Aim of study To study the epidemiological pattern and the effects of envenomation by the hump nosed viper () in children. All previous publications on this subject are based on the adult experience.
Objectives To determine the usefulness of creatine kinase (CK) alone or in combination with lactic dehydrogenase (LDH) in identifying, those infants at risk of developing hypoxic ischaemic encephalopathy (HIE) or a major handicap following perinatal asphyxia. Design Prospective observational study. Method CK and LDH in serum were measured in 35 asphyxiated infants and in 30 controls within 6 hours of delivery. The asphyxiated newborns were monitored for evidence of HIE. Both groups were followed up in paediatric outpatients clinic and a developmental assessment was done at the end of one year. Results Both the CK and LDH levels were significantly raised in all asphyxiated newborns. 25.7% of asphyxiated babies developed HIE. The CK and LDH values of those who developed HIE were significantly higher than the rest of the asphyxiated newborns. Five babies had developmental delay and their CK values too were significantly higher. The same relationship was not seen with their LDH values. Conclusion Both the CK and LDH values are raised in birth asphyxia. The increase is more marked among those who developed HIE. However, only the raised CK levels correlated with long-term outcome. Babies with CK values above 2860 IU/ L should be closely monitored for both the immediate and longterm sequelae.
Objectives To study clinical aspects of the 2001 outbreak of malaria at Medical Officer of Health Division, Mawanella and to analyse the incidence in subsequent years. Design & Setting A prospective study of all blood film positive malarial cases presenting to the Base Hospital, Mawanella from June to September, 2001 and in subsequent years. Method Data was collected from the Register of Anti-Malarial Campaign, Microscopy Service, Mawanella, Bed Head Tickets, interviewing patients and visiting the area. Results During outbreak a total of 366 malaria infections were detected and 120 patients (32.78%) were in the paediatric age group (0-14 years). Of the infections, 277 (75.68%) were due to Plasmodium vivax and 89 (24.32%) to Plasmodium falciparum. Emergence of P. falciparum was detected by the Antigen Test. During this 4 month period a significant number of children had repeated infections mostly due to relapse with P. vivax or reinfection with P. falciparum. Two children were treated with quinine. A very low incidence of malaria was observed in the four subsequent years. Conclusions Outbreak of malaria should be expected when suitable climatic and geographical conditions prevailed in wet zones. Antigen Test is important in identifying species in difficult cases. Low incidence.
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