Nearly three hundred thousand children, from infants to teenagers in the United States alone suffer from some sort of arthritis. Juvenile idiopathic arthritis (JIA) is the most common type of arthritis among the children. The meaning of the term idiopathic is – “unknown origin.” It was previously known as Juvenile rheumatoid arthritis or JRA. Researches are uncertain as to what causes or leads to JIA. No research has been able to provide evidence about JIA being developed because of food, toxins, allergies or lack of vitamins. However, current researches indicate a genetic side to Juvenile idiopathic arthritis. Some researchers in the field are of the view that a trigger like a virus can start the disease in a child who has got this genetic tendency.
The treatment for Juvenile idiopathic arthritis is aimed at helping the child maintain a normal level of social and physical activity. The doctors use a combination of strategies to relive pain, swelling and prevent complications. Some children may just require pain relievers while others may require the help of certain medicines to prevent the growth and progression of the disease.
Some medicines that are used in treatment of Juvenile idiopathic arthritis are –
NSAIDS or Nonsteroidal anti-inflammatory drugs –
These medications like ibuprofen (Motrin,Advil and others) and naproxen help to reduce pain and swelling. The side effects of these medicines include stomach upset and liver problems.
Disease modifying anti-rheumatic drugs (DMARDs.) –
When NSAIDs fail to cure the symptoms of swelling and pain, doctors prescribe these medications. They may also be taken in combination with DMARDs. Some commonly used DMARDs for children are methotrexate (Trexall) and sulfasalazine (Azulfidine). Side effects include nausea and liver related problems.
Immune suppressants –
Since JIA is caused by overactive immune system, medications that suppress immune system are used in treatment of Juvenile Idiopathic Arthritis. Some common medicines that are administered include abatacept (Orencia), rituximab (Rituxin), anakinra (Kineret) and tocilizumab (Actemra). These medicines increase the risk of infections and cancer.
Tumor necrosis factor (TNF) blockers –
Etanercept (Enbrel) and adalimumab (Humira) are TNF blockers that help to reduce pain, swollen joints and morning stiffness. Just like immune suppressants these medicines increase the risk of having infections and some mild cancers like lymphoma.
Corticosteroids –
Medicines like prednisone may be used to prevent inflammation of the sac around the heart and other complications. Corticosteroids can be administered either by mouth or directly into a joint with the help of an injection. The side effects of these medicines include increase in susceptibility to infection and interference in normal growth. It should be used for the shorted possible duration.
In addition to the medications, the doctors will recommend the child to be consulted with a physical therapist to help in keeping the joints flexible and maintain the muscle tone. The physical therapist will suggest any protective equipment that may be necessary along with the best exercises. In rarest cases a surgery may be performed to improve the position of joint for a child suffering from Juvenile Idiopathic Arthritis.
Pediatric Infectious Diseases And Its Treatments –
Infectious diseases are disorders caused by organisms such as bacteria, viruses and fungi. Though families take utmost care and precaution in the upbringing of a child, sometimes certain infectious diseases may develop which needs to be diagnosed by a pediatric who specialises in dealing with infectious diseases in children.
Some pediatric infectious diseases and the treatments required for them are mentioned below –
Rheumatic fever
It is a complication associated with a strep throat. Rheumatic fever is a serious illness and if left untreated, it can even cause a stroke or a permanent damage to the child’s heart. Rheumatic fever generally appears in children between the age of 5 and 15. The treatment for this kind of fever involves getting rid of all group A residual bacteria and controlling the symptoms which is achieved with the help of antibiotics, anticonvulsants, anti-inflammatory treatment and bed rest.
Bronchiolitis
Bronchiolitis is the inflammation of bronchioles, the smallest air passages of the lungs. It occurs in children of less than 2 years of age with the majority aged between 3 to 6 months. Treatment involves typically providing support with oxygen, monitoring fluid and oxygen. Even antibiotics, chest physiotherapy, surfactant and bronchodilators are sometimes used in the treatment.
Respiratory syncytial virus (RSV)
It is the most common and contagious virus that infects the respiratory tract of the children before the age of two. For most of the children it does not generally cause anything more than a cold but for a minuscule percentage some serious problems may develop, like pneumonia. The treatment involves home care of the baby. Removing sticky nasal fluids, giving fluids in small amounts and using cool mist vaporiser to keep the air moist is what helps to cure this infection.
Adenovirus infection
They are a group of common viruses that infect the lining of airways, eyes, lungs, intestines, urinary tract and nervous system. They are generally caused by fever, sore throats, pink eye and diarrhoea. Antibiotics generally do not help in treating adenovirus infections as these drugs only kill the bacteria. Children usually get over this infection within a few days.
Pharyngitis
Pharyngitis is an infection which leads to the inflammation of pharynx, situated in the back of the throat. It is more commonly referred to as sore throat. Pharyngitis may also cause scratchiness and difficulty in swallowing. Drinking plenty of fluids and eating warm broth can help relieve the symptoms. Resting and gargling with warm water also helps to cure it. In certain cases antibiotics maybe prescribed by the doctor.
Roseola
It is a mild viral illness of sudden onset and short duration. Roseola is most common among children of 6 to 24 months of age. A sudden high fever lasting for 3 to 5 days is an early sign of Roseola. After the fever disappears, a rash appears which may last for a couple of days. It is not contagious. Roseola is generally resolved with ibuprofen (such as Advil and Motrin), acetaminophen(Tylenol) or by giving sponge baths to the child.