Volume 20, Nº 1 (2024)

Background:Childhood obesity is an important and serious public health problem worldwide.

Objective:This article aims to familiarize physicians with the evaluation, management, and prevention of childhood.

Methods:A PubMed search was conducted in May 2021 in Clinical Queries using the key terms \"obesity\" OR "obese". The search included clinical trials, randomized controlled trials, case control studies, cohort studies, meta-analyses, observational studies, clinical guidelines, case reports, case series, and reviews. The search was restricted to English literature and children. The information retrieved from the above search was used in the compilation of the present article.

Results:Most obese children have exogenous obesity characterized by a growth rate for height above the 50th percentile, normal intelligence, normal genitalia, and lack of historical or physical evidence of an endocrine abnormality or a congenital syndrome. Obese children are at risk for dyslipidemia, hypertension, diabetes mellitus, non-alcoholic fatty liver disease, obstructive sleep apnea, psychosocial disturbances, impaired quality of life, and shorter life expectancy. The multitude of serious comorbidities necessitates effective treatment modalities. Dietary modification, therapeutic exercise, and behavioral modification are the fundamentals of treatment. Pharmacotherapy and/or bariatric surgery should be considered for obese individuals who do not respond to the above measures and suffer from a serious comorbid condition.

Conclusion:Childhood obesity, once established, is often refractory to treatment. Most treatment programs lead to a brief period of weight loss followed by rapid re-accumulation of the lost weight after termination of therapy. As such, preventive activity is the key to solve the problem of childhood obesity. Childhood obesity can be prevented by promoting healthy diet, regular physical activity, and lifestyle modification. Parents should be encouraged to become involved in school and community programs that improve nutritional status and physical activity in their children.

Background:While generally self-limited, febrile seizures result in significant familial distress. Ambulatory pediatric care providers must be prepared to counsel families on the causes, risk factors, management principles, and prognosis of children with febrile seizures.

Objective:To provide an updated, evidence-based review of febrile seizures focused on the needs of an ambulatory pediatric care provider.

Methods:A narrative review of the literature prioritizing landmark articles, metanalyses, longitudinal population longitudinal cohort studies and national level guidelines.

Results:Febrile seizures are aberrant physiological responses to fever in children caused by complex interactions of cytokine mediated neuroinflammation, environmental triggers, and genetic predisposition. Other than investigations to determine fever etiology, routine bloodwork, lumbar punctures, neuroimaging and electroencephalograms are low yield. The general prognosis is excellent, however, clinicians should be aware of long-term outcomes including: cognitive impairment with non-simple febrile seizures; neuropsychiatric associations; recurrent febrile seizure and epilepsy risk factors; and association between complex febrile seizures and sudden unexpected death. Children with high risk of recurrence, complex febrile seizures, limited access to care, or extreme parental anxiety may benefit from intermittent oral diazepam prophylaxis.

Conclusion:Clinicians should consider four management priorities: 1) terminating the seizure; 2) excluding critical differential diagnoses; 3) investigating fever etiology; and 4) providing adequate counselling to families. The clinical approach and prognosis of febrile seizure can be based on subtype. Children with non-simple (i.e. complex or febrile status epilepticus) febrile seizures require closer care than the vast majority of children with simple febrile seizures, who have excellent outcomes.

Background:Irritable bowel syndrome (IBS) is a prolonged bowel illness that is general-ly stress-related and is characterized by a variety of gastrointestinal problems, the most prominent of which is chronic visceral abdominal discomfort. As a result, IBS typically impacts sufferers' standard of living, and it is typically associated with depression and anxiety symptoms. IBS medica-tion is based mostly on symptom alleviation. However, no effective medicines have been discov-ered too far. As a result, it is essential to discover novel anti-IBS medications.

Objective:The purpose of this brief review is to describe the existing research on nutraceutical sup-plements in irritable bowel syndrome management, including probiotics, prebiotics, symbiotics, herbal products, and dietary fibers.

Methods:This review covered the relevant papers from the previous twenty years that were availa-ble in different journals such as Science Direct, Elsevier, NCBI, and Web of Science that were re-lated to the role and function of Nutraceuticals in Irritable Bowel Syndrome.

Results:Neutraceutical substances have a variety of modes of action, including restoring the healthy microbiome, improving the function of the gastrointestinal barrier, immunomodulatory, an-ti-inflammatory, and antinociceptive properties. According to the literature, these substances not on-ly can improve irritable bowel syndrome symptomatology but also have an excellent long-term safety profile.

Conclusion:Irritable bowel syndrome is a prolonged bowel illness with a lot of gastrointestinal problems. The nutraceuticals treatment works as an anti-IBS intervention and enhances patient compliance with minimum side effects since patients take it better than pharmaceutical treatments.

Background:Dental procedures profoundly affect a child's dental fear and anxiety, ren-dering dental treatment difficult. Inhalation sedation with a mixture of nitrous oxide and oxygen (NO2/02) breathed through a nosepiece is a form of light conscious sedation widely used in appre-hensive children to help them relax and accept dental treatment. This, however, can have both short-and long-term effects on child dental fear and anxiety. This study aimed to assess the short-term immediate effect of inhalation sedation on child dental fear and anxiety scores.

Methods:This analytical cross-sectional study was conducted at the Department of Paediatric Den-tistry at Rehman College of Dentistry, Peshawar, Pakistan, over a period of 1.9 years (January 2019- October 2020). A total of 171 children aged 6-11 years were selected with moderate to severe dental anxiety using the Child Fear Survey Schedule-Dental Subscale (CFSS-DS), requiring pulp therapy in at least one of their deciduous molars. Baseline anxiety scores were calculated using Venham Clinical Anxiety Score (VCAS) and Venham Picture test (VPT) with a dental check-up and fluoride application. VCAS and VPT scores were then assessed at the end of their scheduled second dental visit involving dental anaesthesia and inhalation sedation. VCAS and VPT scores at the end of treatment were compared with the baseline scores.

Results:Out of 171 children, 86 were male and 85 were female, with a mean age of 7.77. Females showed a higher range of VCAS and VPT scores (p ≤0.001) compared to males. The VCAS and VPT scores declined just at the end of the second dental visit following dental anaesthesia with in-halation sedation (mean difference = 1.96 and 3.39, respectively), which was statistically significant (p ≤0.001).

Conclusion:Inhalation sedation has a significant role in reducing child dental fear and anxiety in the short term.