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DIARRHEA 

DIARRHEA IN CHILDREN 

What is diarrhea?
Diarrhea is when motion (bowel movements) are loose and watery. Your child may also need to go to the bathroom more often.
Diarrhea may be either:
Short-term (acute). Diarrhea that lasts 1 or 2 days and goes away. This may be caused by food or water that was contaminated by bacteria (bacterial infection). Or it may happen if your child gets sick from a virus.
Long-term (chronic). Diarrhea that lasts for a few weeks. This may be caused by other health problem which needs medical evaluation.

What causes diarrhea?
Diarrhea may be caused by many things, including:
* Bacterial infection
* Viral infection
* Trouble digesting certain things (food intolerance)
* An immune system response to certain foods (food allergy)
* Parasites that enter the body through food or water
* Reaction to medicines
* An intestinal disease, such as inflammatory bowel disease
* A problem with how the stomach and bowels work (functional bowel disorder), such as irritable bowel syndrome
* Surgery on the stomach or gallbladder.
Severe diarrhea may mean a child has a serious disease. Talk with your child's healthcare provider if symptoms don’t go away. Also talk with the provider if symptoms stop your child from doing daily activities. It may be hard to find out what is causing your child’s diarrhea.

What are the symptoms of diarrhea?
Symptoms can occur a bit differently in each child. They can include:
* Loosestools.
* Belly (abdominal) pain.
* Upset stomach (nausea) Vomiting.
* Urgent need to use the bathroom.
* Fever.
* Bloody stools.
* Loss of body fluids leads to tiredness, lethargy, decreased activity.
The symptoms of diarrhea may look like other health problems. Severe diarrhea may be a sign of a serious disease. Make sure your child sees his or her healthcare provider for a diagnosis.

INVESTIGATION
The healthcare provider will ask about your child’s symptoms and health history. He or she will give your child a physical exam, most of the time NO TESTS IS REQUIRED. Your child may have lab tests if there is a need.

DO S AND DONT FOR DIARRHEA
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Dehydration is the major concern with diarrhea. In most cases, treatment includes replacing lost fluids. Antibiotics may be prescribed when bacterial infections are the cause.

DO
1. Mother feeding
2. Boiled cooled water, safe home cooked food .
3. ORS – Preparation should be with boiled cooled water and mixed as.
4. Parents should prepare food in a hygienic manner.
5. Wash hand before eating food.
6. Wash hand after toilet use.

DONTS ( AVOID)
1.Bottle drink
2.Large amount of plain water
3.Plain glucose water
4.Coffee, soft drinks, squash, milk shakes
5.Bottle feeding

What are the complications of diarrhea? The greatest complication of diarrhea is dehydration. This is more likely with young children and those with a weakened immune system. Dehydration can be mild, moderate, or severe. Mild dehydration is the loss of fluid. Moderate or severe dehydration puts stress on the heart and lungs. In the worst cases it can lead to shock, which is life-threatening.

What can I do to prevent diarrhea?
Proper handwashing can reduce the spread of bacteria that may cause diarrhea.
A rotavirus vaccine can prevent diarrhea caused by rotaviruses. Ask your child's healthcare provider which vaccines are right for your child. When you travel, make sure anything your child eats and drinks is safe. This is even more important if you travel to developing countries.

Travel safety tips for drinking and eating include:
* Not drinking tap water or using it to brush teeth
* Not using ice made from tap water
* Not drinking unpasteurized milk (milk that has not gone through a process to kill Certain bacteria)
* Not eating raw fruits and vegetables unless you wash and peel them yourself
* Not eating raw or undercooked food
* Not eating food from street vendors or food trucks
* Talk with your child's healthcare provider before travelling.

When should I meet my childs health care provider?
Meet your child's provider if your child is less than 6 months old or has any of the following symptoms:
* Belly pain
* Blood in the stool
* Frequent vomiting
* Doesn’t want to drink liquids
* High fever
* Dry, sticky mouth
* Weight loss
* Urinates less frequently (wets fewer than 6 diapers per day)
* No tears when crying
* Sunken soft spot (fontanelle) on baby head

Key points about diarrhea
* Diarrhea is loose, watery stool. Your child may also have to go to the bathroom more often.
* It may be caused by many things, including bacterial infection or viral infection.
* Dehydration is the major concern with diarrhea.
* In most cases, treatment involves replacing lost fluids.
* The rotavirus vaccine can prevent diarrhea caused by that virus.
* Proper handwashing can help prevent diarrhea.
* When you travel, make sure anything your child eats and drinks is safe

HEAD INJURY 

What is a head injury?
Head injuries are one of the most common causes of disability and death in children. The injury can be as mild as a bump, bruise (contusion), or cut on the head, or can be moderate to severe in nature due to a concussion, deep cut or open wound, fractured skull bone(s), or from internal bleeding and damage to the brain.
There are many causes of head injury in children. The more common injuries are falls, motor vehicle accidents (where the child is either riding as a passenger in the car or is struck as a pedestrian), or a result of child abuse.

What are the symptoms of a head injury?
The following are the most common symptoms of a head injury. However, each child may experience symptoms differently. The child may have varying degrees of symptoms associated with the severity of the head injury. The symptoms of a mild head injury may include:

Mild head injury:
* Raised, swollen area from a bump or a bruise
* Small, superficial (shallow) cut in the scalp
* Headache
* Irritability
* Confusion
* Lightheadedness and/or dizziness
* Problems with balance
* Nausea
* Problems with memory and/or concentration
* Change in sleep patterns
* Blurred vision
* "Tired" eyes
* Ringing in the ears (tinnitus)
* Moderate to severe head injury (that requires immediate medical attention) symptoms may Include any of the above plus
* Loss of conscious
* Severe headache that does not go away
* Repeated nausea and vomiting
* Loss of short term memory, such as difficulty remembering the events that led right up to and through the traumatic event
* Slurred speech
* Difficulty with walking
* Weakness in one side or area of the body
* Seizures or convulsions
* Blood or clear fluid draining from the ears or nose
* Deep cut or laceration in the scalp
* Open wound in the head
* Foreign object penetrating the head
* Coma (a state of unconsciousness from which a person cannot be awakened responds only minimally, if at all, to stimuli; and exhibits no voluntary activities)

INVESTIGATION
The full extent of the problem may not be completely understood immediately after the injury, but may be revealed with a comprehensive medical evaluation and diagnostic testing. The diagnosis of a head injury is made with a physical examination and diagnostic tests. During the examination, the doctor obtains a complete medical history of the child and family and asks how the injury occurred. Trauma to the head can cause neurological problems and may require further medical follow up.

Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

OTHER TESTS are prescribed by doctor.

TREATMENT OF A HEAD INJURY 
Specific treatment of a head injury will be determined by your child's doctor based on:
* Your child's age, overall health, and medical history
* Extent of the head injury
* Type of head injury
* Your child's tolerance for specific medications, procedures, or therapies
* Expectations for the course of the head injury

Depending on the severity of the injury, treatment may include:
* Ice
* Rest
* Topical antibiotic ointment and adhesive bandage
* Observation
* Immediate medical attention
* Stitches
* Hospitalization for observation
* Moderate sedation or assistance with breathing that would require being placed on a machine also called a mechanical ventilator or mechanical respirator
* Diagnostic tests
* Surgery

Treatment is individualized depending on the extent of the condition and the presence of other injuries. If your child has a head injury, he or she may require monitoring for increased intracranial pressure (pressure inside the skull). Head injury may cause the brain to swell. Since the brain is covered by the skull, there is only a small amount of room for it to swell. This causes pressure inside the skull to increase, which can lead to brain damage.




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