Treatment of trichuris trichiura infections improves growth, spelling scores and school attendance in some children

The effects of treating Trichuris trichiura infections were investigated in 407 Jamaican children age 6 to 12 years. The children were randomly assigned to receive treatment (albendazole) or a placebo. The outcome variables included growth, tests of reading, spelling and arithmetic, and school attendance. After 6 months of treatment, there was no significant main effect on any of the outcomes. However, there were significant treatment-by-infection intensity interactions with spelling (P < 0.05) and body mass index (P < 0.01), and a significant treatment-by-stunting interaction with school attendance (P < 0.01). In spelling, the children with heavy infections showed improvements with treatment that approached significance d(P = 0.06), whereas those with lower intensities did not. However, the children with lower infection intensities had increased body mass index with treatment (P = 0.02), although there was no difference in children with heavy infections. In school attendance, the stunted children improved with treatment (P < 0.04), whereas there was no difference in the nonstunted children. These findings suggest that in the sample of Jamaican children examined, the treatment of T. trichiura was more likely to benefit school performance in children of poor nutritional status and those with heavy infections, and to improve weight gain in children with lighter infection intensities (AU)

Effects of missing breakfast on the cognitive functions of school children of differing nutritional status

We examined the effects of omitting breakfast on the cognitive functions of three groups of children: stunted, nonstunted controls, and previously severely malnourished. They were admitted to a metabolic ward twice. After an overnight fast half the children received breakfast on their first visit and a cup of tea the second time. The treatment order was reversed for the other half. When breakfast was omitted, both the stunted and previously malnourished groups responded similarly. The malnourished groups had lower scores in influency and coding whereas the control group had higher scores in arithmetic. The children were divided into wasted and nonwasted groups. Wasted children were adversely affected in digit span backwards test and wasted members of the malnourished groups were adversely affected on efficiency of problem solving and those control group in digit span forwards. These results indicate that cognitive functions are more vulnerable to missing breakfast in poorly nourished children (AU)

Sedation for upper gastrointestinal endoscopy: a comparative study of midazolam and diazepam

Comparison of the ease of upper endoscopy, patient tolerance, and amnestic effect, using diazepam, midazolam, or no sedation, was performed on 149 patients. Midazolam and diazepam sedation produced better conditions and improved patient acceptability. Midazolam was associated with better patient tolerance, less thrombophlebitis, and more amnesia than diazepam, but shared a similar recovery time. Midazolam should replace diazepam as the drug of choice in those patients requiring sedation for upper endoscopy. (AU)

Recall and fears of anaesthesia and surgery in 50 Jamaicans paediatric patients

Fifty Jamaican children undergoing anaesthesia at the University Hospital of the West Indies were interviewed. The items they most recalled and feared about the whole experience were noted. Only 8 per cent of the children were able to recall more than 75 per cent of the items associated with their anaesthetic experience. This ability seemed related to previous anaesthetic exposure, particularly if it occurred recently. Over 75 per cent of the children expresses no fear post-operatively about any item, and 56 per cent no fear of the total experience. There was no correlation between the extent of recall and degree of fear expressed. Attempts were also made to determine what the children knew about their operation and the role they wished their parents to play during anaesthesia. Seventy-two per cent of the children exhibited a good conceptual image of their illness. Over 80 per cent expressed a desire for parental involvement in the experience, particularly at induction and in the recovery phase of anaesthesia (AU)