Preauricular sinus is a common condition. A hole near the ear since birth is present in as many as 1% of all individuals. The hole is usually near the upper part of the ear and in front of it. The hole can be only on one side or in front of both ears.
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Recently, I had this ten-year-old boy, who came to me with a four-day-old injury. Apparently, the boys were playing rather boisterously at school. As is usual children, especially if they have not been cautioned earlier, quite forget that even everyday objects can be quite dangerous. While horsing around, one of the children drove the nicely sharpened point of his pencil into the child’s arm.
(more…)The days are long gone when we accepted what came out of our doctor’s mouth as the gospel truth. And good riddance too! There are many reasons why the majority of the population is eager to seek a second opinion. And a third, and a ….
My favorite mantra to all patients.
By far the best way is to request your treating doctor to take a second opinion for you. As I have already mentioned, a really good and self-confident doctor does not in any way balk at asking for second opinions.
In a large hospital, there are many consultants of the same specialty. Ask around, especially the paramedical staff. They are the ones who have seen the results of all the doctors that visit and are usually able to suggest the best person available. Beware of two things though! Sometimes the paramedical staff get awed by the personalities involved and may not be able to give you an objective opinion. Secondly, it can be a very touchy situation if you zero in on a consultant of the same hospital, and the two consultants don’t get along.
Better to ask your family practitioner/family member/friend suggest somebody who is outside the hospital. Even if it is from the same hospital, you can always tell your treating consultant that my so and so has recommended this doctor. Since things are not going too well, can we take a second opinion? Do hasten to add that you know that your doctor is doing his/her best.
Talk at MCIAPS 2017
I gave a guest lecture on “Thoracoscopic Surgeries in Children” This was at the Annual Conference of the Maharashtra Chapter Of Indian Association Of Pediatric Surgeons that was held on July 16 and 17, 2017 at Novotel, Imagica, Khopoli .
Mucoceles are relatively commonly seen in children.
The minor salivary glands, and, there are over 600 of them, are small glands that produce saliva. The glands are too small to be seen by the naked eye and consist of a small globular gland. The saliva that forms in the gland drains out through a narrow tube (the duct) into the mouth. This saliva helps us chew our food and also starts the process of digesting food.
CEMAST (Center of Excellence for Minimal Access Surgery Training), Mumbai conducts courses for surgeons all year around in various disciplines.
Pillion riding is dangerous even for adults but is an absolute no-no for children. It is also illegal to transport children riding pillion on two-wheelers. People who regularly travel by two-wheelers cite the convenience. Given the traffic situation in most towns and cities in India, there is more than a grain of truth in that. Public transport is not as good as it should be. Moreover, public transportation at odd hours or during emergencies may just not be available. Two-wheelers are also much cheaper to maintain than cars.
Yet, children should never travel on two-wheelers, as it is downright dangerous. Most people, do not pay any heed to safety and don’t realize how dangerous it is to ferry children around on two-wheelers. We have this gentleman, nicely protected by his helmet (I suspect more out of fear of the law than by concerns about safety!), ferrying not one, but two kids in the rear.
There is no protection and no restraint. Any accident (whosoever is at fault, whether it be the rider himself, other drivers, the road or pedestrians), will result in the children being flung with great force out of the vehicle and crashing into anything that is nearby. Please do yourself and your children (whom you profess to love so much!) a favor and only travel with them, properly restrained in car seats in the back of four-wheelers! Please!
I have seen children actually dozing off at the back, when pillion riding. I quickly move away from such riders as I would certainly not want to be the instrument of their doom!
At birth, the foreskin, sometimes called the prepuce, is attached to the end of the penis, an area known as the glans. Over time, the foreskin separates from the glans, forming a space between the skin and the glans. Separation is completed in 50 percent of boys by age 3 years, 95 percent by age 5 years, and 99 percent by adolescence. So just wait it out, and it is very likely that the skin will retract back up to the junction between the head and the body of the penis, on its own.
In fact, there is a risk of injury to either the foreskin or the glans, if the foreskin is retracted forcibly. Many of these children who have had injury need to be circumcised at a later date.
Almost every patient that comes to me for consultation for undescended testis, comes armed with an ultrasound (USG) report, that the parent will promptly proceed to show me after the initial formalities, even before I have had a chance to ask as to why they are consulting me.
The sad part is that ultrasound is not only unnecessary but actually misleading in children with undescended testes [1].
USG is accurate in predicting examination findings in only 54% of children. Additionally it delays required surgery in infants by as many as 3 months.
The algorithm for managing undescended testis only requires whether an experienced pediatric surgeon can palpate the testis or not. So please do not get unnecessary tests done.
1. Ultrasound Overused to Diagnose Undescended Testicle