Journal of tropical pediatrics
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Randomized Controlled Trial
Monotherapy with amikacin or piperacillin-tazobactum empirically in neonates at risk for early-onset sepsis: a randomized controlled trial.
Neonates at risk for early-onset sepsis are started on antibiotics empirically. Antibiotic resistance to conventionally used antibiotics is increasingly being reported. Antenatal maternal antibiotic exposure in this setting contributes to low yield on blood culture drawn at birth, limiting the planning of antibiotics based on culture reports. A head-to-head comparison for selecting the appropriate antibiotic is one strategy. ⋯ Monotherapy with amikacin as an empirical antibiotic did not result in a higher incidence of treatment failure in neonates at risk for early-onset sepsis as compared with piperacillin-tazobactum. Both antibiotics were effective in management of babies with early-onset sepsis.
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Randomized Controlled Trial
Effect of therapeutic hypothermia on DNA damage and neurodevelopmental outcome among term neonates with perinatal asphyxia: a randomized controlled trial.
To study the effect of therapeutic hypothermia (TH) on deoxyribonucleic acid (DNA) damage and the neurodevelopmental outcome in term babies with perinatal asphyxia. ⋯ TH reduces oxidative stress-induced DNA damage and improves neurodevelopmental outcome.
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Observational Study
High reliability in respiratory rate assessment in children with respiratory symptomatology in a rural area in Mozambique.
Early recognition of severe medical conditions is often based on clinical scores and vital sign measurements such as the respiratory rate (RR) count. We designed this study to determine the reliability of RR assessment counted three times during a full minute by independent observers in children in a developing country setting. A total of 55 participants were enrolled in the study. ⋯ However, a single reading would have misclassified 5-11% of the participants as non-tachypneic. Repeated RR counts offer reliable results if done during a full minute. Patients not fulfilling tachypnea criterion but with a high RR count should have the measurement repeated.
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Enteroviral infection is one of the most common neonatal infections, and most patients recover without complications. This report describes a neonate who experienced meningitis followed by myocarditis. A 4-day-old boy was admitted with fever, diagnosed with enteroviral meningitis and treated with intravenous immunoglobulin (IVIG). ⋯ A left ventricular aneurysm persisted even though the patient recovered with repeated high-dose IVIG treatment and cardiac supportive care. This report describes a rare case where myocarditis developed several days after a diagnosis of CXB1 meningitis in spite of IVIG treatment. It is important to pay attention to the patient's clinical condition until the end of the second viremia of enterovirus and to consider high-dose IVIG treatment when treating enteroviral infections for neonates.