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Indian Pediatr 2014;51: 1026
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Clippings |
K Rajeshwari
Email:
[email protected]
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Cyclosporine drops for vernal conjunctivitis. (Adv Clin Exp
Med. 2014; 23:455-61.)
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Vernal keratoconjunctivitis (VKC) is a chronic, bilateral inflammation
of the conjunctiva that mostly affects children and young adult males.
Management of VKC is primarily aimed at reducing symptoms and preventing
serious vision-threatening sequelae. The randomized placebo-controlled
trial assessed the efficacy of topical cyclosporine A (CsA) 0.05% on the
signs and symptoms in the management of VKC. Sixty-two patients with VKC
were randomly assigned to treatment with topical 0.05% CsA eye drops or
a placebo (artificial tears) 4 times daily, for a period of 4 weeks.
Ocular signs and symptoms were scored at entry and at the end of 4
weeks. Mean post-treatment scores were lower in cyclosporine group than
those in placebo group (P< 0.001). No side effects of the
treatment with CsA 0.05% eye drops were observed.
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Benefits of pomegranate juice after exercise.
(J Pak Med Assoc. 2014; 64:785-90.)
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The aim of this study was to evaluate the efficacy of pomegranate juice
supplementation on improving antioxidant function in young (age 18-24
yrs) healthy adult males during exhaustive exercise. The study
participants (28) were randomly divided into control and supplemented
groups. One cup of pomegranate juice or one cup of tap water was given
daily for two weeks to supplemented and control groups, respectively.
Fasting blood samples were taken at baseline and at the end of two weeks
of intervention. The participants were given one exhaustive exercise and
then fasting blood samples were taken for testing blood glutathione
peroxidase and superoxide dismutase, and serum levels of high
sensitivity C-reactive protein, zinc, ceruloplasmin, matrix
metalloproteinases 2 and 9, malondialdehyde and total antioxidant
capacity. The blood levels of glutathione peroxidase and superoxide
dismutase and serum levels of total antioxidant capacity after
exhaustive exercise in the supplemented group were significantly
increased (P< 0.05), while the content of matrix
metalloproteinases 2 and 9, ceruloplasmin and malondialdehyde showed a
significant decrease in comparison to the control group. Authors
concluded that regular intake of pomegranate juice significantly
modulates matrix metalloproteinases 2 and 9, and serum levels of some
inflammatory factors, and thus protects against exhaustive
exercise-induced oxidative injury in young healthy males.
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Utility of dipstick urinary analysis in febrile children.
(Pediatrics. 2014; 134:523-9.)
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The performance of automated flow cytometric urinalysis is not well
described in pediatric urinary tract infection. This study sought to
determine the diagnostic performance of automated cell counts and
emergency department point-of-care (POC) dipstick urinalyses in the
evaluation of young febrile children. A convenience sample of febrile
pediatric emergency department patients <48 months of age, who underwent
urethral catheterization to obtain POC, was selected, and automated
urinalyses and urine culture were done. Receiver operating
characteristic (ROC) analyses were performed and diagnostic indices were
calculated for POC dipstick and automated cell counts at different
cut-off points. Of 342 eligible children, 42 (12%) had urinary bacterial
growth e"50000/mL. The areas under the ROC curves were: automated white
blood cell count, 0.97; automated bacterial count, 0.998; POC leukocyte
esterase, 0.94; and POC nitrite, 0.76. Sensitivities and specificities
were 86% and 98% for automated leukocyte counts e" 100/ìL, and 98% and
98% for bacterial counts e" 250/ìL. POC urine dipstick with 1+ or more
leukocyte esterase or positive nitrite had a sensitivity of 95% and a
specificity of 98%. Combinations of white blood cell and bacterial
counts did not outperform bacterial counts alone.
Authors concluded that automated leukocyte and bacterial counts
performed well in the diagnosis of urinary tract infection in febrile
pediatric patients, but dipstick may be an acceptable alternative in
clinical settings that require rapid decision-making.
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Effects of hypothermia for perinatal asphyxia. (N Engl
J Med. 2014;371:140-9.)
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In the Total Body Hypothermia for Neonatal Encephalopathy Trial (TOBY),
newborns with asphyxial encephalopathy who received hypothermic therapy
had improved neurologic outcomes at 18 months of age, but it is
uncertain whether such therapy results in longer-term neurocognitive
benefits. Newborns (n=325) with asphyxial encephalopathy who were born
at a gestational age of 36 weeks or more were randomized to receive
standard care alone (control) or standard care with hypothermia to a
rectal temperature of 33 to 34°C for 72 hours, within 6 hours after
birth. The neurocognitive function of these children at 6 to 7 years of
age was assessed. The primary outcome of this analysis was the frequency
of survival with an IQ score of 85 or higher. A total of 75 of 145
children (52%) in the hypothermia group versus 52 of 132 (39%) in the
control group survived with an IQ score of 85 or more. More children in
the hypothermia group than in the control group survived without
neurologic abnormalities. Among survivors, children in the hypothermia
group, as compared with those in the control group, had significant
reductions in the risk of cerebral palsy (21% vs. 36%, P=0.03)
and the risk of moderate or severe disability (22% vs. 37%, P=0.03);
they also had significantly better motor-function scores.
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