The antipyretic activity of ibuprofen and aspirin was compared in sixteen children with pyrexia due to upper respiratory tract infection and in twelve with fever due to other causes. All 28 children received ibuprofen (7 mg/kg of body-weight) and aspirin (15 mg/kg of body-weight) in a single dose on 2 consecutive days in a crossover manner. Rectal temperature was recorded prior to and at regular intervals up to 8 hours after drug administration. Analysis of the results indicate that ibuprofen and aspirin effectively lower temperature and the two drugs are comparable in their antipyretic activity. In conclusion, significant antipyretic activity, good tolerance profile and availability in syrup form make ibuprofen a useful substitute for aspirin in children with fever.
Malnutrition is associated with multi-organ manifestations including urinary concentrating defects. The purpose of our study was to prospectively determine the effect of body size and malnutrition on kidney size in children. The length and width of both kidneys were assessed in 525 children with no renal disease (289 male: 236 female; age: newborn-12 years) by real time ultrasonography. The nutritional status was assessed using the Indian Academy of Pediatrics classification, where the expected weight (EW) for age is the 50th percentile for Harvard statistics. Thus, Grade 0: 86100% of EW; Grade I: 70-80% of EW, Grade 11: 60-70% of EW; Grade 111: 50-60% of EW; Grade IV:< 50% of EW. There was no difference in renal size between males and females, or between right and left kidneys. The relationship between kidney area and age and grade of malnutrition was as follows: kidney area (mm2)=13.74 age (months) -110.9 grade+ 1265 (P< 0.001). The partial r for grade and age were -0.318 (P< 0.001) and 0.849 (P< 0.001), respectively. Normal Indian children (Grade 0) had smaller kidneys than those obtained in age matched children in the Western world. We conclude that severe malnutrition (Grade IV) reduces kidney size independent of age. Furthermore, we attribute the smaller kidney size in normal (grade 0) children, to the smaller body habitus of Indian children. Age based data alone, which are widely used currentIy to determine if kidney size is appropriate, may not be sufficient in geographic regions where malnutrition is prevalent and/or the growth curves of the population vary from Western derived standards.
The diagnostic and therapeutic efficacy of bronchoscopy was determined in 85 children. The major indications were foreign body removal in younger patients and evaluation of tracheobronchial pathology in older children. Foreign body was commonly isolated in the toddlers and even in the elder age group (19%) as well as in those with suspected ingestion (44%). Groundnut was the predominant foreign body and right bronchus was the most frequent site. Tracheobronchitis (27%), bronchiectasis (13%) endobronchial tuberculosis (9.4%) and mucus plug (3%) were the other frequent findings. Bronchography was performed in 16 patients and it confirmed the diagnosis in 75% of the cases. Minor complications were encountered in 8% of patients. In the present study bronchoscopy yielded definite results in 83% and in many, including those with normal findings it guided further management.
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