Volume 29: Issue 4

Parenteral fluid therapy in children requires careful consideration of patient-specific factors such as weight, hydration status, and concomitant disease states. Recent literature has changed the standard of care for maintenance fluids for children in the past decade and brought to light more questions. Concentrations of electrolytes in fluids and the use of balanced fluids are still controversial. This article will review the use of parenteral fluids in children, including fluid content, maintenance fluid rate, treatment of dehydration, and the basics of parenteral fluid ingredients. All pediatric patients should have a plan for fluid therapy that includes careful consideration of hydration status and individual response to therapy.

OBJECTIVES

Oral liquid medications are frequently prescribed to children because they are easier to swallow than other dosage forms. These pediatric liquid medications (PLMs) have sugars added to them for better compliance or as preservatives. Children with chronic illnesses may frequently consume these medications. The presence of sugars and their frequent exposure presents a high risk of dental caries in these children. Additionally, the critical pH can be reached if acids below a pH of 5.5 contact the tooth, causing enamel demineralization. Hence, there was a need to study the sugar content and pH of these medications.

METHODS

Pediatricians and pharmacists in Vadodara city, Gujarat, India, were given a short questionnaire to assess the most prescribed and sold PLMs for analgesics, antibiotics, antiepileptics, multivitamins, and antitussives in the Indian pharmaceutical market. The sugar content and pH of the 15 most prescribed PLMs were assessed with ultraviolet/visible (UV/VIS) spectrophotometry and digital pH meter, respectively. Descriptive statistics were used to analyze the data.

RESULTS

Only 1 of the 15 most sold/prescribed medicines did not contain sugar. Among the remaining PLMs, the sugar concentration ranged from 6.1% to 78.7%. The pH of the PLM ranged from 3.6 to 7.3.

CONCLUSION

Sugar was present in 93.3% of the 15 analyzed PLMs and the pH was lower than the critical pH in 80% of them. Medications with high sugar content and low pH can cause caries development. Sugar-free PLMs are preferred alternatives.

OBJECTIVE

Hyperuricemia is associated with the progression of chronic kidney disease (CKD). Whether urate-lowering treatment with allopurinol can delay disease progression remains controversial.

METHODS

Relevant databases were searched. Randomized clinical trials comparing the efficacy and safety of allopurinol in patients with CKD were selected. The primary outcomes were changes in serum uric acid concentration and estimated glomerular filtration rate (eGFR). Random-effects modeling was used to calculate the standard mean difference (SMD) with 95% CIs.

RESULTS

Four trials enrolling 698 participants were included. All were 2-arm parallel trials with a mean duration follow-up of 22.5 months. Congenital anomalies of the kidney and urinary tract were the most common cause of CKD in children, whereas diabetes was the leading cause of CKD in adults. Allopurinol significantly increased the eGFR compared with control groups (SMD, 2.04; 95% CI, 0.60–3.49; p = 0.005; I² = 98.23%). Allopurinol led to a significant decrease in serum uric acid concentration compared with the control group (SMD, −5.16; 95% CI, −8.31 to −2.01; p = 0.001; I² = 98.80%). No significant difference in adverse effects was identified between treatment and control groups.

CONCLUSIONS

Allopurinol treatment in patients with CKD and hyperuricemia slows the decline in eGFR as compared with placebo, without risk of increased adverse effects.

Introduction

The peer review process is a cornerstone of academic publishing, ensuring the credibility and reliability of scientific research. However, addressing the comments of journal reviewers can be a daunting task for authors. Reviewers often provide critical feedback that requires careful consideration, and the revision process can be both time-consuming and intellectually demanding. As artificial intelligence (AI) technologies evolve, tools like OpenAI’s ChatGPT have emerged as potential aids in this process.¹

ChatGPT, a large language model, has shown proficiency in understanding and generating human-like text. Its applications span from casual conversation to more complex tasks such as coding, data

PROPOFOL BRIDGE IN CRITICALLY ILL PEDIATRIC PATIENTS TO FACILITATE EXTUBATION. Meghna Basnet, Dimitrios Savva. NewYork-Presbyterian Hospital Morgan Stanley Children’s Hospital. New York, NY

Introduction: While mechanical ventilation can be a life saving measure for critically ill children, extubation of those who have remained on extended duration of ventilation in conjunction with higher exposure to sedatives, remains a challenging process. As extubation failure is associated with numerous negative consequences, optimization of sedation during the peri-extubation period is critical. Recently, short term infusions of propofol have been utilized to facilitate extubation due to its favorable pharmacokinetic properties of rapid induction

High Anion Gap Metabolic Acidosis (HAGMA) After Levetiracetam Administration in an 11-Year-Old Boy With Laminin-α2-Deficiency-Associated Muscular Dystrophy and Epilepsy

Piet Erik BeuskerMD,

Doortje Marieke MehrtensMD,

Eckard HamelmannMD, and

Georg ClassenMD