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THE INDIAN JOURNAL OF PEDIATRICS

Evaluation and management should be done by a team consisting of pediatrician, psychiatrist, psychologist and social worker. Appropriate biopsychosocial intervention is needed. ACKNOWLEDGEMENT

The authors thank the Dean, Thanjavur Medical College and the Superintendent, Government Junior Approved School, Thanjavur for permitting them to do the study and publishing the data. REFERENCES

1. Achar ST, Viswanathaa J. Psychogenic problems, In : Textbook of Pediatrics in Developing Tropical Countries. Orient Longman Publications, II Ed, 1982, 847-848 : 191 2. JeUiffeDB, Jelliffe EFP. Human Milk i~ the Modem World. Oxford University Press, 1978.

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3. Chitkara AJ, Gupta S. Growing up in an urban slum. Indian Pediatr 1986; 23 : 453-458. 4. Gold M, Undetected delinquent behaviour. J Res CHineDelinquency 1966; 3 : 27-46. 5. LewisDO. Conduct disorder and juvenile delinquency In : Comprehensive Textbook of Psychiatry. Vot. II, Ed Kaplan HI, Sadock BJ, 39, 1754-1759. 6. DayalR. Are detinquents born or made by us--a Study of 100 cases. Abstract of the paper presented in XXII National Conference of Indian Academy of Pediatrics, 1985. 7. Sanjivi KS. Health for all - a spiritual approach, The Hindu; July 9, 1986; 8. 8. Verrna IC, Jayashankarappa BS, Palani M. Effect of transcendental meditation on the cognitive performance of children in a delinquent school. Indian J Med Res Supp 1982; 76 : 136-143.

HOW LONG TO TREATACUTE OTITIS MEDIA 10-days has been the customary duration of antibiotic therapy for acute otitis media (AOM). How this was settled has always remained uncertain. Dr Hendrickse and colleagues, in a double blind study, randomized 175 patients with acute otitis media into 2 treatment groups: 10 days of therapy with cefaclor or 5 days of therapy followed by 5 days of placebo. The dosage of cefaclor was 40 mg/kg/day administered orally in 9qually divided does at 12 hour intervals. Tympanocentesis before treatment yielded specimens that contained Streptococcus pneumoniae or Haemophilus influenzae or both in 55% of specimens. Branhamella catarrhalis was isolated from 21% of specimens. Culture of material from the ear canal of patients with spontaneous perforation of the tympanic membrane of less than 24 hours duration yielded pneumococci or H. influenzae or both in 38% of specimens and staphylococci in 31%. In patients with acute otitis media with intact tympanic membranes the authors have not been able to show any advantage of the standard duration of 10 days of therapy over a shortened course of 5 days. However, a 5-day course of antibiotic therapy does not appear to be sufficient for children with acute otitis media and spontaneous purulent drainage. Abstracted from : Hendrickse WA et al. Pediatric InfDis J 1988; 7; 14-23.