Some aspects of two underfive deaths in an urban field practice area.

PIP: Diarrhea killed 4 million children in the world during 1987. It accounts for about 30% of deaths of children under 5 years of age. According to UNICEF (1988), 70% of 4 million deaths could have been prevented if the knowledge of the use of the low-cost oral rehydration therapy was universal. The deaths of children under 5 years of age (149/1000 live births) contribute 47% of all mortality in India. Malnutrition, diarrhea, acute respiratory infections (ARIs), and lack of minimum hygiene are the main factors in these deaths. Case studies of a 6-month-old and a 5-month-old girl are described. In both cases diarrhea was the immediate cause of death despite hospitalization and treatment with antibiotics. An important contributory factor could be the delay in hospitalization, resulting in further dehydration. However, the factors accelerating fatal outcome were accompanying infections, particularly acute ARI. Such infections were aggravated by the simultaneous occurrence of various degrees of undernutrition. Deprivation of maternal care was one of the significant determinants, because in both cases the mothers were working. A 1974 report indicated that 60% of the mothers of undernourished children under 5 were working mothers. Inadequate diet, exposure to infections, and lack of knowledge of elementary hygiene and child care pose a problem in the urban slums, which is aggravated when the infants are not properly breast-fed, weaned, and cared for during illness. Poverty, ignorance, and ill health thus forms a vicious cycle from one generation to the next, from which children have little chance to escape. If older children are to look after their younger siblings proper child spacing must be emphasized.^ieng

Albendazole in pulmonary hydatid disease.

A case of bilateral pulmonary hydatid disease successfully treated with six courses of albendazole obviating need for surgery is being reported. No side-effects of the drug were observed. Though the cysts ruptured initially but disappeared completely. No recurrence has been observed.