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SUMMARY In this cohort study, the association between early exposure to dogs and farm animals and the risk of asthma was evaluated and included all children born in Sweden. The association was assessed as the odds ratio (OR) for a current diagnosis of asthma at age 6 years for schoolaged children and as the hazard ratio (HR) for incident asthma at ages 1 to 5 years for preschool-aged children. The primary outcome was childhood asthma diagnosis and medication used. Of the 1 011 051 children born during the study period, 376 638 preschool-aged (53 460 [14.2%] exposed to dogs and 1729 [0.5%] exposed to farm animals) and 276 298 school-aged children (22 629 [8.2%] exposed to dogs and 958 [0.3%] exposed to farm animals) were included in the analyses. Of these, 18 799 children (5.0%) in the preschool-aged children’s cohort experienced an asthmatic event before baseline, and 28 511 cases of asthma and 906 071 years at risk were recorded during follow-up (incidence rate, 3.1 cases per 1000 years at risk). In the school-aged children’s cohort, 11 585 children (4.2%) experienced an asthmatic event during the seventh year of life. Dog exposure during the first year of life was associated with a decreased risk of asthma in school-aged children (OR, 0.87; 95% CI, 0.810.93) and in preschool-aged children 3 years or older (HR, 0.90; 95%CI, 0.83-0.99) but not in children younger than 3 years (HR, 1.03; 95% CI, 1.00-1.07). Farm animal exposure was associated with a reduced risk of asthma in both school-aged children and preschool-aged children (OR, 0.48; 95%CI, 0.31-0.76, and HR, 0.69; 95%CI, 0.56-0.84), respectively. The authors conclude that exposure to dogs and farm animals during the first year of life reduce the risk of asthma in children at age 6 years. COMMENTARIES

We studied the actual time taken to document temperature in a stable neonate by an electronic digital skin thermometer with automatic time beeper. We studied 100 neonates after initial stabilization. The mean time required for documenting the temperature by a electronic thermometer in axilla was 56.34+/-1.54 secs for term neonates (2500g) and 54.87+/-1.23 secs for low birth weight (2500g). The skin temperature measured simultaneously by the ordinary mercury thermometer kept for traditional 3 minutes supported the electronic measurement (P0.01).

To study the efficacy and tolerability of montelukast as monotherapy in the treatment of mild persistent bronchial asthma.Open, non-comparative, prospective, 12-month study.Asthma clinic in urban multi-speciality trust hospital.Children (age 3-11 yrs) with mild persistent asthma, not on any prophylactic drugs were enrolled consecutively (from January to December 2003) and started on 4 mg (2-4 yrs) or 5mg (4 yrs) montelukast for a period of 12 weeks. Efficacy was assessed by improvements in clinical score, peak expiratory flow rates (PEFR), spirometry measurements and reduction in reliever drug requirement after 4 and 12 weeks of therapy. Side effects were also judged after 12 weeks of therapy.50 children (mean age 5.41 +/-2.11 years) completed the study. There was association with positive family history (92%), allergic rhinitis (64%), exercise induced asthma (40%), cough variant asthma (24%), seasonal asthma (80%) and high IgE (12%) levels. Clinical scores, viz, activity, wheeze and cough, improved effectively from (1.64 +/-0.5253) at baseline to (0.7 +/-0.7071) and (1.72 +/-0.701) to (0.92 +/-0.6952) and (1.5 +/-0.6145) to (0.88 +/-0.8241) respectively after 12 weeks of therapy. Significant clinical improvement (p0.001) was also noted after 4 weeks of therapy. Peak expiratory flow rates (done in 19 cases) documented improvement from (120.21 +/-12.23) at baseline to (135.41 +/-23.34) after 12 weeks. FEV1 / FVC (done in 11 cases) improved from (71.44 +/-1.35%) to (87.10 +/-8.34%) after 12 weeks. Mean improvement in all the parameters demonstrated P value less than.001. A total of 19 of 50 cases showed mild side-effects as anorexia (16%), elevated liver function tests (18%) and headache (10%).The clinical outcome showed significant improvement (p0.01) after 4 and 12 weeks.

This study was conducted to find normative values for thyroid stimulating hormone (TSH) in 1200 cord blood samples of term babies whose mothers were not on any thyroid medications. TSH was estimated within 24 hrs by enzyme immunoassay. A full thyroid profile, viz, T3, T4, TSH, fT3 and fT4 was done at 7-10 days of age in all babies with cord TSH20 mIU/L. The mean, median and standard deviation for the TSH values for the cohort were 6.13 mIU/L, 5.8 mIU/L and 4.523 respectively. 22 babies with TSH values20 mIU/L were given repeat tests. Hypothyroidism was confirmed in two of these babies. We conclude that a cut off value of TSH20 mIU/L is adequate for neonatal thyroid screening in Indian settings.