Management Of Diarrhea Research Articles

Effect analysis of information-guided enteral nutrition-associated diarrhea treatment process in patients with chronic obstructive pulmonary disease undergoing continuous non-invasive assisted ventilation: a mixed cohort study of pre- and post-control

To clarify the application effect of information-guided enteral nutrition-associated diarrhea (ENAD) management process in patients with chronic obstructive pulmonary disease (COPD) undergoing non-invasive assisted ventilation. A mixed cohort study of pre- and post-control was conducted. Thirty-nine patients with COPD who were admitted to the emergency intensive care unit (ICU) of Huzhou First People's Hospital from July 1, 2021 to July 31, 2022 were enrolled. Taking the completion of the software development of ENAD management software for critically ill patients on January 28, 2022 as the time node, 20 patients admitted from July 1, 2021 to January 28, 2022 were set as the control group, and 19 patients admitted from January 29 to July 31, 2022 were set as the observation group. The two groups of patients received the same enteral nutrition support treatment, and the control group implemented the conventional ENAD treatment process with enteral nutrition intolerance disposal process as the core. On the basis of the control group, the observation group implemented the information-guided ENAD treatment process, and the system software actively captured the information of ENAD patients and reminded the medical team to improve the patient's diarrhea-related examination and provide alternative treatment plans. The duration of antidiarrhea, feeding interruption rate, and energy and protein intake, blood biochemical indexes, incidence of abnormal blood electrolyte metabolism, daily continuous non-invasive assisted ventilation and endotracheal intubation after 7 days of targeted diarrhea intervention were compared between the two groups. Except for the basal pulse rate, there were no significant differences in gender distribution, age, and vital signs, basic nutritional status, arterial blood gas analysis and blood biochemistry at admission between the two groups, indicating comparability between the two groups. When ENAD occurred, the patients in the observation group obtained earlier cessation of diarrhea than those in the control group [days: 3.00 (2.00, 3.25) vs. 4.00 (3.00, 5.00), P < 0.01], and the feeding interruption rate was significantly lower than that in the control group [10.53% (2/19) vs. 65.00% (13/20), P < 0.01]. After 7 days of diarrhea intervention, the energy intake of the observation group was significantly higher than that of the control group [kJ×kg-1×d-1: 66.28 (43.34, 70.36) vs. 47.88 (34.60, 52.32), P < 0.01], the levels of hemoglobin (Hb), albumin (Alb) and serum prealbumin (PAB) were significantly higher than those in the control group [Hb (g/L): 119.79±10.04 vs. 110.20±7.75, Alb (g/L): 36.00 (33.75, 37.25) vs. 31.00 (30.00, 33.00), PAB (mg/L): 155.79±25.78 vs. 140.95±14.97, all P < 0.05], the daily continuous non-invasive assisted ventilation duration was significantly shorter than that of the control group [hours: 14 (12, 16) vs. 16 (14, 18), P < 0.01], and the arterial partial pressure of carbon dioxide (PaCO2) was significantly lower than that of the control group [mmHg (1 mmHg ≈ 0.133 kPa): 66.00 (62.00, 70.00) vs. 68.00 (67.50, 70.05), P < 0.05]. However, there were no significant differences in protein intake, incidence of abnormal electrolyte metabolism, and incidence of endotracheal intubation due to acute respiratory failure between the two groups. The information-guided ENAD treatment process can enable the COPD patients undergoing continuous non-invasive assisted ventilation who experience ENAD to receive earlier cessation of diarrhea, and improve the protein energy metabolism and respiratory function of the patients.

Evaluation of India action plan for prevention of pneumonia and diarrhoea - a diarrhoea management program in Bihar, India

Evaluation of India action plan for prevention of pneumonia and diarrhoea - a diarrhoea management program in Bihar, India

Antibacterial activity of crude methanol extract of Anacardium occidentale leaf and its fractions on isolates of diarrhoea-causing pathogenic Escherichia Coli and Salmonella enterica

This study investigated the antibacterial activity of Anacardium occidentale leaf crude extract and it’s derived; petroleum, chloroform and methanol fractions on isolates of diarrhoea-causing pathogenic Escherichia. coli, and Salmonella enterica. The protocol described by Kupchan and Tsou as modified by Houghton and Raman was used to partition the crude extract. Field strains of Salmonellae enterica and E. coli enterobacteria, were obtained using standard procedures adopted by Mufandaedza.. Holes were bored in the agar, using a sterile borer which enabled the application of crude extract and the fractions, and thereafter, incubated for 24 hours. Results of the study showed that the crude extract elicited better (p&lt;0.05) growth inhibitory (56.11 and 58.14%) effect on the E. coli and S. enterica isolates respectively, better than any of the derived fractions that recorded less than 30% activity, suggesting an additive, complementary or synergistic effect of individual composite fraction, rather than the role of a single biomolecular fraction in the leaf extract of A. occidentale, hence partitioning, adversely reduced or disintegrated the additive effect of the crude extract on enterogenic bacteria investigated. In conclusion, the crude extract of Anacardium occidentale, have shown good anti-bacterial activity, principally by inhibiting the growth of diarrhoea causing enterogenic E. coli and Salmonella organisms’ growth in vitro, hence supporting its folkloric use in the management of enterogenic diarrhoea by traditional healers.

Descriptive Epidemiology of Home-Based Management of Diarrhea in Children Under Five Years: The Case of Northern Ghana

Descriptive Epidemiology of Home-Based Management of Diarrhea in Children Under Five Years: The Case of Northern Ghana

Application of Honey Therapy to Decrease Stool Frequency in Children with Diarrhea: A Case Study

Diarrhea is characterized by the presence of watery bowel motions that occur three or more times within 24 hours. Inadequate management of diarrhea in children might lead to fatality. One method involves administering honey treatment to decrease the frequency of bowel movements. The objective was to elucidate the implementation of a way to reduce bowel movement frequency. The design involved a case study conducted on two toddlers suffering from diarrhea. The solution involved administering honey therapy three times daily for five days. Data analysis and presentation in case studies were conveyed through written text, which presented the facts in a narrative format. The use of honey therapy resulted in a reduction in the frequency of bowel movements in subjects 1 and 2. The post-intervention frequency of bowel movement in subject 1 was three times per day, with a mushy consistency. In subject 2, it was four times per day, again with a mushy consistency. Nurses at the Community Health Center (Puskesmas) can offer guidance on using honey therapy to parents whose children are suffering from diarrhea.

Randomized Clinical Trial Comparing The Effect Of Oral Rehydration Therapy With And Without Racecadotril In The Management Of Acute Diarrhea In Children

Objective: This study aimed to investigate the beneficial effect of racecadotril in children with acute diarrheal illness. Methods: This randomized case-control study was conducted at Watim General Hospital over four months from April to July 2023. A total of 120 children aged 3 months to 12 years with acute diarrhoea were included and randomly allocated to two groups. Group A (n=60) received standard treatment with oral rehydration therapy, while Group B (n=60) received oral rehydration therapy, zinc, probiotics, and racecadotril. The primary outcome measured was the mean duration of illness, and the secondary outcome was the number of stools 48 hours after the start of treatment. Data were collected using a pre-designed proforma and analyzed using SPSS version 24. Results: The study population had an average age of 50.35±41.52 months, with equal gender distribution. The mean duration of illness in Group A was 2.72±1.34 days, while in Group B, it was 2.70±1.29 days. There was no statistically significant difference in the mean duration of illness between the two groups (p=0.945). Conclusion: This study did not demonstrate a significant reduction in the mean duration of illness for children with acute gastroenteritis using standard treatment with or without racecadotril. Further investigations and large-scale studies may be needed to establish the efficacy of racecadotril in the management of acute diarrhoea in children. Keywords: Acute diarrhoea, ORS, Racecadotril.

Analisa Hubungan Pengelolaan Sampah Terhadap Kejadian Diare di Provinsi Kalimantan Timur

Household waste that unmanaged well can lead into the emergence of infectious diseases, like diarrhea. The waste management level in East Kalimantan province increases every year, directly proportional to cases of diarrhea. This research’s aim is to know the relationship between waste management level and cases of diarrhea in East Kalimantan province. This research using secondary datas analysis as the method. Datas related to waste management and cases of diarrhea are collected from Central Bureau of Statistics of East Kalimantan and National Waste Management Information System of KLHK. There are six districts/cities as the location of collecting the secondary datas, which are Samarinda, Balikpapan, Bontang, Kutai Kertanegara, Paser and Penajam Paser Utara. The datas collected from 2018 to 2022. The data analysis used chi-square. This research shows Paser District has the lowest waste management level among the others. Whereas, Bontang City has the highest waste management level. The Paser District also has the highest cases of diarrhea. The value of asymptotic significance (2sided) from the chi-square test (0.129) lower than 0.05, so it can be concluded that Ho were approved. It implicated that there is no relationship between waste management level to cases of diarrhea in the East Kalimantan province.

Assessing the relationship of recommended diarrhea case management practices with the nutritional status of children aged between 0 to 59.9 months.

Background Paediatric diarrhoea and malnutrition have a bidirectional relationship, which in turn augments the presence of each other. The diarrhoeal diseases in children can be prevented by using oral rehydration solution (ORS) and oral zinc sulfate. The relationship between paediatric diarrhoea treatment guidelines with the nutritional status is not yet investigated, and this study primarily aims to examine the relationship of recommended diarrhoea case management practices with paediatric undernutrition (wasting, stunting and underweight) among children aged between 0 to 59 months. Methods Data from Pakistan Demographic &amp; Health Surveys (PDHS) conducted in 2012–2013 and 2017–2018 were used in this study to investigate the relationship between paediatric diarrhoea treatment adherence with the various forms of paediatric undernutrition. Data from children with complaints of acute watery non-dysenteric diarrhoea was used in this study, whereas data from those children presented with complaints of either dysentery, and/or severe dehydration, and/or incomplete anthropometry were excluded. Children were classified as complete adherent, partial adherent and non-adherent based on ORS and oral zinc sulfate consumption. The relationship of diarrhoea case management practices with different types of nutritional status was assessed using a binomial logistic regression method. Results The malnutrition in children with acute non-dysenteric diarrhoea is 54.2% in 2012–2013, which decreased to 48.2% in the succeeding survey of 2017–2018. Only 6.2% (1% in 2012–2013 ~ 10% in 2017–2018) children of Pakistan received appropriate treatment for managing their diarrhoea. However, no relationship between the diarrhoea case management and paediatric undernutrition was observed. Conclusion This study found did not demonstrate a significant connection of diarrhoea case management strategies with paediatric undernutrition. This highlights the complexity of addressing both diarrhoea and malnutrition in children. Future research should emphasize the identification and resolution of the multifactorial factors, which contribute to paediatric undernutrition, integrating both diarrhoea management and nutritional improvement strategies.

Evaluation of Efficacy and Tolerability of Fixed Dose Combination of Rifaximin and Metronidazole in The Management of Acute Diarrhea

Background: Infectious diarrhea is endemic in many parts of the world. It is generally mixed in etiology involving virus, bacteria, and parasite. Antibiotics belonging to fluoroquinolones class are most commonly used but are beneficial only in certain types of acute diarrhoea with side-effects like tendinopathy, arthropathy, neuropathy, arrhythmia, hypoglycemia, and hyperglycemia. Rifaximin with its unique mechanism, along with established metronidazole is proposed as a treatment option for acute diarrhea caused due to mixed gastrointestinal infections. The aim of this study is to evaluate the efficacy and tolerability of a fixed dose combination of rifaximin and metronidazole in the empirical management of acute diarrhea.Method: An open-label, non-comparative, non-randomized, multicenter trial was conducted in 238 patients presenting with acute diarrheal episodes involving various etiologies. Patients were given fixed dose combination tablet containing rifaximin 200 mg and metronidazole 400 mg twice a day for 5 days. Primary outcomes were change from baseline in number of soft or watery stools, fever, nausea, vomiting, abdominal pain, and gas/flatulence at day 5.Results: In final analysis 150 patients were included, as 88 patients lost to follow up. After 5 days of therapy, mean number of watery stools per day were reduced from 7.133 ± 2.055 to 0.733 ± 0.833 (p 0.0001). Minor incidences of gastritis, nausea, and metallic taste were reported.Conclusion: Combination of rifaximin and metronidazole significantly reduces number of watery stools and associated symptoms and is a clinically effective and safe option in the empirical management of acute diarrhea of various etiologies.

Barriers to acute management of diarrhea in the home setting: An explorative study of under-five caregivers in southwestern Nigeria

Objectives: Diarrhea remains the second leading cause of morbidity and mortality among children under 5 years of age. Persistent mortality and poor outcomes despite available treatments such as oral rehydration salts (ORS) and zinc tablets are indicators of possible barriers to home management among under-five caregivers. This study was designed to explore the potential barriers encountered by under-five caregivers in providing home management for acute diarrhea within the first 24 hours of recognition. Materials and Methods: This qualitative study was conducted among under-five caregivers attending Primary Health Centers in Ikorodu Local Government Area of Lagos State, Nigeria. Twelve under-five caregivers, who indicated in the larger cross-sectional study that they did not provide any form of home management for the child within the first 24 hours of recognizing diarrhea were interviewed. Interviews were recorded. Naturalized transcription, peer in vivo inductive coding, and debriefing w ere done. Th ematic a nalysis was c onducted and findings were presented as themes and subthemes. Results: Three themes emerged: (1) Waiting for natural stoppage of diarrhea, (2) perceived function of ORS/ zinc, and (3) disconnect between potential consequences of diarrhea and action taken. Subthemes include perceived cause and seriousness of diarrhea, misdiagnosis, misinformation on the functions of ORS/ zinc from health-care providers, and lack of awareness of potential consequences of untreated diarrhea. Conclusion: The study showed that the main barriers to providing adequate home management were caregivers’ perception of the cause and seriousness of diarrhea and the misinformation about the function of ORS and zinc therapy. Continuous and accurate education of under-five caregivers would improve the timely initiation of ORS/ zinc and correct home management of acute diarrhea.

Knowledge On Management Of Side Effects Of Chemotherapy Among Cancer Patients In A Hospital Of Bhaktapur

Background: Cancer is the second leading cause of death worldwide. The increase in incidence of cancer is directly related to the increase in number of patients receiving chemotherapy. The objective of the study was to assess the knowledge on management of side effects of chemotherapy among cancer patients in a hospital of Bhaktapur. Method: Descriptive cross-sectional study was conducted among 104 cancer patients in a hospital of Bhaktapur, Nepal using non-probability purposive sampling technique. Data was collected through face-face interview technique by using self-developed structured questionnaire. The study was conducted between 2079-10-01 to 2079-10-30. Data management, analysis and interpretation was done using descriptive and inferential statistics and represented in tabulated form. Findings: More than half (56.7%) of the cancer patients had adequate knowledge on management of side effects of chemotherapy. Adequate knowledge was present on management of diarrhoea (82.7%), infection (65.4%) and nausea and vomiting (63.5%). However, inadequate knowledge was present on management of constipation (31.8%), extravasation (33.7%) gums bleeding (35.6%) and hair fall (38.5%). The study shows significant association between level of knowledge on management of side effects of chemotherapy with age (p=0.037) and educational status (p=0.029) of the cancer patients. Conclusion: More than half of the cancer patients had adequate knowledge on management of side effects of chemotherapy. Despite of this, respondents had still gap in knowledge on management of side effects of chemotherapy which shows need for, health education and counselling should be done among cancer patients.

Knowledge, Attitude and Practice of Mothers regarding Oral Rehydration Solution in Acute Diarrhoea at Monno Medical College Hospital

Background: Diarrhoea is one of the major causes of morbidity and mortality among the under-five age group in Bangladesh. Effective by ORS treatment can reduce diarrhoea-related mortality and unnecessary hospitalization, for which role of mothers is important. The use of oral rehydration saline (ORS) is greatly affected by mothers’ knowledge and attitude towards using it in treating their children. Objectives: Assessment of the knowledge, attitude and practice of the mothers about ORS for better management of diarrhoea in children. Methodology: A cross-sectional descriptive study was carried out in the department of Paediatrics of Monno Medical College Hospital, Manikganj, during the period from January to December, 2022. Data were collected from 300 mothers by face-to-face interview by a questionnaire. Finally, collected data were analyzed, using SPSS software version 20. Results: Majority (195, 65.0%) of the children’s age were in between 6 month to 2 years. Most (143, 47.7%) of the mothers completed primary education. About two-thirds of the mothers (193, 64.3%) resided in rural areas. In this study, most (213, 71.0%) of the mothers always used ORS during the attack of diarrhoea, 281(93.7%) mothers had adequate knowledge about ORS, 253(84.3%) had knowledge about preparetion of ORS, 235(78.3%) informed to know when to administer ORS and 170 (56.7%) knew the exact amount of ORS to administer. Conclusion: Positive attitude was seen among the participant mothers regarding the use of ORS. But mothers’ knowledge and practices regarding its administration was insufficient. Journal of Monno Medical College, June 2023; 9 (1): 03-06

Role of Fluid Resuscitation and Supportive Management of Diarrhea

The pediatric population is sensitive in every aspect. There are several parts of their bodies that need extreme levels of care and support until these children have reached a mature age. Similarly, there are several aspects of health that require immediate and urgent intervention, particularly in the pediatric population for better care and management. The reason behind this is the delicate and sensitive nature of the children’s health. Compromising any aspect of pediatric care might lead to severe consequences, which could be life-threatening too. Therefore, it is in the best interest of both the parents of the children and the physicians to be vigilant about the affected children’s symptoms just so they do not miss out on any important signs that could be transient or short-lived. Diarrhea is among the pediatric conditions that can very easily take a turn for the worse if it is not managed appropriately. Diarrhea can lead to severe consequences, including death in children, especially the malnourished ones. Diarrhea results in the excessive excretion of water, and electrolytes including sodium, potassium, bicarbonate, and zinc through watery stools. Dehydration ensues when these losses are not sufficiently replenished, leading to deficits in both water and electrolytes. The extent of dehydration is categorized based on symptoms and signs that mirror the quantity of fluid expelled. Depending upon these extents and degrees of dehydration, performing immediate resuscitation measures might be necessary. Among these measures, oral rehydration therapy is considered to be one of the most useful ones. It helps replenish the electrolytes rapidly and without causing any life-threatening consequences, especially when done within the specified time. On the brighter side, these fluid resuscitative measures might be the only interventions required to stop the child's progression further towards a severe form of the disease. This review is based on this fact only, and it revolves around the importance of performing fluid resuscitation and other elementary-level supportive measures that might be the only shot at saving the life of the child if done at an early stage. Thai review will help take action under the right circumstances if such a case arises in the clinical setting.

Using the Simulated Patient Method to Evaluate the Community Pharmacy Management of Childhood Diarrhoea: A Systematic Review

The simulated patient method has been widely used to assess community pharmacy practice in the management of childhood diarrhoea. In such a process, a community pharmacist is required to explore a patient’s history, choose the right medication and provide drug-related information. The aim of this review was to evaluate the aforementioned practice. A comprehensive literature search was carried out over Sage Journal, PubMed, ScienceDirect and Google Scholar, and the analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eligible articles were those published from 2011 to 2021 and original studies that used the simulated patient method to examine the pharmaceutical services provided by pharmacists in relation to childhood diarrhoea. The eight studies that satisfied the eligibility criteria were reviewed. These investigations were undertaken in Brazil, Nigeria, Turkey, Ethiopia and Pakistan. Five of the studies focused on history taking with regard to the characteristics of diarrhoea and revealed that the evaluated pharmacists asked about patient histories. In terms of therapy, three studies indicated that the evaluated pharmacists recommended the administration of oral rehydration salts. Pharmacies should improve their history-taking process, provide drug related information and recommend therapies to increase the knowledge of simulated patients about diarrhoea treatment in children.

Assessment of knowledge and practice of zinc sulphate supplementation in the treatment of diarrhoea among under-five children in Primary Health Care centres in Keffi, Nigeria

Zinc supplementation reduces the severity, duration and recurrence of diarrhoea in children. This study assessed the level of knowledge and practice of zinc supplementation in the management of diarrhoea in children in primary health care facilities in Keffi, Nigeria. Retrospective and qualitative studies were conducted in nine facilities. Validated data collection form and questionnaire were used to collect medications prescribed for diarrhoea in children less than five years old. Descriptive statistics was done, and associate variables were tested using Chi-square Tests. The study assessed 380 case files and 19 health care workers in nine facilities. The finding revealed that 21.1% and 10.5% of the prescribers were aware of and had formal training on the use of zinc in the management of diarrhoea respectively. Oral rehydration salt with zinc and antibiotics were prescribed in 10.5% and 57.9% cases respectively. Only 13.2%, 8.2% and 8.5% of children managed for diarrhoea had correct doses, frequencies and durations of zinc respectively. Only 44.4% facilities had zinc tablet in stock. The study revealed low knowledge and practice among primary health care workers about treatment guidelines on zinc supplementation in the management of diarrhoea in children less than five years.

AMBA CUP: Ensuring Accuracy in Measurement of Volume of Water for Salt Sugar Solution or Oral Rehydration Solution Preparation in Diarrhea Management.

Diarrhea remains a major cause of under-five mortality globally. In 2016, it accounted for 8% of under-five mortality worldwide. Most of these deaths occur in developing countries. Fluid replacement using Oral Rehydration Solution (ORS) or Salt Sugar Solution (SSS), has been the mainstay of diarrhea management. Gaps in knowledge and practice regarding the preparation of these solutions have been identified by various researchers. One challenge encountered by healthcare providers and caregivers of under-five children has been lack of a standard, easy to clean cup for measurement of accurate volume of water for ORS or SSS preparation. Soft drink bottles, which are currently being used, are difficult to clean because of their narrow necks. More so, the size and volume of these bottles change so often that non-numerate caregivers get easily confused. The aim of this paper is to introduce the AMBA CUP, an easy-to-clean cup that can be used to accurately measure one litre of water for SSS or ORS preparation.

Neratinib as Extended Adjuvant Treatment of HER2-Positive/HR-Positive Early Breast Cancer Patients in Germany, Austria, and Switzerland: Interim Results of the Prospective, Observational ELEANOR Study

Introduction: Prognosis of patients diagnosed with HER2+ early breast cancer (eBC) has substantially improved, but distant recurrences impacting quality of life and survival still occur. One treatment option for extended adjuvant treatment of patients with HER2+/HR+ eBC is neratinib, available in Europe for patients who completed adjuvant trastuzumab-based therapy within 1 year. The ELEANOR study is investigating the real-world use of neratinib in Germany, Austria, and Switzerland. Results from an interim analysis of the first 200 patients observed for ≥3 months are reported. Methods: The primary objective of this prospective, multicenter, observational study is to assess patient adherence to neratinib (defined as the percentage of patients taking neratinib on ≥75% prescribed days). Secondary objectives are patient characteristics and treatment outcomes. Results: At cut-off (May 2, 2022), a total of 202 patients had been observed for ≥3 months, with neratinib treatment documented for 187 patients (median age: 53.0 years; 67.9% at increased risk of disease recurrence). In total, 151 (80.7%) patients had received prior neoadjuvant treatment; of these, 82 (54.3%) patients achieved a pathologically complete response. Neratinib was initiated at a median 3.6 months after trastuzumab-based treatment, with 36.4% starting at a dose <240 mg/day. Treatment is ongoing for 46.0% of patients, with median treatment duration of 11.2 (interquartile range 0.9–12.0) months. Diarrhea was the most common adverse event (78.6% any grade, 20.3% grade ≥3); pharmacologic prophylaxis was used in 85.6% of patients. Conclusions: The pattern of anti-HER2 pretreatment observed reflected the current treatment for HER2+/HR+ eBC in Germany, Austria, and Switzerland. These interim results suggest that neratinib as an extended adjuvant is a feasible option after various anti-HER2 pretreatments and that its tolerability can be managed and improved with proactive diarrhea management.

M-Follow up for zinc adherence by caretakers of children with acute watery diarrhoea: A randomized controlled trial.

The standard of care for children with acute watery diarrhea (AWD) with no dehydration comprises oral rehydration solution, zinc, and feeding advice. Adherence to zinc therapy may be an issue in the management of acute watery diarrhoea. Mobile phones are used by over 90% of the population in Tanzania, thus good means to improve adherence to prescribed medication and/or attendance to follow-up visits. The objective of this study was to see whether m-follow-up improves adherence rate to zinc therapy, possible reasons for non-adherence, in children with diarrhea.: A randomized controlled trial was carried out in a suburban municipality in Dar-es-Salaam. Block randomization of participants was carried out with a block size of 4 and a 1:1 ratio of intervention: control. The intervention group comprised participants who were to be followed up using text messages and voice calls; the control group was to be followed up in outpatient. The outcome of interest was adherence to the full course of 10 days' oral zinc, reasons for nonadherence and acceptability. Chi-square was used to compare the categorical variables. δ, the targeted difference in adherence between arms, was pre-set at 20%. The total number of participants were 196, of which 98 participants were enrolled in each arm. Full adherence to the 10-day course of zinc sulphate in children with AWD and no dehydration was 84.1% in the control arm and 89.7% in the m-follow up group (P = 0.33). m-follow up significantly improved physical attendance at 14-day clinic visit compared to control group (39.8% vs. 60.2%; P = 0.006). Commonest reasons for non-adherence in both groups were related to vomiting (67%). Vomiting at enrolment due to gastroenteritis was significantly associated with vomiting zinc sulphate with RR 2.17 (95% CI 1.24-3.79, P = 0.007). The acceptability of m-follow-up was high (99%). In conclusion the idea of m-follow-up was well received by participants who considered it acceptable. In this study, the adherence to Zinc dosing was not significantly different between the intervention and control group, and we consider that for zinc in AWD, counselling alone was good enough to achieve high adherence. The trial was registered with the Pan-African Clinical Trial Registry. Trial number: PACTR201711002737120.

Unique Properties of Yeast Probiotic Saccharomyces boulardii CNCM I-745: A Narrative Review.

Probiotics, both bacterial and yeast, have long been associated with a beneficial health history and human well-being. Among yeasts, Saccharomyces is a genus that is efficacious in rendering better human health, with Saccharomyces boulardii (S. boulardii) CNCM I-745 being classified as a probiotic agent. The present review highlights the unique properties of S. boulardii and its rolein the prevention of antibiotic-associated diarrhea (AAD) and pediatric acute gastroenteritis (PAGE) in comparison to bacterial probiotics. Its unique properties,such as viability over a wide pH range, inability to acquire antibiotic resistance genes, and property to achieve a steady state rapidly, have given S. boulardii an edge over bacterial probiotics. In AAD patients, prophylactic use of S. boulardii has shown a significantly lower risk of AAD (in comparison to controls) and restored the diversity of gut microbiota. Among Indian children with PAGE, S. boulardii CNCM I-745 was found superior to Lactobacillus rhamnosus GG and four strains of Bacillus clausii in shortening the duration of diarrhea and reducing the length of hospital stay. S. boulardii CNCM I-745 being considered a safe probiotic for use in children and adults also finds recommendations in several international guidelines for the management of acute diarrhea. The current review discusses evidence for the proven efficacy and safety of S. boulardii CNCM I-745 as a probiotic for preventing gastrointestinal disorders.

Tingkat Pengetahuan Ibu dalam Penanganan Diare pada Anak Usia 1-5 Tahun

This study aims to assess mothers' knowledge level in the pediatric ward of Bandung Adventist Hospital regarding the management of diarrhea in children aged 1 to 5 years. The method used is quantitative descriptive. This study used a questionnaire assessing maternal awareness of childhood diarrhea. Fifty women randomly selected from the Bandung Adventist Hospital pediatric ward became the research sample. The research results showed that 20% of respondents were in the excellent group, while 80% were in the poor category. In conclusion, based on research findings, mothers' knowledge level in treating diarrhea in children aged 1 to 5 years in the children's room at Bandung Adventist Hospital is in the poor category, with 40 respondents. Efforts that can be made to increase mothers' knowledge are by educating parents about preventing and treating diarrhea in toddlers so that it can increase or improve mothers' knowledge.&#x0D; &#x0D; Keywords: Toddlers, Diarrhea, Knowledge