CHILBLAIN-A MANIFESTATION OF CORONA VIRUS INFECTION,Dr.Dev,Pediatrician and Pediatric Pulmonologist,Sahibabad,Delhi-NCR

CHILBLAIN-A MANIFESTATION OF CORONA VIRUS INFECTION,Dr.Dev,Pediatrician and Pediatric Pulmonologist,Sahibabad,Delhi-NCR

Childern behave differently in corona virus infections.They usually have milder forms of disease.Particularly,infants less than 12 months,are immune to the disease in most of the cases.But they can spread the disease to adults.
In two case series studied retrospectively in Spain and Italy,children have been found to have skin lesions simulating chilblains.Some developed pruritus and some pain over skin. These lesions were observed after a median period of 14 days of other symptoms like cough ,fever,pain abdomen and dirrhoea.
Biopsy from all lesions showed lymphocytis vasculitis.Serum levels of D-dimer were raised, so there were some form of coagulopathy in those cases.Children were between the age of 5-17 years.
All children required analgesics for pain relief,antihistaminics for pruritus and local application of corticosteroids.All children recovered well .So prognosis was excellent.
So, skin lesions in the form of chilblains should be kept in mind while examining a child during Corona virus epidemic

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CHILBLAIN OVER FOOT

REFERENCE:Ped Derm.Published online,May6 and May9 2020

TEETH GRINDING(Daant Kitkitaana),Dr.DEV ,Pediatrician and PediatricPulmonologist,Sahibabad,Delhi-NCR

Teeth grinding which is commonly called Daant Kitkitaana in India, is very common complaint by Parents.In medical term,it is called BRUXISM.
It is a common belief in India that a child grinds his or her teeth due to worm infestations.Worm infestations is very common in India and a child with any symptom ,when investigated may be found to have worms in abdomen which may be a coincidental finding.
A child having worm infestation, grinds his or her teeth, does not has any scientific basis.Worms infestations has various presentations other than teeth grinding.
There are many causes of teeth grinding such as
1.A child having difficulty in getting onset of sleep or having disturbed sleep.
2.A child is irritated when he or she is not heard.
3.A child is feeling depressed because some of his or her requirements have not been fulfilled.
4.A child has not been fed according to his or her desire.
5.A child is suffering from some form of upper respiratory tract problems.
So, a child having teeth grinding should not be given anti worm medicines.

CORONAVIRUS DISEASE 2019,(COVID 19),Dr.Dev,Pediatric Pulmonologist,Sahibabad,UP,NCR-Delhi

Corona virus is a novel virus,known as severe acute respiratory syndrome virus-2(SARS CoV-2).It was first identified in the Wuhan city of china in 2019,so the disease is termed as COVID 2019.From China ,it has travelled to every part of world making human as a vehicle.It has killed many people world wide.

In 80% of infected people it causes mild disturbances and may go unnoticed.In about 12 % of cases ,infected persons become severe enough to be admitted in hospital and in about 6% cases ,the infected persons need ICU care.Mortality due to this disease is about 2%.
ROUTE OF ENTRANCE INTO THE BODY: It enters into the body through nose ,when an infected person coughs in the near vicinity of an individual.The virus may survive in air,on the surfaces and fomites for a variable period.It also comes in saliva in contrast to common cold virus.So,it may be inhaled from these sites.
The incubation period is 8-37 days,with an average 14 days.An infected person can shed virus for a minimum of 8 days to a maximum of 37 days.
The virus mainly damages the respiratory epithelium and alveoli of lungs causing pneumonia.
CLINICAL FEATURES;Symptoms are cough,sore throat,difficulty in breathing,headache,bodyache,wekness,confusion,dizziness and in some cases,loose motion and vomiting
LABORATORY FINDINGS;Commonb findings on CBC are,leukopenia,lymphopenia and leukocytosis.Other abnormalities are neutrophilia,thrombocytopenia and anemia.
In severe cases,there may be raised D-dimer and prolonged prthrombin time.
IMAGING;Chest X-Ray shows bilateral lung infiltrates in 75% of cases and unilateral lung infiltrates in 25% of cases.
Confirmation of diagnosis; RT-PCR of lower respiratory tract specimen(sputum,tracheal aspirate,BAL fluid) confirms the diagnosis.Sensitivity of upper respiratory tract specimen(throat swab,nasal swab,nasopharyngeal swab )is low.
HIGH RISK OF MORTALITY:Older age,high SOFA score(sequential organ function assessment) and serum level of D-Dimer > 1mcg/ml are the contion with very high mortality.
TREATMENT;There is no definite treatment as of now.Some antivirals have been tried like oseltamavir,ritonavir and lopinavir with variable results.Hydroxychloroquine has also been tried.
PREVENTION;Prevention is the only cure.Maintain respiratory etiquette,avoid crowded places,and maintain a distance of at least 1 meter(3 feets)

REFERENCES: 1.BMJ Best practice COVID 19
2.Lancet.doi:10.1016/SO140-6736(20)30566-3

WORLD ASTHMA DAY 07.05.2019 ,Dr.Dev , MD, Pediatric Pulmonologist, Delhi NCR

World asthma day is observed worldwide on first Tuesday of May.The purpose of this observation is to spread the awareness of Asthma among public.Asthma is the most common chronic respiratory disease of children.

Asthma can occur in first year of life to any age.Any child suffering from repeated episode of cough, breathlessness, chest tightness or wheezing should be investigated for asthma.High level of air pollution is very important trigger factor for flare up of asthma.

Asthma is controllable but not curable my regular use of medications.The cornerstone of Asthma management is inahalational steroid by metered dose inhaler.It should always be taken through spacer and in children below 5 years of age with spacer and mask.

The purpose of this ob

Common cold in mother and Breast feeding.Dr.Dev,Pediatric Pulmonologist,Delhi NCR

Common cold is the commonest respiratory disease in children and adults.It is characterised by running nose,sneezing,coughing,fever,headache and generalised bodyache with feeling of low.It is a common belief among mothers that while I am suffering from common cold and breast feed my child,this disease will go into my child through my milk.

This belief is totally wrong.Whenever mother or any member of family is suffering from common cold,child may get infected through close contact because this disease is viral disease and spreads from person to person through air, not through milk or not through saliva.

So it makes no difference,whether a mother feeds her baby or not.If she has common cold,she may transmit it to the baby by just sneezing or coughing near the baby.

So, breast feeding should be continued while mother has common cold.

INHALER MEDICATION/ADDICTION,A MYTH,DR.DEV,PEDIATRIC PULMONOLOGIST,DELHI NCR

Inhaler medications in the form of metered dose inhaler(pMDI) with spacer+/-mask is the cornerstone of asthma management in children as well as in adult.There is a common myth in society that once a child starts to take medicines through pMDI with spacer+- mask,he or she becomes addicted to these medicines and device.This belief is completely wrong.These medicines or devices does not contain any substance which makes the user addicted to it.It depends on the severity of the disease that the medications will be needed for how long.

Suppose, a child has been prescribed a lens with spectacle for problem in eyes.Some children will not require it after few months or few years as the child grows.But few children may require it for life.It does not mean that the spectacle or lens has made the child addicted.Same is the situation with MDI with spacer.

So ,whenever your doctor prescribes it ,use it for a period decided by your doctor.

COUGH and INGESTION of MILK/CURD/BANANA,DR.DEV,PEDIATRIC PULMONOLOGIST,DELHI NCR

Cough is a protective mechanism of body by which body tries to through out some unwanted particles or organisms, which has entered into body through nose or mouth.Usually ,it should not be suppressed by giving medicines.It requires treatment,only when it becomes disturbing and interferes with d ay to day activities or it disturbs the sleep of child or adult..There is a usual habit of purchasing cough syrup and giving it to child.This practice is wrong.On one hand ,it is not the treatment of disease causing cough and on the other hand it can suppress cough temporarily and increase the disease causing cough.Sometimes it can adversly affect the body and mind.There are many causes of cough in a child,which should be diagnosed and treated,cough will go.Cough is a symptom,not a disease..So,always consult your doctor whenever your child has troublesome cough..

Milk,curd or Banana are not responsible for producing or increasing cough in children or adult.If a person has proven allergy to any of these three,it shoud be avoided,as it may produce or increase cough in that case.Banana contains a substance which breaks the substance responsible for breaking down histamine.Thus ,it may increas the level of histamine in body,which may increase the cough,if the child is already coughing.

So,if a child is not allergic to milk,curd or Banana,these should not be prohibited in diet.

COLD,COUGH and BATH,DR.DEV,PEDIATRIC PULMONOLOGIST,DELHI NCR

Cold and cough are the symptoms of a viral disease caused by respiratory virus. It is not caused by cold weather or ingestion of food materials which are cold to touch.It is a common practice,not to give bath to children during cough and cold.

Bath with normal water is not harmful,rather beneficial during cold and cough.It washes out disease causing virus which are lying over the body. Personal hygiene is compulsory and regular bath should be given to children even during cough and cold.

If the child is sensitive to cold,then only, bath with cold water should be avoided.But bath with normal water should always be given.

TEETHING IN CHILDREN and DIARRHOEA,DR DEV,M.D,PEDIATRICIAN AND PEDIATRIC PULMONOLOGIST,DELHI,NCR

It is a common belief in society that diarrhoea (loose motion) in age group of teething children(6 months to 2 years of age) is due to the process of teething and it will go on till teething will be complete.There is also a belief that teething requires some medications.

Teething is a natural process in growth and development of children.It does not require any treatment as the growth of hairs and nails do not require any treatment.These grow naturally unless,there is no deficiency of any element in the body.If the child is taking exclusive breast feed till 6 months of age and thereafter he or she takes proper nutritious diets,there is no need of any medication for teething.Every child requires supplementation of vit-D ,right from birth to 1 year of age and the dose will be decided by treating pediatricians.

At the time of teething,there occurs some sensation in the mouth of baby and the baby puts something in the nearby surroundings into the mouth.It gives instant gratification after chewing.If ,in the surrounding,there are dirty things ,it will go into the mouth of baby and may cause diarrhoea(loose motion and vomiting) due to infections..To prevent that,surroundings should be kept clean.

During the period of teething,a baby may pass one or two times more stools and there may be mild fever but no vomiting.If the child is feeding well,and passing urine normally,nothing to be worried.If the child is passing stools more frequently,.less interested in feeding and passing less urine,then a doctor should be consulted immediately because it is not due to teething but may be due to infections.

HEAT EXHAUSTION IN CHILDREN,DR.DEV,M.D.,PEDIATRICIAN and PEDIATRIC PULMONOLOGIST,Sahibabad,DELHI NCR

Heat exhaustion is commonly seen in children during summer.It occurs in children who use to play in sun for a long time during very hot weather of summer.Symptoms of this condition are,excessive thirst,excessive sweating,,weakness,pain in the legs,headache ,vomiting,high fever and,rapid breathing. Child may suffer from excessive loss of water and electrolytes from the body(Dehydration).

If the child is not treated at this stage,he or she may go into the stage of heat stroke which is a life threatening condition.It is characterised by ,very high fever, no sweating, abnormal body movement and loss of consciosness.

if any symptom of heat exhaution is seen in children,the child should immediately be shifted to shaded area and if available,into an air conditioned room,clothes should be loosened,cold water or cold sports drinks should be given to drink ,skin should be misted with cool water but not very cold water, and fan should be on to evaporate the heat from body and then as soon as possible,a doctor should be consulted.

For prevention,no one should go into hot sunny weather empty stomach.