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Chronic hyperglycemia is captured by A1c but not by FPG (even when repeated twice).
Microangiopathic complications (retinopathy) are associated with A1c as strongly as with FPG.
A1c is better related to cardiovascular disease than FPG.
Fasting is not needed for A1c assessment.
No acute perturbations (e.G, stress, diet, exercise, smoking) affect A1c.
A1c has a greater preanalytical stability than blood glucose.
A1c has an analytical variability not inferior to blood glucose.
Standardization of A1c assay is not inferior to blood glucose assay.
Biological variability of A1C is lower than FPG and 2-h OGTT PG.
Individual susceptibility to protein glycation might be caught by A1c.
A1c can be used concomitantly for diagnosing and initiating diabetes monitoring
Natural history of T2DM in Asia
Diabetes is a global epidemic which is out of control, but worse in Asian countries.
It is a huge and growing problem and costs to the society are high and escalating.
Five countries from Asia figure in the top 10 and account for most cases of diabetes globally.
Asian countries share similar risk factors.
There is an association between economic growth and diabetes.
Rapid urbanization and modernization obesogenic environment i.E. Physical inactivity, psychosocial stress and abundance of food
Asians are prone to developing diabetes at a lower level of obesity.
Diabetes has the potential to negatively impact economy and may bankrupt healthcare systems.
Cost effective interventions in healthy living and diet decrease the burden of diabetes and save on healthcare costs and lost productivity.
There has been a dramatic rise in the number of diabetic population in Korea: economic growth, greater exposure to risk factors (lifestyle and diet), demographic changes (childhood obesity, aging population).
Hypertriglyceridemia: The most difficult lipid disorder to evaluate and treat
Hypertriglyceridemia is the most difficult lipid disorder to evaluate and treat. Hypertriglyceridemic disorder in adults is not a single gene. We do not know if TGs by themselves are an atherogenic risk or is it because of the company they keep.
The intra-individual biological variability (diurnal and monthly) of lipids make it more difficult to define hypertriglyceridemia.
TGs are inversely associated with HDL-C, if high HDL-C levels, almost always TGs are low.
Dietary treatment of severe hypertriglyceridemia: <5%, no alcohol, discontinue all TG-lowering drugs, monitor TG q 3 days until levels are below 1000, then restart treatment.
Fibrates do not reduce the CHD events in high risk patient groups. What impact hypertriglyceridemia has on CHD outcomes is not yet clear.
Lower fasting TG to less than 500 mg/dL; this will reduce the risk of pancreatitis.
Follow the current guideline recommendations to lower LDL-C.
The real value of Apo-B is in patients who do not have raised LDL-C (<100 mg/dL). In such patients it can be very informative and should be taken as an indicator of CVD risk.
Plasma apoB and the other cholesterol indexes are complementary rather than competitive indexes of atherosclerotic risk (Am J Cardiol. 2003 May 15;91(10):1173).
Baseline TGs are determinants of the response to bezafibrate (BIP trial).
Omega-3 fatty acids are beneficial in reducing CV risk (JELIS; Lancet 2007), especially in patients with high TG and low HDL-C (Atherosclerosis. 2008).
If fasting TG is >200 mg/dL and HDL-C <35 mg/dL, consider a fibrate or omega-3 fatty acid.
My 3 year old is sick with a temperature of 100 degrees she can not keep anything down including liquids. What should I do?
I gave birth to a boy on the 24 week1day of pregnancy. 760grms weight. Now in ICU. Have any problem in future?
How to reduce a fever in babies
A fever is a common sign of illness, but it's not always a bad thing. In fact, a fever is usually a normal response of a child's immune system to a virus or bacterial infection.
Most healthy children can tolerate a fever well, and it lasts about 3 to 5 days under normal circumstances.
The most common cause of fevers in babies is a viral infection. In some cases, teething can cause a slight increase in body temperature. In younger babies, a fever could be a sign of a serious infection.
When you see your baby's temperature rise, it can be a great concern for you. You may be in a dilemma whether to call the doctor or get emergency medical care. The guidelines below may be helpful.
Baby fever guidelines as per the American academy of pediatrics (aap):
Newborns up to 3 months of age: anything higher than 100.4 degrees (38 degrees celsius) is a matter of concern.
Infants between 3 and 6 months of age: a fever higher than 101 degrees (38.3 degrees celsius) should be checked by your pediatrician.
Babies age 6 months or older: a temperature over 103 degrees (39.4 degrees celsius) needs an immediate consultation with a doctor.
If your baby shows other signs or symptoms of illness, such as a cold, cough, vomiting or diarrhea, consult your doctor. Moreover, as a parent, always trust your instincts. If you think you should contact the doctor, go ahead.
In any situation, in addition to your doctor's prescribed medication, you can follow a few tips to help manage or reduce your baby's fever.
Here are the top 10 ways to reduce a fever in babies.
1. Cold compresses
As soon as your baby develops a fever, the first thing to do is put a cool, wet washcloth on your baby's forehead. As the water from the wet washcloth evaporates from the skin, it will draw the fever out and the temperature will come down quickly.
Put some cool tap water in a bowl.
Soak a clean washcloth in the water.
Wring out the excessive water, then place the wet cloth on the baby's forehead.
Once the cloth warms, remove it and repeat again.
Do this until the fever has gone.
You can also use the damp washcloth to sponge areas like your baby's armpits, feet, hands and groin to reduce the temperature.
Note: never use very cold or ice water, as it may cause the internal body temperature to increase.
2. Lukewarm bath
A lukewarm bath will help relax a fussy baby and help regulate the body temperature. It will even help your baby sleep better, which is needed for faster recovery.
For babies younger than 6 months, give a lukewarm sponge bath 2 or 3 times a day.
For babies, 6 months or older, give them a regular bath in lukewarm water a few times a day.
After each bath, dress your baby immediately.
Note: never use very hot or cold water, as it may cause the internal body temperature to rise.
3. Breast milk
For babies younger than 6 months old who have a fever, breast milk is very important. It offers a unique balance of nutrients that strengthens a baby's weak immune system and is tailored to fight a baby's illness.
Breast milk is quickly and easily digested. It will even keep a sick baby properly hydrated, which is essential for faster recovery.
Try to breastfeed your young baby frequently. If your baby refuses to nurse while experiencing a fever, try different nursing positions. You can keep the baby upright while breastfeeding to make your baby more comfortable during feeding sessions.
If your baby regularly refuses to nurse, pump out the breast milk and feed it to your baby using a spoon or bottle.
4. Give more fluids
For sick babies, it is important to increase fluid intake. Fluid will help cool them down and replace the fluid lost through sweating to prevent dehydration.
Dehydration may lead to various other complications and delay recovery.
Due to having a fever, babies may refuse large amounts of fluid at a time. So, try to give them smaller amounts more often.
Give oral rehydration solutions (either homemade or readily available in the market) along with lukewarm water to small babies younger than 6 months old to help replenish fluids and electrolytes.
Along with water and oral rehydration solutions, cold milk, ice pops, fruit juice and chilled yogurt can be given to babies 6 months or older.
5. Keep your baby in a cool place
When taking care of a sick baby, it's important to keep a close eye on the room temperature. It should not be too hot or too cold. Keep your baby's room at a comfortable temperature between 70 and 74 degrees (21.1 to 23.3-degree c).
If using a fan, keep it on a low setting. However, make sure your baby is not sleeping directly under the fan.
If using an air conditioner, keep the temperature at a comfortable level. Make sure your baby doesn't shiver and raise his or her temperature.
Also, avoid using the room heater nonstop, as it can make your baby overheated.
Keep your sick baby indoors in a cool place most of the time. If you are taking your baby outside, try to stay in the shade.
6. Dress your infant comfortably
Many parents make the mistake of bundling up their sick child with layers of clothes or extra blankets. This is something parents should avoiding doing, as it may keep the temperature from going down or even make it go higher.
Infants cannot regulate their temperature well, hence, when bundled in layers, it will be harder for them to cool down once overheated. Too much clothing will even prevent radiating body heat into the surrounding air.
Dress your baby in one layer of lightweight clothing. If needed, use a light blanket when your baby is sleeping.
Also, keep your baby in a comfortable room, where the temperature is not too hot or too cool.
7. Foot massage
Rubbing the soles of your sick baby's feet with some warm oil is one of the best ways to calm your fussy baby. Apart from relaxation, it will promote better sleep, which is necessary for quick recovery.
Foot massage also helps regulate body temperature.
Rub some warm olive oil on the bottoms of your baby's feet.
Apply gentle pressure on the soles with your thumbs.
Finally, give a nice massage to the whole foot.
Do this for just a couple of minutes and repeat as needed.
When it comes to a foot massage, be careful not to do too much.
8. Apple cider vinegar
For babies 1 year and older, you can try an apple cider vinegar remedy. Because apple cider vinegar helps draw heat out of the body, it can reduce a high body temperature.
Add a quarter cup of raw, unfiltered apple cider vinegar to a large bowl of lukewarm water.
Soak a washcloth in it, then wring out the excess liquid.
Use this damp cloth to give your baby a sponge bath.
Repeat 2 or 3 times a day until the fever has dropped.
For bringing down a fever, basil is suitable for babies older than 1 year. The herb can help reduce the heat in the body. It works as a natural antibiotic and immune booster.
Boil a handful of basil leaves in 2 cups of water, until the solution is reduced to half. Add a little sugar and give it to your little one, a few times a day.
If your baby is big enough to chew basil leaves, give him or her some thoroughly washed basil leaves to chew at regular intervals.
10. Monitor body temperature
Another important thing when your baby is having a fever is to regularly monitor his or her body temperature. Do not rely on your hand as a means of assessing the child's temperature.
Instead, you can try several ways to take your baby's temperature:
Rectal method (by the rectum)
Oral method (by the mouth)
Axillary method (under the armpit)
Tympanic method (in the ear)
Regularly take your baby's temperature and write it down on a notepad. This will help a doctor assess the changes that have occurred during the days when your baby is not well.
Check on your sick baby from time to time during the night, also.
Monitor your baby and if you notice signs of dehydration and rashes, consult a doctor immediately.
Your baby should urinate at least every 4 hours and the urine should be light colored.
If your child is inconsolable and doesn't stop crying, consult your doctor.
Do not send your baby to daycare until he or she recovers fully.
If your baby is fussy, try to rock your baby while walking to ease his or her distress.
Do not leave a small child with a fever alone for any length of time.
You can give solid food to your baby during a fever, but do not force it.
It is better to feed them foods that are soft and low in fiber, such as bread, crackers and refined hot cereals like oatmeal or cream of wheat.
If your doctor has prescribed medicine, never give more than the recommended dosage to your child.
Always use a measuring device to give medication.
Don't treat a fever in children under 18 years of age with aspirin, as it can lead to serious health problems.
Make sure to keep your baby up to date with all of his or her immunizations.
My son is one year old but his navel is not looking normal, it is looking like some air in it and it is popup like small balloon, may I know is it a serious cause ,it happened before 5 months, before that it looks normal, no pain and nothing ,pls guide me and advice me.
7 months baby is suffering from blocked nose and severe coughing. Does nebulising with saline water helps? Or steam is a better option. We have both the things at home. Does nebulising pose any long term dependence?
Hello Doctors Our baby is 115 days old today, she had her third vaccination yesterday at 11 am, after vaccination she had fever and we gave her CALPOL two times till now, she is having mild fever now and passing stool eight times per day which is more than usual she used to do. Also she is not taking feeding and sometimes she vomits. Please advice if it is matter of any concern as mild fever is also not going away. Thanking you Regards
Can I give yogurt dahi to my 10 months old son? And where do I get wheat grass? What all food I can give to my son.
Hi doctor, i'm 26 years old. Currently am carrying a baby age of 7 weeks. Some people saying that egg is not good for health as it may cause unusual baby hair growth. Is it right? And also let me know how many times I can do hair bath per week.
My baby she is 7 years old she has cold and cough and tonsil problemcontentious what medicine should I give her please suggest me.
Hi Doctor- My 3.5 years old daughter had red rashes on her feet last Thursday which slowly spread to her inner thighs (Friday), around neck (this Monday) & around her mouth (Monday). She did not have fever & her daily activities (eating, urine/stool, playing) was normal. Now her red rashes on her feet, thighs faded but there are rashes (not red now) around her mouth. Just wanted to confirm if this is something related to food allergy (as confirmed by ayurvedic doctor living in same aptmt society) & not measles. We are yet to go clinic as we wanted to ensure this is not contagious (if it is measles)
My son age 5 years height 78cm and weight is 23 kg. His body growth is very thin and he doesn't like have any frood. He doesn't wills to consume food. We forcefully feed food. What to do for his good health any medication required.
My baby is 2 and 1/2 month old, we are feeding him formula milk Lactogen 1 from Nestle due to insufficient milk supply from his mother. But at the time of feeding this formula he is crying too much and refusing to take it. He started doing this just after 5 days of his birth. Doctor says that nothing wrong in his health may be he doesn't like its taste. Please suggest me. I am worrying now.
Maintaining good oral hygiene has now become all the more important. A new study has linked the cause of migraines to be a specific type of bacteria present in mouth and gut. People complaining of splitting headaches is fairly common place nowadays. Statistics in india show that nearly one third indian women and one fifth of indian men suffer from this type of headache.
Symptoms of migraine include:
Moderate to severe pain that affects the whole head or may shift to one side
Increased sensitivity to light, sound and pungent odour
Blurring of vision
Nausea and/or vomiting
Seeing dark spots in front of eyes
There are three different types of headaches- severe headache, cluster headache and migraine.
Headache is simply unpleasant pain in the head region of varying intensity. Cluster headache is intense one sided headache with tearing in the eye of the side of the pain. Migraines are moderate to severe pain in the head, usually diffuse and presents along with the above stated symptoms.
Causes of migraine:
Knowing what causes migraine can help avoid it. Common causes that affect different people are as follows:
Hormonal changes and supplements
Over use of contraceptive pills
Sleeping in small closed rooms with inadequate ventilation
Overuse of mosquito repellent
Bad oral hygiene
Overuse of pain killers
Food that triggers migraine:
Many people experience migraine because of different food items. Identify your trigger and then try hard to avoid it.
Processed and canned meat products
Onions, potatoes, spinach, and over eating of rice
Since many years now, nitrate medicines have been used to maintain cardiovascular health and previous research has revealed that heart patients who were given medications containing nitrates routinely complained of headaches. The migraineurs had high nitrate levels, but the actual connection to link the two had not been established until now.
Researchers at the university of california-san diego investigated this further to identify the connection between what the migraineurs eat that alters their experience with migraines. Bacterial sequencing was done on the 172 participants of samples collected from their mouth and gut. Tests showed an abundance of nitrate reducing bacteria in their faecal samples, but even more in their mouth bacteria.
The study published in the journal msystems has identified the link between oral bacteria and migraine, but it is still not evident whether these bacteria are the cause or a result of migraine. But even then it is best to stay safe from our side by maintaining a healthy lifestyle and a good oral hygiene. Migraine is often neglected by the patients and hence becomes difficult to treat. Identify the above triggers and causes of migraine and consult a physician if you have any of them.