Nitazoxanide is a broad-spectrum antiparasitic drug active against Cryptosporidium parvum. A study in Zambia (

) has shown it to be effective treatment for cryptosporidial diarrhoea in children. The trial included 47 HIV-negative and 49 HIV-positive children. A 3 day course of the drug gave significant benefit in the HIV-negative group (resolution of diarrhoea within 7 days, 14/25 (nitazoxanide) v 5/22 (placebo); parasitological response by 10 days, 13/25 v 3/22; deaths within 8 days, none v four) but not in the HIV-positive group. A second 3 day course given to both HIV-negative and HIV-positive non-responders appeared to benefit many of them.

Sinoatrial re-entry tachycardia is a form of supraventricular tachycardia in which the P-wave morphology is normal. Radiofrequency ablation has been used but until now the youngest patient so treated has been 15 years old. Now cardiologists in Utrecht (

) have treated a 2 month old baby who had intermittent paroxysmal tachycardia and a dilated left ventricle with globally impaired systolic function. They decided to use radiofrequency ablation rather than antiarrythmic drugs because they feared making the ventricular dysfunction worse. Although they took precautions to avoid heat injury to the right phrenic nerve the baby developed transient paralysis of the right hemidiaphragm. He was …