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Indian Pediatr 2019;56: 344 |
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Clippings
Theme: General Pediatrics
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K Rajeshwari
Email:
[email protected]
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Levetiracetam monotherapy for childhood epilepsy (Mymensingh
Med J. 2018:27:776-84)
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Levetiracetam has been introduced for the control of seizures as
monotherapy in children with epilepsy. This randomized controlled trial,
conducted in children aged 1 mo to 15 y, was done to assess the efficacy
and tolerability of levetiracetam compared to phenobarbital in childhood
epilepsy (idiopathic focal, generalized, focal with secondary
generalization). The children were followed up for 12 months at
3-monthly interval to compare the seizure remission and side effects
with Levetiracetam and Phenobarbital. During 3 months of intervention
55.8% patients of levetiracetam group achieved 50-75% seizure remission
compared to 44.2% in phenobarbital group; at 6 months, 75-100% seizure
remission observed among 57.4% patients of levetiracetam group compared
to 42.6% of phenobarbital group, which continued to increase at 9 months
in levetiracetam compared to phenobarbital. No further improvement was
observed at 12-month follow-up. Behavioral problem was reported among 4
patients of phenobarbital group without any evidence of cognitive
deterioration; 3 patients receiving levetiracetam experienced
irritability, but no child in either treatment group discontinued
treatment due to side effects. It appears monotherapy with levetiracetam
is more effective in controlling seizures in epilepsy (focal,
generalized and focal with secondary generalization) compared to
phenobarbital, with minimum side effects.
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Chronic cough in under-five children (Medicine.
2019;98:e13910)
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Chronic cough is one of the most common clinical symptoms in children.
Its etiology often involves the disciplines of pulmonology,
gastroenterology, ENT (ear, nose, and throat), and neurology. Finding
the etiology of nonspecific chronic cough is more difficult in
under-five children as majority of examinations (such as lung function,
induced sputum test, exhaled nitric oxide test) are difficult to perform
for this age group. This study attempted to analyze the etiology of
nonspecific chronic cough in children under 5 years of age. The medical
records of children less than 5 years of age who visited Outpatient
Department with cough as the main clinical manifestation of more than 4
weeks and no significant abnormalities in the chest X-ray film
were included. Exclusion criteria included children having other
symptoms besides cough, abnormal chest X-ray and serious systemic
diseases. Upper airway cough syndrome was the most common (37.6%) cause
of nonspecific chronic cough, followed by cough variant asthma (31.8%)
and post-infection cough (18.8%).
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Physical activity in adolescents and Quality of life (Health
Qual Life Outcomes. 2019;17:2)
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Health-related quality of life is a multidimensional concept with
significant effects on children and adolescents. Physical activity and
screen time have been suggested as its probable predictors. This study
aimed to investigate the association of physical activity, screen time
and their combination with health-related quality of life in a sample of
Iranian children and adolescents. A sample of 25,000 students aged 6-18
years was selected via multi-stage cluster sampling from 30 provinces of
Iran. Sociodemographic data was obtained by using the questionnaire of
the World Health Organization-Global school-based student health survey
(GSHS). Persian Pediatric Quality of Life inventory (PedsQL) and
Physical Activity Questionnaire for the pediatric age group (PAQ-A) were
applied for evaluating health related quality of life and physical
activity, respectively. Physical activity scores 1-1.9 and 2-5 were
respectively considered as low and high. The average duration of time
spent on watching TV and leisure time computer use were considered as
screen time behaviors. Screen time of less than 2 hours was considered
low. Screen time duration had an inverse relationship with quality of
life while physical activity was associated with better quality of life.
High physical activity and low screen time had the best health related
quality of life scores.
Thus it is essential to increase play time and other
outdoor activities for children and adolescents to improve quality of
life, especially in cities with lack of open spaces and playgrounds.
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Papaya seeds for deworming. (BMC Complement Altern
Med. 2018;18:327)
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Soil transmitted helminths (STH) are among the world’s neglected
tropical diseases. Morbidity due to STH is greatest in school-age
children who typically have the highest burden of infection. In this
study, maize (corn) flour fortified with grounded dried papaya (Carica
papaya) seeds was used to prepare porridge for three primary schools
in Kenya. One school received 300 mL papaya fortified porridge daily
(papaya group), the second school received similar serving of plain
porridge without the papaya ingredient (control group), and the third
school received plain porridge and the conventional deworming agent 400
mg albendazole. The children were monitored daily for two months and
final stool sample analysis and clinical monitoring was done at the end
of the study. The overall prevalence of Ascaris lumbricoides was
29.4%, Trichuris trichura 5.2%, and hookworm 1%. After two
months, papaya seed fortified porridge reduced the Ascaris egg count by
63.9% as compared to 78. 8% in the albendazole arm. The control group
showed an increase in egg count; though, it was not statistically
significant. Hemoglobin counts in the papaya group increased by a mean
of 2 g/dL as compared to the albendazole arm where it increased by 1 g/dL.
No significant change was observed in the placebo arm. Interestingly,
the papaya group showed a significant reduction of children with Tinea
capitis (ringworms) as compared to the albendazole arm that showed an
increase in ringworm infestation.
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