Medical Guide Archives - Page 2 of 4 - CHILD AND CHEST HEALTH CARE

Monkeypox-another threat after COVID-19 ,Dr.Dev(Dr.D.K.Jha) M.D.,Pediatrician and Pediatric Pulmonologist,Rajendra Nagar,Ghaziabad,Delhi NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 22 May, 2022 - Child Health Guides,Medical Guide,Professionals Guide, - 0 Comment

As the name suggests,this disease comes in human from animal,so it is called a zoonotic disease

It is caused by monkeypox virus from the family of poxviridae

It resembles closely with small pox

It comes from animal to human from direct contact with blood,body fluids or muco-cutaneous lesions of infected animals

The natural reservoir is not clear till now but most likely it is rodents-Rope squirrel,tree squirrel

Possible risk factor for getting infected is eating inadequately cooked meat or other products of infected animals

Human to human transmission occurs via close contact with respiratory secretions,objects used by infected persons or mucocutaneous lesions

Prolonged face to face contact may result in transmission of virus through respiratory droplets.

The incubation period is 6-13 days with a range of 5-21 days

Clinical picture can be divided into 2 phases- Invasion phase and eruption phase

INVASION PHASE -It lasts between 0-5 days and characterised by high fever,intense headache,body pain ,back pain ,profound weakness and lymphadenopathy.

Lymphadenopathy differentiates it from other similar viral diseases with rash like measles and chicken pox

ERUPTION PHASE-Skin eruption starts from 1-3 days of start of fever.

Rashes are seen more concentrated over the face and extremities ,less over the trunk.

Rashes may affect palms,soles,oral mucosa and most dangerously the cornea which may be lead to corneal opacity

Rashes evolves from macules to papules to vesicles to pustules, sequentially

These rashes may be few to thousands,crusts and fall off

Rashes may coalesce and a large portion of skin may slough off

It is a self limiting disease and gets spontaneously cured after 2-4 weeks

It may be complicated by secondary bacterial infections,bronchopneumonia,sepsis,encephalitis,corneal involvement and loss of vision

The case fatality(mortality) has been reported to be very high recently and it is 3%-6%

Diagnosis is done by polymerase chain reaction of lesions.

TREATMENT is only symptomatic and only antiviral recommended is TECOVIRIMAT

PREVENTION-Small pox vaccination is very effective but not available now

Recently two doses vaccines for Monkeypox has been recommended but not widely available so personal protection is the cornerstone for prevention

REFERENCES:WORLD HEALTH ORGANISATION(WHO),MONKEYPOX,19 May 22

virus-The most common trigger for asthma exacerbation in children,Dr.Dev,M.D.,Pediatrician and Pediatric Pulmonologist,Rajendra Nagar,Ghaziabad,Delhi NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 06 Mar, 2022 - Child Health Guides,Common Childhood Disease,Medical Guide,Professionals Guide, - 0 Comment

Asthma exacerbation Asthma is the most common chronic disease in children.

The exact cause of asthma is not clear but there are several theories to explain the cause of asthma.

It is the interaction of genetic predisposition and environment which causes asthma to manifest in children.

Although not a single theory can explain the causation of asthma ,it is clear that, it is a heterogenous disease and there are so many triggers of its exacerbation.

Among triggers, there are ,allergens,pollutants,exertion,cold air,pollens,molds,and sudden change in ambient temperature

Among viruses ,Respiratory Synsytial virus(RSV),rhinovirus,influenza virus and seasonal coronavirus are known triggers for asthma exacerbation in children.

Investigators hypothesized that VIRUSES are the most important triggers for pediatric asthma exacerbation. To prove this ,the investigator studied on children admitted with severe asthma exacerbation in various hospitals form 2014 through 2021. Asthma exacerbation was confirmed through electronic records by continuous use of inhalational salbutamol. Viral testing were done on all children to confirm viral infection.

Investigators studied asthma exacerbation 15 -52 weeks after CDC implemented non pharmaceutical measures to prevent spread of Corona virus disease 2019 ,which limits the spread of virus from person to person including corona virus.These measures are physical distancing,use of mask and respiratory ettiquets.

The average rate of weekly asthma exacerbation in children decreased from approximately 64 % during the period of 2014 to 2019 to approximately 13% in 2020.

The average rate of viral infection positivity decreased from approximately 56% during the period of 2014 to 2019 to approximately 30% in 2020.

Researchers also observed that there was no change significantly in the environmental level of molds,pollens,pollutants and AQI(air quality index)

Researches found that, among various triggers for asthma exacerbation in children ,viral infections were most closely related which was obvious by the measures adopted to spread COVID 19 ,decreased the exacerbation of asthma.

It was concluded that ,measures to minimise viral infections in children will translate into fewer excerbation of asthma in children.

REFERENCES:

Poole A, Holcomb M, Jamieson A, et al. Social distancing reveals determinants of pediatric asthma exacerbations. Presented at: American Academy of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting; February 25–28, 2022; Phoenix, AZ. Abstract 178.

Bronchiolitis/Azithromycin/Recurrent Wheeze,Dr.Dev.M.D.,Pediatrician and Pediatric Pulmonologist,Rajendra Nagar,Ghaziabad,Delhi NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 26 Feb, 2022 - Medical Guide,Professionals Guide, - 0 Comment

Acute bronchiolitis is very common condition in infants
It is viral disease ,most commonly caused by Respiratory Syncytial virs(RSV)
In most of the cases, it is mild and does not require hospitalisation
Only symptomatic treatment is needed in most of the cases
It has been observed that most of the physicians prescribe antibiotics for this condition which does work and not needed
Azithromycin is very frequently prescribed in this condition and it is believed that it will prevent future episodes of wheezing in infants and children
Azithromycin is known to reduce the airway inflammation.
To know that,the oral use of Azithromycin in severe RSV infection reduces recurrent wheeze in infants,Researchers studied on 200 children between the age of 1 months to 18 months hospitalised with severe RSV infection with no comorbid conditions.It was a single centre double blind placebo controlled trial.Recurrent wheeze was defined as third episode of wheeze in next 2-4 years and it was the primary outcome of study.Secondary outcomes were annualised use of inhalational salbutamol,annualised episodes of respiratory symptoms,subsequent use of antibiotics and subsequent use of oral corticosteroids
Children were divided into 2 cohorts.One cohort received oral Azithromycin 10 mg/kg for 7 days then 5 mg/kg for next 7 days.Second cohort received placebo.
It was observed that the risk of recurrent wheeze was not different in Azithromycin and placebo groups(Adjusted Hazard Ratio [aHR] 1.45; 95% CI, 0.92-2.29; P =.11). There was no difference in secondary outcomes between two cohorts.
It was seen that the level of interleukin 8 in nasal wash ,which is a marker of neutrophilic inflammation was low in Azithromycin treated group.
It was concluded that the use of Azithromycin does not reduce the risk of recurrent wheeze in children with severe RSV infection although it reduces inflammation.
The study is a part of conference coverage of American Academy of Allergy,Asthma and Immunology, Feb 2022
REFERENCES:
Beigelman A, Srinivasan M, Goss C, et al. Azithromycin to prevent recurrent wheeze following severe RSV bronchiolitis: the APW-RSV II clinical trial. Presented at: American Academy of Allergy, Asthma & Immunology (AAAAI) 2022 Annual Meeting; February 25–28, 2022; Phoenix, AZ. Abstract 456.

Large population of Delhi NCR children have ASTHMA.Dr.Dev,MD,Pediatrician and Pediatric Pulmonologist,Ghaziabad,Delhi NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 16 Sep, 2021 - Child Health Guides,Common Childhood Disease,Medical Guide,Parents’ Guide,Professionals Guide, - 0 Comment

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

Five signs of disturbed sleep in children,Dr.Dev,M.D.,Pediatrician and Pediatric Pulmonologist,Sahibabad,Ghaziabad,Delhi NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 23 Oct, 2020 - Child Health Guides,Medical Guide,Parents’ Guide,Professionals Guide, - 0 Comment

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

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 10 Oct, 2020 - Child Health Guides,Medical Guide,Parents’ Guide,Professionals Guide, - 0 Comment

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.

WHEN AND HOW TO START BABIES ON SOLID FOODS(WEANING),DR.DEV,M.D.,Pediatrician and Pediatric Pulmonologist,Sahibabad,Ghaziabad,Delhi NCR

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 28 Aug, 2020 - Child Health Guides,Medical Guide,Parents’ Guide,Professionals Guide, - 1 Comment

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

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 21 Aug, 2020 - Child Health Guides,Medical Guide,Parents’ Guide, - 0 Comment

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

Pediatrician and Pediatric Pulmonologist Dr.Dev Kumar Jha,Formerly at AIIMS,New Delhi - 10 Jul, 2020 - Child Health Guides,Medical Guide,Parents’ Guide,Professionals Guide, - 0 Comment

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

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.