Effects of gender and age on paediatric headache

The aim of this study was to evaluate the impact of gender and age on headache characteristics and disability. Headache characteristics were assessed at an initial visit to a paediatric specialty care centre and five follow-up visits. A total number of 4121 patients were evaluated. Fifty-eight per cent of the sample was female. Boys were younger at their first headache and initial visit. They more frequently described headache pain as squeezing and location as top of the head. Girls reported more frequent and longer headaches. Girls more often described headache pain as sharp and location as back of the head. Age accounted for more variance than gender in headache severity, duration, frequency and disability. Gender differences exist in headache characteristics. Age is also an important factor in the variability in characteristics and disability. Longitudinal studies are needed to describe further the natural history of headaches in childhood and compare outcome between genders.     

The effect of a child's disability on mother's mental health

The prevalence of maternal depression was investigated in the mothers of 96 children: 30 premature infants at risk for the development of cerebral palsy; 35 premature infants considered not to be at risk for the development of cerebral palsy; and 31 healthy fullterm infants. There were equally high levels of depression in all three groups of mothers, regardless of birth status, prediction of disability, or presence of actual disability, throughout the first year of the children's lives. Depressed mothers were, however, found to have significantly more psychosocial stress. An early physiotherapy intervention had no effect on the prevalence of depression in mothers whose children were at risk for the development of cerebral palsy.     

Impact of home blood glucose monitoring on childhood diabetes

Ninety diabetic children each provided at least one 24-hour blood glucose profile at home using an impregnated filter paper strip. The mean 24-hour blood glucose level correlated significantly with urine control, height velocity, and Hb A1. The correlation coefficient for individual blood glucose values (r = 0.61) and for mean 24-hour blood glucose values (r = 0.73) repeated within 14 days showed an acceptable degree of reproducibility for the blood glucose profiles. Mean 24-hour blood glucose values fell significantly overall (11.4 to 9.8 mmol/l; 205 to 176 mg/100 ml) in 47 children who had repeated profiles more than 2 weeks apart. Unrecognised nocturnal hypoglycaemia (less than 3.0 mmol/l; 54 mg/100 ml) was found in 19% of children on twice-daily Semitard insulin. The study shows that children over age 7 years manage home blood glucose monitoring without difficulty. It shows that the results are reproducible and correlate with other indices of control, and that it provides a practical basis for the improvement of diabetic control.     

Apnoea induced by airflow obstruction

Total obstruction of the airways caused all respiratory efforts to stop on 15 occasions in 10 preterm babies. This was not seen in 60 studies on 38 term babies. These findings suggest that failure to achieve an oral airway may not be the only mechanism by which upper airway obstruction might cause the cot death syndrome.     

An assessment of factors contributing to treatment adherence and knowledge of TB transmission among patients on TB treatment

Background  

The treatment guidelines for tuberculosis treatment under Directly Observed Treatment, Short-course (DOTS) have been a common strategy for TB treatment in Zambia. The study was carried out in Ndola, Zambia, to investigate factors contributing to treatment non-adherence and knowledge of TB transmission among patients on TB treatment, in order to design a community-based intervention, that would promote compliance.     

Continuous muscle fiber activity syndrome

A 5.5 year old Turkish boy who suffered from progressive muscle stiffness was diagnosed as having continuous muscle fiber activity syndrome. Electromyography showed continuous motor neuron activity at rest and following intravenous injection of diazepam. Peripheral nerve block, spinal and general anesthesia diminished the spontaneous activities. The clinical and electrophysiological findings of our case were compared to the previously reported cases with emphasis on the heterogeneity of the syndrome.     

Agnathia (severe microghathia), aglossia and choanal atresia in an infant

A neonate is reported here, who was born with severe mandibular hypoplasia, complete absence of the tongue, unilateral choanal atresia, contralateral choanal stenosis and developed severe airway obstruction at birth. Arrested development of the ventral first branchial arch most likely underlies the clinical deficits. Most reported cases of agnathia have been lethal but the infant reported here has survived into infancy with a tracheostomy and feeding gastrostomy. Her clinical features, assessment and management are discussed.