Journal of tropical pediatrics
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Life-threatening infections account for about 25 per cent of children requiring admission to pediatric intensive care units (PICU). The results of the use of polyclonal intravenous immunoglobulins as an adjuvant in pediatric sepsis syndrome therapy are conflicting. A prospective study of 100 sepsis syndrome PICU patients aged 1-24 months and divided into two matching groups (septic cases and control, 50 patients each) was performed. ⋯ A multiple logistic regression model revealed that treatment with IVIG, LOS, severity of sepsis and lymphocyte percentage (L per cent) on admission were significant predictors for survival. In summary the study revealed that the use of polyclonal IVIG among PICU sepsis syndrome showed a significant reduction in mortality, LOS and less progress to complications. A multicenter study is recommended to confirm these results.
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Randomized Controlled Trial Clinical Trial
Room air vs. 100 per cent oxygen for neonatal resuscitation: a controlled clinical trial.
The aim of the study was to determine whether neonates resuscitated with room air compared with 100 per cent oxygen in the delivery room were less likely to have hypoxic ischemic encephalopathy and/or death before discharge. A controlled clinical trial was carried out at a tertiary care institute. All newborns weighing 1000 g or more with apnea or gasping respiration and/or heart rate less than 100 beats/min requiring positive pressure ventilation after initial steps of resuscitation were included. ⋯ The composite primary outcome occurred in 41.1 per cent of the neonates assigned to receive room air and 43.3 per cent of those in the 100 per cent oxygen group (odds ratio in the group assigned to room air, 0.92; 95 per cent confidence interval, 0.52-1.60). Resuscitation of a newborn baby with room air instead of the current practice of 100 per cent oxygen does not confer a benefit in terms of reduced HIE and/or mortality. Significantly, there is no increase in adverse outcome with the use of room air, which can be recommended for resuscitation if oxygen is not available.
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Neurocysticercosis is the most common parasitic infestation of the central nervous system which manifests commonly as acute onset focal seizures. We report a rare clinical presentation of neurocysticercosis in a 1-year-old infant who presented with involuntary movements. ⋯ Young children are rarely affected by this disease. In endemic areas, when a child presents with seizures or unusual neurological features and the CT scan shows contrast enhancing lesions or cystic lesions neurocysticercosis should be considered however young the child may be.
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Comparative Study
Sudden unexpected child deaths: forensic autopsy results in cases of sudden deaths during a 5-year period.
The aim of the present study was to determine the incidence of various causes of sudden unexpected child deaths (SUCD) and to assess the importance of an autopsy in predicting the likelihood of finding a cause of death. A retrospective analysis of autopsy findings in 97 cases of SUCD between the ages of 0--11 years was undertaken at the Council of Forensic Medicine, Ankara during a 5-year period (1995--2000). Cases were classified as explained causes (80.42 per cent) and sudden infant death syndrome (SIDS) (19.58 per cent). ⋯ The incidence of SIDS in the newborn period was 33 per cent. The incidence of unexplained causes of deaths in the postneonatal period was 31 per cent and the causes of deaths were respiratory pathology (15 cases), aspiration (five cases), gastrointestinal pathology (four cases), SIDS (14 cases), and other causes (four cases). The study of an entire population provides more reliable data regarding causes of sudden unexpected child deaths than does the study of small groups and it is also recommended that in addition to a through evaluation, a detailed autopsy must be performed for each case in experienced centers.
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Comparative Study
Is there a relationship between childhood Helicobacter pylori infection and iron deficiency anemia?
An association between Helicobacter pylori infection and iron deficiency anemia has been reported in children, and it has been proposed that H. pylori infection needs to be eradicated to treat absolutely iron deficiency anemia (IDA). We investigated whether there was any correlation between H. pylori infection and iron deficiency (ID) and IDA in children, and whether the eradication of H. pylori infection without iron treatment would lead to the resolution of ID. Hemoglobin and ferritin levels, H. pylori stool antigen test and (14)C urea breath test were measured in 140 children aged 6--16 years (median 9.5 years). ⋯ Hemoglobin and MCV values rose significantly compared with baseline values after H. pylori eradication without iron supplementation in children with IDA (p=0.002 and p=0.003, respectively). Ferritin values increased significantly after H. pylori eradication in children with ID (p<0.001). We conclude that complete recovery of ID and IDA can be achieved with H. pylori eradication without iron supplementation in children with H. pylori infection.