Success of vaccination in an individual child is assessed by sero-conversion (development of adequate antibody titers), while success of a vaccine or vaccination program is indicated by seroconversion rate or decrease in incidence of disease, among inoculated population. Important determinants of Immunization effectiveness include — a) Dose and immunogenicity of antigen: Live vaccines are highly [...]

Since the global eradication of small pox from May 8th, 1980, Immunizations for children has been established as the most cost- effective preventive measure against infectious diseases. Immunizations for children may be defined as ‘induction of specific immune response’ by either — a) Deliberate inoculation of irnmunogens to stimulate in vivo antibody production (active immunization), [...]

Hypermagnesemia – Although clinical severity may not correlate with serum levels, the term Hypomagnesemia denotes S. magnesium levels < 1.3 mg/dl. Causes Hypomagnesemia frequently co-exists with hypocalcaemia, usually due to impaired absorption or increased urinary losses. Clinical manifestations: Hypomagnesemia induces skeletal resistance to PTH, leading to hypocalcaemia. Consequently, hypomagnesaemia and hypocalcaemia frequently co-exist and present [...]

Tetany in children: Tetany is a clinical entity, indicative of neuronal hyperexcitabiliiy due to abnormal concentration of various ions in the fluid bathing nerve cells. Causes: Tetany is caused by Hypocalcaemia (S. ionic Ca< 3.0 mg/dl), Hypomagnesemia (S. Mg < 1.0 mg/dl), Alkalosis – Respiratory or Metabolic Clinical manifestations Carpopedal spasm is the hallmark of [...]

Hypocalcemia in children: Though the term ‘hypocalcemia’ is generally used to denote S. Calcium <9 mg/dl, clinical manifestations depend on ionic Ca levels (<3.0 mgldl). If facility to measure ionic Ca’ is not available, it is worthwhile to measure S. albumin levels simultaneously. In normal buminic, low S. Calcium reflects ionic hypocalcemia in children. However, [...]

Hypokalemia in children is the commonest electrolyte abnormality in sick children, defined as S. Potassium levels <3 mg. Causes Severe diarrhea/vomiting is the commonest cause of acute hypokalemia in children, while persistent hypokalemia usually indicates underlying renal disease. Pathophysiology Low extracellular potassium levels slow down the post-depolarization return of potassium into the cells, delaying process [...]

Hypernatremia in children is relatively less common than hyponatremia, defined as serum sodium levels> 150 meqlL. Causes Hypernatremia in children is usually iatrogenic in origin, due to use of concentrated ORS/parenteral fluids. Concentration hypematremia is seen in disorders with excessive water loss e.g. diabetes insipidus. Pathophysiology Hypernatremia leads to increased ECF osmolarity > osmotic movement [...]

Edema in children is a clinical term to denote – excess accumulation of fluids in interstitial fluid compartment, which normally contributes to —45% of TBW. Etiology Edema is caused by any factor that a) reduces plasma oncotic pressure, b) increases hydrostatic pressure, c) increases capillary permeability, and d) prevents lymphatic return. Diagnostic approach: Although the [...]

Lactation failure – Breast milk (EM) is the only food that a baby needs unto first 4-6 months of life and gives the best possible nutritional start to the neonate. Exclusive breastfeeding (BF) means that the neonate gets only breast milk and nothing else like honey, water, juices, vitamins (unless medically indicated) or any other [...]

Although Breast feeding (BF) is a norm in India, many problems during lactation may be avoided by following correct breastfeeding practices, discussed below — Antenatal preparation is one of the good breastfeeding practices with Breast examination to check protractility of nipples, maternal counseling regarding importance and correct practices of Breast feeding, and identification of ‘at-risk’ mothers [...]