RESUMO
Idiopathic pulmonary hemosiderosis is conventionally treated withsteroids, prolonged usage of which maybe deleterious anddisease often recurs on tapering. We initiated hydroxy-chloroquine and azathioprine early in treatment along withsteroids in seven children with idiopathic pulmonaryhemosiderosis, and observed that early introduction of secondline immunosuppressants helped in reducing disease flare andsteroid toxicity without serious adverse effects.
RESUMO
JUSTIFICATION: The first guideline on diagnosis and management of malaria in children was formulated by Infectious Diseases Chapter of IAP in 2005. In subsequent year WHO proposed artemisinin based combination therapy in all cases of uncomplicated falciparum malaria. The number of falciparum malaria as well as multidrug resistant falciparum malaria cases are constantly on the rise. So there was need to revise the existing guideline. PROCESS: The first recommendations on the diagnosis and management of malaria in children were formulated in 2005. The same protocol was revised on 12 October 2007 in NIMHANS, Bangalore in the light of various recommendations of WHO, where all the members of the Task Force Committee on Malaria in Children were present. OBJECTIVE: To revise and update treatment guidelines for malaria with special reference to artemisinin based combination therapy. RECOMMENDATIONS: The need for Artemisinin based combination therapy (ACT) is emphasized in chloroquine resistant falciparum malaria. Monotherapy with artesunate will further increase the resistance. Once malaria treatment is initiated it should be completed. In severe malaria the maintenance dose of artesunate is revised.