KidsDoc Monthly Newsletter from AllForKids

March -2009,Vol -1,Issue-15

By Dr. M.Vijayalakshmi M.D(Peds), M.D(USA), FAAP, DAA
Content Sources: CDC, American Academy of Pediatrics


What is new at AllForKids


To serve you better, we will be moving to a new location in Tripunithura. Please see below for details. Other than our physical location everything else will remain the same including our quality of service, friendly staff, telephone numbers and everything else that you have got accustomed about AllForKids. Thank you all for your continued patronage.




New vaccines now available in India


Here is a list of two new vaccines that were approved for use last year in India and should be available with many healthcare providers including at AllForKids.

 1.Rotarix – Rotavirus Vaccine

ROTARIX is indicated for the prevention of rotavirus gastroenteritis caused by G1 and non-G1 types (G3, G4, and G9) when administered as a 2-dose series in infants and children.

The vaccination series consists of two 1-mL doses administered orally. The first dose should be administered to infants beginning at 6 weeks of age. There should be an interval of at least 4 weeks between the first and second dose. The 2-dose series should be completed by 24 weeks of age.

 2.Cervarix – Cervarix is a vaccine against certain types of the human papillomavirus (HPV).

Cervarix is designed to prevent infection from HPV types 16 and 18, which currently cause about 70% of cervical cancer cases. Type 16 is also associated with oropharyngeal squamous-cell carcinoma, a form of throat cancer. Additionally, some cross-reactive protection against virus strains 45 and 31 were shown in clinical trials. Cervarix is also formulated with AS04, a proprietary adjuvant that has been found to boost the immune system response for a longer period of time. This vaccine is recommended for girls and women above 10 years up to 45 years of age. The vaccination consists of 3 doses administered by intramuscular injection


Allergy Testing from AllForKids


AllForKids now offers skin testing for allergies at its Tripunithura clinic.

An allergy skin test is used to identify the substances that are causing your allergy symptoms. It is often performed by applying an extract of an allergen to your skin, scratching or pricking the skin to allow exposure, and then evaluating the skin's reaction to the allergen.

How is the test done?

The procedure varies depending on what type of skin test you are having. The type of skin test offered by AllForKids is a prick test.

Prick test is also known as a puncture or scratch test. First, a doctor will examine the skin on your forearm and clean it with alcohol. (Sometimes, the skin test is performed on an area of your back for adults.) Areas on your skin are then marked with a pen to identify each allergen that will be tested. A drop of extract for each potential allergen -- such as pollen, dust mite,  cockroach, mosquitoes, fungus, dog and cat dander, food allergens like egg, fish etc. -- is placed on the corresponding mark. A small disposable pricking device (a lancet) is then used so the extract can enter into the outer layer of the skin. The skin prick is not an injection and doesn't cause bleeding or pain.
If there are allergic antibodies in your system, your skin will become irritated and may itch, much like a mosquito bite. This reaction means you are allergic to that substance.

How Long Does the Test Take?

Plan to spend about an hour for the entire test. For the prick skin test, the allergen placement part of the test takes about 5 to 10 minutes. Then you will have to wait about 15 minutes to see how your skin reacts.

Is there any  preparation required for the test?

Inform your doctor who is going to perform the skin test about all medicines you are taking, including over-the-counter medications.

Since allergy medicines, including over-the-counter antihistamines, stop allergic reactions, you should not take them for a few days before the test. Talk to your doctor about discontinuing your allergy medicines prior to the test.

Your doctor will give you a list of medicines to avoid before the test, since there are other drugs that can interfere with the results.


Disease Focus – Lice Infection


Lice are parasitic insects that can be found on people's heads, and bodies, including the pubic area. Human lice survive by feeding on human blood. Lice found on each area of the body are different from each other. The three types of lice that live on humans are:

  1. Head louse (Pediculus humanus capitis)
  2. Body louse, clothes louse (Pediculus humanus corporis)
  3. Crab" louse (Pthirus pubis)

Among these only the body louse is known to spread disease.

Lice infestations are spread most commonly by close person-to-person contact. Dogs, cats, and other pets do not play a role in the transmission of human lice. Lice move by crawling; they cannot hop or fly. Both over-the-counter and prescription medications are available for treatment of lice infestations.

We will focus on head lice which is commonly found in children in school settings in tropical climate like Kerala.

Head lice are not known to transmit any disease and therefore are not considered a health hazard.

Head lice infestations can be asymptomatic, particularly with a first infestation or when an infestation is light. Itching is the most common symptom of head lice infestation and is caused by an allergic reaction to louse bites. It may take up to 6 weeks for itching to appear the first time a person has head lice infection.

Other symptoms may include:

  1. A tickling feeling or a sensation of something moving in the hair;
  2. Irritability and sleeplessness; and


Treatment for head lice is recommended for persons diagnosed with an active infestation. All household members and other close contacts should be checked All infested persons and their bedmates should be treated at the same time.

Retreatment of head lice usually is recommended because no approved pediculicide (peh-DICK-you-luh-side) is completely ovicidal, that means they cannot kill the eggs. To be most effective, retreatment should occur after all eggs have hatched but before before new eggs are produced. If 2-3 treatments with over the counter lice shampoos does not seem to take care of the problem consult your pediatrician for other prescription options.

The following are steps that can be taken to help prevent and control the spread of head lice:

  1. Avoid head-to-head (hair-to-hair) contact during play and other activities at home, school, and elsewhere.
  2. Do not share clothing such as hats, scarves, coats, sports uniforms, hair ribbons etc.
  3. Do not share combs, brushes, or towels. Disinfest combs and brushes used by an infested person by soaking them in hot water (at least 130°F) for 5-10 minutes
  4. Do not lie on beds, couches, pillows, carpets, or stuffed animals that have recently been in contact with an infested person
  5. Wash and dry clothing, bed linens, and other items that an infested person wore or used during the 2 days before treatment using the hot water (130°F) and the high heat or direct sun drying. Clothing and items that are not washable can be dry-cleaned OR sealed in a plastic bag and stored for 2 weeks.
  6. Vacuum the floor and furniture, particularly where the infested person sat or lay.
  7. Do not use fumigant sprays or fogs; they are not necessary to control head lice and can be toxic if inhaled or absorbed through the skin.


Breastfeeding Questions


There is no dearth of advice and information from traditional and family sources about breastfeeding and when to start solid and other food for babies. Here are a few recommendations as per the AAP, CDC and WHO guidelines. We will continue this feature for the next few editions of the newsletter to answer more questions on breastfeeding.

When should a baby start eating solid foods such as cereals, vegetables, and fruits?
Breast milk alone is sufficient to support optimal growth and development for approximately the first 6 months after birth. For these very young infants, the American Academy of Pediatrics (AAP) states that water, juice, and other foods are generally unnecessary. Even when babies enjoy discovering new tastes and textures, solid foods should not replace breastfeeding, but merely complement breast milk as the infant’s main source of nutrients throughout the first year. Beyond one year, as the variety and volume of solid foods gradually increase, breast milk remains an ideal addition to the child’s diet.

How long should a mother breastfeed?
The American Academy of Pediatrics (AAP) recommends that breastfeeding continue for at least 12 months, and thereafter for as long as mother and baby desire. The World Health Organization recommends continued breastfeeding up to 2 years of age or beyond.

What can happen if someone else's breast milk is given to another child?
HIV and other serious infectious diseases can be transmitted through breast milk. However, the risk of infection from a single bottle of breast milk, even if the mother is HIV positive, is extremely small. For women who do not have HIV or other serious infectious diseases, there is little risk to the child who receives her breast milk. See Diseases and Conditions for more information.

Stress and today’s child


Psychologists believe that today's child actually are faced with more stress than the children of previous generations were and have fewer social supports available. The change in family structure from the large, supportive, extended families and to the present high incidence of divorced families has drastically altered the experience of childhood.

Even in intact and stable families, the growing number of households with two working parents often forces children to spend more time in after-school programs or at home alone. For some children this loss of time with their parents is quite stressful. So, too, is the responsibility for caring for themselves and the family home and sometimes for overseeing a younger sibling after school.

Many children and their families are stressed by the multiple activities that fill children's free time.

Today's children are also being raised in an era in which they are exposed to violence and peer pressure and are warned to be cautious about kidnapping, sexual abuse and other crimes. This sense that they are living in an unsafe world is a constant source of stress for some children. In short, today's youngsters are regularly confronted with challenges to their coping skills.

Good and bad stress

Not all stress is bad. Moderate amounts of pressure imposed by a teacher or a parent, for example, can motivate a child to keep her grades up in school or to participate more fully in sports activities. Successfully managing stressful situations or events enhances a child's ability to cope in the future.

When the stress is continuous or particularly intense, it takes a toll on both the psyche and the body. Sudden stressful events will accelerate your child's breathing and heartbeat, constrict her blood vessels, increase her blood pressure and muscle tension and perhaps cause stomach upset and headaches. As stress persists, she might be more susceptible to illness and experience fatigue, nightmares, teeth-grinding, insomnia, tantrums, depression and school failure.



Interested in accessing previous issues of our Newsletter? Please visit the following link

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Pediatric and Adolescent Clinic
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Phone: 0484-645 2772,Website: ,


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