Indian journal of pediatrics
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The fact that M. tuberculosis develops resistance to anti-tuberculosis drugs has been known since the introduction of chemotherapy in 1952. Resistance has been reported to various drugs in India. Several factors pertaining to patients, physicians and environment are responsible for this. ⋯ Management of multi-drug resistant (MDR) tuberculosis is difficult and frustrating. Several second line drugs are being used. It is important to prevent this condition by adequate treatment of routine cases of tuberculosis and their contacts by directly observed therapy short course (DOTS).
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Status epilepticus (SE) is a common pediatric emergency, which warrants prompt and aggressive treatment. This report presents a brief description and classification of SE. Therapy should be directed towards rapid termination of the SE, prevention of seizure recurrence and treatment of any underlying cause. ⋯ The morbidity and mortality of SE is significant and directly dependant upon prompt and appropriate medical therapy. The treatment of refractory SE requires labour intensive hemodynamic support and suppression of seizures using either barbiturates or anesthetic agent. Formulation and adherence to standard treatment protocols provides the best results.
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The Eutectic Mixture of Local Anesthetics (EMLA) is a topical application, which has proved to be a useful medication for providing pain relief among children. It is an emulsion containing a 1:1 mixture of lidocaine and prilocaine. The high concentration of the uncharged anesthetic base in the microdroplets of the emulsion ensure effective skin penetration. ⋯ The dose of EMLA is between 0.5 to 1 gram, and the cream should be applied half to one hour prior to the procedure. Local side effects are very mild, and the only systemic side effect of importance is the risk of methemoglobinemia in young infants. The literature has conflicting reports about the safety of EMLA in neonates.
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Many dangerous surgical complications like intestinal obstruction, acute appendicitis with perforation, ileal perforation in a typhoid patient, Meckel's diverticulitis, disruption of post operative intestinal anastomosis, volvulus, and intussusception are known to occur due to ascariasis, with considerable morbidity and mortality. In this retrospective study of 250 cases of gastrointestinal ascariasis admitted in paediatric surgical wards of Govt. Medical College, Jabalpur (MP), the authors analysed the results of conservative (especially the use of hypertonic saline enema-given just like an ordinary soap water enema but substituting freshly made hypertonic saline in place of soap water) and surgical treatment. ⋯ It also helps to increase the intestinal motility and passage of worms into the colon. The use of hypertonic saline enema is safe and effective in the conservative treatment of gastrointestinal ascariasis. Authors feel that it is the most grossly under utilized part of conservative treatment and deserves to be known and used on wider scale.