Thursday, August 22, 2013

Help - My baby has been bitten by a Rat - Does he need Rabies Vaccine ?

Question: Help - My 3 year old boy baby has been bitten by a Rat - Does he need Rabies Vaccine ?
Answer: Rabies is transmitted through the bites, scratches, abrasions, or contact with animal saliva via mucous membranes or a break in the skin. 
Dog, cat and bats can transmit rabies. Raccoons, skunks, foxes and coyotes can also transmit rabies. Rabies has been reported in large rodents (woodchucks and beavers) but small rodents, such as squirrels, chipmunks, rats, hamsters, gerbils, guinea pigs, mice, and lagomorphs (rabbits and hares) are almost never identified as infected with rabies virus; there has never been a case of transmission to a human from one of these animals.

Hence, your child is NOT going to get Rabies from this rat bite. However, I do suggest that All children are at a risk for dog bites (& monkey bites in certain regions of India) and hence I personally recommend that every parent should consider Rabies vaccine for their child routinely to prevent this fatal disease. I have given the Rabies vaccine to my daughter :-)


Friday, August 02, 2013

Why HPV (Cervical Cancer ) vaccination can’t wait ?

Wednesday, July 24, 2013

What is the dose of Nexpro Junior (Esomeprazole) for infants with Reflux ?

For infants (less than 1 year old) with repeated vomiting & lack of weigth gain due to reflux (GERD), there are very limited medicines that are available for effective treatment in India.
A relatively new molecule is Esomeprazole marketed in the form of Nexpro Junior Satchets. I was trying to search for the effective dose in a 3 month old in my care who has significant reflux (vomiting, decresed weight gain, opisthotonic posturing etc.)
Here is what I found

Usual Pediatric Dose for Erosive Esophagitis

Healing:
12 to 17 year olds: 20 or 40 mg once daily
Duration of therapy: 4 to 8 weeks
1 to 11 year olds:
-weight less than 20 kg: 10 mg once daily
-weight greater than or equal to 20 kg: 10 or 20 mg once daily
Duration of therapy: 8 weeks
Comments: Doses over 1 mg/kg/day have not been studied.

Due to acid-mediated GERD:
1 month to less than 1 year old:
-weight 3 kg to 5 kg: 2.5 mg once daily-weight greater than 5 kg to 7.5 kg: 5 mg once daily
-weight greater than 7.5 kg to 12 kg: 10 mg once daily
Duration of therapy: For up to 6 weeks
Comments: Doses over 1.33 mg/kg/day have not been studied.

Read more at http://www.drugs.com/dosage/esomeprazole.html#iukblX6mMgSAPTLx.99 

Each satchet contains 10 mg of Esomeprazole and hence I have started the baby on 5 mg (1/2 satchets) once a day for the same.
Previously I have been using Junior Lanzol (Lansaprazole) tablets by Cipla, but they are a little difficult to dissolve in water to feed an infant. Hopefully this would be a more acceptable solution for an infant.