The schedules and dosages of vitamin B12 treatment are widely variable and there is no consensus on it. The cause of megaloblastic anemia and the response to…
Diseases of the Blood… Biochemical markers of B12 deficiency 4 Sep 20224 Sep 2022 Previous Post : Vitamin B12 levels Serum Holo-Transcobalamin Vitamin B12 bound to Transcobalamin = Holo-TC Represents 10 -30% of total Vitamin B12 present in serum Cells take up Holo-TC via…
Diseases of the Blood… Vitamin B12 Levels 28 Aug 202228 Aug 2022 WHO DefinitionsVitamin B12 cut-offB12 adequacy> 221 pmol/LLow B12148 -221 pmol/LB12 deficiency< 148 pmol/L Pitfalls of Serum Vitamin B12 Neither sensitive, nor specificVitamin B12 levels mostly reflect the predominant but functionally…
INFECTIOUS DISEASES… When it is NOT congenital syphilis 21 Aug 202220 Aug 2022 Congenital syphilis is unlikely in following scenario- Any neonate who has a normal physical examination and a serum quantitative nontreponemal serologic titer (VDRL) equal to or less than four-fold the…
The Fetus and the Neonatal Infant APT Test For Swallowed Maternal Blood 18 Aug 202216 Aug 2022 In a newborn infant with rectal bleeding or a blood streaked gastric aspirate, we need to determine whether the blood originated from infant’s gut or whether it’s the swallowed maternal…
Antimicrobials… Trimethoprim-Sulfamethoxazole 14 Aug 202214 Aug 2022 Always used as a fixed dose combination of Trimethoprim-Sulfamethoxazole in ratio of 1:5. Dose of Trimethoprim(TMP) is used for calculation purposes. Mild to Moderate Infections 4 mg TMP/kg/dose PO - 12…
Anti Parasitic Drugs… Permethrin- Therapeutic uses 7 Aug 202212 Aug 2022 Scabies Infants ≥2 months, Children, and Adolescents: Topical Permethrin 5% cream : Apply and massage in cream from head to toe (average adult requires 30 g); leave on for 8 to 14…
Respiratory System… Role of a sleep study in pediatric Obstructive Sleep Apnea Syndrome 31 Jul 20225 Aug 2022 Obstructive Sleep Apnea Syndrome(OSAS) is a disorder of breathing during sleep characterized by prolonged partial upper airway obstruction and/or intermittent complete obstruction (obstructive apnea). This disrupts normal ventilation during sleep &…
Rheumatic, Connective Tissue and Collagen Vascular Diseases of Childhood When To Suspect Vasculitis In Children 28 Jul 202226 Jul 2022 Vasculitis should be suspected in patients with unexplained fever, weight loss, skin rashes; especially when associated with high ESR and CRP. The most common primary vasculitides in children are Henoch-Schonlein purpura (HSP)…
Rheumatic, Connective Tissue and Collagen Vascular Diseases of Childhood Neonatal Lupus- A Missed Diagnosis 24 Jul 202222 Jul 2022 Neonatal lupus is caused by autoantibodies crossing the placenta from the mother to the fetus. Mothers of the affected infants maybe asymptomatic at the time of delivery. Most common presentation…
The Endocrine System Acanthosis Nigricans 21 Jul 202219 Jul 2022 Acanthosis Nigricans(AN) It is a common condition characterized by velvety, hyperpigmented plaques on the skin. Intertriginous sites, such as the neck and axillae, are common sites for involvement. Less frequently, acanthosis…
CROUP… Croup- How to Manage? 17 Jul 202217 Jul 2022 Use The The Croup Clinical Score# to Classify Croup as Mild, Moderate or Severe.. Mild and moderate croup They can be treated as out patient Mist Therapy(Saline Nebulisations) can be given, Steam…
CROUP… Nebulized Epinephrine for Croup 14 Jul 20228 Jul 2022 The administration of nebulized epinephrine to patients with moderate to severe croup often results in rapid improvement of upper airway obstruction. Epinephrine constricts precapillary arterioles in the upper airway mucosa and decreases…
CROUP… Mist Therapy in Croup 10 Jul 20228 Jul 2022 Humidified air is frequently used in the treatment of croup, although studies supporting its efficacy in reducing symptoms are limited. Although humidified air does not reduce subglottic edema, it may…
CROUP… CROUP SCORING 3 Jul 20228 Jul 2022 Clinical Feature Degree - ScoreStridor None - 0At rest on auscultation 1At rest without auscultation 2Recessions None - 0 Mild 1Moderate 2Severe 3Cyanosis None - 0With agitation 4At rest 5Consciousness level Normal - 0Altered 5 CROUP SCORE 0-2 = Mild Croup3-5 = Moderate Croup6-11 = Severe croup Next Post: Mist therapy in Croup
IMPETIGO… Treatment of Impetigo 30 Jun 202230 Jun 2022 For antibiotic therapy, the chosen agent must provide coverage against both Staphylococcus aureus and Streptococcus pyogenes Limited impetigo — Topical therapy for impetigo should be administered if there are a limited number of lesions. Topical…
IMPETIGO… Ecythyma 26 Jun 202224 Jun 2022 Ecthyma is an ulcerative form of impetigo where untreated lesions of nonbullous impetigo progress to a deeper infection. Lesions consist of "punched-out" ulcers covered with yellow crust surrounded by raised violaceous margins. A subsequent…
IMPETIGO… Bullous Impetigo 23 Jun 202221 Jun 2022 Previous Post Non-Bullous Impetigo Bullous impetigo is a form of impetigo seen primarily in young children in which the vesicles enlarge to form flaccid bullae with clear yellow fluid, which…
IMPETIGO… Non-Bullous Impetigo 19 Jun 202217 Jun 2022 Previous Post - Impetigo Non-bullous impetigo is the most common form of impetigo. Lesions begin as papules that progress to vesicles surrounded by erythema. Subsequently they become pustules that enlarge…
IMPETIGO… IMPETIGO 16 Jun 202217 Jun 2022 Impetigo is the most common bacterial infection in children, which is highly contagious. It presents as an acute infection of the superficial layers of the epidermis and is caused by Group…
Environmental Hazards… Managing a heat stroke 12 Jun 20227 Jun 2022 Outside Hospital: Move patient to a cool place.Remove clothing and drench skin with cool water, fan skin.Place ice packs on the armpit and groin areas.Offer cool fluids if alert and…
Environmental Hazards… Prevention of Heat Related Illnesses 9 Jun 20229 Jun 2022 Previous Post - Types of Heat Related Illnesses Following measures should be advocated to prevent heat related illnesses- Wear loose fitting, Light coloured, preferably cotton clothing Drink plenty of fluids. Staying…
Environmental Hazards… Heat Related Illnesses 5 Jun 20227 Jun 2022 Heat related illnesses can be grouped as: Exertion associated collapseHeat exhaustionHeat stroke Exertion Associated Collapse: It is a feeling of light headedness, collapse or syncope after a strenuous exercise is stopped. The contraction…
Diabtes insipidus… When to suspect diabetes insipidus in children with polyuria 2 Jun 202231 May 2022 Previous Post : True polydipsia or polyuria vs Psychogenic polydipsia Diabetes Insipidus: When serum osmolality > 300 mOsm/kg and Urine osmolality < 300 mOsm/kg, in presence of significant polyuria and…
Evaluation of Renal Disease… How to differentiate a true polydipsia or polyuria from psychogenic polydipsia 29 May 202227 May 2022 Previous Post- Approach to Polyuria True PolydipsiaPsychogenic polydipsiaDesperate for waterBottle/Sipper addictionWill drink anything offeredPreference for juices and sweetened drink. May refuse waterWaking at nights for waterSleeps through nightPolyuria irrespective of…
Evaluation of Renal Disease… Approach a child with polyuria 26 May 202224 May 2022 Previous Post: What is Polyuria While evaluating a child with suspected polyuria, first step is to confirm polyuria by measuring the 24 hour urine output. Once confirmed detailed history should…
Evaluation of Renal Disease… What is polyuria 22 May 202222 May 2022 Polyuria is an increase in total daily output of urine. Urine output more than 2000 ml/m2/ 24 hrs is defined as polyuria. Preschool child >1 L/24 hrsSchool Children >2L/24 hrsAdults >3L/24 hrs qualifies…
Evaluation of Renal Disease… How to manage a child with Polakiuria 19 May 202216 May 2022 Previous Post What is Polakiuria First step in management is to obtain a detailed history and physical examination followed by a urine analysis, a random blood sugar and Urine culture (if…
Evaluation of Renal Disease… What is Polakiuria 15 May 202216 May 2022 POLAKIURIA -Also known as benign urinary frequency, it means increased urinary frequency during day time. It commonly affects school aged children who are toilet trained and are previously healthy. Child…
The Fetus and the Neonatal Infant… Umbilical Granuloma 12 May 20227 May 2022 Umbilical granuloma is a soft, moist, pink, usually pedunculated, friable lesion of granulation tissue that varies in size from 3 to 10 mm in length. Granuloma formation is more likely…
Breastfeeding… Galactagogues in breastfeeding 8 May 20226 May 2022 Foods, herbs, and drugs that are believed to help boost maternal milk flow/production are called galactagogues. These are prescribed very frequently when breastfeeding is not going well, presuming that the maternal…
The Digestive System… Umbilical Hernia 5 May 20225 May 2022 Umbilical hernia is due to a persistent opening of the umbilical ring, which normally spontaneously closes. After birth, this fascial opening (umbilical ring) closes spontaneously with continued growth of the…
Screening, Anticipatory Guidance and Counseling Computer Vision Syndrome or Digital Eye Strain 1 May 202229 Apr 2022 The symptoms associated with excess or inappropriate screen use are referred to as Computer Vision Syndrome (CVS) or Digital Eye Strain. Most common symptoms observed are eyestrain, headaches, blurred vision, dry eyes,…
Chronic Cough… Otogenic Cough 28 Apr 202226 Apr 2022 A rare cause of chronic cough in children is reflex cough due to the otogenic reflex. In a minority of individuals, the external ear is innervated by a branch of…
Diseases of the Blood… Timing of G6PD Assay 24 Apr 2022 Previous post - Neonatal Jaundice & G6PD deficiency G6PD diagnosis deficiency testing is based on direct measurements of G6PD activity in a population of RBCs. In the setting of an…
Diseases of the Blood… Neonatal Jaundice and G6PD Deficiency 21 Apr 202224 Apr 2022 Previous post - G6PD Deficiency Anemia and jaundice are often first noted in the newborn period in individuals with severe G6PD deficiency (Class I variants). The degree of jaundice is…
Diseases of the Blood… G6PD DEFICIENCY 17 Apr 202224 Apr 2022 G6PD deficiency is an X-linked disorder. The presence of anemia will vary depending on the severity of deficiency in the affected cells. WHO classified it according to the magnitude of the enzyme deficiency and…
Motion Sickness… Pharmacological options for a Motion Sickness 14 Apr 202212 Apr 2022 Previous Post: Non Pharmacological interventions for a Motion Sickness ANTIHISTAMINES – They are the most frequently used and widely available medications for motion sickness; non-sedating ones appear to be less effective. None…
Motion Sickness… Nonpharmacologic interventions for Motion Sickness 10 Apr 20228 Apr 2022 Previous Post Clinical Manifestations of Motions Sickness Following Non- Pharmacological Measures can help Prevention or treat motion sickness: Optimizing position to reduce motion or motion perception—Selecting seats where swinging or…
Motion Sickness… Clinical Manifestations of Motion Sickness 7 Apr 20225 Apr 2022 Previous Post - What is Motion Sickness Besides Nausea or Vomiting/Retching, which are more often reported by patients, other symptoms exhibited are: SweatingCold sweatsExcessive salivationApathyHyperventilationIncreased sensitivity to odoursLoss of appetiteHeadacheDrowsinessWarm sensationGeneral discomfort…
Pediatric Practice... Pearls for your Pediatric Office Practice 