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Amit P Shah
Email:
[email protected] |
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Omega-3 fatty acid effective for the treatment of
children with ADHD (DOI: 10.1016/j.jaac. 2011.06.008) |
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It is known that children with attention deficit hyperactivity disorder
(ADHD) have omega-3 differences in both plasma and erythrocyte membranes
compared with their healthy peers. Omega-3 fatty acids have
anti-inflammatory properties and can alter central nervous system cell
membrane fluidity and phospholipid composition. Several studies have been
conducted with variable results, so this meta-analysis of 10 trials with
699 total children with ADHD was done. Those who received omega-3
supplements had a "small but significant" improvement in symptom severity
compared with those who were given placebo. This effect was also
significant in the children who received supplements that specifically
contained higher doses of eicosapentanoeic acid. Because of its relatively
benign side-effect profile, omega-3 supplements may be a reasonable add-on
to traditional interventions or an option for psychopharmacologic
treatments where parents are reluctant for pharmacological intervention.
Editor’s Comments Good news for manufacturers
of energy drinks. They may now add a little bit of omega-3 fatty acid
to their formula mix and claim that it will increase the attention
span and also control naughty children!
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Early vs interval appendectomy for children with
perforated appendicitis (Arch Surg. 2011; 146(6):660-5) |
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Despite the frequency of this common surgical disorder, there is little
agreement on the best management strategy for perforated appendicitis.
This was the first of its kind randomized trial to compare early vs
delayed surgery. The group included 131 children with median age of 10
years. The main criterion for this was time away from normal activities
(days) along with overall adverse event rate. Early appendectomy
significantly reduced the time away from normal activities. The overall
adverse event rate after early appendectomy was significantly lower
compared with interval appendectomy.
Editor’s Comments I am now convinced of my
wife’s habit of throwing away any unused/damaged item in the house as soon
as it is discovered to be there!
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Asthma flare-ups more
often in obese kids (DOI: 10.1016/j.jaci.2011.06.031) |
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This retrospective study was done to determine the
effect of obesity on treatment of asthma in children. Overweight (BMI
percentile for age, 85% to 94%) and obese (BMI percentile for age,
³95%) children were
more likely to have increased prescription of
b-agonists and oral
corticosteroids compared with normal-weight (BMI percentile for age, 16%
to 84%) children.
Editor’s Comments The airlines which have started charging the obese
for two seats, should now think of a concessional ticket on compassionate
ground as the obese face a dual/triple burden of disease.
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AAP Guidelines for Diagnosis and Treatment of UTI in Children
(Pediatrics 2011; 128:572-575) |
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Urinary tract infections (UTIs) are one of the most common bacterial
infections in young children of 2-24 months. Repeated UTIs can lead to
kidney scarring and life-long decreased kidney function. For the first
time after 1999, AAP has changed recommendations for how initial urinary
tract infection in infants and toddlers is diagnosed and treated after the
analysis of ten years of scientific studies. Major changes in the
Guidelines are as follows:
• Selective
urine testing based on the prior probability of UTI;
• Elimination
of routine voiding cystourethrograms (VCUGs) after first UTI;
• Choice of
antibiotic on the basis of the clinical course rather than on
sensitivity testing of the isolated uropathogen;
• A
renal/bladder ultrasound examination after a first febrile UTI to rule
out anatomic abnormalities; and
• Parents of
children with confirmed UTI should seek prompt (ideally within 48 hours)
medical evaluation for future febrile illnesses.
Editor’s Comments The revised Indian
guidelines on UTI were also released recently (in 2011) after a gap of 10
years. The Indian Padiatric Nephrology group needs to be congratulated for
churning out practice guidelines on a regular basis.
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