Transfusion of Blood and Components in Critically Ill Children.

The physicians prescribing transfusions must have a thorough understanding of the various blood products, their indications and contraindications, and requirements for modification of the blood products to prevent probable adverse effects. Decision to give an RBC transfusion should not be based solely on Hb concentration, it should take in account high severity of illness; active bleeding; emergency surgery; etc. Using restrictive transfusion strategy of transfusion RBCs can decrease transfusion requirements without increasing adverse outcomes. In most circumstances, platelets should be maintained greater than 10×109/L. Platelet counts greater than 20×109/L are indicated for invasive procedures and greater than 50× 109/L for major surgeries or invasive procedures with risk of bleeding. Whenever possible, ABO-compatible platelets should be administered. Fresh frozen plasma should be transfused in multiple coagulation factor deficiencies, DIC with bleeding, replacement of rare single congenital factor deficiencies when specific concentrates are not available (e.g., protein C or factor II, V, X, XI, or XIII deficiency). During transfusion child should be monitored carefully.

School Absenteeism Among Children and its Correlates: A Predictive Model for Identifying Absentees.

Objectives: To determine the magnitude of absenteeism and its correlates and to develop a model to predict absenteeism in school children. Design: A cross-sectional study. Setting: Three government schools in Delhi. Participants: 704 students, aged 10 to15 years. Methods: Students were registered and interviewed using a pre-designed questionnaire. The frequency and causes of school absenteeism were ascertained by school records, leave applications and one month’s recall. The factors were subjected to univariate analysis and a stepwise multiple logistic regression analysis and a predictive model was developed. Results: The average absenteeism of a student over 6 months was 14.3±10.2 days (95% CI 13.5-15.0). 48% children absented themselves for more than two days per month on an average. The main factors associated with school absenteeism were younger age, male sex, increasing birth order, lower levels of parental education and income, school truancy, school phobia and family reasons. The discriminating ability of the predictive model developed was 92.4%. Conclusions: It is possible to identify potential absentees in school children.