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Treatment of Child and Adolescent Problems
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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.
I had 6 month baby & from last two -three days he is having watery stools. We are giving him cefixime & vizylac drops. Kindly suggest what to do.
My baby 1 and half year has got her DPT vaccination today but in the evening our pet bite her by mistake. He z also vaccinated. Do my child needs rabipur??
My daughter is 3 months, she is active in all manner like a normal baby but she sleep less comparatively to other children. I am worried since she have less weight otherwise no health issues. Kindly suggest.
Hi, my 2.6 years old girl has weight 8.3 kg only since one years last we have given therapy for t. B after Dr. Advice then otc drug albendazole I syrup one time dose have given for worms since I am pharmacist. Please guide.
Hi Child girl 6 is breathing through mouth for last 6 months but since 15 days the same has aggravated. Finally she has enlarged adenoids which are not responding with antibiotics. Any effective nasal drop for relieving pressure in nose apart from otrivin or tab or else.
My son 15 month s has loss appetite and runny nose, with a slight diarrhea, he's not taking milk, rice, etc. I noticed that his molar tooth upper is coming out, can it be because of this ? he had a fever for 2 days but now normal, it's been 4 days now altogether.
My son about 9 years old is a patient of ADHD.He has no interest about any kind of teaching & learning. He has destructive nature.
Sir my baby suffer by ischemic fits or seizures. Please tell me the best treatment to cure this condition.
It's with respect to my 15 month old son. Could you please advice a list of fruits we can feed him with? His general diet like what should we give him for breakfast lunch evening filler and dinner. He is just about 10.5 kgs. Has been a colic child.
One of my friend, child was born yesterday, normal delivery. Its boy baby and baby is not crying. What will be the reason of not crying and please advice.
Hello doc my height is 5'10 nd my wife, s height is 5 Now I have a child new born baby I want to know baby's height. Baby grows on me or my wife thanks.
Sir/madam, my son is eight years old his perfectly alright but he is facing problem with his irregular n bad teeth. He was given bottle feeding at younger age. Is this the problem how to solve this.
She is taking milk from bottle since birth. She was properly sucking the bottle's nipple. But as she turned 1. She started holding bottle by herself and slowly stopped sucking the bottle's nipple. Now the stage is. She holds the bottle for 1 hour in her mouth and doesn't drinks even 30 ml of milk from that bottle. How should I again train her to suck the nipple. Please help.
Many parents mistakenly assume that baby teeth aren't important because they are eventually replaced by permanent teeth. In fact, early dental decay not only threatens the underlying secondary teeth, it can cause severe toothaches.
As soon as the first tooth comes in, parents should begin practicing preventive dental hygiene. Babies should not be permitted to fall asleep while nursing or sucking a bottle; this allows milk to pool in the mouth, and the sugar[lactose] in it can cause extensive tooth decay.
Offering a little water at the end of a feeding rinses any remaining milk from the baby's mouth. The gums and emerging teeth can be wiped gently with a gauze-wrapped finger.
Sugar is the major cause of childhood tooth decay; avoid offering sugary soft drinks and sweet snacks. A chunk of cheese or a piece of fruit are better alternatives that provide important nutrients without harming the teeth.