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#childobesity #childoverweight #childhoodoverweight #childhoodobesity #craniopharyngioma #bardet-biedlsyndrome #leptindeficiency #sleepapnoea  #PCOS #polycysticovarysyndrome #buriedpenis

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Seven and a half-year-old  Emma trembled as she walked into my OPD. Crying silently, her face taut with fear, she firmly declined all my attempts at befriending her.  The simple act of taking a blood pressure at the registration desk had set her off today. It turns out that over the last two years, she had been through batteries of blood, urine, and sonography tests as advised to try and get the diagnosis of her symptom of having early signs of growing up and is now scared of hospitals. The family had patiently been through it all, but when one more test was abnormal, and they got asked to repeat almost the entire gamut all over again, they lost it. They promptly turned up from a 2-hour drive away to see me.   The first thing the mother said was ‘ Doctor, please try not to do any more tests, would you please try and interpret the earlier reports first? You can see how Emma hates all this. ’

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This is Part - 1 of the Children's Thyroid Conditions Blog Series. Introduction and Symptoms

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Announcing “ From Bone pain to Back pain “- Children’s Bone disorders event.

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On World Thyroid Day, if your child is not gaining weight and/ or height, it could be due to several reasons, of which thyroid problems are common. Consult a Paediatric endocrinologist to ensure it is picked up and treated efficiently to ensure your child gets the best in life for his/ her optimal overall development. Dr. Smita Koppikar, Paediatric endocrinologist, Reliance Foundation Hospital, Mumbai #drsmitakoppikar #thyroid #IAP#IndianAcademyofPaediatrics #WorldThyroidDay

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On World Thyroid day, if your child has a neck swelling just below the chin, it could be a Goiter {swelling of the thyroid gland}. Consult a Paediatric endocrinologist to ensure quick and efficient treatment. Dr. Smita Koppikar, Paediatric endocrinologist, Reliance Foundation Hospital, Mumbai #drsmitakoppikar #thyroid #IAP#IndianAcademyofPaediatrics #WorldThyroidDay

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On World Thyroid Day, ensure you get your newborn baby’s blood heelprick test done for congenital hypothyroidism. Early diagnosis and treatment enables maximizing your baby’s IQ . If your child is not developing adequately, ensure a thyroid test is done along with other tests, to pick up a faulty thyroid gland. Dr. Smita Koppikar, Paediatric endocrinologist, Reliance Foundation Hospital, Mumbai #drsmitakoppikar #drsmitakoppikar #thyroid #IAP#IndianAcademyofPaediatrics #CH #congenitalhypothyroidism#WorldThyroidDay

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The baby with the brittle bones

3 day old  Vansh was howling in pain. In the maternity hospital, it got everybody worried. Try as they might, they could not placate him.  And then on day 4, there appeared the tell-tale swellings; on the chest, on the arms, and the legs. Red and swollen and angry-looking they were.  Specialists  were duly consulted and they said they were fractures.  “How come?” They said.  “He did not fall anywhere. Why, he is not even walking yet ! How, pray,  could a newborn baby, not even a week old,  have fractures, and that too, so many of them ? “

Note : Left Panel in the image showing Fractured arm bone Right Panel the same fractured arm bone showing a swelling indicating healing.

The answer was that Vansh has ‘brittle bone disease’  a rare genetic condition called  ‘Osteogenesis Imperfecta’ .  His bones were defective due to an inherent defect, and that made him prone to breaking his bones with pressures that any normal newborn can easily withstand.  So much so, that Vansh, despite being born by a Caesarean section {where there is no pressure on the baby to push through the mother and make it’s entry into the world, as opposed to a normal delivery}, still broke so many ribs {bones of the chest}.

Thankfully, Vansh’s doctors directed him to a specialist team in Mumbai where there was access to a team that could look after this very rare and challenging condition, that needs long –term treatments.

He was sent to a place where there is a Paediatric Endocrinologist, who would evaluate the condition of the softness of the bones and direct appropriate treatments that would strengthen Vansh’s bones.  To deal with the fractures already existing, he would be given pain relief, as fractures are extremely painful and that was the reason poor Vansh was howling so. .   The family was given instructions on special ways of handling Vansh. Ie. Even changing nappies, dressing Vansh and picking him up could cause fractures, so they needed special training on ways to minimize this.

A specialized Children’s Orthopaedic {bone and joint specialist} surgeon gave his specialist inputs.

I could go on and on about Vansh’s treatment, but suffice it to say that children with brittle bones need a lot of specialist doctor’s inputs over a continued period of time.  If you know of someone who may have fractured with minimal impact, please do get them in touch with us.

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Is your child drinking too much ?

3  old Vidisha’s parents were puzzled.  She had started drinking and passing urine almost constantly.  The previously toilet trained child had even started wetting her nappies now constantly.  Whereas she previously slept through the night, she now woke up constantly asking for a drink, and in addition, her multiple wet nappies in the night kept her parents constantly awake.      Their doctor very wisely did a blood sugar test, as the commonest thing to think of was Juvenile  Diabetes mellitus {sugar ki bimari- bacchon waali }. When that was normal, no one knew what next. The family put up with this for the next several months, after which they noticed a swelling on the jaw. Some trips to the dentist led to needing a biopsy. It turned out that the too much drinking and urinating and the bone swelling was connected. Vidisha had a very unusual condition that really needed prompt diagnosis and efficient management.

Though I will not go into too much detail about Vidisha’s condition, it is essential for parents to think of whether this applies to their child.  Ie drinking too much liquids and passing too much urine.  If it is happening over two to three days in a row, and you think it is unexplainable by hot weather, it needs looking into as a matter of priority.

The commonest condition to think of is the children’s type of diabetes which needs an urgent blood sugar test. The results need to be made available the same day, and if abnormal, the child needs to be sent straight to either the casualty or to a Paediatric endocrinologist, preferably after discussing with them {your Doctor should ideally make this call}.

If the blood sugar test is normal, the excess drinking and urinating STILL NEEDS LOOKING INTO.  The most important step is for parents to NOT STOP the child drinking till the Paediatric Endocrinologist has seen them.  Stopping  access to liquids can get the child dangerously dehydrated in certain medical conditions. This is why it is essential to let them drink and urinate, but seek help quickly.   Many a times it can be something simple, but there is no saying which child has a harmless condition and which one has a condition that needs immediate attention.  Sticking to the above guidelines will enable dealing quickly and efficiently with these children’s condition.

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Paediatric Endocrinology means Children’s Hormonal disorders. Specialists of this kind are very rare in India, and Dr. Koppikar brings the expertise of 12 years in Europe to India. Many disorders are so subtle, they may not even be picked up by other doctors. Therefore, it is necessary for parents to have a high degree of watchfulness and report to the appropriate specialist. It is better to be safe than sorry.