online consultation

Greetings, to all my patients and their parents.

i will be in Malaysia for next three months, so unfortunately I will not be physically present for consultation at my residence in Tarikhet.

However i will be certainly available for online consultation, as usual free of any charge.

so you can contact me on whatsup, no. 9911101576.

Raj rani Mitra

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Frequent fever, colds and cough occurs in all the children till they are 5 years of age. The no of attacks will vary from 4 to 10 a year. The attacks cannot be prevented by budecort, however if with the attacks child has wheezing or prolonged severe cough then budecort or \and monteleukast will help.
Whether you should give budecort continuously or intermittently depends on no of attacks the child gets. If these are almost every month then you can give budecort daily to prevent the wheezing. However if they are less frequent then you can give budecort for about a week, only when your child starts with cold and sneezing.
For how long to give? This is very variable. If you are giving budecort continuously, in that case after about 3 months, if your child has not had any attack of wheezing then you can attempt to stop ; however if he starts wheezing again then you can restart it. Giving budecort for prolonged period has no side effects.

Babies falling from bed

Yesterday a mother brought her 7 month old child to my clinic with complain that the baby fell from bed. Baby was fast asleep so the mother went to kitchen to fetch something. Suddenly she heard a loud thump and when she came to the room she found the baby on the floor howling loudly. Baby was alright but naturally the mother was very worried.

In my clinic over the years, many a babies are brought with the same complaint. Most of the time they are all right, sometimes they get a bump over the head which subsides on their own but occasionally some serious problem can occur, so one should be careful.

In our culture, babies sleep with their mothers on the family bed. Cots are many times bought but hardly used. In the beginning parents do try to keep baby in the cot, but she cries when ever shifted from bed to cot so eventually the attempt is abandoned. The problem arises any time when baby is between 5 to 6 months of age. At this time the babies learn to turn over. So when left alone on the bed, she turns over and falls. So do not leave the baby on the bed unattended even if she is fast asleep. Either put her in the cot or if not possible then let her sleep on the floor on a thin mattress. This is safer as long as they are no cockroaches or any other pests inside the house.

Dr Raj Rani Mitra

Redness around umbilicus

After birth of baby umbilicus seperates on 5th Or 7 th day.

Initially there can be redness in that area.

At this stage one needs to take good care otherwise this can get infected.

1.Apply surgical spirit with a swab 4 to 5 times a day.

2. If it gets wet, pat dry it and then apply spirit.

3. Do not apply oil or any ointment over it.

4.The scab will seperate in a day Or two. Sometimes at this stage there can be slight bleeding. You need to put pressure on it with a dry gauge for a minute or two, the bleeding usually stop. At this stage do not apply any thing.

Later on spirit can be applied.

5.This will take another 5 to 6 days to heal

Hello

Life has been tough for every one for last 2 years. Now we hope that Corona virus will not be any threat any more and there will be ceasefire in Ukraine very soon.

I was in kolkata for last 3 months. I had to undergo a hip replacement surgery. Fortunately operation was a success and i am fit to start seeing my patients again and giving advice online.

i will be going to Tarikhet in Uttarakhand where I reside now. I have a charitable clinic in that beautiful village.

My whatsup no. Is 8862083680. Please feel free to contact me for any advice for your children.

Take Care

Raj Rani

Hypertension in children

I am sure most of you know the importance of checking the blood pressure of adults as high blood pressure can have serious consequences such as stroke and heart attack.

You may be wondering, should I get my childrens’ blood pressure checked? Can they get hypertension?.
Answer, is yes.Children can get high blood pressure , fortunately, not as common as adults. However since they can get hypertension their blood pressure should checked.
Hypertension can be either “essential”, where precise cause is not detected or can be secondary where underlying cause is found.

Children under 3 years of age usually have secondary hypertension so in their cases thorough investigation should be done to find the cause and treat it. Secondary hypertension are due to diseases affecting the kidneys, blood vessels, endocrine glands, heart or brain.
While children above 3 years of age can have essential hypertension just like adults but of course they can have secondary hypertension also, so their hypertension should be termed essential only after excluding secondary hypertension.

So for all the children blood pressure should be measured once a year. However if any child has any disease that can cause high blood pressure their blood pressure should be measured more frequently.

There are two factors one must know while measuring the blood pressure in children.
1. The cuff that is used to measure the blood pressure, need to be of appropriate size for children.
2. Value of normal blood pressure in children varies with age.

The table below gives normal blood pressure in children according to age.
(This is for children who have average height. The blood pressure will be a bit more for taller children and a bit less for shorter children.)

Age. Systolic. Diastolic
Years
1. 98. 52
2. 100. 55
3. 101. 58
4. 102. 60
5. 103. 63
6. 103. 66
7. 105. 68
8. 106. 69
9. 107. 70
10. 108 72
11. 110 74
12. 113 75
13. 120. 80

Treatment
For children where there is an underlying cause for hypertension, beside treating the hypertension underlying cause need to be treated also.
For older children in whom essential hypertension is diagnosed and who have mild hypertension, life style changes should be attempted especially for obese children.
However if this does not help in reducing the blood pressure do not hesitate to give drugs that your doctor will prescribe for your child.
In children with moderate to high hypertension, drug therapy should be started as soon as hypertension is confirmed. The treatment will need to be continued for a very long time.
Blood pressure of children with hypertension should be monitored at home, 2 to 3 times a week and the results should be noted in a diary.
This will help the doctor to adjust the treatment for your child.

Now in India weather is very hot and with that comes the germs (viruses, bacteria and parasites) that can cause diarrhea and vomiting. The youngest children, less than 2 years, are most vulnerable to diarrheal diseases. Fortunately if we take proper precautions we can prevent these diseases. So today we will talk about the measures for prevention of diarrheal diseases.

Prevention in infant

Breast feeding is natural protection for most of the diseases especially diarrhea. World Health Organization recommends that babies should be exclusive breast fed until 6 months of age.

Those who are not breast fed should be fed with breast milk substitute that is infant formula milk. It is important that certain precautions should be taken in preparing the feeds when formula milk is used. The bottles and nipples should be sterilized in a commercial sterilizer (follow the manufacturer’s instruction) or boiled in a pan. The water that is used for preparing the feeds should be boiled even if you are using bottled water. After boiling the water it should be cooled for less than 30 minutes (to not less than 70c) and then should be mixed with measured amount of powder. The reason is that the milk powder may not be sterile, however when it is mixed in hot water the germs in it will be killed. The prepared feed should be cooled down quickly in running cold water or in a pan of cold water. If not consumed within 2 hours it should be thrown away. The prepared formula feeds can be refrigerated for 24 hours. After taking out from refrigerator it can be warmed in a bowl of hot water and then used.

Babies can get germs from the hands of those who touch them; so those who handle them should wash their hands with soap and water or use hand sanitizer before touching them.

Prevention in older children

Using Safe water is most important to prevent diarrheal diseases. Bottled water is usually safe but be sure to check the seal that it is not tampered with. If one is not sure about the water supply then it should be boiled. If boiling is not possible then micropore filtering or disinfecting agents like iodine tablets should be used especially while one is travelling outside the country. Bottled or properly packed beverages are usually safe; again the seals should be checked.

When one is eating in restaurants and is not sure whether proper food hygiene precautions are taken in that place, then be sure that the food you eat is well cooked and steaming hot. The food items that are not cooked like salads should be avoided.

One can get diarrhea from home made food also if one does not take certain precautions. While buying food from stores check the “use before date”. The frozen food should be brought home within one hour of buying and should be placed in the refrigerator immediately. Food once thawed should not be frozen again. Raw food and ready to eat items should be kept separately. Food especially poultry, meat, and fish should be cooked thoroughly. No part of it should remain pink. Uncooked eggs should not be eaten unless they are pasteurized. Cooked food if not consumed immediately should be cooled quickly(within 1 to 2 hours) and kept in the refrigerator. Do not keep hot food in the refrigerator, as with this the temperature in the refrigerator will rise and thus bacteria will grow in the other food items. Cooked food can be kept in refrigerator for 2 days. In the freezer as long as it remains frozen, but the texture and taste will change with prolong storing. Food once taken out of the refrigerator and warmed or kept out for a length of time should not be kept back in the refrigerator.

In the kitchen the sinks, work tops and utensils should be cleaned thoroughly. Dish clothes should be washed in hot water frequently or disposables ones should be used. Hands should be washed after touching uncooked food. The knife and chopping board which is used for cutting uncooked food should be thoroughly washed. It is better to use separate knife and chopping board for cutting salads and fruits. If you are taking the cooked food to be eaten outside home then it should be transferred in a cool bag with ice trays. Lastly hand washing is must before eating. Taking above measures will keep the germs away from you and your loved ones to a great extend. 

Use of budecort inhaler in children

Easy Baby Care

Dear Doctor,
my daughter is two and half year now. She started getting cough and cold frequently when she was 1 year old. doctor gave ger DERIPHYLLIN syrup and she was better after that. but since than her cold , cough , fever become a monthly routine and my paediatrician suggested to test the total IGE serum. it was found elevated around 400 while the normal range was 19. Seeing the report my paedia suggested to keep her on budecort for two years and mont LCZ for three month. I was not in the favour of giving the medicine for so long continuously, so I stopped them in between. but the problem is, she is countinue with her monthly. Should i put her on budecort for two years or not, i am confused.
Dear Kusum
Frequent fever, colds and cough occurs in all the children till they are 5 years…

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Prevention of Gastroenteritis (Diarrhea and Vomiting) in Infants and children

Easy Baby Care

We are in the middle of summer now and with this comes the germs (viruses, bacteria and parasites) that can cause diarrhea and vomiting. The youngest children, less than 2 years, are most vulnerable to diarrheal diseases. Fortunately if we take proper precautions we can prevent these diseases. So today we will talk about the measures for prevention of diarrheal diseases.

View original post 701 more words

Prevention of diarrhoea in summer

Easy Baby Care

Now in India weather is very hot and with that comes  the germs (viruses, bacteria and parasites) that can cause diarrhea and vomiting. The youngest children, less than 2 years, are most vulnerable to diarrheal diseases. Fortunately if we take proper precautions we can prevent these diseases. So today we will talk about the measures for prevention of diarrheal diseases.

Prevention in infant

Breast feeding is natural protection for most of the diseases especially diarrhea. World Health Organization recommends that babies should be exclusive breast fed until 6 months of age.

Those who are not breast fed should be fed with breast milk substitute that is infant formula milk. It is important that certain precautions should be taken in preparing the feeds when formula milk is used. The bottles and nipples should be sterilized in a commercial sterilizer (follow the manufacturer’s instruction) or boiled in a pan. The water that is used…

View original post 599 more words