Cough and cold are the most frequent symptoms seen in children
It has become a trend to keep medicines at home for cough and cold
Many Parents are in habit of giving self medications to their children without any knowledge of dose and frequency of admininstration
Moreover,the dose of medicines keeps on changing in children unlike in adults
Parents are giving cough and cold medications for other purposes also like while air travelling to sedate the baby.
Cough and cold medications containing DIPHENHYDRAMINE ,when given in excessive doses,act as stimulants rather than sedatives.
The preparation containing DIPHENHYDRAMINE has killed many children.
There is evidence that these medications do not lessen the severity or duration of cough and cold.
Maximum deaths have occured in children below 2 years of age
In many homes,children easily access these medicines
THESE MEDICINES SHOULD NEVER BE PRESCRIBED IN CHILDREN BELOW 2 YEARS OF AGE
REFERENCES:Pediatrics: “Pediatric Fatalities Associated With Over-the-Counter Cough and Cold Medications,” “Pediatric Poisoning Fatalities: Beyond Cough and Cold Medications.
Child Health Guides
Large population of Delhi NCR children have ASTHMA.Dr.Dev,MD,Pediatrician and Pediatric Pulmonologist,Ghaziabad,Delhi NCR
Delhi is among most polluted cities in the world
Air pollution directly affects lung
Lungs of children are most vulnerable as the lungs are growing.
Children breath in more air than adults due to fast respiratory rate as compared to adults
Particulate matters in air particularly PM10 and PM2.5 can enter the airways and PM2.5 can go into alveoli
The level of PM10 and PM2.5 are 15 times higher in Delhi air as compared to set standard by World Health Organisation
The pollutants in air comprise obesogenic compounds responsible for making a child Obese
Obesity is associated with the development of Asthma in children
According to a cross sectional study done in 3 cities in India including the most polluted city Delhi and 2 less polluted cities in South India-Kottayam and Mysore, Published in LUNG INDIA September-October 2021,approximately 30% children in Delhi are suffering from Asthma.
Almost 50% children reported cough and 30% complained of shortness of breath.
Among 4361 children studying in private schools between the ages of 13-14 and 16-17,boys and girls, 3157 successfully completed the ISAAC Questionnaire and performed spirometry.
On the basis of spirometry ,which shows airway obstruction, a diagnostic component of Asthma,almost 30% children were diagnosed as having ASTHMA.
Most of the parents and children are not aware of this disease in children.
They are not easily accepting the diagnosis of ASTHMA in children, but it is a fact and we should do something proactively to control the level of pollution in cities to control the ASTHMA
The study has been published in LUNG INDIA September-October,2021
REFERENCES;. Singh V, Singh S, Biswal A. Exceedances and trends of particulate matter (PM2.5) in five Indian megacities Sci Total Environ. 2021;750:141461
Cited Here | PubMed | CrossRef
2. Central Pollution Control Board, Ministry of Environment, Forest and Climate Change. National Ambient Air Quality Status and Trends. 2019 Available from: https://cpcb.nic.in/upload/NAAQS_2019.pdfLast accessed on 2020 Oct 28
Cited Here
3. The Lancet Planetary Health. . Government indifference over air pollution crisis in Delhi
Tips to maintain good appetite in children,Dr.Dev,M.D.,Pediatrician and Pediatric Pulmonologist,Mohan Nagar,Sahibabad,Ghaziabad,Delhi NCR
A good appetite is gift of nature to every individual born on the planet.
As soon as the child is born ,he or she is hungry to take feeds.
Any child may not remain without taking feeds for a long time.
If the child is not hungry ,it is not natural.
A child with less appetite or loss of appetite is definitely suffering from some problems,either physical or psychological.
TIPS TO MAINTAIN APPETITE:
Do not feed the child very frequently as this practice inhibits the appetite centre of brain ,because you are not allowing time for this centre to be stimulated by hunger .
So, child should be given foods after a minimum gap of 2-3 hours.
Child should be given foods of their choice not of the choice of family members.
Child should never be forced to feed at a certain point of time if he or she is not interested to take feed at that time.
The food items should be well grinded so that any child may not have difficulty in manipulating it inside the mouth.
The child should be involved in outdoor play as long as possible so that their activities could be maximised which maintains the appetite.
There are some foods especilally zinc containing foods which increases the appetite.
These are -nuts like peanuts,almonds
Seeds like sesame seeds,pumpkin seeds
Cheese contains good amount of zinc.Beans contain good amount of zinc.
Child should be given foods with Indian spices in good quantity which increases appetite.
Every child should be exposed to household foods between the age of 6-12 months because this is the time of developing taste buds.By doing so,they will accept household foods in future during entire childhood period ,otherwise they will be more interested in foods from markets.
Child after the age of 1 year shuold not drink more than 500 ml of milk per day ,otherwise they will not be able to take the necessary elements as their stomach will be full of milk.
If the child is not interested in drinking milk,there is no problem,give them milk products like yoghurt ,cheese ,paneer which will meet the requirement as well as increase the appetite.
Never give tea or coffee to any child
DO not give fruit juices to children,instead give whole fruit after proper cutting or mashing as per the age of the child.
Avoid giving more oily foods as it may lower the appetite.
Loss of appetite is the feature of many diseases.So consult your doctor if the problem of less appetite persists.
Do not overfeed the child as it will increase the weight above the normal range making your child overweight or obese which is as bad as loss of weight.
NOTE; EVERY CHILD SHOULD BE GIVEN ONLY AND ONLY THE MILK OF MOTHER TILL THE AGE OF 6 MONTHS.
OIL MASSAGE TO BABY-KNOW THE FACT,DR.DEV,M.D.,PEDIATRICIAN AND PEDIATRIC PULMONOLOGIST,SAHIBABAD,GHAZIABAD,DELHI NCR
OIL massage is an important part of giving health to babies.
Oil maasage should be given to all babies starting at the period of newborn.
The best time to start oil massage to baby is ,approximately 10 days after birth when the umbilical stump falls off automatically.
The best time to give massage is before giving bath and it should be 90 minutes before or after the feed.
If the massage is given in close proximity to feed,there is more chance of vomiting.
The massage should be given preferably by mother so that there occurs a good bonding between mother and child.
The best oil for massaging a baby is pure coconut oil and the next best is olive oil.
If possible the massage should be given in open sun light provided there is no cold wind.
Baby should be unclothed fully during massage in warm ambience.
Massage can be given starting from top to bottom or in reverse order.
Lie the baby on his or her back and start massaging with oil from head.oil the scalp hair and massage gently,then start from mid point of forehead and go towards both sides gently.Massage the nose gently because the bone of baby’s nose is soft.DO NOT INSTIL OIL INTO NOSTRILS OR EARS.
Massage the back of ears then cheeks then armpits.Chest massage should be started from the midline moving toward both sides(periphery)
Massage the tummy in a clockwise movements of your hands very gently.
Arms should be massaged from low to high for 5-6 times.Then both the palms should be massaged.Legs should be massaged from low to high again 5-6 times ,then soles should be massaged.Oil should always be applied in the area of groin .
Now, the baby should lie on the tummy and back massage should be done starting from centre towards both sides.
Oil massage stimulates the different nerves of the baby,increases blood circulation in different parts of body, thereby helps in promoting growth of the baby.It can also detect some hidden injury when baby starts crying in pain which is easily recognised by mother.By increasing bonding with mother, when the baby enjoy the massage,it also helps in overall development of the baby.
Oil massage should preferably be done two times per day and during winter season, it also protects the baby from cold environment.
Five signs of disturbed sleep in children,Dr.Dev,M.D.,Pediatrician and Pediatric Pulmonologist,Sahibabad,Ghaziabad,Delhi NCR
Sleep is very important state of health.
Sleep is a state in which body and mind repares itself.
Adequate sleep is related to time and quality of sleep.
Either less time of sleep or poor quality of sleep ,may affect the body and mind adversely.
Children require more hours of sleep in comparision to adults.
A newborn,less than 4 weeks of age,require 16-18 hours of sleep per day.
A school going children,6-12 years of age require 9-10 hours of sleep per day.
Sleep is essential for the smooth functioning of body and mind.
Following are the 5 signs of disturbed sleep.
1.MORNING HEADACHE:
This is a very important sign of inadequate sleep.It is caused by CO2 retention due to sleep apnea(stoppage of breathing for more than 20 seconds)
2.HYPERACTIVITY:
This is a separate disease entity in children due to many causes,but sleep disturbances is an important cause.
3.ATTENTION DEFICIT:
Excessive sleepiness during day time and poor academic performances is an important sign of inadequate sleep but the child may become inattentive with less capacity to concentrate on anything due to less and bad quality of sleep.
4.RESTLESSNESS AND FRAGMENTED SLEEP:
Frequent arousal during sleep and excessive movement of any part of body is an important sign of disturbed sleep.
5.SOUND DURING SLEEP:
Sleep should ideally be soundless.Any audible sound during sleep is a sign of sleep disordered breathing.
Noisy breathing in the form of snoring is an important sign of upper airway obstruction,which leads to poor growth of body and mind of child and in long term ,it may cause heart disease in children.
Corona virus on human skin,Dr.Dev,Pediatrician and Pediatric Pulmonologist,Sahibabad,Ghaziabad,Delhi NCR
It is very difficult to study the virus on human skin due to fear of spread of infection among volunteers.
This is the reason,researchers have chosen to study on the skin of cadaver,which is used for the graft purposes.
Research has proven that the novel corona virus survives on human skin for more than 9 hours.
Influenza A virus survives on human skin for less than 2 hours.
Both viruses are killed when hands are rubbed for 15 seconds using 80% alcohol .
Viruses are also killed when hands are washed with soap water for at least 20 seconds.
Inspite of the fact that novel corona virus spreads mainly by droplets or aerosoles,CDC has recommended sanitizing hands with 60-95% alcohlo based hand sanitizers or washing hands with soap water for at least 20 seconds to check the spread of corona virus.
REFERENCES:https://bit.ly/34vrdlm Clinical Infectious Diseases, online October 3, 2020.
BREATH HOLDING ATTACKS,DR.DEV,M.D.,Pediatrician and Pediatric Pulmonologist,Sahibabad,Ghaziabad,Delhi NCR
Breath holding spells is not uncommon in children.
The phenomenon is very much frightening to the parents.
It is usually seen in children after the age of 6 months.
It usually starts between the age of 6-18 months and mostly observed in the age group of 1-3 years.
It abolishes automatically after 4-6 years of age.
There is no difference between male and female.
There are two types of attacks-1.Pallid spells and 2. cyanotic spells
In pallid spells, the heart rate of the child becomes slow,the child looks pale(more white) and there is loss of consciousness for few seconds ,but definitely ,less than 60 seconds(1 minute).
The pallid spell is usually triggered by pain ,like fall from the bed ,fall on the ground while playing,or minor impact on head of child by gently slapping.
In CYANOTIC SPELLS-
The colour of child becomes blue or purple specially around the lips.It is triggered by aggression,frustation,emotional distrubances and crying in fear or frightening environment to the child.There occurs a short burst of cry or single cry in which at the end of cry the child exhales for a slightly long period and holds the breath in exhalaltion ,not followed immediately by inhalation.There is loss of consciousness for a brief period ,not more than a minute.The muscels of the body may becomes stiff and there may be arching of the body in backward direction.Sometimes,there may be abnormal body movement and rarely there may be seizure.
This phenomena is typically described by parents as the child sometimes forget to take breath.
WHAT TO DO IN THESE SITUATIONS:This condition is harmless to the child with no long term effect on the brain and growth of the child.
The parent should not panic and should be very calm and comfortable.Those objects which may cause injury to the child and particularly sharp objects should be taken away from near of the child.
Make the child lie on the lap.
Do not through water on the face of the child as is usually practiced.It may be dangerous.
The child regain consciousness within a minute.If not,take the child to a doctor/clinic/hospital nearby.
If this episode is the first time,certainly go to the doctor/clinic/hospital.This is because, there may be some serious problems in heart and or brain of the child leading to these symptoms.There may be seizure disorder presenting like this.There may be congenital prolonged QT syndrome presenting like this.
If by proper clinical examination and if required proper investigations,it becomes clear that it is not due to any pathology in the brain and or heart,nothing to be worried.
It has been observed that ,these attacks are more common in children suffering from iron deficiency anemia
It should be investigated and treated ,the child becomes normal.
In some children,the episodes happens many times a day and in others only after few days or months.
It has been seen that ,it happens more frequently in circumstances where parents are more apprehensives.
So,parents should take care of themselves,not to show apprehensions in front of children and not to allow secondary gain to children.
Sometimes ,the episode becomes life threatening,and parents should learn ,how to resuscitate babies by giving mouth to mouth breath and chest compressin if required.
Sometimes ,medications in the form of atropine may be required,which should strictly be used by a qualified medical doctor.
WHEN AND HOW TO START BABIES ON SOLID FOODS(WEANING),DR.DEV,M.D.,Pediatrician and Pediatric Pulmonologist,Sahibabad,Ghaziabad,Delhi NCR
It is very common question and very common mistakes by parents,regarding when and how a solid food is introduced to baby.All babies should exclusively be breast fed right from birth ,preferably starting within 30-60 minutes of birth till the age of 6 months.Some mother says that since the child is born through caesarean section(OPERATION),I have started the baby to feed through bottle with formula milk.This is not the correct reason to start formula feeds.Milk production is very less during initial 3 days of child birth but it is sufficient for the baby and it is highly nutrItious and immunobooster to the child.Milk production begins only when the baby starts sucking.If the baby sucks more ,the milk production will be more,if the child sucks less,the milk production will be less and if the child does not suck,there will be no milk production.
Solid foods should be started at the completion of 6 months of age.It should be noted by parents that the child is able to hold his or her head before starting solid foods.
It can be started with any food available in the house but it should be in purees form.There is sufficient evidence from agriculture based families that they start with any grain available to them like corn,millets,rice,wheat.What they do it that,they make the grain in powder form and mix it with animal milk and feed the baby.We have sufficient evidence from hunter and gatherers family that they start giving meat that is made like purees.
So,it is safe to start with any food items like rice,millets,banana,apple,wheat but it should be in the form of purees.It is a good practice that mother should taste the food before feeding the baby.If mother can propel the food placed over tongue through the roof of mouth towards the back of tongue very easily,it can be given to baby safely.
It should be noted that ,it is the time, just to start the baby on solid foods,not to completely feed the baby with solid foods.The staple food for the baby is still breast milk.So,give the starting food 2-3 times daily and continue one item for 1 week then change to another item.
Some baby may reject the food .In such circumstances,try giving the food with spoon 3 times before stop giving for that session.It has been seen that on third attempt most babies accept the feed.If the baby tries to hold the spoon,let the baby do it,and you can feed them with another spoon.
NOTE:The baby should be seated upright as shown in picture at the outset, and food should not be sticky or lumpy to avoid the chance of chocking.
SPICY AND FLAVOURED FOOD:These food items can be given at this age of weaning the child.Since the child is already exposed to these spices and flavours in food through breast milk or even before birth in the uterus through the blood of mother,the child accepts it and there is no harm to the child.
ALLERGIC FOODS:Allergic food items can safely be started at this age and moreover,introducing allergic foods like egg,peanuts,fishes at this age may lessen the chance of developing allergy later in life.
NOTE:If the elder sibling is allergic to some food item,it is mandatory to get the baby tested for allergy before giving that food.
Food items should be changed every week and all kinds of foods should be introduced by the age of 9 months.It has been observed that by doing so,the child accepts all kinds of food items later in life.
Breast feed should be continued till the age of 2-3 years.It has been observed that the child who continue to breast feed till 2-3 years ,accepts all home made foods easily in comparision to those who continue breast feed for lesser period.
The quantity of solid foods should be increased gradually and by the age of 9 months, some lumpy foods which dissolves easily in mouth or mashed foods should be given to baby.Teeth are not erupted completely at this age but the child learns to manage food items with gums and propel towards back of tongue.By doing so ,the chewing muscles also gain strength.
NOTE;There should not be particles of food in mouth after getting broken in mouth by baby to avoid choking.
Honey should not be given before 1 year of age due to risk of BOTULISM
It is a common practice in India to start weaning with DAL WATER(Pulse water) It is a wrong practice.Start with whole DAL in the form of purees,(any dal)then give khichri after 1 week,then give rice and pulse after 1 week like that.
you can make powder of multiple grains and give one grain mixed with breast milk or animal milk at a time then add another after 1 week and gradually give multiple grains after 4-5 weeks . Fruits and vegetables should be given in the same manner.
REFERENCES:
Abrams EM and Becker AB. 2015. Food introduction and allergy prevention in infants. CMAJ. 187(17):1297-301.
American Academy of Pediatrics. 2017. Starting Solid Foods. Retrieved from https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Switching-To-Solid-Foods.aspx (12/28/2018).
American Academy of Pediatrics Committee on Nutrition. 2000. Hypoallergenic infant formulas. Pediatrics. 106(2 Pt 1):346-9.
Cameron SL, Taylor RW, Heath AL. 2015. Development and pilot testing of Baby-Led Introduction to Solids–a version of Baby-Led Weaning modified to address concerns about iron deficiency, growth faltering and choking. BMC Pediatr. 15:99.
Coulthard H, Harris G, Emmett P. 2009. Delayed introduction of lumpy foods to children during the complementary feeding period affects child’s food acceptance and feeding at 7 years of age. Matern Child Nutr. 5(1):75-85.
Daniels L, Heath AL, Williams SM, Cameron SL, Fleming EA, Taylor BJ, Wheeler BJ, Gibson RS, Taylor RW. 2015. Baby-Led Introduction to SolidS (BLISS) study: a randomised controlled trial of a baby-led approach to complementary feeding. BMC Pediatr. 15:179.
de Lauzon-Guillain B, Jones L, Oliveira A, Moschonis G, Betoko A, Lopes C, Moreira P, Manios Y, Papadopoulos NG, Emmett P, Charles MA. 2013. The influence of early feeding practices on fruit and vegetable intake among preschool children in 4 European birth cohorts. Am J Clin Nutr. 98(3):804-12.
Dogan E, Yilmaz G, Caylan N, Turgut M, Gokcay G, Oguz MM. 2018. Baby-led complementary feeding: Randomized controlled study. Pediatr Int. 60(12):1073-1080.
Du Toit G, Foong RM, and Lack G. 2016. Prevention of food allergy – Early dietary interventions. Allergol Int. 65(4):370-377.
Forestell CA. 2017. Flavor Perception and Preference Development in Human Infants. Ann Nutr Metab. 70 Suppl 3:17-25.
Forestell CA and Mennella JA. 2007. Early determinants of fruit and vegetable acceptance. Pediatrics 120(6):1247-1254.
Forestell CA and Mennella JA. 2017. The Relationship between Infant Facial Expressions and Food Acceptance. Curr Nutr Rep. 6(2):141-147.
Harris G and Mason S. 2017. Are There Sensitive Periods for Food Acceptance in Infancy? Curr Nutr Rep. 6(2):190-196.
Howcroft R. 2013. Weaned Upon A Time: Studies of the infant diet in prehistory. Stockholm.
Ierodiakonou D, Garcia-Larsen V, Logan A, Groome A, Cunha S, Chivinge J, Robinson Z, Geoghegan N, Jarrold K, Reeves T, Tagiyeva-Milne N, Nurmatov U, Trivella M, Leonardi-Bee J, Boyle RJ. 2016. Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune Disease: A Systematic Review and Meta-analysis. JAMA. 316(11):1181-1192
Liem JJ, Huq S, Kozyrskyj AL, Becker AB. 2008. Should Younger Siblings of Peanut-Allergic Children Be Assessed by an Allergist before Being Fed Peanut? Allergy Asthma Clin Immunol. 4(4):144-9.
Mennella JA, Reiter AR, Daniels LM. 2016. Vegetable and Fruit Acceptance during Infancy: Impact of Ontogeny, Genetics, and Early Experiences. Adv Nutr. 7(1):211S-219S.
Mura Paroche M, Caton SJ, Vereijken CMJL, Weenen H, Houston-Price C. 2017. How Infants and Young Children Learn About Food: A Systematic Review. Front Psychol. 8:1046.
Okubo H, Miyake Y, Sasaki S, Tanaka K, Hirota Y. 2016. Feeding practices in early life and later intake of fruit and vegetables among Japanese toddlers: the Osaka Maternal and Child Health Study. Public Health Nutr. 19(4):650-7.
West C. 2017. Introduction of Complementary Foods to Infants. Ann Nutr Metab. 70 Suppl 2:47-54.
title image of baby touching hands in high chair by lmnop88a / flickr
imagine of baby foods by Frédérique Voisin-Demery / flickr
image of baby making funny face while eating by Fimb /flickr
image of baby turning away from food by Abigail Batchelder /flickr
image of baby grabbing spoon by César Rincón / flickr
Content last modified 1/2019
VACCINATION(IMMUNISATION),IN CHILDREN,Dr.Dev,M.D.,Pediatrician and Pediatric Pulmonologist,Sahibabad,Ghaziabad,Delhi NCR
Vaccination(Immunisation) is a process in which a modified part of disease producing organism is given into the body, either through mouth or through injections.This modified part is not capable of causing disease but capable of activating the body to produce a substance in the body which kills the disease producing organism which subsequently invades the body.This is called active immunisation.It is done before any organism attacks the body.
When an organism has already attacked the body and body is not capable of fighting it,antibody already available is injected into the body to kill that organism and it is called passive immunisation
Immunisation starts from birth, when no organism has yet attacked the body. When it is not done ,antibody which has come from mother to newborn acts as a killer to any attacking organism,provided it is already present in mother.
SCHEDULE OF VACCINATION:
AT BIRTH(1.);BCG-to protect against Tb(Tuberculosis) is given on left arm and a scar may form at the site after healing of the wound formed 4-6 weeks after the vaccination.Scar persists lifelong.
(2) Hepatitis B first dose is given to protect against hepatitis ,a liver disease.
(3)Oral polio vaccine is given through mouth to protect against polio disease.
AT 6 WEEKS OF AGE:a combination vaccine is given which contains DPT,IPV,Hepatitis B,Hemophilus influenzae b. DPT protects against Diphtheria,Tetanus and Pertussis.IPV is injectable polio vaccine to protect against polio,Hemophilus vaccine protects against a bacterial infections causing pneumonia and meningitis.
At this age Pneumococcal conjugate vaccine can be given to protect against severe form of pneumonia and Rotavirus vaccine can be given orally to protect against severe form of diarrhoea.
AT 10 WEEKS OF AGE: All vaccines given at the age of 6 weeks are repeated.
AT 14 WEEKS OF AGE:All vaccines given at the age of 10 weeks are repeated except Rotavirus if R1 has been used.If R5 has been used for Rota virus protection,then it is also repeated as third dose.
AT 6 MONTHS OF AGE;The first dose of influenza vaccine is given to protect against influenza virus causing severe form of pneumonia in children.
AT THE AGE OF 7 MONTHS;The second dose of influenza vaccine is given which is then repeated every year.
AT 9 MONTHS OF AGE;MMR vaccine is given to protect against viral diseases caused by measles,mumps,and rubella viruses.
At this age Typhoid conjugate vaccine can be given as a single dose to protect against Typhoid fever and Meningococcal conjugate vaccine can be given to protect against meningitis(brain fever) caused by Meningococcus.It is repeated after 3 months,.
AT 1 YEAR OF AGE;Hapatitis A vaccine is given to protect against hepatitis ,liver disease.At this age ,Encephalitis vaccine(JEEV) can be given to protect against Japanese encephalitis ,a lethal disease.This vaccine(JEEV) is repeated after 4 weeks.
AT THE AGE OF 15 MONTHS:MMR vaccine is repeated .At this age, Varicella vaccine is given to protect against chicken pox.The booster dose of Pneumococcal conjugate vaccine is given at this age.
AT THE AGE OF 18 MONTHS:BOOSTER doses of DPT,IPV and Hepatitis A is given.Booster dose of Hemophilus influenza type b is also given at this age.
AT THE AGE OF 2 YEARS; Vi Polysaccaride vaccine may be given to protect against Typhoid to those child who has not received Typhoid conjugate vaccine
AT THE AGE OF 4-6 YEARS;BOOSTER DOSES of DPT,MMR AND VARICELLA are given at this age.
AT THE AGE OF 10 YEARS;TdaP Vaccine is now recommended which acts as a booster for Diphtheria,Tetanus and Pertussis.For girl child ,HPV vaccine is given to protect against cervical cancer and it should be repeated after 1 -2 months and 6 months of first dose.
AT THE AGE 16 YEARS:TdaP vaccine is repeated.
POST EXPOSURE VACCINE;In case of dog bite or bite from any wild or unknown animal ,a vaccine is given to protect against a lethal disease,Rabies.It is 100% lethal disease for which no treatment is available.
Five doses are given on days 0,3,7,14,28.In third degree, bite immunoglobulin is also given as early as possible and not beyond 7 days.
NOTES;a minimum of 4 weeks interval is must between two doses of same vaccine.But, it can be given if one has missed the schedule date.It is safe to be given between 4-8 weeks.
If a child is completely vaccinated, there is no need of repeated Tetanus vaccine after minor injuries.
No vaccine gives 100% protection.
Adverse effects can happen to any vaccine ,most commonly within 30 minutes after vaccination but may occur later on.
;
Certain hand sanitizers are life threatening,Dr.Dev,M.D.,Pediatrician and Pediatric Pulmonologist,Sahibabad,Ghaziabad,Delhi-NCR
In the Pandemic of Coronavirus disease 2019(COVID 19) , hand sanitizers are life saving.
It kills most of the micro-organisms which come in contact with hands.
It should be used when hand washing facility with soap and water is either not available or not feasible.
Hand sanitizers should be composed of ethanol and it should be at least 60% ethanol ,not methanol.
It should be rubbed over hands on all sides till the hands become dry.
Methanol containing hand sanitizers can become dangerous when absorbed through skin or ingested.If there is frequent use of hand sanitizers it can be absorbed through skin.Sometimes it can be ingested by children or inadvertently by adults.Some companies are making and selling methanol containing hand sanitizers.
There has been some reports of death,blindness and hospitalisation after ingestion of methanol containing hand sanitizers by adults and children. Methanol are used to create fuel and antifreeze.
SIGN AND SYMPTOMS OF METHANOL TOXICITY: Nausea,vomiting,headache,blurred vision.
There may be permanent blindness,seizure,coma,permanent neurological damage and death.
FDA has warned against the use of methanol containing hand sanitizers ,stating that some companies are taking undue advantages of coronavirus pandemic and selling methanol containing hand sanitizers.
It is being recalled from the market .It should be disposed properly using hazardous waste container and should not be poured into drain and should not be mixed with any fluid.
REFERENES;fda.gov