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Santosh Kondekar

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Dengue fever in mumbai children: when to worry? what is the course.
for detailed understanding, please visit your local doctor
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swine flu or H1N1
basic understandings about its issues in children: This article is only for medical professionals. If you are a patient relative, please visit your local doctor to clarify issues.
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Skin rash in children: chicken pox measles or allergy or is it hand foot mouth virus?

Skin rash with fever in kids. Getting rational!@

Allergy does cause an itchy swollen rash... often without fever and at times may progress to respiratory discomfort.. and hence need to be promotly understood treated and prevented. Common allergies are related to diet protein nut/egg/oats/milk/fish etc
Around winter.. three types of viral rashes are often seen. Although any viral fever including dengue fever can rash; the viral rash is often strongly described and seen with measles and chicken pox and hand foot mouth disease.
Commonest of these 3 being hand foot mouth disease HFMD... is the mildest of all and often may not need any specific measures unless has bad oral sores or complications. Its easy to know that HFMD rash is small reddish mini fluid bumps and doesnt affect trunk or back and often has a mouth sore. Fever may be short and mild. All may disappear in two weeks though can spread very fast.
Chicken pox on other hand appears more dreadful and scary rash. It has high fever at onset with trunk lesions and takes three days to spread over rest of body. Different sizes and stages of small to large fluid bumps called vesicles in different stages at a time and each bump surely scarring in a week; and no new bumps beyond ten days since onset is most likely chicken pox. It can cause complications like acute pneumonia.
Rash of HFMD is discrete-small and in measles bumps are very small size and in 'chicken pox and measles' heavily spread all over body.
Measles rash is more common in kids who have skipped measles vaccine of 10 month age. Rash is fine sand like but red; starting in neck with high fever and spreading all over body in two days. Fever settles by three days and rash in a week without any scar. If u see WOUNDS or scar.. surely its not measles. Measles causes fall in immunity and has serious complications like pneumonia or TB to follow over a month.

Its important not to panic; but understand the disease course and visit a doctor earliest. Read danger signs and basic care in viral fever at

Remember if child refuses feed even twice or prefers to lie down more than six hours without sleep.. it may be a sign for hospital based observation.
There are tens of viruses and bacteria that cause a large variety of rashes. This is just an awareness basic.

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Developmental delay in a child




Heard of developmemtal delay?/neurological delay?
Its important to understand for every parent that "Not noticing the delay in time" is real delay.
Often parents sit at home, saying he will learn sooner.. his mom or dad also learnt it late.. or whats the urgency etc
Please donot fall into a trap; by accepting delay in development or growth of a child normal; we are halting the progress of the child.
Visit your doctor, ask when to worry about a delay; when not to worry about a... delay. What is the maximum potential of the child? is he lagging behind peers of same age in certain areas of development? to what extent it is normal? what may happen if u donot note in time?
Its important for us to understand that any delay is rectifiable only if picked up early and intervened early by some brain training therapies; that your occupational therapist or pediatrician may guide about.
Certain delay if not noted in time may cause serious mental retardation. A common known reversible cause of developmental delay is dietary iodine deficiency related hypothyroidism; which gets reversed with near normal intellect once the disease is diagnosed and started on medications.#
There is a huge market stressing you from nutritional advertisements stating that marginal under performance can be related to iron or DHA or calcium or other micronutrient deficiency. Surely malnutrition is an important reason for developmental delay.
When a doctor assesses a child with labelled developmental delay like say delayed smile, delayed sitting, delayed rollover, delayed sitting, delayed standing walking running or comprehending in words or social interactions; the doctor has kept in mind all these causes to decide about action plan. Neverthless, the detailed neurological examination also helps a doctor to decide the need for evaluation of serious neurological disorders from cerebral palsy, autism, etc to neurodegenerative disorders and strokes.
Early Intervention therapy, helps child cope up with the lag and develop a step in milestone development by training the developing cortex using vaious sensory,vibrations/kinaesthetic senses.
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Apple for health? Myths and facts




iron apple health -  myth

often i see people consuming lots of apples.. also giving same to infants... boiled pureed and what not forms.. considering it is very healthy for kids for iron and calories... not true exactly.

Apple gives calories as equal as a banana... sixty calories for 120gm serving. See the cost effectiveness.
A water melon slice is equal to same. means cheaper fruits like banana and watermelon are richer in calories compared to apple. So why apple madness?
Age old saying is.. an apple a day keeps doctor away. its supposed to keep u healthy by keeping u low in calories. if u have an apple prior to a meal.. u may eat 180 calorie less. In short.. its a weight reducer.. so why punish kids with it when they need to gain weight.

Now coming to iron... are u maddened by apple content of iron cos it turna black when kept open to air... then again u r fooling urselves. iron requirement for adults is say 10mg per day for males and 20 mg per day for females.. and for kids its around 2mg per kg body weight per day. Now look at apple iron content its around 0.22 mg for medium size apple. now imagine how many apples you need to eat to make 20 mg per day.
Last but not the least ... apple is good source of  vitamin C. that is ten mg.. oh yeah and the requirement for vit C per day is around 60 mg. so if u eat six apples a day.. you are sure to get malnourished.

Moral: Eat fruits... but for taste. dont go for fanatism.. dont expect a single diet source to give all. by having a single food in excess you are compromising on other dietary necessities.
Dr kondekar

so what to give kids?
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cough diagnosis made easy
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