Elston J (1985). Sticky eyes in infancy. Maternal and Child Health 10(8):248, 250-251.

Fok TF, Wong W, Cheng AFB (1995). Use of eyepatches in phototherapy: effects on conjunctival bacterial pathogens and conjunctivitis. Pediatric Infectious Disease Journal 14(12):1091-1094.

Harris MJ (1996). Infections in the first months of life. Journal of Paediatrics, Obstetrics and Gynaecology 22(2):13-15.

Matejcek A, Goldman RD (2013). Treatment and prevention of ophthalmia neonatorum. Canadian Family Physician 59(11).

Moten J, McGuiness B (2000). Is your midwifery practice evidence based? Here’s milk in your eye: an exploration of the use of colostrum for the treatment of ophthalmia neonatorum. Open Line 8(2):6-7.

Newell SJ, Miller P, Morgan I et al (1997). Management of the newborn baby: midwifery and paediatric perspectives. In: Henderson C, Jones K eds. Essential midwifery. London: Mosby. 229-264.

Verd S (2007). Switch from antibiotic eye drops to instillation of mother’s milk drops as a treatment of infant epiphora. Journal of Tropical Pediatrics 53(1):68-69.

Zuppa AA, D’Andrea V, Catenazzi P et al (2011). Ophthalmia neonatorum: what kind of prophylaxis? Journal of Maternal-Fetal and Neonatal Medicine 24(6):769-773.

Useful websites

http://www.nhs.uk/Conditions/Watering-eye/Pages/Treatment.aspx [Accessed 23 January 2014]

http://www.patient.co.uk/health/tear-duct-blockage-in-babies [Accessed 23 January 2014]

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Acute intestinal infections in babies

The baby fell ill suddenly: body temperature rose, vomiting appeared. The chair became frequent, liquid, plentiful, watery. It contained inclusions of undigested food, sometimes an admixture of mucus, greenery, less often - streaks or an admixture of blood. All bases to assume, what is it an intestinal infection.

Due to repeated vomiting and frequent liquid stools in young children, severe, life-threatening dehydration can occur as early as 6-8 hours. A high temperature, sometimes rising to 40-41 ⁰ , capable of "leading" convulsions.

Call a doctor immediately and start acting energetically without missing a beat: in such a situation, you yourself must become an "ambulance"! Now it doesn’t matter what has overtaken the baby: dysentery, salmonellosis, rotavirus or other intestinal infection (more than 40 pathogens are known) - all of them at first manifest themselves very similarly, and first aid, both with high body temperature and with dehydration of the body as a result of vomiting and frequent loose stools are the same.

To prevent dehydration of the baby's body, from the first hours, start giving the child boiled water - "drink" him. But since not only water is lost with loose stools and vomit, but also salts of sodium, potassium, chlorine and other electrolytes, which are essential for the normal functioning of the heart, kidneys, brain and other organs, water alone is not enough, saline solutions are required.

For more than 30 years all over the world for oral rehydration (compensation of pathological losses of water and electrolytes through the mouth - "drinking" in case of intestinal infections) glucose-salt solutions specially developed by WHO have been used. In our country, Regidron, which is produced in powders and freely sold in pharmacies, has been widely used both in hospitals and in the treatment of intestinal infections at home. Before use, the contents of the sachet are diluted in a liter of warm boiled water and given to the child to drink. The drug effectively compensates for the existing losses of water and electrolytes, prevents further dehydration of the child's body and aggravation of his condition, but does not have a pronounced therapeutic effect.

In recent years, in accordance with the recommendations of the European Society for Pediatric Gastroenterology and Nutrition (ESPGAN), for better absorption of water and electrolytes in the intestine, the electrolyte composition of solutions has been slightly changed, namely, their osmolarity and sodium-glucose ratio have been reduced. In many pharmacies, the Gastrolit glucose-saline solution, which meets the new standard, has already appeared on sale. Unlike rehydron, gastrolith also contains chamomile extract, which additionally has an anti-inflammatory, antiseptic and antispasmodic effect on the intestines, that is, "Gastrolit" also has a therapeutic effect.

Which glucose-saline solution is best for drinking ?

There are no significant differences in their effectiveness, but when a child is "drinked" with a solution of "Gastrolit", abdominal pain, vomiting, flatulence phenomena (bloating, rumbling, etc.) disappear 1-2 days faster, the frequency and watery nature of the stool decrease . Before use, the content of 1 sachet of gastrolith is diluted in 200 ml necessarily hot boiled water to obtain chamomile infusion and cooled to room temperature.

If these solutions are not available at home, prepare a decoction - for 1 liter of water, either 100 g of raisins or 500 g of carrots (cut into pieces and boil). Add a teaspoon of table salt (without top), ½ teaspoon of baking soda, 4 teaspoons of granulated sugar to it, bring to a boil and cool - the “homemade rehydron” is ready. It is even easier to prepare a sugar-salt solution - for 1 liter of boiled water you need a teaspoon of salt, ½ teaspoon of baking soda and 8 teaspoons of granulated sugar.

When "drinking" an infant with these solutions, drink from a spoon every 5-7-10 minutes. But little by little! For example, 1-3 teaspoons or 2-3 "sips" through the nipple. It is impossible to give a lot of liquid at once, even if he drinks greedily - this can provoke a new attack of vomiting. For a child 2-3 years old and older, a single dose of solutions can be increased to 2-3 tablespoons, and intervals - up to 10-15 minutes.

What is the total volume of fluid needed to compensate for the pathological loss of water and electrolytes with stool and vomiting ?

WHO experts recommend that in the presence of vomiting and "watery" stools, a young child loses about 10 ml per 1 kg of body weight for each bowel movement. For example, a child weighing 10 kg with each loose stool will lose 100 ml of fluid, which must be “drinked” between bowel movements and feeding the child. To avoid dehydration, the child should receive a total of approximately as much fluid per day, including nutrition, as a healthy baby of the same age needs, plus the amount lost with vomiting and loose stools. If he eats less than he should (and during illness this is almost inevitable), then the missing amount of food must be compensated by liquid.

When gastrolith is used, the solution must not be sweetened and can only be “drained” with gastrolith alone. Age dosages of the required volume of the prepared gastrolith solution for children are detailed in the attached instructions. While the solution of rehydron should be only half the required daily amount of liquid. In this case, the intake of rehydron should be alternated with the intake of the same volume, either weakly brewed unsweetened tea, or boiled water or 5% glucose solution, which can be bought at a pharmacy.

It is widely believed that a solution of potassium permanganate (potassium permanganate) helps stop vomiting and diarrhea. I often give it to drink, make enemas with it. Vomiting and diarrhea in most cases really stop, but only for a few hours. Moreover, the chair is absent from the fact that under the influence of potassium permanganate, a fecal plug is often formed, which prevents the exit of intestinal contents. And it's far from safe! With loose stools, the body is freed from a huge amount of pathogenic microbes and viruses, pathogens of intestinal infections, their toxins, gases and other toxic substances formed in the intestines as a result of inflammatory or fermentation processes. With a fecal plug, all of them, lingering in the intestines, begin to be absorbed into the blood, and after a few hours of “relative” well-being, the child’s condition deteriorates sharply - bloating, shortness of breath and indomitable vomiting appear. In such cases, immediate hospitalization is required.

There are even worse situations with potassium permanganate. A sick baby is given a concentrated solution, believing that it will work more efficiently or a solution containing undissolved crystals. And the ending is tragic: burns of the mucosa of the gastrointestinal tract, intestinal bleeding, intestinal perforation with the development of peritonitis, requiring urgent surgical intervention, and even the death of a child.

Please do not give potassium permanganate by mouth to children under any circumstances !

Vomiting and diarrhea in intestinal infections are initially protective in nature - the body tries to "throw out" microbes and toxic products with vomit and frequent loose stools. It is more expedient to help the body in this - to wash the stomach and even make a cleansing enema. At home, let the child drink as much boiled water as possible and the vomiting that has begun will “wash out” microbes and toxins from the stomach. If it is not there, call it yourself by pressing on the root of the tongue with the handle of a clean spoon, in extreme cases, with a finger wrapped in a sterile gauze or bandage. This should be repeated 2-3 times, and then let the child drink an enterosorbent (smecta, filtrum, enterosgel, etc.), strictly observing the age dosages indicated in the instructions. Enterosorbents "bind" microbes, viruses and their poisons in the gastrointestinal tract, then remove them with feces, which greatly facilitates the course of the disease, quickly reduces the frequency and improves the consistency of the stool. It is not rational to use activated carbon for this purpose - its effectiveness in normal dosages is very low.

After gastric lavage and enterosorbent intake, vomiting in intestinal infections usually stops. If this does not happen, then vomiting and diarrhea, especially in infants, may be one of the manifestations of diseases such as appendicitis, influenza, otitis media, pneumonia, meningitis, etc. In these cases, it is necessary to call a doctor at home or an ambulance » for the hospitalization of the child in the appropriate hospital. It is better to stop therapeutic measures before the doctor arrives, with the exception of antipyretics, and the volume of liquid for “drinking” should not exceed pathological losses with loose stools.

To feed or not to feed ?

The general rule is this: it is necessary to give food, reducing the daily amount of food, but not more than half. However, it all depends on the frequency of vomiting and the condition of the child, and this is what you need to focus on. Ideal: feed "according to appetite", but more often and in small portions, so as not to overfill the stomach and not provoke vomiting. If the baby is breastfed, continue breastfeeding. But with frequent vomiting (or regurgitation), it is better to switch to “metered” feeding with expressed breast milk in small portions at regular intervals (after 2-2.5-3 hours with a night break). A baby who is bottle-fed, as well as a 2-3-year-old child and older, on the first day of the disease can be fed with normal food (kefir, cottage cheese, adapted infant formula, cereals with half milk, etc.), but preference should be given to medical - prophylactic food products enriched with bifido- or lactobacilli (children's kefir "Bifidok", mixture "Agusha", acidophilic mixture "Baby", "Kroshechka", etc.).

In case of a pronounced fermentation process (increased gas formation, bloating and rumbling in the abdomen, foamy stools, etc.), it is better to replace the child’s usual food for several days with commercially available and age-adapted low-lactose or lactose-free baby foods. It is also recommended to introduce cereals on water or vegetable broths into the diet, an earlier appointment of meat gosha is shown.

Older children in the acute period of intestinal infection should be completely excluded from the diet of foods that cause fermentation in the intestines and increased gas formation, containing coarse fiber: whole milk and cereals with whole milk, fermented baked milk, cream, black bread, meat, chicken and fish broths, dishes from beans, peas, beets, cabbage, grapes, citrus fruits, as well as all fatty, fried, canned food (except canned food for baby food), limit sweets. Carbonated drinks (fanta, etc.) are also prohibited.

Emergency treatment for high body temperature.

The temperature is not higher than 38 ⁰ (if the child tolerates it well and provided that such rises were not accompanied by convulsions before), you can not “knock down”. But if the mercury column rises above 38-38.5 ⁰ or the so-called "convulsive readiness" appears - trembling of the fingertips and chin, proceed to intense antipyretic measures.

Attention! If the hands and feet are hot , like the rest of the body - start with physical methods of cooling. Undress the baby and fan it vigorously (option: put a fan nearby). Put a napkin moistened with cold water and wrung out on your forehead, and plastic bags with ice or bottles of cold water wrapped in a thin cloth in the armpits and inguinal cavities. Let's drink cool water or a glucose-salt solution (rehydron or gastrolith) as often as possible.

If the temperature has risen to 40 ⁰ and above, wiping the body with 3% vinegar or a special mixture is required: water, table vinegar (not essence) and alcohol in equal amounts. Pour the prepared mixture into the palm of your hand and rub the baby’s chest, stomach, back, arms and legs quite intensively, but very carefully - everything except the face. It is very useful to wear stockings or socks moistened with this liquid.

The temperature should drop after 10-15 minutes. If there is no effect, give the child antipyretics: children's panadol, efferalgan, etc. As soon as the temperature drops to at least 38 ⁰ , stop physical cooling. If after some time it rises again, then repeat the cooling measures until the doctor or ambulance arrives.

Attention! If the hands and feet are cold - doctors call this condition “white hyperthermia”: it indicates a violation of heat transfer due to spasm (contraction) of skin vessels and then physical methods of cooling are contraindicated! They can increase the spasm, the heat transfer will decrease, the temperature will rise even more and the child's condition will worsen before our eyes. You can only gently rub the body with a water-vinegar-alcohol mixture, if possible, to a slight reddening - this procedure expands the blood vessels of the skin and heat transfer increases.

The main thing to reduce the temperature in such cases is antipyretics for children, as well as vasodilators - papaverine, dibazol, etc.

If convulsive readiness or convulsions appear, in addition to antipyretics, give the child any of the antihistamines: pipolfen (it also has an antiemetic effect), suprastin, etc. But this is not enough. If there are convulsions, you can’t hesitate and wait for the local pediatrician - call an ambulance!

Open a window for fresh air - oxygen is vital for a child;

Don't leave your baby alone, he might fall out of bed. If he is lying on his back, turn his head to one side so that he does not choke on vomit. Even better, the position on his side - this will facilitate their discharge;

Wipe your mouth with a damp gauze pad around your finger to remove vomit and mucus;

· Be careful not to sink the tongue - this threatens to suffocate;

Try not to pick it up so as not to cause pain, but hold it upright when you pick it up.

As the temperature decreases, convulsions usually disappear.

And finally, one more recommendation-caution: all medicines should be only in the age dose. Grind the tablets, dilute in boiled water and give from a spoon. No other drugs (especially antibiotics) - without a doctor's prescription! Do not rush to give enzyme preparations, especially proteolytic (abomin, etc. ) and pancreatin with bovine bile components (festal, etc.) - they can only increase diarrhea, especially with intestinal infections of viral etiology, which in young children are up to 70 -80% of the total. The appointment of antibiotics or other antibacterial drugs (furazolidone, etc.) in these cases only aggravates the course of the disease and contributes to the development of dysbacteriosis.

Acute intestinal infections, except for severe forms, can be treated at home. The main directions of treatment tactics and during the hospitalization of the child are the same: a rational diet, "drinking", enzyme preparations (pancreatin, mezim forte, etc.), symptomatic therapy (antiemetic, antipyretic, analgesic drugs, etc.). In severe dehydration, a drip is prescribed.

In recent years, highly effective methods have been developed for the treatment of intestinal infections without antibiotics, including severe forms, using probiotics, enterosorbents, and specific immunoglobulin preparations.

Remember, the earlier treatment is started, the more effective it is. If your baby has diarrhea and/or vomiting, call the doctor at home. Only he, having understood the various causes of the disease, can prescribe the necessary treatment.

April 29, 2013 61835

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How to choose a lens solution?

Long-life contact lenses - two weeks, a month, three months or more - require daily mechanical cleaning and disinfection with a special solution. This is important not only for the quality of vision, but also for the health of the patient's eyes.

The solution is needed for cleaning and storing lenses, as well as for rinsing the container and tweezers. We tell you how lens care products differ and how to choose a solution that is suitable for your type of lenses.

Bonus at the end of the article - TOP-5 best solutions.

Types and purpose of lens solutions

Contact care products are divided into four types, depending on the functions they perform.

Water-salt

This type of solution is practically not used today, but in the past it was almost the only option for cleaning lenses. Therefore, some patients from those who have been using contact correction for a long time still use it.

Water-salt solution moisturizes and softens lenses, but it does not provide a disinfectant function, so ophthalmologists recommend that this product be discarded.

Multipurpose

Multipurpose (or universal) solution is the best option for everyday use. The tool performs all the functions that are needed for high-quality and safe use of contact lenses:

• Disinfection - the destruction of bacteria, fungi and other microorganisms dangerous to the eyes;
• Moisturizing;
• Cleaning from dirt and dust;
• Removal of protein and lipid deposits that are part of the lacrimal fluid.

The products are considered universal and in most cases suitable for any type of lens, but it is better to consult a specialist before buying - it is important that the liquid is combined with the material from which the lenses are made.

Thanks to a special formula, some products save the patient from the need to mechanically clean the lenses - disinfection and removal of contaminants occur even without it. That is, the patient can simply remove the means of contact correction and immediately place them in a container with a fresh solution. However, this should be discussed with an ophthalmologist as not all solutions are suitable for this cleaning.

Another advantage of multifunctional products is that they do not cause burning, pain or other unpleasant sensations when they get into the eyes.

Enzymatic (enzymatic)

Enzymatic products are designed to remove organic deposits that multifunctional solutions cannot cope with. As a rule, this is true for lenses with a long replacement period. So, for example, they are often recommended for cleaning orthokeratology lenses, the replacement period of which is one year.

Enzyme products are in the form of tablets to be added to the multifunctional solution. Suitable for soft and hard lenses.

Peroxide

Solutions based on hydrogen peroxide provide high-quality and deep cleaning of lenses from possible bacteria, fungi and deposits. However, these products do not moisten the lenses and are not suitable for lens storage.

If hydrogen peroxide gets into the eyes, it will cause burning and pain. In some cases, peroxide can even cause corneal burns or mucosal inflammation. Therefore, after using a peroxide solution, the lens must be washed or the exposure time must be maintained, after which the solution will be neutralized and become safe.

In addition, the product is not suitable for everyday use. Contraindicated for hydrogel contact lenses.

Fluid selection

It is not recommended to select the fluid yourself. Seek help from a specialist, he will assess the condition of the eyes and select a product that suits your type of contact lenses.

Sign up for a selection of contact lenses

Top 5 solutions for lenses

Introducing a selection of the best contact lens care products.

Opti Free

Another multifunctional solution that fits all types of soft contact lenses, Opti Free. Provides deep disinfection, reduces the amount of lipid deposits and maintains continuous hydration of the lenses for 16 hours.

Manufactured by Alcon.

Biotrue

Biotrue is a multifunctional solution designed for hydrogel and silicone hydrogel contact correction products. The acidity pH is close to natural tears, making the liquid suitable even for patients with high eye sensitivity or a tendency to allergies.

Manufacturer - Bausch & Lomb.

Aculife

Aculife Multipurpose Soft Lens Solution contains hyaluronic acid, which keeps lenses moist for a long time.

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