Acute Gastroenteritis

This year’s winter is definitely more unique than ever. Temperatures in high 50’s and no snow on Christmas has altered winter break plans as well as the cycle for the most common pediatric condition such as acute gastroenteritis (AGE), commonly known as “stomach flu”.

AGE usually presents with vomiting, diarrhea, fever and abdominal cramping pain. In medical literature, diarrhea is defined as a passage of three or more loose or watery stools per day (or more frequent passages of stool than is normal for the individual). Frequent passage of formed stools is not diarrhea, nor is passing of pasty stool by a breastfed infant.

Vomiting is usually the first of presenting symptoms, and more commonly than not, it occurs in the middle of the night. After emesis subsides, diarrhea begins. Ongoing fluid and electrolyte losses lead to dehydration in children which is the major cause of morbidity in children with acute gastroenteritis. Continue reading “Acute Gastroenteritis”

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Ear infections

Ear infections are the most common clinical complain in the pediatrician office.  Most cases are seen in children ages 6 month to 24 month of age. The prevalence of the ear infections decreases as the child matures and are infrequent in school-age children, adolescents, and adults.

The biggest culprit of ear infections is usually a common cold. To understand better how a common cold leads to an ear infection, let us go back to basic physiology. Our nose and throat connected with middle ear through the Eustachian tube.   The Eustachian tube is positioned at the angle to prevent reflex of the secretions from the nose and throat getting into the middle ear.

Eustachian tube - difference between normal middle ear and the one with Otitis media
Eustachian tube – difference between normal middle ear and the one with Otitis media

The other responsibility of the Eustachian tube is to keep the air pressure inside the middle are same as outside. Normally middle ear compartment is filled with air only, but when patient has a cold it begins to accumulate fluid.  During viral process an increase amount of mucus produced inside in the nose. The viral particles cause inflammation inside the nose and later in the Eustachian tube.

The obstruction of the Eustachian tube in turn causes poor ventilation and leads to the accumulation of secretions in the middle ear. This fluid is sterile, but nasal secretions are not and when the Eustachian tube temporarily relaxed virus particles/bacterial particles get in.  Microbial growth inside the secretions in the middle ear, cause the clinical symptoms of the ear infection.

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Common Cold

As the tree leaves succumb to fall and temperatures drop, the dreaded common cold season begins. Sneezing, rhinorrhea (runny nose), coughing, sore throat, general malaise (feeling ill), low grade fever are some of the symptoms of the common cold. It’s an acute viral, self-limited illness. It requires no antibiotics and the treatment of care is supportive. I thought it would be a good idea to remind about some of the recommendations that may help to get back on feet quickly and remain healthy.

Common cold (also known as viral infection), is usually caused by various respiratory viruses. It is an acute illness, whose symptoms usually peak on 2nd or 3rd day of illness and gradually improve over time. In general, in infants and young children, the symptoms may last over 10-14 days. In older children and adolescents, symptoms usually resolve within a week or less.

Continue reading “Common Cold”