Paediatrics and international child health
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Paediatr Int Child Health · Aug 2013
Comparative StudyA comparative study of rectal tympanic and axillary thermometry in febrile children under 5 years of age in Nigeria.
Fever alone accounts for over 25% of paediatric emergency room consultations. Accurate determination of temperature is critical for the management of sick children by both parents and health care-providers. ⋯ Mean (SD) rectal temperature was 38.8 (0.7)°C, and mean (SD) tympanic and axillary temperatures were 38.7 (0.7)°C and 38.1 (0.7)°C, respectively. There was no significant difference between rectal and tympanic temperatures (P = 0.14), and a strong correlation was identified between values from these two sites (r = 0.91). At 91.5%, the sensitivity of tympanic thermometry in determining fever was higher than that of axillary measurements (54.0%). A mathematical relationship was demonstrated between rectal/tympanic temperatures and between rectal/axillary temperatures as follows: Rectal temperature (°C) = 6.03+0.85 * Mean tympanic temperature (°C) Rectal temperature (°C) = 11.7+0.71 * Axillary temperature (°C) Conclusion: In febrile children, tympanic temperature better reflects rectal temperature than does axillary temperature; tympanic temperature should therefore be measured when there are no contra-indications for its use.
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Paediatr Int Child Health · Aug 2012
Case ReportsCervical intramedullary conglomerate tuberculomas with tuberculous meningitis--rapid response to medical therapy.
Common manifestations of tuberculosis of the central nervous system are tuberculous meningitis and intracranial tuberculomas. Cervical intramedullary tuberculomas are very rare in immunocompetent children. An unusual presentation of tuberculous meningitis with hydrocephalus and conglomerate cervical intramedullary tuberculomas in a 4-year-old boy is reported.
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Paediatr Int Child Health · Aug 2012
Association of indoor air pollution with acute lower respiratory tract infections in children under 5 years of age.
Indoor air pollution is an important risk factor for acute lower respiratory tract infections (ALRTI) in developing countries. ⋯ Indoor air pollution caused by using cooking fuel other than LPG and socio-economic factors are significantly associated with ALRTI.
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Dengue is a serious public health problem worldwide. Dengue shock syndrome (DSS), the severe form of dengue fever, can cause death within 12-24 hours if appropriate treatment is not promptly administered. For patients with DSS and the 30% of non-shocked dengue patients who require intravenous fluid therapy, a range of solutions is available for plasma volume support. ⋯ This paper summarises the key clinical data, comparing fluid regimens in children with severe dengue, and concludes that the majority of patients with DSS can be treated successfully with isotonic crystalloid solutions. If a colloid is thought necessary, a medium-molecular-weight preparation that combines good initial plasma volume support with good intravascular persistence and an acceptable side-effect profile is optimal. Further research should aim to determine whether there are benefits to early treatment with colloids, and which colloid solution is most effective for resuscitation of DSS patients.