Pneumonia still a major cause of mortality in Indian children

Pneumonia still a major cause of mortality in Indian children

Many children lack access to the Pneumococcal Conjugate Vaccine

New Delhi, 30 November 2017: About 20 children die every hour due to pneumonia in India, reveal recent statistics. Despite efforts being made toward universal immunization, more than 25 million children in India were not immunized with Pneumococcal Conjugate Vaccine (PCV) in 2016.Pneumonia claims more lives in children around the world than any other infectious disease. A majority of those who die are from low and middle-income countries. If this continues, the disease is likely to claim 22,587 lives 2030.

Pneumonia is an acute respiratory infection which affects the lungs. It causes difficulty in breathing and limits oxygen intake. It can be caused by bacteria, fungi or viruses and is a contagious disease.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "Pneumonia in India in children under five is caused by malnutrition, low birth weight, non-exclusive breastfeeding, lack of measles immunization, indoor air pollution and overcrowding. When the germs reach the lungs, the lungs become inflamed and fill up with fluid. This causes breathing difficulties, which makes it difficult for enough oxygen to enter the bloodstream. The body's cells can't function as they normally would, and infection can't be flushed from the body. If untreated, the infection may continue to spread, leading to death. Certain children whose immune defenses or lungs are weakened by other illnesses, such as cystic fibrosis, abnormalities in the immune system or cancer (as well as by the chemotherapy used to treat cancer), may be more likely to develop pneumonia. Children whose airways or lungs are abnormal in other ways may have a higher risk.”

Pneumonia usually produces a fever, which in turn may cause sweating, chills, flushed skin, and general discomfort. Children can lose their appetite and seem less energetic than normal. Babies and toddlers may seem pale and limp, and cry more than usual.

Adding further, Dr Aggarwal, said, “Pneumonia can be treated with antibiotics. A large majority of the cases can be tackled at home itself. Hospitalization is recommended only in very severe cases. Pneumonia is not contagious, but the upper respiratory viruses and bacteria that lead to it are. It is a good idea to keep kids away from anyone with stuffy or runny nose, sore throat, cough, or respiratory infection in general”.

Here are some tips to prevent pneumonia in children.

• Breastfeed regularly as it is a great way to boost immunity.
• Wash hands frequently with alcohol based sanitizer every time you blow your nose, use bathroom and before eating and preparation of food.
• Children younger than 5 should be vaccinated against pneumococcal pneumonia a common form of bacterial pneumonia.
• Keep children away from people suffering from colds, flu or other respiratory infections. This greatly increases their risk of catching an infection.

Adequate intake of Vitamin D can prevent the risk of Type 1 diabetes in children

Adequate intake of Vitamin D can prevent the risk of Type 1 diabetes in children

It can also lower the risk of developing islet autoimmunity

New Delhi, 29 October 2017: A recent research indicates that children receiving higher levels of Vitamin D during infancy and childhood have significantly lower risk of developing islet autoimmunity as well as Type 1 diabetes. The incidence of Type 1 diabetes is increasing by about 3% to 5% annually worldwide. Statistics indicate that over 80% of people in India are deficient in Vitamin D. Vitamin D represents a candidate protective factor for Type 1 diabetes as it regulates the immune system and autoimmunity.

Islet autoimmunity is detected by antibodies that appear when the immune system attacks the islet cells in the pancreas that produce insulin. This is a precursor to Type 1 diabetes. Type 1 diabetes in children requires consistent care. However, advances in blood sugar monitoring and insulin delivery have improved the daily management of the condition.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Although the exact cause of Type 1 diabetes is unknown, in most people the body's immune system mistakenly destroys insulin-producing (islet) cells in the pancreas. Genetics and environmental factors have a role to play in this process. Insulin has a critical role – that of moving glucose from the bloodstream to the body's cells. When food is digested, glucose enters the bloodstream. Once the islet cells are destroyed, very little or no insulin is produced. This causes glucose to build up in the bloodstream, where it can cause life-threatening complications. Type 1 diabetes develops gradually, but the symptoms may seem to come on suddenly.”

One of the early signs of diabetes in children is increased urination and thirst. Some other warning signs include fatigue, changes in vision, fruity smelling breath, extreme hunger and unexplained weight loss, and unusual behavior such as being more moody or restless than normal.

Adding further, Dr Aggarwal, said, “While it may not be possible to prevent this condition entirely, it is possible to reduce complications by helping your child maintain good blood sugar control as much as possible; teaching them the importance of eating a healthy diet and participating in regular physical activity; and scheduling a yearly eye exam beginning no more than five years after the initial diabetes diagnosis. This condition requires lifelong treatment and includes blood sugar monitoring, insulin therapy, healthy eating, and regular exercise.”

In Type 1 diabetes, tight control of blood sugar can prevent diabetes complications. Some other preventive tips for those with Type 1 diabetes include the following.

• Choose healthy foods to share.
• Take a brisk walk together every day.
• Talk with your family about your health and your family’s risk of diabetes and heart disease.
• If you smoke, seek help to quit.
• Make changes to reduce your risk for diabetes and its complications — for yourself, your families and for future generations.

Preterm babies are more likely to develop cognitive and other difficulties later

Preterm babies are more likely to develop cognitive and other difficulties later

Such children also more likely to develop ADHD

New Delhi, 14 October 2017: As per a new large-scale study conducted among more than 60,000 children, it has been found that preterm babies are at a higher risk of developing cognitive, motor, and behavioral difficulties in later childhood, affecting even their later school performance. Preterm children are also twice as likely to be diagnosed with attention deficit hyperactivity disorder (ADHD).

The World Health Organization (WHO) estimates that every year, about 15 million babies are born prematurely around the world amounting to more than one in 10 babies born globally. The rate of preterm birth across 184 countries ranges from 5% to 18% of babies born. In India, the figure stands at 3.5 million babies out of the 27 million babies born every year.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “A premature birth is one that happens before 37 weeks of pregnancy. A normal pregnancy usually lasts about 40 weeks.
A baby born prematurely has less time to develop in the womb and often has complicated medical problems. Many preterm babies who survive suffer from various disabilities like cerebral palsy, sensory deficits, learning disabilities and respiratory illnesses. The morbidity often extends to later life, causing physical, psychological, and economic stress to the individual and the family.”

Preterm babies are small in size, sharper looking and have a disproportionately large head, less rounded features than a full-term baby, fine hair covering much of the body and low body temperature. Labored breathing or respiratory distress and lack of reflexes for sucking and swallowing are further signs of a preterm birth.

Adding further, Dr Aggarwal, said, “While preterm births cannot be attributed to one particular reason, the predisposing risk factors include age at pregnancy; previous preterm birth; multiple pregnancies; infections and chronic conditions such as diabetes and high blood pressure; stress; genetic factors and nutritional disorders. Lifestyle is increasingly becoming an important factor for preterm births. Identification of risk factors and educating the pregnant woman about the signs and symptoms of preterm labor during antenatal care can prevent preterm births.”

Here are some measures women can take to avert the risk of preterm delivery.

Do not miss antenatal care This is the best way to avert any preterm labor and identify signs. The doctor should be able to advice on how to eat right, what is the ideal weight, and what can be harmful for the baby.

Understand your risks Some women are at more at risk of delivering early. This is truer for those who have had a prior preterm delivery; who smoke or drink; have pre-existing health problems, etc. Understanding these can help you cope better.

Watch your weight Find out how much weight gain is apt for your body type and the baby. Too much weight gain can also cause complications like gestational diabetes and preeclampsia. Talk to your doctor about the recommended weight and eat accordingly. Ask your doctor about a healthy exercise plan.

Eat right Consume a nutritious diet as it is vital to the development of the fetus. Whole-wheat carbs, healthy sources of protein and dairy, and an abundance of fruits and vegetables is key. Avoid tobacco, alcohol & other non-prescribed drugs.

ADHD in children can be managed with few simple measures

ADHD in children can be managed with few simple measures This condition is not the result of eating too much sugar or activities such as watching TV New Delhi, 09 September 2017: Some few and disparate studies conducted indicate that about 1.6% to 12.2% of children in India have ADHD or Attention Deficit Hyperactivity Disorder. ADHD can run in families with environmental stress and academic pressure being two factors that can aggravate the condition. As per the IMA, ADHD occurs mostly in young children, during their preschool or kindergarten years. In some children, the condition can become worse when they enter teenage. It can also occur in adults. ADHD is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. The brain of a person with ADHD is generally 5% smaller than someone without ADHD, particularly regions involved in attention, impulse control, and stimulus integration. The other factors that play a role include imbalanced levels of the neurotransmitters norepinephrine and dopamine. Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "Children with ADHD are extremely active and may also exhibit certain other behavioral problems. This makes it difficult to care for them and even manage and teach them. They may even find it tough to fit in the school regime because they are overactive and impulsive. Provided this is addressed at the early stage, it can pose problems later in life. While there is no cure for ADHD, treatments revolve around reducing symptoms and improving functioning in such children. Some treatment options include medication, psychotherapy, education or training, or a combination of these.” The symptoms of ADHD are often grouped into three categories: inattention, hyperactivity, and impulsivity. Sugar doesn’t cause ADHD and neither do watching too much TV, a poor home life, poor schools, or food allergies. Adding further, Dr Aggarwal, said, “Education, support and creativity can go a long way in managing this condition in children. Although it is a challenge to stay organized with children having ADHD, prioritizing and managing time can help. Parents must remember that ADHD is not an indicator of your child’s intelligence or capability. Find out their strengths and focus on them for better results.” Here are some tips to manage children with ADHD. • Set routines. Set clear boundaries so that everyone knows what behavior is expected. • Award and reward Reinforce positive behavior with specific praise or rewards. You can try using a points or star system to reward good behavior. • Look out for warning signs If the child looks like he/she is about to lose self-control, it is a good idea to intervene. Distract the child if possible. • Invite friends over This will help them mingle but ensure that the child does not lose self-control. • Improve sleep Make your child get quality sleep. Ensure that they do not indulge in strenuous or exciting activities close to bedtime.

Children increasingly becoming susceptible to asthma

Children increasingly becoming susceptible to asthma Timely and accurate diagnosis as important as equipping children in being self sufficient to handle this condition New Delhi, 30 July, 2017: Statistics indicate that about 700 million people in India inhale smoke from biomass and kerosene stoves and other sources that spew carbon particles, carbon monoxide, nitrous oxides, sulphur oxides, formaldehyde and cancer-causing substances such as benzene. This smoke is a leading cause of asthma in the country. Estimates by the WHO show that between 15 and 20 million people have asthma in India, and the numbers do not show any signs of decreasing. Studies also indicate that the prevalence is higher in children as they have smaller airways which become constricted due to all the pollutants. Schoolchildren are the worst affected and many are growing up with irreversible lung damage. All this can be blamed on the rising pollution levels which cause fatal lungs disorders, severe respiratory problems, nausea, palpitation, loss of vision, blood pressure, and fatigue. Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said "Asthma is a chronic respiratory disorder triggered by allergic reactions. It leads to breathing difficulties as a result of narrowing of the bronchial passage, which is responsible for carrying oxygen to the lungs. Asthma can have two affects: swelling in the lungs due to accumulation of mucus in the airways; and inflammation due to tightening of the muscles around the airways. What exacerbates the situation is that asthma is often mistaken as a recurrent cough. Due to this, it is not taken seriously or treated with cough syrups. In kids, it is difficult to assess symptoms because they may not show the typical symptoms of asthma such as breathlessness, wheezing, coughing, and chest tightness. Besides, every child’s asthma is different." Certain triggers can make an asthma attack worse. Once asthma is diagnosed in a child, it is imperative to remove triggers from the house or keep the child away from these. Adding further, Dr Aggarwal, said, "Young children may not understand how chronic this condition is or how it can affect their daily life. Education is the key here. Parents of children with asthma should ensure that the child is well aware of his/her condition and teach them steps to be followed during a possible emergency." Some tips for managing asthma and associated symptoms in children are as follows. • Help them take medications daily without fail. • Visit the doctor regularly. • Give them only the prescribed medicines. • Take precautionary measures to avoid any triggers. • Always carry their inhaler with you and encourage them to never feel shy to use it in public. • Inform the doctor if any other health ailment is bothering the child. • Lastly, help them reduce stress and try to remain calm and happy.

Children with dyslexia can learn normally with the right approach

Children with dyslexia can learn normally with the right approach Early detection imperative in providing the right treatment and helping manage condition better New Delhi, 28 July, 2017: Statistics indicate that Dyslexia is one of the most common learning disabilities affecting 1 in 10 children worldwide. The Dyslexia Association of India estimates that about 10% to 15% of school-going children in India suffer from some type of Dyslexia. Multilingualism, which is common in the country, can also impact the difficulty. This condition can affect boys and girls alike. If undetected by Class 2, dyslexic children can grow up to be dyslexic adults, at which point, this condition cannot be cured. A developmental reading disorder, Dyslexia occurs in children with normal intelligence. It is caused when the brain is unable to translate images received from the eyes or ears into understandable language. Although there is evidence to suggest that dyslexic children can excel in other areas such as sports and extracurricular activities, lack of awareness is an impediment to the progress of such children in India. Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said "The brain of a dyslexic person is structurally and functionally different from others. The inborn wiring system of the brain responsible for development of mental skills is different in a dyslexic person, making this the root cause for this condition. It is due to this that even minor acts of comprehension and usage can take longer in such children. The sad part about this condition in our country is that children can be classified as under achievers. They are also labeled as lazy, having low intellect, and unmotivated. All this affects their personality and results in low confidence and self esteem. Early detection can play a major role in helping such children. Assessment of the child's family history and other related information can help trace the causes." Some symptoms of dyslexia in children include difficulty in verbal skills; abstract reasoning; impaired hand-eye coordination; poor concentration, perception, and memory; and impaired social adjustment. Adding further, Dr Aggarwal, said, "The first line of understanding for a child is his/her parents. They should ensure that instead of running away from the problem, the child undergoes proper assessment to diagnose the difficulty. If the child is diagnosed with dyslexia, understand that it is not the end of everything. Understanding, acknowledging, and supporting your child in his/her efforts can help in handling this condition in a better and more informed manner." There are some techniques that can be used to help dyslexic children overcome their learning and comprehension problems. • Indulge in positive reinforcement. Communicate with your child in a positive manner and be patient with them when they take time to grasp things. • Dyslexic children are more inquisitive and hence, it is important to give them logical answers. Help them in getting their doubts cleared. • Teaching science and math in a tabular manner can help them in understanding the subjects better. • Use more of audio-visual aids as they can grasp things better with this technique. For younger children, flash cards can be used. • Yoga is a good way of increasing concentration in children with this condition. Breathing exercises and alternative therapy can help them cope better than medicines.

Pneumonia a leading cause of death among Indian children

Pneumonia a leading cause of death among Indian children Though progress has been made in combating the diseases, there is still a long way to go New Delhi, 02 June 2017: According to recent statistics, India has the highest number of pneumonia deaths among children around the world. About three lakh children died of the disease in 2016 alone, said a report. The other countries with the highest global burden of child pneumonia include Nigeria, Pakistan, Democratic Republic of Congo, and Angola. Although there has been some progress in combating pneumonia among young children in these nations, they still account for hundreds of thousands of preventable deaths around the world. Pneumonia is a form of acute respiratory infection affecting the lungs. In a healthy person, the small sacs called alveoli in the lungs fill with air while breathing. However, in pneumonia, these get filled with pus and fluid, making breathing painful and limiting oxygen intake. Pneumonia can be caused by viruses, bacteria, and fungi. Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “The viruses and bacteria commonly found in a child's nose or throat can infect the lungs if inhaled. They can also spread through air- borne droplets such as those during coughing or sneezing. Most healthy children can fight this infection with natural immunity. However, in some children, especially those whose immune systems are compromised due to malnutrition or undernourishment, or no breastfeeding, this infection can become serious. Some other risk factors include indoor air pollution, living in crowded homes, and parental smoking” Some symptoms of this disease include rapid or difficult breathing, cough, fever, chills, loss of appetite, and wheezing (prticularly in viral infections). In severe pneumonia, a child can undergo lower chest wall indrawing, where the chest moves in or retracts during inhalation Infants can experience unconsciousness, hypothermia, and convulsions. Adding further, Dr Aggarwal, said, “Pneumonia can be treated with antibiotics. A large majority of the cases can be tackled at home itself. Hospitalization is recommended only in very severe cases. Pneumonia is not contagious, but the upper respiratory viruses and bacteria that lead to it are. It is All communications intended for headquarters office should be addressed to the Hony. Secretary General a good idea to keep kids away from anyone with stuffy or runny nose, sore throat, cough, or respiratory infection in general”. It is imperative to improve a child’s natural immunity through adequate nutrition and this starts with exclusive breastfeeding for the first six months. Breastfeeding is not only effective in preventing pneumonia, but can also help in reducing the duration of the illness. Some other points to consider are reducing indoor air pollution and encouraging good hygiene in crowded homes.

Childhood obesity on the rise among Indian children

Childhood obesity on the rise among Indian children India records about 10 million cases of childhood obesity annually New Delhi, 08 June 2017: According to a study published in an international journal called Paediatric Obesity, India will have over 17 million obese children by 2025. The country will also be second among 184 countries in terms of the number of obese children. Childhood obesity is one of the leading causes of diabetes, high blood pressure, and high cholesterol among children today. Research also indicates that about 70% of obese youth had at least one risk factor for cardiovascular disease. Childhood obesity is a condition where a child is overweight in comparison to his or her age and height. Statistics say that there are about 10 million cases of childhood obesity in India annually. Although this condition cannot be cured, it can definitely be managed through the right approach at the right time. Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said," Obesity in children and the associated side effects are a major cause of concern today. Junk food and lifestyle are to be blamed for the increasing number of obese children. Many school canteens sell pizzas and cold drinks without giving a second thought to the health implications surrounding such a diet. Though many schools have taken steps to stop selling unhealthy food in their canteen, a lot more still needs to be done. It has also become easier for parents today to take kids out to eat in malls and restaurants. Outdoor activities have been replaced by digital devices, and children are eating more calories than they can expend. There is a need to create awareness on the fact that such a lifestyle can lead to complications in children at a very early age." Obese children and adolescents are more prone to bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor self-esteem. Overweight children are also more likely to grow up into overweight adults. Adding further, Dr Aggarwal, said, "It can become very difficult for a child to let go of the addiction for junk food once it becomes a habit. It is important that parents start inculcating good nutritional habits from the beginning in their children. Ensuring enough physical activity right from an early age is an equally important aspect of every child's growth." Here are some tips to tackle childhood obesity. • Encourage healthy eating habits right at the onset. • Try making favorite dishes healthier. Few changes can make even snacks healthier. • Avoid tempting children with calorie-rich food. It is okay to treat them but in moderation and by limiting high-fat and high-sugar or salty snacks. • Make kids understand the importance of being physically active. • Lead by example. Indulge in at least 60 minutes of moderate to intense physical activity every day. • Reduce sedentary time. While reading is a good option, too much of screen time is not. Replace screen time with the outdoors and fun activities to keep children engaged.

Tackling obesity in children

Tackling obesity in children More than 30% people of the society including children have potbelly abdominal obesity. India reportedly witnesses 10 million cases of childhood obesity annually. New Delhi, March 22, 2017: India is witnessing an epidemic of metabolic syndrome, which is characterized by abdominal obesity, high triglyceride, low good cholesterol, high blood pressure and high sugar. Abdominal girth of more than 90 cm in men and 80 cm in women indicates that the person is vulnerable to future heart attack. Normal weight obesity is the new epidemic. A person could be obese even if his body weight was within the normal range. Children with BMI equal to or exceeding the age-gender-specific 95th percentile are defined obese. An extra inch of fat around the abdomen increases the chances of heart disease by 1.5 times. Padma Shri Awardee Dr K K Aggarwal, National President, Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement said that, “Normally once the height stops growing, most of the organs will also stop growing. The weight of the heart, liver of kidney cannot increase after that. Only muscles can build up to some extent. The only thing, after that stage, which can increase the weight of the body, is deposition of fat. Therefore any weight gain after puberty is invariably due to fat. Though the overall weight can be in the acceptable normal range but any weight gain within that range will be abnormal for that person. One should not gain weight of more than 5 kg after the age of 20 years in males and 18 years in females. After the age of 50, the weight should reduce and not increase.” “Potbelly obesity is linked to eating refined carbohydrates and not animal fats. General obesity is linked to eating animal fats. Refined carbohydrate includes white rice, white maida and white sugar. Brown sugar is better than white sugar. Refined carbohydrates are called bad carbohydrates and animal fat is called bad fat. Trans fat or vanaspati is bad for health. It increases the levels of bad cholesterol and reduces good cholesterol in the body. Reduction in weight can reduce snoring, pain of arthritis, blood pressure and control uncontrolled diabetes”, add Dr K K Aggarwal. Childhood Obesity can further lead to diabetes, high blood pressure and high cholesterol. 70 percent of obese youth had at least one risk factor for cardiovascular disease. Children and adolescents who are obese are at greater risk for bone and joint problems, sleep apnea, and social and psychological problems such as social stigma and poor self-esteem. Following are some key points for tackling obesity in children: 1. Skip carbohydrates once in a week. 2. Combine a sweet food with bitter food (prefer aloomethi over aloomatar). 3. Walk, walk and walk… 4. Consume green bitter items in foods such as karela, methi, palak, bhindi etc. 5. Do not eat trans fats (vanaspati). 6. Do not consume more than 80 ml of soft drink in a day. 7. Do not consume sweets with more than 30% sugar. 8. Avoid maida, rice and white sugar. Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859125/

Antibiotic resistance rising in children too

Antibiotic resistance rising in children too Antibiotic resistance is a growing concern and its impact on patients and communities are known to us all. This is a public health problem, one which is rapidly spreading across the globe, with not enough resources to control it. Antibiotic resistance has made it harder for us to treat many infections such as typhoid, pneumonia, tuberculosis. Antibiotic resistance prolongs hospitalization, increased cost of treatment and increases risk of death. Several studies have corroborate the adverse impact of antibiotic resistance on health. Researchers from the Case Western Reserve University School of Medicine, Cleveland, Ohio examined the prevalence of multidrug-resistant Gram-negative enteric Enterobacteriaceae (MDR-GNE) infection in children between January 1, 2007, and March 31, 2015 and its association with hospital length of stay and death before discharge. This retrospective study observed an astounding 700% increase in MDR-GNE infections in a short period of eight years. A 20% increase in the lengths of hospital stay was observed in patients with MDR-GNE infection. The odds for death also increased, though this did not reach statistical significance. More than 75% of the antibiotic-resistant infections were already present at the time of hospitalization, contradicting earlier studies which showed that such infections were most hospital acquired.” The study is published in the March 2017 issue of the Journal of the Pediatric Infectious Diseases Society. This study has yet again highlighted the escalating problem of antibiotic resistance. It has shown that antibiotic resistance can affect individuals of any age, even children. In its first global report on antibiotic resistance, the WHO has warned that “A post-antibiotic era—in which common infections and minor injuries can kill—far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century”. Doctors as well as patients should be aware about and advocate judicious use of antibiotics. Over prescription and self prescription, both, need to be checked. Taking cognizance of the impact of antibiotic-resistant infections, IMA has proposed several initiatives to tackle this public health threat - “Jaroorat Bhi Hai Kya”, "3A Avoid Antibiotic Abuse campaign", “Use Wisely not Widely”, “Think Before you Ink”. IMA will also come out with a book on ‘When Not to Use Antibiotics’. We are also concerned about declining research in the field of newer antibiotics and support formulation of a national antibiotic policy. (Source: Case Western Reserve University School of Medicine, News Release, February 24, 2017) Dr KK Aggarwal National President IMA & HCFI

Flu in children

Flu in children With the onset of winter, children become increasingly prone to influenza infections highlighting the importance of preventive measures and good hygiene practices. New Delhi, Dec 26, 2016: Influenza is a viral illness and it often manifests in a mild form in children. Influenza infections are most frequent in winter and children are especially susceptible to infection due to weaker immune system. The classical features of uncomplicated flu in children include abrupt onset of fever, headache, muscle pain and malaise affected by manifestation of respiratory tract illness – sore throat, sough and nasal discharge. Flu symptoms in children are usually very similar to the symptoms of a cold, or upper respiratory tract infection. It might also cause nausea, vomiting and diarrhoea in occasional cases. Padma Shri Awardee Dr. K.K Aggarwal, President Heart Care Foundation of India (HCFI) and National President Elect Indian Medical Association (IMA), adds “ Flu is highly contagious, particularly when kids stay in close vicinities like they do in school classrooms. The spread of influenza occurs when children inhale droplets that are coughed up or sneezed by an infected person, or when they come in direct contact with mucus or spit from someone who has the disease. The best way to avoid flu in children is to get a yearly vaccination. Parents should consult a physician for the same. ” Ear discharge, development into asthma and pneumonia are common complications in children. Complicated pneumonia may be severe and rapidly fatal, especially if the bacterium is Staph. However, it is not necessary that all the mentioned symptoms be present in all children, individual variations do occur. Moreover, the duration of fever can also last from a week to upto ten days. “During winter, flu should be considered in all children with fever; children with fever and acute onset of respiratory illness; children with fever and exhilaration of underlying chest condition; children with pneumonia and children with fever of more than 100, with severe cough or sore throat. In 95% of the cases, more than 39oC fever is present and about 77% of the cases present with cough and nasal discharge. The treatment is often symptomatic. Paracetamol should be given in recommended doses upto 48 hours and encourage your child to rest and drink lots of fluids, preferably warm fluids. One important point to remember is that flu is caused by a virus, so antibiotics won’t help and can even cause stomach upsets and diarrhoea.”, adds Dr. K.K Aggarwal.

Heart Disease in children

Heart Disease in children New Delhi, September 26, 2016: India is inching towards becoming the heart disease capital of the world. With the increasing lifestyle irregularities and stresses of the 21st century, heart disease is extremely common in the age group of 30+. However the incidence of the disease in young children is also very high. Heart disease in children can be of different kinds, congenital and acquired heart disease. Around one percent of children in India are born with congenital heart disease and some of them are often referred to blue babies. There was a time when there was a no cure for this and parents were just informed the inevitable fate of their child. However medical advancements over the past few decades have made it possible for most children suffering from congenital heart disease to live normal lives post timely surgical intervention.
Speaking on this topic, Padma Shri Awardee, Dr. KK Aggarwal, President HCFI & President Elect IMA said, Rheumatic heart disease on the other hand is common amongst school going children and develops post a strep throat infection. Given this it is always recommended that parents must never ignore a cough in a child who has no cough and sneezing since that is the most common indication of the bacterial infection which often leads to the development of heart disease affecting the child’s heart valves. While the sore throat, or swollen joints and fever, in the child may get okay and disappear, the valves of the heart run the risk of getting permanently damaged causing rheumatic heart disease. The affected children may require valve replacement, which if not done in time may even result in death. A large number of children with congenital heart disease and rheumatic heart disease die because of non-availability of operative facilities in the country, especially for complex congenital heart disease. Additionally the lack of funds for the usually expensive surgery forces parents to ignore the illness and accept the fate of their child. However what a lot of people do not realize is that there are ways to overcome this and help can be sought.
The following options are available for children with heart diseases who cannot afford treatment:
• Sameer Malik Heart Care Foundation Fund, an initiative by Heart Care Foundation of India provides assistance to the needy and underprivileged children suffering from heart disease in need of surgical intervention. Anyone can call the Helpline no. 09958771177, which is open from Monday to Saturday and ask for help • Various Rotary Clubs in the country provide free surgery to children with heart disease. • ‘Being Human’, the organization run by the actor Salman Khan also provides financial assistance to children with congenital heart diseases. • Most states provide assistance of up to Rs 1 lakh for congenital heart disease to children if they possess BPL or equivalent card in the state. • The Delhi State Government also provides free heart treatment to children whose parents have annual income of less than Rs 3 lakhs. • Parents can apply through legal counsel to municipal corporations for assistance, through their local MLA or through their MP to the Prime Minister Relief Fund. • Children can also approach Puttaparthi Heart Centre at Bengaluru, which provides free surgeries to such children. • Various NGOs and associations also provide free treatment; for example, Maheshwari Club provides free treatment to Maheshwari families. • People can also approach their religious organizations like Gurudwaras, Mosque committees and Hindu Mahasabhas etc. for free assistance in respective category. • Under Article 21 of the Constitution of India, people can also approach respective High Courts for directions to respective state heart departments to avail free surgeries. • In every state, there are government hospitals, which provide free surgeries; for example, GB Pant Hospital provides free surgery to everyone with heart disease. • Safdarjung Hospital, New Delhi provides free heart surgery to all BPL patients from across the country. • People can also approach various PSUs for assistance under their CSR policy. • People can also approach various large private companies for assistance under their CSR policy. • The end result is – no children in India should die of curable heart disease just because he or she cannot afford it.

2-18 years age: Consume less than 6 teaspoons of added sugars in a day

2-18 years age: Consume less than 6 teaspoons of added sugars in a day Children aged 2-18 years should consume less than 6 teaspoons of added sugars a day and less than 8 ounces of sugar-sweetened drinks a week, an IMA-Heart Care Foundation of India statement advises. Table sugar, fructose and honey, sugar used in processing and preparing foods or beverages or sugars added to foods at the table, or eaten separately are added sugars. Children younger than 2 years should not consume added sugars at all. This advisory is in line with American Heart Association guidelines published August 22 in the journal Circulation. Regular consumption of foods and drinks high in added sugars can lead to high blood pressure, obesity and diabetes. Sugars remain a commonly added ingredient in foods and drinks. Starting in July 2018, food products sold in the United States will have to list the amount of added sugars on the Nutrition Facts Panel.

2-18 years age: Consume less than 6 teaspoons of added sugars in a day

2-18 years age: Consume less than 6 teaspoons of added sugars in a day

Dr K K Aggarwal Children aged 2-18 years should consume less than 6 teaspoons of added sugars a day and less than 8 ounces of sugar-sweetened drinks a week, an IMA-Heart Care Foundation of India statement advises. Table sugar, fructose and honey, sugar used in processing and preparing foods or beverages or sugars added to foods at the table, or eaten separately are added sugars. Children younger than 2 years should not consume added sugars at all. This advisory is in line with American Heart Association guidelines published August 22 in the journal Circulation. Regular consumption of foods and drinks high in added sugars can lead to high blood pressure, obesity and diabetes. Sugars remain a commonly added ingredient in foods and drinks. Starting in July 2018, food products sold in the United States will have to list the amount of added sugars on the Nutrition Facts Panel.

Do not ignore a sore throat in children

Do not ignore a sore throat in children New Delhi, August 22, 2016: Viral infections continue to plague Delhi with more and more people becoming victims of high fever, cough and nasal discharge. Mosquito borne diseases such as chikungunya and dengue are also on the rise. “At such times it is important to remember a few basic guidelines. Firstly there is no need to take antibiotics when an adult patient has symptoms such as high fever, a cough and a cold. In patients with suspected dengue, NSAIDs barring Paracetamol must not be taken as they run the risk of capillary leakage. One must remember that Chikungunya though painful is not a life-threatening disease and takes about a week ten days for the symptoms to disappear”. said Padma Shri Awardee Dr KK Aggarwal – President Heart Care Foundation of India (HCFI) and Honorary Secretary General IMA. It is however impirtant to remember that a sore throat in school children should not be ignored and shown to a local family doctor. This should be done to rule out bacterial sore throat infection, which if goes undetected, can cause rheumatic involvement of the valves of the heart, a condition known as rheumatic fever. Such children invariably will complain of throat pain while swallowing, red angry–looking tonsils and painful enlargement of lymph nodes at the angle of the mouth. Immediate antibiotics are needed to treat this to avoid future heart disease. In such patients no cough and nasal discharge will be present. Children also should not be given aspirin indiscriminately as it is known to be associated with fatal liver disease, in susceptible children. The first attack of rheumatic fever is rare after the age of 35.

AAP/AAPD issue updated guidelines on safe sedation for children

AAP/AAPD issue updated guidelines on safe sedation for children The American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD) have released updated guidelines on the monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures. • The guidelines recommend that practitioners consult with appropriate subspecialists and/or an anesthesiologist for patients at increased risk of experiencing adverse sedation events because of their underlying medical/surgical conditions. • The child shall be accompanied by a parent, legal guardian, or other responsible person to and from the treatment facility. • Facilities, personnel, and equipment to manage emergency and rescue situations should be immediately available, including an emergency cart or kit containing the necessary age- and size-appropriate equipment (oral and nasal airways, bag-valve-mask device, LMAs or other supraglottic devices, laryngoscope blades, tracheal tubes, face masks, blood pressure cuffs, intravenous catheters, etc.) to resuscitate a nonbreathing and unconscious child. • The guidelines recommend documentation prior to sedation with regard to informed consent and instructions and information provided to the responsible person. • During the procedure, ventilation should preferably be monitored by capnography or by amplified, audible pretracheal stethoscope. • Not only the practitioner, but the support personnel should also be trained in and capable of providing advanced airway skills (e.g., PALS). A useful acronym ‘SOAPME’ is suggested as a checklist. S: Size-appropriate suction catheters and a functioning suction apparatus (eg, Yankauer-type suction) O: adequate Oxygen supply and functioning flow meters or other devices to allow its delivery A: size-appropriate Airway equipment (eg, bag-valve-mask or equivalent device [functioning]), nasopharyngeal and oropharyngeal airways, LMA, laryngoscope blades (checked and functioning), endotracheal tubes, stylets, face mask P: Pharmacy: all the basic drugs needed to support life during an emergency, including antagonists as indicated M: Monitors: functioning pulse oximeter with size-appropriate oximeter probes, end-tidal carbon dioxide monitor, and other monitors as appropriate for the procedure (eg, noninvasive blood pressure, ECG, stethoscope) E: special Equipment or drugs for a particular case (eg, defibrillator) The guidelines were published online June 27, 2016 and in the July issue of the journal Pediatrics