Monday, September 30, 2013

My child has been diagnosed with a hole in the heart - ASD, what should I do?

Q: I have a 1 year old daughter who was diagnosed with an 4.3 mm "Ostium Secoundum ASD" on the 15th day of life. Now she is 1 year old and without any symptoms, what should I do? 
A: Ostium Secondum ASD is a relatively common birth defect. For a small size ASD like in your child, it does not require any specific treatment unless there are symptoms. I would suggest repeat ECHO at 1 year age (now) and then yearly ECHO till 4-5 years age. There is around 70 % chance that this will close or become less than 3 mm with no flow through the ASD. In this situation, the child is normal and does not require any further treatment / evaluation. If the ASD remains large or the child has symptoms (like irritability, increased sweating, difficulty feeding, weight loss etc.) then you need to get in touch with a pediatric cardiologist for further evaluation and specific treatment like a catheter device or surgery.
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Saturday, September 07, 2013

What is the normal reaction after getting the BCG vaccination?

Question: What is the normal reaction after getting the BCG vaccination?
Answer: Children in India are routinely given BCG at birth. 
In the individuals previously uninfected by M.tuberculosis, about 2 to 4 weeks after the 
vaccination, erythema around an area of induration appears. Approximately at the site of prick 
of injection a nodule shows up. Within 3 to 10 days time, it softens giving rise to a pustule. 
Bursting of the pustule in about 2 to 5 days after its appearance results in an ulcer 4 to 8 mm 
in size. This painless depressed ulcer with undermined edges is soon covered by a thin crust 
or scab, which tends to peel off at the slightest provocation. The healing of ulcer in to a 
depressed, thin, shining scar with undermined edges in 4 to 6 weeks of its formation, marks 
the uneventful termination of sequence of occurrences at the site of BCG vaccination. 
In an individual previously infected with Mycobacteria, exaggerated and accelerated reaction of 
similar nature as described above, is seen. The reaction in this case starts within hours after 
vaccination and ulcer, 6 to 12 mm in size, occurs within a week. Ulcer also heals into the scar 
earlier. Size of the erythema, induration, nodule, pustule, ulcer and scar all are bigger than 
those in the uninfected. 
Similarly a repeat BCG vaccination also results in bigger local reactions. They are, however, 
smaller than those in the infected individuals. Onset of reaction in them, is almost similar to the 

Friday, September 06, 2013

Question - Reaction after BCG vaccine

Question: My baby girl is 1 month old. she had her bcg vaccine in 1 week after birth, and after 3 weeks it started swelling, is that a sign of tb or is it normal?
Answer. This is absolutely normal. The vaccine site is supposed to swell and then drain with a white pus like painless discharges. After a few weeks there would be a small white scar remaining at the site,
In fact if no reaction happens, you are supposed to repeat the vaccination for BCG !
Hope this helps
Dr Gupta, 

Thursday, September 05, 2013

Parent Question : Baby, Child care, Mother Care & Parenting Magazines in India

Question: I have been blessed with a newborn baby, & I want to know which child care magazines to subscribe to?
Answer: I have limited personal experience with magazines for mother & child care in India. However, I have found 'Parenting' to be a good magazine, and had subscribed to it for the clinic for an year too.
Many of the child rearing tips have been very helpful & not known to me too.
Here is a list of some other magazines that are not available in India

1. Parenting
2. Mother & Baby
3. Child
4. Parent Edge
5. Parents India
6. Responsible Parenting - A new magazine focusing more on the mental & emotional aspect of Parenting

You can get details of subscription here

While there are many foreign child care magazines available in India, these magazines mentioned above tend to maintain an Indian focus, and have tips that are generally more useful to Indian parents,
I would welcome any additions and suggestions and reviews by the parents themselves