Journal of tropical pediatrics
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The outcome of cardiopulmonary resuscitation at the research ward of the Kenya Medical Research Institute is reviewed. The outcome for respiratory arrest was 15 per cent (95 per cent CI 6.6-27) to discharge, and worse for cardiorespiratory arrest with no survival. The illnesses leading to cardiopulmonary arrest and causes for the disappointing outcome are discussed.
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A prospective cohort of 908 consecutively enrolled pregnant women with biparietal diameter (DBP) compatible with gestational age equal to or below 21 weeks were followed up regularly at 2-4 weeks intervals. Normal antenatal care routine was applied. The newborns were followed until 7 days postpartum. ⋯ Of the cohort women, 9.7 per cent delivered SGA newborns. It was concluded that maternal constitutional factors, particularly maternal weight gain, maternal height and maternal weight as well as syphilis and malaria during pregnancy, need to be given attention concerning the adverse outcomes addressed. The establishment of an obstetric cohort, followed prospectively, was possible in a low-income setting with limited numbers lost to follow-up at delivery.
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Radiographic changes of rickets are well characterized, but no method of grading the severity of these changes has been in general use. Consequently, it is difficult to compare objectively or follow radiographic improvement. We prospectively evaluated the utility and reproducibility of a scoring method for measuring the severity of rickets. ⋯ A broad representation of mean radiographic scores was moderately correlated with alkaline phosphatase (r = 0.58). Interobserver correlation of radiographic scores was 0.84 or greater for all observer pairs and intraobserver correlation was 0.89 or greater for each observer. Researchers and clinicians should find the score useful to assess objectively the severity of rickets.
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Paediatric intensive care in Malaysia is a developing subspecialty with an increasing number of specialists with a paediatric background being involved in the care of critically ill children. A part prospective and part retrospective review of 118 consecutive non-neonatal ventilated patients in University Hospital, Kuala Lumpur was carried out from 1 June 1995 to 31 December 1996 to study the clinical epidemiology and outcome in our paediatric intensive case unit (PICU). The mean age of the patients was 33.9 +/- 6.0 months (median 16 months). ⋯ The main diagnostic categories were respiratory (32 per cent), neurology (22 per cent), haematology-oncology (18 per cent); the aetiology of dysfunction was mainly infective. Non-survivors were older (29.5 vs. 13.8 months, p < 0.0001), had more severe illness (mean PRISM score 30 vs. 14, p < 0.0001), were more likely to develop MODS (96 vs. 53 per cent, p < 0.0001) and required more intervention and monitoring. Paediatric intensive care in Malaysia differs widely from that in developed countries in patient characteristics, severity of illness, and care modalities provided.