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Amit P Shah
E-mail: [email protected]
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Severe iron-deficiency anemia in adolescents: Consider
Helicobacter pylori infection (J Paediatr Child Health 2008;
44:647-650) |
Clinicians at Royal Melbourne Hospital at University of
Melbourne, Australia reported three cases of refractory iron deficiency
anemia in otherwise healthy adolescents All three were found to have H.
pylori gastritis on diagnostic endoscopic gastric biopsy. Iron
deficiency was successfully corrected following antibiotic eradication of
H. pylori infection.
Comment We come across a large number of
adolescents suffering from iron deficiency anemia. This study highlights
the importance of considering H. pylori infection as a cause of
refractory iron-deficiency anemia in adolescents, even in the absence of
gastrointestinal symptoms. |
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Clinicians fail to recognize obesity
clinically (Arch Dis Child 2008; 93: 1065-1066) |
Eighty health care professionals were asked to view
photographs of 33 children and assign each into one of six categories,
ranging from "very underweight" to "obese". The health care professionals’
categorization was compared with the children’s degree of adiposity based
on conventional clinical criteria for BMI. The health care professionals
were found to be generally poor at assessing the weight status of the
children, and in particular tended to underestimate overweight and obesity
in children.
Comment Pediatricians in India are also now
facing the increasing prevalence of obese children in our society. This
study suggests that it is not appropriate to rely on informal assessment
to identify obesity and it is imperative to have anthropometric
measurements every time we see a child in our clinic. |
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Pseudoephedrine use is common among
young children (Pediatrics 2008 Dec;122(6):1299-304) |
Pseudoephedrine, a decongestant found in many
cough-and-cold medications, is known to be associated with deaths and
adverse events in young children. This study was done at Boston
University, USA to describe the prevalence and patterns of pseudoephedrine
use among 4267 US children, aged 0 to 17 years and enrolled from 1999 to
2006 in a USA national random-digit-dial telephone survey of medication
use. Overall, use was highest for children who were younger than 2 years.
Of the pseudoephedrine products used, most were multiple-ingredient
liquids (58.9%) and multiple-ingredient tablets (24.7%).
Comment India, like USA, has a number of
over the counter and prescription cough remedies containing
pseudoephedrine and its exposure mostly in the form of multiple-ingredient
products, is common among children, especially who are younger than 2
years. These are at the highest risk for toxicity and safe dosing
recommendations are lacking. We should discourage its use for extended
period of time.
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Parents of new babies should be
considered for a whooping cough booster vaccination (BMJ 2008; 337:
a343) |
Evidence is growing that the incidence of pertussis is
rising in adolescents and adults all over the world and many developed
countries have recommended to give booster dose of Tdap to adults and
adolescents. Infectious adults within a family are the main source of
infection for unimmunized infants. Doctors at the Royal Hospital for Sick
Children in Edinburgh reported two fatal cases of invasive pertussis in
unvaccinated young infants where investigation revealed the pertussis
infection in one of the parents.
Comment Pre-vaccination infants now account
for the majority of pertussis-related complications, hospitalizations and
deaths. Most of these infants catch the disease from affected household
members, with parents accounting for more than half of the cases.
Introduction of an adult booster or targeted vaccination of household
contacts of young infants should be considered. This is reflected in the
latest IAPCOI Recommendation also. |