Ann Trop Paediatr
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Twenty-four cases of dengue haemorrhagic fever/dengue shock syndrome were studied in Delhi in the months of September and October, 1988. The majority of these cases were boys aged 6-10 years. Classical symptoms of dengue (fever, headache, aesthesia, myalgia) occurred in all the patients. ⋯ Thrombocytopenia and prolongation of coagulation profile were found in 62.5% of cases. Three patients (12.5%) who presented with encephalopathy died. The other 21 patients recovered after an average period of 2-8 days.
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Many paediatricians are unaware of the disease entity of discitis, which must be included in the differential diagnosis of several acute and subacute diseases of infancy and childhood. In order to draw attention to this disorder, three Swedish and two Arabic children, aged from 9 months to 3 years, are jointly presented. The onset of symptoms was 2-4 weeks prior to admission. ⋯ The children were treated with immobilization, and three of them received antibiotics. Full recovery was achieved in all children after 1-2 months. The diagnostic procedure and the rationale of using or not using antibiotic treatment is discussed.
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A review of 965 children with neurological disorders, seen at the Paediatric Neurology Clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, over a 3-year period (1985-1987), revealed that epilepsy was the most common neurological problem affecting 60% of the children, followed by cerebral palsy (16%), speech disorders (8.3%), mental retardation (7.2%), behaviour disorders (2.2%), paralytic poliomyelitis (1.55%), premature craniosynostosis (1.0%), visual and auditory impairment (1.0%) and muscle disorders (0.72%). Perinatal problems such as birth asphyxia, severe neonatal jaundice and infections were the most common aetiological factors identified. ⋯ The need for improved maternal and perinatal health services and vigorous health education strategies is emphasized by this review. The positive effect of the Expanded Programme on Immunization (EPI) is reflected in the sharp decline in the proportion of children with neurological disorders owing to paralytic poliomyelitis, from 9.2% in the period 1978-1980, to 1.55% in the present study.
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Acquired immunodeficiency syndrome is associated with considerable morbidity in infants and children. It is caused by human immunodeficiency virus (HIV) which can be transmitted vertically from mother to infant early in pregnancy. Transmission might also occur via breast milk. ⋯ There is no available cure for HIV infection. Supportive treatment and relief of pain and suffering are the only means of management at present. Prevention of spread of the illness to infants and young children is therefore of paramount importance.
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Hepatic copper accumulation is characteristic of Indian childhood cirrhosis (ICC) but in experimental animals causes only modest liver damage. Plant and fungal biocidal agents may be hepatotoxic, may increase hepatic copper concentration, and may be secreted in milk of lactating animals. Crotalaria species, Parthenium hysterophorus and Aspergillus flavus are possible contaminants of animal feeds in rural India, and we hypothesise that their products may be synergistic with copper in causing ICC.