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Chocolate Folklore
Published in Linda K. Fuller, Chocolate Fads, Folklore, & Fantasies, 2020
Chocolate-flavored syrup, a mixture of cocoa, sugar, corn syrup, and flavorings, is used as a sauce, topping, or in beverages. • Various cultures have altered chocolate to suit their own particular tastes. The Aztecs added spices to it, because they liked it with a bitter taste. Spaniards preferred chocolate sweeter, and added sugar. The Italians enjoyed it with liquid, especially hot. It was the English who added milk to chocolate, to be enjoyed as a warm and frothy beverage. Luckily, the Swiss invented milk chocolate for eating.
Common problems in pregnancy
Published in Anne Lee, Sally Inch, David Finnigan, Therapeutics in Pregnancy and Lactation, 2019
It has been suggested that heartburn is sometimes due to reflux of alkali from lower down the gastrointestinal tract back into the stomach. If antacids are ineffective, very dilute acids may be effective in some women. A solution of hydrochloric acid (0.1 ml diluted in 10 ml flavoured syrup) has been used, but no commercial preparation is available. Lemon juice or acidic lemonade may be more palatable alternatives.33
Ethosuximide
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
ESM is available as a 250 mg capsule or as a flavored syrup. Because the formulations have equal bioavailability, there is no difficulty in switching from one to the other. Therapy can be instituted by starting with one capsule after supper and increasing the dosage every 3 days until a maintainence dosage of 15 to 20 mg/kg/day is reached. The drug can be given once daily but many patients prefer to take the capsules in two or three divided doses after meals. Steady state will be achieved about one week after full dosage is administered. Because of the long-life ESM levels fluctuate little from day to day and the timing of plasma level monitoring is not critical. It is advisable to maintain a dosage sufficient to achieve a plasma level greater than 40 μg/ml for approximately a month. The parents should be asked to record the frequency of attacks; then the dosage can be increased at monthly intervals up to 40 mg/kg in children. ESM is metabolized at a rather constant rate, and plasma concentrations are relatively unaffected by the presence of other AEDs. Steady-state therapeutic levels, in the main, depend on regular intake of an adequate dosage based on body weight. There is a significant relationship between ESM dosage in mg/kg and body weight. The administration of ESM at 20 mg/kg in boys or girls under 11 years of age will result in mean plasma concentrations of approximately 50 μg/ml. It is very important to anticipate the increased dosage requirement due to growth or weight gain so as to maintain effective plasma concentrations. Once attained, it would be unfortunate to lose good seizure control. Plasma ESM levels should be monitored monthly until seizure control is attained, then at 3-month intervals. Noncompliance is a particular problem here because absence attacks are much less frightening to both parents and teachers than are GTCSs.
Effectiveness and safety of Ketamine and Midazolam mixture for procedural sedation in children with mental disabilities: A randomized study of intranasal versus intramuscular route
Published in Egyptian Journal of Anaesthesia, 2020
Sanaa Farag Wasfy, Rasha Mahmoud Hassan, Reham Mustafa Hashim
Oral sedation can be used in these patients but it has various disadvantages as delayed onset of action, bitter taste, postoperative nausea and vomiting [2,3], and the need for the addition of different types of flavored syrup or honey according to the preference of the patient. Some children may refuse to take such oral drugs up to spitting it. On the other hand, intramuscular sedation is an easy effective way of administration [4], and it is preferred due to its rapid onset of action and higher predictability of the duration, however, phobia of the pain of injections must be considered as a disadvantage in this vulnerable pediatric patient. The intranasal route is an important alternative route because it is a painless and needleless approach with rapid drug absorption from nasal mucosa reaching the cerebrospinal fluid and bypassing the first-pass metabolism in the liver [5].