Recurrent Episodes Of Diarrhea Research Articles

Incidence of Cryptosporidium: A Neglected Parasite in Immunocompetent Adults in Swabi

Objective: To highlight the increasing incidence of Cryptosporidium in immunocompetent adults and the resultant altered epidemiology. Methodology: This study was conducted over a period of one year, from 1st January 2023 to 1st of January, 2024 at Microbiology Laboratory MTI- GKMC/BKMC, Swabi. Modified Ziehl Neelsen staining was performed on the received stool samples from patients presenting with wide range of symptoms associated with Irritable Bowel Syndrome (IBS). Abdominal pain, recurrent episodes of diarrhea and weight loss were the main symptoms. Modified ZN stain being one of the most reliable, quick and cost effective methods for the detection of cysts of Cryptosporidium using 40X and oil immersion lens was used for diagnosis. Results: A total of 62 samples were received from immunocompetent patients in the said period out of which 34% were positive for the oocysts of Cryptosporidium species. Out of a total of 21 positive samples 62% were males and 38% were females. The age range of the patients spanned between 20 to 60 years. Conclusion: Knowing this high incidence 34% of Cryptosporidium spp. in the healthy adults, necessitates to prioritize steps for the prevention of this infection by implementation of public health measures.

Single-cell and microarray chip analysis revealed the underlying pathogenesis of ulcerative colitis and validated model genes in diagnosis and drug response

The morbidity rate of ulcerative colitis (UC) in the world is increasing year by year, recurrent episodes of diarrhea, mucopurulent and bloody stools, and abdominal pain are the main symptoms, reducing the quality of life of the patient and affecting the productivity of the society. In this study, we sought to develop robust diagnostic biomarkers for UC, to uncover potential targets for anti-TNF-ɑ drugs, and to investigate their associated pathway mechanisms. We collected single-cell expression profile data from 9 UC or healthy samples and performed cell annotation and cell communication analysis. Revealing the possible pathogenesis of ulcerative colitis by Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA) analysis. Based on the disease-related modules obtained from weighted correlation network analysis (WGCNA) analysis, we used Lasso regression analysis and random forest algorithm to identify the genes with the greatest impact on disease (EPB41L3, HSD17B3, NDRG1, PDIA5, TRPV3) and further validated the diagnostic value of the model genes by various means. To further explore the relationship and mechanism between model genes and drug sensitivity, we collected gene expression profiles of 185 UC patients before receiving anti-tumor necrosis factor drugs, and we performed functional analysis based on the results of differential analysis between NR tissues and R tissues, and used single-sample GSEA (ssGSEA) and CIBERSORT algorithms to explore the important role of immune microenvironment on drug sensitivity. The results suggest that our model is not only helpful in aiding diagnosis, but also has implications for predicting drug efficacy; in addition, model genes may influence drug sensitivity by affecting immune cells. We suggest that this study has developed a diagnostic model with higher specificity and sensitivity, and also provides suggestions for clinical administration and drug efficacy prediction.

Evaluation of the Fecal Proteome in Healthy and Diseased Cheetahs (Acinonyx jubatus) Suffering from Gastrointestinal Disorders.

Simple SummaryThe cheetah (genus Acinonyx), which is considered vulnerable by the IUCN Red List, suffers quite frequently from chronic gastrointestinal (GI) diseases, often associated with Helicobacter spp., with a significant mortality, especially in captive animals. The study of the fecal proteome aims to investigate possible new markers of disease that could be useful in diagnosing and/or monitoring, when performed in feces, gastrointestinal disorders. Considering the invasiveness of some diagnostic investigations (e.g., GI endoscopy) in general and the difficulties of carrying out even simple blood sampling in animals such as the cheetah, the possibility of deriving clinical-diagnostic information from fecal samples is extremely interesting. Herein, a fecal proteomic evaluation from healthy and diseased cheetahs suffering from GI disorders is performed.Fecal proteomics allows for the identification of proteins and peptides present in stools and is useful in finding possible new biomarkers for diagnosing and/or monitoring gastrointestinal (GI) disorders. In the present study, we investigated the fecal proteome in healthy and diseased cheetahs (Acinonyx jubatus). Captive individuals of this species frequently show gastrointestinal disorders characterized by recurrent episodes of diarrhea, rare episodes of vomiting and weight loss, associated with Helicobacter spp. infection. Fecal proteomic evaluation has been performed by two-dimensional electrophoresis followed by liquid chromatography-tandem mass spectrometry. In healthy cheetahs, the results showed the presence of the following proteins: collagen alpha-1 (II) chain, transthyretin, IgG Fc-binding protein, titin, dystonin, isopentenyl-diphosphate Delta-isomerase 1, sodium/potassium-transporting ATPase subunit alpha-1 and protein disulfide-isomerase A6. The presence of albumin isoforms was found only in diseased cheetahs. The present paper reports the study of the fecal proteome in the cheetah, evidences some differences between healthy and diseased patients and confirms, once again, the potential of fecal proteomics for the study of the GI environment, with promising developments regarding the identification of new diagnostic/monitoring markers.

Diarrhoea prevalence, characteristics and outcome among children admitted into the emergency ward of a tertiary hospital in Southern Nigeria

Diarrhoea is a leading cause of morbidity and mortality in children, particularly in developing nations. The majority of cases can be successfully managed at home, but a few cases may necessitate admission to the emergency ward. The purpose of this research is to determine the prevalence, characteristics, outcome, and associated factors among those admitted. After obtaining consent, all children who presented with diarrhoea within a year were recruited for the study. A semi-structured interviewer-administered questionnaire was used to collect biodata, diarrhoea treatment, and outcome information from caregivers. The Statistical Package for Social Sciences (SPSS) version 21 was used to analyze the data. A total of 164 of the 5,087 children seen were admitted for diarrhoea, resulting in a 3.2% prevalence. A higher proportion of the participants were males, aged 0-24 months, and were not exclusively breastfed. A third of the participants had diarrhoea in the previous year, with a higher proportion having 1-2 episodes. The case fatality rate was 2.4%. The prevalence of diarrhoeal admissions is low, as is the case fatality rate. Stool frequency, hydration status, and socioeconomic class were all significant predictors of fatal diarrhoea outcomes. Recurrent episodes of diarrhoea were significantly associated with maternal education and attendance at day care centers.

Exploring the Fundamental Risk Factors of Child Malnutrition: An Application of Proportional Odds Model (POM)

Background: This study was designed with the objective to evaluate the fundamental risk factors of malnutrition among children in Lahore city and its outskirts, Pakistan. Methods: Data of four hundred and five children with age group less than 5 years was collected from Children hospital and Jinnah hospital, Lahore. We used weight-for-height anthropometric index, designed by World Health Organization (WHO), to measure the nutritional status of children. Preliminary analysis was performed by using Pearson Chi-square and Gamma statistics to check the association between factors (demographic, socio-economic and health related variables) and response variable i.e., nutritional status. Then, proportional odds model (POM) was fitted to the information collected. Results: Of 405 children included in the study, 33% (135) were found malnourished, whereas, approximately 67% (270) were found nourished. Findings of the study revealed that child’s age, maternal education level, socio-economic status, maternal age at the birth of child, low birth spacing, status of antenatal-postnatal care, incomplete vaccinations, exclusive breastfeeding, prevalence of fever, cough and recurrent episodes of diarrhea were the significant risk factors of malnutrition. Prevalence of acute respiratory infection (ARI) was turned out to be insignificant risk factor. In this study, parallel lines assumption was satisfied and proportional odds model was fitted well with p-value greater than 5% level of significance. Conclusion: This paper highlights the significant risk factors that are affecting the child’s health. Recognizing and understanding the identified risk factors would be very helpful in prevention of malnutrition in Pakistan.

Is BCL11B a potential candidate gene for the diffuse cutaneous mastocytosis: A case report

Objective: Mastocytosis is a heterogeneous clinical phenotype spectrum characterized by the accumulation of mast cells in various organs. Cutaneous mastocytosis is the skin bounded form of this spectrum. Diffuse Cutaneous Mastocytosis (DCM) is a rare type of cutaneous mastocytosis that accounts for only 1 to 5% of all cases. The aim of this study is to report the molecular characterization of a Turkish patient with DCM with a large duplication on the long arm of chromosome 14, including the BCL11B (CTIP2) gene. Case: A 32-months-old girl was referred to our department because of DCM and stuttering. In our patient who was born at 38 weeks of gestation after an uneventful pregnancy, in the neonatal period; recurrent episodes of diarrhea and atopic dermatitis began and DCM was diagnosed due to diffuse bullous lesions on the skin at the age of 4 months. Although growth and motor development were normal, there was language delay. Routine karyotype analysis of the case was normal (46,XX). In the microarray-CGH analysis, de novo 7.7 megabase (Mb) duplication containing 15 morbid OMIM genes including BCL11B gene at 14q32.2-q32.33 locus was detected. Conclusions: BCL11B, which is highly expressed during the development of T lymphocytes, is a transcriptional regulatory protein. It has been shown immunohistochemically that BCL11B is also expressed in the normal human epidermis. We suggest that the BCL11B gene may be a potential candidate gene for diffuse cutaneous mastocytosis. Other cases with such clinical signs should be examined for mutations of the BCL11B gene.

An Unusual Cause of Chronic Diarrhea

Question: A male patient presented with recurrent episodes of diarrhea that developed after a Caribbean cruise 1 year ago. He also complained of severe epigastric pain, arthralgias, myalgias, significant weight loss, and ocular symptoms, which were diagnosed as iritis. He had undergone an extensive workup at an outside hospital including a colonoscopy, which showed colonic mucosal congestion, loss of vascular architecture, and diverticulosis. Biopsies were interpreted as mild active chronic colitis and the possibility of inflammatory bowel disease was raised.

Heterotopic gastric mucosa in jejunum: A rare case report.

Heterotopic gastric mucosa (HGM) has been described as an incidental finding in various parts of gastrointestinal tract. HGM of the small bowel is a congenital disorder with variable manifestations like bleeding, obstruction or perforation, penetration into adjacent organs, and fistulization. We present a case of a 55 year old female being evaluated for anemia associated with recurrent episodes of diarrhoea and dyspepsia. The cause was found to be HGM in thejejunum.

A 10-year-old boy presented with recurrent episodes of diarrhea, low grade, irregular fever and severe wasting

This article has no abstract. The first 100 words appear below: A 10-year old boy, the only issue of his deceased parents, was admitted to the department for the management of recurrent episodes of diarrhea and severe wasting for 2.5 months, low grade, irregular fever with evening rise of temperature, anorexia and repeated attack of skin blister for the last 1 year. The patient complained of chronic, painless, non-bloody, profuse watery diarrhea with a weight loss of 10 kg (decrease to 18 kg from 28 kg prior to illness). He also complained of cough for the last seven days. His father was a driver and died at his 1 year of age due to an unknown disease.

Nonspecific Symptoms in Celiac Disease- Case Report

Celiac disease is an immune-mediated systemic disorder with a genetic predisposition. The availability of more specific serology tests showed that celiac disease is more common than previously suspected and that many patients do not demonstrate specific clinical or even histological sings. We present a case of celiac disease with the unset at 5 years, with recurrent episodes of diarrhea, weight loss and anemia. The serology tests showed a high level of IgA tissue transglutaminase antibodies, exceeding 10 times the upper limit but the intestinal biopsy showed normal size villi, intact surface epithelium and a lymphoplasmacytic infiltrate at chorionic level (Marsh 1). The diagnosis of celiac disease was confirmed by resolution of symptoms and normal tissue transglutaminase antibodies level, six month after starting the gluten free diet.

Letter to the Editor Adrenal function and MC1R gene analysis in a prepubertal girl with generalized hyperpigmentation:

Letter to the Editor Adrenal function and MC1R gene analysis in a prepubertal girl with generalized hyperpigmentation:

Efficacy of an enterovaccine in recurrent episodes of diarrhea in the dog: a pilot study

Recurrent episodes of self-limiting diarrhea in the dog, due to sudden dietary changes and to stressful or exciting situations, are conditions sometimes difficult to treat. Colifagina(®), a commercially available bacterial enterovaccine, showed, in previous studies performed on experimentally induced colitis in mice, to be able to improve both disease activity index and histological appearance, increase colonic secretion of IgA, and reduce inflammatory chemokine secretion. In the present study Colifagina(®) was administered to five dogs presenting recurrent episodes of self-limiting diarrhea and to one dog presenting chronic diarrhea. During the follow-up period, almost all patients decreased the number of episodes of abnormal defecation and the fecal score of such episodes improved in five out of six dogs. Even if further studies are needed to understand the exact potential of the compound, in dogs presenting recurrent episodes of self-limiting diarrhea due to sudden dietary changes and/or stressing or exciting situations, Colifagina(®) seems to be helpful in managing most of these patients.

The Challenge of HIV-1 Genetic Diversity: Discordant CD4+ T-Cell Count and Viral Load in an Untreated Patient Infected With a Subtype F Strain

The Challenge of HIV-1 Genetic Diversity: Discordant CD4+ T-Cell Count and Viral Load in an Untreated Patient Infected With a Subtype F Strain

Chronic norovirus infection in renal transplant recipients

Norovirus infection is the most common cause of acute gastroenteritis. In immunocompetent subjects, norovirus infection is a self-limiting disease of short duration. The present report provides first evidence that norovirus can cause chronic infection in renal transplant recipients. Two patients showed persisting norovirus excretion for >7 months and 3 months, respectively. The first patient was asymptomatic after an acute episode of gastroenteritis and eliminated the virus spontaneously. The second patient developed severe symptomatic chronic infection with diffuse abdominal discomfort, fever, transient transplant dysfunction, recurrent episodes of diarrhoea, weight loss and histological signs of chronic intestinal inflammation. Norovirus elimination and relief of symptoms occurred only after reduction of immunosuppression. Thus, norovirus can evoke asymptomatic and symptomatic chronic infection in renal transplant recipients. Norovirus should therefore be considered in the differential diagnosis of both acute and chronic diarrhoea after transplantation. Reduction of immunosuppression may be indicated to allow virus elimination in symptomatic cases.

Identificação do vírus da Diarréia Viral Bovina tipo 2 (BVDV-2) no sul do Brasil

Amostras do vírus da Diarréia Viral Bovina (BVDV), denominadas de BVDV tipo 2 (BVDV-2), foram inicialmente identificadas em surtos de BVD aguda e enfermidade hemorrágica e têm sido isoladas predominantemente na América do Norte. O presente artigo descreve dois casos de enfermidade gastroentérica/respiratória seguidos de isolamento e identificação de amostras de BVDV tipo 2 no sul do Brasil. Os vírus foram isolados de duas novilhas de diferentes rebanhos. Um dos animais apresentou enfermidade aguda, cursando com anorexia, atonia ruminal, diarréia escura ou muco-sanguinolenta, tenesmo e descarga nasal muco-purulenta. O outro animal desenvolveu enfermidade de longa duração (7 meses), caracterizada por crescimento retardado, anorexia, quadros recorrentes de diarréia, dermatite interdigital, hemorragias digestivas e genitais ocasionais, conjuntivite, artrite e pneumonia crônica. Congestão disseminada das mucosas, ulcerações extensivas e profundas na língua, palato e esôfago, áreas necróticas na mucosa do rúmen, áreas de congestão e ulcerações cobertas com fibrina no intestino delgado foram os achados mais proeminentes. Antígenos do BVDV foram demonstrados por imunohistoquí-mica no epitélio da língua, nos pulmões e em linfonodos mesentéricos. Amostras não-citopáticas do BVDV foram isoladas em cultivo celular a partir de leucócitos e do baço dos animais afetados e identificadas por imunofluorescência. Caracterização antigênica e análise filogenética desses isolados, e de outras duas amostras de BVDV isoladas de fetos coletados em matadouros, revelou tratar-se de BVDV tipo 2. A presença do BVDV tipo 2 na população bovina do Brasil possui um significado epidemiológico importante e pode ter conseqüências para o diagnóstico, estratégias de imunização e produção de vacinas.

Outcome of cases of persistent diarrhea after discharge.

After recovery from persistent diarrhea, some children have recurrent episodes of diarrhea and associated problems. We undertook this study to identify the risk factors responsible for this relapse. All patients reporting at 1 month follow up since discharge, with > 7 diarrheal days, or inadequate weight gain compared to the weight at discharge, constituted the failure group. All others constituted the non-failure group. Various risk factors were studied in 21 cases (failure group), and 42 controls (non-failure group). Univariate analysis revealed a significant association of hospital stay < 5 days (OR 10.6; 95% CI 3.13-36), working mothers (OR 8.5; 95% CI 2.5-27), poor socioeconomic status (OR 4.5; 95% CI 1.4-14) and presence of younger sibling (OR 3.69, 95% CI 1.1-12.6) with failed outcome. On logistic regression analysis, only hospital stay < 5 days (OR 11.7; 95% CI 1.02-134.68) and female children (OR 17.65; 95% CI 1.26-246) remained significant. We therefore conclude, that a short hospital stay, limited optimal contact and limited health education adversely affects the outcome. Pediatricians should be more cautious while managing female children.

A food‐based systems approach to improve the nutritional status of Australian aborigines: A focus on zinc

Several studies have identified impaired zinc status in remote Australian Aboriginal communities, which contributes to poor growth, low immunity and recurrent episodes of diarrhoea in children. Indigenous foods were identified for inclusion into a community or household garden which would include fruit and vegetables and lead to their availability, affordability, freshness and quality. Suitable indigenous foods which provide zinc include Brachychiton para‐doxum (zinc 7.9 mg/100g), Sterculia quadrifida (zinc 6.5 mg/100 g), Portulaca oleracealintraterranea (zinc 6.5 mg/100 g), and Acacia coriacea (zinc 5.8 mg/ 100 g). A brief review of the literature on zinc bioavailability is presented and an attempt is made to estimate and improve the bioavailability of zinc from these indigenous foods. This includes food processing techniques which reduce the content of zinc inhibitors, mainly phytate, and the consumption of zinc absorption facilitators with meals. Concomitantly, adequate health and hygiene is suggested in order to minimise the infection‐malnutrition cycle that can result from a reduced zinc status and recurrent episodes of infection. An education program, which includes nutrition, gardening and cooking skills, could form the basis of a sustainable approach to combating impaired zinc status in this population.

Persistent diarrhea associated with AIDS.

Chronic diarrhea and wasting are very common manifestations of AIDS in adults in developing countries. Etiologic studies show that protozoa (including Cryptosporidium parvum, Isospora belli, and Enterocytozoon bieniusi) and Mycobacterium avium-intracellulara are the most frequently identified pathogens. Limited data in children suggest that common enteric pathogens are equally as likely in HIV+ and HIV- babies. Preliminary analysis of an ongoing longitudinal study of 469 babies born to mothers with known HIV serostatus in Kinshasa, Zaire, reveals progression of acute to persistent diarrhea is six times greater in HIV+ compared to HIV- babies, and 3.5 times greater in HIV- babies born of HIV+ mothers in comparison to HIV- babies with HIV- mothers. HIV+ babies were also at greater risk than HIV- babies to have recurrent episodes of diarrhea (RR = 2.3). Fifty percent of the deaths were due to acute or persistent diarrhea, and were strongly associated with HIV infection. Efforts to improve child survival in AIDS infected populations will need to address HIV infections in both mothers and infants.

Overview of the worldwide problem of diarrhoea.

Acute infectious diarrhoea is the major killer of children in the Third World. It is also the principal cause of malnutrition in children under 5 years of age. More than 4 million children die each year of diarrhoea and its complications. Acute diarrhoea kills by causing dehydration, which leads to hypovolaemia and metabolic acidosis. Recurrent episodes of diarrhoea lead to malnutrition as the result of anorexia, catabolism from infection, and lack of adequate caloric and protein intake because of the widespread custom of 'starving' diarrhoea. Oral rehydration therapy (ORT) is effective in the prevention and treatment of dehydration caused by diarrhoea. Because it is cheap, easy to administer and very effective, ORT has the potential to allow substantial reductions in the morbidity and mortality of acute diarrhoea in children living in less developed countries. The major obstacles to achieving its potential are the social ones of production and distribution of oral rehydration solutions and of educating parents in how to use ORT.

Surgical experience with corticotropin in ulcerative colitis.

PREVIOUS reports of perforations of the upper gastrointestinal tract in patients undergoing therapy with corticotropin (ACTH) and cortisone have been well noted. 1 A more recent report 2 of three cases of large bowel perforation occurring in ulcerative colitis patients under treatment with corticotropin is interesting. In regard to this last report, we feel the following case presentation is warranted from a surgeon's operative point of view. REPORT OF A CASE A 42-year-old drug salesman was admitted to the hospital Nov. 5, 1951, complaining of marked diarrhea. His symptoms dated back to 1935, and in 1946 a definite diagnosis of chronic ulcerative colitis had been made. Since that time the free periods between his recurrent episodes of diarrhea had gradually grown shorter. These attacks were severer, with an increase in pain and in the passage of blood and mucus. He had lost 15 lb. (6.8 kg.) in the four months