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| Testimonials For Pediatric Oncall |
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Preeti
I am a final yr medical student and i just love ur website!!! I regularly use it to help me with my preparations. The topics are so lucidly written and easily understood with up to date information.. Even the HIV related web site ( www.hivinchildren.org) by Dr.Ira Shah is just fabulous!!! |
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Dr Parang N Mehta
Dear Dr Ira Shah, Congratulations on putting up an excellent website, which will be of great use to practicing pediatricians everywhere. You have achieved the near impossible in getting some of the biggest names in pediatrics in India to contribute content to your site. |
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| Sailala
An excellent website!! good and useful information! Many Thanks for to u all! |
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Sujatha
Very informative site, and queries are getting resolved immediately. Thanks |
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Uttam Laisram
I found the Vaccine Reminder feature on your Website very interesting. My request is that this useful facility may not be restricted to Registered Users, but may be made available to all Visitors, who may like to enter their child's details and take a print-out of the Vaccine schedule. Please consider. Keep up the excellent work in providing India-relevant information for child care. |
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Dr Ira Shah
M.D, DNB, DCH(Gold Medalist), FCPS
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Kawasaki's disease also known as mucocutaneous lymph node syndrome or Infantile polyarteritis was first reported in Japanese children after World War II. It is primarily seen in children younger than 5 years of age. The cause remains unknown but bacterial toxins and autoimmunity have been postulated in its etiogenesis. It is characterized by fever (lasting for at least 5 days), bilateral nonpurulent conjunctival injecton, strawberry tongue, erythema of hands or feet with desquamation usually beginning periungually, polymorphous truncal rash and cervical lymphadenopathy. Transient arthritis may also occur. Other manifestations may include diarrhea, vomiting, abdominal pain, hydrops of gall bladder, myositis, ulcerative stomatitis, aseptic meningitis, cranial or peripheral nerve palsies and hepatosplenomegaly.
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Cardiac involvement is the most important manifestation of Kawasaki’s disease. 10-40 % of untreated children have evidence of coronary vasculitis within 2 weeks of illness as seen by coronary dilatation or aneurysm on 2D Echo that may lead to myocarditis and on long term early myocardial infarction.
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Laboratory investigations show predominance of leukocytosis, thrombocytosis, elevated C-reactive proteins and high ESR.
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Treatment consists of intravenous gamma globulin (IVIG) during the acute phase along with high dose aspirin (100mg/kg/day) to prevent coronary vascular damage. IVIg is given as a single dose (2gm/kg) over 10-12 hours. Low dose aspirin (5mg/kg/day) as single daily dose is advocated for continuation phase for 6-8 weeks after the active disease subsides for its anti-thrombotic effects and till coronary lesions resolve. For patients unresponsive to initial treatment with IVIg a retreatment with second dose of IVIg is recommended. It is found that patients with low Hb (Hb< 10gm/dl), leucocytosis and low albumin are at risk of failure of initial IVIg and may require retreatment with second dose of IVIg. For patients with active coronary thrombosis or peripheral artery ischemia, thrombolytic therapy with streptokinase may be required.
Last Updated on 11-08-2007
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