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Treatment of Child and Adolescent Problems
Thyroid Problems Treatment
Thyroid Disorder Treatment
Paediatric Critical Care
Treatment of Childhood Infections
Child Nutrition Management
Growth And Development Including General Paediatri
Management of New Born Care
Preimplantation Genetic Diagnosis (Pgd)
Congenital Ear Problem Treatment
Treatment of Polycystic Ovary Syndrome In Adolesce
Treatment of Thyroid Disease in Children
Cleft Lip Treatment
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Gastritis is the most common silent disease of the gastrointestinal tract, affecting more than half of the world population. It is well known that H.pylori is the chief etiological agent of chronic gastritis, peptic ulcer, gastric adenocarcinoma, malt lymphoma. Helicobacter pylorus was discovered by Warren and Marshal in 1983. H. pylori has some unique characteristics:
It defied its detection by scientists for centuries.
It survives in the stomach, an organ which is devised by the nature to kill all bacteria.
85% of the population hosts this organism asymptomatically.
It persists in the gastric mucosa for decades.
It does not penetrate the gastric mucosa for decades.
It reduces the risk of oesophagitis, Barrett’s esophagus, esophageal adenocarcinoma, in the infected individual.
Gastritis is defined as an inflammatory response of the gastric mucosa to infections or irritants.
In the histology of normal gastric mucosa, inflammatory cells – neutrophils are spare and lymphoid tissue is absent.
ACUTE GASTRITIS is diagnosed endoscopically in the presence of hyperemia, intermucosal hemorrhages, and erosions in the gastric antrum and/or body mucosa.
Erosions are flat, or elevated white based lesions with an erythematous margin, and are frequently seen in the antrum.
Histology shows marked surface epithelial degeneration and heavy infiltration with neutrophils, but it is rarely performed.
CHRONIC GASTRITIS may be classified as chronic active, non-atrophic (superficial), atrophic and pernicious anaemia.
On histology of the gastric mucosa, there is a predominant increase in the chronic inflammatory cells – lymphocytes, plasma cells and an occasional lymphoid follicle may be present.
Presence of numerous neutrophils indicates activity (chronic active gastritis).
The vast majority of chronic gastritis patients are asymptomatic. Non colicky pain in upper abdomen within 15 minutes after ingestion of a spicy meal and absence of pain on delaying or omission of a spicy meal are considered suggestive of chronic gastritis. Heaviness in upper abdomen immediately after a meal is also not an uncommon symptom. With a fiberoptic gastroscope a definite diagnosis of chronic gastritis is easy with biopsy from the body mucosa and the antrum. H.pylori causes chronic gastritis in all subjects. H.Pylori colonizes normal antrum and may extend into the body mucosa causing corpus gastritis. Chronic gastritis due to H.pylori slowly progresses over a few decades from the superficial to atrophic gastritis, intestinal metaplasia, dysplasia and gastric adenocarcinoma.
H. pylori was earlier responsible for more than 80% of chronic gastritis but its prevalence is decreasing in countries with improved sanitation.
H.PYLORI AND PEPTIC ULCER
The patients. with duodenal ulcer may present with dull aching pain in the epigastrium, occurring daily on an empty stomach or at midnight relieved soon after the ingestion of antacid, milk or non-spicy food. Nearly half of the numbers of patients with typical history of duodenal ulcer do not show any ulcer on endoscopy. The popular multi-factorial theory of stress and spices causing duodenal ulcer, died its natural death, with the discovery of H.pylori in 1983.
A major breakthrough in understanding of the etiology of duodenal ulcer was the discovery of H.pylori in the antral mucosal biopsy of humans, on upper gastrodudenal endoscopy- as; H.pylori is present in the antral mucosal biopsy of >90 % of duodenal ulcer patients., following the eradication of H.pylori from the gastric mucosa, annual duodenal ulcer recurrence reduced to less than 10% compared to 80%. Failure to eradicate H. pylori results in a higher recurrence rate of duodenal ulcer. H. pylori infection of the antral mucosa increases the risk of duodenal ulcer by 3-6 folds.
Pt. with benign gastric ulcer does not have any classical pattern of symptoms for a clinical diagnosis. Pt. may complain of dull aching pain in upper abdomen soon after food intake, nusea, heaviness, heamatemesis or symptoms of anemia.
Benign gastric ulcer is rare in Indian population, it may occur with ch.gastritis due to H.pylori or following ingestion of aspirin or NSAID. H. pylori increases the risk of benign gastric ulcer by 3 folds.
Gastric mucosal Biopsy
Gastric secretion: Acid, Pepsin, Intrinsic factor
Co vita B12 excretion test
Fasting serum pepsinogen,serum gastrin
Parietal cell, intrinsic factor, helicobacter pylori antibody
H.pylori detection : invasive ,non invasive methods
THE HOMOEOPATHIC APPROACH
Abdominal pain and inflammation present difficulties in diagnosis for even the most experienced physician. All cases of dynamic diseases, acute or chronic even when resulting from mechanical or psychological injuries, are amenable to homoeopathy. The homoeopathic medicine works quite well in the treatment of an acute abdomen often averting the need for surgery in many of cases. The problem may range from entrapment of gas, to constipation, perforation of the bowel which results in sever inflammation and sepsis which may result in death. Any acute onset of abdominal pain should be considered a medical emergency.
By carefully applying the law of similars, the physician will observe that all cases of curable dynamic disease are curable with homoeopathy. To achieve this, the physician must be thoroughly familiar with the principles of homoeopathy as taught in the ORGANON and must know how to make the use of materia medica.
Repertories are used as essential links between the patient’s symptoms and the vast materia medica.
Clinical guides such as below mentioned, provide a synopsis of the most characteristic symptoms of the leading remedies in a given condition. Their objective is to give assistance only. While using it one has to be aware of two general drawbacks. One, it may fail because of its incompleteness as only leading remedies in given a given condition can be presented, and the symptomatology of each remedy presented is limited to only the leading characteristic symptoms.
In clinical practice the patient will most of the time present some symptoms that can only be found in a more complete materia medica. Second, there is the inevitable temptation to associate remedies with a given disease. The practice of homoeopathy consists of constant individualization. – The more we understand this science the more we individualize. Frequent follow up to monitor the patient’s condition is a must.
Gnawing, hungry faint feeling at the epigastrium
Burning and distension of stomach with palpitation
Tendency to eat far beyond the capacity for digestion
Great appetite, craving for meat, pickles, radish, turnips, coarse food
Flatulence disturbs the heart’s action
Wants to lie down all the time
Pain in stomach always comes on after eating
Sensation as if a hard-boiled egg had lodged in the cardiac end of stomach
Great craving for food at noon and night
Dyspepsia of the aged, after tea or tobacco
Constitution – Pale, lean, emaciated persons.
Symptoms relating to GIT indicating hyperacidity – Burning pains as of an ulcer
Cancer of stomach
Vomits every kind of food
Heartburn and water brash
Concomitants – Profuse salivation
Intense burning thirst
Haemorrhage from bowels
ALSO MANY REMEDIES ARS.ALB. , SULPH, CAL.CARB.ETC
My daughter is 3 years old & I don't want another child at least for 2-3 yrs. Can you please suggest me any tablet which I can take on regular basis to avoid unwanted pregnancy.
Sir ,a baby (girl) 4 month old . We heard snoring sound from his chest. What kind of treatment We can be give. Please advise me.
My daughter which is 1 month old is having itching or redness in her anus due to which she is not drinking her mother's milk. Please suggest some cream to treat this problem.
I had cesarean when my baby boy was nine months of pregnancy. Now he is five month baby. Now I am having severe backache. What can I do?
My daughter is 3year 10 months old. In her left eye there is a clout from 2 months. Doctor said it puss. How it can be treated?
My baby girl is 7 months old. Her stool is hard and too small amount. She is crying during potty. Her wt is 7.5 kg. We are giving her enfamil a+ and rice dal. Please suggest what to do ?
Mouth gargling with warm water with salt added to it is a very effective method especially in chilling winters to reduce tooth ache arising due to sensitive teeth. Though it relieves the pain, consult your dentist for permanent cure.
Attention deficit/hyperactivity disorder (ADHD) is among the most common neurobehavioral disorders presenting for treatment in children and adolescents. ADHD is often chronic with prominent symptoms and impairment spanning into adulthood. ADHD is often associated with co-occurring disorders including disruptive, mood, anxiety, and substance abuse. The diagnosis of ADHD is clinically established by review of symptoms and impairment. The biological underpinning of the disorder is supported by genetic, neuroimaging, neurochemistry and neuropsychological data. Consideration of all aspects of an individual’s life needs to be considered in the diagnosis and treatment of ADHD.
Multimodal treatment includes educational, family, and individual support. Psychotherapy alone and in combination with medication is helpful for ADHD and comorbid problems. Pharmacotherapy including stimulants, noradrenergic agents, alpha agonists, and antidepressants plays a fundamental role in the long-term management of ADHD across the lifespan.
The management of ADHD includes consideration of two major areas: non-pharmacological (educational remediation, individual and family psychotherapy) and pharmacotherapy.
I personally support Psychotherapy. Specialized educational planning based on the child’s difficulties is necessary in a majority of cases. Since learning disorders co-occur in one-third of ADHD youth, ADHD individuals should be screened and appropriate individualised educational plans developed. Educational adjustments should be considered in individuals with ADHD with difficulties in behavioral or academic performance. Increased structure, predictable routine, learning aids, resource room time, and checked homework are among typical educational considerations in these individuals. Similar modifications in the home environment should be undertaken to optimize the ability to complete homework. For youth, frequent parental communication with the school about the child’s progress is essential.
Symptoms in children and teenagers
The symptoms of ADHD in children and teenagers are well defined, and they're usually noticeable before the age of six. They occur in more than one situation, such as at home and at school. The main signs of each behavioural problem are detailed below:
Inattentiveness: having a short attention span and being easily distracted making careless mistakes – for example, in schoolwork appearing forgetful or losing things being unable to stick at tasks that are tedious or time-consuming appearing to be unable to listen to or carry out instructions constantly changing activity or task having difficulty organising tasks
Hyperactivity and impulsiveness: being unable to sit still, especially in calm or quiet surroundings constantly fidgeting being unable to concentrate on tasks excessive physical movement excessive talking being unable to wait their turn acting without thinking interrupting conversations little or no sense of danger
These symptoms can cause significant problems in a child's life, such as underachievement at school, poor social interaction with other children and adults, and problems with discipline.
Related conditions in children and teenagers
Although not always the case, some children may also have signs of other problems or conditions alongside ADHD, such as:
anxiety disorder – which causes your child to worry and be nervous much of the time; it may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness
oppositional defiant disorder (ODD) – this is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers
conduct disorder – this often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals
sleep problems – finding it difficult to get to sleep at night, and having irregular sleeping patterns
autistic spectrum disorder (ASD) – this affects social interaction, communication, interests and behaviour
epilepsy – a condition that affects the brain and causes repeated fits or seizures
Tourette’s syndrome – a condition of the nervous system, characterised by a combination of involuntary noises and movements called tics
learning difficulties – such as dyslexia Symptoms in adults In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD.
ADHD is a developmental disorder; it's believed that it can't develop in adults without it first appearing during childhood. But it's known that symptoms of ADHD often persist from childhood into a person's teenage years, and then adulthood. Any additional problems or conditions experienced by children with ADHD, such as depression or dyslexia, may also continue into adulthood. By the age of 25, an estimated 15% of people diagnosed with ADHD as children still have a full range of symptoms, and 65% still have some symptoms that affect their daily lives. The symptoms in children and teenagers, which are listed above, is sometimes also applied to adults with possible ADHD. But some specialists say that the way in which inattentiveness, hyperactivity and impulsiveness affect adults can be very different from the way they affect children. For example, hyperactivity tends to decrease in adults, while inattentiveness tends to get worse as the pressure of adult life increases. Adult symptoms of ADHD also tend to be far more subtle than childhood symptoms.
Some specialists have suggested the following list of symptoms associated with ADHD in adults:
carelessness and lack of attention to detail
continually starting new tasks before finishing old ones
poor organisational skills
inability to focus or prioritise
continually losing or misplacing things
restlessness and edginess
difficulty keeping quiet and speaking out of turn
blurting out responses and often interrupting others
mood swings, irritability and a quick temper
inability to deal with stress
taking risks in activities, often with little or no regard for personal safety or the safety of others – for example, driving dangerously
Additional problems in adults with ADHD As with ADHD in children and teenagers, ADHD in adults can occur alongside several related problems or conditions. One of the most common conditions is depression. Other conditions that adults may have alongside ADHD include:
personality disorders – conditions in which an individual differs significantly from an average person, in terms of how they think, perceive, feel or relate to others
bipolar disorder – a condition that affects your moods, which can swing from one extreme to another
obsessive-compulsive disorder (OCD) – a condition that causes obsessive thoughts and compulsive behaviour
The behavioural problems associated with ADHD can also cause problems such as difficulties with relationships, social interaction, drugs and crime. Some adults with ADHD find it hard to find and stay in a job. If you notice any of the above in your child or yourself , it is worth making the effort and spending some time and money to have your child and or yourself assessed on a priority basis as ADHD causes neural changes in the brain. If you wish to discuss about any specific problem, you can consult a psychologist.
My child 15 year male suffering from adhd disease he has not control his bathroom in bed at sleeping time every time please suggests to solve this problem he has doing bathroom in every 15 to 20 minute.
My son 5 years old.(birth wt 2.5 kg, normal delivery, 38 weeks). He is very thin and weak. He tired early during any activity (running, jumping, cycling etc.). Also he said that he tired and can't do that. He also feels low self esteem when see other child to doing these activities. Also when he get coughing, it goes away approx 20 days every time. We consulted paediatrician/physician also 3-4 times. Following test carried out: Echo test/Chest xray- normal TB gold test:-ve ESR-10 mm/HR TLC/DLC-normal, RBC-3.7 Hb: 9-10 (four times repeated, every 3 month gap during last 1.5 years. Dr. Given following: Iron + folic acid syrup, Zinc+Multivitamin + multiminerals syrup. We also give him chapati/rice/milk/paneer, egg/almond/kismis/banana, other fruits etc. But his weight & Hb is not increases. We are (parents & son) vegetarian. What test is to be carried out to find any problems for not gaining weight and strength. What food (veg/non veg) & supplement give to him for increasing weight/Hb?
My baby is 6 month old. Want to know can I give her solid food before half an hour of her bedtime in night. Which food should I give that is easy to digest.
I am ten years old I have commuted epilepsy. I treatment of allopathy need to ayurvedic or homeopathy I am child 10 years old so I can consult by online doctor.
Dear Doctor I ve 4 months and 20 days old baby till date I ve been giving oly breast milk I have to join office in two days I feel so guilty about it, am planning to express my milk and feed baby when am not at home, is it good to feed my milk storing in fridge, am really so guilty about it. Please help me to over come my guilty or is there anything that I can do?
Thalassemia is a type of a disease, resulting in the abnormal production of hemoglobin in the blood. Hemoglobin stimulates oxygen circulation all over the body. Therefore, a dip in the hemoglobin count can lead to anemia, a disease inducing weakness as well as fatigue. Acute anemia can take a toll on the organs and ultimately cause death.
Severe thalassemia in children yields symptoms, such as dark urine, abdominal swelling, slow growth, jaundice, a pale appearance and deformed skull bones. Diarrhea, frequent fevers and eating disorders are also common.
- Blood transfusions: Regular blood transfusion is the only treatment needed for beta thalassemia aiming to keep sufficient Hb level to avoid long-term complications, though bone marrow transplant is radical cure for the disease.
- Iron chelation therapy: The hemoglobin in the red blood cells is rich in iron-protein that gets deposited in the blood with regular blood transfusion. This condition is known as iron overload as it damages heart, liver and various parts of the body. Iron chelation therapy is used to prevent this damage as it helps to remove the excess iron from the body. Deferoxamine and Deferasirox are two such medicines used for this therapy.
- Folic acid supplements: Folic acid being a B vitamin produces healthy red blood cells and is therefore recommended as a substitute for the above procedures.
- Transplant of blood and marrow stem cell: A blood and a marrow (a substance within the cavities of bones where blood cells are produced) transplant replaces the faulty stem cells with healthy ones contributed by a donor.