March 2020 - Page 2 of 4 - CHILD AND CHEST HEALTH CARE

USE OF INHALER WITH SPACER WITH MASK FOR ASTHMA ,BELOW 5 YEARS OF AGE,Dr.Dev,Pediatric Pulmonologist(Child Chest specialist),Sahibabad,UP,Delhi NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 20 Mar, 2020 - Child Health Guides,Parents’ Guide, - 0 Comment

Inhalational corticosteroid is the mainstay of treatment for asthma in children.It is effective only when taken with correct technique,taught by a trained Doctor .If the technique is faulty,there will be no benefit of treatment and it will give a false sense of medication being given.In such situations,disease will progress and parents will think that the disease is progressing due to inlaler or there is no benefit of inlaler.PLEASE CLICK BELOW TO WATCH FOR A CORRECT TECHNIQUE OF ASTHMA MEDICATION
https://www.youtube.com/watch?v=VXsG13dzhy4

CAVITORY LESION CAN BE SEEN IN SCHOOL AGE CHILDREN WITH PULMONARY TUBERCULOSIS,DR.DEV,M.D.,Pediatric Pulmonologist,Sahibabad,UP,Delhi NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 20 Mar, 2020 - Medical Guide,Professionals Guide, - 0 Comment

Five year old female child came to me with the history of fever,loss of appetite for 15 days and weight loss for 1 month.On examination,the weight of child is 10 kg which should be 18 kg.On chest auscultation,breath sound was markedly diminished on right inframammary region.Chest X-Ray was done which shows cavity on right mid zone.Contact history for tuberculosis was negative.Clinical setting and chest X-Ray is suggestive of pulmonary tuberculosis.Further investgations are being done to confirm the diagnosis.

Message: Cavitory lesion which is usually seen in adolescent and adults suffering from tuberculosis,may be seen in children with school age group.

Precautions while going to Hill stations.Dr.Dev,M.D.,child specialist and child chest specialist,Sahibabad,UP,Delhi NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 20 Mar, 2020 - Child Health Guides,Parents’ Guide, - 0 Comment

It is a common practice to visit hill stations during holidays .Some children may develop acute mountain sickness ,the commonest form of high altitute illness when they suddenly go to high altitude on the mountain.The symptoms of this disease are headache,vomiting,tiredness,getting difficulty in sleep and dizziness.These symptoms resolve within 12-48 hours of acclimatization.

If these symptoms are ignored,the child may develop life threatening complications in the form of high altitude pulmonary edema and high altitude cerebral edema.

PRECAUTIONS:One should not travel on high altitude for more than 9000 feet on a single day.After 9000 feets,one shuold not go for more than 500 meters per day.One shuold take 24 hours of rest for acclimatization after every 1000 meters above 9000 feets.One should avoid vigorous exercise 48 hours prior to going up.

On feeling symptoms,one should consult doctor if available.Oxygen therapy may be needed in few cases. If despite treatment,the symptom is not improving,one should get down gradually

SUNSCREEN CREAM FOR CHILDREN,DR.DEV,M.D.,Child specialist and Child chest specialist,Sahibabad,UP,Delhi,NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 20 Mar, 2020 - Child Health Guides,Parents’ Guide, - 0 Comment

Sunscreen should be applied to all children, 15-30 minutes before going out in sun.It is more important for fair skinned children.Dark skinned children have more melanin in their skin to protect from bad effects of sun.But they should also apply sunscreen as the protection that is inherent is not sufficient.Children below 6 months of age should be protected by loose clothes covering all vulnerable areas and hat with brim should be put before going going out in sun.Exposed areas like outer surface of hands should be protected by sunscreen cream or lotion.

According to American Academy of Dermatology,the sunscreen for children should have SPF(Sun protection factor) of at least 30.The sunscreen comes in the market in different formulations,like cream,lotion,gel,and sticks.Sticks can be used for area around eyes and gel can be used on hairy area like scalp.Sunscreen should be applied in sufficient amount.It should be water proof which remains effective for about one hour in water like in swimming pools. If it is not water proof,it should immediately bereapplied while coming out of swimming pool.It should also be sweat proof.If not ,then reapplied after sweating.Usually it should be applied 2 hourly.It should be protective from both UVA and UVB,(Ultraviolet A and B)

NIPAH VIRUS DISEASE IN CHILDREN,DR.Dev,M.D.,Child specialist and child chest specialist,Sahibabad,UP,Delhi NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 20 Mar, 2020 - Professionals Guide, - 0 Comment

Human Nipah virus disease is a life threatening disease with mortality rate of 40-75%.It is a zoonotic disease caused by a paramyxovirus,NIPAH VIRUS,named after a village in Malaysia Sungai Nipah.

The natural reservoir of this virus is large fruit bats of genus Pteropus.Transmission of this virus to human occurs when there is a contact with infected bats,or consuming fruits contaminated with secretions of bats,or infected pigs.Human to Human transmission has ben proved in 2001.

Symptoms of the disease are fever,nausea,vomiting,headache.When the disease progresses,it may cause shortness of breath,and on deterioration ,it may cause,drowsiness,confusion and coma.There may be features of encephalitis.

It is diagnosed by detecting viral antigen by real time PCR,in samples from nasal swab,throat swab,CSF,urine and blood.In the later peroid,antibody may be detected by ELISA.

TREATMENT is mainly symptomatic with supportive care.There is no specific treatment.RIBAVARIN, an antiviral may have role in encephalitis caused by Nipah virus

Rashes over body;Dr.Dev,M.D.,Child specialist and Child chest specialist,Sahibabad,UP,Delhi NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 20 Mar, 2020 - Child Health Guides,Medical Guide,Parents’ Guide,Professionals Guide, - 0 Comment

Rashes over body of children may of different types and due to different reasons.Most common rashes over the body of children are due to allergy.Allergy may be due to any thing which is in the air or which the child commonly eats or drinks.Allergic rashes may cover the whole body within minutes or progresses over the day.Some children may have some congenital defect and they are more vulnerable to allergic rashes.Allergic rashes are usually red coloured and wheel shaped but it can be like pin heads and confluent erythmatous rashes.Sometimes there may be swelling of lips ,tongue and digits.In the most severe form,there is swelling of the larynx(the door to the lungs) causing laryngeal edema and there is spasm (narrowing) of bronchi(airway).In this case life of the child may be endangered.So,any rash over the body of child should not be ignored and a doctor should be consulted as soon as possible.Allergy may be caused by any drug,whether the child has taken it previously or not.Allergy may be due to any vaccine.

Rashes may be due to viral infections in the form of Measles,Rubella,or Chicken Pox.These can be identified only by a qualified doctor.Vaciines are available to prevent these viral diseases..

Rashes over body may be due to some autoimmune diseases which is chronic condition requiring detailed investigations and complex treatment.

Rashes may be due to atopic dermatitis which requires long term treatment..

Rashes may be due to scabies in which case other family members are also affected.

JAUNDICE IN NEWBORN IS DIFFERENT FROM JAUNDICE IN OLDER CHILD OR ADULT,DR.DEV,M.D.,CHILD SPECIALIST AND CHILD CHEST SPECIALIST SAHIBABAD,UP,DELHI NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 20 Mar, 2020 - Child Health Guides,Parents’ Guide, - 0 Comment

There is a general conception among parents that jaundice in newborn baby is the same type as in older child or in adults.

Jaundice in newborn baby is totally different from older child or adults.In newborn baby, jaundice is caused by break down of red blood cells(RBC),whereas in older child and adults,jaundice is caused usually due to inflammation(swellig) of liver.So the jaundice in adults and older children is a sign of hepatitis ,whereas jaundice in newborn is a sign of breakdown of blood.In some circumstances,breakdown of blood is also responsible for jaundice in older child or adults and on the other hand hepatitis is also responsible for jaundice in newborn babies.

Jaundice is the commonest clinical sign in a newborn baby.In newborn babies,jaundice is commonly seen on the skin as increase yellowness of skin after blanching. It appears first on face then progresses downwards .If it appears on the palms and soles,it becomes dangerous and immediate treatment is required..In newborn, slight level of jaundice is normal and does not require any treatment,which is known as physiological jaundice.It disappears automatically in due course of time.But parents should always consult a qualified doctor if a newborn appears yellow..When the level of jaundice is high or prolonged which will be decided by a qualified doctor,it needs treatment and the jaundice is called pathological jaundice.It happens due to various causes ,the most common among them is blood group incompatibility between mother and newborn,mainly Rh incompatibility,when the mother is Rh negative and the baby is Rh positive.

The treatment is phototherapy and in severe cases exchange blood transfusion, in which the whole blood of baby is exchanged with matched blood.

REPEATED COUGH AND/OR DIFFICULTY IN BREATHING MAY BE ASTHMA IN CHILDREN,DR.DEV,M.D.,PEDIATRICIAN AND PEDIATRIC PULMONOLOGIST,SAHIBABAD,UP,DELHI NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 20 Mar, 2020 - Child Health Guides,Medical Guide,Parents’ Guide,Professionals Guide, - 0 Comment

Repeated episodes of cough or difficulty in breathing may be a manifestation of Asthma in children.It is a common belief that,Asthma is a disease of adults and it does not occur in children.The fact is that, Asthma can occur at any age and it has been diagnosed and treated successfully in many infants less than one year of age.

Asthma has a genetic predisposition but a child not predisposed genetically may also develop Asthma.There should be an interaction with offending environment for a child genetically predisposed to develop Asthma.

Asthma in children is an allergic disease of respiratory system.But it may be nonallergic also.Allergy may be due to many things in the air or in the foods.

When a child develop breathlessness,usually parents call it as pneumonia.But it may not be pneumonia,it may be Asthma only or Asthma associated with Pneumonia.There are many conditions in children which looks like Asthma. So an expert and qualified doctor only can diagnose the condition as Asthma.

The mainstay of long term management of Asthma is inhalational steroid.Many parents are scared of steroid.There is no reason to be scared of steroid if it is given in right dose and duration which will be decided by a doctor. Steroid is not a poison,rather it may be nector when it becomes life saving in acute severe exacerbation of Asthma. In such conditions, it is given orally(through mouth) or intravenously(i.v.injections) as the condition permits.

Asthma is not curable but controllable.It must be controlled by regular use of inhalational steroid in children, as the lungs of children are growing lungs, and if left uncontrolled, the lung growth will be hampered .If lungs will not grow properly,body will also not grow properly.

BREAST FEEDING DURING PREGNANCY,DR.DEV,M.D,CHILD SPECIALIST AND CHILD CHEST SPECIALIST,SAHIBABAD,UP,DELHI NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 20 Mar, 2020 - Medical Guide,Parents’ Guide,Professionals Guide, - 0 Comment

Breast feeding is the most essential part of infant caring.Every child should be breast fed exclusively for the first 6 months of life.There is no substitute for this.

There are many nutrients available in mothers milk which are not available in other milk.It is essential for the proper growth of infants.It also helps mother in many ways.It is also essential for emotional bonding between mother and child.

There are pressures on mother from family,society and from some medical professionals ,not to breast feed the baby if she has become pregnant again.

There are many explanantions in favour of it.It is believed that, if a mother feeds the baby when she is pregnant again,there will be spontaneuos abortion,there will be preterm delivery,there will be growth retardation of fetus carried by mother,mother will become weak due to nutritional deficiency.

All explanations for not breasting feeding during pregnancy are baseless as per current knowledge.There has been no scientific study to prove these concepts.

The fact is ,mother can continue breast feed her infant while she is pregnant and she has to take nutritious diets and keep her health in good condition.

THALASSEMIA,DR.DEV,CHILD SPECIALIST,Sahibabad,UP,Delhi,NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 20 Mar, 2020 - Child Health Guides,Medical Guide,Parents’ Guide, - 0 Comment

Thalassemia is a disease of deficiency of blood in body.It is a cause of Anemia.It is a disease of genetic origin of hereditary pattern.It means,it passes to generations through genes.It has autosomal recessive pattern of inheritance,means,all children of affected persons will not have the disease.

It is of two types=Thalassemia major and Thalassemia minor.In case of Thalassemia major,the child will have deficiency of blood after the age of 6 months and before the age of 12 months.This child will need repeated blood transfusion,every 3-4 weeks.But in case of Thalassemia minor,which is detected by blood tests,the child will have little deficiency of blood and will not require blood transfusion for this disease.

PRECAUTION IN CASE OF THALASSEMIA MINOR-If a child has been diagnosed as Thalassemia minor,he or she should not get married with a partner having Thalassemia minor.If they get married with the same trait,their child will have more chance to have Thalassemia.