Being old school ,I was never a believer in video consultation in medicine. I always thought that unless I see a patient and examine them, I will not be able to do justice to the consultation. I refused to do video calls many times in my last twelve years of practice.

Covid pandemic challenged my belief. As I cannot call a covid positive patient to my clinic , I have no other option left other than to do a video consultation for them. I started hesitantly as I was not comfortable doing it.Then one morning everything changed ,I got a SMS from one of my patient’s father -” Doctor my whole family got Covid, I need a video consultation for my two year old daughter Mohini urgently” . I replied – “Will plan it as soon as I reach Clinic.”

Video consultation for Mohini was scheduled for 12 pm. My receptionist reminded me to call the patient 5 min to noon. I made a video call on whats app to the registered number.I could see Mohini in her fathers lap as the call started.As soon as the father saw me, he just broke down and started crying inconsolably, while crying he said that now Mohini will recover fast because we saw you.

I was taken aback with this kind of reaction and to see that just seeing a doctor on a video call matters to a patient so much. It gives them so much confidence in these difficult times.I consoled the father, did the consultation, and told him that Mohini will recover in 72 hours as symptoms for her were mild. I ended the consultation by emailing him the digital prescription.

After this episode, I was able to overcome my hesitation of doing video consultation and was able to help hundreds of covid positive patients by doing video consultation. It made me understand how a doctor’s presence or just seeing them gives so much emotional support to a patient and how it helps in healing.

I was getting ready for my evening clinic. It was quite cloudy outside.I was praying that I could reach clinic before rain starts. As I dislike driving in rain.

I skipped my evening tea so that I could quickly get into my car and start my journey. As I was wearing my shoes to leave, I noticed on the balcony that it started drizzling. I did not want to get wet, I left my house immediately.

As soon as I got out of the lift in the basement my worst fear became true, it started pouring heavily. I have to take a small walk in the open from the basement to the car which was parked under a shade.

I was waiting at the edge of the basement for rain to slow down so that I could walk to my car. I was watching people around me who were rushing into the basement from an open area to save themselves from rain. That moment I saw a girl maybe around five or six years standing in the open with her red umbrella.To my surprise next moment she removed her umbrella over her head and was holding it upside down. She was trying to collect rainwater in the bowl of her umbrella and while doing so she was getting wet but was enjoying each and every moment of it.She was trying to collect each and every drop possible.

It was so mesmerizing to see this girl enjoying the rain that for the moment I forgot that I have to leave for clinic. I realized that I was trying to save myself from a few drops of rain and here this girl is getting drenched and not moving a inch. Seeing this made me so calm and it made me think how I get bothered by small things, even by so natural event like rain. Sometimes accepting things as they are is the most liberating and beautiful act we can do in some situations.

By this time rain slowed down. I started walking towards my car. I was walking slower than my normal pace so that I could feel the rain on my face, I was no longer worried about getting wet , that girl has changed me. I started my drive to work, but throughout the evening I had a smile on my face. Rain.. rain….. come again!!

It was a busy Monday evening at my clinic. I was seeing a patient in my cabin. In the middle of the consultation, my receptionist, Tamil comes inside and asked me for Rs 100, as some patient needed money to pay for the auto fare. Apparently the family did not have the required money with them. I was amused at this strange request but did not give much thought to it as I was busy with another patient. I took out my wallet and handed over 100 rupee note to Tamil.

After finishing the consultation, a mother carrying his 2 yr old son Abhijat in her arm entered my room. Abhijat was drowsy. Mother was in a state of panic. I quickly took the baby from her arms and ask her to take a seat. She told me that Abhijat had fever for the past 2 days, and all of a sudden had a convulsions [ fits ] 30 min back. She did not know what to do as her husband was still at work. She just took her child in his arm and rushed to my clinic in an auto.

I examined the child and concluded that child had got convulsions because of high fever, and it was not something serious. Abhijat was drowsy but was recovering. I explained to the mother about the child’s condition and reassured her, and gave her a prescription. I could see that the mother was now recovering from her initial panic.

As she was leaving my cabin, she made an unusual request. She wanted me to loan her 1000 rupees to purchase medicines and take a cab back home! In her panic-stricken state, she had rushed to reach my clinic, and had forgotten her purse at home. She further added that she was the same patient for whom my receptionist had asked for Rs 100 earlier.

I handed Rs 1000 to her. After she left I was thinking that how much she believed in me, and how sure she was, that I would see her child and would also sponsor her whole trip to my clinic!!  Some patients do expect so much from a doctor 🙂

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Just few months back I got a phone call from a mother of a newborn baby. She told me that she got my number from Google while she was searching for paediatrician. She further added that she was very worried about her newborn son, and had many questions about the child. I asked her to book an appointment through a mobile app  and meet me.

Next morning she was the first patient at my clinic with her 20 day old son, Aatish. Her husband also accompanied them. Both the parents were looking very anxious. It was quite normal for first time parents to be anxious. I quickly examined Aatish and concluded that baby was absolutely fine. Parents had a list of question, which they started shooting at me one after another. I patiently gave answer to all of them. The consultation went for 25 min that’s the maximum time I give to a patient. Usually after answering all questions the parents gets relaxed and will have a faint smile of relieve on their face, but this couple was still looking anxious and worried. I could not help myself and asked them that why they are still anxious though there is no issue with their child and I answered all their doubts best to my ability.

Mother replied “Doctor I conceived after 6 yrs of our marrriage, so this child is very precious for us that’s why we are so worried.” I instantly understood their problem. I told them that they had to let go of their past baggage of pain and suffering then only they can enjoy present joy of parenthood. My words immediately struck the cord with them, and I could see the parents getting relaxed immediately, as they completely understood the futility of carrying a baggage. They thanked me and left my clinic.

Carrying a baggage is never useful, whether it comprises of happy memories or painful. Baggage interferes with our present and never lets us experience the present completely. So to live the life completely let go of your baggage..

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As a parent, you never want to believe that your precious bundle has a problem. But when it comes to autism, catching it early—ideally by the age of eighteen months—makes a huge difference. But no matter your child’s age, don’t lose hope. Treatment can reduce the disorder’s effects and help your child learn, grow, and thrive. Discussing with you all early signs of Autism

• Doesn’t make eye contact (e.g. look at you when being fed)
• Doesn’t smile when smiled at
• Doesn’t respond to his or her name, or to the sound of a familiar voice
• Doesn’t follow objects visually
• Doesn’t point or wave goodbye, or use other gestures to communicate
• Doesn’t follow the gesture when you point things out
• Doesn’t make noises to get your attention
• Doesn’t initiate or respond to cuddling
• Doesn’t imitate your movements and facial expressions
• Doesn’t reach out to be picked up
• Doesn’t play with other people or share interest and enjoyment
• Doesn’t ask for help or make other basic requests

Burn is one of the common accident injury in childhood.So discussing the first aid for a burn becomes important

Dos

• Remove the child away from the substance which has caused burn
• Wash the burned area of skin under tap water for 10 minutes
• Apply some antiseptic ointment [ Soframycin,T bact ,Betadiene or Neomycin] on the effected area
• Give one dose of paracetamol to relieve pain
• Consult a doctor so that he can judge the severity of burn

Don’ts

• Applying toothpaste , turmeric or coffee on the burned area is not advised as none of the things are sterile and can cause infection of the skin
• Tying clothes on the burned area, again increases the chances of infection of the effected area

As the dengue cases are on the rise so also all rumours and wrong information. So I thought through this post I will try to give some clarity and information to parents about the disease.

Dengue Fever

• Is a viral infection which is transmitted by mosquitoes
• Dengue is not transmitted by touch or eating together or staying together
• It gets transmitted only when a mosquito bites a dengue patient and then same mosquito bites a healthy child
• Symptoms of Dengue are fever [ moderate to high] , rashes [ on palms and front body most commonly seen], vomiting , body pain, mild cough and cold
• Blood test – Dengue test comes positive , platelet low, haemoglobin slightly high
• If diagnosed early can be treated successfully

Advice

•  Any fever persisting more than 2 days for a child, please consult your pediatrician
• To treat fever use only Paracetamol/Calpol/Crocin

Prevention

• Don’t allow water to stagnate near your house or balcony as this becomes the breeding place of mosquitoes
• Put nets on the windows
• Mosquitoe repellents like Allout etc can be used in homes
• While taking small babies to park or garden make your they are properly covered as mosquitoe bites commonly on expose parts

What is not Dengue?

• Fever with bad loose motion
• Rashes which itch
• Fever with ear pain

Dear Parents ,

In my pediatric practice I regularly see children with damaged skin and reason for it many times is that parents are not aware of how to take care of the skin.I will discuss this topic under 3 headings

1.  Child age < 1 yr

2. Child age > 1 yr

3. Common practices that damages the skin

1. Child age < 1 yr

There is a triad to take care of skin, first is use oil to massage [ olive oil is considered good] ,then giving bath by using soap at skin pH [ eg. Tedibar , Cetaphil or Sebamed] and at last using a body lotion . Now I will elaborate these points. Oil massage should be gentle and the only purpose of massage is that skin absorbs the oil, so please no extra pressure to be applied while giving massage to the baby.Next is moisturization of theskin.It’s a common practice that body lotion is used once in a day but there is no rule as to how many times in a day body lotion can be used.So feel free to use it once, twice or thrice according to the need of the skin.

2. Child age > 1 yrs

Here also we follow triad of using soap at skin pH ( eg. Tedibar, Cetaphil or Sebamed) , body lotion and sunscreen lotion. Oil massage can be continued or stopped according to parents choice . There are lots of apprehensions about the safety of sunscreen use , I would like to assure parents the sunscreen use is completely safe for a child more than 1 year. And while buying it just see that the SPF of the lotion is above 25 for good sun protection.

3. Common practices that damage the skin

I would like to enumerate these – like not using body lotion , using gram flour/ turmeric and milk for bath, not using sunscreen lotion, using dettol in washing clothes are few common practices.

I hope the article was helpful. Please feel free to leave comments.

The most common complain I hear from parents is that my child doesn’t eat healthy food items like dal , fruits , vegetables and eggs. So this blog I am devoting to how to make these food items interesting so children eats them without complain

Dal / Pulses

What I see that children like eating stuff parathas more than other food stuffs so for making dough of the chappati/ paratha use the cooked dal instead of water.

Vegetables

• Green leafy vegetables can be added to dal while boiling the dal. So instead of plain dal you can make palak dal.
• Beans, carrot or onion can be fine chopped and can be mixed with eggs or dosa batter, finally making omelette or dosa out of it

Fruits

• fruit custard
• fruit cream [ with the help of Amul cream and sugar]
• Fruits , curd and honey can be blended together to make a fruit shake

4. Eggs

For children who don’t like eating boiled eggs or omelette , French toast is a good option in which bread can be soaked in egg and after that fry it on a pan.

I always tell parents that in case of children what you give them to eat is less important, but how you give or present it, matters more

What is stammering?

Although the quantity and type of the stammering differs for each individual, the following features are more usual. Remember that even if your child is showing a few of these characteristics in their speech this does not necessarily mean that your child has developed a full stammering problem. Typically many young children repeat words and syllables:

– Repetition of whole words, e.g. “and, and, and, then I left”

– Repetition of single sounds or syllables, e.g. “c-c-come h-h-here mu-mu-mummy”

– Prolonging of sounds, e.g. “sssssssometimes I go out”

– Blocking of sounds, where the mouth is in position, but no sound comes out

– Muscle tension – around the eyes, nose, lips, neck, or in arms, legs, chest etc. Extra body movements may occur as the child attempts to ‘push’ the word out: stamping a foot, shifting body position or finger tapping

– Avoiding eye contact during a moment of stammering

– Breathing may be disrupted, for example, the child may hold his breath while speaking or take an exaggerated breath before speaking. Generally the flow of speech is unevenly disrupted and this may cause distress to the speaker and the listener

Sometimes the child adopts strategies to try and minimise or hide the problem, for example:

– Avoiding or changing words – the child may say “I’ve forgotten what I was going to say”, or may switch to another word when he begins to stammer, e.g. “I played with my br- br- br… my sister on Saturday”

– Avoiding certain situations – for instance, speaking in assembly or asking questions in class

– Some children become so adept at hiding their problem in this manner that they may appear fluent, or just become very quiet

What causes stammering?

This debate is going on from centuries still any one factor is not found solely responsible for stammering. Mutiple factors come in play in a child who stammers like

– Physical like development problem

– Genetics

– Speed of talking

– Personality of a child

– Parents anxiety

– Time pressure

– Speech problem

-Enviornmental like more in school

Psychological impact of stammering

Stammering decreases child’s confidence and effects his academic performance also. Constant teasing from family and friends makes the thing worser.

How to decrease stammering

These are few suggestions which parents can ask there child to do

– Try to take your time rather than rushing

– Speak a bit more slowly

– Say what you want to say

– Be patient with yourself and say what you want to say

– Pause for a moment before you start to speak

– Don’t always expect the worst – sometimes it goes well

– Remember to congratulate yourself for trying things out

– Try to have a go at things

– Don’t force the words – it just makes them harder to say

– Get plenty of sleep

-The faster you try to speak the less you will manage to say

– Talk about it rather than trying to hide it

Professional Help

There are many centres in Bangalore which run courses for adults and children. Where they train them and make them practice regularly to speak fluently.

With parent’s support and professional help a child can overcome his stammering problem to a large extent.