Valvar aortic stenosis, commonly called aortic stenosis, is a disorder which occurs when the aortic valve of the heart becomes narrow. The narrowing of the valve prevents its full opening, and hence, blood flow from the heart to the aorta is restricted. When the aortic valve gets obstructed, the heart has to exert much more effort to pump the blood. The heart muscles get weakened as a result. This condition is more common in children.

Diagnosis of valvar aortic stenosis-
Before diagnosis, we should know about the symptoms of valvar aortic stenosis in children. They include:

 Feeling breathless
 Angina or chest pain with a feeling of pressure or tightness
 Syncope of fainting
 Palpitations and enhanced heartbeats
 A steady decline in regular activities and energy levels
 Fatigue due to little exertion
 Not gaining weight
 Poor eating patterns
 Problems in breathing

The wall of the left ventricle also thickens muscularly, and the thick wall occupies more space in the lower chamber of the heart and hence, the room for adequate blood supply is reduced. This may lead to heart failure.

Echocardiogram-
The initial test that is recommended for patients with symptoms of valvar aortic stenosis is doppler echocardiography. This test enables the doctor to estimate the aortic valve region, peak or mean transvalvular gradients and the maximum aortic velocity. These primary measures are required to assess the severity of the disease. Echocardiography provides important information on the valve function, left ventricular filling pressure and disruptions in other valves.

Other major tests which help in the diagnosis of valvar aortic stenosis include:
 Mri or magnetic resonance imaging, which provides images of internal body structures with great detail.
 Ct scan or computed tomography where three-dimensional images are extracted.
 Chest x ray
 Cardiac catheterization where a dye is used to highlight blockages, if any, in the heart.

Treatment-
Usually, there are no medicines for fixing valvar aortic stenosis as the disease is not reversible. Medicines can be used to treat the problems, which are caused by the condition.

Replacement of the damaged valve by surgery is the best treatment for valvar aortic stenosis. The surgery performed is called valvuloplasty. This is a cardioscopic surgery where a tube with a small balloon is inserted into a vein. The tube is guided into the heart, and the balloon is inflated. The balloon and tube are removed after the valve is opened. The damaged valve is replaced by mechanical valve or the valve of a cow or pig by an open-heart surgery.

Valvar aortic stenosis is a severe heart condition in children, and the only permanent remedy for this disease is a valve replacement surgery.

Diagnosis and Treatment of Valvar Aortic Stenosis in Children

Which baby doesn't spit up their food! This is usually not a reason to worry, but if this spitting up is chronic and is accompanied by other symptoms it is known as Gastroesophageal reflux disease or GERD. Severe GERD can cause weight loss and breathing problems and thus, should not be ignored.

Reflux occurs when food is pushed out of the stomach and back up the esophagus. This is usually because the digestive system in babies is not yet fully developed. Vomiting often during the day is one of the most common symptoms of GERD. Other symptoms include:
- A persistent cough
- Choking or gagging while eating
- Refusing to eat
- Crying while feeding
- Heartburn
- Pain in the stomach

Most cases of GERD can be diagnosed by its symptoms and a look at the baby's medical history. In some cases, additional tests may be required, such as:

Barium swallow
The child is given a chalky substance to drink. This highlights the esophagus, stomach and upper part of the small intestines in a special X-ray. It is used to check if there are any blockages in the digestive system.
pH probe

A long, thin tube with a probe at one end is put down the child's throat. This is kept in the esophagus for 24 hours. The probe measures the levels of acidity in the stomach. This test is usually done when the child complains of breathing problems along with reflux.

Upper GI endoscopy
Here the doctor puts a thin, flexible tube down the child's throat. At one end of the tube is a camera that allows the doctor to look into the esophagus, stomach and small intestine.

Gastric emptying study
One of the causes of reflux is the slow emptying of the stomach. To check this, the doctor will mix a radioactive chemical with the baby's milk that allows a special camera to follow its path down the digestive system.

In most cases, GERD can be treated by making a few lifestyle changes. Some of these are:
- Raise the head of the baby's crib
- After feeding the baby, do not let him lie down, but hold him upright for half an hour or so.
- Change his feeding schedule
- Ask your doctor if you can try giving him solid food. Else, check if you can thicken his feed with cereal.
- Make the baby burp after feeding

Most infants outgrow this condition within a year, so do not stress yourself and enjoy life with your baby.

Gastro-Oesophageal Reflux In Babies

Allergic rhinitis is characterized by symptoms of a runny nose, congestion, itchy eyes and sneezing. This disorder is usually caused by allergens such as pollen and dust. Commonly known as hay fever, allergic rhinitis may exhibit the following symptoms:

The symptoms of allergic rhinitis are:
1. You may experience a runny nose and congestion in the nose
2. You may have allergic conjunctivitis where your eyes turn itchy and watery
3. Persistent coughing
4. Symptoms of sneezing
5. Swelling may develop underneath the eyes
6. You may have an itchy nose
7. Constant signs of fatigue

Causes
Allergic rhinitis or hay fever causes the immune system to recognize certain airborne substances as harmful. The immune system in the body starts to form antibodies to combat these irritants. The antibodies cause the body to release  histamine , a chemical that triggers the symptoms of allergic rhinitis.

The various triggers that may cause allergic rhinitis are:
1. Dust mites
2. Tree pollen
3. Grass pollen
4. Spoors from outdoor and indoor fungi
5. Ragweed pollen

The treatment for this disorder is to avoid exposure to the triggers. Mild symptoms of this disorder may be treated with over-the-counter medications whereas severe symptoms may require prescription medications.
The various medications for allergic rhinitis are:

Antihistamines: Antihistamines may be administered as pills or nasal sprays; these medications can help with itching and sneezing. Antihistamines help in limiting the effects of histamine in the body.
Nasal corticosteroids: These prescription medications can help treat itching and inflammation in the nose. They are usually the first medications that are administered.
Decongestants: Decongestants are over-the-counter medications that can be used to treat congestion in the nose. You should be careful not to overuse these medicines as they can increase blood pressure.
Allergy shots: If medications do not relieve symptoms of allergic rhinitis, the doctor may prescribe allergy shots to treat the disorder. The injections contain allergens in small amounts which are injected over a period of time; this causes the body to get used to these allergens, resulting in a reduction of the symptoms.

Allergic Rhinitis - 7 Signs You Are Suffering from it!

Stomach aches and pains are common in babies, infants and parents are always in search of quick fixer to help their little ones get a relief instantly. Though instant reliefs do not come always, and there are colicky infants and babies with common stomach problems, yet some remedies and treatments always help.

Stomach pain in older kids
The common home remedies in not so serious pains are as follows:
- let the child rest and lie down. This may help to ease the pain in 20-30 minutes.
- give the child some liquid to drink, which is soothing, like light tea, soup, water or diluted fruit juice.
- let the child go to the toilet and encourage him or her to pass stool. This may help ease off the pain sooner.
- avoid any bulk food intake in one meal and divide it into smaller meals through the day until symptoms go away.
- don't give oily and fried food. Give easy to digest food, mostly boiled or light fried.
- avoid giving a medicine without medical advice.

These steps generally help and the pain goes away without going to a doctor immediately. If the pain is severe and is persistent in any one part of the abdomen, then it may require immediate medical attention. Common causes may be appendicitis or gall stone problem or may be a case of acute jaundice, diarrhoea, food poison, etc. Pain on pressing one part of the belly, or high body temperature with pain, and serious vomiting are serious symptoms which you must not ignore and take the kid immediately to a medical centre or doctor.

Stomach pain in infants
Stomach pains in infants are caused due to extra air entering the stomach while feeding. This can be avoided by burping the baby manually. There are a few burping techniques which your paediatrician and baby care giver will show you.

If you are with a colicky baby, then you would try administering the baby's nursing bottle first. There are new age nursing bottle designs, which keep off extra air from entering the stomach. The extra air mainly causes the stomach pain, and therefore, the bottle which prevents mixing of air with milk or water keeps the baby safe from colicky pains. Keep baby colic pain syrups at home ready, and give the baby a dose as and when required. It will eventually give the pain a relief.

Treating Stomach Aches and Pains in Kids

The term pollution means introduction of harmful and unwanted contaminants into our environment. Due to the borderless nature of our atmosphere and oceans, contamination at a small level can have a huge impact that to in places which are nearby and one of the best examples of this is crop stubble burning in Punjab and Haryana which is a major contributor to Delhi smog. Pollution is a slow poison and is deleterious to the life of all beings, including plants, animals, and humans. With the rise in the pollution levels, no one can escape the harmful effects of the same on health. Though pollution poses a great threat to everyone, it is the children who are most effected, let us read on to know the reasons

Why are children more susceptible to pollution?

The lung function, immune system, and metabolic systems in children are not fully developed and functional which makes it difficult for the body to fight these pollutants.
Children breathe in more air per kilogram of their body weight than adults, so they take in more pollutants per breath.
Children are not only more active but also have a faster breathing rate than that of adults. This means that they take in more environmental toxins and at a much faster rate.
What are effects of pollution on children s health?

Exposure of pregnant women to polluted air is strongly associated with premature birth, low birth weight, and intrauterine growth retardation. Low birth weight babies and premature infants are more prone to developmental delays and other disorders.
Exposure to certain pollutants like carbon monoxide and ozone are linked with septal and valvular defects in the heart of a child.
There is a strong association between particulate pollution and symptoms like wheezing and bronchitis in both adults and children. This is the main reason why there is an increased prevalence of Asthma in children in urban areas. Research has shown that high level of pollutants in air cause deficits in lung function growth.
The immune system which protects the body from infections and germs is not fully developed in children. Pollutants are known to cause suppression of immunity in small children making them more prone to infections.
Children need sufficient Vitamin D for strong and healthy bones. Vitamin D is known as sunshine vitamin and is synthesized in the body on exposure to UVB rays of the sun. Increased particulate components in the air reduce the amount of UVB radiation reaching the ground level. More than 60% children are Vitamin D deficient and require supplements orally.
The exhaust of gasoline and diesel is known to emit carcinogens which are thought to play a role in the development of leukemia (blood cancer) in children.
The nervous system is a target for many environmental pollutants. Exposure to these pollutants can lead to neurological deficits and delays in development. Some of these effects are irreversible and long-lasting.
Unfortunately, with urbanization and increased population, the levels of particulate pollutants in the air are increasing at an alarming rate. The problem of pollution needs to be addressed immediately, until then it is best to keep the children indoor and take necessary precautions and keep children safe from exposure to the pollutants.

Pollution - How Is It Worse For Children?

When you have a newborn bundle of joy, no parent would be ready for constant crying bouts from the infant. However, for various reasons, even healthy, well-fed infants can be colicky.

What is it: although a mystery, a baby is said to be colicky if it cries for more than 3 hours a day for more than 3 days a week for more than 3 weeks at a stretch. The baby is completely healthy, and the symptoms start about 2 to 3 weeks of life in both breast-fed and bottle-fed babies. The baby usually has a red face from crying and could be pulling its legs towards its chest due to the abdominal discomfort.

Causes: though still not exactly established, some things that are believed to cause colic include:
1. The baby's digestive system that is growing and goes through spasms
2. Extreme sensitivity to noise and light in the surrounding environment
3. Accumulation of gas in the belly that is ingested with the milk (breast or bottles)
4. Hormones that are supposedly affecting the baby's moods

Treatment: as there is no specific cause identified, the treatment is also symptomatic and aims at soothing the baby's pain and discomfort.

1. Altered feeding: given that a baby's tummy is very small and is about the size of a fist, it makes sense to feed it small amounts at regular intervals than to give a full feed once in like 4 to 5 hours. The baby is sure to feel full with this and therefore the discomfort. Burping between the feed is also shown to help avoid feeling of fullness. If you are breast feeding, try to not let the baby doze off when feeding.

2. Anti-colic bottles: these bottles have a vent inside the bottle which will help reduce the accumulation of gas within the bottle. There are various brands available in the market, these could be a good solution if the baby is even partially bottle-fed.

3. Simethicone: this is an anti-flatulent, which again helps eliminate gas bubbles in the stomach and thereby provides relief to the infant. It can be given either by a dropper or a syringe.

4. Exercise: try bending the legs at the knee and holding it towards the baby's stomach, this can help ease the pain.

Remember that this is a very transient thing and usually disappears on its own by the 4th month, and the above measures are only to help the baby and the mother.

Colic Pain - How to Treat It

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