Accuracy of Infrared Forehead Skin Thermometry in Newborns - A Comparison with Digital Axillary and Rectal Mercury Thermometers.

Temperature is an important vital sign especially in neonates. Providing thermal comfort to baby is part of essential newborn care. The ideal temperature measurement method should be accurate, safe, noninvasive, time efficient, easy to operate and non-disturbing to baby. Mercury thermometers have been banned; rectal measurements are hazardous. Digital axillary thermometers although widely accepted, also have their limitations and sometimes produce questionable results in newborn. Infrared forehead thermometry is a promising tool with controversial results; hence this newer technology needs to be repeatedly tested and validated.METHODSThis is a prospective comparative study conducted in a tertiary care hospital situated in the hilly areas of Solan district of Himachal Pradesh. We simultaneously recorded three temperatures at three sites by different methods and different thermometers Forehead skin temperature was recorded in apparently normal newborns by INNOVA infrared thermometer and axillary temperature was recorded by digital thermometer and rectal temperature was recorded by mercury in glass thermometer.RESULTS260 newborns were included in the study. Data was analysed for correlation by Pearson r coefficient and for agreement by Bland-Altman method. A strong correlation was found between infrared forehead temperature and digital axillary temperature with a Pearson r of 0.826 and 0.801 between infrared forehead temperature and rectal mercury thermometer. Bland-Altman analysis of difference produced a mean difference of 0.49 and level of agreement of -1.67 and +2.65 when axillary digital and infrared forehead thermometry measurements were compared. Mean difference of 0.15 with level of agreement as -2.09 and +2.40 were obtained when rectal mercury and infrared forehead temperatures were compared.CONCLUSIONSAlthough a strong correlation of infrared skin thermometry was found with both axillary digital and rectal mercury temperature measurements. The level of agreement has a wide variation which is not clinically acceptable hence infrared forehead skin thermometry is not recommended for use in newborns.

Evaluation of antipyretic activity of alcoholic extract of Murraya koenigii leaves in rabbits

Background: The present study was carried out to evaluate the antipyretic activity of alcoholic extract of Murraya koenigii leaves in rabbits by using PGE1 induced hyperpyrexia method. We found that not much work has been done on the antipyretic effect of this plant.Methods: Laboratory breed New Zealand strains of rabbits of either sex weighing 1000-1500 gm were used in the study. The animals were divided into five groups (n=6). The rabbits of all the groups were made febrile by injecting misoprostol (PGE1) subcutaneously in the dose of 100 mcg/kg. For group 1 and 2, normal saline 2ml/kg as control and aspirin 28mg/kg as standard were given respectively. Alcoholic extract of Murraya koenigii leaves in the doses of 200, 400 and 800mg/kg were administered in remaining three groups respectively. Rectal temperatures were recorded with help of digital thermometer for every 30 min after drug treatment.Results: Alcoholic extract of Murraya koenigii produced highly significant (p<0.001) antipyretic effect in 400 and 800 mg/kg doses. But onset of action was fast with 800mg/kg dose.Conclusions: This study concludes that Alcoholic extract of Murraya koenigii has fast onset of action and also exhibited sustained anti pyretic action in New Zealand rabbits.

Comparación de valores de temperatura obtenidos con termómetro ótico digital y con termómetros axilar y rectal de mercurio en menores de 5 años / Comparison of body temperature measurements obtained with otic digital thermometer and mercury axillary and rectal thermometers in children under the age of five

Introducción: En los últimos años han aparecido nuevos métodos para medir la temperatura en niños, como el termómetro digital ótico. Siendo este un método más rápido para medir la temperatura y por lo tanto ideal para el servicio de urgencias, es necesario conocer su confiabilidad. Objetivo: Comparar los valores de temperatura corporal que entrega el termómetro ótico digital con los termómetros de mercurio axilar y rectal. Pacientes y Método: Se efectuó la medición de la temperatura en 50 pacientes menores de 5 años elegidos al azar, que consultaron en el Servicio de Urgencia del Hospital de Niños y Cunas de Viña del Mar. Se les midió la temperatura con un termómetro digital ótico al lado izquierdo y derecho, y las temperaturas axilar derecha y rectal con termómetros de mercurio. EL análisis de los resultados se efectuó en el grupo estudiado, separado en dos grupos, menores y mayores de 6 meses. Resultados: Los resultados entre ambos subgrupos fueron los mismos. La temperatura media rectal obtenida fue 0,414°C más alta que la media ótica derecha (p < 0,001) y 0,438°C más alta que la temperatura media ótica izquierda (p < 0,001). Conclusión: El termómetro ótico digital entrega una temperatura significativamente más baja que la que entregan los termómetros de mercurio axilar y rectal.

Background: In recent years, otic thermometers to measure body temperature in children have become increasingly popular as they reflect changes in body temperature sooner than other thermometers. The have become valuable assets in hospital emergency rooms; however, their accuracy and reliability need further studies. Objective: To compare corporal temperature readings between an otic thermometer and mercury axillary and rectal thermometers. Patients and Method: 50 patients under the age of 5, who were treated at the emergency room of our hospital, were randomly chosen to participate in this study. Temperature was measured on their right and left ears using an otic thermometer, and their rectal and right axillary temperature was taken using mercury thermometers. Patients were separated into 2 subgroups for comparison, children under and over 6 months old. Results: The results between the 2 subgroups were very similar. The average temperature obtained by rectal thermometers was 0.414°C higher than the average right-ear temperature (p < 0.001) and 0.438°c higher than the average left-ear temperature (p < 0.001). Conclusion: The otic thermometer's reading is significantly lower than the one obtained using mercury rectal and axillary thermometers.

Accuracy and precision of digital thermometer in neonatal temperature measurement.

Objective: The purpose of this study was to determine the accuracy and precision of digital thermometer for axillary ad rectal thermometry in neonates. Study design: A prospective study was conducted. One hundred infants, 0 to 28 days old, weighing 860 to 3,750 gm with a gestational age of 26 to 43 weeks were measured by a gold standard mercury-in-glass thermometer and then a digital thermometer for axillary and rectal temperatures, respectively. The accuracy was analyzed by the accepted difference between mercury-in-glass versus digital thermometer of 0.1oC and 0.2oC. Results: For rectal thermometry, accuracy of +0.1oC and +0.2oC was 68% (95% CI = 58.3%, 76.3%) and 87% (95% CI = 79%, 92.2%), respectively. For axillary thermometry, accuracy was 64% (95% CI = 54.2%, 72.7%) and 78% (95% CI = 68.9%, 85%) for +0.1oC and +0.2oC, respectively. The precision of the digital thermometer was 86% (95% CI = 77.9%, 91.5%) and 75% (95% CI = 65.7%, 82.5%) for rectal and axillary digital thermometry, respectively. Conclusion: The digital thermometer could be used instead of the mercury-in-glass thermometer in relatively healthy neonates who could accept a wider range of temperature fluctuation within +0.2oC. But for sick or critical neonates, the mercury-in-glass thermometer is still the recommended thermometer.