ABSTRACT
Provision of optimum comfort control to a critically ill child, in Pediatric Intensive Care Unit (PICU) requires a great degree of skill and planning and should be a prime concern for all practising paediatricians. Failure to provide adequate sedation and analgesia to control the stress response has been seen to be associated with increased complications and mortality. Sedation/analgesia in PICU is required both for, short term procedure and as an adjunct to pediatric intensive care. One has to identify the requirement whether sedation, analgesia or both. The ideal approach should be a sedative/hypnotic for sedation, an anxiolytic for anxiety, and an analgesic for pain. Threfore, it is essential, to provide the right drug for the problem at the right time in the right dosage. The drugs commonly used for sedation analgesia in PICU and their side effects have been described here.
Subject(s)
Analgesics/therapeutic use , Anesthetics, Local/therapeutic use , Anxiety/drug therapy , Child , Humans , Hypnotics and Sedatives/therapeutic use , Critical Care , Pain/drug therapyABSTRACT
OBJECTIVES: To evaluate efficacy of polymerase chain reaction (PCR), using the insertion sequence IS6110 as target for DNA, to detect Mycobacterium tuberculosis in body fluids of children with suspected tuberculosis (TB). SETTING: Hospitalized patients. METHODS: A comparison of PCR on body fluids, Acid Fast Bacilli staining (AFB), mycobacterial culture and clinical features, with special emphasis on central nervous system (CNS) TB was done over 18 month period. A total of 80 children were evaluated, 41 with probable TB disease and 39 controls. Cases were defined by specific clinical criteria. Controls included patients free of clinical TB. PCR was done on the clinical specimens and compared with clinical findings, radiological features, Mantoux (Mx) testing, AFB staining and culture on Lowenstein-Jensen (LJ) medium. RESULTS: Sensitivity of PCR in CSF samples was 100%, in gastric aspirate samples was 20% and in pleural fluid samples was 100%. CONCLUSION: PCR technique may become a valuable diagnostic tool for the diagnosis of tuberculosis in children especially in CNS TB.