Child Specialist

 Q. My 1 year old son has developed hacking cough specially at night. A. The change in weather resulting in dryness and cold results in allergic episodic cough. This occurs chiefly in children prone to allergies. This causes a bit of bronchospasm, and secretion of mucus. The obstruction to breathing results in coughing. The cough is episodic and occurs in intervals. This occurs specially at night. Giving steam with salt in the hot water helps in clearing the air passages. IN addition, using a humidifier at night is very beneficial. Use of anti allergics is very important. If need be nebulizers should be used. Consult a doctor on what nebulizing solution to use. Nasal sprays are also helpful. Website - http://www.drmubinaagboatwalla.com/

  Q 1. What are the signs and symptoms of constipation in children ??? Constipation is very common in children. It is more of a dietary and life style issue than a medical problem. Children eating fast food are more prone to it. Less fibre in the diet, less vegetables and fruits and more potatoes, white flour, cakes, pasta, noodles promotes it. Rice also leads to constipation. Children also do not indulge in healthy activities and don’t do exercises. They are either on iPad, phone or watching television. This unhealthy lifestyle promotes constipation. Extreme constipation leads to hard stools which produces fissures in the lower anus. The child gets scared to pass stools and the stools are very hard. Sometimes there   is a streak of blood along the stools. If not treated, the constipation becomes even more severe.

Pyrexia of unknown Origin means fever more than 100 F in a child for more than 14 days for which no cause can be found. It can occur in any child whose fever is not settling down with the usual medicines and no focus of infection is found on physical examination. According to Dr Mubina Agboatwalla – child specialist in Karachi , the common causes of fever include respiratory viral and bacterial infections, typhoid, malaria, dengue, viral and bacterial gastrointestinal infections. Meningitis and encephalitis as well as urinary tract infections. In addition, osteomyelitis and rheumatoid arthritis and septic arthritis need to be considered. Further investigations need to include auto immune disorders, rare viral infections, other SARS infections. Blood culture plays a very important role in diagnosis often overlooked due to common use of antibiotics.

High grade fever due to unknown cause is known as Pyrexia of Unknown Origin (PUO). These days high grade fever in children is very common.  According to Dr Mubina Agboatwalla-child specialist in Karachi , every high grade fever is not dengue. It can be a bacterial throat infection, chest infection, due to diarrhea, urinary tract infection, Malaria, Typhoid. However, do not self treat and diagnose yourself. Go to a doctor. Based on history and investigations diagnosis will be made. Self treatment is not advisible.  Common investigations include blood CBC, ICT Malaria, Blood Culture, Urine D/R and Culture. ESR, Dengue NS1 among others. Ultrasound may be ordered if necessary.  People generally tend to use broad spectrum antibiotics like Cefixime. Do not use antibiotics without consultation.

  Q 1. What are febrile fits ?? Ans 1. Febrile fits happen in some children when the fever becomes very high. They generally start when the temperature starts to rise and occurs in children under 5 years of age. The fits occur for a few seconds. The child does not lose consciousness and generally there no frothing from the mouth. The febrile fits can reoccur in some children if the temperature rises again. Q 2. What is the treatment and prevention of febrile fits ?? Ans 2. Febrile fits are generally harmless and do not affect the neurological status of the child. They generally do not require any treatment and anti convulsants need not be given. Prevention is the best cure. In such children, every effort should be made to prevent the fever from rising. AS soon as the child develops fever anti pyretics should be given together with tepid sponging. Febrile fits do not occur after 5 years of age. Website Link - http://www.drmubinaagboatwalla.com/

 It is very common for children to ingest different foreign bodies. The most common is ingestion of small coins. The child or toddler while playing tends to put the coin in the mouth.  The coin can either go in the digestive tract or in the trachea or wind pipe. If it goes in the windpipe or trachea it can result in a medical emergency. It can obstruct the trachea and result in gagging. Severe respiratory obstruction and breathlessness can occur. The coin may get stuck in the trachea or go in the bronchi.  Immediate bronchoscopy needs to be done. And the coin removed. If the coin is in the upper segment or pharynx, thumping on the back can result in the child coughing out the coin. Dr. Mubina Agboatwalla - A Child Specialist in Karachi, another alternative is that the coin enters the oesophagus. It does not generally produce any symptoms and the coin enters initially the stomach, then the intestines and finally the rectum. The coin can be seen on the X- Ray and the progress followed

  Q2. What is neonatal physiological jaundice?? A.      In neonatal physiological jaundice, the bilirubin starts to rise after 3 days of birth.   According to Dr. Mubina Agboatwalla - A Child Specialist in Karachi , in the full-term baby the bilirubin remains below 12 mg%. This rise in bilirubin is due to the immaturity of the liver and subsides by itself in the next 10 days. It is helpful to expose the baby to the ultraviolet rays of the sun early morning and late evening.

Q 1. Why is a premature newborn baby put in a incubator ??? A . A premature newborn baby is born before term. This baby is lacking in many aspects. The baby is unable to maintain the temperature as the temperature regulating centre is not fully developed. The incubator maintains the temperature of the new born. In addition,   the closed environment of the incubator provides a protective environment to prevent infections from outside. Otherwise, the low immune system of the baby makes it susceptible to get infections. Oxygen can easily be given to the baby in the incubator.

  Tetanus Toxoid injection should be given to every child. In Infancy Tetanus becomes part of the routine immunization of DPT. Diphtheria Pertussis Tetanus with a booster shot at 18 months and five years.   However, After five years the tetanus toxoid shot should be repeated after every five years. At 10 years at 15 years and so on. Even in adult hood. As children are prone to frequent falls and injure themselves frequently , while playing giving small cuts. The Tetanus Toxoid shot protects against tetanus. It is frequently asked after a small injury if Tetanus shot should be given.  According to Dr Mubina Agboatwalla , the answer is that if the child has taken the Tetanus shot in the past five years there is no need to give the tetanus injection. Even during pregnancy the mother should be given Tetanus Toxoid shots, so as to prevent neonatal tetanus one of the leading causes of death in neonates. It is vaccination of the mother that prevents tetanus in neonates.

  Q 1. My Child is 16 months of age and not talking. What do I do ???When will she start to talk ?? A1. The child starts to speak in monosyllables ba ba da da by 6-9 months. Between 11- 14 months the child can say mama papa yes no. By 18 months she can say around 20 words. By 2 years child can make two-word sentences like mama go. Daddy come and so on. More comprehensive three-word sentences like I want toy take place by 3 years of age. Best to wait and let the child interact with other children. One thing to observe is if the child responds actively to sound, music etc. In that case there should not be a problem.   Link -  http://www.drmubinaagboatwalla.com/child-specialist-karachi/

  Q .   Can I give banana to my child. Does it produce chest Congestion ??? A: There is a wrong notion that banana produces chest congestion. Infact, banana is one of the first weaning items to be introduced in an infant. Banana is full of nutrients, minerals specially Potassium. It is specially given during diarrhea and helps in watery diarrhea. Banana is extremely helpful in controlling excessive stools and motions.

  Physiological Neonatal jaundice occurs in 50-70% newborns. It occurs in the first few days of life and generally disappears by 10 th day of life. A neonate is born with a haemoglobin of 18-19 gm%. In the first few days of life the haemoglobin falls. In addition, the liver enzymes are immature and unable to process the haemoglobin. Thus, excess unconjugated bilirubin is formed leading to yellow discoloration of skin and sclera. The jaundice is not serious and there are generally no complications. According to Dr Mubina Agboatwalla – Child Specialist in Karachi , in term neonates the bilirubin is 10mg% or less. In prematures 12mg % or less. The baby is active and feeds well. Physiologic jaundice sometimes runs in families. It cannot be prevented and resolves by itself once the baby grows up and the enzymes become mature. Generally there are no complications. Giving sunlight to the baby helps. Early morning and late evening sun rays are effective.

Proteins are an important component of any diet specially for growing children. Proteins help children grow. They are an important component of DNA, RNA, cells, muscle tissue, skin and hair. Without proteins the skin loses the glow, the hair loses the shine and muscles become flabby. The child becomes weak and loses weight. There is no growth and the child does not gain weight. There is stunting.  The common sources of proteins are eggs, yoghurt, milk, cheese, butter, meat, chicken, beef etc. The vegetarian sources of proteins are legumes, red beans, daal, sprouts. Nearly 20% of the child’s diet should comprise of proteins. According to Dr Mubina Agboatwalla – Child Specialist in Karachi , the deficiency of proteins is called Protein Calorie Malnutrition. The child is weak, extremely under weight, emaciated, thin weak extremities, dry, colourless, lusterless hair which easily breaks. The skin breaks and is dry. The child is stunted. Another form of PCM is Kwashiorkor. In this there i

Conjunctivitis means infection of the eye. Conjunctivitis is very common in children. Neonatal conjunctivitis is characterized by eye infection in the neonate due to passage of the neonate through the birth canal. Neonatal conjunctivitis occurs around the first week of life . The eyes are sticky and there is yellow coloured discharge. The eyes are so sticky that the neonate cannot open the eyes. Neontal conjunctivitis takes atleast 15 days to resolve with medications. Other types of conjunctivitis can occur at any age. There is red colouration of the eyes, watery eyes and itching in the eyes. A sticky yellow coloured discharge so that the child has difficulty in opening the eyes. Generally both eyes are involved. There may be swelling around the eyes.  According to Dr Mubina Agboatwalla – Child Specialist in Karachi , treatment consists of cleaning the eyes with saline and distilled water and then putting in the antibiotic eye drops. This should be accompanied by putting in eye ointmen

Asthma is a condition characterized by severe spasm of the bronchi and bronchioles. It chiefly occurs in the winter months but can occur throughout the year also in susceptible individuals. It can start as early as 3 months of age in susceptible children. Generally, there is a family history of asthma or allergy. Any event like cold air, exercise, dust, perfume or paint smell, excessive use of airconditioners. A wheezing sound is heard when the bronchioles go into spasm. This is a whistling sound heard even by the mother. The intercostal muscles work overtime and hard causing intercostals recession. There is subcostal recession causing a depression below the subcostal area. Breathing rate is very rapid more than 60 times per minute. Child is breathless. According to Dr Mubina Agboatwalla – child specialist in Karachi , the child responds to bronchodilators. These are generally given by a nebulizer or inhaler. Children find it difficult to take an inhaler unless given with a spacer. O