Subject(s)
Anemia, Sickle Cell/drug therapy , Child, Preschool , Cyclophosphamide/therapeutic use , Hemoglobin E/drug effects , Hemolysis/drug effects , Humans , Immunoglobulins, Intravenous , Immunosuppressive Agents/therapeutic use , Male , Reticulocytes/drug effects , Splenectomy , Syndrome , beta-Thalassemia/drug therapyABSTRACT
OBJECTIVE: To evaluate the risk of fulminant hepatic failure in relation to paracetamol overuse with therapeutic intent in febrile children. METHODS: It was a case control study. Paracetamol ingestion for the current febrile illness was compared between 25 cases of fulminant hepatic failure and 33 hospital age matched controls. RESULTS: Supra-therapeutic doses of paracetamol (mean 145 mg/kg/day) were consumed by all 25 cases compared to none in the control group. Mean paracetamol level in the cases and controls were, respectively, 26.84 mg /dl and 0.051 mg /dl (p< 0.001). The mean duration of paracetamol intake prior to admission in cases was 3. 45 days compared to 1.85 days in the control group. Nineteen, 5 and 3 were, respectively, graded as hepatic encephalopathy grade 1, 2 and 3. All six patients in grade 2 and 3 had hepatomegaly compared to 78% in the grade 1. Four had jaundice and all were in grade 2 or 3. Mean alanine aminotransferase was 2781 U/L None of the randomly selected cases (6) had serological evidence of Hepatitis A, Hepatitis B or Dengue. Three cases died. CONCLUSION: Exposure to multiple supratherapeutic doses of paracetamol is a risk factor to develop fulminant hepatic failure in children with an acute viral like febrile illness.
Subject(s)
Acetaminophen/poisoning , Analgesics, Non-Narcotic/poisoning , Case-Control Studies , Child , Child, Preschool , Female , Fever/drug therapy , Humans , Infant , Liver Failure, Acute/chemically induced , Male , Drug Overdose , Risk Factors , Virus Diseases/complicationsSubject(s)
Adrenal Gland Neoplasms/diagnosis , Child, Preschool , Electroencephalography , Female , Follow-Up Studies , Humans , Lymph Nodes/pathology , Myoclonus/diagnosis , Neuroblastoma/diagnosis , Ocular Motility Disorders/diagnosis , Risk Assessment , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Objective To study cognitive development of children exposed to lead in Colombo. Design A cross-sectional descriptive study. Setting City of Colombo, near Borella junction. Study population 50 children with blood lead levels ranging from 1.6-13.5 ,g/dl. Method Risk factors for lead exposure were assessed using an interviewer administered questionnaire. Development and cognitive abilities of the children were assessed. Results Close proximity to traffic congested highways and surface water drains were common to entire cohort. Purchase of food from roadside vendors was found in all children. 78% children residing in area >10 years and 66% children attending school for >5 years had a below average developmental score. Blood lead levels correlated significantly with increasing age and length of stay in this area.