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Question

Will pedimmune work in a case of recurrent rti? 2.role of granisetron in vomiting due to acute gastroenteritis? 3.should imovax polio be given to all child instead of oral polio? 4.should a child receive pneumococcal vaccine if he is on budecort inhaler?

Answer

According to a study by Merck (manufacturer of Pedimune) "Episodes of URTI and diarrhoea reduced significantly by 91.19 % and 86.60% at the end of therapy respectively" (ref: Indian J Pediatr. 2006 Jul;73(7):585-91.)There are not much double blind placebo-controlled trials to prove its efficacy, though a lot of experience about its good effects in various disorders is available in the literature.

2. The role of anti-emetic medications in the treatment of gastroenteritis-related vomiting is not clear.Some physicians agree with the use of anti-emetic medications because vomiting is unpleasant and distressing for the child and parents alike, and because vomiting can increase the likelihood of dehydration, electrolyte imbalance, and the need for intravenous hydration or hospitalization. Several surveys have shown that anti-emetic medications are commonly prescribed in the treatment of pediatric gastroenteritis and that adverse events are uncommon. Randomized, placebo-controlled trials suggest that ondansetron is efficacious and superior to other anti-emetic medications in the treatment of gastroenteritis-related vomiting. A recent double-blind clinical trial showed that a single oral dose of ondansetron reduces gastroenteritis-related vomiting and facilitates ORT without significant adverse events.

3. The risk with vaccine associated poliomyelitis is rare in children. Hence IPV is only recommended in children with immunocompromised state or in those in whom live vaccines are contraindicated.

4. Inhaled steroids are not a contraindication of any vaccine.
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