Indian journal of pediatrics
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Japanese encephalitis is considered as a serious disease due to the complexity of the disease and lack of specific treatment. A secular trend towards declining of JE has been brought in China, Korea, and Japan with widespread use of JE vaccine. In India, the actual JE burden could be estimated only by strengthening diagnostic facilities for JE confirmation in hospitals. ⋯ Under these circumstances, feasibility of JE vaccination in India has to be considered as a preventive measure, for which identification of risk areas, target populations to be immunized, cost-evaluation of immunization is emphasized. Since, JE vaccine is produced in India, extension of the availability of this vaccine into routine JE-immunization programs is not remote. China has proved that countries with limited sources can produce safe and effective JE vaccines.
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Acute lung injury and acute respiratory distress syndrome are an important challenge for pediatric intensive care units. These disorders are characterized by a significant inflammatory response to a local (pulmonary) or remote (systemic) insult resulting in injury to alveolar epithelial and endothelial barriers of the lung, acute inflammation and protein rich pulmonary edema. The reported rates in children vary from 8.5 to 16 cases / 1000 pediatric intensive care unit (PICU) admissions. ⋯ Pharmacological strategies have not made any significant impact on the outcomes. Preliminary data suggests some role for use of corticosteroids in non-resolving ARDS. The mortality rates have declined over the last decade chiefly due to the advances in supporting critically ill patients.