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Query: UMLS:C0018681 (headache)
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In India, 110 boys, 6-13 years old, working in 23 carpet-weaving factories within a 2 km perimeter of the walls around Jaipur in Rajasthan were compared with 290 age- and neighborhood-matched male students (controls) to determine the health and nutritional status of the child laborers. The cases had worked nonstop for most days of the month for the past 6 months. They had been employed, on average, for 3.4 years (range, 0.5-6.5). They worked 10-14 hours/day and were allowed at least one short tea break. Common working conditions included overcrowding (20/23 factories), improper ventilation, and poor lighting (particularly in basement factories). The boys either squatted or crouched for long hours. Good personal hygiene was more common among the students than the weavers (94.8% vs. 76.4%). In all age groups except the 6-7 year and 7-8 year groups, the students had greater weight and height than the weavers (p 0.05) (e.g., 13-14 years, height = 146.9 vs. 139.9 cm; weight = 32.5 vs. 28.9 kg). They even had a bigger chest circumference (p 0.05) (e.g., 13-14 years, 62.3 vs. 58.8 cm). The weavers were more likely than the students to suffer from headaches (34.2% vs. 15.9%; p 0.001), backache (18.2% vs. 5.9%; p 0.001), lower limb pains (15.5% vs. 5.2%; p 0.001), and acute respiratory infections (26.4% vs. 15.2%; p 0.005). They were also more likely to have signs of nutritional deficiency (conjunctival pallor; angular stomatitis; Bitot's spots; lusterless hair; Koilonychia nails; and spongy gums). The controls were more likely to be immunized than the cases. These findings reveal that carpet weaving takes a heavy toll on the health status of the child laborers. They need frequent medical care.
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PMID:Health status of carpet weaving children. 787 89

The postural orthostatic tachycardia syndrome is a disease characterized by excessively increased heart rate during orthostatic challenge associated with symptoms of orthostatic intolerance including dizziness, exercise intolerance, headache, fatigue, memory problems, nausea, blurred vision, pallor, and sweating, which improve with recumbence. Postural orthostatic tachycardia syndrome patients may present with a multitude of additional symptoms that are attributable to vascular vasoconstriction. Observed signs and symptoms in a patient with postural orthostatic tachycardia syndrome include tachycardia at rest, exaggerated heart rate increase with upright position and exercise, crushing chest pain, tremor, syncope, loss of vision, confusion, migraines, fatigue, heat intolerance, parasthesia, dysesthesia, allodynia, altered traditional senses, and thermoregulatory abnormalities. There are a number of possible dermatological manifestations of postural orthostatic tachycardia syndrome easily explained by its recently discovered pathophysiology. The author reports the case of a 22-year-old woman with moderate-to-severe postural orthostatic tachycardia syndrome with numerous dermatological manifestations attributable to the disease process. The cutaneous manifestations observed in this patient are diverse and most noticeable during postural orthostatic tachycardia syndrome flares. The most distinct are evanescent, hyperemic, sharply demarcated, irregular patches on the chest and neck area that resolve upon diascopy. This distinct "evanescent hyperemia" disappears spontaneously after seconds to minutes and reappears unexpectedly. Other observed dermatological manifestations of this systemic disease include Raynaud's phenomenon, koilonychia, onychodystrophy, madarosis, dysesthesia, allodynia, telogen effluvium, increased capillary refill time, and livedo reticularis. The treatment of this disease poses a great challenge. The author reports the unprecedented use of an oral angiotensin II type 1 receptor antagonist resulting in remarkable improvement.
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PMID:Postural orthostatic tachycardia syndrome: a dermatologic perspective and successful treatment with losartan. 2516 60