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Dr. Sanjeev Tandon

Pediatrician, Delhi

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Dr. Sanjeev Tandon Pediatrician, Delhi
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I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage....more
I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage.
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My daughter age is 18 month And 05 days. When his age is 6 and half months than we find that she is suffering from Iron deficiency Anemia based on report 1) RBC=Anisochromia andanisopoikilocytosis. Microcytic hypochromic rwe cell with some tear drop cells, elliptical cell, target cells and occasional fragmental red cell are noted. 2) That time hemoglobin level is 6.5% 3) WBC- Matured with increase total count. Few reactive lymphocytes are also seen. 4) Platelets;- Increased, Serum Ferritin-05 ng/ml. 5) Comments- severe microcytic hypochromic anemia with leukocytosis and thrombocytosis. Please correlate clicinally and evaluate for iron deficiency anemia and hemoglobin disorder. That time hemoglobin level is 6.5% and that time required blood transfusion and that time HB% was-12.20%. After again one month later that when she admitted in hospital that time Hemoglobin level is 10.38% and at presently we take some test. At present Hemoglobin % is 12.20 and LDH level 597U/L and S. Ferritin level is 63.8 ng/ml and we also taken HB ELECTROPHORESIS and result is HB A- 96.5%, HB A2-2.3% and HB F -1.2%. On dated 01/05/2016 HB% becomes down 10.20% RBC-4.18% and Blood culture report and Urin RME and Stool RME report is ok. Some times we give her nebulizer. Most of the time Runny nose itchy eye and regular cold and fever problem. Now I want to know the above report result mean. On the other hand last 4 months his weight is constant at 9 kg. How we can gain weight my baby. We are worry about that. 1 Doctor Answered.

Diploma in Child Health (DCH), F.I.A.M.S. (Pediatrics)
Pediatrician, Muzaffarnagar
My daughter age is 18 month And 05 days. When his age is 6 and half months than we find that she is suffering from Ir...
Above report is more in favor of Iron/ multi nutritional deficiency anemia. Blood transfusion increases Hb temporarily. Intermittent fall of Hb may be due to interrupted treatment and lack of nutritional diet as indicated by constant wt at 9 kg. To improve his wt and normalize Hb, give him Iron, B Complex, Vit C and other micro nutrients and continue at least for about 3 months after Hb comes to normal, add oil/ ghee in his nutritious diet for wt gain.
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My son just 5 months old we are giving him only mothers milk .but we think that only mothers milk is not sufficient for stomach full so please suggested some alternative.

M.Sc - Dietitics / Nutrition, B.Sc Home Science (hons)
Dietitian/Nutritionist, Ludhiana
My son just 5 months old we are giving him only mothers milk .but we think that only mothers milk is not sufficient f...
hello ideally you should breast feed for 6 months exclusively. you can start with mashed banana . introduce new foods every week like boiled potatoes, dal water, rice water, custard, curd . thank you
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My 5 month old daughter x ray report is minimally thick bronch vasscular both lung please help me.

MBBS
General Physician, Mumbai
My 5 month old daughter x ray report is minimally thick bronch vasscular both lung please help me.
Reports needs to be corelated with symptoms and -how fast is she breathing and -is she coughing and -cough can be heard in her chest- and does she have fever- all this factors needs to be taken into consideration before treatment.
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Nephrotic Syndrome In Childhood- What Parents Need To Know!

MD - Paediatrics, MBBS, FISPN & FISPN - Pediatric Nephrology
Pediatrician, Noida
Nephrotic Syndrome In Childhood- What Parents Need To Know!

Nephrotic syndrome is a type of kidney disorder wherein, the body passes out the excess amount of proteins through urine, owing to the damage caused to the tiny clusters of blood vessels in the kidneys. The symptoms include putting on excessive weight as a result of fluid retention, foamy urine and severe swelling around the region of the feet, ankles and eyes. 

The main feature of nephrotic syndrome is that the kidneys leak a lot of protein. Normally, urine contains virtually no protein. In nephrotic syndrome the urine contains large amounts of protein. What happens is that filters in the kidneys (the glomeruli) become 'leaky' and protein, instead of remaining in the blood, leaks out into the urine. Protein in the urine is called proteinuria. 

The other key features of nephrotic syndrome are: 

  1. A low level of protein in the blood as a result of protein loss in the urine. Although there is a drop in many of the proteins normally found in the bloodstream, the main protein that leaks from the blood into the urine is called albumin. A low blood level of albumin is main feature of nephrotic syndrome. 
  2. Fluid retention (oedema). This is a consequence of the low level of albumin in the bloodstream, and other complex factors not fully understood. 
  3. A high blood level of cholesterol and other fats (lipids). This is due to the change in the balance of various protein levels in the blood due to the protein leakage. 
  4. Normal kidney function, at least initially. This means that the 'waste clearing' function of the kidneys is not affected - at least not at first. However, some of the conditions that cause nephrotic syndrome can progress to cause chronic kidney disease. 
  5. Other typical symptoms and signs of nephrotic syndrome are discussed later. 

Common causes behind it 

Minimal change disease (also known as nil disease) leads to the abnormal functioning of the kidneys.. Most common cause almost 90% of children have this entity. No body knows why the Minimal change disease nephrotic syndrome occurs. Other reasons for nephrotic syndrome are infections, autoimmunity mediated and few medications. 

Nephrotic syndrome (NS) is the name given to a collection of kidney-related findings in your child’s body. These include: 

  1. proteinuria—high levels of protein in the urine (based on your child’s age and size) 
  2. hypoalbuminemia—low levels of protein in your child’s blood, since it’s being passed out of his body in his urine 
  3. edema—swelling. This happens because the proteins in your child’s blood act as a sponge to keep fluid in the blood. With fewer proteins to do this, the fluid may leak out of the blood into your child’s tissues, causing them to swell, especially around the stomach area.
  4. high cholesterol (blood fat) levels—low levels of protein in the blood stimulate the body to overproduce certain kinds of blood fats
  5. While nephrotic syndrome is not a disease, it can be the first sign of disease that can damage the kidney's tiny blood-filtering unit (glomeruli) where urine is made. 

Here’s what you need to know about nephrotic syndrome: 

  1. In the vast majority of children, NS is idiopathic, meaning that doctors don’t yet know what causes it. 
  2. Nephrotic syndrome always affects both kidneys. 
  3. It usually appears between the toddler and elementary school years, although it may appear later. 
  4. There are thought to be two forms of nephrotic syndrome, minimal change disease (MCD) and focal sclerosis (FSGS). 
  5. MCD is much more common in children, and likely to respond to therapy. 
  6. FSGS is a more aggressive disease, and may lead to kidney damage. 
  7. Most children with NS outgrow it by young adulthood. 

Treatment Available 

Pediatric Nephrotic syndrome is mainly treated by high dose steroids. So we classify Nephrotic syndrome as Steroid sensitive Nephrotic syndrome and Steroid Resistant Nephrotic syndrome. As long as the Nephrotic syndrome is steroid sensitive, kidneys usually do not fail and eventually the child recovers. Other aspect of management of Nephrotic syndrome in kids is, that is a relapsing and remitting disease in more than 2/3 of patients, so parents must be making a Nephrotic diary as suggested by the doctor so that the relapse of disease is picked before the swelling appears. Target of Nephrotic syndrome treatment is to make the child grow normally and using steroid sparing agents in kids with frequent relapses and Steroid dependence else they can develop high blood pressure, short stature, cataract, glaucoma and diabetes which all are irreversible. Never start or stop the steroids on your own considering the side effect profile. All vaccines including oral polio drops are not to be given in children receiving daily dose steroids. If you wish to discuss about any specific problem, you can consult a pediatrician.

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My son is 1 year 7 days old. I had stopped giving him formula milk (I was giving enfamil stage 2). Is this good beginning to give him cow's milk. If so do I need to add any health drink powder like Junior horlicks, pediasure. Please advise.

MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Paediatrics
Pediatrician, Mohali
My son is 1 year 7 days old. I had stopped giving him formula milk (I was giving enfamil stage 2). Is this good begin...
Hello sir, your child is big enough to eat with the family. Cow's milk can be started. Give him all the foods that you eat. If not begun weaning, start with cerelac, daliya, khichdi, dal water, rice, mashed potatoes, banana, even roti also. Avoid nuts because they can get stuck in throat. Health supplements do not have much role if you are giving him proper diet. At this age, milk should only be 2-3 times a day.
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My baby is 17 days old and he is suffering from coughing last 7 days can I give medicine to him.

C.S.C, D.C.H, M.B.B.S
General Physician, Alappuzha
Newborn babies coughing is not due to infection and they are throat clearing and if he feeds well her is nothing to worry.
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My girl baby birth weight is 3.3 kg.Now she is 6 months completed. Bt her weight is 5.3.is this any problem for my child.

B.Sc.(Hons), P.G.Dietetics
Dietitian/Nutritionist, Gurgaon
My girl baby birth weight is 3.3 kg.Now she is 6 months completed. Bt her weight is 5.3.is this any problem for my ch...
Hi , Have you started feeding other meals to your child? Your child,s weight is fine , it should be between 5-7 Kg for 6 month old. You can feed her little bit of mashed banana, rice water, sooji kheer , dal water etc.
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My daughter aanviya is 8 month old now what type of food shall I give to her. Pls say including every food.

Nutrition - Management of Weight & Lifestyle Related Disorders
Dietitian/Nutritionist, Delhi
My daughter aanviya is 8 month old now what type of food shall I give to her. Pls say including every food.
You should include thin custurd, sujii porridge, rice water, dal water, fruit juices, veg soup, thin khichdi, Scrambled egg, Daliya water or mashed daliya porridge in her diet.
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