A hospital-based descriptive recall study was conducted to assess the relationship, if any, between breastfeeding practices and morbidity from respiratory and diarrhoeal diseases in infants. A total of 343 infants (285 admitted patients and 58 controls) were recruited. Clinical and sociodemographic data and details regarding breastfeeding practices, timing of the first respiratory or diarrhoeal illness, and the timing of the first admission for a respiratory or diarrhoeal illness, were carefully documented. Three broad groups of those who were exclusively breastfed for 3 months or less, 4 months or more, and those who were never breastfed were identified. There was no significant difference in the numbers of infants who developed a respiratory or diarrhoeal illness or were admitted to hospital with a respiratory or diarrhoeal illness during the period of exclusive breastfeeding, irrespective of the period of exclusive breastfeeding. However, significant numbers of patients who were breastfed for 3 months or less developed the first respiratory infection, the first episode of diarrhoea, and the first hospital admission for respiratory or diarrhoeal disease during the first 3 months following the introduction of other foods and in the subsequent 3 months following this period. Those who were never breastfed showed the worst results. Significantly fewer of those who were breastfed for 4 months or more fulfilled the same criteria. Identical findings were noted whether the additional feeds used to terminate exclusive breastfeeding were water, herbal tea, native medicines, or formula milk. Similar results were obtained in the control group. This study reiterates the extended protective effects of exclusive breastfeeding for periods of over 4 months against respiratory and diarrhoeal diseases using a novel set of outcome measures.

Eighty six children with troublesome wheezing were studied, in a semiprospective clinical trial with the patients acting as their own controls, to assess the efficacy and cost effectiveness of inhaled steroids. Improvement in school attendance, hospitalisations, breakthrough wheezing, and acute severe attacks were used to assess clinical efficacy. Expenditure for the family, on a cost of illness framework, before and after treatment, was used to estimate cost effectiveness. There are no previous reports of cost-benefit assessment of inhaled steroids in childhood asthma. It is concluded that, even for developing countries with financial constraints, inhaled steroid treatment for prophylaxis of asthma is a cost effective and rational form of treatment. (Arch Dis Child 1995; 72: 312-316)

A case of hyperhemolysis in a 2-year-old boy with β thalassemia major was noted. After several transfusions, he developed hyperhemolysis with a positive (C3d only) direct antiglobulin test (DAT) and no clinically significant RBC allo- or auto-antibodies. (There was a weak cold antibody, showing a narrow thermal range). Because there was no significant improvement with steroid and immunoglobulin infusions, cyclophosphamide therapy was tried with notable success.

Antibiotics are commonly prescribed drugs in paediatrics. However, the threat of antibiotic resistance among children is a cause for concern. A study of the administration patterns of antibiotics prior to admission was carried out on children admitted to a paediatric ward of Teaching Hospital, Jaffna from June to August 2008, using a pre-tested structured questionnaire. Descriptive and basic statistical tests were used to analyse the data. The total number of admissions to the ward was 420 out of which 227 (54%) had been given antibiotics prior to admission. Of this, 53 (23%) were infants. Of the entire cohort, oral antibiotics were given to 214 (94%) and 47 (22%) of them were given two or more antibiotics. Amoxicillin (48%), erythromycin (20%) and cephalexin (16%) were the antibiotics commonly prescribed. Sixty three percent were prescribed antibiotics by general practitioners and 16% were given antibiotics without consulting a doctor. Only 53 (23%) of the parents knew the name and the sideeffects of the antibiotics used on the children. Hospital stay was significantly more for children given prior antibiotics than for those who did not have prior antibiotics (14% against 8% p<0.05). Other medications had been administered to 298 (71%). In order to reduce the risk of antibiotic resistance of microbes, an antibiotic policy should be carefully instituted and implemented.

Objective To assess the possible relationship of bodyweight and body mass index (BMI) to childhood asthma and allergic rhinitis.Setting Chilaw divisional secretariat area.Design Prospective observational study.Method Children aged 13-14 years in 20 out of 22 schools were assessed from April to June 2003 using the internationally validated ISAAC questionnaire on asthma and allergies. The children and parents filled the questionnaire. Height and weight of children were measured using a standardized procedure. Reference ranges for the normal BMI data were obtained from reference growth charts of Ministry of Health. Data was analysed using Epi info version 6.0.Results Total number of children recruited was 866. 185 (21%) gave a positive response to ever having had wheezing.

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