ABSTRACT
Infants of HIV-infected mothers are at great risk of becoming infected with HIV during childbirth. Many infants acquire HIV during labor and delivery. Others can acquire HIV through the mixing of fetal and maternal blood as the placenta separates. The duration of membrane rupture, acute chorioamnionitis and invasive delivery techniques that increase the baby's contact with the mother's blood have been associated with higher risks of MTCT during labor and delivery. HIV is present in breast milk and risk of its transmission during breastfeeding depends on several factors, including: infant age, pattern of breastfeeding, breastfeeding duration, breast health, maternal viral load and maternal immune status. Infants born to HIV infected mothers carry their mother's antibodies in their blood into the second year of life, even if the infants themselves are not infected. For this reason, standard HIV antibody tests cannot reliably confirm HIV infection in infants until after the maternal antibodies have disappeared. Tests that can diagnose pediatric HIV infection accurately during the first year of life include HIV-PCR, CD4/CD8 counts, P24 antigen tests, and viral cultures. PCR offers an effective tool to reliably diagnose HIV in a pediatric age group. Nineteen infants born by normal delivery to HIV-1 seropositive mothers were studied by PCR for the HIV1 env gene. Thirteen babies (68.5%) were negative whereas 6 babies were found to be positive (31.5%). Although PCR is one of the most useful tests for this clinical situation, it is not definitive. Therefore, PCR should be interpreted with caution and repeated at regular defined intervals, preferably lasting until the HIV antibody status of the infant is resolved.
Subject(s)
Genes, env/genetics , HIV Infections/diagnosis , HIV-1/genetics , Humans , Infant , Infant, Newborn , Infectious Disease Transmission, Vertical , Polymerase Chain Reaction/methodsABSTRACT
Neonatal Lupus Erythematosus (NLE) is an uncommon condition manifesting with congenital complete heart block and occasionally other manifestations like hepatitis. Neonatal Lupus with severe cholestasis with positive anti SS-A/Ro and anti SS-B/La antinuclear antibodies in the mother and child is being reported.
Subject(s)
Antibodies, Antinuclear/analysis , Biliary Atresia/diagnosis , Cholestasis/etiology , Heart Block/etiology , Humans , Infant , Lupus Erythematosus, Systemic/complications , MaleABSTRACT
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.
Subject(s)
Base Sequence , Case-Control Studies , Child , Child, Preschool , DNA, Bacterial/analysis , Female , Humans , India , Infant , Male , Molecular Sequence Data , Mycobacterium tuberculosis/isolation & purification , Polymerase Chain Reaction/methods , Reference Values , Sensitivity and Specificity , Tuberculosis/diagnosisABSTRACT
Results of 202 obturator neurectomies including 190 intrapelvic and 8 extrapelvic obturator neurectomies in 100 patients were evaluated. Obturator neurectomy, intrapelvic in particular, yielded gratifying results in properly selected patients. It controlled adductor spasticity, scissoring, improved perineal care and helped the patients in sitting and early ambulation. Pre- and post-operative intensive physiotherapy was necessary to get maximum benefit of the surgery. Poor motor status, low IQ, athetosis and inadequate post-operative care had adverse effect on final outcome.