AN EPIDEMIOLOGICAL STUDY OF BLOOD PRESSURE AMONG SCHOOL CHILDREN

Blood pressure was measured in 1170 school children between 5 and 15 years of age. Mean blood pressure was significantly higher in boys than girls in all age groups and a steady increase in blood pressure with age was seen in both the sexes. Mean blood pressure was significantly higher among children with positive family history of cardiovascular morbidity. Children from higher socio-economic strata and overweight children also showed higher blood pressure. Nine (0.77%) children had persistent hypertension. However, the degree of hypertension was mild and all these children were asymptomatic. Baseline investigations failed to detect any underlying pathology or target organ involvement. This study suggests that childhood could be a reasonably profitable time to look for such factors and to selectively screen children belonging to the high risk group for hypertension.KEY WORDS: Hypertension, Blood pressure, Epidemiology     

PREVALENCE AND DISTRIBUTION OF CERTAIN CORONARY RISK FACTORS IN AIR FORCE PERSONNEL

180 Airforce personnel selected by stratified random sampling technique were studied for coronary risk factors. Nearly 27% individuals had one, 21% had two and 15% had multiple risks. Tobacco smoking was found to be the commonest risk factor (54%) followed by physical inactivity (45%), hyper-cholesterolaemia (22.2%), obesity (20%), hypertension (15%) and positive family history (12.2%). The prevalence of smoking, physical inactivity, excessive intake of dietary cholesterol and serum cholesterol values were seen significantly rising with age. The mean cholesterol values in the age group of 30–39, 40 years and above were higher than the WHO recommended values. The findings of the study suggest a greater emphasis on health education of airmen on coronary heart disease and its positive association with certain risk factors.KEY WORDS: Coronary heart disease (CHD), Hypertension, Hypercholesterolaemia, Obesity, Physical inactivity, Tobacco smoking     

SUBACUTE SCLEROSING PANENCEPHALITIS (A Report on Two Cases)

We report two cases of subacute sclerosing panencephalitis (SSPE) which is a rare, late neurological sequel, of measles infection acquired in childhood. The diagnosis was reached by adopting criteria defined by Dyken. Past history of measles was present in both the cases and they showed high titres of measles specific antibody in CSF and serum by quantitative ELISA.KEY WORDS: SSPE, Measles     

Hiding in the Bunker: Challenges for a radiation oncology department operating in the Severe Acute Respiratory Syndrome outbreak

In February 2003, one woman returned from Hong Kong to Singapore with a previously undescribed atypical pneumonia. Two months later, Singapore is facing its greatest ever threat to its population's health and the country's economy. The government has taken strong action to break the chain of infection of Severe Acute Respiratory Syndrome (SARS). As a radiation oncology department in Singapore, we have faced challenges in keeping staff and patients safe while continuing to provide a service to our patients. In this article, we outline the measures taken to curb SARS in Singapore and discuss the implications for Australasian radiation oncology departments.     

IMPORTANCE OF PROSTATIC SPECIFIC ANTIGEN (PSA) IN CLINICAL PRACTICE : OUR EXPERIENCE

A total of 89 patients in the age group of 50-92 years having different histopathologically proven prostatic conditions were analysed with prostate specific antigen (PSA) and clinical co-relation undertaken. PSA levels were found to be significantly higher (p < 0.05) in 48 carcinoma prostate cases (mean 93.16 ± 50.75 ng/ml) as compared to 32 benign prostatic hyperplasia (mean 4.66 ± 3.85 ng/ml). Similarly, levels were considerably reduced in 15 post-operative adenocarcinoma cases (mean 10.77 ± 9.65 ng/ml) as compared to their pre-operative samples (mean 93.16 ± 60.75 ng/ml). PSA levels were moderately higher in 9 cases of prostatitis (mean 13.28 ± 4.53 ng/ml). A very high degree of sensitivity, specificity and positive predictive value of PSA e.g. 95.8%, 75.6% and 82.2% respectively was found in adenocarcinoma cases, when levels of PSA were > 10 ng/ml. Thus it necessitates a detailed and thorough examination in such cases to come to final conclusion and early management of the cases.KEY WORDS: Prostatic Specific Antigen (PSA)     

Herpes simplex virus infections in the neonate

Objectives: To review the experience of the Camperdown Children's Hospital with neonatal herpes simplex viral (HSV) infections between 1960 and 1992.
Design: A retrospective record review of all cases of HSV infection.
Results: Fifteen proven HSV infections were found. Only three cases had a definite history of HSV infection during pregnancy. Six were delivered at 36 weeks gestation or earlier. Seven weighed 2500 g or less. Forty-three per cent developed physical signs within 7 days of birth. Three cases were confined to skin, eyes and mouth, five were generalized, six had encephalitis with or without skin lesions, and one had pneumonitis. The mortality rate comprising the five with generalized infection was 47%, one with encephalitis and the one with pneumonitis. Four of the eight survivors have persisting neurological impairment. Those with disseminated infection and encephalitis did poorly regardless of antiviral treatment.
Conclusion A high index of suspicion of HSV infection is important so that antiviral treatment can be commenced early, particularly for those infections localized to skin, eye and mouth where there may be a good prognosis.     

Intellectual function and age of repair in cyanotic congenital heart disease

Eighty one children, comprising 51 with tetralogy of Fallot and 30 children with transposition of the great arteries (TGA) were assessed using the Wechsler intelligence scale for children--revised, and a battery of neuropsychological measures. They were compared with a group of 33 children who had surgery for ventricular septal defect. All children were aged over 10 years when reviewed and were in good health, attending normal schools. No significant negative correlation was found between any component or subtest of the IQ scores and operating age. There was no evidence of a detrimental effect of older age at operation in the children who had cyanotic heart disease as assessed by neuropsychological measures. Delaying surgery for children with TGA or tetralogy of Fallot does not appear to adversely affect their intellectual development. This finding may provide reassurance in cases where surgery has to be delayed for medical, social, or economic reasons.     

The Course of Biological Parameters and 6-Mercaptopurine Pharmacokinetics during Maintenance Treatment of Children with Acute Lymphoblastic Leukaemia

ABSTRACT. Twenty patients on maintenance therapy (MT) for acute lymphoblastic leukaemia (ALL) with oral 6-mercaptopurine (6-MP) and methotrexate (MTX) were studied. White cell and red cell indices and platelets counts were monitored every second week as were drug levels. Mean values for 6-MP and MTX doses, and blood component parameters were calculated for each 6-month period for the whole patient group. 6-MP plasma concentrations and liver-function tests were determined once every six months and mean values calculated. 6-MP and MTX mean doses did not change significantly during MT. The mean area under the concentration versus time curve (AUC) 0-4 hours varied slightly from the start to the end of the MT (257 and 296 ng/ml-h, respectively). The mean plasma peak concentration increased from 98 ng/ml to 195 ng/ml ( p <0.01) during the same period. There were significant decreases betwen the initial white blood cell counts (WBC) and red blood cell counts (RBC) as compared to levels at the end of therapy ( p <0.01 and 0.02, respectively). A linear correlation was found between 6-MP peak concentrations and both WBC ( r =0.96) and RBC ( r =0.87). At the end of MT liver function tests became normal in all except 6 patients. In conclusion, MT have moderate effects on bone marrow and liver and monitoring 6-MP plasma concentration might be of value for determination of the optimal WBC levels during MT.     

Parent and teacher perceptions of child behaviour following cardiac surgery

To determine if parents whose children had undergone successful cardiac surgery perceived their children any differently from parents of children who had not undergone surgery, we used the Achenbach Child Behaviour Checklist (CBCL) to compare parent and teacher perceptions in these two groups. Subjects included 168 children who had undergone cardiac surgery 4 to 8 years previously and 51 controls. On the behaviour scale of the CBCL, the teachers' mean t scores showed no significant difference bctween the cardiac and control groups, in contrast to the parents' scores where parents perceived a higher degree of behavioural problems in children who had undergone cardiac surgery. On the Social competence scale of the CBCL, the parents scored their children who had undergone cardiac surgery as less Socially competent than did the parents of the controls. Teachers' scores showed no difference between groups.