scholarly journals THE FREQUENCY OF HYPONATREMIA AND HYPOKALEMIA IN MALNOURISHED CHILDREN WITH ACUTE DIARRHEA

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Sushil Kumar Bakolia ◽  
Gajendra Kumar Verma ◽  
Dinesh Kumar Barolia
Keyword(s):  
Acute Diarrhea ◽  
Acute Diarrhoea ◽  
Diarrhoeal Disease ◽  
Malnourished Child ◽  
Electrolyte Disturbances ◽  
Malnourished Children ◽  
Life Threatening ◽  
Sub Saharan ◽  
Grade 3 ◽  
Global Health Problem

Background: Malnutrition is a major global health problem, with the major burden being in South Asia and Sub-Saharan Afric. The study was undertaken to determine the frequency of hyponatremia an hypokalemia in malnourished children with acute diarrhea. Methods: Hospital based prospective study was conducted on 100 children between the age group of 6months to 5years presenting with acute diarrhea was include in the study. Results: Hyponatremia was observed in total 15 (15.00%) cases of diarrhea. Regarding the grade of malnutrition, hyponatremia was observed in only 4.44% in grade 1, 8.69% in grade, 41.67% in grade 3 and 60.00% in grade 4 malnutrition respectively.  Hypokalemia was noticed in 10.00% cases (10 out of 100) with acute diarrhea. The frequency of hypokalemia was 4.44% in grade 1, 8.69% in grade 2, 25.00% in grade 3 and 40.00% in grade 4 malnutrition respectively. Conclusion: Electrolyte disturbances are often subclinical in malnourished children, but become obvious during the episode of acute diarrhoeal disease. Hence serum electrolytes of every malnourished child with acute diarrhoea should be estimated in order to do immediate correction and avoid serious life-threatening outcome. Keywords: IAP, Malnutrition, Diarrhoea

scholarly journals Studies on diarrhoeal illness among hospitalized children under 5 years of age in Baghdad during 1990-97

2002 ◽  
Vol 08 (01) ◽  
pp. 181-188
Author(s):  
H. I. Tawfeek ◽  
N. H. Najim ◽  
S. Al Mashikhi
Keyword(s):  
Escherichia Coli ◽  
Acute Diarrhoea ◽  
Diarrhoeal Disease ◽  
Teaching Hospitals ◽  
Hospitalized Children ◽  
Enteropathogenic Escherichia Coli ◽  
Threatening Condition ◽  
Life Threatening ◽  
Therapeutic Measures ◽  
Children Under 5

A retrospective study of all infants and children admitted to two paediatric teaching hospitals in Baghdad city complaining of acute diarrhoea during 1990-1997 was carried out. Of all children admitted, 14.9% were for diarrhoea, 55.5% of whom were under 1 year of age. The peak incidence was at 3-6 months and tended to be during the summer months. In 97% of cases only one pathogen was identified, enteropathogenic Escherichia coli being the most frequently isolated organism, isolated from 13% of the patients. The proportion of deaths associated with diarrhoea was 28.6%. The documented frequency and patterns of occurrence of diarrhoeal disease emphasize the need for improved diagnostic, preventive and therapeutic measures against this potentially life-threatening condition.

scholarly journals A Study of Serum Electrolytes in Malnourished Children

2020 ◽  
Vol 8 (1) ◽  
pp. 41-43
Author(s):  
Mohd Zakir Mohiuddin Owais ◽  
N.L Sridhar
Keyword(s):  
Severe Acute Malnutrition ◽  
Cross Sectional Study ◽  
Acute Malnutrition ◽  
Cross Sectional ◽  
Electrolyte Disturbances ◽  
Malnourished Children ◽  
Serious Infections ◽  
Life Threatening ◽  
The Mean

Background: Severe acute malnutrition (SAM) is one of the most common health problems. SAM children are more prone to serious infections that culminate in different co-morbid conditions and result in electrolyte disturbances. Objective: To study the electrolyte profile in severely malnourished children. Subjects and Methods:This was Hospital based cross sectional study. Duration: 1 year from June 2018 to May 2019. Setting: Department of Pediatrics. Participants: 50 Children.Detailed history and physical examination were made. Anthropometric measurements, such as weight and height, were recorded. On admission, electrolytes were performed and children were classified as either hypo / hypernatramic or hypo / hyperkalemic, which depend on the levels of the electrolytes.Result:The Hyponatremia was high with 72% on the day 1, and hypernatremia was 6%, on day 3 hyponatremia was 60% and hypernatremia was 4% and on day 8 Normal sodium was seen in around 68% of the children. The mean sodium significantly improved from day 1 to day 8 with a mean of 135.8±9.9 on the day 8th. The Hypokalemia was highest with 38% on the day 1, Hyperkalemia was seen in 28% of the patients on day 3 and normal potassium was seen in 80% of the children on the day 8th. The mean potassium significantly improved from day 1 to 8 with a mean of 5.5±1.24 on the day 8th. Conclusion:Most of the children with SAM and electrolyte derangements also had diarrhoea. Therefore determination of the electrolyte profile of all patients with SAM immediately on admission and proceeding days after admission is vital as it helps the clinician to decide on the most appropriate fluids to give to help reduce on the morbidity and mortality associated with life threatening electrolyte derangements.

scholarly journals Burden, Antibiotic Resistance, and Clonality of Shigella spp. Implicated in Community-Acquired Acute Diarrhoea in Lilongwe, Malawi

2021 ◽  
Vol 6 (2) ◽  
pp. 63
Author(s):  
Abel F.N.D. Phiri ◽  
Akebe Luther King Abia ◽  
Daniel Gyamfi Amoako ◽  
Rajab Mkakosya ◽  
Arnfinn Sundsfjord ◽  
...  
Keyword(s):  
Real Time ◽  
Antibiotic Susceptibility ◽  
Virulence Genes ◽  
Shigella Flexneri ◽  
Acute Diarrhoea ◽  
Virulence Determinants ◽  
African Countries ◽  
Shigella Species ◽  
Shigella Spp ◽  
Sub Saharan

Although numerous studies have investigated diarrhoea aetiology in many sub-Saharan African countries, recent data on Shigella species’ involvement in community-acquired acute diarrhoea (CA-AD) in Malawi are scarce. This study investigated the incidence, antibiotic susceptibility profile, genotypic characteristics, and clonal relationships of Shigella flexneri among 243 patients presenting with acute diarrhoea at a District Hospital in Lilongwe, Malawi. Shigella spp. were isolated and identified using standard microbiological and serological methods and confirmed by identifying the ipaH gene using real-time polymerase chain reaction. The isolates’ antibiotic susceptibility to 20 antibiotics was determined using the VITEK 2 system according to EUCAST guidelines. Genes conferring resistance to sulfamethoxazole (sul1, sul2 and sul3), trimethoprim (dfrA1, dfrA12 and dfrA17) and ampicillin (oxa-1 and oxa-2), and virulence genes (ipaBCD, sat, ial, virA, sen, set1A and set1B) were detected by real-time PCR. Clonal relatedness was assessed using ERIC-PCR. Thirty-four Shigella flexneri isolates were isolated (an overall incidence of 14.0%). All the isolates were fully resistant to sulfamethoxazole/trimethoprim (100%) and ampicillin (100%) but susceptible to the other antibiotics tested. The sul1 (79%), sul2 (79%), sul3 (47%), dfrA12 (71%) and dfrA17 (56%) sulfonamide and trimethoprim resistance genes were identified; Oxa-1, oxa-2 and dfrA1 were not detected. The virulence genes ipaBCD (85%), sat (85%), ial (82%), virA (76%), sen (71%), stx (71%), set1A (26%) and set1B (18%) were detected. ERIC-PCR profiling revealed that the Shigella isolates were genetically distinct and clonally unrelated, indicating the potential involvement of genetically distinct S. flexneri in CA-AD in Malawi. The high percentage resistance to ampicillin and sulfamethoxazole/trimethoprim and the presence of several virulence determinants in these isolates emphasises a need for continuous molecular surveillance studies to inform preventive measures and management of Shigella-associated diarrhoeal infections in Malawi.

scholarly journals Non-prescription dispensing of antibiotic agents among community drug retail outlets in Sub-Saharan African countries: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sewunet Admasu Belachew ◽  
Lisa Hall ◽  
Linda A. Selvey
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Acute Diarrhoea ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Retail Outlets ◽  
Sub Saharan ◽  
Tract Infections ◽  
Ssa Countries

Abstract Background The development of antimicrobial resistance, which is partially attributable to the overuse and/or misuse of antibiotics in health care, is one of the greatest global public health challenges. In Sub-Saharan African (SSA) countries, non-prescribed dispensing of antibiotics in community drug retail outlets (CDROs) has been flagged as one of the contributing factors for the widespread misuse of antibiotics in the community. Objective The current review aimed to estimate the proportion of non-prescription antibiotics requests or consultations that resulted in provision of antibiotics without a valid prescription among CDROs in SSA region, and describe the type of antibiotics dispensed. Methods A literature search was conducted using PubMed, CINAHL, Scopus and Google Scholar. We also searched reference lists of relevant articles. Random effect model meta-analysis was employed to determine the pooled proportion of over the counter sale of antibiotics. Subgroup and meta-regression was undertaken to explore the potential cause of heterogeneity in effect size across studies. Results Of 671 total citations retrieved, 23 met the inclusion criteria (seven cross-sectional questionnaire-based surveys and 16 cross-sectional client-based studies). The overall pooled proportion of non-prescription antibiotics requests or consultations that resulted in supply of antibiotics without prescription was 69% (95% CI 58–80). Upper respiratory tract infections and/or acute diarrhoea were the most frequently presented case scenarios, and amoxicillin and co-trimoxazole were the most frequently dispensed antibiotics to treat those symptoms. Conclusions Non-prescribed dispensing of antibiotics was found to be a common practice among CDROs in several SSA countries. Ease of access to and overuse of antibiotics can potentially accelerate the emergence of resistance to antibiotics available in the region. Our review highlights the need for a stringent enforcement of existing policies and/or enacting new regulatory frameworks that would regulate antibiotic supply, and training and educational support for pharmacy personnel (e.g. pharmacists, pharmacy assistants) regarding judicious use of antibiotics and the importance of antimicrobial stewardship.

scholarly journals Zero hunger and malnutrition in the African continent is potentially feasible, if nutrition programs are prioritized politically and scientifically

2021 ◽  
Vol 4 (9) ◽  
pp. S93-S108
Author(s):  
Laila Hussein
Keyword(s):  
Food Systems ◽  
Malnourished Child ◽  
Fermented Foods ◽  
Linear Modeling ◽  
African Countries ◽  
Sustainable Solutions ◽  
Malnourished Children ◽  
Moderate Malnutrition ◽  
Zero Hunger ◽  
Ready To Use Foods

African countries and in particular the Sub Sahara ones contribute to the largest proportion of the global burden of poverty and associated diet-related diseases in all its forms, including micronutrient malnutrition. Malnutrition rates remain alarming: and stunting an indicator of chronic malnutrition is declining too slowly. The main objectives of the present article are to focus on 1- the current food supply and nutritional status among the vulnerable young population in African countries 2- Insight on the efforts towards reaching the global goal (2) for ending hunger within the context of the SDS2030. The methodology included urgent short- and medium-term interventions priorities programs implemented by foreign aids and international organizations for the management of severe and moderate malnutrition among African children. Details on the composition of the so-called ready-to-use foods used for treating malnourished children are presented. The outcomes of such programs with all their positives and negatives were put together as lessons to be learned and to close the information gap. The cost for treating one single malnourished child with these ready to use foods is in the range between 50 up to 200 US$. To make Goal 2 a reality by the year 2030, a number of scientific-based sustainable solutions were created and recommended for application. Maximizing the use of local food resources, and minimizing losses by applying the logarithm of linear modeling so that nutritious recipes can be formulated at the lowest cost. Capacity building of junior African academics and increased investments in research focusing on diet quality for optimizing the formulation of recipes for feeding infants and children. Strengthening scientific collaboration and exchange of visits and experiences between scientists from the 54 African countries. The establishment of an African Consortium with experts in the diverse areas of food systems to work together more effectively under the umbrella of the African Union. Keywords: African countries, Staple foods, Intake of animal-sourced foods, Severe and moderately malnourished children, Ready to use foods, SDG 2030, Sustainable nutrient-dense diets, Linear programming, Fermented foods, Intra Africa trade agreements, Political will.

Does the primary tumour location affect the prognosis of patients with colorectal cancer peritoneal metastases treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy?

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Haipeng Chen ◽  
Sicheng Zhou ◽  
Jianjun Bi ◽  
Qiang Feng ◽  
Zheng Jiang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Primary Tumour ◽  
Cancer Center ◽  
Tumour Location ◽  
Life Threatening ◽  
Grade 3 ◽  
The Impact

Abstract Background The impact of primary tumour location on the prognosis of patients with peritoneal metastasis (PM) arising from colorectal cancer (CRC) after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is rarely discussed, and the evidence is still limited. Methods Patients with PM arising from CRC treated with CRS and HIPEC at the China National Cancer Center and Huanxing Cancer Hospital between June 2017 and June 2019 were systematically reviewed. Clinical characteristics, pathological features, perioperative parameters, and prognostic data were collected and analysed. Results A total of 70 patients were divided into two groups according to either colonic or rectal origin (18 patients in the rectum group and 52 patients in the colon group). Patients with PM of a colonic origin were more likely to develop grade 3–4 postoperative complications after CRS+HIPEC (38.9% vs 19.2%, P = 0.094), but this difference was not statistically significant. Patients with colon cancer had a longer median overall survival (OS) than patients with rectal cancer (27.0 vs 15.0 months, P = 0.011). In the multivariate analysis, the independent prognostic factors of reduced OS were a rectal origin (HR 2.15, 95% CI 1.15–4.93, P = 0.035) and incomplete cytoreduction (HR 1.99, 95% CI 1.06–4.17, P = 0.047). Conclusion CRS is a complex and potentially life-threatening procedure, and we suggest that the indications for CRS+HIPEC in patients with PM of rectal origin be more restrictive and that clinicians approach these cases with caution.

scholarly journals Management of chronic respiratory complications in children and adolescents with sickle cell disease

2020 ◽  
Vol 29 (157) ◽  
pp. 200054
Author(s):  
Michele Arigliani ◽  
Atul Gupta
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Current Knowledge ◽  
Sub Saharan Africa ◽  
Cell Disease ◽  
Respiratory Complications ◽  
Progressive Decline ◽  
Blood Disorder ◽  
Life Threatening ◽  
Sub Saharan

Sickle cell disease (SCD) is a life-threatening hereditary blood disorder that affects millions of people worldwide, especially in sub-Saharan Africa. This condition has a multi-organ involvement and highly vascularised organs, such as the lungs, are particularly affected. Chronic respiratory complications of SCD involve pulmonary vascular, parenchymal and airways alterations. A progressive decline of lung function often begins in childhood. Asthma, sleep-disordered breathing and chronic hypoxaemia are common and associated with increased morbidity. Pulmonary hypertension is a serious complication, more common in adults than in children. Although there is a growing attention towards respiratory care of patients with SCD, evidence regarding the prognostic meaning and optimal management of pulmonary issues in children with this condition is limited.This narrative review presents state-of-the-art evidence regarding the epidemiology, pathophysiology and therapeutic options for chronic respiratory complications commonly seen in paediatric patients with SCD. Furthermore, it highlights the gaps in the current knowledge and indicates future directions for studies that aim to improve our understanding of chronic respiratory complications in children with SCD.

scholarly journals Reduced Parasite Burden in Children with Falciparum Malaria and Bacteremia Coinfections: Role of Mediators of Inflammation

2016 ◽  
Vol 2016 ◽  
pp. 1-14 ◽  
Author(s):  
Gregory C. Davenport ◽  
James B. Hittner ◽  
Vincent Otieno ◽  
Zachary Karim ◽  
Harshini Mukundan ◽  
...  
Keyword(s):  
Geometric Mean ◽  
Parasite Burden ◽  
Sub Saharan Africa ◽  
Mediation Model ◽  
Multiple Mediation ◽  
Mediators Of Inflammation ◽  
Threatening Condition ◽  
Life Threatening ◽  
Sub Saharan

Bacteremia and malaria coinfection is a common and life-threatening condition in children residing in sub-Saharan Africa. We previously showed that coinfection with Gram negative (G[−]) enteric Bacilli andPlasmodium falciparum(Pf[+]) was associated with reduced high-density parasitemia (HDP, >10,000 parasites/μL), enhanced respiratory distress, and severe anemia. Since inflammatory mediators are largely unexplored in such coinfections, circulating cytokines were determined in four groups of children (n=206, aged <3 yrs): healthy;Pf[+] alone; G[−] coinfected; and G[+] coinfected.Staphylococcus aureusand non-TyphiSalmonellawere the most frequently isolated G[+] and G[−] organisms, respectively. Coinfected children, particularly those with G[−] pathogens, had lower parasite burden (peripheral and geometric mean parasitemia and HDP). In addition, both coinfected groups had increased IL-4, IL-5, IL-7, IL-12, IL-15, IL-17, IFN-γ, and IFN-αand decreased TNF-αrelative to malaria alone. Children with G[−] coinfection had higher IL-1βand IL-1Ra and lower IL-10 than thePf[+] group and higher IFN-γthan the G[+] group. To determine how the immune response to malaria regulates parasitemia, cytokine production was investigated with a multiple mediation model. Cytokines with the greatest mediational impact on parasitemia were IL-4, IL-10, IL-12, and IFN-γ. Results here suggest that enhanced immune activation, especially in G[−] coinfected children, acts to reduce malaria parasite burden.

scholarly journals Managing drug-induced QT prolongation in clinical practice

2020 ◽  
pp. postgradmedj-2020-138661
Author(s):  
Rani Khatib ◽  
Fatima R N Sabir ◽  
Caroline Omari ◽  
Chris Pepper ◽  
Muzahir Hassan Tayebjee
Keyword(s):  
Qt Interval ◽  
Simple Algorithm ◽  
Torsades De Pointes ◽  
Daily Practice ◽  
Qt Prolongation ◽  
Key Factors ◽  
Drug Induced ◽  
Electrolyte Disturbances ◽  
Related Risk ◽  
Life Threatening

Many drug therapies are associated with prolongation of the QT interval. This may increase the risk of Torsades de Pointes (TdP), a potentially life-threatening cardiac arrhythmia. As the QT interval varies with a change in heart rate, various formulae can adjust for this, producing a ‘corrected QT’ (QTc) value. Normal QTc intervals are typically <450 ms for men and <460 ms for women. For every 10 ms increase, there is a ~5% increase in the risk of arrhythmic events. When prescribing drugs associated with QT prolongation, three key factors should be considered: patient-related risk factors (eg, female sex, age >65 years, uncorrected electrolyte disturbances); the potential risk and degree of QT prolongation associated with the proposed drug; and co-prescribed medicines that could increase the risk of QT prolongation. To support clinicians, who are likely to prescribe such medicines in their daily practice, we developed a simple algorithm to help guide clinical management in patients who are at risk of QT prolongation/TdP, those exposed to QT-prolonging medication or have QT prolongation.

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