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Guillain-Barré Syndrome (GBS) is a rare neurological disorder that can affect children, although it’s more common in adults. In pediatrics, GBS typically presents as an acute, rapidly progressing, autoimmune condition where the body’s immune system attacks the peripheral nervous system. It often fol...

Guillain-Barré Syndrome (GBS) is a rare neurological disorder that can affect children, although it’s more common in adults. In pediatrics, GBS typically presents as an acute, rapidly progressing, autoimmune condition where the body’s immune system attacks the peripheral nervous system. It often follows an infection, such as a respiratory or gastrointestinal illness, and is associated with pathogens like Campylobacter jejuni, cytomegalovirus, Epstein-Barr virus, 1. Symptoms: Muscle Weakness: Progressive, symmetric weakness starting in the lower limbs and moving upward. In severe cases, it can affect breathing muscles, causing respiratory distress. Reflex Loss: Reduced or absent reflexes (areflexia) in the affected limbs. Sensory Symptoms: Children may experience tingling or numbness, but pain can also be present, especially in the back or limbs. Autonomic Dysfunction: Some children may have abnormal heart rate, blood pressure fluctuations, and issues with bladder or bowel control. 2. Diagnosis: Clinical Evaluation: Symptom progression, presence of areflexia, and history of recent infection. Electrodiagnostic Studies: Nerve conduction studies and electromyography (EMG) can confirm the demyelination or axonal damage in the peripheral nerves. Cerebrospinal Fluid Analysis: Elevated protein with normal white cell count (albuminocytologic dissociation) in the cerebrospinal fluid is characteristic of GBS, although this may appear a few days into the illness. 3. Treatment: Supportive Care: Monitoring respiratory function is crucial; mechanical ventilation may be necessary if respiratory muscles are affected. Immunotherapy: Intravenous immunoglobulin (IVIG) is the preferred treatment in children and is generally well-tolerated. Plasma exchange is an alternative but is less commonly used in pediatrics. Pain Management: Addressing pain, which can be significant in children with GBS, is important, using medications like NSAIDs or gabapentin. Physical Therapy: Early rehabilitation is essential to aid in muscle strength recovery and prevent complications. 5. Complications: Respiratory Compromise: Due to paralysis of breathing muscles, requiring close monitoring in an ICU setting. Autonomic Dysfunction: Can lead to cardiac arrhythmias or blood pressure instability. Psychosocial Impact: Hospitalization and reduced mobility can affect a child’s mental well-being, requiring family support and sometimes counseling. Puberty and Related Problems Puberty: The period of physical and sexual maturation in children, usually starting between 8-13 years in girls and 9-14 years in boys, driven by hormonal changes. Common Puberty-Related Problems 1. Precocious Puberty: Early onset of puberty (before 8 in girls, 9 in boys). Symptoms: Early breast or testicular development, pubic hair, growth spurts. Treatment: GnRH agonists to delay puberty if necessary. 2. Delayed Puberty: Late onset (after 13 in girls, 14 in boys). Symptoms: Lack of breast development in girls or testicular enlargement in boys. Treatment: Observation for familial cases or hormone therapy if deficiency is present. 3. Gynecomastia in Boys: Benign breast enlargement due to hormonal imbalance. Often resolves on its own; surgery only if persistent and bothersome. 4. Menstrual Irregularities in Girls: Issues: Primary amenorrhea (no menstruation by 15), infrequent periods (oligomenorrhea). Management: Monitor; further evaluation if irregularities persist. These issues require early identification and appropriate management to support normal adolescent development. Mental retardation( Intellectual Disability) (ID) in Children Definition: A developmental disorder with limitations in intellectual functioning (IQ < 70) and adaptive behavior, arising before age 18. Classification: 1. Mild: Can learn basic academic and social skills, may live semi-independently. 2. Moderate: Limited academic abilities; needs moderate support. 3. Severe/Profound: Significant limitations; requires full-time support. Causes: Genetic: Chromosomal abnormalities (e.g., Down syndrome). Prenatal: Maternal infections, toxins. Perinatal: Birth complications. Postnatal: Illnesses, trauma. Diagnosis: IQ tests, adaptive behavior scales, medical evaluation. Management: Early intervention (speech/physical therapy), special education, behavioral therapy, family support. Prognosis: Varies by severity; early support can improve outcomes, especially in mild/ moderate cases. Prevention: Prenatal care, newborn screening, immunizations, and lead poisoning prevention. Mouth Ulcers Definition: Painful sores or lesions on the mucous membranes inside a child’s mouth, including the cheeks, tongue, gums, or lips. Types: 1. Aphthous Ulcers (Canker Sores): Small, round ulcers with a white or yellow center and a red border; often recurring. 2. Herpetic Stomatitis: Caused by herpes simplex virus (HSV), characterized by multiple small ulcers and blisters, often with fever. 3. Traumatic Ulcers: Resulting from injury (e.g., biting, sharp food, dental appliances). 4. Other Causes: Nutritional deficiencies (iron, B12), hand-foot-and-mouth disease, and systemic conditions like Crohn’s disease. Causes: Infections: Viral (e.g., HSV, coxsackievirus). Nutritional Deficiencies: Iron, vitamin B12, folate. Trauma: Biting, brushing too hard, dental appliances. Systemic Diseases: Less common, but consider autoimmune or gastrointestinal conditions in recurrent cases. Symptoms: Pain and discomfort, especially when eating or talking. Red or white sores inside the mouth. Possible fever, swollen gums (in infectious causes). Diagnosis: Clinical examination based on ulcer appearance and history. Blood tests may be ordered for recurrent ulcers (to check for deficiencies or immune issues). Management: 1. Pain Relief: Topical anesthetics (e.g., benzocaine gel) or mild painkillers (acetaminophen for children). 2. Good Oral Hygiene: Rinsing with salt water, avoiding spicy or acidic foods. 3. Nutritional Support: Address deficiencies if identified (e.g., iron, B12). 4. Antiviral Medication: For herpetic stomatitis if severe, under doctor’s guidance. Prevention: Balanced diet to avoid deficiencies. Avoidance of known triggers (e.g., acidic foods). Good dental hygiene practices. Dental Caries Definition: Tooth decay caused by the breakdown of tooth enamel due to bacterial activity, leading to cavities. Causes: Bacteria: Primarily Streptococcus mutans. Sugary Foods: Sugars and starches promote bacterial growth and acid production. Poor Oral Hygiene: Lack of proper brushing and flossing. Risk Factors: Frequent snacking, bottle-feeding at bedtime, sugary drinks, and inadequate fluoride. Symptoms: White spots or dark stains on teeth. Tooth pain or sensitivity. Visible holes or pits in teeth. Prevention: Good Oral Hygiene: Brush twice daily with fluoride toothpaste, floss regularly. Limit Sugary Foods and Drinks: Reduce juice, soda, and sugary snacks. Regular Dental Check-ups: Early detection and fluoride treatments. Management: Fluoride Treatments: To strengthen enamel. Dental Fillings: For cavities. Dental Sealants: Protective coating on teeth to prevent decay. Complications: Untreated caries can lead to infection, pain, and tooth loss, affecting speech, eating, and self-esteem. Bronchitis Definition: Inflammation of the bronchial tubes, which carry air to the lungs, often leading to cough and mucus production. Types: 1. Acute Bronchitis: Usually viral; lasts a few weeks. 2. Chronic Bronchitis: Rare in children; persistent cough lasting over 3 months, typically due to underlying conditions. Causes: Viral Infections: Common cold or flu viruses (e.g., rhinovirus, RSV). Environmental Irritants: Smoke, pollution, allergens. Symptoms: Persistent cough, often with mucus. Wheezing and chest discomfort. Low-grade fever, fatigue, and sore throat. Diagnosis: Clinical exam based on symptoms and lung sounds. Chest X-ray or tests only if severe or recurrent. Management: 1. Symptomatic Relief: Plenty of fluids and rest. Humidifier for easier breathing. Acetaminophen or ibuprofen for fever. 2. Avoid Cough Suppressants: Usually not recommended in young children. 3. Inhalers or Bronchodilators: For wheezing if prescribed by a doctor. Prevention: Good hygiene to avoid infections. Avoiding smoke exposure and allergens. Prognosis: Most cases of acute bronchitis resolve within 1-2 weeks without complications. Dysentery Definition: An intestinal infection causing severe diarrhea with blood and/or mucus, often accompanied by abdominal pain and fever. Causes: 1. Bacterial: Shigella (most common), Escherichia coli (E. coli), Salmonella. 2. Parasitic: Entamoeba histolytica (amoebic dysentery). 3. Viral: Less common; viral gastroenteritis typically doesn’t cause bloody stools. Symptoms: Frequent, painful diarrhea with blood and/or mucus. Abdominal pain and cramping. Fever and vomiting. Dehydration (dry mouth, decreased urination, fatigue). Diagnosis: Stool Examination: Detects blood, mucus, and identifies causative organisms. Blood Tests: May assess severity or detect infection spread. Management: 1. Hydration: Oral rehydration solutions (ORS) to prevent dehydration; IV fluids if severe. 2. Antibiotics: For bacterial dysentery, only if prescribed by a doctor; not used for viral causes. 3. Antiparasitics: For amoebic dysentery (e.g., metronidazole). 4. Avoid Anti-Diarrheal Medications: These can worsen symptoms in children. Prevention: Good hand hygiene. Clean drinking water and proper food handling. Vaccination against certain pathogens (e.g., rotavirus). Pancreatitis Definition: Inflammation of the pancreas, a gland behind the stomach that aids in digestion and blood sugar regulation. Types: 1. Acute Pancreatitis: Sudden inflammation, usually resolves with treatment. 2. Chronic Pancreatitis: Long-term inflammation, causing progressive damage and digestive issues. Causes: 1. Infections: Viral (e.g., mumps, Coxsackie virus). 2. Medications: Certain drugs (e.g., corticosteroids, valproic acid). 3. Trauma: Abdominal injury. 4. Genetic/Metabolic Disorders: Cystic fibrosis, hyperlipidemia. 5. Gallstones: Rare in children but can block pancreatic ducts. Symptoms: Severe abdominal pain, often radiating to the back. Nausea and vomiting. Fever. Abdominal tenderness and bloating. Diagnosis: 1. Blood Tests: Elevated amylase and lipase levels. 2. Imaging: Ultrasound or CT scan to view pancreas and surrounding structures. Management: 1. Supportive Care: IV fluids, fasting to rest the pancreas, and gradual reintroduction of diet. 2. Pain Management: Analgesics for pain relief. 3. Nutritional Support: Low-fat diet after recovery; may require enzyme supplements for digestion in chronic cases. 4. Treat Underlying Cause: Discontinue causative medications, treat infections, manage metabolic issues. Anemia Definition: A condition where there is a lower-than-normal level of red blood cells (RBCs) or hemoglobin, leading to reduced oxygen delivery to body tissues. Causes: 1. Nutritional Deficiency: Iron deficiency is the most common cause; other deficiencies include vitamin B12 and folate. 2. Inherited Disorders: Sickle cell disease, thalassemia. 3. Chronic Diseases: Kidney disease, infections. 4. Blood Loss: Due to gastrointestinal bleeding, heavy menstruation, or injury. Symptoms: Fatigue and weakness. Pale skin or pale inner eyelids. Rapid heartbeat and shortness of breath. Irritability and poor concentration. Delayed growth and developmental issues in severe cases. Diagnosis: 1. Blood Tests: Complete blood count (CBC) to check hemoglobin and RBC levels. 2. Iron Studies: Ferritin and serum iron to assess iron levels. 3. Additional Tests: Depending on suspected cause (e.g., hemoglobin electrophoresis for sickle cell disease). Management: 1. Iron Supplements: Oral iron is common for iron deficiency anemia. 2. Dietary Changes: Encourage iron-rich foods (e.g., meats, leafy greens, fortified cereals) and vitamin C to enhance iron absorption. 3. Treatment of Underlying Causes: Manage chronic diseases or inherited disorders. 4. Blood Transfusion: In severe cases or specific types of anemia. Prevention: Balanced diet with adequate iron and vitamins. Regular check-ups for children with risk factors (e.g., premature birth, vegetarian diets). Sickle Cell Disease Definition: A genetic blood disorder where red blood cells are abnormally shaped like a “sickle,” leading to poor oxygen delivery, blood flow issues, and increased cell breakdown. Cause: Genetic Mutation: Inherited mutation in the hemoglobin gene (HbS), causing red blood cells to become rigid and sickle-shaped, especially under low oxygen conditions. Symptoms: 1. Pain Crises (Vaso-Occlusive Crises): Sudden severe pain in bones, chest, or abdomen due to blocked blood vessels. 2. Anemia: Fatigue, pallor, and weakness due to rapid breakdown of sickled cells. 3. Frequent Infections: Increased susceptibility, especially to bacterial infections. 4. Delayed Growth and Development: Due to chronic anemia and low oxygen levels. 5. Other Complications: Jaundice, swollen hands/feet (dactylitis), stroke, organ damage. Diagnosis: 1. Newborn Screening: Often detected in newborn screening programs. 2. Hemoglobin Electrophoresis: Confirms the presence of abnormal hemoglobin (HbS). 3. Blood Tests: CBC and reticulocyte count to assess anemia severity. Management: 1. Pain Management: Painkillers during crises; warm compresses for relief. 2. Hydration and Oxygen: Adequate fluid intake and oxygen therapy during crises. 3. Medications: Hydroxyurea: Reduces frequency of pain episodes and complications. Antibiotics: Daily penicillin for young children to prevent infections. Folic Acid: Supports RBC production. 4. Blood Transfusions: For severe anemia or prevention of complications like stroke. 5. Bone Marrow Transplant: Potential cure, but suitable for select cases with a matched donor. Prevention of Crises: Avoid dehydration, extreme temperatures, and high altitudes. Routine vaccinations to prevent infections (e.g., pneumococcal, meningococcal). Hemophilia Definition: A genetic bleeding disorder where the blood doesn’t clot properly due to a deficiency in clotting factors, leading to prolonged or spontaneous bleeding. Types: 1. Hemophilia A: Deficiency in clotting factor VIII (more common). 2. Hemophilia B: Deficiency in clotting factor IX (also known as Christmas disease). Cause: Genetic Mutation: Inherited as an X-linked recessive disorder, affecting mostly boys. Females are usually carriers, while males are more likely to have the disease. Symptoms: Easy Bruising: Especially after minor bumps. Prolonged Bleeding: From cuts, dental procedures, or surgeries. Spontaneous Bleeding: Especially in joints (hemarthrosis), causing joint pain, swelling, and stiffness. Internal Bleeding: In severe cases, can lead to bleeding in muscles, organs, or the brain (severe headache, vomiting, or drowsiness may indicate brain bleed). Diagnosis: 1. Blood Tests: Measure levels of clotting factors VIII and IX. 2. Genetic Testing: For families with a history of hemophilia, prenatal and carrier testing may be done. Management: 1. Factor Replacement Therapy: Regular infusions of the missing clotting factor (either factor VIII or IX) to prevent and treat bleeds. 2. Desmopressin (DDAVP): For mild hemophilia A; stimulates release of factor VIII. 3. Antifibrinolytic Medications: Help prevent clot breakdown, especially useful during dental procedures. 4. Physical Therapy: Helps maintain joint function and manage joint bleeding. 5. Bleeding Precautions: Avoid contact sports, use protective gear, and prompt treatment for any injuries. Prevention of Bleeds: Regular prophylactic factor infusions in severe cases. Avoidance of high-risk activities and medications that increase bleeding risk (e.g., aspirin). Growth Disturbance Definition: A condition where a child’s growth rate deviates from the expected pattern for age and gender, resulting in stunted or excessive growth. Types: 1. Short Stature: Height below the 3rd percentile for age. 2. Tall Stature: Height above the 97th percentile for age. 3. Growth Delay: Slower growth than expected but may catch up later. Causes: 1. Genetic Factors: Familial short or tall stature. 2. Hormonal Disorders: Growth hormone deficiency, hypothyroidism, Cushing’s syndrome. 3. Nutritional Deficiency: Lack of essential nutrients can lead to growth delay. 4. Chronic Illnesses: Kidney disease, gastrointestinal disorders, or congenital heart defects. 5. Psychosocial Factors: Severe stress or neglect can cause psychosocial dwarfism. Symptoms: Height significantly shorter or taller than peers. Delayed or accelerated puberty. Slower weight gain or other physical developmental delays. Diagnosis: 1. Growth Chart: Plotting height and weight on growth charts over time. 2. Bone Age X-ray: Determines maturity of bones, often delayed in growth delay. 3. Blood Tests: Hormone levels, thyroid function, and nutritional status. 4. Genetic Testing: For conditions like Turner syndrome or genetic growth disorders. Management: 1. Treat Underlying Conditions: Address any hormonal or nutritional deficiencies. 2. Growth Hormone Therapy: For conditions like growth hormone deficiency or Turner syndrome. 3. Nutritional Support: Ensure a balanced diet with adequate protein, vitamins, and minerals. 4. Psychosocial Support: Counseling if stress or emotional factors contribute to growth issues. Hyperthyroidism Definition: A condition where the thyroid gland produces excessive amounts of thyroid hormones (T3 and T4), leading to an overactive metabolism. Causes: 1. Graves’ Disease: The most common cause, an autoimmune disorder where the immune system attacks the thyroid, stimulating excessive hormone production. 2. Thyroid Nodules: Rarely, a thyroid nodule can produce excess thyroid hormone. 3. Thyroiditis: Inflammation of the thyroid, leading to temporary hormone release. 4. Medications: Certain medications (e.g., iodine-based drugs) can also trigger hyperthyroidism. Symptoms: Hyperactivity and irritability. Excessive Sweating and heat intolerance. Weight Loss despite an increased appetite. Rapid Heartbeat (tachycardia) or palpitations. Tremors (shaking hands or fingers). Growth Delay in some cases. Enlarged thyroid gland (goiter), visible in the neck. Sleep Disturbances and fatigue. Bulging Eyes (in severe cases, particularly with Graves’ disease). Diagnosis: 1. Blood Tests: Elevated T3 and T4 levels. Low TSH (Thyroid Stimulating Hormone), as the pituitary gland tries to reduce thyroid activity. 2. Thyroid Antibody Tests: To detect antibodies in Graves’ disease. 3. Ultrasound or Radioactive Iodine Scan: To evaluate thyroid structure or nodules. Management: 1. Antithyroid Medications: Methimazole or propylthiouracil to inhibit thyroid hormone production. 2. Beta-blockers: To control symptoms like rapid heart rate and tremors. 3. Radioactive Iodine: To destroy overactive thyroid cells (used less frequently in children). 4. Surgery: Rarely, thyroidectomy is performed if medications and radioactive iodine aren’t effective. 5. Monitoring: Regular follow-up to check hormone levels and adjust treatment. Ottorhoea Definition: Ear discharge, often indicating an infection or ear-related condition. Causes: 1. Otitis Media: Middle ear infection, with or without a perforated eardrum. 2. Otitis Externa: Outer ear canal infection, often from bacteria or fungi. 3. Foreign Body: Objects inserted into the ear. 4. Trauma: Injury to the ear or eardrum. 5. Eczema/Dermatitis: Skin conditions affecting the ear canal. Symptoms: Ear drainage, pain, fever, hearing loss, and irritation. Diagnosis: Clinical Examination: Inspection with an otoscope. Culture: To identify bacteria or fungus. Imaging: If needed for chronic or complex cases. Management: 1. Antibiotics for infections. 2. Ear Drops for otitis externa. 3. Pain Relief: Acetaminophen or ibuprofen. 4. Foreign Body Removal: By a healthcare provider. Prevention: Keep ears dry, avoid inserting objects, and treat infections promptly. Prognosis: Most cases resolve with treatment; chronic issues may require ongoing care. Parotiditis Definition: Inflammation of the parotid glands, which are the largest salivary glands located near the ears. It can be caused by infections or other conditions. Causes: 1. Mumps Virus: The most common cause, an infectious viral disease. 2. Bacterial Infections: Can occur due to a blocked duct, dehydration, or oral infections (e.g., Staphylococcus). 3. Non-infectious Causes: Dehydration, medications, or autoimmune disorders. Symptoms: Swelling in front of and below the ears (unilateral or bilateral). Pain or tenderness in the swollen area. Fever and malaise. Difficulty swallowing or dry mouth. Sometimes, redness or warmth over the swelling. Diagnosis: Clinical Examination: Inspection of swelling and tenderness. Salivary Gland Ultrasound: To evaluate gland inflammation. Lab Tests: Serology for mumps virus or bacterial cultures if infection is suspected. Management: 1. For Mumps: Supportive care (hydration, pain relief, and fever management). Mumps is typically self-limiting. 2. For Bacterial Parotiditis: Antibiotics may be needed if a bacterial infection is confirmed. 3. Hydration and Oral Care: Encourage fluids and good oral hygiene. 4. Warm Compresses: For comfort and to promote salivation. Prevention: Vaccination: The MMR vaccine (measles, mumps, rubella) is highly effective in preventing mumps. Prognosis: Mumps-related parotiditis usually resolves within a few weeks with no long-term complications. Bacterial cases may require longer treatment and have a risk of recurrence if not treated promptly. Congenital Diseases and Genetic Disorders 1. Duchenne Muscular Dystrophy (DMD) Definition: A genetic disorder causing progressive muscle weakness and degeneration. Cause: X-linked recessive mutation in the Dystrophin gene, affecting the production of dystrophin, a protein that helps maintain muscle cell structure. Symptoms: Muscle weakness, starting in the lower limbs. Difficulty with motor skills like running, jumping, and walking. Gower’s sign (using hands to rise from the floor). Progressive loss of muscle function leading to wheelchair use by age 12. Management: No cure, but corticosteroids may slow progression. Physical therapy to maintain muscle function. Heart and respiratory management as disease progresses. 2. Neural Tube Defects (NTDs) Definition: Birth defects involving incomplete development of the brain, spine, or spinal cord. Types: Spina Bifida: Incomplete closure of the spinal cord. Anencephaly: Absence of a major portion of the brain and skull. Encephalocele: Brain tissue protruding through a skull defect. Cause: Insufficient folic acid during pregnancy, along with genetic and environmental factors. Symptoms: For spina bifida, symptoms include motor and sensory loss, bladder and bowel dysfunction, and deformities. Anencephaly results in stillbirth or death shortly after birth. Management: Surgery for spina bifida to close the spinal defect. Physical and occupational therapy for motor disabilities. Folic acid supplementation during pregnancy can reduce the risk of NTDs.  3. Down Syndrome (Trisomy 21) Definition: A genetic condition caused by the presence of an extra 21st chromosome. Cause: Chromosomal abnormality where a child inherits three copies of chromosome 21 instead of the usual two. Symptoms: Intellectual disability (mild to moderate). Characteristic physical features: flat facial profile, upward-slanting eyes, and a small mouth. Developmental delay, hypotonia (low muscle tone), and heart defects (e.g., congenital heart disease). Management: Early intervention programs for developmental support. Speech, physical, and occupational therapy. Cardiac surgery if congenital heart defects are present. Regular health check-ups to manage associated conditions. 4. Other Chromosomal Disorders Turner Syndrome (45, X) Cause: Monosomy X, where one of the two X chromosomes is missing or partially missing. Symptoms: Short stature, webbed neck, delayed puberty, and infertility. Management: Growth hormone therapy and estrogen replacement for puberty. Klinefelter Syndrome (47, XXY) Cause: An extra X chromosome in males. Symptoms: Infertility, reduced testosterone levels, and learning difficulties. Management: Testosterone therapy and educational support. Patau Syndrome (Trisomy 13) and Edwards Syndrome (Trisomy 18) Cause: Extra copies of chromosomes 13 and 18, respectively. Symptoms: Severe developmental and physical disabilities, including heart defects, cleft lip/palate, and intellectual disability. Management: Supportive care, but life expectancy is generally very short (often less than 1 year). Leukemia Definition: Cancer of the blood and bone marrow, leading to abnormal white blood cell production. Types: 1. Acute Lymphoblastic Leukemia (ALL): Most common in children. 2. Acute Myeloid Leukemia (AML): Less common, affects myeloid cells. 3. Chronic Leukemias: Rare in children (e.g., CML, CLL). Causes: Genetic mutations, previous chemotherapy, family history, environmental factors. Symptoms: Fatigue, pallor, fever, joint pain, swollen lymph nodes, easy bruising, abdominal swelling. Diagnosis: Blood tests (CBC), bone marrow biopsy, genetic testing, imaging. Treatment: 1. Chemotherapy (primary treatment). 2. Stem cell transplant (for relapsed cases). 3. Radiation therapy and targeted therapy. 4. Supportive care: Blood transfusions, antibiotics. Prognosis: High survival rate for ALL (~85-90%). AML has a lower survival rate but improved with treatment. Early treatment improves outcomes. Fluid Therapy Definition: Administration of fluids to maintain hydration and electrolyte balance in children, especially during illness or surgery. Indications: Dehydration, hypovolemia, electrolyte imbalances, post-surgery, and chronic conditions. Types of Fluids: 1. Crystalloids: Isotonic (e.g., normal saline, Lactated Ringer’s) for general hydration. Hypotonic (e.g., 0.45% saline) for excess sodium. Hypertonic (e.g., 3% saline) for severe hyponatremia. 2. Colloids: Large molecules like albumin, used for severe blood loss or plasma expansion. Administration: Oral: For mild dehydration (ORS). IV: For severe dehydration or when oral intake is not possible. Fluid Calculation: Maintenance fluid based on weight: 10 20 kg: 1500 mL + 20 mL/kg for each kg >20 Complications: Fluid overload, electrolyte imbalances. Monitoring: Regularly track intake, output, weight, and vital signs to adjust therapy. Dehydration and Its Management Dehydration occurs when there is a deficit of water and electrolytes in the body, leading to a disruption in normal physiological functions. Causes: Diarrhea, vomiting, fever, excessive sweating, or inadequate fluid intake. Infections, such as gastroenteritis, which are common in children. Diabetes (poorly controlled) or other chronic conditions. Types of Dehydration: 1. Mild Dehydration: Loss of up to 5% of body weight. Symptoms: Slight dry mouth, slightly reduced urine output. 2. Moderate Dehydration: Loss of 5-10% of body weight. Symptoms: Dry mouth, reduced urine output, lethargy, sunken eyes, and fontanelle (in infants). 3. Severe Dehydration: Loss of more than 10% of body weight. Symptoms: Very dry mouth, extreme lethargy, sunken eyes, absence of tears, cool skin, rapid pulse, hypotension, and shock. Symptoms: Thirst, dry mouth, sunken eyes, lethargy, reduced urine output, dark-colored urine, dry skin, and in severe cases, hypotension and shock. Management: from diarrhoea Prevention: Encourage adequate fluid intake, especially during illness or hot weather. Use ORS early when signs of dehydration appear, especially in cases of vomiting or diarrhea. Vaccination (e.g., rotavirus vaccine) to prevent dehydration caused by certain infections.