MONDAY TO SATURDAY
Morning: 9am to 12pm
Evening: 6pm to 10pm
On Prior Appointment Only.
Children Problems We Treat
One of the most common childhood health problems is Constipation. Constipation is defined as “delay or difficulty in defecation (passing motions), present for 2 weeks or more, and sufficient to cause significant distress to the patient. NASPGHAN- The North American Society of Pediatric Gastrology, Hepatology And Nutrition. The condition is so very common that very 4th (1 in 4) child in India is having either identified or unidentified constipation. Though there are many organic causes for same; most common is functional (where cause is not known).
History taking remains the key to diagnosis. Clinical examination adds on to clues to diagnosis of organic causes. Hardly ever any investigations required still physician/ pediatrician has to advice judicially on case to case basis to rule out the cause. In organic cases the treatment of cause will automatically treat the constipation; still time being disimpaction therapy may be required in some cases. Since majority of cases are functional constipation and non-organic, the method sited here takes care of that kind of conditions. Good fibre intake in form of at least 2 fruits and 2 medium sized bowls cooked/raw vegetables by average child fulfils this requirement.
Good fluid intake roughly 1.5- 2 litres of water. Avoidance of constipation causing junks which are empty calories, non-vegetarian foods and less of fibre foods to not more than 2 times a week. Not more than 200 ml of milk in a day. The above recommendation is for average child weighing around 20 kgs. So it becomes RULE OF 2- 2 Fruits, 2 bowl veges, 2 litres water, 200 ml of milk, <2 times a week junks and non-vegetarian food. Few children needs disimpaction and/or maintenance medical therapy too which needs to be individualized.
Ear Ache and Itchy Ear
One of the common problem faced by infants (itching of the ear), toddlers and children (earache) which sometimes needs urgent doctor’s attention and causes lots of apprehension in patients. It is actually a symptom rather than disease. Patient needs to be evaluated with comprehensive history and examination. Most common causes for these conditions are wax, common cold (coryza), middle ear infection, fungal infection of ear drum, boil in external ear, meningitis (infection of brain covering) and trauma. Certainly one can sort out the cause on detailed evaluation.
Wax is something which is commonly present but doesn’t cause symptoms and it get cleared on its own without any intervention (body has its own cleaning mechanism); but if it causes pain in ear it needs to be removed cautiously with syringing by ENT specialists. Infants have tendency to itch ear normally also; in such situation, look out for 3 things, redness, ear discharge and irritability; if nothing is present, no need to treat it and worry about it.
Common cold (coryza) usually gets treated with treatment of nasal and oral decongestants, still some times ear analgesics and anesthetic drops are prescribed as per individual need. Boils in external ear and fungal infection of ear drum can be treated with respective ear drops. Severe infections causing these symptoms are more dangerous than these symptoms and needs immediate attention with high dose antibiotics and usually get treated on its own once causative infection comes under control. Trauma and damage due to same needs detailed ENT evaluation and medical/surgical treatment as per the damage.
Allergic Skin Problems
There is spectrum of allergic skin diseases caused by various allergens. Local reaction to chemicals or contact, ingested food can cause skin reaction; worm infestation can lead to skin reaction and last but not the least sun exposure. With good history and clinical examination one can differentiate the causes to large extent, e.g. exposed part is involved likely cause is pollutant chemical contact or sun exposure skin damage, unexposed part involvement is likely in contact dermatitis, generalised involvement is most likely to have systemic origin like food, inhaled toxin or worms, etc.
Type of rash also gives clue about the cause of reaction as small red raised/non-raised boils can be because of contact dermatitis or reaction to some food, worms, medicine etc. whereas big red patches can be due to food or sun exposure. Basically, improper skin care is major route cause of skin problems. Proper nourishment and hydration of skin right from the beginning is the key treatment since birth. Treating majority of skin reaction is pretty simple to give right anti-histaminic to right person in right dose and intense hydrating skin lotion/ cream. Sometimes rarely if the reaction is too severe local application of steroid ointment or even short course of oral steroid is indicated.
Above all is the spotting the allergen and avoid it. It is usually advised to patients to go back two days of start of allergic rash and note down all events, where the child has visited, what child has eaten, probability of insect bite, change of detergent to wash clothes, change in soap, cleaning at home etc..
Sore throats are common in children and can be painful. However, a sore throat that is caused by a virus does not need antibiotics. In those cases, no specific medicine is required, and your child should get better in seven to ten days. In other cases, a sore throat could be caused by an infection called streptococcal (strep throat).
Strep cannot be accurately diagnosed by simply looking at the throat. A lab test or in-office rapid strep test, which includes a quick swab of the throat, is necessary to confirm the diagnosis of strep. If positive for strep, your pediatrician will prescribe an antibiotic. It’s very important that your child take the antibiotic for the full course, as prescribed, even if the symptoms get better or go away. Steroid medicines (such as prednisone) are not an appropriate treatment for most cases of sore throat.
Babies and toddlers rarely get it strep throat, but they are more likely to become infected by streptococcus bacteria if they are in child care or if an older sibling has the illness. Although strep spreads mainly through coughs and sneezes, your child can also get it by touching a toy that an infected child has played with.