Indian Journal of Trauma and Emergency Pediatrics

Seeking donor funding to attempt to improve patient access to expensive drugs and services is nothing new. Aid and donor contributions have been the mainstay of the developed world approach to providing evelopment to developing countries. This approach has been compellingly criticised as ‘Dead Aid’ in that it does not improve circumstances for developing country poor. Despite this fact, the pressure to secure donor funding is both current and ongoing. In addition to failing to provide targeted improvements, donor funding generates other unintended consequences, which are sub optimal. This paper reviews the donor funding approach to solving medical problems and identifies a number of negative consequences in both the seeking and distribution of donor funds. The medical problem of snakebite is utilised to provide some useful examples of the pitfalls and potential tactical responses to improve the process.  

Keywords Funding, Health Economics, Snake Bites, World Health Organisation, Antivenoms, Epidemiology. 

This is the first of the series on Cochrane systematic reviews planned for the Journal.Data comparing room air with 100% oxygen for neonatal resuscitation in a systematic manner have been scant.This review on a common management scenario by ShankarJ and Jhuma S translates best evidence into best care.It analyses several important findings and merits consideration of its implications for practice.The Editorial Board looks forward for such relevant submissions.

For 50 years despite frequent initiatives, meetings and reports, WHO and their expert advisers in this field have failed to find a solution to the problem of reducing snakebite mortality and morbidity for both children and adults in developing countries. This situation has arisen from three main problem areas that have dominated the debate: 1. The problem of epidemiology –the belief that high mortality numbers are necessary to convince donors to provide funds, 2. The problem of policy – that always asking the same experts the same questions will somehow generate new answers. 3. The problem of sustainable and affordable anti snake venom provision. In the key area of epidemiology, which provides data on the requirements for anti snake venom little progress has been made. This has impacted on anti snake venom provision. Alternative approaches, which demonstrate effective methods of achieving, sound epidemiology for anti snake venom volume estimation and in the provision of the product itself have been largely excluded. This paper provides a review of the current approach and how the long sort for reductions in mortality and morbidity can be achieved.

Key words: Snake Bites, World Health Organisation, Envenoming, Antivenoms, Health  

Hydrocarbon poisoning is a common cause of accidental poisoning in children. The most important complication anticipated with hydrocarbon ingestion is chemical pneumonitis. Monitoring and supportive care is the key to successful management of hydrocarbon poisoning as prognosis is good in such cases. Long term complications in the form of abnormal pulmonary function tests may be observed in few cases.

Key words: hydrocarbon, poisoning, children

No abstract

Guillian Barre syndrome is most common cause of rapidly progressing paralysis in children in most countries. It is charachterized by rapidly progressing weakness , often symmetric with relative paucity of sensory symptoms. It often follows upper respiratory tract or gastrointestinal infections and has been associated with a variety of other systemic disorders. Intravenous immunoglobulin therapy and plasma exchange hasten recovery and have greatly reduced the mortality and morbidity. Studies on pathogenesis demonstrate that antibodies against myelin components and macrophages play a major role in causing injury to the myelin or axons.Guillian Barre Syndrome (GBS) is the most common cause of rapidly progressing paralysis in children and adults. There are few other emergencies that call for rapid and organized approach to diagnosis and management. Mortality from Guillian Barre syndrome was 20 to 30% and much of the reduction in mortality is the result of improvement in management of the critically ill in the Intensive care setting and prompt implementation of supportive and disease modifying therapy. In this paper, we will discuss the clinical features of Guillian Barre syndrome, differential diagnosis and orderly evaluation and management.

Key words: Childhood polyneuropathy, demyelination, ganglioside antibodies, plasmapheresis, plasma exchange.