Wednesday, November 4, 2009

PNEUMONIA IN CHILDREN

Pneumonia means an infection of the lungs. In the early 1900's pneumonia was responsible for many deaths even in children. Fortunately, with the invention of antibiotics and certain vaccines, pneumonia occurs less commonly today and can be effectively treated in most cases.
CAUSES OF PNEUMONIA
There are several types of germs that can cause an infection of the lungs; bacterial and viral. Although there are many different types of bacteria and viruses,fungi that can cause pneumonia, there tend to be related to age and other circumstances. For example the bacteria that cause pneumonia in newborns differ than those that cause the same infection in older children.
Signs and Symptoms......Symptoms of pneumonia vary, depending on the age of the child and the cause of the pneumonia. Common symptoms include:
• fever
• chills
• cough
• unusually rapid breathing
• breathing with grunting or wheezing sounds
• labored breathing that makes a child's rib muscles retract (when muscles under the rib cage or between ribs draw inward with each breath)
• vomiting
• chest pain
• abdominal pain
• decreased activity
• loss of appetite (in older kids) or poor feeding (in infants)
• in extreme cases, bluish or gray color of the lips and fingernails
When pneumonia is caused by bacteria, an infected child usually becomes sick relatively quickly and experiences the sudden onset of high fever and unusually rapid breathing. When pneumonia is caused by viruses, symptoms tend to appear more gradually and are often less severe than in bacterial pneumonia. Wheezing may be more common in viral pneumonia.
Some types of pneumonia cause symptoms that give important clues about which germ is causing the illness. For example, in older kids and adolescents, pneumonia due to Mycoplasma is notorious for causing a sore throat and headache in addition to the usual symptoms of pneumonia.N.B.....some children persistent high fever (more than 4 days) can be the only sign of pneumonia
INVESTIGATIONS
Although the doctor can sometimes hear specific noises with stethoscopes, that suggest pneumonia, the diagnosis is confirmed by a chest x-ray. After the full treatment course, children usually fully recover and there is no need to repeat the chest X-ray. However if the child was very ill, had a large or severe pneumonia, a repeat chest x ray may be recommended to make sure the pneumonia has cleared. If this is the case, a repeat X ray is performed 4- 6 weeks after treatmants.
TREATMENT OF PNEUMONIA
Viral pneumonia..........No treatment, although in most cases the doctor cannot tell if the cause is viral and will treat all pneumonias with antibiotics.
Bacterial Pneumonia .....treated by complete dose of antibiotics for 7-10 days.Children less than 3 months of age with pneumonia are admitted to hospital for intravenous antibiotics, oxygen treatment and rehydration.
Children with weakened immune systems are usually hospitalized and may need different(stronger) antibiotics than the children with normal immune systems.

After the full treatment course, children usually fully recover and there is no need to repeat the chest X-ray. However if the child was very ill, had a large or severe pneumonia, a repeat chest x ray may be recommended to make sure the pneumonia has cleared. If this is the case, a repeat X ray is performed 6-8 weeks later.
PREVENTION OF PNEUMONIA..........People who has cough should be treated,Avoid close contact with someone coughing,Those coughing should protect mouth and nose from with handkerchiefs when coughing or sneezing,Hand washing in people with cough or cold,Exclusive breastfeeeding in the first 4-6 months protects children from pneumonia,Balanced diet for older children,Avoid overcrowding,Vaccination..vaccines are available to protect pneumonia.

DIARRHOEA IN CHILDREN

Diarrhoea is the condition of having frequent loose or liquid bowel movements. It is the passing of watery stools more than three times a day. It is often a symptom of an infection or acute/long-term condition.
Diarrhoea can either be:
• acute: diarrhoea that comes on suddenly, and lasts for five to 10 days, or
• chronic: diarrhoea that lasts for more than two weeks.
Acute diarrhea is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause severe dehydration which is one cause of death in diarrhea sufferers. Along with water, sufferers also lose dangerous amounts of important salts, electrolytes, and other nutrients.
What causes diarrhoea?
Acute diarrhoea is usually caused by a viral or bacterial infection and affects almost everyone from time to time.
Rotavirus is the major cause of paediatric severe diarrhoea worldwide. Live attenuated vaccines, shown to be highly effective where they have been so far trialed, are increasingly being implemented within universal infant immunization schedules.
How common is it?
Diarrhoea and vomiting is very common, especially in children. A baby or toddler will probably have diarrhoea and vomiting two or three times a year.
How serious is it?
Diarrhoea usually clears up in a couple of days and is not serious. However, it can be serious in babies and the elderly because of the risk of dehydration.
If diarrhoea is persistent or there are other symptoms, such as bleeding, see your General Practitioner
If your child is between three months and one year old, diarrhoea should last no longer than 48 hours.
Symptomatic treatment for diarrhea involves the patient consuming adequate amounts of water to replace that loss, preferably mixed with electrolytes to provide essential salts and some amount of nutrients. For many people, further treatment is Symptomatic treatment for diarrhea involves the patient consuming adequate amounts of water to replace that loss, preferably mixed with electrolytes to provide essential salts and some amount of nutrients. For many people, further treatment is unnecessary.
The following types of diarrhea indicate medical supervision is require
• Diarrhea in institutions such as hospitals, child care centers, or geriatric and convalescent homes.
• Diarrhea in infants
• Moderate or severe diarrhea in young children;
• Diarrhea associated with blood
• Diarrhea that continues for more than two days;
• Diarrhea that is associated with more general illness such as non-cramping abdominal pain, fever, weight loss, etc;
In many cases of diarrhea, replacing lost fluid and salts is the only treatment needed. This is usually by mouth – oral rehydration therapy – or, in very severe cases, intravenouslyi.e through the vein.