Blood lead levels of children with pica and surma use.

Blood lead levels of 253 Delhi children were estimated by dithizone method. In 82 (controls) children with no symptoms mean blood lead level was 9.6 micrograms/dl (+/- SD 6.8: median 10 micrograms); only 6 had high levels between 30-33 micrograms/dl. In 88 children with pica, the mean blood lead level was 23.0 micrograms/dl (+/- SD 13.82; median 17 micrograms) which was significantly higher than the control; 26 had high levels between 30-92 micrograms/dl. Sixteen children with pica and surma-use and 46 children suspected of lead poisoning showed lead level patterns like the pica group. However, 21 surma-using children without pica resembled the control group. Children with pica were significantly more anemic than the controls and showed higher prevalence of abdominal-neurological symptoms. Because, in India, blood lead cannot be estimated in most of the hospitals, it is suggested that children with severe pica, anemia, abdominal-neurological symptoms and exposure to surma or lead, be suspected of lead poisoning, kept in lead-free environment with corrected nutrition, and be given a short cautious therapeutic trial with oral penicillamine.

Multi drug resistant Salmonella typhi infection: clinical profile and therapy.

Multiple drug resistant Salmonella typhi infection was observed in thirty five recent cases among forty eight children with bacteriologically proven enteric fever. Incidence of complications such as shock, myocarditis, encephalopathy and paralytic ileus was higher among these. A combination of cephalexin and gentamicin was successfully used in the management of these children.