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Query: UMLS:C0000737 (abdominal pain)
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Barrio San Antonio is a coastal settlement on the San Juanico straits in the municipality of Basey on the island of Samar, the Philippines. It has a population of approximately 1,900 in 320 households. Initially, 851 residents (45%) of 240 households participated in this survey to determine the prevalence and intensity of Schistosoma japonicum infection, and morbidity as indicated by associated hepatomegaly and splenomegaly. As a result of an initial single stool examination of 1 ml by a modified formalin concentration technique, 40% of this population was found to be infected. On subsequent examinations, with the addition of serologic techniques and recording the history of therapy, approximately 70% of this population was found to be infected with S. japonicum after the age of 10 years. If judged by the number of eggs produced per milliliter of feces, infection intensity in this population might be considered to be low. However, 25% (73 of 391 positives on single examination) exhibited schistosomal hepatomegaly or hepato-splenomegaly and had a mean egg count of 10.9. Those infected but without hepatomegaly had a slightly lower mean egg count of 8.4. Of the infected males with hepatomegaly, 75% were 19 years of age or less and 45% of these were producing less than 10 eggs/ml of stool. Of infected females with hepatomegaly, only 28% were 19 years of age or less, and 68% of these were producing less than 10 eggs/ml. Abdominal pain, distress, diarrhea, and dysentery were significantly more frequent in the infected than uninfected persons, and this frequency was related to egg output. The heights and weights of these infected individuals were less than those of the uninfected members of this population and significantly less than the Filipino norm. The small percentage of the infected population (6.6%) that were producing 51% of the eggs had a mean egg count of approximately 260 with a mean age of 33.7. In this group, 7 of the 22 individuals were in the age group 10--14 years and 15 were above 20 years of age. Although some individuals of Barrio San Antonio have sought therapy, this population and area have been largely unstudied and have not up to the present been involved in control or mass chemotherapy programs. The findings of this survey give an opportunity to determine the impact of such programs when they are instituted in this area.
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PMID:Schistosomiasis japonica in Barrio San Antonio, Basey, Samar , The Philippines. I. Epidemiology and morbidity. 31 24

Factors that affect food intake in acute shigellosis were studied in 82 children aged 24-59 months. Children were offered an energy-dense milk-cereal-oil-based diet every 2 h. Food intake was compared between children with Shigella dysenteriae 1 infection and those infected with other Shigella spp (predominantly S. flexneri). Mean energy intake in the first 48 h was 435 kJ/kg.d in children infected with S. dysenteriae 1 and 536 kJ/kg.d in children infected with other Shigella spp (P < 0.001). Febrile children ate significantly (P < 0.05) less food than afebrile ones (469 vs 517 kJ/kg.d). Food intake remained significantly (P < 0.001) less in children infected with S. dysenteriae 1 after controlling for the effect of fever. The results show that food intake is significantly reduced in dysentery due to S. dysenteriae 1 infection compared to that of other Shigella species; however, adequate calorie intake can be maintained by providing frequent energy-dense meals despite anorexia, fever, abdominal pain and diarrhoea.
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PMID:Decreased food intake in children with severe dysentery due to Shigella dysenteriae 1 infection. 142 37

75 patients with acute ame bic dysentery treated with pipemidic acid (PPA) alone and 11 patients with norfloxacin (NFX) alone constituted two study groups and 30 patients treated with metronidazole (MNZ) formed a control group. It was found that the cure rates of PPA, NFX and MNZ were similar (P greater than 0.05), being 98.67%, 100% and 93.33%, respectively; the number of days to become afebrile and to stop abdominal pain in these three groups was also similar (P greater than 0.05); the number of days to stop diarrhea in PPA group was similar to that in NFX (P greater than 0.05), but it was significantly shorter in these two groups than that in the controls (P less than 0.01 and 0.05). As to adverse drug reactions, PPA had the least, NFX was similar to PPA (P greater than 0.05), but MNZ had significantly more than PPA (P less than 0.01).
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PMID:[Quinolones in the treatment of acute amebic dysentery]. 166 68

Data from studies of 916 children with diarrhea, including 122 from whom shigellae were isolated, and data on patients affected in an epidemic due to Shigella dysenteriae type I were analyzed to determine whether a diagnostic clinical profile of shigellosis could be identified. Blood and/or mucus in stool, increased frequency of stool, abdominal pain, rectal tenesmus, and fever were noted more frequently in patients with shigellosis. The diagnostic confirmation of shigellosis depends on the isolation of the organism, but in the clinical situation early initiation of appropriate antibiotic therapy can be based on clinical judgment that utilizes local perceptions regarding dysentery.
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PMID:Intestinal manifestations of invasive diarrheas and their diagnosis. 204 55

Among 72 patients clinically suspected of Entamoeba histolytica (E. histolytica) infections, 39 positive cases (54%) were detected serologically by the indirect hemagglutination (IHA) test. Parasitologically, microscopic examination of three consecutive stool specimens from all these patients indicated positivity for E. histolytica cysts and or trophozoites in 10 of the patients with IHA antibody titers greater than or equal to 1:128, which is of clinical significance. Another 2 patients were parasitologically positive but showed low IHA antibody titres (1:32-1:64); follow up indicated response to treatment with metronidazole. The highest serological positivity (100%) were detected in patients with liver abscess, all were clinically proven cases of extra-intestinal amoebiasis. IHA antibody levels of clinical significance were seen in all four patients with chronic dysentery with parasitological evidence of E. histolytica in their stools. In a group of patients with abdominal pain nine positives were detected serologically, four of which were positively diagnosed concurrently by parasitology; the remaining five patient's sera showed high IHA antibody titres with absence of cysts or trophozoites in stools, indicative possibly of persistence of antibodies from past infection. The serologic determination of E. histolytica IHA antibodies in a control group consisting of normal healthy school children and adults of both sexes without any clinical evidence of amoebiasis showed the absence of any positive titres of clinical significance; low titres (1:32-1:64) were detected in 5.2% of 232 sera tested. Parasitological examination of three consecutive stool specimens from all individuals in the control group showed the presence of cysts of E. histolytica in just two among 232 tested (0.9%).
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PMID:Indirect haemagglutination (IHA) test in the serodiagnosis of amoebiasis. 254 99

As part of a health impact evaluation of a water supply and sanitation project in a rural area of Bangladesh, diarrhoeal morbidity was recorded in children 0-4 years of age using weekly recall in household interviews, during the period March 1984 to December 1987. During the baseline year, 1984, the incidence rate of all diarrhoea episodes (3.8 episodes per child per year), and those defined as persistent, duration greater than 14 days (0.6 episodes per child per year), showed a similar age distribution, peaking in the 12-23 month age group. Sixteen per cent of all episodes were classified as persistent, and this proportion was greatest in the 0-5 month age group (25%). Children suffering at least one episode of persistent diarrhoea in 1984 also experienced a higher incidence of acute diarrhoea (less than = 14 days duration) than those suffering acute diarrhoea only (4.2 versus 3.7 episodes per child per year). Persistent diarrhoea showed a similar seasonal pattern to that of all episodes. Rates of abdominal pain, isolation of Shigella spp and a diagnosis of dysentery were significantly higher in persistent episodes than in acute episodes. Closer follow-up of children during 1986 and 1987, through the recording of all periods of absence of the child from the home, showed that overall diarrhoea incidence rates were little affected when absence was taken into account, but that the incidence of persistent diarrhoea and the proportion of episodes classified as persistent were significantly reduced. The implications of this methodological problem are discussed.
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PMID:Persistent diarrhoea in a rural area of Bangladesh: a community-based longitudinal study. 262 Oct 34

One hundred and sixteen cases of adult patients hospitalized for shigellosis have been reviewed. The most common presentation included diarrhea (most frequently watery), fever, and abdominal pain, while dysentery has been less frequent. S. flexneri infection, as compared to S. sonnei, was more common in elderly patients and in males, and was characterized by a more prolonged clinical course. Abnormalities of serum electrolytes and hepatic enzymes were the most common laboratory complications, most often seen in elderly patients. Most isolates exhibited susceptibility to the common antimicrobial agents used in shigellosis therapy.
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PMID:Shigellosis in adults: epidemiologic, clinical, and laboratory features. 273 62

In a health and morbidity screening among 500 carpet weaving children and 450 children attending school selected at random in a rural field practice area the age group studied was from 6 to 16. Each child was thoroughly interviewed and examined for any deviation from health. The height and weight were taken by standard procedures and clinical assessment of morbidity and nutritional status was also observed. The results showed that the heights and weights of schoolchildren were greater than those of the carpet weaving children in both boys and girls. Clinically, 56% of the schoolchildren as against 41.6% of carpet weaving children had no nutritional defects. The main complaints in the carpet weaving children were in order of descent, headache, blurring of vision, backache, abdominal pain, limb pains, and respiratory tract infection. Both groups of children were later followed up for six months from September 1981 to March 1982. The incidence of subjective and objective deviations from health were higher in the carpet weaving than in the schoolchildren and the first ten major complaints in the carpet weaving children were respiratory tract infection, headache, backache, pain in the abdomen, injuries (major and minor), joint pains, diarrhoea and dysentery, fever of unknown origin, dermatitis, and chilblains.
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PMID:Health status of school age children employed in carpet weaving in Ganderbal Block. 349 Aug 78

The Research Committee of the World Organization of Gastroenterology has gather information regarding the etiology of acute abdominal pain. Seven diseases cover 96% of the causes of this syndrome in many countries of the world, but some geographical variations have been observed. One example of these variations is amoebic liver abscess, present in 5 to 10% of Mexico City patients. Right upper quadrant pain is often present in amoebic liver abscess and acute cholecystitis. Thus, differential diagnosis of these two entities is difficult. Using discriminant analysis and "stepwise" procedures in 100 cases with cholecystitis and a similar number of patients with amoebic liver abscess, we found six variables (symptoms and signs with a significant chi square to distinguish between these two diseases. The symptoms and signs chosen were hepatomegaly, Murphy's sign, duration of pain greater than or equal to 48 hours, previous history of abdominal pain, dysentery, and facial pallor. These variables proved to be better than laboratory test results. With five of these variables it was possible to obtain an accuracy of 92%. Using six variables, if cases of tie (three variables present and three absent) were excluded, accuracy rose to 96%.
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PMID:Differential diagnosis between amoebic liver abscess and acute cholecystitis. 635 41

Multi-drug resistant Shigella dysenteriae type 1 caused an epidemic of dysentery in a village in southern India. The epidemic started as a common source outbreak, through the piped water supply of the village with subsequent person-to-person spread. Although the attack rate was high, with nearly 1/2 the children under age 5 being affected, the case fatality rate was only about 1%. Of the 248 patients who attended the field clinic, 89.4% passed small mucoid stools mixed with blood, with the majority complaining of crampy lower abdominal pain and tenesmus. The other 10.6% had a history of diarrhea, only without blood and mucus. Moreover, 126 patients were given appropriate doses of sulphamezathine for 4-7 days. Adequate doses of neomycin were also given as therapeutic agent to infected individuals. The role of early maintenance of hydration and nutrition in the field situation in managing diarrheal epidemics is emphasized. Comparisons with mortality figures in other epidemics support the hypothesis that early and adequate maintenance of hydration and nutrition is a significant factor in reducing mortality.
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PMID:Epidemic dysentery caused by the Shiga bacillus in a southern Indian village. 638 64


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