Child Specialist

Platelets are cells in the blood just like other cells. Red blood cells contain haemoglobin and provide haemoglobin to carry oxygen. The white blood cells provide immunity to the body and prevent infections from attacking the body. The platelets are cells in the blood that prevent bleeding. Whenever, there is an injury or cut in the body, the platelets immediately come and prevent bleeding by sealing the blood vessel. If there were no platelets a small cut could result in massive bleeding. The bleeding time increases with a low platelet count. The normal platelet count is 150,000 to 450,000. Platelets can become low in many conditions like viral conditions, suppression of the bone marrow- aplastic anaemia, Dengue fever etc. According to Dr Mubina Agboatwalla – A child specialist in Karachi , platelet counts less than 50,000 must be monitored. Small red spots like petechie may appear on the skin. Sometimes, big bruises can occur too. In severe conditions, there might be

With the onset of winter allergic cough, respiratory bronchospasm and rhinitis is on the rise. Children generally come up with allergic cough. This cough is non productive and can occur at any time of the day but occurs mainly at night. The cough may occur in spasms and bouts of coughing occurs. This may be accompanied by bronchospasm. Where the child may have shortness of breath. There may be associated rhinitis (runny nose) and red and runny eyes. In few cases, obvious wheezing may occur. Treatment is mainly supportive; simply giving cough suppressants is not the solution. The mainstay of treatment is giving anti allergies and nebulization. In some cases, simple nebulization with normal saline is enough. In other cases, nebulization with bronchodilators may be needed. According to Dr Mubina Agboatwalla a child specialist in Karachi , steam inhalation is important; twice a day steam inhalation with salt water or using a humidifier at night is very helpful. In some case

Dengue fever is a mosquito borne viral infection which can be life threatening. Symptoms occur around two weeks after infection. These include high grade fever, vomiting, headache, body aches and pains and a typical rash. It is also known as break bone fever due to the severe aches and pains. In a small minority of cases (5%) it can be life threatening. Small petechiae can develop – small red spots due to breaking of the capillaries as well as a low platelet count. A low platelet count is hallmark of the disease. There may be bleeding from the mucosa and gums. The fever is saddle back: coming and going. If the fever does not resolve there may be gastrointestinal bleeding, fluid retention. The fluid may get collected in the abdomen leading to ascites.   According to Dr Mubina Agboatwalla - A Child Specialist in Karachi . The bleeding can cause haemhorrages and sudden circulatory collapse. This can result in a condition of shock. Diagnosis is by Serology . Confirmation by

It is very common for children to inhale or ingest foreign bodies. While playing with small beads children tend to put the foreign bead in the nostrils. This can either result in difficulty in breathing or the bead gets stuck in the nose. It can generally not be seen and if you try to take it out with your fingers it gets pushed further. If not taken out infection can develop around it and a foul smelling pussy discharge starts coming out. The child should be taken to the doctor who uses surgical instruments to take the bead out. It is a simple procedure and just takes a few minutes. The other common foreign body is ingestion of a coin. This can either go in the respiratory tract- bronchi or in the gut. If it goes in the gut it gradually comes out over a period of few days in the stools. In either case, it can easily be seen on the X -Ray. Besides, the coin other small foreign bodies like small plastic pieces of toys or metallic nails etc can be inhaled. There is generally a sudden b

Neonatal Jaundice is characterized by jaundice in the first week of life. This jaundice can be physiological or pathological. Physiological jaundice occurs in 60% neonates and starts on the 3 rd or 4 th day of life. It also occurs in 80% premature babies. A bilirubin level of 13 mg/dl or less does not require any treatment. However, if the bilirubin increases more than 5 mg/dl per day it indicates intervention. Physiological jaundice may stay from 10 days to 2 weeks. According to DrMubinaAgboatwalla a child specialist in Karachi ,it generally resolves by itself or exposure to early morning sunlight. If it increases slightly, then phototherapy may be indicated. Pathological jaundice may be due to a number of reasons. It starts in the first 24 hours after birth. The reasons maybe Blood Group incompatibility, ABO or RH incompatibility, G6PD deficiency, Trauma or bruising, hypothyroidism, biliary aresia, septicemia, congenital TORCH infections etc. In cases where the bi

Kwashiorkor is a condition characterized by deficiency of proteins. It occurs generally in children under 2 years of age. It occurs in children who do not take an adequate diet, are malnourished but especially deficient in protein containing foods. The child develops edema or swelling of the ankle and feet as well as puffiness of the eyes. The skin initially becomes dry and lusterless, and then starts peeling off. Skin lesions start developing. The hair initially becomes dry and lusterless, looses its colour and starts to fall. It can easily be plucked out. The weight is far below normal. The eyes becomes dry and less shiny. Patches appear on the face. These are patches of discolouration. The belly is protruding and liver is enlarged. The muscle mass is reduced and the arms and legs become thin. Mouth ulcers may develop. The child generally has diarrhea off and on. This happens when there is a deficiency in the diet, specially protein deficiency. According to Dr Mubin

Pott’s Disease is tuberculosis of the spine. It spreads from the lungs to the spine. The disease spreads via the blood to the vertebrae and then the adjoining intervertebral space. The thoracic region is mostly affected. The area around the vertebrae develops a cold abcess or swelling. The disc dies and the two vertebrae collapse over the intervertebral space. The spinal cord is damaged. Initially, there is fever, night sweats and weight loss.  There is associated back pain. According to DrMubina – A Child Specialist in Karachi , gradually the spine starts getting stiff. This is also known as vertebral spondylitis. The nerves start getting damaged and there is weakness in the legs. In severe cases, there is complete paralysis. There is kyphosis of the vertebral column. The child assumes a stiff position. The X Ray shows collapse of the vertebrae – Fish bone appearance of the vertebrae . The spine presents a bamboo like appearance of the spine. Management comprises of or

Dysentery is a condition characterized by blood in the stools due to infection. It can be caused by a number of organisms. This includes amoebic dysentery which is most common followed by other organisms including shigella, salmonella, E. Coli etc. In amoebic dysentery the stool is green in colour, semi solid, foul smelling with mucus in the stools. The child complains of cramps in the stomach. The colour of blood is generally dark red and the blood is mixed with the stool. The child generally has fever. In shigellosis or salmonella or other bacterial infections the child is toxic looking with high grade fever. The stool colour is dark green and the stool is watery with mucus.   Large quantities of stool are passed and the child quickly becomes dehydrated and toxic. Septicemia may develop too. Vomiting can occur too. Dysentery is different from diarrhea and needs urgent care. According to Dr Mubina Agboatwalla a child specialist in Karachi , antibiotics need to be administ

The onset of summer brings with it several skin infections. Because of high humidity, heat and sweating the child is liable to develop infections of the skin specially caused by staphylococcus Aureus. These are known as impetigo. They are rounded coin shaped lesions occurring anywhere in the body, with redness and itching or sometimes with a pussy discharge. As the child scratches from one part to another, these lesions spread. In addition, small boils develop anywhere in the body. These boils may develop pus and the infection can get deep, developing an abcess. The abcess initially is a red, hot and tender area. Later pus develops and it becomes yellowish and painful. The pus may also discharge.   According to Dr Mubina Agboatwalla - A Child Specialist in Karachi , these skin infections can be prevented by the use of an anti bacterial soap and keeping the body clean by frequent baths. The nails of the child should be trimmed so that there is less scratching. Anti allergie

Children are very prone to develop heat stroke during this hot weather. This occurs when the outside temperature is very high and the internal body temperature rises above 104 F. There may be confusion, irritability, altered state of consciousness. Sometimes fits may occur and the child becomes unconscious. The skin is flushed and red, as well as hot and dry to touch. There is severe headache. The respiratory rate and heart rate becomes rapid. In addition ,there maybe nausea and vomiting. If left untreated, there are chances of brain damage and there maybe internal organ failure including kidneys. According to Dr Mubina Agboatwalla a child specialist in Karachi ,   treatment   must be given immediately. Try to cool the child. Put the child in a tub of water or give him a bath. The important thing is to bring the body temperature down. Keep the child under a fan. Immersing the child in water is the most important method of cooling the body. Intravenous fluids are an effe

Infection of the ear is common among children known as Otitis Media. This is basically infection of the middle ear. In newborns the Eustachian tube (connecting the throat with the middle ear) is very small. Therefore, while the newborn is taking milk, some of the milk enters through the middle ear cavity. It gets collected there and infection sets in. It is a very painful condition. It is known as Otitis Media.   It also occurs in slightly older children. The child is generally crying and unable to express himself. The child keeps on touching the ear, and if an older child says that the ear is hurting. There is fever, as well as heaviness in the ear. The hearing is affected for some time. If the condition worsens, pus gets collected behind the ear drum (tympanic membrane). As more pus gets collected, it bursts through the ear drum and there will be pussy discharge.   According to Dr Mubina Agboatwalla a child specialist in Karachi , if the condition is not treated the pus

Malaria is caused by malarial parasite Plasmodium. There are four varieties of Plasmodium. Out of which Plasmodium Vivax is most common and Plasmodium Falciparum, is the one with most complications. The Plasmodium species are found in blood of mosquitoes. When a mosquito bites the child, plasmodium enters into the blood stream of the child. They enter the red blood cells where they multiply. The onset is with fever generally high grade accompanied by shivering. It is common in endemic areas like Africa, South Asia and South East Asia. The onset is generally sudden but can be chronic. There is associated headache, vomiting and muscle pain. Seating is common. The malarial parasite resides in the spleen. In cases of chronic malaria, the spleen is enlarged. The plasmodia break up the red blood cells and the child is anaemic. Complications include cerebral malaria whereby the brain is affected, there is brain edema and the patient is unconscious. There may be liver failure w

Dr. Mubina Agboatwalla- a child specialist in Karachi Cough is a condition very common in children. Parents often complain of their children having different types of cough. Cough is reflex action with the body trying to get rid of the secretions in the bronchi or irritation due to allergies. Cough can be of different types. It can be productive with sputum, which can be white or yellow in colour or sometimes even green. This is secondary to infection. The lungs produce mucus which the body tries to get rid of by coughing. Sometimes, there is throat infection and irritation of the throat. The child tries to get rid of the secretions and clears the throat in the form of a cough. Flu or nasal irritation can cause a post nasal drip and again the child coughs. Allergies cause a dry cough. They cause the bronchioles to get constricted, and this irritating cough occurs all the time but specially at night. The bronchspasm in frank asthma can cause continuous bouts of coughing.

Rickets is characterized by deficiency of Vitamin D. In the recent years, it has become more common. This is secondary to a number of reasons. One important reason is the diet of children has changed over a period of time. Mothers themselves are deficient in vitamin D.   Such newborns are vitamin D deficient as their mothers are also vitamin D deficient. When they breast feed their child, the newborn does not get enough vitamin D. Over a period of time as the child gets older they don’t take enough milk and the diet is deficient in milk and dairy products. The concentration is more on junk food. Another very important factor is the residential style of living. People tend to stay in small congested flats where there is little sunlight. Sunlight is necessary for activation of Vitamin D. The recent changes in life style has led to children either watching television or playing games on the computer. Children do not spend time playing outside and hence there is less exposure to sunlight

Club Foot is a condition characterized by inward turning of the foot at birth. The incidence is 1 in 1000, one of the most common congenital abnormalities. The tendons connecting the muscles of the leg to the foot are shortened. This is not a painful condition. According to Dr Mubina Agboatwalla – a child specialist in Karachi , in half the cases of club foot, both feet may be involved. Boys are more likely to be affected than girls. In the affected leg, the leg is slightly shorter than the other one. If left untreated, the child will walk on the outer side instead of walking on the sole, develop calluses and unable to wear shoes. Treatment should be started immediately after birth and non surgical. It is known as Ponsetti method. The foot is gently manipulated in the corrected position and casting done.   Each week repositioning is done and casting is done. And this goes on weekly for 6-8 weeks. In 90% of the cases, Achilles Tenotomy needs to be done. A small cut is made in

The cold weather brings with it several respiratory illnesses. The cold harsh winds cause bronchospasm. The child develops dry cough and fever. The respiratory rate increases becoming more than 40 breaths/minute. There is nasal flaring and the intercostal spaces start depressing. The sub costal area i.e. the area between the ribs and abdomen starts developing a depression. There is wheezing, sounds can be heard coming from the chest. Cough is continuous and bouts of coughing occur. Bronchitis is generally viral with super added bacterial infection. The fever may increase to more than 101 Fahrenheit. This condition should be taken as an emergency. Nebulization should be immediately started, using normal saline and other bronchodilators as prescribed by the physician. Humidifier is very helpful as well as steam inhalation. If necessary, oxygen may be given to the child. Intravenous antibiotics should be started. Anti-allergies need to be given. Bronchodilators as advised by t