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Juvenile Idiopathic Arthritis(JIA) In Children
Medical conditions that plague the joints are not only prevalent in adults but can be seen in children too. Juvenile idiopathic arthritis is one such condition characterised by swelling of the joints in young children.
If your child is diagnosed with this condition, it is best that you gather all the information required to prepare yourself for her care.
What Is Juvenile Idiopathic Arthritis?
Juvenile idiopathic arthritis (JIA) is an autoimmune disease which causes tissue that lines the joints to swell. The tissue called as synovium gets inflamed and leads to intense pain in the joints. The disease shows up in children between the ages of 6 and 16 and has no known cause as of now. In autoimmune diseases like this, the immune system of the body turns against the cells of the body and attacks them after identifying them as hostile.
Types
There are seven types are JIA that are recognised.
Systematic Arthritis
Also called as Still’s diseases, this affects the child’s entire body. It causes symptoms of high fever in the child which may increase around the evening and disappear. It can also cause rashes and make the child appear pale. Systematic arthritis is also known to affect internal organs of the body like the heart, spleen, liver and the lymph nodes. It can enlarge the lymph nodes and the spleen.
Oligoarthritis
The condition is also called as juvenile rheumatoid arthritis and affects the joints at the knee, ankle and the wrist. It does not affect more than five joints. Oligoarthritis can also affect the iris in the eye and is more common in girls than boys. Most children outgrow this condition as they grow older.
Polyarthritis - Rheumatoid Factor Negative
This condition is more common in girls than in boys and affects about to four or five joints. Joints on the hands and the other joints like knees, ankles, neck, feet and the hips, which bear weight may also be affected. It may also cause mild fever and subject the nodes in the body to pressure as the children sit or lean.
Polyarthritis - Rheumatoid Factor Positive
This variant of JIA exhibits itself like adult rheumatoid arthritis. The kids of this condition may be diagnosed with a protein called rheumatoid factor (RF) or a CCP antibody (anti-cyclic citrullinated peptide) in the blood. These kids may be more prone to risks of damage caused by erosions when compared to kids with other types of JIA.
Psoriasis Arthritis
In addition to arthritis, children also have the skin condition called psoriasis in this type of JIA. Psoriasis presents itself in the form of rashes on the elbows, knees, behind the ears, etc.) Very often, children are diagnosed with this even when they may not show evidence of the skin condition but they have a family member who has the condition. Such kids may have pitted nails on the fingers and the toes.
Enthesitis-Related Arthritis
Children with this form of JIA suffer pain in the legs and the spine. It affects the places where tendons connect to the bones, also called entheses. The inflammation can cause pain in the hips, the back or their knees. This type of JIA often affects boys above the age of 8 who have a male relative with a history of ankylosing spondylitis or arthritis of the back.
Undifferentiated Arthritis
The features of arthritis do not correspond with any of the mentioned categories or can be related to multiple types of arthritis.
What Are the Causes of Arthritis in Children
Arthritis is an autoimmune disease and has currently no identifiable cause. However, scientists and researchers believe that it can be linked to the following factors.
Environmental triggers or viruses may cause the immune system of the body to recognize the lining of the joints as a foreign body, thus attacking it. This causes inflammation in the joints.
Certain infection may cause reactive arthritis which subsides after a few weeks. It hasn’t been found out whey the condition doesn’t subside in children who develop JIA.
Children who have a family member with rheumatoid arthritis or other rheumatologically conditions have a higher chance of developing JIA. However, this does not indicate that it is genetically passed down.
Signs and Symptoms
The symptoms of arthritis in children are very vague and do not specifically indicate the presence of the condition. It is possible that children don’t show symptoms at all. Some of the probable symptoms of JIA are:
Stiffness in the joints
Swelling, pain, and tenderness at the joints
Fever
Weight loss
Rashes
Irritability
Fatigue
Blurred vision
Redness or pain in the eye
Limping
Lack of appetite
Diagnosis and Tests
Since there is no specific test for juvenile idiopathic arthritis, a form of eliminative diagnosis is conducted to rule out similar conditions like Lupus, bone disorders, fibromyalgia, etc.
The doctor will require a complete medical history of your child and conduct a physical exam. Additional tests may also be performed to determine the type of arthritis in the kid.
Tests may include:
Complete blood count test can check the red blood cells, the white blood cells and the platelets to determine the appearance and the amount of the cell type and narrow down on any specific medical condition.
Blood culture is conducted to detect bacteria in the bloodstream which may be the cause of infections.
Bone marrow biopsy is conducted to test for leukaemia.
Erythrocyte sedimentation rate is checked to see the rate at which the red blood cells fall to the bottom of the test tube. The rate is high in people suffering from conditions that cause inflammation.
The level of C-reactive protein (CRP) is also checked. The liver releases this protein into the bloodstream if there is a chance for infection or inflammation. The level of this protein can also rise in the event of arthritis.
Rheumatoid factor (RF) or cyclic citrullinated peptide antibody (CCP) are also tested for a specific kind of JIA. However, this is more common in adult arthritis.
ANA (antinuclear antibody) is conducted to identify autoimmune diseases. It can also indicate if the child is likely to have eye diseases as a result of JIA.
X-rays or an MRI of the joints are taken to check for bone damage.
A bone scan may be done in the event of unexplained pain in the bone and the joints.
An orthopaedic surgeon may also perform a sampling of the joint fluid and the synovial tissue.
Complications
If symptoms of JIA are noticed in your child, it is essential that you take the child to a doctor and seek medical advice. Left untreated it can have the following complications.
Severe damage to the joints.
Limit growth. Certain medications prescribed for inflammation are also known to cause musculoskeletal problems in children.
An inflammation of the eye called uveitis
The eye condition, when not treated, can cause glaucoma, cataract or even blindness.
Deformities in the joints of children who receive no treatment.
A severe form of the condition, when not treated, can also lead to loss of hand function in the child.
Treatment and Management
Treatment of juvenile arthritis can include physical therapy, medication and a combination of exercises. The course of treatment is also dependent on the type and the severity of the condition.
Medications
Non-steroidal anti-inflammatory drugs (NSAIDs) can be prescribed to relieve pain and inflammation in kids. These include Ibuprofen drugs like Advil, Motrin, etc. Dosage for these medicines is determined by the condition.
Corticosteroids may also be prescribed to treat instances of arthritic flares. However, it has side effects like slow growth, weight gain, skin changes, etc. Hence, it is usually not prescribed to children.
Disease-modifying anti-rheumatic drugs (DMARD) like methotrexate may be given in case the NSAIDs fail to relieve inflammation and pain. Hydroxychloroquine, sulfasalazine and TNF drugs that tumour necrosis factor may also be given to children with JIA.
There is also a new category of drugs called biologics that can be given to kids with JIA. Injections and IV infusions may be performed on a regular basis at the hospital.
2. Physical Therapy
Physical therapy can help your child improve movement. The therapist will suggest certain exercises to reduce the stiffness in the joints, increase flexibility and improve strength in the child. Physical therapy exercises will be coined based on the specific condition of the child.
3. Regular Exercise
A habit of regular exercise can help your child overcome a lot of pain and provide the support necessary to the joints. It can also improve motion in the joints. Warm-up activities and safe exercises like walking, swimming, cycling are recommended for children. You can also check with your doctor about any impact sports that your child needs to avoid due to the risk of serious injury.
Timely treatment of juvenile idiopathic arthritis can help the child overcome pain and lead a relatively comfortable life. It is important that you track the development of the child and provide a nutritious and balanced diet to your child and aid in the recovery process.
Also Read: Rickets in Children Read more
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Raising a Compassionate Child
Being kind and caring, is a virtue that is developed over years of practice. Hence, it is very important for parents to instill the values of compassion and kindness in their children at a young age. Let us understand the ‘why’ and ‘how’ of raising your kids to be compassionate.
Compassion will teach your kids, how to develop love for everyone, including themselves and lead a meaningful life. It will make them care for the environment around them and be more respectful. However, experiencing the feeling of compassion does not come naturally to all kids. It is something that they will pick up only when the people around them will show them acts of being compassionate and kind.
As Dalai Lama very correctly said, “If you want others to be happy, practice compassion. If you want to be happy, practice compassion.”
If you are worried about your kid not showing compassion at all, don’t worry. There is a field of study called ‘science of altruism’ which reveals that all kids have the feeling of compassion hidden inside them. We just need to find ways to discover and nurture that feeling. Let us look at ways of how you can teach your kids to be compassionate:
1. Positive Modelling
Home is the best place to learn, and kids tend to keenly observe and learn from what adults do. Hence, it is very important for you to never let go of any opportunity to practice the act of compassion in front of your kids. Help an old woman with her groceries or cross the road; check up on your friend’s health to find out how fast he/she is recovering.
2. Provide Opportunities
Kids will not learn compassion, if they just hear you talk about it. They must practice compassion in their daily lives. Hence, it is your responsibility to make them experience situations – with friends, family, neighbors where he can practice empathy, and understand the feeling of being in someone else’s skin in a tough situation.
3. Acknowledge Kindness
Show your child that you notice when someone does something thoughtful. For example, if a car slows down for you to cross the road, praise the driver by saying “It was kind of him to let us cross the road.” Likewise, acknowledge and praise your child in similar acts.
4. Volunteering Act
Involve your kids in community services. Make them spend some time at the orphanage, old-age home, and animal shelter during the weekend. Making them experience other people’s lives, will trigger the feeling of compassion and empathy in them.
5. Practicing ‘Giving’ and ‘Sharing’
Always encourage your child to share things with everyone around. Explain why he/she should be sharing the chocolate with his/her friend. Encourage the practice of good deed by donating your child’s old toys and clothes and make sure about your child’s involvement in the act.
6. Keep a Family Pet
Explain why it is important to be nice and friendly to animals. And if possible, keep a pet at home. Developing a relation with animals, will help your child understand and develop respect for all living beings.
7. Gardening Compassion
Gardening can encourage compassion too. Being responsible for a plant’s life with love, care and patience will nurture the feeling of compassion in your child.
Only, when we acknowledge and feel blessed about our own lives, we will be able to instill the values of compassion and kindness in our kids. However, before we make kids tread on the path of compassion, it is important for us to practice it first. And, the sooner we start doing it; the sooner we will see ourself standing as a proud parent of a compassionate kid. Read more
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Yay I did it – Exclusively breastfed!!!!
My Preparedness for this Journey .
I stil remember very clearly, my breastfeeding journey began much before the little
one had even arrived, I believe that is because I was determined that I wanted
my kiddo to be exclusively breastfeed, so, I was on a mission I researched
everything so well, was speaking to my pre- natal comates, coaches and getting
tips from my mom friends and most importantly reading up as much as possible. So
finally, when the day arrived for the first latch my son had no problem latching on right away, so
basically making sure you are aware of techniques was my very first learning. Also,
this was despite a C-section delivery so the first very common myth was busted
right there that you can’t feed comfortably if you have a c-section.
I had a late pregnancy and was
always doubtful if I will have a healthy pregnancy or not so made sure I was
doing 3 things religiously, reading up on pregnancy and post pregnancy care,
eating right during and importantly after pregnancy and last but not the least
exercising. One more thing that goes without saying is the support of your
spouse which is the most important. I remember tagging along my husband to as
many prenatal classes as possible so he also understands the nuances of baby
and mother care.
There can’t be anything more important
than a supporting husband as I remember the first 3 months are tuff on a first-time
mom most especially the feeding sessions which last for 20 mins each and the burping
right after and diaper change if needed and before you know it, its time again
for the next feeding session every 2 hours that too round the clock. So, if I
was able to pull along and complete the 3 months successfully with more than
expected weight gain of the baby was because we kept at it making sure I was
feeding the baby once every two hours.
Ok I want to emphasize and like I do
tell every new mom that I meet, follow this schedule and it will help set up a
sort of routine for you and your baby and get some me time while the baby sleeps
because my baby was on a clock, I knew exactly what times I needed to feed him,
so really if you get their bath time and feeding times in, their sleep time
will fall in place without any hassles. So, trust me when I say this, I had a
timetable baby by the end of 6 months. It just made life that much simpler, of
course there were good and not so good days but that is all a part of the
journey!
There are peaks and valleys with
breastfeeding and sometimes you will thoroughly enjoy it, and sometimes you
will resent it–but in the end you will not regret that you stuck with it, even
though you were not feeling that joy 100% of the time. When you are in a
valley, rest assured that the joy you have felt with feeding in the past will
reappear and you will be glad you pushed through and reap the benefits for a
long time to come. Read more
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Do I Actually Do What I Want To Do Anymore?
Picking up pebbles, counting leaves, wearing my favourite dress to a party I like, eating what I want to, certainly when I want to are few things I miss not doing anymore. Life has become looking for an APPROPRIATE choice rather than a favourite one. I don’t remember doing my own thing in the longest of times. It’s always what I SHOULD do. Yes, ladies and gentlemen this is me, an urban house wife. Welcome to my world of juggling and going crazy everyday to be what I should be. My life is putting up with continuous expectations from a wife, mother and a daughter in law.
15 years have passed in a flash it seems. Its been a roller coaster with 2 children and a house full of people whom I love. I have always been an independent girl. But I fell in love with this extremely charming childhood friend whom I couldn’t resist and voila! Here I was, amidst the hustle bustle of a big family. As years passed I didn’t even realise and I had forgone my preferences and likes. It wasn’t long before I underwent an extreme change in personality. An aggressive, flamboyant girl was replaced by a humble, docile and adjusting woman. As I look back there are smiles all the way, but I can’t recall one thing I did because I wanted to. There were vacations, gifts and celebrations which were at all times decided by my husband or family. Of course I enjoyed every bit and am thankful to god to give me such a happy space. But it wasn’t how I had wanted it to be. No one ever asked, no one ever took opinion.It was taken for granted. Recently, when I mentioned it to my husband he snapped back at me with " what more do you want? You have the best of everything? ". I really wanted to take forward the argument by asking him, who decides what’s best for me? Who would know better than me what was best for me..Even if it was irrelevant for my husband? Did I really matter? Were my choices in life wrong? Am I wrong in complaining so many years later?
Life is all about choices. There is no future. Present is all we have. The choices we make determine the life we live. Should we not have a fundamental right to choose just like 7 others in our constitution. I wish we had. Life is easier with a legal stamp on a statement. Sometimes, I wonder why it is so ironical that the things I love are often demeaned by my husband. Moreover, he leaves no occasion to mention it amongst friends and family. His boast often belittles me in every possible way. I feel suppressed and choked.
Gradually, I stopped mentioning my choices even in the pettiest fields of life like food, movie or outing.In fact, I have forgotten all together to make choices. I get uncomfortable if I am repeatedly asked to do so. I avoid situations where I am asked to choose for the fear of mockery. What have I now become? Let me not portray myself as a miserable woman. I am just devoid of certain things that I would rather have. There may be women who don’t even realise they are deprived of their choices. The amalgamation of adjustment and throwing away preference is so seamless that it doesn’t even strike, sometimes never. But believe me, I could give away my precious things if I was promised acknowledgement of the things I want to do.
Disclaimer: The views, opinions and positions (including content in any form) expressed within this post are those of the author alone. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The responsibility for intellectual property rights of this content rests with the author and any liability with regards to infringement of intellectual property rights remains with him/her. Read more
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6 quick tips to ease your Maternity leave planning.
So you are about to get into your 2nd or 3rd Trimester. It’s now a great time to plan your maternity leave. The Maternity Benefit Amendment Act 2017, passed in March 2017 -which is applicable to organisations having over 10 employeesentitles a working womeninIndia-
apaid maternity leave for 26 weeks (approx 6 months).
So what you do and how you plan? Here are few points that should help you maternity planning the next 6-12 months.
1- Know the HR policy’s:
Companies have implemented 26weeks maternity leave, but there can be some silver lining here. Based on your profile of work , there can be additional options & benefits such as WFH ifyou are in final trimester. Also companies offer medical reimbursement upto an amount which can differ for both normal/C -section.
Reach out to your HR and go through the complete maternal policy & benefits. Also understand the supporting documents like medical bills, test reports etc. which will be required to claim the leave as well as other benefits later.
2- Speak to your manager:
Generally when you are passed your first trimester(i.e.first 3 months), you can use this time to break the news to your manager. Don’t delay further as the bump will begin to be visible towards the mid of your 2nd trimester. If you need flexibility in time or WFH towards the end of your 3rd trimester give him/her the intimation so that the required planning can begin. Important thing is to remain professional and not let the work suffer when you are not around during your leave.
It’s alright if you are not comfortable to share this news with other colleagues yet at office. They will know in few weeks and that’s totally fine!
3- Speak to your colleagues:
Once aligned with your manager - you can begin knowledge transfer of the critical task your colleagues will handle when you are away during the maternity leave. Better if you can prepare a SOP & share with the concerns (including your manager) so that you are least bothered during your maternity leave.
4- Speak with your family :
So since 6 months or more you will be on at home ,plan with your partner, parents, in laws and friends of who all would be there to ‘support you’ when you are home and when you would be going back to work. Include nanny hunt as well to the task list!
5- Save up the leaves :
In case you have Privilege leaves available , avoid clubbing it with your maternity leave if possible . You have already spend 6 months away from office and I am sure you would be looking forward to go back to work. You can later utilise those leaves for travelling & exploring with your little one. After all you both need a break and exploring after being at home for so long. Or worse , God forbidden if the little one falls sick - atleast you don’t have to worry about loss of pay because you wouldn’t have used up all the leaves.
6- Be worry free :
You are pregnant- a very unique & beautiful journey that any women you google about will say. Your body is going through rapid changes each second so don’t get bothered about anything. I know it’s harder than me just saying so but try to focus and be organised and everything will be just fine.
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Dr Ghouse has added a new answer
Guardian of 0 children
10 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
10 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
10 hours ago
Q. i feel some fever internally also
Dr Ghouse
Paediatrician
10 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
9 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
9 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
shilpi Bhandari has added a new answer
Guardian of 0 children
5 hours ago
Q. Hello
What is better normal or csec?
shilpi Bhandari
Mom of 2 children
4 hours ago
A. hello dear this is not about which is better this is all about your body and the condition of the baby no doubt the normal procedure is the painful but side effect are not there but after C6 you have to be little more careful and you have to take more precaution but again I am saying that this is not about the better one this is about the condition of your pregnancy
Santu has added a new answer
Expecting Mom due this month
3 hours ago
Q. #asktheexpert
1) till how many days after delivery baby needs to keep on uterus temperatures/warm temperature?
2) Can baby & mother both take bath after 24 hours of delivery?
Santu
Mom of 2 children
3 hours ago
A. It depends on moms and babys health I feel and suggest It's better to check with your doctor and follow their advise. That would be one of the best and safest option for your baby as of now. Take care.
shilpi Bhandari has added a new answer
Guardian of 0 children
2 hours ago
Q. dual marker test is for what purpose??
shilpi Bhandari
Mom of 2 children
2 hours ago
A. The double marker test helps determine whether the unborn baby has any risk of developing neurological abnormalities or mental disorders
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