• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.3
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• pp.163-179
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• 2022

Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.

• Journal of Korean Historical Folklife
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• no.46
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• pp.195-237
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• 2014

Palsapum are ornaments to reveal the purpose of commander of three naval forces as well as symbols to remember the greatness of admiral Yi, Sun-Shin. In 1966, ther were designated as a treasure No. 440 based on their value; however, they have not received attention from academia because they are relics from China. This study compares and analyzes the document, paintings, and relevant references from Korea and China focusing on Palsapum, understands their formal characteristics, and examines their historical value such as years and location of creation. As a result, the study determines five of them are original, but three of them were newly created by the later generations. The five, Dodogin (都督印, Commander's seal)·Yeongpae (令牌, Commander's tablet)·Gwido (鬼刀, Replica of the devil sword)·Chamdo (斬刀, Replica of the decapitation swor d)·and Gognapal (bugle) were created by Ming Dynasty before 1598, and delivered by the hands of General Chen Lin. The other three, Dokjeongi (督戰 旗, Battle flag)·Hongsoryeonggi (紅小令旗, Commander's flag)·and Namsoryeonggi (藍小令旗, Commander's flag), were created in 19th century by Joseon Dynasty. After analysis on the former relics, the study determines that they are not official relics with the dignity of Ming Dynasty but personal relics with regional characteristics; in other words, Palsamun are not the royal gifts from Emperor Shenzong to Admiral Yi, Sun-Shin. but personal momentoes left by General Chen Lin in the Tongjeyoung to celebrate the admiral. The names, variety, numbers, and appurtenances of Palsapum have been changed with time as follows. First, the scholars of Jeseon in 17the century only focused on Dodogin. It was certainly created in Ming Dynasty; however, it was a personal stamp, so considered to be not from the emperor but from General Chen Lin. Second, Palsapum was called Palsamul and consisted of 14 pieces of 8 kinds in 18the century, ; it is confirmed on the 「Dosul(圖說, stories with pictures of」 『Yi Chungmugong Literary Collection』 The sizes of five relics including Dodogin are similar to the records, but their patterns and shapes are exotic, or cannot be found in Joseon. Thus, they reflect the regional characteristics of Guangdong province. Third, they were called Palsapum, and consisted on 15 pieces of 8 kinds in 19th century; it is confirmed on , a sixteen-fold folding screen drawn by Shin, Gwan-Ho in 1861. The stamp box, tablet bag, and three flags were newly created to engrave Joseon style letters and patterns on damageable materials such as leather and cloth. The relics easy to be destroyed have been renewed even after 19th century. Last, there are many misunderstandings about Palsapum by governmental indifference and improper management of records even though they were designated as a treasure in very early times. Thus, authorities should be concerned with Palsapum to provide the measures for stable maintenance of the relics; this will let people remember not only the history of cooperation between Korea and China to stop the Japanese ambition, but also Admiral Yi, Sun-Shin and General Chen Lin to bring victory in Japanese invasions of Korea.