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How to deal with persistent cough and can a child manage with a single kidney?

Q: My daughter is 3 years 8 months old, 15 kgs in weight and height is 92 cms. She is having cough for the past 1.5 months. We have given medicines like Triaminic, Mox, Benyline-E, Sal mucolite etc. We have seen various doctors. But it still continues. She gets cough when she sleeps and finds difficult in breathing and vomits whatever she eats once she coughs. Since bangalore, where we stay is chilly, the problem continues. I want to know what can be done for this and how to increase resistance against cold. She was 15.75 kgs 1.5 months ago and she is now 15 kgs. She is going to school. Please suggest me regarding this. My daughter was having PUJ obstruction in the right kidney and we found during my pregnancy itself. First surgery was done when she was 6 months but she was facing problems and she was having continuos fever and her stomach was bulged and so second surgery was done when she was 8 months old and during this surgery the right kidney was removed. Now she is having only left kidney. Is the child safe with one kidney and till now she is healthy without problems. Any special care should be taken and should she have a checkup once in 1 or 2 years about the functioning of the left kidney. Will it be a problem when she gets married or if she strains a lot. I am very afraid of this and always I have a guilty feeling about this. She is my only child. Please reply.

A:You have raised 2 issues regarding the health of your child. I shall address them one by one.1.Respiratory tract infections are very common in young children specially around 3-4 years of age. At this age the child starts going to school and comes in contact with many children. This increases their exposure to various viruses. The tendency to recurrent infections subsides over the next 1-2 years as the child acquires immunity. Most episodes of viral infection last for 3-7 days. However, some cough may remain for some more time. Sometimes a child may get re-infected by another virus and it appears as if the same episode is continuing. However, if your child is having persistent cough for 1.5 months, she merits a thorough evaluation including an x-ray chest, and some other tests including Mantoux test, blood tests, etc. There are many conditions that can be responsible for this situation and they need to be looked for. Avoid self medication and have your child evaluated by a paediatrician. 2. It is unfortunate that your child had to loose one kidney at a young age. However, I assure you that one healthy kidney is totally capable of handling the work of both. So your child is unlikely to have any problems. In fact in some individuals, one kidney may be absent since birth! I am sure the function of the other kidney would have been evaluated before the decision to remove one kidney was taken. If its structure and function was found to be normal at that time, it is expected to remain normal. However noting your concern I see no harm in recommending a yearly ultrasound, blood pressure recording and urine routine examination. These tests do not involve any discomfort to the child and are not expensive either. Their results should reassure you.

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