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Clippings |
Amit P Shah
[email protected]
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Delayed umbilical cord clamping boosts fine motor
skills (JAMA Pediatr. 2015;doi: 10.1001/jamapediatrics.2015.0358.)
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There is evidence in favour of delaying clamping of umbilical cord in
terms of hematological benefits. Currently, the World Health
Organization recommends delaying cord clamping for at least 1 minute.
This study presents the long term outcome of infants whose cords were
not clamped immediately at birth. This study tells that clamping
umbilical cord after about 3 minutes of birth increases the iron storage
and helps brain development. It also shows that fine motor skills were
better in these infants.
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Upper mid arm circumference is a more reliable
indicator of malnutrition (J Nutr.
2015;doi:10.3945/jn.114.209718)
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A large proportion of undernourished children present with diarrhea but
there is no valid tool for assessing undernutrition in children with
diarrhea and possible dehydration. This study was done in Bangladesh to
assess the validity of different measures of undernutrition in children
with diarrhea. Anthropometric measurements, including weight-for-age
z score (WAZ), weight-for-length z score (WLZ), mid upper arm
circumference (MUAC), and mid upper arm circumference z score
(MUACZ), were calculated pre- and post-hydration in all patients.
Measurements were evaluated for their ability to correctly identify
undernutrition in children with varying degrees of dehydration. MUAC and
MUACZ were the most accurate predictors of undernutrition in children
with diarrhea. These findings add to the increasing list of advantages
of MUAC-based criteria for identifying malnutrition.
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Medicines as first-line treatment for insomnia
– A big no! (http://www.choosingwiselycanada.org/recommendations/psychiatry/)
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Antipsychotics should not be routinely used to treat primary insomnia in
children, adults, or the elderly, according to new recommendations
issued by leading Canadian psychiatric organizations. The CWC psychiatry
working group recommends thorough assessment to establish possible
behavioral causes (e.g. poor sleep-wake schedule, use of caffeine and
nicotine), emotional causes (e.g. stress), and psychiatric or physical
causes (e.g. pain, sleep apnea) of insomnia. The first treatment option
offered in most cases should be nonpharmacologic interventions,
including patient education about proper sleep hygiene techniques and
behavioral modification. It is also recommended that melatonin should be
tried first to help regulate sleep-wake cycles. We must remember that
aggressive pharmacological interventions might offer symptomatic benefit
in the short term, but may also lead to numerous potential complications
in the long term.
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General anesthesia in young children linked to
poorer intelligence, language development (Pediatrics.
2015;doi: 10.1542/peds.2014-3526)
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This interesting research evaluated the effect of general anesthesia on
overall intelligence and language development in children less than 4
years of age. Various tests were done, including magnetic resonance
imaging, and it was found that lower test scores among the children who
underwent surgery were mediated by reduced grey matter density in the
occipital cortex and cerebellum of the brain.
No doubt the current anaesthesia techniques are very safe and that
the benefits of most surgeries for young children far outweigh the risks
associated with anesthetic exposure, this is just a step forward to look
for safer options in future.
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Three laboratory tests predict serious
bacterial infections in infants (http://www.pm360online.com/three-lab-tests-predict-serious-bacterial-infectious-in-infants/)
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Bacterial meningitis, urinary tract infections, and bacteremia are
considered serious bacterial infections. Many young infants with these
infections are difficult to identify; current laboratory protocols for
identifying them include urinalysis, white blood cell counts, band
counts, and sometimes cerebrospinal fluid examination. This study states
that positive urinalysis, absolute neutrophil count of 4.09×1,000/mm 3
or higher, and serum procalcitonin of 1.71 ng/mL or higher, taken
together, were 98%-99% sensitive and about 60% specific, in predicting
SBI. This new prediction rule – which does not require cerebrospinal
fluid examination – could limit lumbar punctures, antibiotic use, and
unnecessary hospitalizations among infants at negligible risk of serious
bacterial infections.
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