General

Mothers who choose to bottle feed babies must be respected, says Royal College of Midwives.

https://news.sky.com/story/mothers-who-choose-to-bottle-feed-babies-must-be-respected-says-royal-college-of-midwives-11402127

https://ramnikmathur.com/2017/05/27/breast-feeding-is-best-_-_-_/

Mouth Ulcers (Stomatitis)

We all suffer with mouth ulsers at some point in time. They can be quite painful and becomes a major problem in little children when they refuse to eat or drink. They can be caused by

Rare causes include

Most of the time, they can be treated with Antinicrobial mouth washes (Not possible in small children < 5), local anaesthetic gels like Bonjela, LA sprays. Sometimes, they can get infected, needing Antibiotics, but this is rare as long as good oral hygeine measures are followed.

https://www.nhsinform.scot/illnesses-and-conditions/mouth/mouth-ulcer

http://www.bonjela.co.uk/conditions/mouth-ulcers/general-advice/?gclid=CjwKCAjwr-PYBRB8EiwALtjbz85nIcUzcK20sprvCZt7w9Y82Kecw2pWy3cMRayvqe100JWm_9It2xoCkUAQAvD_BwE

A new laxative – Laxido

Recently, I’ve seen lots of patients being prescribed Laxido, instead of Movicol. It is bascially the same composition and pretty much the same electrolyte balance.

Each sachet of LAXIDO  contains the following quantitative composition of active ingredients: The laxatives are very safe and should be used in the correct doses to releive constipation.

Macrogol 3350

Sodium Chloride

Sodium Hydrogen Carbonate

Potassium Chloride

13.125g

350.7mg

178.5mg

46.6mg

The content of electrolyte ions per sachet following reconstitution in 125ml of water is equivalent to:

Sodium

Chloride

Hydrogen Carbonate (Bicarbonate)

Potassium

65mmol/l

53mmol/l

17mmol/l

5.4mmol/l

https://ramnikmathur.com/2016/06/08/constipation/

Image result for laxido composition

Epilepsy – some good resources

Epilepsy is a neurological disorder marked by sudden recurrent episodes of sensory disturbance, loss of consciousness, or convulsions, associated with abnormal electrical activity in the brain. (Source: Wikepedia)

https://www.nhs.uk/conditions/epilepsy/

https://www.epilepsysociety.org.uk/

https://www.epilepsy.org.uk/info/what-is-epilepsy

https://patient.info/health/epilepsy-and-seizures

Erythema multiforme

Erythema multiforme is a skin reaction that can be triggered by an infection or medication. It’s usually mild and goes away in a few weeks. 

The rash comes on suddenly and develops over a few days. It tends to start on the hands or feet, before spreading to the limbs, upper body and face. The rash:

  • starts as small red spots, which may become raised patches a few centimetres in size
  • often has patches that look like a target or “bulls-eye”, with a dark red centre that may have a blister or crust, surrounded by a pale pink ring and a darker outermost ring
  • may be slightly itchy or uncomfortable
  • usually fades over two to four weeks

In more severe cases, the patches may join together to form large, red areas that may be raw and painful. It can sometimes be associated with headache, temperature, red eyes, mouth ulcers, painful & swollen joints and swollen lips. See your GP as soon as possible if your child may have erythema multiforme. If you’re unable to see a GP, contact your local out of hours service or NHS 111 for advice.

Most cases are caused by a viral infection – often the herpes simplex virus. This virus usually lies inactive in the body, but it can become reactivated from time to time. It can also be triggered by mycoplasma bacteria, a type of bacteria that sometimes cause chest infections. Medication can occasionally cause the more severe form of erythema multiforme. Possible medication triggers include:

Treatment aims to tackle the underlying cause of the condition, relieve your symptoms and stop your skin becoming infected. Treatment may include:

  • stopping any medication that may be triggering your symptoms – do not try this without speaking to your doctor first
  • antihistamines and moisturising cream to reduce itching
  • steroid cream to reduce redness and swelling (inflammation)
  • painkillers for any pain
  • antiviral tablets, if the cause is a viral infection
  • anaesthetic mouthwash to ease the discomfort of any mouth sores

Reference : NHS Choices

Target lesion

Permission for picture taken from the child and his parents. He wanted his hand to be famous 😉

Vasovagal syncope (Fainting)

There are many causes of fainting, including heart disease, dehydration, epilepsy, medications, low blood glucose level etc.

Many children faint, usually after a painful trigger, like bump in the head or a cut. I have seen adults fainting at the site of blood. These episodes are usually due to vagal nerve stimulation. Vagus is a nerve in the body to calm us down. It gets stimulated by several triggers and the blood flow from the heart slows down. This leads to a reduction in blood supply to the brain. Body is clever and to restore the supply to the brain, we fall down, so that brain gets at the same level as the rest of the body. The blood supply gets back to the brain and we wake up.

Usually no investigations are needed, but sometimes if their is family history of heart disease, we may do an ECG (Electrocardiogram, a trace of the heart) or an EEG (Electroencephalogram, a trace of the brain activity). Their is no treatment required, but I advise children to drink plenty of water, specially in hot weather. If you usually eat a very low salt diet, eat some salty food, as low Sodium in the body can lead to dizziness.

Here are some useful links

https://www.nhs.uk/conditions/fainting/causes/

http://www.rbht.nhs.uk/patients/condition/vasovagal-syncope/

 

Scarlet fever resurgence!

Scarlet fever has made a comeback after many years.  http://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(17)30694-1.pdf

It is a bacterial (Group A Streptococci) infection, thus needs antibiotics for treatment. Here is a good link about the condition https://www.nhs.uk/conditions/scarlet-fever/