Effect of Zinc Supplement on Severity Of Acute Diarrhea Among Childern Under Five Years Of Age

According to World Health Organization (WHO) approximately four million children less than 5 years of age in Asia, Africa, and Latin America die annually from diarrhea; and 80% of these deaths occur in the first year of life. Objective: To see how a zinc supplement influences the severity of acute diarrhea in children under the age of five. Methods: In current study, we analyze the effect of zinc on diarrheal patients. Zinc was randomly assigned to diarrheal patients in different concentration 5 mg, 10 mg, 15 mg and 20 mg. There were two groups in our study, treatment and control group. Results: The results are presented in the form of descriptive and inferential statistics. In T1 (Treatment Group) number of Diarrhea patients < 1 Year of age were 16, 2-4 years of age were 45, 4-5 years of age and maximum no of patients in T1 < 2 year of age were 57. Number of male patients were 84 while female patients were 67 in T1.In T2 (Control Group) number of male patients were 92 while female patients were In T1 number of patients residing in urban area were 51 while rural were 100. In T2 number of urban were 69 while rural were 82.Number of patients stay in the hospital for one day were 67 ,15 for Four days and only 1 for seven days in T1. In T2 number of patients stay in the hospital for one day were 29, 17 for four days and only 6 for seven days. In T1 number of Patients with watery diarrhea were 87, Mucoid consistency of stool were 31,soft consistency of stool were 23 and formed consistency of stool were 9.In T2 watery diarrhea were 92,Mucoid consistency of stool were 25,soft consistency of stool were 31 and formed consistency of stool were 4. Frequency of stool significantly reduced (P<0.005) at 7th day of zinc treatment while consistency of stool was significantly improved (P<0.005) at day 3 and day 5 of zinc treatment. Children who received zinc supplements showed a marked improvement in all outcome measures, suggesting that this deficiency is amenable to correction by replacement.

Molecular characterization of enterotoxigenic Escherichia coli toxins and colonization factors in children under five years with acute diarrhea attending Kisii Teaching and Referral Hospital, Kenya

Background Enterotoxigenic Escherichia coli (ETEC) is one of the leading causes of infectious diarrhea in children. There are no licensed vaccines against ETEC. This study aimed at characterizing Escherichia coli for ETEC enterotoxins and colonization factors from children < 5 years with acute diarrhea and had not taken antibiotics prior to seeking medical attention at the hospital. Methods A total of 225 randomly selected archived E. coli strains originally isolated from 225 children with acute diarrhea were cultured. DNA was extracted and screened by multiplex polymerase chain reaction (PCR) for three ETEC toxins. All positives were then screened for 11 colonization factors by PCR. Results Out of 225 E. coli strains tested, 23 (10.2%) were ETEC. Heat-stable toxin (ST) gene was detected in 16 (69.6%). ETEC isolates with heat-stable toxin of human origin (STh) and heat-stable toxin of porcine origin (STp) distributed as 11 (68.8%) and 5 (31.2%) respectively. Heat-labile toxin gene (LT) was detected in 5 (21.7%) of the ETEC isolates. Both ST and LT toxin genes were detected in 2 (8.7%) of the ETEC isolates. CF genes were detected in 14 (60.9%) ETEC strains with a majority having CS6 6 (42.9%) gene followed by a combination of CFA/I + CS21 gene detected in 3 (21.4%). CS14, CS3, CS7 and a combination of CS5 + CS6, CS2 + CS3 genes were detected equally in 1 (7.1%) ETEC isolate each. CFA/I, CS4, CS5, CS2, CS17/19, CS1/PCFO71 and CS21 genes tested were not detected. We did not detect CF genes in 9 (39.1%) ETEC isolates. More CFs were associated with ETEC strains with ST genes. Conclusion ETEC strains with ST genes were the most common and had the most associated CFs. A majority of ETEC strains had CS6 gene. In 9 (39.1%) of the evaluated ETEC isolates, we did not detect an identifiable CF.

Hypomagnesaemia in children under five years of age having acute diarrhea.

Objective: To determine the frequency of hypomagnesaemia in children under five year of age having acute diarrhea. Study Design: Descriptive Cross Sectional study. Setting: Department of Pediatric Medicine, Rashid Latif Medical College / Arif Memorial Teaching Hospital, Lahore. Period: August 2019 to January 2020. Material & Methods: A total of 96 children aged between 6 months to five years having acute diarrhea and duration of illness <14 days were enrolled. All the patients were subjected to measurement of serum magnesium level. The proportion of hypomagnesaemia was analyzed in acute diarrhea. The effect modifier and confounding variables were controlled through stratification of data on duration of illness less as < 14 days and more than 14 days, age as < 2 year or > 2 year and weight as < 2SD or > 2SD on weight for age chart. Chi square test was applied considering p value < 0.05 as significant. Results: Our study comprised of 96 patients having acute diarrhea, of these 96 study cases, 62 (64.6%) were boys and 34 (35.4%) were girls. Mean age of our study cases was 19.25±15.71 months. Mean weight of study cases was 9.56±3.01 kg. Mean duration of illness was 5.74 ± 3.26 days. Mean Serum Magnesium level was 1.63 ± 0.32 mg/dl (ranging from 1.0 mg/dl to 2.8 mg/dl). Hypomagnesaemia was present in 47 (49%) cases. Conclusion: High frequency of hypomagnesaemia was observed in children under 5 years of age having acute diarrhea. Duration of illness had significant impact on hypomagnesaemia. Serum magnesium levels must be regularly monitored in children with acute diarrhea.

Antibacterial Activity of Bay Leaf (Syzygium polyanthum) Ethanol Extract on Escherichia coli Growth

Acute diarrhea is liquid stool with a frequency of more than 3 times a day and lasts less than 14 days. One of the most common causes of acute diarrhea is Escherichia coli. Diarrhea caused by bacteria can be treated with the use of antibiotics, but the relatively high intensity of antibiotic use causes various health problems, especially bacterial resistance. Therefore, the search for antibacterial agents derived from natural ingredients was carried out as an alternative treatment. Bay leaf (Syzygium polyanthum) is one of the natural ingredients that has the potential as an antibacterial because it contains active compounds such as essential oils, flavonoids (quercetin), saponins, tannins, and alkaloids. This study aimed to analyze the antibacterial activity of the ethanolic extract of bay leaves on the growth of Escherichia coli. This research uses the dilution method which aims to determine the Minimum inhibitory concentration (MIC) and Minimum bactericidal concentration (MBC). The results showed that the MIC value at a concentration of 200mg/ml and the MBC value at a concentration of 500mg/ml.

Which Probiotic Is the Most Effective for Treating Acute Diarrhea in Children? A Bayesian Network Meta-Analysis of Randomized Controlled Trials

Acute diarrhea is a major cause of morbidity and mortality in children under five. Probiotics are beneficial for treating acute diarrhea in children, but unclear which specific probiotic is the most effective. We performed a Bayesian network meta-analysis to examine the comparative effectiveness of probiotics. By searching EMBASE, PubMed, and the Cochrane Library up to 31 March 2021, randomized clinical trials (RCTs) on probiotics for treating acute diarrhea in children were included. Primary outcomes included the duration of diarrhea and diarrhea lasting ≥2 days, and secondary outcomes included the mean stool frequency on day 2 and duration of hospitalization, fever, and vomiting. We assessed the certainty of the evidence of outcomes according to Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guideline. Eighty-four studies with twenty-one different interventions in 13,443 children were included. For the primary outcomes, moderate evidence indicated that, Lactobacillus reuteri [mean difference (MD) = −0.84 day; 95% confidence interval (CI), −1.39, −0.29], Bifidobacterium lactis (MD = −0.98 day; 95%CI, −1.82, −0.14), Saccharomyces boulardii (MD = −1.25 day; 95%CI, −1.59, −0.91), Lactobacillus species (spp.) plus Bifidobacterium spp. plus Saccharomyces spp. (MD = −1.19 day; 95%CI, −1.81, −0.58), and Bacillus spp. plus Enterococcus spp. plus Clostridium spp. (MD = −1.1 day; 95%CI, −1.84, −0.35) significantly reduced the duration of diarrhea when compared with placebo. Saccharomyces boulardii [Odds ratio (OR) = 0.22; 95%CI, 0.11, 0.41] and Lactobacillus reuteri (OR = 0.23; 95%CI, 0.090, 0.60) significantly reduced the risk of diarrhea lasting ≥2 days when compared with placebo or no treatment, with moderate evidence. Among all probiotics, Saccharomyces boulardii may be the most effective in reducing both duration of diarrhea (compared with placebo) and risk of diarrhea lasting ≥2 days (compared with placebo or no treatment), with moderate evidence. To be conclusive, Saccharomyces boulardii may be the most effective probiotic for treating acute diarrhea in children, followed by several other single-strain and multi-strain probiotics.