Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0740441 (acute diarrhea)
 2,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To identify a suitable substrate for an oral rehydration solution (ORS) at home, this study evaluated the efficacy and safety of cassava-salt suspension (CSS) prepared from a dietary staple, cassava, with added sodium chloride. The results were compared with those of standard World Health Organization (WHO) recommended ORS. One hundred thirty-two dehydrated children aged between 6 and 24 months with acute diarrhoea of less than 3 days duration were chosen for the study and randomly rehydrated with CSS or WHO-ORS. The intake of ORS (CSS or WHO-ORS), water, and food was comparable in both groups. The mean stool output on day 1, total stool output, and duration of diarrhoea were 45.3 +/- 37.3 g/kg, 60.8 +/- 58.9 g/kg, and 18.9 +/- 22.4 h for the group on CSS. These are significantly different from the corresponding values of 69.7 +/- 64.9 g/kg, 88.2 +/- 100.4 g/kg, and 28.2 +/- 27.0 h obtained for controls. Failure of therapy occurred in four children on CSS (6%) and three children on WHO-ORS (4.5%). It is concluded that CSS is both efficacious and safe for use as an ORS, particularly in the home management of acute diarrhoea in children.
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PMID:Evaluation of cassava-salt suspension in the management of acute diarrhoea in infants and children. 798 Aug 37

Since the irrational administration of drugs in diarrhea cases is a serious problem, a prescribing survey was made among 10 government health facilities (GHF) and private dispensaries (PD) in the Dhaka, Tangail, and Serajgong districts of Bangladesh. Using standard indicators on prescribing, patient care, and drug supply developed by the International Network for the Rational Use of Drugs, 12 prescriptions written for children under 5 years old with acute diarrhea were studied from each center (total = 120). It was found that the average number of drugs administered per encounter was 1.82 and 2.30 in the GHFs and PDs, respectively. Almost every prescription (0.79 and 0.96 in the GHFs and PDs, respectively) had an antimicrobial component, with metronidazole used in most cases despite the fact that it is not indicated in acute diarrhea and treatment guidelines advise against its use in children under age 5 years in Bangladesh. Oral rehydration salt solution was used in each facility in about 80% of cases (vs. 11% of cases in the community). Because of the inclusion of the antimicrobial, standard treatment guidelines were followed in only 17 and 23% of cases in the GHFs and PDs, respectively. Patient care indicators revealed that 1.8% of patients were examined in the GHFs vs. 65% in the PDs. 50% of patients in both facilities could report the correct dosing schedule for the drugs they were given. The GHFs do not label prescriptions, but all the drugs administered by the PDs remain in manufacturer-labeled containers. The existence of an essential drugs list and the distribution of standard treatment guidelines have not ensured good prescribing habits among health professionals for this common disease. Additional efforts are required to improve this situation.
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PMID:Prescribing pattern in acute diarrhoea in three districts in Bangladesh. 827 59

ELISA techniques using monoclonal antibodies have been recently developed for the detection of Cryptosporidium parvum fecal antigens. The aim of this work was to compare the yield of these ELISA techniques with Ziehl-Nielsen and Safranin stains in formaldehyde-salt fixed samples. One hundred five fecal samples of patients with acute diarrhea were studied. Forty-seven samples did not contain Cryptosporidium and ELISA was negative. Also, ELISA was positive in 52 or 58 samples that contained Cryptosporidium (89.6%); the samples with false negative results contained scanty oocysts. Seven intensely positive Paf-fixed stool samples from AIDS patients with chronic diarrhea, were not reactive to ELISA. There was a good correlation between visually and mechanically read samples and there were no false positives. It is concluded that ELISA cannot be used in Paf-fixed samples and has a lower sensitivity that the stained commonly used for the diagnosis of cryptosporidiosis.
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PMID:[Detection of fecal Cryptosporidium parvum antigens using an ELISA technique]. 852 73

A household survey of fluid intake and feeding practices during episodes of acute diarrhea in Nigerian children under 5 years of age indicates a need for community education on the home management of diarrhea. The 1994 study, part of a survey aimed at providing baseline data for the design of a diarrhea disease control program in southeast Nigeria's Odukpani local government area, encompassed 5296 children from 3070 households. Mothers whose children experienced a diarrhea episode in the 24 hours preceding the survey were interviewed. The sugar-salt solution use rate in the previous 24 hours was 35.4% (average amount, 368 ml). The oral rehydration solution use rate was 49.2% (average amount, 274 ml). 6% of children were given an increased amount of fluid during the diarrhea episode, 37.3% received the same amount, and 48.2% were given less fluid than before the onset of illness. 5.0% received more food, 49.0% received the same amount, and 32.2% received less food during diarrhea than before becoming ill; the remaining 13.8% stopped feeding. Only 40.1% of children who were still breast feeding were nursed during the episode. Education of care givers should emphasize the importance of continuous liberal dietary intake, including breast feeding, during and after diarrhea.
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PMID:Fluid intake and feeding practices during diarrhoea in Odukpani, Nigeria. 875 26

In India, a survey was conducted of 6285 persons living in 1090 households in the Jhuggi clusters of Sanjay Amar Colony, Hathi Park, and Jai Prakash Colony in New Delhi to identify diarrhea management practices at home and at a health facility and to determine knowledge levels about preparation of oral rehydration solution (ORS) and sugar salt solution (SSS). 183 (2.9%) persons experienced diarrhea in the previous 2 weeks. 68.3% were younger than 5 years old. 13.1% of all diarrhea cases had blood in their stool. Oral rehydration therapy (ORT) was provided to 3.3% in ORS form, 10.4% in SSS form, 5.5% as dal water, and 5.5% as shikanji. Correct preparation of SSS via finger pinch, scoop, or spoon and glasses was performed in 36.6% of households. Only 11.5% could correctly measure the water needed to make 1 liter of ORS. The first action against the diarrhea was often taken on day 2 (13.1%) and day 3 (18%). 55.7% of diarrhea cases sought treatment at a private practice. 7.1% went to a government health facility. 79.1% of cases taken to a medical practitioner received a drug (e.g., antidiarrheals and antimicrobials). Yet, antimicrobials were indicated in only 13.1% of diarrhea cases taken to a health facility. These cases had dysentery. Only 31.3% received ORS or home-available fluids. Government health facilities were more likely to provide ORT than private practitioners (61.5% vs. 27.4%). All diarrhea cases experiencing dehydration received ORT or intravenous fluids. These findings stress the need for reorientation training of physicians on appropriate case management of diarrhea and rational use of drugs in cases of acute diarrhea. Families also need training in correct preparation and use of ORT and in restriction on the use of drugs.
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PMID:Diarrhea management in some Jhuggi clusters of Delhi. 877 29

Acute diarrhoeal diseases are an important cause of morbidity and mortality, particularly in children. Acute diarrhoea may be watery, where features of dehydration are more prominent or dysenteric, where the stools contain blood and mucous. Rehydration therapy is the key to the management of acute watery diarrhoea, whereas antibiotics play a vital role in the management of acute invasive diarrhoea, particularly shigellosis. Rehydration may be done either by the oral or intravenous routes depending upon the degree of dehydration. Oral rehydration salt solution of WHO formula is recommended for oral rehydration therapy (ORT). Ringer's lactate is the ideal intravenous fluid for correction of severe dehydration due to diarrhoea. Antibiotic therapy is beneficial for cholera and shigellosis only. Antiparasitic agents are indicated only if amoebiasis or giardiasis is present. Antidiarrhoeals are of no benefit for the treatment of acute diarrhoea. Appropriate feeding during diarrhoea is recommended with beneficial outcome.
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PMID:Management of acute diarrhoea. 878 11

A study conducted in the Pediatric Outpatient Department of the Institute of Medical Sciences in Srinagar, India, assessed the acute diarrhea management strategies of various categories of health care practitioners. Of the total of 1030 infants enrolled at private clinics or other health units, 71.7% were treated by general practitioners and chemists, 11.6% saw hospital residents, and 16.7% were treated by pediatricians. Antidiarrheal and antispasmodic preparations were given to most infants, either alone (46.8%) or in conjunction with oral rehydration therapy (ORT) (45.4%). Only 4.1% of infants received ORT alone. 87.2% of pediatricians selected a combination of drugs and ORT. Both qualified and unqualified practitioners provided drugs such as lopermaide (57.9%), pipenzolate (2.1%), metoclopramide (13.7%), and steroids (2.5%). All categories of health workers prescribed marketed ORT preparations containing insufficient sodium; only 23.7% of cases received home-made sugar-salt solution. Parents in India express a preference for the use of drugs and parenteral fluids in acute diarrhea, and most practitioners appear to gear their practices to this preference. Education of both parents and health professionals about the adequacy of ORT in most cases of acute diarrhea is needed to prevent electrolyte imbalances, iatrogenic hazards, and the emergence of multidrug-resistant strains of microorganisms.
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PMID:Medical practitioners and their practices in acute diarrhea. 941 Aug 27

The interactions between diarrhoeal disease and nutritional status are complex and synergistic. These are serious issues globally because they affect hundreds of millions of young children and annually cause > 3 million deaths in children aged under 5 y. Despite intensive field-based and laboratory studies over three decades, many questions remain unanswered about the causes, pathophysiology and best approaches to management and prevention of this "diarrhoea-malnutrition" syndrome. Oral rehydration therapy (ORT) has been a major advance and has saved many lives from acute diarrhoea. However, persistent diarrhoea is now a major problem and is very significant because of its strong negative impacts on nutritional status and because persistent diarrhoea and dysentery are now major causes of infant and young child deaths. ORT provides clear and practical methods for replacement of fluid and electrolyte losses during diarrhoea. Rehydration salts can be made available as (i) a simple, easy-to-use package, complete with user instructions; (ii) cereal-based formulae based on widely available ingredients that can be prepared domestically or commercially; and (iii) home-made mixtures of sugar and salt which should be simple to prepare but are risky because of inadequate understanding about their preparation at home and the chance of mixing the ingredients inaccurately and giving them wrongly. Continuation and encouragement of breastfeeding is an important strategy to prevent and control diarrhoea and as part of its management. Early refeeding during diarrhoea is another important principle to help to reduce its duration, severity and its nutritional impacts. Supplementation with specific dietary ingredients, such as vitamin A, zinc and folate, is rather contentious and drug therapy is of little value unless specifically indicated. Some patients may require enteral nutrition or parenteral nutrition but these require specialized equipment and skills that are usually beyond the reach of developing countries and infants and children who live in remote areas.
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PMID:Nutritional effects and management of diarrhoea in infancy. 1056 33

Diarrhoea continues to have a devastating impact in infants and children. It is a major cause of retarded growth. Substantial declines in hospitalization rates and possibly in the mortality due to diarrhoea have occurred following the launch of programmes based on oral rehydration therapy, and yet about 1 million diarrhoea-related deaths occur each year in South-East Asia. The World Health Organization currently recommends oral rehydration therapy plus continued breast- and complementary feeding for children with diarrhoea, and antibiotics for dysentery or associated systemic infection. Although oral rehydration therapy has achieved substantial acceptance, physicians and families continue to prescribe and seek drug therapy to reduce diarrhoeal duration and severity. Research is aimed at developing improved oral rehydration salt solutions or identifying adjunct therapy that will provide substantial benefit in reducing stool output together with safety and selectivity of action. It must, however, be recognized that control of malnutrition is a key requirement to reduce the duration and severity of acute diarrhoea.
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PMID:Current and future management of childhood diarrhoea. 1071 4

Oral rehydration therapy (ORT) was hailed 10 years ago as potentially the most significant medical advance of the century. ORT is a simple and inexpensive means of treating diarrheal dehydration, which killed approximately 5 million children each year in the late 1970s. Today 25% of the world's children have access to ORT, and it is estimated that every year it saves 500,000 lives. Where ORT is not widely available, diarrheal dehydration remains the leading killer of children. It is still responsible for 25% of the 250,000 worldwide child deaths each week. Because there have been problems with acceptance of the ORT formula of salt, sugar, and water, researchers have been experimenting with cereal-based oral rehydration formulas that are much like traditional home remedies for diarrhea. In addition to relieving dehydration, these cereal-based formulas lessen severity and duration of diarrheal illness. Critics, however, claim that they fail to provide a child with sufficient calories, and call for a combination of ORT with early feeding--4-8 hours after completion of rehydration. Even with growing evidence of the benefits of early feeding, the practice of withholding food from children with diarrhea persists in the developing world and in the U.S. Problems in developing countries are greater, but each year 14 of every 1,000 American infants are hospitalized because of acute diarrhea. The major hurdle that ORT faces in the U.S. is that it is a simple form of therapy attempting to displace a higher technology. As long the U.S. health care system serves as a model for developing countries, distrust of ORT by American doctors will hamper efforts to spread ORT in the developing world.
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PMID:500,000 lives saved each year. ORT 10 years after. 1217 78


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