One of the commonest disease that we come across in children other than diarrhea and vomiting is pneumonia. Pneumonia basically means there is infection in the lungs. Clinically, we see pneumonia as a child who is a bit sick, have cough and cold, in addition the mother will complain that the child is breathing fast. Whenever the child is breathing fast, we call it as pneumonia. In addition if the pneumonia is severe the child can have in drawings in the chest with a rapid respiratory rate, fever and cough. Sometimes these pneumonias can be even more severe whereby the child stops eating properly, becomes little irritable, becomes semi-comatose or turns blue or throws a fit. These are al the red flag signs that the parents should look for. If a child is having cough and cold and the child is breathing fast, it is the time that you should see a healthcare worker. Majority of the causes are viral, in addition, some of the causes can be bacterial infections and to detect them it’s always that as your child starts having fever with breathing very fast you should see that you should reach the healthcare facility as early as possible. If you are able to check the oxygen saturations at home, that will be an early indication that your child is going to turn blue. If the oxygen concentration is less than 92, you should immediately report to a healthcare facility. Since we have a good set poof vaccines that we use prevention of the pneumonia to some extent can be possible with proper vaccination or a complete vaccination. If these problems increase, the best way is to reach a healthcare worker. Majority of these infections are taken care at home if the child is not turning blue by giving simple medicines for fever, cold and cough. Sometimes these children may require antibiotics if the lungs are really infected badly. If the child is not taking orally and is sicker he may require admission to the hospital.

"Fever is a common phenomenon that we see after vaccination particularly in DPT vaccine. Vaccines with a fever is not a disease. It is just a reaction of the body to the vaccine and the antigens that are there in a vaccine. So fever in a vaccine should not be troublesome except that some vaccines such as DPT vaccine causes more fever than other vaccines. This causes lot of worry in parents. Fever after vaccine is a normal phenomenon and parents should not panic about that and the only medicine that is usually required is paracetamol. It’s a body’s way to react to the vaccine and generate immunity or what is also called as pyro genesis sometimes that happens with the vaccine components that are given. So the body reacts in the form of generating more temperature which is not unusual which is not a disease or an infection. Majority of the children with new generation nowadays do not generate too much of fever but still some children can have it. The only concern that sometimes stays with the parents is some children can throw a fit. If there is a family history of fits with fever such parents have a little concern about that. But that doesn’t mean that your child should not be vaccinated because fever that comes with vaccine are generally mild or moderate whereas if the same disease comes to the child it may have a lot of havoc on the baby. Fever that comes with vaccine is generally mild to moderate, it is benign, it usually doesn’t cause any problem. A simple paracetamol is more than enough to take care of the fever. Usually it lasts for a day or two and not more than that. Anytime if a child has very high fever, shows any other symptom like getting very sick, not responding, throwing a fit then that is a totally different phenomena and if such thing happens then you should immediately return to the hospital and the concerned people will take care of it"

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"Nowadays we are coming across children who are having recurrent coughs and cold. The parents are usually worried about the child having repeated episodes of cough and cold. They had a very nice cold and cough free duration of two years during the lockdown.as you come out and you get exposed to the society, you are exposed to different infections. As the schools are opening up, offline classes are starting, offline exams are starting, the children have started coming out and playing together in a play area, they are always exposed to one or the other infection. Whenever a child has an infection and he is playing with other children, he is likely to transfer it to other children. These are common phenomenon and absolutely nothing to be worried about. As the child comes out and get these viral coughs and colds, there is nothing to panic about. A simple seasonal flu is actually an exercise for our immune system. A child suffers a bit, a couple of days, 3 days of fever, followed by 7-8 days of cough. But they all develop immunity to this over a period of time, they get used to it so what we call it as a herd immunity. All the children will get these infections. They will all infect each other. Over a period of time they get used to it and none of them will cough. This initially when you come out in a place you have been not exposed to those infections, then you will get all those infections and slowly all will settle down. So a new infection whenever this comes in the society, the same thing happens. Pre monsoon times when the schools again open up, these are the times when the child gets repeated coughs and cold. There is absolutely nothing to worry about. These can very well be prevented by taking some vaccines and the common vaccines that we recommend are the flu vaccine and all the routine vaccines, they help in avoiding these infections including the DPT, BCG, Measles, and Rubella. All these vaccines help in prevention of some or other form of cough or cold. Some of the coughs and cold can also be prevented by not sending your sick child to the school. If your child is not well he should stay at home till he is better so that he doesn’t infect other children. Adolescents who know they have symptoms which are similar to Covid-19 symptoms. They should also stay at home until they feel that they are completely alright. They are not coughing anymore. They should test themselves, isolate themselves if the need arises. Majority of the cough and cold can be taken care by good nutrition and proper hydration. The best cough syrup is lot of water to drink. Hydration i9s one of the best cough syrup. If your child is dehydrated, he will cough a little more because the secretions become sticky. Good hydration and good nutrition help in preventing complications that can occur with cough. Good nutrition in the form of fruits and vegetables. Avoid junk foods. This improves the immunity of the child and helps in improving the endurance of the lungs. Helping them to use their own clearing mechanism by reducing obesity, exercising, doing lung exercises in the form of pranayama"

"Circumcision is one of the common procedures that is done by the pediatric surgeons or other surgeons for babies. Circumcision is basically done so that the extra foreskin that is there in front of the penis gives wait for urination and sometimes in some religions also it is done ritually. Circumcision is medically indicated when the foreskin becomes very tight and it hampers the flow of urine. A clean stream should be there when a male child is passing urine. If this is not happening, there is dribbling of the urine and the child has to strain for urine or if there is ballooning of the foreskin or prepuce what we call, then this is the time you should visit a doctor. Any pain in that area, any redness or pus discharge in that area, should immediately warn you that you should see a doctor as early as possible. A doctor will examine your child and he would look for any tightness of the foreskin or any extra foreskin or if there is any other anomalies of the foreskin. Circumcision can be done at any age right from 2 months of age depending upon what is the indication. In some cases even the circumcision is not done, if there are some anomalies of the penis. So it’s always better to seek the help of a pediatrician before you go for a ritualistic circumcision also. Circumcision is a quite simple procedure. It is a day care procedure and usually the children who undergo uncomplicated circumcision are discharged within 6-8 hours or max a day after surgery. Some of the complications that can arise are bleeding and local infection. Signs when circumcision is needed in children are extra foreskin, ballooning of skin before urination, straining by child while urination , pus discharge or redness in that area"

"Vitamin D deficiency which in children we call it as Rickets and in adults we call it as osteomalacia. It is one of the commonest deficiency now a days. With the facilities to investigate the child, have given us early diagnosis of Vitamin D deficiency which is called as Biochemical Rickets. The serum Vitamin D3 levels are low even before they manifest clinically. But off late what we are seeing is because of the lockdown, because of different issues, too much of clothing, not going out in sun and playing and in general the dark skin of the Indian people doesn’t allow the synthesis of Vitamin D3 in the skin with the help of sunlight. Nowadays most of the children show some or other symptoms of Vitamin D. as per the recommendations of different scientific organisations, all the newborns till the age of 1 year are supplemented with Vitamin D so that their bones and teeth are strong. Vitamin D has many roles in body. It acts as a building block and also helps as a hormone. So Vitamin D deficiency usually in small children manifests as excessive sweating on the forehead. The child may have a lot sweating. They have delayed dentition. There is bossing of frontal and parietal head. Some of these children have hot cross bun appearance of the head. The head looks a little big and there is a lot of sweating. Frontal sutures are bit open. Some of these children have a sulcus on the ribs called as Harrison sulcus. They have because of the soft ribs. They may have protuberant abdomen. They may have a wide wrist, wide ankle. They can have bowing of legs or they may have knock knees. These are all because of soft long bones and they bend. This is because of Vitamin D deficiency. The best way of prevention is the child should be playing in sunlight and have a adequate calcium containing food. All the cereals particularly is a rich source of calcium for baby. Mother’s milk is the best source of calcium. Exclusive breast feed till 6 months and thereafter continuing till 2 years and beyond. Along with that a proper complimenting feeding in the form of homemade food. People who eat non veg get a lot of calcium once the baby is 1 year old or above. Sunlight is very important. So all the children should be encouraged to go out and play in the sunlight particularly the morning sun is important for the synthesis of Vitamin D3. Anytime you feel your child has these symptoms in the form of bowing of the legs, wide wrists, recurrent infections, and little big head, whole of head is not fusing although the baby is one and a half year of age. These are the things that should guide you to go the doctor for the advice regarding Vitamin D deficiency"