Infants are frequently vulnerable to transient functional gastrointestinal disorders (FGIDs) including constipation. Evidence suggests stool frequency and consistency depends upon the various nutritional components including fats. Long chain saturated fats esterified at the sn-1 and sn-3 positions seen in vegetable oil-based infant formulas, are associated with the formation of calcium fatty acid soaps, contributing to constipation. Moreover, fatty acids esterified at sn-2 position, seen in breast milk, lead to formation of softer stools, reducing the chances of constipation. Thus, reducing palmitic acid from a vegetable oil-based infant formula appears to be the go-to solution to improve stool consistency.
The immature gastrointestinal (GI) tract makes infants vulnerable to transient disorders including colic, gastro-oesophageal reflux (GER) and constipation. These conditions cause a significant distress to infants and caregivers, and are among the most common reasons for the paediatrician referral. In addition, these conditions are associated with a significant morbidity, hospitalisations and high healthcare costs, adding to the burden of the disease. Although they are additions to the ongoing physiological development or arise from maladaptive behavioural responses, the evidence remains limited. The vague aetiology and the self-limiting nature, has devoid these conditions of robust clinical attention, both in the research and clinical practice. Frequent early-life intestinal insults may translate as a risk factor in the development of chronic GI disorders and psychological problems later in life. Emerging evidence suggests that providing an optimal nutritional intervention closer to the breast milk can be a path breaking approach to manage these frequently encountered conditions and aid the growth and development of infants.
Despite an alarmingly rise in prevalence of allergic rhinitis in the last 2 decades, yet till date it remains underdiagnosed, undertreated, or mistreated in India. The distinguishing features of allergic rhinitis are commonly misinterpreted with the common cold and thus early detection of allergic rhinitis is often delayed in primary care. Poorly controlled allergic rhinitis adversely impairs overall long-term productivity at work or school, quality of life (QoL) and can also trigger underlying comorbidities like asthma. Thus, early diagnosis and timely referral is the need of the hour for more effective management which will reduce the overall burden of allergic rhinitis in India. As allergic rhinitis needs long-term management, it is also paramount to prescribe highly efficacious, cost-effective treatment with minimal side effects like drowsiness to prevent disruption of patient’s QoL. However, current therapies including intranasal corticosteroids have adverse long-term complications and antihistamines like cetirizine, levocetirizine, and fexofenadine have varying degrees of sedation.With these concerns, a management algorithm was developed to aid for early diagnosis in primary care which provides cost effective option of right medication for a proper duration of time to optimize overall patient care. After a thorough discussion of key opinion leaders and evidence-based recommendations, it was highlighted that loratadine deserves to be considered as a first-line antihistamine therapy due to its rapid and long-lasting symptom relief, non drowsy, and low complication rate for long-term management of allergic rhinitis.
Headache is one of the most common, painful, and disabling conditions that affects people of all ages worldwide and can have a substantial impact on quality of life of those affected. Stress is one of their main aggravating factor for headache across geographies, more so in millennials and females. Headache disorders are most troublesome in the productive years of life with lost working days and reduced productivity. Majority of those with headache have primary headache disorder especially migraine, tension-type headache and medication-overuse headache. Without proper treatment, headaches can be severe and interfere with day-to-day activities and can also become chronic or recurring affecting the well-being of an individual and predispose them to other illnesses. Self-care with simple analgesics in managing primary headache disorders can help reduce frequency of attack and severity with positive effect on physical symptoms and functional capacity. Paracetamol (acetaminophen) is a safe analgesic with good gastrointestinal tolerance and is recommended as 1 line treatment option to reduce pain in various conditions including primary headache disorders. Caffeine, a common additive to analgesic drugs is known to increase the analgesic potency. The anti-nociception enhancing effect of caffeine when given with acetaminophen significantly improves efficacy over use of only paracetamol.
More than two billion people suffer from micronutrient deficiencies (MiNDs) globally, with nearly half living in India. The current risk of ‘hidden hunger’ is severe in India due to serious deficiency risks across an array of essential micronutrients. A nationwide advisory board meeting attended by more than 20 Indian health care professionals (HCPs) was conducted to determine their clinical viewpoint on MiND. An in-depth search of PubMed studies emphasizing various aspects of MiND relevant to the Indian scenario was performed and presented to eminent HCPs from across India who then shared their opinions and perspectives based on their clinical experiences associated with MiND.
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