q Breastfeeding leads to intelligent kids, this much is known. What this study tried to look at was whether polyunsaturated fatty acids (PUFA) in breast milk were responsible for this increase in IQ. Pregnant mothers were recruited consecutively at maternity care centres. PUFA were analyzed in colostrum and breast milk at 1 and 3 mo. The children were tested with the full WISC-III at 6.5 y. The findings support the importance of high levels of PUFA for cognitive development. However, the sample is small and the results must be interpreted with caution. Acta Paediatr 2004; 93: 1280

q The authors of this study decided to compare the analgesic effects of a small dose of glucose solution given orally by spray and by syringe during heel lancing in term neonates, using a validated behavioral acute pain rating scale. Sixty hyperbilirubinemic full-term neonates were studied. Each infant was assessed three times receiving 0.5 ml 30% glucose in spray form, 0.5 ml 30% glucose by syringe or 0.5 ml sterile water by syringe in random order, 2 min before heel lancing. Pain scores were significantly lower in the 30% glucose given either sprays or syringe groups compared with the placebo group. The spray form has the advantage of being easy to use and is well accepted by newborn babies. Acta Paediatr 2004; 93:1330

q Do parents influence the decision to use antibiotics in infants? Informed consent to participate was obtained from 1443 women expecting their first child and their spouses. The final regression analysis showed the potent factors associated with recurrent use of antibiotics: male gender, frequent physician consultations in early infancy and the father's need for outside support. Thus in the prevention of antibiotic overuse, social and psychological factors should be considered. Acta Paediatr 2004; 93: 1386

q Can Iron deficiency lead to a reversible decline in developmental test scores in infants? This prospective, single-blind, controlled clinical intervention study was made on 108 children aged 6-30 months. The cases were classified as control, non-anemic iron deficiency (NAID), and iron deficiency anemia (IDA) on the basis of their MCV, hemoglobin and ferritin levels. IDA and about half of the NAID subjects were treated with oral iron for 3 mo. Subjects with iron deficiency showed significantly lower developmental test scores both with BSID-I and DDST-II compared to their iron-sufficient peers (p < 0.05). After 3 mo of iron treatment, lower mental developmental test scores were no longer observed among the IDA and NAID groups whose anemia and iron deficiency were also corrected. Acta Paediatr 2004; 93: 1391

q Ceftriaxone, a third generation cephalosporin, is widely used for treating infection during childhood. It is excreted via the kidneys. One of the known side-effects of this drug is biliary pseudolithiasis. The aim of this study was to assess whether ceftriaxone associated nephrolithiasis develops by the same mechanism. The study involved 51 children with various infections. Serum urea, creatinine, and calcium levels were normal in all patients before and after treatment. Post-treatment ultrasound identified nephrolithiasis in four (7.8%) of the 51 subjects. The stones were all of small size (2 mm). The renal stones disappeared spontaneously in three of the four cases, but were still present in one patient 7 months after ceftriaxone treatment. Arch Dis Child 2004; 89: 1069

q Trachoma, caused by repeated ocular infection with Chlamydia trachomatis, is an important cause of blindness. Can mass treatment with Azithromycin reduce this leading cause of preventable blindness? In this community based study in an endemic region the incidence of C. trachomatis infection fell from from 9.5 percent to 2.1 percent at 2 months and 0.1 percent at 24 months after mass treatment with a single oral dose of azithromycin. The authors conclude that one round of very-high-coverage mass treatment with azithromycin, perhaps aided by subsequent periodic use of tetracycline eye ointment for persons with active disease, can interrupt the transmission of ocular C. trachomatis infection. NEJM 2004; 351: 1962

q The risks of influenza vaccination in asthmatic children are still being discussed. The risk that influenza vaccination may exacerbate asthma is an issue in this debate. The authors conducted a randomized double-blind placebo-controlled trial in 696 children 6-18 years of age with asthma. Except for cough during the day in the first season, there were no differences indicating that vaccination exacerbates asthma. Vaccine 2004; 15; 23: 91

q Although amblyopia can be successfully treated with patching or atropine, there have been few prospective studies of amblyopia recurrence once treatment is discontinued. A study of 156 children with successfully treated anisometropic or strabismic amblyopia (145 completed follow-up), who were younger than 8 years of age showed some interesting results. Patients were followed off treatment for 52 weeks to assess recurrence of amblyopia. Approximately one fourth of successfully treated amblyopic children experience a recurrence within the first year off treatment. For patients treated with 6 or more hours of daily patching, the data suggest that the risk of recurrence is greater when patching is stopped abruptly rather than when it is reduced to 2 hours per day prior to cessation. JAAPOS 2004; 8: 420

q Drooling is a difficult to manage problem in children with CP. During a controlled clinical trial, single-dose BoNT (Botulinum Toxin) injections into the sub-mandibular salivary glands were compared with scopolamine treatment. Forty-five school-aged children were included. Salivary flow rates from all major glands were obtained at baseline and compared with measurements during the interventions. Compared with baseline, the mean decrease in submandibular flow was 25% during scopolamine and 42% following BoNT injections. The difference scores were significant with maximum reductions 2, 4, and 8 weeks following BoNT. Intraglandular BoNT injections significantly reduced salivary flow rate in the majority of drooling CP children, demonstrating high response rates up to 24 weeks. The procedure is simple to perform, effective, and safe when ultrasound guidance is used. Neurology 2004; 26: 1371

Dr. Gaurav Gupta,
Consultant Pediatrician,
Charak Child Care, SCF 85 (FF), Phase 7,
Mohali, Punjab 160061, India.
E-mail: [email protected]