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Kidney Stones in Children
Urolithiasis or nephrolithiasis, which is commonly known as kidney stones occur rarely in children. Kidney stones cause excruciating pain in children and parents tend to panic and become helpless.
What are Kidney Stones?
Collection of some materials, such as minerals and acid salts form small stone-like structures within the urinary tract. These stones block the free flow of urine causing pain. Although kidney stones are rare in children, the number of cases where children develop stones is growing. Generally, children recover without future complications. However, if kidney stones are not treated on time, it can lead to kidney problems.
How do Kidney Stones Develop?
The urinary tract comprises of two kidneys, ureters, a bladder and the urethra. The urine contains substances such as calcium, cysteine, oxalate and uric acid. When the level of these substances is higher, they crystallise. If these crystals are small, they move within the urinary tract and pass out of the body through urine. If they are not flushed out, they rest on the kidney and increase in size. As the size increases, it causes pain and sometimes blocks urine flow. Stones that are less than 0.2 inches can pass through easily.
How Common are Kidney Stones in Kids?
The chances of kidney stones developing in adults are higher when compared to children. Typically, most of the children with kidney stones have an existing medical condition, which increases the chances of them developing kidney stones.
Types of Kidney Stones
There are four types of kidney stones, which are:
1. Calcium Stones
These stones are the most common type among the four. There are two types of calcium stones:
Calcium oxalate - a combination of calcium and oxalate
Calcium phosphate - a combination of calcium and phosphate
2. Cystine Stones
These stones are rare and occur due to genetic disorders. Cystine is a chemical that the body makes naturally. In people with genetic disorders, cystine leaks into the urine through the kidneys.
3. Uric Acid Stones
If the urine is acidic, there are chances of developing uric acid stones. These stones can be formed by the acid itself or by combining itself with calcium.
4. Struvite Stones
These stones develop in people who have recurrent urinary tract infections. In some Urinary Tract Infections (UTI), bacteria make ammonia. The ammonia in urine can cause stone formation. These stones are made up of phosphate, ammonium and magnesium.
What Causes Kidney Stones in Child?
Following are some of the causes of developing kidney stones:
Higher mineral content in the urine.
Highly concentrated urine, wherein the water content is low, and the mineral content is high.
Less water intake or dehydration.
Some stones develop due to genetic disorders. Although these cases are rare, inborn metabolic issues lead to stone formation. The body makes stones due to certain genetic conditions.
A family history of kidney stones.
Defects in the urinary tract or persistent UTI.
Obesity and reduced activity.
A diet that has high sodium, protein, or both.
In some cases, the causes for developing kidney stones are unknown.
Kidney Stone Signs and Symptoms in Kids
Following are some of the common symptoms
Abdominal or back pain
Hematuria or blood in the urine
Frequent urination
Nausea or vomiting
The urgency to urinate
Recurrent UTI or urinary infections that exist for longer periods
Fever
How is Kidney Stone Diagnosed in a Child?
To ascertain the presence of kidney stones and treat children, physicians recommend a comprehensive diagnosis. Typically, a complete diagnosis includes:
Understanding the child’s medical history
Physically examining the child
Performing lab and imaging tests
Medical History
The first step in diagnosing involves understanding your child’s medical history. This helps the doctor in understanding whether there is a family history of kidney stones or any other genetic disorder that can be the cause. Previous conditions and treatments give doctors a clear idea about the child’s health conditions.
Physical Examination
Typically, a paediatric urologist and a paediatric nephrologist physically examine your child and also discuss the child’s health and dietary intake, specifically fluids. If you have managed to collect a stone that was passed out while urinating, the doctor examines it and sends it out to the lab for performing further tests.
Lab and Imaging Tests
Doctors recommend a couple of lab tests to diagnose various aspects about the kidney stones. Following are some of the tests:
Urine and Blood Tests - Urine analysis is important to determine the factors that lead to stone formation. For example, high calcium levels in the urine can cause stones. Blood tests are used to identify other risk factors that can be the cause or might affect the child.
Genetic Tests - As some genetic disorders can cause kidney stones, genetic tests are performed to evaluate and determine the risk factors.
Scanning Tests - Doctors examine the urinary tract for kidney stones by performing an ultrasound scan. If the ultrasound results are inadequate, a Computed Tomographic (CT) scan is performed. Sometimes, an X-ray is also performed.
Imaging Tests - Imaging tests are used to determine the precise size and the exact location of the stone, which is useful during treatment.
Other Tests - Determining the chemical composition of the stone, if it has been collected while urinating can help in identifying the stone type. It also helps in analysing the causes of the stone formation.
Risks
Following are some of the factors that increase the risk of developing kidney stones in children:
If the child has a past history of kidney stones, there are chances of it reoccurring.
The fluid intake by a child directly impacts the urine formation. Drinking less water or other fluids leads to less urine formation, which increases the risk of developing stones.
Diets that are low in carbohydrates are known as ketogenic diets. Following this diet increases the risk of kidney stone formation.
Children who have cystic fibrosis are at a greater risk of developing stones.
Abnormalities in the kidneys, ureters, or bladder since birth increase the risk of developing kidney stones.
Use of some medicines contributes to stone formation in the urine. For example,
furosemide (Lasix)
acetazolamide (Diamox)
allopurinol (Aloprim, Zyloprim)
Rare genetic disorders that are inherited from parents or from the family line can increase a child's risk of developing kidney stones.
Complications of kidney stones in kids can occur due to increased intestinal oxalate absorption (Inflammatory bowel disease), which impacts the oxalate level in the urine.
Treatment
Some of the following treatments are used to eliminate the stones:
Extracorporeal Shock Wave Lithotripsy (ESWL) is one of the common treatment methods used in children. A lithotripter is used to send acoustic shock waves through the skin to crush the stones. These stones can move easily through the urinary tract and pass out of the body. ESWL does not need incisions but is performed under anaesthesia.
Ureteral Stent is required if there is a blockage in the ureter or the ureter is narrowing. The ureter is a tube that transports urine to the bladder from the kidney. A stent is a soft tube that is placed in the ureter to help urine flow. A child with a stent can move around but should avoid strenuous activities.
Percutaneous Nephrolithotripsy(PCNL) is preferred for treating large kidney stones. In this method, a tube passes through an incision in the child’s back. The tube is inserted into the kidney, and the doctor uses nephroscope to locate and remove the stones.
Nephrostomy Tube Procedure for Kidney Stones uses a small tube to drain the urine. If the kidney stone is blocking urine drainage, this tube is used so that damage to the kidney and infections can be curbed. In this procedure, an external bag is used to drain the urine.
Ureteroscopy uses a small scope, which is sent through the urethra into the urinary bladder, then into the ureters and kidneys. Cameras fixed to the scope help doctors to locate and remove stones using various instruments.
Home Remedies
Following are some home remedies:
Increasing the fluid intake helps in increasing the urine formation and decreasing the quantities of mineral components that form stones.
Basil is known to help in stabilizing uric acid levels. This can prevent kidney stone formation. It also has acetic acid, which helps in dissolving some stones.
Pomegranate's antioxidant properties might reduce the chances of developing stones.
How to Prevent Your Child from Developing Kidney Stones?
After treating the kidney stones, you might wonder, “Can children get kidney stones, again?” Children with a history of kidney stones have a chance of developing it again. However, the precautions can be taken to minimize the chances:
Drinking water is the best solution.
Additionally, continuous monitoring to determine the presence of new stones is helpful.
Kidneys are important organs and damage to it can be harmful. Although kidney stones are uncommon in kids, it is always better to take precautions, wherever required.
Also Read: Urinary Tract Infections in Kids Kids Read more
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Genetic Testing during Pregnancy - Purpose, Types & Accuracy
You may have to undergo various tests and screening during pregnancy to ensure your baby’s well-being. Sometimes parents may be advised for genetic testing during pregnancy, this may be performed to overrule any genetic abnormalities in the unborn baby. In the following article, we shall be discussing the purpose, types and various other aspects of genetic testing.
What is Genetic Testing?
Genetic testing involves testing the blood of both the parents to look out for abnormal genes, which the parents may pass on to their baby. In case one of the parents has abnormal genes, there may not be any genetic complications. In case both the parents have an abnormality in their genes, even then there is only a 25 percent chance that your baby may have faulty genes too.
When is Genetic Testing Ideally Done in Pregnancy?
It is recommended that genetic testing should be done before you plan to get pregnant. And where the pregnancy may be unplanned, it is recommended that you opt for genetic counselling at the earliest.
Why is This Testing Recommended?
You may be advised genetic baby testing or genetic foetal testing by your doctor because of any of the following reasons:
If you are a woman who has had two or more than two miscarriages. Sometimes, certain chromosomal deformities in the foetus may lead to a spontaneous miscarriage.
If you, your partner or a close relative has some kind of genetic disorder.
If you already have a child who is suffering from birth defects (due to genetic reasons).
If you are an older woman, 35 years or more then genetic testing for pregnancy over 35 may be recommended.
If you have had a stillbirth with your baby having prominent physical signs of genetic illness.
If the prenatal screening results were abnormal.
These are some of the reasons for which your doctor may recommend you to go in for genetic testing.
What Are Common Genetic Diseases
Here are some common genetic diseases that may occur due to faulty or deformed genes:
1. Thalassemia
Thalassemia is a blood disorder which may lead to complications like anaemia, liver ailments or problems in bone growth. In some cases, if a baby has this genetic disorder, he may not even survive.
2. Cystic Fibrosis
Cystic fibrosis is a fatal genetic condition that may cause life-threatening complications in your baby. It may cause severe digestive problems or may even lead to lung damage.
3. Sickle Cell Disease
This genetic problem may lead to various health complications such as anaemia, weakened immune system etc.
4. Fragile X Syndrome
This may lead to mental retardation, learning disabilities and developmental complications in your child.
5. Tay-Sachs Disease
This genetic disorder adversely affects the nervous system of your baby and thus, may lead to various problems of the nervous system, especially during early childhood.
6. Duchenne Muscular Dystrophy
This genetic disorder becomes prominent before your child may begin his formal education, which is around 6 years of age. This may lead to weaker muscles and may also cause fatigue; it may progress from the legs to the upper part of the body.
Main Types of Prenatal Genetic Tests Performed during Pregnancy
You may wonder what genetic testing is done during pregnancy? Well, there are two main tests that your doctor may recommend, screening tests and diagnostic tests. Here is more information on how these prenatal genetic tests may be performed during pregnancy to check for any genetic glitches:
1. Screening Tests
The screening tests may tell if you have a baby with genetic ailments.
a. First Trimester Combined Screening Test
Genetic testing during pregnancy first trimester is done through blood tests during your 10 to 12 weeks of pregnancy which may also include an ultrasound at around 11 to 13 weeks of pregnancy. The results of both these tests may help in establishing the risk of trisomy 21 (Down syndrome) or trisomy 18. However, the tests do not tell whether or not your baby may have these ailments.
b. Maternal Serum Screening
For genetic testing during pregnancy second-trimester, blood test may be conducted around 15 to 20 weeks of pregnancy to establish the risk of neural birth defects (spina bifida), Down syndrome or trisomy 18. In case you are at risk, you may be recommended to go for further tests.
2. Diagnostic Tests
The diagnostic tests may tell you about the defects that your baby may have.
a. Chorionic Villus Sampling (CVS) (11 to 12 weeks)
This test involves taking a sample of the placenta and testing it for any genetic diseases such as cystic fibrosis, Down syndrome and others. In some rare cases, a woman may have a miscarriage due to this test, though the chances are only 1 in a hundred.
b. Amniocentesis (15 to 18 weeks)
This test involves testing the amniotic fluid to check for any genetic disorders such as Down syndrome and others. Sometimes this test may lead to a miscarriage, though the chances are very minimal (1 in every 200 cases).
c. Ultrasound Scans (18 to 20 weeks)
This test may be done at a bit later stage in pregnancy to identify structural and physical abnormalities, limb defects, heart abnormalities and spina bifida.
What Do the Results of Prenatal Genetic Testing Mean?
The test results of the prenatal genetic testing can be positive or negative. If the test results are positive this means that your baby may be at a higher risk of having various genetic abnormalities but that does not mean that your baby will definitely have them. On the other hand, if the test results are negative then it means that your baby has low chances of having any genetic diseases; however, it does not entirely rule out the possibility.
The genetic testing that involves amniocentesis or Chorionic Villus Sampling, may give you more comprehensive and definite results in comparison to other testing methods. After your test results, your doctor may guide you to take help of a genetic counsellor in understand your case and also on the further course of action.
How Accurate Are These Genetic Screening Tests?
Just like the possibility of any test results going faulty, there are chances that genetic screening tests may show faulty results too. If the tests results are positive but there is not any problem, then it is called false-positive test results. Whereas, if the test results are negative but there is a problem, then it is called false-negative test results. You may get in touch with your doctor to know more about your test results and their authenticity.
Are there Any Risks of Genetic Testing While Pregnant?
Pregnancy may make you sceptical because everything that you do may have an impact on your baby too. So, you may wonder are there any genetic testing pros and cons that you should know about. The first and foremost thing to understand is that genetic testing is a personal choice. So, if you are thinking whether or not genetic counselling have any risk, the answer is that it may have more emotional stress rather than physical stress. Because it can be extremely disheartening and difficult to know that you may have a baby with a genetic disorder, which may adversely affect your child’s life.
Also, the screening tests only tell you whether you at a risk of having a baby with a genetic disorder and to know defects you will have to undergo diagnostic tests. Where some parents may want to know about a genetic disorder to prepare better for their baby, on the other hand, others may want to know to terminate the pregnancy. However, there are some parents who do not want to know whether or not their baby may have any genetic disorder. It is entirely up to you as a parent to decide, if you want to go in for genetic counselling or not.
If you wish to go for genetic testing or not, it is absolutely your decision to make. However, if you think you may or your partner may have any kind of genetic disorder, then it will be a good idea to talk to your doctor about the same and know what best you can do to avoid complications in your baby.
Also Read:
Double Marker Test during Pregnancy
Triple Marker Test in Pregnancy
Quadruple Marker Test During Pregnancy Read more
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Dear 2020, you actually won as the new year says - 2021 (read as twenty twenty won)!
Dear 2020,
You were unpredictably memorable. You brought the entire humankind to a stop for once. We were stuck in this rat race since ever. The race to achieve one thing after the other. Eventually forgetting that we are spending our entire life in the hope to create a better life for ourselves.
This pandemic has hurt many by taking away their loved ones. On the other hand, it was a reality check for others. A reality check on themselves and how their lives affect their near and dears. We got to know ourselves better.
Every individual utilised this time in their own way. Some took a back-seat and took rest after years of work. Those who could get to be with their families, they worked on strengthening their bonds. Some learnt and polished life-skills like cooking up a meal. It is a survival skill after all. Other learnt to swim or picked up a sport that they had been keen on learning but had to put away the idea due to non-availability of time. TIME- we got ample time to reflect upon ourselves.
Never forget, all these while doctors, the medical fraternity, security personnels and everybody consisting the Frontline workers... they toiled day and night to try to save as many lives possible. They have been doing all they can to make sure that the sick are tended well and try to curb the virus however possible.
I for one, am grateful that I got to spend time with my parents and my toddler. We went to Nani's for Holi celebration and were there with them all this time. Citing the pandemic restrictions and regulations, it was the best decision. Moreover, it would have been such a pain to look after my fire-cracker, wall climbing, energy-bomb baby by myself. She had the time of her life. Making friends with birds, peacocks, ducks and bees. Running around under the blue sky on open green grasslands, eating fresh produce from the farms and jumping into cool rivulets.
Thankyou 2020 for reminding us the important things in life, for helping us see who actually cares about us and refreshing our minds to what are we living for. We live once and our lives are so fragile that we never know what tomorrow brings. We got to be grateful and appreciate even small things like the sun that rises every day and the wind that blows, so we can breath.
Dear 2020, you have won against us humans. And shown us the better way. Thank you. Read more
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Tofu Lettuce Tomato Sandwich
The tofu tomato sandwich is a quick fix healthy snack. The tofu provides all the protein one needs in a day. Tomatoes are rich in vitamins A and C and keeps our soft and supple. The tomato-tofu sandwich is easy to prepare too.
Serves
Preparation Time
Cooking Time
2 People
5-10 Minutes
5-7 Minutes
Ingredients
200 g Tofu (drained and rinsed)
2 tbsp hung curd
4 slices wheat bread (toasted)
2 pieces lettuce leaf
1 tomato (sliced)
1/2 tsp oil
1/2 tbsp mustard sauce
1/2 tbsp soya sauce
1 tsp oil
1/2 tsp tobasco sauce
Method
Step 1
Pre-heat oven to 475°F. Grease a baking sheet with oil.
Step 2
Combine mustard, soy sauce and 1/4th tsp tobasco sauce in a small bowl.
Step 3
Slice tofu crosswise into two 1/2-inch-thick pieces. Pat dry with a paper towel and place on the prepared baking sheet.
Step 4
Using a spoon, spread half the mustard mixture on one side of the tofu. Turn the slices over and spread the remaining mixture on the other side.
Step 5
Bake the tofu for 20 minutes.
Step 6
Combine hung curd with the remaining 1/2 teaspoon tobasco in a small bowl.
Step 7
Spread the mixture on toasted bread. Divide the tofu, lettuce and tomato among 2 slices of toast and top with the remaining toast to make 2 sandwiches. Cut in to half and serve.
Nutritional Information
Calories
255 K cal
Proteins
17.1 g
Fat
7.35 g
Carbohydrates
27.6 g
Read more
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This Is How You Can Get Your Preschooler Ready to Read!
With all the distractions that kids have today, it is harder for them to learn to read. So much so that it seems like the people behind the cutesy cartoons, fun smart phone and tablet games all seem to be conspiring against you!
Since reading is an essential skill for your child, it is up to you to get your preschooler ready for it. Here's what you should do.
1. Surround Your Child with Books
For your child to get interested in reading, he should first know and be attracted toward what a book looks like. Get a couple of books that you think will appeal to your child. If you are not sure what to get him, pick books that have lots of images in bright colours. It is no secret that kids love pretty and colourful images.
2. Make Sure The Books Are Age Appropriate
No point buying pretty books if they contain words that are too hard for your little one to understand. For this reason, it is important that you buy books as per her age. Most books have the reading age specified on the jacket, or if you are buying them online, in the product description or images. Generally, books for preschoolers are designed so that they take about 15 minutes to read.
3. Play Word Games to Increase Phonemic Awareness
Which kid doesn't love games? Phonemic awareness is when one is able to identify and think of sounds in spoken speech. You can help your child to identify sounds by making them easier to hear. For example, ask your child, “I like to eat ba-ba-ba-bananas. What do you like that begins with ba-ba-ba?” His answer should be something like, “I like to play ba-ba-ba-basketball.”
4. Help Him Understand The Association Between Written Words and Spoken Words
Until now, your child has only used picture books. Now that he is growing up, he is ready to handle books with words and pictures. It is necessary for you to pick such books as your child needs to know that she has to read words, and the pictures she sees only illustrate these words. To help him, understand that the words in the book are also used in everyday life. All you have to do is ensure that he is paying attention. You can check if she is really listening to you by asking him questions about the story once you have finished reading. Listening is a key component of phonemic awareness, so don't forget to check on your child while you read to him.
5. Make Reading Fun and Interactive
Read aloud and smile while you do it, and your child will attempt to do the same. If you look like you are having a good time, your child will also learn to enjoy reading. Instead of seeing it as a chore, she will look forward to it as a fun activity. For more ways to get your child to enjoy reading, click here. Ensure that your child is involved in the reading process. Let her pick the book, turn the pages, and attempt to read aloud too. This will keep her engaged and also help build her vocabulary.
Improved listening skills, longer attention span, and a better imagination are just a few advantages of reading to your preschooler. In fact, various studies have proved that students who perform well in school started reading before they even entered preschool. And although the world is changing rapidly every day, reading is one thing that will never lose its significance. Read more
Dr Ghouse has added a new answer
Expecting Mom due in 4 months
6 hours ago
Q. hello everyone, please suggest me, am getting pain in lower abdomen right side, anybody plz tell me why am getting pain pls
Dr Ghouse
Paediatrician
6 hours ago
A. this needs proper examination to find out problems like appendicitis. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Rashmi has added a new answer
Expecting Mom due in 2 months
5 hours ago
Q. hi mam for 2days I am seeing my baby bumb decreasing is it cause of worry?
Rashmi
Mom of a 9 yr 8 m old girl
5 hours ago
A. I don’t know how the bumps of your child decreasing that’s not fair to me second you have not mentioned the current age of your child to do it and there is no clarity in the query it would be difficult for me to help us so if you don’t mind can you please repost with all the necessary details associated with your question
Dr Ghouse has added a new answer
Trying To Conceive
4 hours ago
Q. Hello I had my period missed for April month and today I got my period. Is it normal to have period after 1 month or is there anything I should be worried about? Iam worried please let me know if that's ok or should I consult my doctor
Read moreDr Ghouse
Paediatrician
3 hours ago
A. consult your doctor for any evaluation required. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Dr Ghouse has added a new answer
Guardian of 0 children
3 hours ago
Q. hllo am in 34 week of pregnancy,cramps in my hand and foots,my pulses is very fast,i feel tiredness internally,are these symptoms are normal
Dr Ghouse
Paediatrician
3 hours ago
A. get investigations particularly hemoglobin level. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Dr Ghouse has added a new answer
Guardian of 0 children
3 hours ago
Q. i feel some fever internally also
Dr Ghouse
Paediatrician
3 hours ago
A. please check the temperature and get the investigations. fever can be because of different reasons most of the times viral bacterial sometimes due to less immunity there can be recurrence better to treat only with paracetamol if the fever more than 100degr
Rashmi has added a new answer
Guardian of 0 children
2 hours ago
Q. Now I am having pain till then my miscarriage has been done at home
Rashmi
Mom of a 9 yr 8 m old girl
2 hours ago
A. I’m sorry I’m unable to understand your query as you haven’t given any detail about it so whatever the situation is you should get a check with your gynaecologist the doctor would be able to give you better help in whatever treatment of precaution you need to require further
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