Archives of disease in childhood
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Case Reports
Intravenous paracetamol overdose: two case reports and a change to national treatment guidelines.
Two cases of 10-fold accidental overdose with intravenous paracetamol are presented. Case 1: A 5-month-old child with intussusception received 90 mg/kg intravenous paracetamol over an 8 h period. She was not initially treated with an antidote and developed hepatic impairment. ⋯ This should be taken into consideration when prescribing the intravenous formulation. The concentration-time nomogram used following oral paracetamol overdose should be used with caution following intravenous overdose. Significant overdose should be discussed with the National Poisons Information Service whose guidance suggests intervention with antidote following an overdose above 60 mg/kg.
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Review
Children's access to treatment for epilepsy: experience from the Lao People's Democratic Republic.
Epilepsy affects an estimated 10.5 million children worldwide, of whom 80% live in developing countries. The treatment gap is estimated at around 90% in the Lao People's Democratic Republic (Lao PDR). The present work analyses some of the reasons that could explain the low access to antiepileptic drugs (AED) for children with epilepsy in the Lao PDR. ⋯ Traditional beliefs, fear and stigma are common among the general population and shared by 40% of health staff. Poor knowledge of the disease and its treatment, low trust in modern treatment, restricted access to AED and ignorance of long-term treatment explain the low access to AED. Improving understanding of epilepsy and its treatment, will improve the treatment gap for epileptic children in the Lao PDR.
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Randomized Controlled Trial
Randomised controlled trial of thermostatic mixer valves in reducing bath hot tap water temperature in families with young children in social housing.
To assess the effectiveness of thermostatic mixing valves (TMVs) in reducing bath hot tap water temperature, assess acceptability of TMVs to families and impact on bath time safety practices. ⋯ TMVs and accompanying educational leaflets are effective at reducing bath hot tap water temperatures in the short and longer term and are acceptable to families. Housing providers should consider fitting TMVs in their properties and legislators should consider mandating their use in refurbishments as well as in new builds.
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Intravenous paracetamol (acetaminophen) has recently been registered for treatment of pain in neonates but the pharmacodynamics, including effects on body temperature, have not been reported. ⋯ Administration of intravenous paracetamol does not result in hypothermia in normothermic neonates. In those with fever, maximal temperature reduction is achieved within 2 h following paracetamol administration.