Search

Background: Use of same length needle for intramuscularly administered vaccines had been reported to cause under-and over-penetration among infants due to their different body weights and underlying variations in the fat and muscle thickness. Normative data regarding thigh compartment thickness are, however, lacking among neonates and infants aged ≤12 weeks particularly in low- and middle-incoming countries with high burden of low birth weight/growth restricted infants.Methods: Present study investigated skin to muscle and skin to bone (STBD) distances of anterolateral thigh of babies (n = 300) aged ≤12 weeks (1-80 days) with different weight groups (<3 kg, 3-4 kg and >4 kg) by ultrasonography during their intramuscular vaccinations.Results: Overall, mean [standard deviation (SD)] STBD was 17.04 (2.66) mm with range of 10.60-23.30 mm. Stratifying by current body weight, mean (SD) STBD in infants weighing less than 3 kg was 14.39 (1.23) mm. For infants weighing between 3-4 kg and >4 kg, the mean (SD) STBD were 16.69 (1.43) mm and 17.04 (2.66) mm, respectively. Estimated safety (no risk of over-penetration) of 16 mm was observed in 57.33% (172) infants whereas 25 mm needle had 100% over-penetration risk in the study cohort. Current body weight of infants was a significant predictor of safe injection [area under the receiver operating characteristic (ROC) curve 0.95; 95% CI 0.92-0.97].Conclusions: Our study offers objective normative measurements of anterolateral thigh for safe intramuscular vaccination in young infants especially for low birth weight and growth restricted infants in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

The article talks about the importance of patient adherence to antihypertensive therapy in the effectiveness of hypertension treatment. Topics discussed include the benefits of adherence to dietary approach to stop hypertension (DASH) diet; the clinical trials with antihypertensive therapy; and the use of high-performance liquid chromatography tandem mass spectrometry to monitor the therapeutics.

Objective: Radiological appraisal in children with clinically diagnosed severe pneumonia and its association with clinical outcome. Design: Prospective. Setting: Civil Hospital in Himachal Pradesh. Patients: Eighty-three children hospitalized with severe pneumonia. Results: Lobar consolidation (n=43, 51.8%) was the most common radiological abnormality. Twenty six (31.3%) had interstitial abnormalities and 14(16.9%) had normal chest radiographs. Clinical characteristics at admission could not predict a radiographic abnormality. Time to defervescence for outcome measures of fever and tachypnea was similar in children with consolidation, interstitial pneumonia or normal radiograph. However, length of hospital stay was significantly longer in children with abnormal chest radiographs on univariate analysis. Conclusion: Radiological findings in hospitalized children with clinically defined severe pneumonia have limited value in predicting clinical improvement. [ABSTRACT FROM AUTHOR]

Several letters to the editor are presented in response to article "A Selective Endothelin-Receptor Antagonist to Reduce Blood Pressure in Patients With Treatment-Resistant Hypertension: A Randomised, Double-Blind, Placebo-Controlled Trial," by M. A. Weber and colleagues published in a 2009 issue.