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  1. Article: Paediatrics: how to manage viral gastroenteritis.

    Leung, Alexander Kc / Hon, Kam Lun

    Drugs in context

    2021  Volume 10

    Abstract: Background: Viral gastroenteritis is the most common diarrhoeal disorder seen in general practice and emergency departments. This article aims to provide a narrative updated review on the evaluation and management of viral gastroenteritis in children.!## ...

    Abstract Background: Viral gastroenteritis is the most common diarrhoeal disorder seen in general practice and emergency departments. This article aims to provide a narrative updated review on the evaluation and management of viral gastroenteritis in children.
    Methods: A PubMed search was performed with Clinical Queries using the key term 'viral gastroenteritis'. The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies and reviews. The search was restricted to the English literature and the paediatric population.
    Results: Acute viral gastroenteritis is usually self-limiting. However, it can lead to dehydration and electrolyte imbalance if not properly treated. Adequate fluids containing physiological concentrations of glucose and electrolytes should be provided to compensate for gastrointestinal losses and cover maintenance needs. Oral rehydration therapy is as effective as intravenous (IV) fluid therapy for rehydration for children with mild-to-moderate dehydration. Measurements of serum electrolytes, creatinine and glucose are usually not necessary and should only be considered in a subset of children with severe dehydration who require hospitalization and IV therapy. Judicious use of ondansetron can increase the success rate of oral rehydration therapy and minimize the need for IV therapy and hospitalization.
    Conclusion: Acute viral gastroenteritis is associated with substantial morbidity in developed countries and significant mortality in developing countries. Physicians should educate caregivers on proper personal hygiene and handwashing to prevent faecal to oral transmission of the pathogen as well as the importance of rotavirus vaccine in the prevention of rotavirus gastroenteritis. Several norovirus vaccines are currently undergoing clinical trials with promising results. It is hoped that development of an effective norovirus vaccine will further reduce the incidence of viral gastroenteritis.
    Language English
    Publishing date 2021-03-26
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2719560-0
    ISSN 1740-4398 ; 1745-1981
    ISSN (online) 1740-4398
    ISSN 1745-1981
    DOI 10.7573/dic.2020-11-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Paediatrics: how to manage functional constipation.

    Leung, Alexander Kc / Hon, Kam Lun

    Drugs in context

    2021  Volume 10

    Abstract: Background: Despite being a common problem in childhood, functional constipation is often difficult to manage. This article provides a narrative updated review on the evaluation, diagnosis and management of childhood functional constipation.: Methods!# ...

    Abstract Background: Despite being a common problem in childhood, functional constipation is often difficult to manage. This article provides a narrative updated review on the evaluation, diagnosis and management of childhood functional constipation.
    Methods: A PubMed search was performed with Clinical Queries using the key term 'functional constipation'. The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies and reviews. The search was restricted to the English literature and to the paediatric population. The information retrieved from the above search was used in the compilation of the present article.
    Results: A detailed history and thorough physical examination are important in the evaluation of a child with constipation to establish the diagnosis of functional constipation as per the Rome IV criteria and to catch 'red flags' suggestive of organic causes of constipation. These 'red flags' include delayed passage of meconium, ribbon stool, rectal bleeding/blood in the stool unless attributable to an anal fissure, failure to thrive, severe abdominal distension, absent anal wink/cremasteric reflex, tight and empty rectum on digital examination and explosive expulsion of liquid stool and gas on withdrawal of the finger, hair tuft/dimple/lipoma/haemangioma in the lumbosacral area, and an anteriorly displaced anus. For functional constipation, pharmacological therapy consists of faecal disimpaction and maintenance therapy. This can be effectively accomplished with oral medications, rectal medications or a combination of both. The most commonly used and most effective laxative is polyethylene glycol. Non-pharmacological management consists of education, behavioural modification and dietary interventions. The combination of pharmacological therapy and non-pharmacological management increases the chance of success.
    Conclusion: Polyethylene glycol is the medication of first choice for both disimpaction and maintenance therapy. If polyethylene glycol is not available or is poorly tolerated, lactulose is the preferred alternative. Other laxatives may be considered as second-line therapy if treatment with osmotic laxatives fails or is insufficient. Maintenance treatment should be continued for at least 2 months. Early treatment will result in a faster and shorter treatment course.
    Language English
    Publishing date 2021-03-26
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2719560-0
    ISSN 1740-4398 ; 1745-1981
    ISSN (online) 1740-4398
    ISSN 1745-1981
    DOI 10.7573/dic.2020-11-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Childhood guttate psoriasis: an updated review.

    Leung, Alexander Kc / Barankin, Benjamin / Lam, Joseph M / Leong, Kin Fon

    Drugs in context

    2023  Volume 12

    Abstract: Background: Guttate psoriasis is common and affects 0.5-2% of individuals in the paediatric age group. This review aims to familiarize physicians with the clinical manifestations, evaluation, diagnosis and proper management of guttate psoriasis.: ... ...

    Abstract Background: Guttate psoriasis is common and affects 0.5-2% of individuals in the paediatric age group. This review aims to familiarize physicians with the clinical manifestations, evaluation, diagnosis and proper management of guttate psoriasis.
    Methods: A search was conducted in July 2023 in PubMed Clinical Queries using the key term "guttate psoriasis". The search strategy included all observational studies, clinical trials and reviews published within the past 10 years. The information retrieved from the search was used in the compilation of the present article.
    Results: Guttate psoriasis typically presents with an abrupt onset of numerous, small, scattered, tear-drop-shaped, scaly, erythematous, pruritic papules and plaques. Sites of predilection include the trunk and proximal extremities. There may be a history of preceding streptococcal infection. Koebner phenomenon is characteristic. Guttate psoriasis may spontaneously remit within 3-4 months with no residual scarring, may intermittently recur and, in 40-50% of cases, may persist and progress to chronic plaque psoriasis. Given the possibility for spontaneous remission within several months, active treatment may not be necessary except for cosmetic purposes or because of pruritus. On the other hand, given the high rates of persistence of guttate psoriasis and progression to chronic plaque psoriasis, some authors suggest active treatment of this condition.
    Conclusion: Various treatment options are available for guttate psoriasis. Triggering and exacerbating factors should be avoided if possible. Topical corticosteroids alone or in combination with other topical agents (e.g. tazarotene and vitamin D analogues) are the most rapid and efficient treatment for guttate psoriasis and are therefore the first-line treatment for mild cases. Other topical therapies include vitamin D analogues, calcineurin inhibitors, anthralin, coal tar and tazarotene. Ultraviolet phototherapy is the first-line therapy for moderate-to-severe guttate psoriasis, as it is more practical than topical therapy when treating widespread or numerous small lesions. Systemic immunosuppressive and immunomodulatory therapies (e.g. methotrexate, cyclosporine, retinoids, fumaric acid esters and biologics) may be considered for patients with moderate-to-severe guttate psoriasis who fail to respond to phototherapy and topical therapies.
    Language English
    Publishing date 2023-10-23
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2719560-0
    ISSN 1740-4398 ; 1745-1981
    ISSN (online) 1740-4398
    ISSN 1745-1981
    DOI 10.7573/dic.2023-8-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Tinea pedis: an updated review.

    Leung, Alexander Kc / Barankin, Benjamin / Lam, Joseph M / Leong, Kin Fon / Hon, Kam Lun

    Drugs in context

    2023  Volume 12

    Abstract: Background: Tinea pedis is one of the most common superficial fungal infections of the skin, with various clinical manifestations. This review aims to familiarize physicians with the clinical features, diagnosis and management of tinea pedis.: Methods! ...

    Abstract Background: Tinea pedis is one of the most common superficial fungal infections of the skin, with various clinical manifestations. This review aims to familiarize physicians with the clinical features, diagnosis and management of tinea pedis.
    Methods: A search was conducted in April 2023 in PubMed Clinical Queries using the key terms 'tinea pedis' OR 'athlete's foot'. The search strategy included all clinical trials, observational studies and reviews published in English within the past 10 years.
    Results: Tinea pedis is most often caused by
    Conclusion: Topical antifungal therapy (once to twice daily for 1-6 weeks) is the mainstay of treatment for superficial or localized tinea pedis. Examples of topical antifungal agents include allylamines (e.g. terbinafine), azoles (e.g. ketoconazole), benzylamine, ciclopirox, tolnaftate and amorolfine. Oral antifungal agents used for the treatment of tinea pedis include terbinafine, itraconazole and fluconazole. Combined therapy with topical and oral antifungals may increase the cure rate. The prognosis is good with appropriate antifungal treatment. Untreated, the lesions may persist and progress.
    Language English
    Publishing date 2023-06-29
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2719560-0
    ISSN 1740-4398 ; 1745-1981
    ISSN (online) 1740-4398
    ISSN 1745-1981
    DOI 10.7573/dic.2023-5-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Paediatrics: how to manage septic shock.

    Hon, Kam Lun / Leung, Karen Ka Yan / Oberender, Felix / Leung, Alexander Kc

    Drugs in context

    2021  Volume 10

    Abstract: Background: Septic shock is a common critical illness associated with high morbidity and mortality in children. This article provides an updated narrative review on the management of septic shock in paediatric practice.: Methods: A PubMed search was ... ...

    Abstract Background: Septic shock is a common critical illness associated with high morbidity and mortality in children. This article provides an updated narrative review on the management of septic shock in paediatric practice.
    Methods: A PubMed search was performed using the following Medical Subject Headings: "sepsis", "septic shock" and "systemic inflammatory response syndrome". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies and reviews. The search was limited to the English literature and specific to children.
    Results: Septic shock is associated with high mortality and morbidity. The outcome can be improved if the diagnosis is made promptly and treatment initiated without delay. Early treatment with antimicrobial therapy, fluid therapy and vasoactive medications, and rapid recognition of the source of sepsis and control are the key recommendations from paediatric sepsis management guidelines.
    Conclusion: Most of the current paediatric sepsis guideline recommendations are based on the adult population; therefore, the research gaps in paediatric sepsis management should be addressed.
    Language English
    Publishing date 2021-06-01
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2719560-0
    ISSN 1740-4398 ; 1745-1981
    ISSN (online) 1740-4398
    ISSN 1745-1981
    DOI 10.7573/dic.2021-1-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Antidotes for childhood toxidromes.

    Hon, Kam Lun / Hui, Wun Fung / Leung, Alexander Kc

    Drugs in context

    2021  Volume 10

    Abstract: Background: Poisoning causes significant morbidity and sometimes mortality in children worldwide. The clinical skill of toxidrome recognition followed by the timely administration of an antidote specific for the poison is essential for the management of ...

    Abstract Background: Poisoning causes significant morbidity and sometimes mortality in children worldwide. The clinical skill of toxidrome recognition followed by the timely administration of an antidote specific for the poison is essential for the management of children with suspected poisoning. This is a narrative review on antidotes for toxidromes in paediatric practice.
    Methods: A literature search was conducted on PubMed with the keywords "antidote", "poisoning", "intoxication", "children" and "pediatric". The search was customized by applying the appropriate filters (species: humans; age: birth to 18 years) to obtain the most relevant articles for this review article.
    Results: Toxidrome recognition may offer a rapid guide to possible toxicology diagnosis such that the specific antidote can be administered in a timely manner. This article summarizes toxidromes and their respective antidotes in paediatric poisoning, with an emphasis on the symptomatology and source of exposure. The antidote and specific management for each toxidrome are discussed. Antidotes are only available for a limited number of poisons responsible for intoxication. Antidotes for common poisonings include N-acetyl cysteine for paracetamol and sodium thiosulphate for poisoning by cyanide.
    Conclusion: Poisoning is a common cause of paediatric injury. Physicians should be familiar with the recognition of common toxidromes and promptly use specific antidotes for the management of childhood toxidromes.
    Language English
    Publishing date 2021-06-02
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2719560-0
    ISSN 1740-4398 ; 1745-1981
    ISSN (online) 1740-4398
    ISSN 1745-1981
    DOI 10.7573/dic.2020-11-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Paediatrics: how to manage acute respiratory distress syndrome.

    Hon, Kam Lun / Leung, Karen Ka Yan / Oberender, Felix / Leung, Alexander Kc

    Drugs in context

    2021  Volume 10

    Abstract: Background: Acute respiratory distress syndrome (ARDS) is a significant cause of mortality and morbidity amongst critically ill children. The purpose of this narrative review is to provide an up-to-date review on the evaluation and management of ... ...

    Abstract Background: Acute respiratory distress syndrome (ARDS) is a significant cause of mortality and morbidity amongst critically ill children. The purpose of this narrative review is to provide an up-to-date review on the evaluation and management of paediatric ARDS (PARDS).
    Methods: A PubMed search was performed with Clinical Queries using the key term "acute respiratory distress syndrome". The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies and reviews. Google, Wikipedia and UpToDate were also searched to enrich the review. The search was restricted to the English literature and children.
    Discussion: Non-invasive positive pressure ventilation, lung-protective ventilation strategies, conservative fluid management and adequate nutritional support all have proven efficacy in the management of PARDS. The Pediatric Acute Lung Injury Consensus Conference recommends the use of corticosteroids, high-frequency oscillation ventilation and inhaled nitric oxide in selected scenarios. Partial liquid ventilation and surfactant are not considered efficacious based on evidence from clinical trials.
    Conclusion: PARDS is a serious but relatively rare cause of admission into the paediatric intensive care unit and is associated with high mortality. Non-invasive positive pressure ventilation, lung-protective ventilation strategies, conservative fluid management and adequate nutrition are advocated. As there has been a lack of progress in the management of PARDS in recent years, further well-designed, large-scale, randomized controlled trials in this field are urgently needed.
    Language English
    Publishing date 2021-06-01
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2719560-0
    ISSN 1740-4398 ; 1745-1981
    ISSN (online) 1740-4398
    ISSN 1745-1981
    DOI 10.7573/dic.2021-1-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Motion sickness: an overview.

    Leung, Alexander Kc / Hon, Kam Lun

    Drugs in context

    2019  Volume 8

    Abstract: Background: Motion sickness is a common phenomenon that affects almost everybody at some point in their lifetime. Clinicians should be familiar with the proper management of this condition.: Objective: To provide an update on the current ... ...

    Abstract Background: Motion sickness is a common phenomenon that affects almost everybody at some point in their lifetime. Clinicians should be familiar with the proper management of this condition.
    Objective: To provide an update on the current understanding of the pathophysiology and management of motion sickness.
    Methods: A PubMed search was performed with Clinical Queries using the key term 'motion sickness.' The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature. The information retrieved from the earlier search was used in the compilation of the present article.
    Results: Motion sickness is typically triggered by low-frequency vertical, lateral, angular, rotary motion, or virtual stimulator motion, to which an individual has not adapted.
    Conclusion: In most cases, motion sickness can be prevented by behavioral and environmental modifications (avoidance, habituation, and minimization of motion stimuli). Pharmacotherapy should be considered in the prevention and/or treatment of more severe motion sickness and for patients who do not respond to conservative measures. Medications are most effective when combined with behavioral and environmental modifications. Drugs that are effective in the prophylaxis and/or treatment of motion sickness include anticholinergic agents and antihistamines.
    Language English
    Publishing date 2019-12-13
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2719560-0
    ISSN 1740-4398 ; 1745-1981
    ISSN (online) 1740-4398
    ISSN 1745-1981
    DOI 10.7573/dic.2019-9-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Gastroesophageal reflux in children: an updated review.

    Leung, Alexander Kc / Hon, Kam Lun

    Drugs in context

    2019  Volume 8, Page(s) 212591

    Abstract: Background: Gastroesophageal reflux is a common disorder in pediatrics. Clinicians should be familiar with the proper evaluation and management of this condition.: Objective: To provide an update on the current understanding, evaluation, and ... ...

    Abstract Background: Gastroesophageal reflux is a common disorder in pediatrics. Clinicians should be familiar with the proper evaluation and management of this condition.
    Objective: To provide an update on the current understanding, evaluation, and management of gastroesophageal reflux in children.
    Methods: A PubMed search was performed with Clinical Queries using the key term 'gastroesophageal reflux'. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to the English literature and the pediatric age group.
    Results: Regurgitation is the most frequent symptom of gastroesophageal reflux and is present in nearly all cases. Gastroesophageal reflux occurs normally in infants, is often physiological, peaks at 4 months of age, and tends to resolve with time. Gastroesophageal reflux disease occurs when gastric contents reflux into the esophagus or oropharynx and produce troublesome symptom(s) and/or complication(s). A thorough clinical history and a thorough physical examination are usually adequate for diagnosis. When the diagnosis is ambiguous, diagnostic studies may be warranted. A combined esophageal pH monitoring and multichannel intraluminal esophageal electrical impedance device is the gold standard for the diagnosis of gastroesophageal reflux disease if the diagnosis is in doubt. In the majority of cases, no treatment is necessary for gastroesophageal reflux apart from reassurance of the benign nature of the condition. Treatment options for gastroesophageal reflux disease are discussed.
    Conclusion: In most cases, no treatment is necessary for gastroesophageal reflux apart from reassurance because the condition is benign and self-limiting. Thickened feedings, postural therapy, and lifestyle changes should be considered if the regurgitation is frequent and problematic. Pharmacotherapy should be considered in the treatment of more severe gastroesophageal reflux disease for patients who do not respond to conservative measures. Proton pump inhibitors are favored over H
    Language English
    Publishing date 2019-06-17
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2719560-0
    ISSN 1740-4398 ; 1745-1981
    ISSN (online) 1740-4398
    ISSN 1745-1981
    DOI 10.7573/dic.212591
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Tinea versicolor: an updated review.

    Leung, Alexander Kc / Barankin, Benjamin / Lam, Joseph M / Leong, Kin Fon / Hon, Kam Lun

    Drugs in context

    2022  Volume 11

    Abstract: Background: Tinea versicolor is a common superficial fungal infection of the skin with various clinical manifestations. This review aims to familiarize physicians with the clinical features, diagnosis and management of tinea versicolor.: Methods: A ... ...

    Abstract Background: Tinea versicolor is a common superficial fungal infection of the skin with various clinical manifestations. This review aims to familiarize physicians with the clinical features, diagnosis and management of tinea versicolor.
    Methods: A search was conducted in July 2022 in PubMed Clinical Queries using the key terms "tinea versicolor" OR "pityriasis versicolor". The search strategy included all clinical trials, observational studies and reviews published within the past 10 years.
    Results: Tinea versicolor is caused by
    Conclusion: Selection of antifungal agents depends on several factors, including efficacy, safety, local availability, ease of administration, likelihood of compliance and potential drug interactions of the antifungal agent.
    Language English
    Publishing date 2022-11-14
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2719560-0
    ISSN 1740-4398 ; 1745-1981
    ISSN (online) 1740-4398
    ISSN 1745-1981
    DOI 10.7573/dic.2022-9-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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