Acute Otitis Media (AOM) in Pediatrics: Diagnosis and Management

Febrile Seizures in Children: Evaluation and Management

Febrile seizures occur between 6 months and 5 years with fever and no central nervous system infection. Simple febrile seizures are generalized, last under 15 minutes, and do not recur within 24 hours; complex seizures are focal, prolonged, or recurrent within a day. For simple febrile seizures, no EEG, neuroimaging, or routine lumbar puncture is needed; evaluate and treat the fever source, and control fever with antipyretics for comfort. Prolonged seizures beyond 5 minutes are terminated with buccal midazolam or rectal diazepam. Lumbar puncture is reserved for meningeal signs or clinical concern for meningitis. Counsel parents that about one third recur, that the risk of epilepsy is only slightly increased, and teach first aid positioning.

Acute Gastroenteritis and Dehydration in Children: Assessment and Management

Assess dehydration by weight change, general appearance, eyes, mucous membranes, tears, capillary refill, and skin turgor. No or mild dehydration is managed at home with oral rehydration solution in small frequent volumes plus continued feeding and breastfeeding. Moderate dehydration receives ORS, about 50-100 mL/kg over 4 hours, with ongoing losses replaced and reassessment. Severe dehydration with lethargy, sunken eyes, weak pulse, or prolonged capillary refill requires immediate intravenous isotonic fluid boluses of 20 mL/kg, repeated as needed, then transition to ORS. Ondansetron can support oral rehydration in persistent vomiting. Zinc supplementation shortens episodes, routine antibiotics are not indicated, and rotavirus vaccination prevents severe disease.

Neonatal Jaundice: Evaluation and Management

Jaundice within the first 24 hours of life is always pathological and demands urgent evaluation. Measure total serum bilirubin and plot it on an hour-specific nomogram to determine risk and treatment thresholds, checking blood group, Coombs test, and G6PD status where hemolysis is likely. Phototherapy is the mainstay once bilirubin crosses the hour-specific threshold, with intensive phototherapy for higher levels. Exchange transfusion is reserved for levels near exchange thresholds or signs of acute bilirubin encephalopathy. Optimize feeding and hydration, repeat bilirubin after phototherapy to catch rebound, and investigate prolonged jaundice beyond 2 weeks with conjugated fraction to exclude biliary atresia.