ALL OF US HAVE MALNUTR WRITTEN IN OUR DNA

 

Life-as-we-know-it is as much an expression of the conditions on our planet as it is of biological organisation

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Life’s encyclopaedia arose during an era in which a unique relationship between triples of nucleotides and single amino acids became locked in place.

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“There is a saying in Tibetan, 'Tragedy should be utilized as a source of strength.' No matter what sort of difficulties, how painful experience is, if we lose our hope, that's our real disaster.”

― Tenzin Gyatso, His Holiness the 14th Dalai Lama of Tibet

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1 BN PPL LIVE IN WORLD WITH A DISABILITY

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HUMANKIND AND COFFEE CAME FROM ETHIOPIA 

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"Why some things—a word, a glance, a scene glimpsed from a window, a random memory, a fragrance, a conversational anecdote, a fragment of music, or of a dream—have the power to stimulate us to intense creativity while most others do not, we are unable to say."

-- Joyce Carol Oates, The Faith of a Writer

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PUR NARRG - ONLY LOGIC NO MAGIC

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p kzn 

Bulging fontanelle in febrile infants as a predictor of bacterial meningitis

Dania Takagi, Amit Oren-Ziv et al.

Eur J Pediatr. 2020 Nov 9 [Epub ahead of print]

It is common practice to perform a lumbar puncture in infants presenting with fever and a bulging fontanelle in order to rule out bacterial meningitis. However, most of these infants have benign, self-limiting diseases. The objective was to determine whether there is an association between bulging fontanelle and bacterial meningitis in febrile infants. This retrospective cohort study included febrile children with a bulging fontanelle who underwent lumbar puncture at Meir Medical Center from 2005 through 2015. A total of 764 children ages 2-18 months underwent lumbar puncture during the study period. Among them, 304 had a bulging fontanelle and fever on evaluation and cerebrospinal fluid pleocytosis was found in 115 (37.8%), including 1 case of bacterial meningitis (0.3%). None of the infants described on admission as appearing well on presentation was found to have bacterial meningitis. Of the 764 children who underwent lumbar puncture, 10 infants were diagnosed with bacterial meningitis, and only one (10%) presented with a bulging fontanelle.Conclusion: The finding of a bulging fontanelle has very low sensitivity and specificity for bacterial meningitis. Most causes of a bulging fontanelle in febrile infants are self-limiting diseases. The routine approach of performing a lumbar puncture in febrile infants with a bulging fontanelle should be reconsidered. What is Known: • It is common to perform a lumbar puncture in febrile infants with a bulging fontanelle, to rule out bacterial meningitis. • However, there are only few researches regarding the relationship between bulging fontanelle and bacterial meningitis. What is New: • The finding of a bulging fontanelle has very low sensitivity and specificity for bacterial meningitis • The need for routine lumbar puncture in these cases should be reconsidered.

SOURCE : European Journal of Pediatrics

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