Expert speak – Dr.Anas :Paediatrician & Adolescent specialist – Part2

Dr Anas paediatrician and adolescent specialist discusses some common paediatric health problems he usually comes across in his little patients. This is the continuation of part 1. Read part 1 here.


  1. Loose stools very frequently affect children. If associated with abdominal pain, foul smelling, greenish mucoid bloody stool then possibility of infection. Antibiotics along with ORS (adequate hydration) and ZINC for 2 weeks help in early recovery. Avoid glucose during diarrhoea. Monitor urine output and fluid intake.

    Good hand hygiene helps preventing spreading to other family members. Close contact at times also spread loose stool via oral nasal route (air borne transmission of diarrhoea causing organism)

  2. Hand foot mouth disease, chickenpox, viral Exanthem (skin rashes) are also common causes for OP visits in paediatrics. Vaccinations are available against chicken pox where as hand food mouth disease is self limiting disease requiring symptomatic treatment. Viral rashes like measles have vaccines and others are self limiting.
  3. Other common problem is mumps which can be prevented by 2 doses of vaccines three months apart Or booster dose at 5th year same like chicken pox vaccine.
  4. Loss of layer on tongue, oral ulcer all cause for abdominal problems. Can be corrected by zinc and Antibiotics.
    Zinc and iron also corrects Bruxism (grudging of teeth at night).
  5. Snoring and open mouth breathing is a very common presentation in paediatric op. Children presents with recurrent respiratory infection, allergy. On asking they tell about snoring and open mouth breathing. Cause can be adenoid hypertrophy (enlarged tonsils associated). Leading to recurrent allergy, running nose, cough & infection, teeth malposition and protruding lips, ear infection, lack of quality sleep leading to day time sleepers, learning disability, decreased immunity, allergy and it affects growth as growth hormone is released during sleep. Children with adenoids enlarged, sleep facing down and neck extended to facilitate breathing. It can be corrected after grading the size of adenoids enlargement with nasal sprays. Allergy needs to be controlled and finally a minor surgery is done.
  6. Asthma (wheezing) very common presentation and nocturnal (Night) cough, exercise induced cough and cough induced by crying and laughing.

All asthma variants can be managed by inhalers if recurring frequently, Anti allergy measures and medications. Proper treatment prevent from leading to COPD (chronic obstructive pulmonary disease) in later age. Inhalers deliver only very minimal quantity of medicine compared to oral treatment. So it is safe in long term management. Proper usage of spacers along with inhaler helps in correct delivery of medicines. Inhalers can be stopped if the child remains asymptomatic (asthma/cough free for 6 months). Most childhood asthma gets better by age 5 years. Inhalers are better and safer options than nebulisers.

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