There was no comparative difference seen in response to tahini in those children with eczema (n=26, t=0.296, p>0.05).There is statistically significant difference between exposure groups (eat sesame, never tried/empirical avoidance and previous reaction) in the difference between their tahini vs sesame wheal, (ANOVA (F(2,44)= 6.744, p=0.03)). The difference in reaction size between tahini and sesame was larger in those that have previously reacted (mean=2.00 ±2.45)) compared to those that never tried/empirically avoided sesame (mean=0.11±0.85)(p=0.02).Conclusions The results show greater reaction to tahini vs sesame, in the number of positive responses, and average size of response wheal. Importantly, the wheal size appears to be greater in those who have previously reacted compared to those who have avoided sesame.Those with eczema did not produce a greater mean difference between tahini and sesame wheal size, suggesting tahini is not acting as an irritant.Specific IgE and/or challenge testing could validate whether the additional positives (9/50) reflect true sesame allergy.
Paratyphoid fever is a systemic bacterial infection caused by bacteria Salmonella paratyphi serovars A, B, or C. It is most associated with travel to endemic areas but can occur sporadically in non-endemic areas. While the disease is more commonly seen in adults, it can occur in children, and the presentation can be variable. It is clinically difficult to differentiate Typhoid from Paratyphoid without isolation of organism. We present a case of a 5-year-old boy, from Telangana state of South India, who presented with watery diarrhea of 8 to 10 episodes per day and abdominal discomfort for 5 days. At presentation child had some dehydration and very poor oral intake. Child did not respond to standard acute gastroenteritis with some dehydration management and continued to have persistent loose watery stools. Routine blood investigations, urine and stool microscopy revealed normal study. Further evaluation in the second week of illness revealed paratyphi on stool culture, and the child started to respondwithsensitive antibiotic cefotaximeinjections after 3 days of starting. However the child did not have other classical symptoms caused by paratyphi, such as fever, vomiting, or rose spots. Other classical investigations like blood culture and urine culture were negative. This case highlights the importance of considering paratyphoid as a potential cause for persistent diarrhea, even in young children, and the importance of prompt diagnosis and treatment with appropriate antibiotics, especially in the absence of classical clinical or laboratory findings.
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