eLetters

1492 e-Letters

  • Simply poison
    Camille de San Lazaro

    A six month old child is admitted with seizures as a result of the deliberate administration of sulphonylurea.

    Things have come to a pretty pass when the term "poisoning" does not feature in the keywords of this paper.

    The authors' use of the term "Munchausen syndrome by proxy" implies that they have knowledge of the perpetrator's motivation. In our view, they have not justified this conclusion. The on...

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  • Reliability of adolescents
    Bryan Lask

    Dear Editor

    I write with reference to the article by "Archivist" on Sex Preference in the April issue.

    "Archivist" asks if the view that adolescent iconoclasm and tongue in cheek humour could have an effect upon how they answer questionnaires, or whether that is just too cynical. I am the father of two sons, both of whom were often approached during their adolescent years to participate in psychologic...

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  • Adolescents have it too easy
    P S Prabhu

    I fully agree with the authors of this letter and suggest that the paediatricians in the whole country should pressurise the health secretary to bring out a bill to highlight this problem. Many of my nights on call are now spent taking care of 15 and 16 year old kids who have taken overdoses of paracetamol or aspirin. There seems to be an especially large number of such cases in the Lincolnshire area as compared to Yorksh...

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  • The debate between sedation and anaesthesia for children undergoing MRI
    Michael Sury

    Drs Lawson and Bray (1) have presented arguments for and against deep sedation of children by non-anaesthetists. We would like to contribute to the debate by expanding on issues which have influenced and encouraged the development of a nurse led sedation service for MRI at our hospital.(2)

    There continues to be a huge demand for MR imaging and as a result we have had to meet the challenge of providing a sedation a...

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  • Re: Dipstick examination for urinary tract infections: misleading analysis?
    Sudhin Thayyil Sudhan

    We agree with Dr Deshpande that the sensitivity quoted for dipstick testing might not be the "true value" as a screening test for urinary tract infection as urine culture was not done on all the children in the study.

    Our study was based on the current practice at our hospital of sending urine for culture if any dipstick (nitrites, protein, leucocyte esterase or blood) was abnormal or if there was a clinical su...

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  • Coeliac screening just as important!
    Richard Russell

    EDITOR, - The paper by Noble et al on capillary dried spot testing for TSH measurement is a welcome advance for children with Down's syndrome (DS).(1) In reducing the number of venepunctures this patient group needs, we hope that those professionals caring for children with DS do not omit screening for coeliac disease (CD). This condition is equally prevalent and can be as difficult to diagnose as hypothyroidism in DS as i...

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  • While having some sympathy with Drs Wynne and Speight...
    John A Davis

    While having some sympathy with Drs Wynne and Speight over the despair that they feel about the containment of child neglect and abuse, the answer surely cannot be the wholesale transfer of children from the frying pan of their own homes (one notes that the West children remained in a way fond of their father despite truly appalling treatment at his hands) to the fire of local authority institutions staffed by paedophile...

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  • Fits, pyridoxine and hyperprolinaemia type II
    S Vivekanandan

    Currently two types of measurements are used to assess (chemical and functional) vitamin B6 status, which measure directly B6 and its metabolites and activation of vitamin B6 dependent enzymes and associated aminoacids. The load tests are also used to reveal the subtle defects by stressing the B6 metabolic pathway. None of them is ideal and a combination of them is recommended. Additionally there is no concordance betwe...

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  • Lymphopenia in lymphatic malformations
    R Lakshman

    Hodge et al(1) draw our attention to the possible association of hypogammaglobulinemia and global lymphopenia with Proteus syndrome. They suggest that this may be secondary to loss of immunoglobulins and lymphocytes into lymphoedematous tissue. We have seen a similar phenomenon in a child with massive cystic hygroma in the neck. Immunological investigations showed persistent severe lymphopenia with low levels of all lym...

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  • Dipstick examination for urinary tract infections: misleading analysis?
    Sanjeev Deshpande

    Editor,

    Thayyil-Sudhan and Gupta suggest that urine culture needs to be undertaken if any of the four indices of dipstick analysis (nitrates (sic), blood, protein or leucocyte esterase) are abnormal (1) based presumably on the high sensitivity and negative predictive value (NPV) of this criterion. However, the design of their study wherein urine cultures were not performed on the majority of samples where dips...

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