ATOPIC-DERMATITIS ASSOCIATED WITH INFANTILE COLICMCI Registration NumberFULL NAME (As in your Pancard)EmailPhone/MobileCityStateSpecialityBank DetailsAccount Holder NameA/c NumberIFSC CodeUpload Cancelled Cheque (Max Size - 2 MB)Choose File Pancard NumberUpload Pancard Details (Max Size - 2 MB)Choose File 1. Did you encounter the cases of atopic dermatitis with the history of infantile colic? Yes No2. Did atopic dermatitis occur in the same period as infantile colic? Yes No Don't know3. If both occurred, which condition appeared first? Infantile colic appeared first Atopic dermatitis appeared first Both appeared approximately at the same time Don't know4. Approximate interval between onset of the two conditions: Same time 0 – 3 months 3 – 6 months 6 – 12 months More than 12 months5. Did the child continue to have atopic dermatitis after the colic symptoms resolved? Yes No Not applicable Don't know6. Has the child ever been diagnosed with atopic dermatitis/atopic eczema by a physician? Yes No Don't know7. At what age was atopic dermatitis first diagnosed? Less than 3 months 3–6 months 6–12 months 1–2 years More than 2 years8. Did the child experience infantile colic during the first 4 months of life? Yes No Don't know9. At what age did colic symptoms begin? Less than 3 months 3–6 months 6–12 months 1–2 years More than 2 years10. Approximately how long did the colic symptoms continue? Less than 2 weeks 2–4 weeks 1–2 months More than 2 months I have read and agree to the Terms and Conditions .Submit Form