Coronavirus Infection in Children

June 8th, 2020 healthwiki Child Health 0

The coronavirus outbreak has become a global problem, creating panic and concern all over the world. The pandemic has restricted movement, paralysed business and affected the economy in many countries including Bangladesh. The World Health Organisation (WHO) has declared it as a pandemic and global emergency.

Coronavirus is a large family of viruses that cause illness ranging from the common cold to severe respiratory distress. The novel coronavirus disease (COVID-19) is a very contagious disease and has claimed the lives of about half a million people worldwide.  COVID-19 started its journey from Wuhan, China and now has spread over 195 countries of the world. Bangladesh has recorded more than 60,000 confirmed cases and around 900 deaths so far.

The novel coronavirus can affect anybody, from neonates to adults. Fortunately, children are being less affected by it and their signs and symptoms are not exaggerated. Why are the children less affected is not so clearly known. The reasons might be that they might be exposed less, their receptor for viruses are less or they might have better immunity than adults and develop better antibodies.

Based on available evidence, children do not appear to be at high risk for COVID-19. Elderly people with comorbidity is more at risk. China conducted a research on 2,143 paediatric patients, among which two-third were suspected cases and the rest were laboratory-confirmed COVID-19 cases. About 4% of them were asymptomatic, 51% had mild illness and 39% had moderate illness. Boys and girls were equally affected. About 6% had severe illness compared to 18.5% of adults. They also found infants develop more critical manifestation then older children.

As it is a new virus we must wait for more information and explanation regarding children’s infection. Whatever may be the seriousness we have to prevent it and the steps of prevention are the same for everyone.

Frequent hand washing for at least 20 seconds with soap, using alcohol based sanitisers, maintaining social distancing, staying at home and avoiding touching the nose, mouth and eyes with unclean hands are imperative.

Having lukewarm water often and increased intake of vitamin C is also important. The use of proper masks while going out and proper disposal of used tissue papers after coughing or sneezing are important. It is better to avoid the consumption of raw or uncooked food.

By any means we must prevent/lower the community transmission and the best way to do that is to keep yourself at home. Do not come out of your home until it is very much essential. Social, religious or political gatherings must be halted and avoided. Public transportation should also be avoided.

It is important to not panic. Be cautious, be safe and make others safe by staying at home.

Author: Prof M Karim Khan

The author is a Professor of Paediatrics at Community Based Medical College, Mymensingh.

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Is Your Child Using Marijuana

June 23rd, 2011 healthwiki Child Health 0

Marijuana use has some common signs among most of its users. If your child is high on Marijuana, they might seem dizzy and have trouble walking; seem silly and giggly for no reason; have very red, bloodshot eyes; and have a hard time remembering things that just happened. When the early effects fade, over a few hours, the user can become very sleepy.

Parents should be aware of changes in their child’s behaviour, although this may be difficult with teenagers. Parents should look for withdrawal, depression, fatigue, carelessness with grooming, hostility, and deteriorating relationships with family members and friends. Besides, changes in academic performance, increased absenteeism, lost interest in sports or other favorite activities, and changes in eating or sleeping habits could be related to drug use. However, these signs may also indicate problems other than use of drugs.

In addition, parents should be aware of signs of drugs and drug paraphernalia, including pipes and rolling papers; odor on clothes and in the bedroom; use of incense and other deodorisers; use of eye drops; clothing, posters, jewelry, etc. promoting drug use.

Facts about marijuana addiction
Marijuana is often rolled in paper, so it looks similar to a cigarette and smoked. When anyone smokes, it releases harmful chemicals into your lungs. Many people do not know that marijuana smoke contains more tar and more than 400 chemicals with some cancer-causing than tobacco smoke.

* Some people addicted to marijuana have a hard time quitting and have to find treatment. Some people who use a lot of marijuana every day and then quit suddenly may have sleeping problems, anxious, irritation or nervousness without the drug. Or they may have an upset stomach or lose their appetite. These symptoms rarely last more than a few days.

* To get the maximum effect, people who smoke marijuana often inhale more deeply and hold the smoke in their lungs longer than tobacco smokers do. This increases the risk of cancer.

* Smoking marijuana irritates your lungs and has been linked to chronic cough and bronchitis. It may also make asthma worse.

* In people at high risk of developing schizophrenia, Marijuana may bring on symptoms earlier.

* Using of marijuana for a long time may make it harder to pay attention, remember things and learn.

* If you smoke Marijuana, the effects last for several hours. But the main active ingredient is stored in your fat cells and can stay in your body for days or weeks!

Dr Sat Parkash

How to Clean Your Baby Ear Safely

June 23rd, 2011 healthwiki Child Health 0

New parents always want to take best possible care of their babies. Sometimes they cannot deliver the best care simply because they do not have experience. Very often, parents ask physician about cleaning of baby’s ear. Is it really necessary to clean the ear? How to clean them safely or how often we should do that? These are frequently asked questions asked by new parents.

Outer part of the ear can be cleaned while giving bath to the baby. It is to be done by soft, clean cotton cloth. But do not use any cotton bud or finger tips. Wax inside ear is protective and natural and rarely needed to clean it. But if there is excess accumulation of wax which impairing hearing or if there is pain, itching, tinnitus, you may need to clean them. Sometimes few drops of olive oil are put inside ear to make the wax soft, it is also now a days not recommended.

Soft clean cotton cloth to be rolled to make a wick and only that can be inserted inside ear to clean the inner aspect of the ear. Please do not insert any cotton bud inside ear, if you use cotton bud that will push dirt deep inside and moreover you may injure the membrane of ear or introduce infection. Doctors may use medicine to soften the hard wax but do not use these by yourself. Consulting a pediatrician will dictate you what to do and what not to do. Take care of your sweet baby.

Prof M Karim Khan

Save The Newborn

August 1st, 2009 healthwiki Child Health,Pregnancy 0

The death of a newborn is a very painful experience for the mothers who have taken the ordeal of pregnancy for 9 months or so. The causes of newborn death in Bangladesh are manifold like poverty, lack of medical check up, home delivery etc.

Bangladesh has one of the highest newborn deaths in the world. It is about 37 per thousand live births per year. Nearly 4 million babies die after delivery each year throughout the world out of which 98% die in developing countries including Bangladesh. Out of total deaths 45% die within first four weeks of life and 30% die within one year.

In order to decrease this huge number of deaths every year, a pragmatic coordinated approach is needed by all concerned, it is not possible for the government to solve this gigantic problem all alone, both government and non governmental organisations should make every effort in a combined way to mitigate this human tragedy.

MDG-5 is to reduce child mortality by two thirrd by the year 2015. It is heartening to note that the under 5 mortality in Bangladesh has come down significantly in the last decade, from 88 to 66 per 1000 live births per year.

But the main contributing factor affecting the high under-5 mortality is the bulk of the new born deaths that occur within the first 28 days of life. So it is imperative that we need to address the problems that affect the new born deaths more seriously in a coordinated way at the grass root level i.e. in the non urban areas, where a large proportion of deliveries take place in the home setting, compounded by meager medical facilities and man power within the vicinity.

We all know that the main cause of newborn death in Bangladesh is home delivery, lack of trained personals and medical facilities, delayed referral, transportation problem etc. To address these problems the most important thing is to produce skilled birth attendants (SBA) who will be trained to do the following things:

1) Conduct normal deliveries
2) Identify the danger signs
3) Quick referral and transportation to higher centers

At the same time we should put emphasis on:
1) Improve obstetric and neonatal care at thana and district level
2) Control population boom
3) Compulsory birth and marriage registration
4) Improve women education
In a country like Bangladesh institutional delivery is not possible, we need to utilise our human resources by producing more SBA’s in order to bring down neonatal mortality.

This is a huge task which needs to be jointly addressed by all.

Vision Can Be Saved If Detected Early

June 23rd, 2009 healthwiki Child Health,Eyes 0

A most common primary intraocular (inside the eyes) malignancy of childhood arises from primitive retinal cells of the eye. About 90% cases are diagnosed less than 3 years of age.

A common presentation is white pupillary reflex, some with squint and some with inflammation of the eye. In our country, most of the patients present with advance stage when the tumor extends externally.

In advance stage though the chance of saving eye is less but when other eye is examined and if a small lesion is detected, can be treated by focal therapy (Photocoagulation with Laser). Early detected is very important in that respect.

When treating retinoblastoma, it is first and foremost important to understand that it is a malignancy. When the disease is contained within the eye, survival rates exceed 95% in the western world.

However with extra ocular spread survival rates decreases to under 50%. Therefore, in deciding on a treatment strategy, the first goal must be preservation of life then preservation of eye and finally preservation of vision.

The modern management of intraocular retinoblastoma currently incorporates a combination of different treatment modalities including chemotherapy, photocoagulation with Laser, cryotherapy, radiation therapy and surgery like enucleation (removal of globe).

Metastatic disease is managed with intensive chemotherapy, radiation and bone marrow transplantation. Among all of this treatment options — the best, cheap and less hazardous option is photo-coagulation with Diode Laser if tumor is detected in early stage with a very small lesion. If laser is applied, eye can be saved, even useful vision can be preserved.

The treatment of children with retinoblastoma requires a team approach including an ocular oncologist, pediatric ophthalmologist, pediatric oncologist and radiation oncologist.

The chemo, radiation therapies are very expensive. Comparing all modalities, the photocoagulation therapy with Diode Laser is cheaper. This facility is available at the government set-up in Sylhet MAG Osmani Medical College Hospital. The facility is available on courtesy of WHO. Expert manpower is available there and moreover the service is offered at free of cost.

The facility of laser photocoagulation can save valuable life of a child and also rescue a family from a danger point. Children with intraocular retinoblastoma who have access to modern medical care have a very good prognosis for survival.