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Indian Pediatr 2009;46: 918 |
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Amit P. Shah
Email: [email protected]
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Don’t hold a child in your lap on
playground slides (J Pediatr Ortho 2009; 29: 606-608) |
This study conducted at Winthrop University Hospital, USA, reviewed
children with fractures of tibia, over eleven months and found that 13.8%
of the tibia fractures were sustained while sliding down a slide on an
adult’s lap. It was found that a child has more probability of getting
tibia fracture when in an adult’s lap while sliding; the leg of the child
is thus fixed and gets twisted, creating a torque that leads to a fracture
in the lower extremity.
Comments Many parents think it is actually safer to
hold their toddler while going down a playground slide. The study gives a
clear message contrary to this popular belief. Do not hold a child in your
lap on playground slides.
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Antipyretic agents may not prevent
febrile seizures (Arch Pediatr Adolesc Med 2009; 163: 799-804) |
This randomized, placebo-controlled, double-blind study was done in
Finland. Children with their first febrile seizure were observed for 2
years to assess the effectiveness of different antipyretic agents and
their highest recommended doses for preventing febrile seizures. During
follow-up, all febrile episodes were treated first with either rectal
diclofenac or placebo, and after 8 hours, treatment was continued with
oral ibuprofen, acetaminophen, or placebo. The primary endpoint of the
study was recurrence of febrile seizures.
The rate of febrile seizure recurrence was 23.4% in
those receiving antipyretic agents and 23.5% in those receiving placebo
(difference, 0.2; 95% confidence interval [CI], "12.8 to 17.6; P=0.99).
Independent of the medication given, fever was significantly higher during
the episodes with seizure versus those without seizure (39.7°C vs. 38.9°C;
difference, 0.7°C; 95% CI, "0.9°C to "0.6°C; P<0.001).
Comments Antipyretic agents are not effective for
the prevention of recurrences of febrile seizures in children with a
febrile episode that leads to a recurrent febrile seizure. Parents should
be informed about the inefficacy of antipyretic agents during a febrile
episode and reassured about the benign nature of febrile seizures.
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Relation between abdominal obesity, waist
circumference, body mass index, and echocardiographic measures in children
and adolescents (Congenital Heart Dis 2009; 4: 338-347) |
A total of 49 clinically normal children aged 3-19 years, including 17
with abdominal obesity, underwent detailed echocardiographic assessment to
explore the associations between waist circumference (WC) and cardiac
function. Compared to subjects without abdominal obesity, those with
abdominal obesity had increased left atrial dimensions, posterior wall
thickness, and left ventricular (LV) mass index 2.7 (P<0.05 for
each comparison). Those with abdominal obesity also had altered LV filling
patterns at the septal, lateral, and inferior wall. WC was the sole
predictor of, and was negatively associated with the ratios of early/late
peak velocity at the septum, inferior wall, and right ventricle; these
associations were independent of LV mass (P<0.001 for each
comparison). Both BMI and WC were independent predictors of left
ventricular mass index (P= 0.001 and 0.05, respectively).
Comments This study suggests that otherwise normal
children and adolescents with abdominal obesity has altered left
ventricular diastolic function and these differences are better predicted
by waist circumference than by BMI.
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