1433 e-Letters

  • Title : Congenital hypothyroidism screening- incidence in semi-urban hospital.

    Thyroid hormone is critical for normal growth and brain development, and hypothyroidism in infancy is the leading cause of intellectual impairment worldwide. Congenital hypothyroidism (CH), defined as deficiency of thyroid hormones at birth. Congenital hypothyroidism is very important clinically since severe cases will lead to irreversible mental handicap without prompt treatment.

    The essential role of thyroid...

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    Jorge Pisapia

    To the editor:

    We have found very interesting the paper by Dr Allegaert et al. about iv paracetamol pharmacokinetics (1) in which they referred that between- subject variability (BSV) is explained by covariates such as size, weight, disease characteristics or co-administration of drugs. They mentioned that they found an unexplained variance in paracetamol clearance, and that it remained high (39,1 per cent) even a...

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  • Exploring the impact of early life factors
    Michael A. Colvin

    The MCS research by Massion and colleagues on childhood obesity should be read in the light of other recent cohort studies exploring the impact of early life factors in the UK and the USA (1). Kimbro and Augustine found that US children living in married two biological parent households had a lower risk of obesity than those living in other family types. In the presence of other controls, poverty was not a significant r...

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  • Re:Holes in the net: safety netting in Emergency Departments needs to improve
    Evelien de Vos-Kerkhof

    Dear editor,

    In their letter, colleagues Jacob et al. raised further evidence of the lack of standardised safety netting. We thank them for their comments emphasizing the disparity between paediatric trainees' perception of their safety netting practice and their documentation in the medical notes.

    To overcome the lack of information on the difference of given safety netting advice and its documentation...

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  • Treatment of Bronchiolitis in a Poor- Resourced Settings
    Suhair A osman

    Bronchiolitis is on rise, both in prevalence and severity in our country due to many social and life style factors. in our hospital we adopted a protocol named: SuProNO INCLUDE:- - PROVIDE VITAL SIGN ASSESSMENT and close monitoring - PROVIDE O2 AS NEEDED - Provide IV fluid/ NGT Feeds as appropriate -provide Hypertonic (3%) saline nebulization -provide nasal decongestant drops/ spray and suctioning as needed - provide anti...

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  • Holes in the net: safety netting in Emergency Departments needs to improve
    Hannah C Jacob

    Safety netting in the Emergency Department (ED) is key to the practice of safe medicine. Following the article by de Vos-Kerkhof (1), we present further evidence to suggest that there is a lack of standardised safety netting. In addition, we found a disparity between paediatric trainees' perception of their safety netting practice and what they actually documented in the medical notes.

    In a retrospective case...

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  • Point of care lactate testing in resource-poor settings
    Aubrey J Cunnington

    Khan et al. make a strong case for investment in point-of-care lactate testing in low and middle income countries (LMICs) (1). They believe that this would identify children at high risk of death, and would save lives because these children could receive earlier resuscitation. Unfortunately the optimal management of children with hyperlactataemia in LMICs is far from clear. Although Khan et al. extrapolate from findings i...

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  • Re: Treatment of the hyperinsulinaemic hypoglycaemia unresponsive to diazoxide and octreotide: sirolimus should be considered
    Arunabha Ghosh

    We agree that sirolimus may help children with Congenital Hyperinsulinism who do not respond to diazoxide or octreotide. Sirolimus is, however, unlicensed, with little long term experience, and the mechanism by which it reduces hypoglycaemia remains speculative. As sirolimus is an immunosuppressant, its use in young infants has to be carefully monitored in specialist centres under strict protocols. We are, therefore, re...

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  • Re:Invertase is an alternative to Sucraid in the treatment of CSID
    Mark R

    My child also has CSID. She is about to be 8 yrs old and has been on Sucraid for the last 6-7 yrs. I am looking for an alternative to this medication as sometimes we cannot get the medication and have to go a strict diet until we can get some again. I will look into this alternative and post results later.

    Conflict of Interest:

    None declared

  • Varicella vaccination in the UK: reduced risk of stroke might be another advantage
    Andrew L. Lux

    We read with interest the review by Amirthalingam[1] and colleagues of the potential value of a UK varicella vaccination programme. They cite Blumental[2] and colleagues' article in the same issue which assessed the burden of varicella and outlined some of the known complications, such as bacterial skin and soft tissue infections, pneumonia, and neurological complications including meningitis and encephalitis. The Blumen...

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