RESUMO
Methotrexate, the mainstay of treatment in Juvenile idiopathic arthritis, might not be effective in a few patients of polyarticular and systemic onset juvenile idiopathic arthritis. Use of biologicals like TNF-α blockers, the next line of preferred drugs is constrained by the high cost. We successfully used leflunomide in four patients.
RESUMO
Dyggve–Melchior–Clausen syndrome is a rare autosomal-recessive disorder, characterized by progressive spondylo-epi-metaphyseal dysplasia associated with mental retardation. The clinical and radiological findings resembles Morquio disease at the onset of condition, which may hinder its diagnosis. Two siblings with chatacteristic clinical (progressive postnatal dwarfism and mental retardation) and radiological features (irregular lace-like appearance of the iliac crests) are reported.
RESUMO
Effect of vitamin A supplementation on duration of diarrhea was evaluated in 108 cases between 6 months to 5 years of age suffering from acute diarrhea of less than 3 days duration and results were compared with equal number of age and sex matched controls having comparable feeding pattern, nutritional and socio-economic status and clinical profile who did not receive vitamin A supplementation. There was no significant difference in the mean duration of diarrhea in cases who received vitamin A and the controls. However, on subgroup analysis of the study and control groups a significant (p = 0.009) beneficial effect of vitamin A supplementation was noticed in cases who had a pre-existing vitamin A deficiency with CIC stage 3/5 and above. Even though vitamin A supplementation in malnourished children did not significantly alter the duration of diarrhea, a beneficial effect was observed in children who had CIC state 3 and above in association with malnutrition (p = 0.025). Our results indicate that vitamin A supplementation does not significantly reduce the duration of a diarrheal episode. However, in children with pre-existing vitamin A deficiency particularly those who have associated malnutrition it may have a beneficial effect.