Time Elapsed from Onset of Symptoms to Antituberculosis Treatment in Children with Central Nervous System Tuberculosis in a Tertiary Hospital in South India: A Mixed-Methods Pilot Study

A pilot study with a mixed-methods design was conducted to estimate the time for tuberculosis (TB) treatment initiation and associated factors among children with central nervous system-TB (CNS-TB). A total of 38 children were enrolled for the quantitative component, and 20 in-depth interviews were conducted. The median duration (interquartile range) from onset of symptoms to treatment initiation was 23 (11, 55) days. About 44% and 31% of the children presented with Stage II and Stage III of CNS-TB, respectively. The major reasons for delay were symptoms not taken seriously (50%) and too many referrals (21%). About 89% of the families went into catastrophic health expenditure due to the disease. The treatment delay may be due to both patient delay and health system delay. Tailoring approaches to target the pediatric population could further improve early detection and treatment initiation of CNS-TB.

An analysis of blinding success in a randomised controlled trial of fish oil omega-3 fatty acids

<p><b>INTRODUCTION</b>Incidental reports collected in clinical trials suggest that amongst participants, omega-3 fatty acids derived from fish oil ('omega-3') may be difficult to blind.</p><p><b>MATERIALS AND METHODS</b>We conducted a systematic evaluation of blinding success in a 24-week trial of omega-3 versus an oil-based placebo. Within 1 week of supplement commencement (Week 1), a blinding questionnaire was completed by 131 children enrolled in a trial of omega-3 for the treatment of disruptive behaviour disorders. A version of the questionnaire was also completed by their parents at Week 1, and by the children at the end of supplement administration (Week 24).</p><p><b>RESULTS</b>Participants were unable to differentiate omega-3 from placebo, and accuracy did not improve as a function of: the confidence of guesses, reason for guesses, notice of any change, beliefs about what should change, or time. Child and parent guesses also showed high concordance.</p><p><b>CONCLUSION</b>Taken together, these data provide strong evidence that the identity of omega-3 can be blinded to participants.</p>

Atividade antioxidante de macrófagos alveolares em ratos endotoxêmicos / Anti-oxidative activity of alveolar macrophages in endotoxemic rats

Avaliou-se o efeito da endotoxemia sobre a atividade antioxidante de macrófagos alveolares em ratos da linhagem Wistar. Foram utilizados 24 ratos machos, com idade entre 90 e 120 dias, os quais foram divididos em dois grupos: controle e endotoxêmico. O grupo endotoxêmico foi submetido à injeção intraperitonial de lipopolissacarídio na dose de 1mg/kg de peso corporal. Após 24 h, coletou-se sangue para contagem total e diferencial de leucócitos; lavado broncoalveolar para contagem total e diferencial dos leucócitos e, a partir de macrófagos isolados deste lavado, foram realizadas as dosagens de superóxido e superóxido dismutase. A endotoxemia aumentou a contagem total de leucócitos e o número de neutrófilos no sangue periférico, no lavado broncoalveolar, e aumentou a produção de superóxido sem modificar a produção da superóxido dismutase. Esses resultados sugerem que a endotoxemia induz a uma resposta inflamatória no pulmão. Contudo, não altera a atividade antioxidante em ratos adultos. Tal fato potencializa a resposta contra agentes infecciosos pelo hospedeiro, mas também pode contribuir na patogênese de injúria pulmonar.

The effects of endotoxemia on the antioxidant activity in alveolar macrophages of Wistar rats were evaluated. Twenty-four male rats, 90-120 days of age, were separated into 2 groups: control and endotoxemic. To the endotoxemic animals was administered, intraperitoneally, a lipopolyssaccaride at dosage of 1mg/kg body weight. Twenty-four hours after this procedure, blood was collected for total and differential leukocytes counts. In addition, bronchoalveolar lavage was collected for total and differential leukocyte counting. From this lavage macrophages were isolated for the dosage of superoxide and superoxide dismutase. The endotoxemia increased the total leukocyte counts and the number of neutrophils in the peripheral blood and bronchoalveolar lavage of the rats. There was an increased superoxide production without changing the superoxide dismutase. Our findings indicate that endotoxemia induces lung inflammatory response. However, it does not alter the antioxidant activity in adult rats. This fact not only enhances host response against infectious agents, but might also contribute to the pathogenesis of pulmonary injury.

Effects of CBT on children with disruptive behaviour disorders: findings from a Singapore study

Objective: The study examines the effectiveness of a CBT treatment programme over and above that of Treatment As Usual (TAU), with children who were referred to an outpatient child psychiatric clinic for disruptive behaviour disorders in Singapore. Methods: One hundred and three children aged 8 to 12 (mean±SD=10.22±1.31) who participated in the study were assigned to either the CBT+TAU (n= 51) or TAU group (n=52). Children in both the CBT+TAU and TAU groups received a standard and typical service offered to children at the outpatient child psychiatric clinic. In addition, children in the CBT+TAU group attended the CBT treatment programme that consisted of nine 1.5 hour weekly sessions. Results: Findings from ANCOVA indicated that children in the CBT+TAU treatment group showed significantly lower levels of aggression and significantly lower levels of parental stress at posttreatment and at 3-month follow-up in comparison to the TAU group. Conclusions: Findings from the present study provided some evidence of the effects of CBT in reducing aggressive behaviour and parental stress among children with disruptive behaviour disorders. Interpretation of the findings, recommendations for future research, and implications of the present study were presented.