Intractable Diarrhea from Carbamazepine

Diarrhea has been reported as an early, mild, and uncommon complication of carbamazepine (CBZ) therapy. We report three cases of intractable diarrhea induced by CBZ necessitating discontinuation of the drug.     

Molecular epidemiology of norovirus variants detected in children under five years of age in Hyderabad,India

PurposeNoroviruses are common viral agents in acute diarrhea in all age groups worldwide. Norovirus has been classified into 10 genogroups, GI to GX with over 48 genotypes among them the GII.4 genotype has evolved over time with a clear pattern of periodic variant replacement. Immunity is strain or genotype specific with little or no protection conferred across genogroups. The present study was aimed to determine the epidemiology, prevalent genotypes of norovirus in children below five years of age in the Hyderabad region, India.MethodsThe stool samples and clinical data were collected from 458 children below 5 years of age comprising of cases with acute gastroenteritis (n ?= ?366) and a control group (n ?= ?92) admitted to the pediatric ward. All the samples were tested for Norovirus by ELISA and RT-PCR. Sequencing was done for predominant strains.Results10.3% (n ?= ?38) of cases and 3.2% (n ?= ?3) of the control group were found to be Norovirus positive. Predominant genotypes were GII-82.5% followed by GI-12.5%.ConclusionSequencing and Phylogenetic analyses of 20 GII.4 strains was done. All of the isolates are clustered away from published the GII.4 variants thus suggesting the appearance of a new variant.     

Human rotavirus specific T cells: quantification by ELISPOT and expression of homing receptors on CD4+ T cells

Using an intracellular cytokine assay, we recently showed that the frequencies of rotavirus (RV)-specific CD4(+) and CD8(+) T cells secreting INFgamma, circulating in RV infected and healthy adults, are very low compared to the frequencies of circulating cytomegalovirus (CMV) reactive T cells in comparable individuals. In children with acute RV infection, these T cells were barely or not detectable. In the present study, an ELISPOT assay enabled detection of circulating RV-specific INFgamma-secreting cells in children with RV diarrhea but not in children with non-RV diarrhea without evidence of a previous RV infection. Using microbead-enriched CD4(+) and CD8(+) T cell subsets, IFNgamma-secreting RV-specific CD8(+) but not CD4(+) T cells were detected in recently infected children. Using the same approach, both CD4(+) and CD8(+) RV-specific T cells were detected in healthy adults. Furthermore, stimulation of purified subsets of PBMC that express lymphocyte homing receptors demonstrated that RV-specific INFgamma-secreting CD4(+) T cells from adult volunteers preferentially express the intestinal homing receptor alpha4beta7, but not the peripheral lymph node homing receptor L-selectin. In contrast, CMV-specific INFgamma-secreting CD4(+) T cells preferentially express L-selectin but not alpha4beta7. These results suggest that the expression of homing receptors on virus-specific T cells depends on the organ where these cells were originally stimulated and that their capacity to secrete INFgamma is independent of the expression of these homing receptors.     

胃-肠瘘引起腹泻的临床分析(附5例报告)

目的 探讨胃－肠瘘引起腹泻的临床特点。方法 从1988年1月－1998年12月我院消化内科住院患者2885例中筛选出以腹泻为主要临床表现的所有病例,其中胃－肠瘘为病因的5例,总结分析其各方面的临床资料。结果 5例患者均有毕II式胃大部切除术病史,腹泻特点均为吸收不良性腹泻表现,予去麦胶饮食及抗感染治疗,疗效欠佳。就诊时均有明显的低蛋白血症。均能通过消化道钡餐造影明确诊断,胃镜诊断率仅40％。二次手术治疗,症状均得到缓解。结论 在诊治腹泻患者,特别是有胃大部切除病史的患者时,要考虑到胃－肠瘘的可能。     

《中西医结合防治小儿腹泻病专家共识》解读

小儿腹泻病是儿童消化系统最常见的疾病,2022年中国中西医结合学会儿科专业委员会制定了《中西医结合防治小儿腹泻病专家共识》。现结合临床实践及最新的研究结果,对《中西医结合防治小儿腹泻病专家共识》中小儿腹泻病的发病机制、诊断和治疗中的重点内容进行解读,以期加深医务工作者对《中西医结合防治小儿腹泻病专家共识》的认识,促进中西医结合规范化治疗小儿腹泻病。     

Impact of rotavirus vaccination on diarrheal hospitalizations in children younger than 5 years of age in a rural southern Mozambique

BackgroundRotavirus vaccine (Rotarix®) was introduced in Mozambique through its Expanded Program of Immunization in September 2015. We assessed the impact of rotavirus vaccination on childhood gastroenteritis-associated hospitalizations post-vaccine introduction in a high HIV prevalence rural setting of southern Mozambique.MethodsWe reviewed and compared the trend of hospitalizations (prevalence) and incidence rates of acute gastroenteritis (AGE), and rotavirus associated-diarrhea (laboratory confirmed rotavirus) in pre- (January 2008–August 2015) and post-rotavirus vaccine introduction periods (September 2015–December 2020), among children <5 years of age admitted to Manhiça District Hospital.ResultsFrom January 2008 to December 2020, rotavirus vaccination was found to contribute to the decline of the prevalence of AGE from 19% (95% CI: 18.14–20.44) prior to the vaccine introduction to 10% (95% CI: 8.89–11.48) in the post-introduction period, preventing 40% (95 % IE: 38–42) and 84% (95 % IE: 80–87) of the expected AGE and laboratory confirmed rotavirus cases, respectively, among infants. Similarly, the overall incidence of rotavirus was 11.8-fold lower in the post-vaccine introduction period (0.4/1000 child-years-at-risk [CYAR]; 95% CI: 0.3–0.6) compared with the pre-vaccination period (4.7/1000 CYAR; 95% CI: 4.2–5.1) with the highest reduction being observed among infants (16.8-fold lower from the 15.1/1000 CYAR in the pre-vaccine to 0.9/1000 CYAR in the post-vaccine eras).ConclusionsWe documented a significant reduction in all-cause diarrhea hospitalizations and rotavirus positivity after vaccine introduction demonstrating the beneficial impact of rotavirus vaccination in a highly vulnerable population.     

思密达治疗婴幼儿腹泻86例临床实验

目的 评价思密达治疗婴幼儿腹泻的疗效。方法 思密达口服治疗婴幼儿腹泻。病例为儿科门诊病人,年龄２－６０个月,疗程在３天内,症状为排稀水样便。就诊前未服用过本组实验组物的腹泻病人１７３人,随机分二组,分别给予服思密达或黄连素片。结果 治疗组平均疗程２．９３天,对照组４．４７天,ｘ＾２＝４．３９,ｐ〈０．０５。思密达总有效率９４．１％,对照组７９．３％,ｘ＾２＝１３．８,ｐ〈０．０１。两组结果比较,差     

金双歧、肯特令联合治疗婴幼儿秋季腹泻疗效观察

目的：观察金双歧、肯特令联合治疗婴幼儿秋季腹泻的疗效。方法：228例患儿随机分为三组，A组采用金双歧治疗；B组有用肯特令治疗；C组采金双歧肯特令联合治疗，结果：联合治疗组的总有效率93．1％，明显高于金双岐组（79．5％）和肯特令组（77．9％），结论：金双歧、肯特令联合治疗婴幼儿秋季腹泻的疗效显著。     

穴位注射加灸治疗小儿腹泻疗效观察

目的　观察穴位注射加灸治疗小儿腹泻的疗效。方法　选用庆大霉素和 6 5 4 - 2肌注、穴注、穴注加灸治疗小儿腹泻 ,每日 1次 ,3次后比较 3组疗效。结果与结论　穴注组治愈率明显高于肌注组 (P<0 .0 5 ) ,穴注加灸组治愈率明显高于穴注组(P<0 .0 0 5 )     

双黄连粉针剂加蒙脱石治疗婴幼儿秋季腹泻的疗效观察

目的: 观察双黄连粉针剂加蒙脱石口服治疗婴幼儿秋季腹泻的疗效.方法: 双黄连粉针剂加蒙脱石口服治疗102例秋季腹泻患儿,并与单用蒙脱石或双黄连组相比较.结果: 治疗组总有效率达92.1%,病程明显缩短(4.52±0.56)d;而单用蒙脱石或双黄连组有效率分别为67.4%,60.2%;病程分别为(5.90±0.72)d,(6.15±0.92)d,联合用药组与单用蒙脱石或双黄连组相比较,总有效率及病程均有显著性差异(P＜0.01).结论: 双黄连加蒙脱石治疗婴幼儿秋季腹泻疗效好,可提高治愈率,缩短病程,是较为安全而有效的药物.