Advanced Centre For Child Care at Fortis Hospital Chennai

Paediatrics is a specialised division in medicine that is defined by it ‘relationship-rich’ characteristics in view of the number of relations between children and their parents, between siblings and also medical practitioners who represent a varied spectrum of healthcare disciplines. 

What is paediatrics?

Paediatrics is a medical specialty that includes taking care of infants, children and adolescents from a medical perspective. The scope of paediatrics may be defined as looking in to the possible risks, symptoms, diagnosis and treatment in to healthcare anomalies that impact individuals in this specific age group. This includes supervision and paying attention to common as well as acute and chronic medical conditions in children, until they reach maturity. A medical practitioner who is an expert in this branch of medicine is known as a paediatrician. 

Paediatrics – Sub Specialties
Paediatrics has multiple sub-specialties including:

• Adolescent medicine
• Child abuse paediatrics
• Clinical informatics
• Developmental-behavioural paediatrics
• Genetics
• Headache medicine
• Hospice and palliative care
• Medical toxicology
• Neonatology
• Pain medicine
• Paediatric allergy and immunology
• Paediatric cardiology
• Paediatric cardiac critical care
• Paediatric critical care
• Paediatric cardiac critical care
• Neurocritical care
• Paediatric emergency medicine
• Paediatric endocrinology
• Paediatric gastroenterology
• Transplant hepatology
• Paediatric haematology
• Paediatric infectious disease
• Paediatric nephrology
• Paediatric oncology
• Paediatric neuro-oncology
• Paediatric pulmonology
• Pediatric rheumatology
• Sleep medicine
• Social paediatrics
• Sports medicine

Secondary Specialties that also fall under the purview of paediatrics are:

• Child neurology
• Brain injury medicine
• Clinical neurophysiology
• Endovascular neuroradiology
• Epilepsy
• Headache medicine
• Neurocritical care
• Neuroimmunology
• Neuromuscular medicine
• Pain medicine
• Paediatric neuro-oncology
• Sleep medicine
• Vascular neurology
• Child psychiatry, subspecialty of psychiatry
• Neurodevelopmental disabilities
• Paediatric anaesthesiology, subspecialty of anaesthesiology
• Paediatric dentistry, subspecialty of dentistry
• Paediatric dermatology, subspecialty of dermatology
• Paediatric gynaecology
• Paediatric neurosurgery, subspecialty of neurosurgery
• Paediatric ophthalmology, subspecialty of ophthalmology
• Paediatric orthopaedic surgery, subspecialty of orthopaedic surgery
• Paediatric otolaryngology, subspecialty of otolaryngology
• Paediatric radiology, subspecialty of radiology
• Paediatric rehabilitation medicine, subspecialty of physical medicine and rehabilitation
• Paediatric surgery, subspecialty of general surgery
• Paediatric urology, subspecialty of urology

Common Paediatric Conditions

There are several health conditions that affect infants, children and adolescents. The five most common medical maladies amongst them are:
• Sore throat
• Ear Pain
• Urinary Tract Infection
• Bacterial Infections 
• Fungal Infections

Symptoms of Common Paediatric Conditions

Here are the symptoms of five most common paediatric conditions:
Sore Throat is distinguished by three key parameters – pain, scratchiness or irritation. This feeling often tends to ger worse when children try to swallow. 
Common symptoms of sore throat include:

• If there is a scratchy sensation or pain in the throat
• If the pain gets worse particularly when talking or swallowing
• If your child finds it hard to swallow
• If the glands in your child’s neck or jaw experience swelling and soreness
• If your child’s tonsils become red and swollen
• If there is white patched or pus on the tonsils
• If your child’s voice grows hoarse or muffled

Secondary symptoms that may also indicate towards a sore throat in a child or infant are:

• If your child has a temperature
• If your child is experiencing cough
• If you notice you child with a runny nose
• If your child is sneezing a lot
• If your child is complaining of body aches 
• If you child is experiencing head aches
• If your child is overtly nauseas or vomiting

It is recommended that you seek immediate medical attention if your child experience these symptoms:

•    If your child is finding it difficult to breathe
•    If your child is having trouble in swallowing
•     If you notice any unusual drooling, which may point towards an inability to swallow, particularly relevant to infants

    Ear Pain is a condition that mostly older children typically complain of. However, that does not imply that infants and younger children do not experience ear pain. The common symptoms of ear pain include:

• If your child is experiencing fever without any probable cause
• If you notice your child to be usually fussy
• If you observe that your child is having trouble sleeping
• If you see that your child is trying to pull at their ears
• If you note that your child is finding it difficult to respond to or hear quiet sounds

In some rare cases, children experiencing ear infection may also have some fluid drainage from their ears.

Urinary Tract Infection symptoms are more or less evident in older children. Common signs are:

• If your child is experiencing pain the in the lower belly, back or side
• If your child is feeling an urge to urinate or is urinating more often than usual

Those kids who have undergone toilet training may possibly wet their bed as they tend to lose bladder control, thus, indicating towards a urinary tract infection. 

You may need to delve slightly deeper particularly in the case of younger children who are not able to voice their discomforts. General symptoms in younger children include:

• If you see your child to be unnecessarily fussy
• If you child lacks an interest in food
• If your child has fever

Other symptoms of a Urinary tract infection involve:

• If your child is experiencing a burning sensation or pain while urinating
• If you observe a foul-smell in your child’s urine 
• If you notice your child’s urine to be cloudy
• If your child has an urgent need urinate, and then only urinating a few drops
• If your child is experiencing fever
• If you see that you child is nauseas or vomiting
• If your child has diarrhoea

    Bacterial Infection is a condition where spotting symptoms can be difficult. However, some common indicators include:

• If your child is suffering from high body temperatures that keeps increasing
• If your child’s temperature is prolonged and has lasted for over two days
• If you notice a lack of appetite in your child by refusing to eat or displaying disinterest in meals
• If your child’s toilet habits are changing, especially by urinating less or passing stools frequently
• If you note that your child is unusually sleepy or lethargic

Fungal Infections impact children whose immune systems are weak by way taking advantage of the child’s current physical health condition leading to an infection. Fungal infections can survive within and outside the body or penetrate into deeper areas of the biological system. 

Here are a few symptoms of fungal infections:

• If you notice a rash with raised edges on your child’s skin
• If your child’s skin feels itchy
• If you observe any peeling or cracking on the skin
• If your child experiences any pain on the infected area on the skin
• If your child is undergoing hair loss due to scalp infection
• If you notice that the infection is causing discolouration and crumbling of the fingernails and toenails

 

Causes of Common Paediatric Conditions

The following includes the causes behind the five most common paediatric conditions.

Sore Throat is caused by:
Viral infections including common cold, influenza, Mononucleosis, measles, chicken pox, croup
Bacterial infections that include Streptococcuspyogenes, or group A streptococcus

    Other causes that cause a sore throat are:

• Allergies
• Dryness
• Irritants
• Muscle strain
• Gastroesophageal reflux disease (GERD)
• HIV infection
• Tumours   

Ear Pain are caused due to the following reasons:

• Viruses or bacteria that results in infections in the middle ear
• These germs travel from the back of the throat to then middle ear via the eustachian tube which may be swollen from a cold

   Urinary Tract Infection may be the caused by infections in the following areas in the child’s body:

• Kidney leading to an infection called pyelonephritis
• Ureters
• Bladder resulting in a UTI known as cystitis
• Urethra

Female children are more prone to contracting UTIs as their urethra is shorter and bacteria from the anus can enter more easily into the vagina and urethra.

    Bacterial Infections mainly plague those children who have low immunity and come into contact with environments where bacteria thrive, frequently. 

Here are the most common types of infections:

• Cold characterised by a runny nose, fever, and high body temperatures
• Respiratory Infections displaying signs of coughing and infections related to the respiratory tract, for example, bacterial bronchitis
• Intestinal Infections leading to intestinal infections, resulting in vomiting and diarrhoea
• Meningitis 
• Sepsis  
• Fungal Infections manifest in a variety of forms in children 
• Tinea Capitis or Scalp Ringworm that affects the scalp and hair shafts in children
• Athlete’s Foot that affects the sides of the toes, and sometimes the bottom of the feet and toenails     Tinea Corporis or Body Ringworm which is a circle shaped rash appearing in various parts of the body, apart from the soles of the feet, palms of the hands, groin and scalp
• Jock itch develops in the upper thighs and the groin area
• Candida is a form of infection affecting the skin surrounding the nails in children.

 

It also appears in the form of patches on the mouths in infants.

The common causes of fungal infections in children are:

• If your children are wearing clothes which are tight fitting and prevents breathability, particularly in hot weather
• If your child has used a shared towel where fungi can survive up to several days
• Inflammatory Infections are cause as a result of a weakened immune system in your child. The hormonal levels are not in balance as a result of inflammatory infections leading to fungal infections.

Diagnosis of Common Paediatric Conditions

•     Sore throat can be diagnosed by a general paediatrician post examining your child, in order to rule out the possibility of a bacterial infection.
•     Ear pain may be diagnosed by examining the ear drum with the help of an otoscope. Areas in the ear drum that the doctor looks are include:
• Fluid in the middle ear
• Colour and position of the ear drum
• Pressure in the middle ear

Urinary Tract Infection can be diagnosed by a paediatrician by taking your child’s urine sample that will be tested for the presence of bacteria. The urine sample may be collected in the following ways:

• Older children may urinate in a sterile cup
• Younger children may urinate in a plastic bag
• Children wearing diapers may require the insertion of a catheter in their urethra and bladder
• Infants may need a needle to the injected in to the bladder via the abdomen

The sample will be examined under a microscope in a laboratory to check for germs in the urine. It may also require to be cultured that examines the presence of bacteria and its type. 
If your child has experience UTIs a few times already, the paediatrician may propose additional tests to check for any other complications in the urinary tract. These include:

• Ultrasounds that looks for blockages in the kidneys
• Voiding cystourethrogram (VCUG) that checks of complications in the urethra or bladder when the child urinates
• Nuclear scans to check the functioning of the kidneys
• CT, or computed tomography Scan that takes detailed images of the kidneys and the bladder
• MRI or magnetic resonance imaging takes visuals of the bladder and the kidneys

    Bacterial Infections may be diagnosed by taking tissue samples and blood analysis that undergoes a rapid detection test in the laboratory. If the bacteria are too small to be easily detected, the lab technicians grown them in the laboratory as culture to perform additional analysis. This process generally takes 24 to 48 hours. 

   Fungal Infections may be diagnosed with the help of a general practitioner or a dermatologist by scaping a part of the scaling skin off the child. This sample is then inspected under a microscope in order to detect presence of any type of fungus. 
Treatment for Common Paediatric Conditions
Sore Throat is usually the result of a virus. The best care plan to help your child recover is:

• Keep your child comfortable
• Give him or her a lot of fluids
• Allow your child to rest

In addition to the above, your paediatrician may suggest over-the-counter medications to relieve the pain and fever. 

    Ear Pain can be treated in the following manner:

• Get your child to sit or sleep with their head in an elevated position as the pain may worsen by lying down
•     Apply warm compresses to ease the discomfort in the ear
• Medications to relieve your child’s discomfort

Urinary Tract Infection is treated primarily with antibiotics in order to destroy the bacteria. General dosage and duration last anywhere between three and ten days. Your paediatrician may suggest another urine test to confirm that the infection has been successfully treated. 

Bacterial Infections are treated with the help of an antibiotic course prescribed by your paediatrician. In order to eliminate the infection, the medications have to take at the right time of the day and in the recommended dosage. 

Fungal Infections have to treated in consultation with your doctor who may suggest using an anti-fungal cream. Typical duration lasts approximately two weeks. If the cream does not work, the paediatrician may prescribe anti-fungal tablets.

In addition to the medication, you will be advised to make your child wear breathable clothes and prevent him or her from scratching the affected area. 

About the Department

The Department of Paediatrics at Fortis Hospital in Chennai has the perfect balance experience and expertise along with world class infrastructure and technologies that offer outstanding care for our young patients. 

Representing decades of clinical collaboration, our full spectrum of services includes speciality clinics such as cardiology, endocrinology, gastroenterology and nutrition, nephrology, paediatric surgery and rheumatology. We also offer diagnostic services, behavioural health services, neurology, pulmonology, rehabilitation services, and neurodevelopmental assessments. Our state of the art emergency services dedicated to paediatric patients is staffed with leading pedestrians in the city, round the clock, throughout the week. 

At Fortis, Chennai our patients have total access to top-notch specialists and resources. Our experts are involved in active research in order to implement treatment that is modern and technologically advanced. 
As our young patients mature into adulthood, the Department of Paediatrics at Fortis, Chennai, ensures a smooth transition between paediatric services to our wider array of healthcare services relevant to adult patients. 

 

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