1578 e-Letters

  • 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


    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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  • Is the Children Act failing severely abused and neglected children
    Michael Little

    I recognise that Drs. Speight and Wynne, wrote an unbalanced article (Is the Children Act failing severely abused and neglected children) to encourage discussion but I expect more respect for evidence in Archives of Disease in Childhood.

    I could trade insults based on factual inaccuracies (the Children Act was enacted in 1989 not 1990 and implemented in 1991), selective and inaccurate references and many unsuppor...

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  • Prone sleeping and circulatory control in infants
    Hassib Narchi


    I read with interest the article by Chong et al, in which they studied the variations in blood pressure, heart rate, shin and abdominal wall skin temperature in 44 term infants during sleep, in 4 different positions, prone and supine, horizontal and with a 600 head up tilt respectively. They concluded that the variations observed in the 4 different positions, due to vasomotor tone, may have a role in su...

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