Most ORS formulae do little to control the frequency of diarrhea, leading to a lack of parental satisfaction. The aim of this work was to study feasibility of diarrhea control in children by feeding fermented milk prepara-tions. A randomized controlled clinical trial was carried out in 150 children divided in three groups. Group 1 was given a commercial fermented milk preparation (Actimel), group 2 was given a standardized Indian dahi preparation, while group 3 was given ultra-heat-treated yoghurt preparation (no live bacteria). In conclusion, fermented milk containing Lactobacillus casei DN-114001, and Indian Dahi significantly reduced the duration of diarrhea in children; the former preparation being superior. (European Journal of Clinical Nutrition 2002; 56: S56)

Novel use of an age-old drug! Feeding intolerance is a common problem in preterm infants resulting in a prolonged hyper-alimentation. To evaluate the safety and efficacy of oral erythromycin as a prokinetic agent in promoting enteral feeding in preterm infants with feeding intolerance, 10 preterm infants were enrolled in this study with a mean GA of 30.8 weeks. Nine of 10 infants responded to treatment within 24 hours. The average time to establish full enteral feeding after the drug treatment was 6.6 days. No adverse effects were noted. The preliminary data indicates that oral erythromycin is effective and safe in facilitating enteral feeding in preterm infants with feeding intolerance. In view of the small sample size further randomized controlled trials are warranted. (J Med Assoc Thai 2002; 85: S1177)

The current standard care in pediatrics is to administer hypotonic saline in maintenance parenteral fluids. The safety of this approach has never been evaluated. A review of the literature reveals that the administration of hypotonic fluids is potentially dangerous and may not be physiologic for the hospitalized child. Common childhood conditions requiring parenteral fluids, such as pulmonary and central nervous system infections, dehydration, and the postoperative state, are associated with a nonosmotic stimulus for antidiuretic hormone production, which can lead to free water retention and hyponatremia. The authors feel that the administration of isotonic saline in maintenance parenteral fluids would help in preventing hyponatremia in children who receive parenteral fluids. (Pediatrics 2003; 111: 227)

Does oral diazepam provide effective pharmacokinetics in the prevention of recurrent febrile seizures? To determine serum levels of diazepam after oral administration in children, 46 children admitted with febrile seizures were orally administered with 0.25 mg/kg/dose of diazepam six hourly for four doses. Neither recurrent seizure nor serious adverse effects occurred in any of the patients. Serum concentrations above the therapeutic levels were achieved after orally administered diazepam at 0.25 mg/kg/dose six hourly for four doses. Thus oral diazepam may be used as another method in the prevention of recurrent febrile seizures. (J Med Assoc Thai 2002; 85: S1065)

Does tonsillectomy prevent psoriasis? Numerous studies implicate subclinical or recurrent streptococcal infection as a trigger or maintenance factor in the pathogenesis of psoriasis in children. The purpose of this meta-analysis was to review the efficacy of antibiotic therapy and tonsillectomy as treatments for childhood psoriasis. The available evidence does not demonstrate the efficacy of either antibiotic therapy or tonsillectomy in the treatment of childhood psoriasis. Because these treatments are relatively benign compared to other treatments for severe psoriasis, the use of antibiotic therapy or tonsillectomy may still be worth considering, especially for those patients with recurrent streptococcal infections that seem to trigger or maintain their skin disease. (Pediatr Dermatol 2003; 20: 11)

Body cooling techniques have generated a lot of interest in trying to decrease neurological morbidity in perinatal asphyxia. To assess the safety of selective head cooling in birth-asphyxiated term newborn infants 26 term infants with Apgar = 6 at 5 minutes or cord/first arterial pH <7.1, plus evidence of encephalopathy, were studied. Cooling was achieved by circulating water at 10 degrees C through a cap placed around the head. This study suggests that selective head cooling combined with mild systemic hypothermia of 34.4 degrees C or 35.0 degrees C is a stable, well-tolerated method of reducing cerebral temperature in term newborn infants after perinatal asphyxia. Further studies are on to determine the effectiveness of the same. (Pediatrics 2003; 111: 244)

Dr. Gaurav Gupta,
Senior Resident Pediatrics,
PGIMER,
Chandigarh - 160 012.
Email: [email protected]