Indian pediatrics
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Rituximab is a chimeric mouse-human monoclonal antibody against the CD 20 antigen on the surface of B lymphocytes. It binds to CD20 and causes B cell death by antibody dependant cell-mediated cytotoxicity, complement mediated cytotoxicity and apoptosis. It leads to rapid and sustained depletion of B cells. ⋯ Nephrotic syndrome and opsoclonus-myoclonus syndrome are among the emerging indications for rituximab. In solid organ transplantation, rituximab is useful in the prevention and treatment of acute and chronic rejection as well as in post transplantation lymphoproliferative disease. Toxicity includes acute infusion reactions, susceptibility to bacterial infections, and reactivation of viral infections.
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Randomized Controlled Trial
Effect of high-dose phenobarbital on oxidative stress in perinatal asphyxia: an open label randomized controlled trial.
To evaluate the effect of high dose phenobarbital on lipid peroxidation and antioxidant enzymes in perinatal asphyxia. ⋯ Phenobarbital (40 mg/kg) given in the first two hours of life in term neonates with perinatal asphyxia led to a decrease in CSF levels of lipid peroxides and antioxidant enzymes at 12 ± 2 hours of life.
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NEED AND PURPOSE OF REVIEW: Hyperglycemia is prevalent among critically ill pediatric patients. Previously thought to be an adaptive response to stress, hyperglycemia is now recognized to be associated with an adverse outcome. Correction of such hyperglycemia with insulin infusion has been shown to improve outcome but carries risk of hypoglycemia. This review addresses these issues related to treatment of hyperglycemia. ⋯ Blood sugar monitoring and correction of hyperglycemia while caring for critically ill children is crucial. A modest blood glucose target of <150 mg/dL is appropriate. Providing adequate nutrition along with training of the nursing personnel would prevent any adverse effect such as hypoglycemia.
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The aim was to study the efficacy of rescue High Frequency Oscillatory Ventilation (HFOV) in improving the oxygenation and ventilation in neonates with acute respiratory failure after failing Conventional Mechanical Ventilation (CMV). Primary outcome was short term oxygenation, lung recruitment, and ventilation and secondary outcome studied was survival. 675 babies were ventilated and 97 of them received HFOV. HFOV significantly improved oxygenation index, alveolar-arterial oxygen gradient, pH, PCO2, PO2 and caused better lung recruitment within 2 hours. Fifty seven babies (58.77%) survived and the mortality was more in <28 weeks, babies with pulmonary hemorrhage, sepsis and CDH.