Treatment Of Diarrhea Research Articles

Nitazoxanide in Acute Rotavirus Diarrhea- A Randomized Controlled Trial Study in a Tertiary Care Hospital in Bangladesh

Background: Acute rotavirus diarrhea is one of the leading cause of morbidity and mortality in children younger than 5 years. Nitazoxanide, an antiparasitic agent, acts by inhibiting the maturation of rotavirus viral protein 7 thus interferes with viral morphogenesis. Aim of the study: was to evaluate the role of nitazoxanide in the treatment of acute rotavirus diarrhea in 6 months to 2 years aged children. Methods: This randomized controlled trial was conducted at Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh from June 2018 to July 2020. A total of 70 children with acute onset diarrhea of <48 hours. duration was included in this study. All the studied patients were divided into two equal groups (group I and group II) by lottery, each comprising 35 children. The groupI represented the study group who received standard treatment of diarrhea plus oral nitazoxanide (15mg/kg/day) twice daily for 3 days and the group II is the control group received standard treatment only. Results: Study demonstrated that maximum number of patients 22 (31.4%) were between 14-17 months of age group and 36% patients came from rural, 64% from urban areas. Study showed before commencement of treatment most of the patients in both groups experienced some dehydration, vomiting, fever, & abdominal distension. At 48 hours’ improvement was observed in both groups, comparatively higher in group I. Difference of some dehydration and vomiting improvement between two groups were statistically significant (p <0.05). After 3 days’ treatment normal stool consistency was found in 24(68.5%) patients in group I & 10 (28.5%) in group II patients. The difference was also statistically significant (p=<0.05). Mean time of resolution of diarrhea 62.5 hours in Group-I and 96.5 hours in group-II. Compared to the group II, group I showed decrease in mean time of resolution of diarrhea (p= 0.001). The mean duration of hospital stay was prolonged in group-II (86.5 hours vs. 102.5 hours in group I & II respectively), the difference was statistically significant (p˂0.05). Conclusion: In the present study, oral nitazoxanide was found effective in the treatment of acute rotavirus diarrhea in 6 months to 2 years old children.

Ethnomedicinal Value, Phytochemical Evaluation, and Pharmaco-Toxicological Profiling of Cipadessa Baccifera (Roth) Miq. among Communities of Bokod, Benguet

Cipadessa baccifera (Roth) Miq was studied for its traditional use, phytochemical properties, and pharmaco-toxicological properties. The descriptive qualitative method was used in this study to describe the traditional use of the medicinal plant, and the experimental quantitative method was used to determine the plant’s components and capabilities. Assays such as Thin Layer Chromatography (TLC), Chorioallantoic Membrane Assay (CAM), Brine Shrimp Assay, and Zebrafish Embryotoxicity Assay were done to profile the C. baccifera. Based on the results, traditionally, the plant parts were used as a treatment for diarrhea, toothache, cough, colds, indigestion, flu symptoms, dysmenorrhea, urinary tract infection, bleeding and swelling of gums, skin rashes, lowering blood sugar, dandruff, natural family planning, animal farm deworming and skin diseases. Its phytochemical contents include anthraquinones, anthrones, alkaloids, flavonoids, fatty acids, triterpenes, steroids, phenols, and essential oils. Furthermore, the CAM vascularity inhibition of Cipadessa baccifera concentrations increased with concentration, indicating that the inhibition of vascularity increased with concentration. Similarly, the brine shrimp cytotoxicity test revealed that the number of shrimp deaths increased as the concentration of plant extract increased. Furthermore, the plant extract’s calculated LC50 was 434ppm. Microscopic analysis of the zebrafish embryo exposed to the ethanolic extract of the plant sample, on the other hand, revealed malformation in the larvae exhibiting scoliosis at 100ppm extract concentration. Additionally, at plant extract concentrations ranging from 250ppm to 1000ppm, retarded and coagulated embryos were observed. Given the findings of the research study, it is highly recommended that future studies include the ecology and biology of C. baccifera in the Philippines to establish a further taxonomic classification of C. baccifera endemic to the country. Keywords: Pharmaco-toxicological properties, phytochemical analysis, CAM Assay, Embryotoxicity, Philippines

Analysis of nutrients in Apriona germari and treatment of diarrhea in mice fed with insect powder

The insect larvae of Apriona germari, Apriona swainsoni and other closely related species are related to the insects that bore through the stems of the Caesalpinia decapetala. Because of therich nutritional as well as medicinal value of edible A. germari, it is often used to nourish the body, enhance immunity, and to treat ailments such as diarrhea. The soluble protein content of A. germari was determined using Kjeldahl and Soxhlet extraction methods. The crude fat content and the content of various fatty acids was determined by the normalization method, normalization method refers to that after the fat in the sample is extracted by hydrolysis ether solution, it is saponified and methylated under alkaline conditions to generate fatty acids and methyl esters, which are analyzed by capillary column gas chromatography and quantitatively measured by area normalization method. Amino acid content determined using an amino acid analyzer after acid hydrolysis showed 17 kinds of amino acids. A diarrhea mouse model was established by injecting a suspension of Escherichia coli into the abdominal cavity of mice. The mice were then fed with A. germari fodders at dose concentrations of 12%, 8%, 4% and 0%. The number of E. coli was determined from the intestinal tracts of mice; the activities of antioxidant enzymes and digestive enzymes in the serum were determined. Eleven kinds of fatty acids were detected in A. germari; unsaturated fatty acids accounted for 71.87% of the total fatty acids. A. germari is an edible resource insect with high nutritional value. Mice fed with A. germari showed an increase in the activity of antioxidant enzymes and digestive enzymes in the serum, which helped in the effective inhibition and reduction in the total number of intestinal bacteria and E. coli. The results indicate that A. germari has high nutritional value; A. germari also has a certain therapeutic effect on diarrhea caused by E. coli in mice.

Effectiveness of the WHO Combination Treatment Regimen in the Management of Dehydration as a Panacea to Diarrhoea Prevention in Under-Five Children in Oyo State

This study assessed the effectiveness of WHO combination treatment regimen in diarrhoea prevention through dehydration management amongst under-five children attending primary health care centres in Oyo State, Nigeria. The study used a quasi-experimental design consisting of a pre- and post-test for a single group. Sixty people who met the inclusion criteria were selected at random throughout the admissions process. Children with diarrhoea between the ages of 3 months and 60 months who met the inclusion and exclusion criteria and were hospitalised at the designated PHC Centres were the study's participants. Recovery rates at 24 hours, 2 weeks, and 4 weeks post-intervention were used to evaluate the efficacy of the combined therapy regime using a standardised instrument of the WHO observational check-list. Descriptive and inferential statistics were used to analyse the data. The results of this study demonstrate that the median ages of the participants range from 13 to 24 months (21; 35.0%), 3 to 12 months (18; 30.0%), 25 to 36 months (12; 20.0%), and 36 to 60 months (9; 15.0%). There are a total of 32 men and 28 females in this sample (53.3% vs 46.7%). However, upon arrival (Baseline), 47 individuals (78.3%) were already somewhat dehydrated. However, within 24 hours post-intervention, the majority of subjects (46, or 76.6%) no longer showed any signs of dehydration. After two weeks of intensive monitoring during home visits, the situation had improved significantly, with the vast majority (52, or 86.7%) of participants displaying no signs of dehydration. After 4 weeks of home visits, all 60 participants (100%) were found to be well hydrated upon re-examination. Dehydration status improved significantly after 24 hours, 2 weeks, and 4 weeks post-intervention, suggesting the combination of WHO-ORS and zinc is extremely effective in the treatment of diarrhoea in children younger than five. Therefore, PHC health professionals should use a combination of therapies rather than relying on just one to treat dehydration.

A single dose of ciprofloxacin reduces the duration of diarrhea among service members deployed in Africa

ObjectivesTo assess the effectiveness of the adjunction of a one-gram single dose of ciprofloxacin to a symptomatic treatment for the early treatment of uncomplicated diarrhea during military operations of the French service members in Africa. Patients and methodsThis phase IV, multicentric, randomized, open-label, controlled trial was conducted in Chad, Mali, and in Central African Republic. A total of 267 French service members having at least one loose stool in the previous 24 hours were enrolled from May 2015 to June 2016. Participants were randomized to receive ciprofloxacin 1 g and a symptomatic treatment (racecadotril 100 mg three times a day and ad libidum oral rehydration solution) or a symptomatic treatment alone. The primary outcome was the duration of the diarrhea. Secondary outcomes were evaluated at the 72-hour endpoint and included recovery status, number of loose stools, frequency and duration of associated symptoms and safety of treatments. ResultsAmong 267 participants, 242 completed the trial. Participants receiving ciprofloxacin and a symptomatic treatment (n = 124) were significantly more likely to be cured at the endpoint than those who only received a symptomatic treatment (118): 94.4 % versus 74.6 % (OR = 5.7; 95 %CI: [2.4–13.6]; p < 10-3). The antibiotic therapy reduced the average diarrhea duration by 30 % (p = 10-4). Fever at inclusion was associated with a longer episode (HR = 0.61; 95 %CI: [0.41–0.89]; p = 0.012). No adverse event of medications was reported. ConclusionA single dose of ciprofloxacin was effective and safe in treating uncomplicated diarrhea among service members in Africa.

Promotion of intestinal epithelial cell apoptosis by enterotoxigenic Escherichia coli via PKA-mediated inhibition of mTORC1 activation

Enterotoxigenic Escherichia coli (ETEC) is the main causative pathogen of diarrhea. It causes acute watery diarrhea that leads to rapid dehydration and prostration within hours. ETEC is still an important cause of neonatal and post-weaning diarrhea in pigs. However, the mechanism underlying ETEC-induced diarrhea is not yet clear. In this study, we investigated these mechanisms and found that the mTORC1 pathway plays a role in the host response to ETEC F4 infection. Specifically, we found that ETEC F4 treatment significantly repressed mTORC1 activity as well as cell proliferation, promoted apoptosis and regulated the expression of diarrhea-related genes via the promotion of PKA-mediated phosphorylation of SIN1, which plays a critical role in the assembly of mTORC2. These findings indicate that PKA is a checkpoint for ETEC-induced diarrhea. In terms of potential therapeutic strategies, we found that ZnSO4 dramatically rescued ETEC F4-induced the inhibition of mTORC1 activity and cell viability and the induction of apoptosis and alterations in the expression of diarrhea-related genes. Thus, the present findings demonstrate that ETEC F4 influences mTORC1 activation by inhibiting the assembly of mTORC2 through PKA-mediated phosphorylation of SIN1. Further, supplementation with ZnSO4 is an effective strategy for blocking the effect of ETEC F4 on mTORC1 activation, and it may have potential clinical applications in the treatment of ETEC F4-induced diarrhea.

Ileus Presenting with Malnutrition Associated with Anti-diarrheal Drugs in Pediatric Patient: A Case Report

Ileus is described as a complication after the use of regular anti-diarrheal agents, such as loperamide. In children, loperamide is not recommended as a regular treatment for acute diarrhea. This case report aimed to elaborate on the cases of Ileus as a side effect of anti-diarrheal drug use in children and to signify parents' education role in cases of malnutrition. In this study, a-7-year old boy came with symptoms of increasingly severe abdominal pain, distended abdomen, and difficulty defecating in the last 3 days after consumption of anti-diarrheal drugs by his parents within 6 months. The patient has a poor history of food consumption. Clinical investigations revealed anemia, leukocytosis, underweight, short stature, and local ileus. He was diagnosed with Ileus and malnutrition and treated with fluid therapy, antibiotics, and blood transfusion and was consulted by a pediatric surgeon. In conclusion, the use of anti-diarrheal agents should be avoided in connection with their safety for children and the complications that can arise. Parental knowledge plays an important role in preventing malnutrition in children.

Poria cocos Polysaccharide Ameliorated Antibiotic-Associated Diarrhea in Mice via Regulating the Homeostasis of the Gut Microbiota and Intestinal Mucosal Barrier.

Poria cocos polysaccharides (PCP) have been validated for several biological activities, including antitumor, anti-inflammatory, antioxidant, immunomodulatory, hepatoprotective and modulation on gut microbiota. In this research, we aim to demonstrate the potential prebiotic effects and the therapeutic efficacies of PCP in the treatment of antibiotic-associated diarrhea (AAD), and confirm the beneficial effects of PCP on gut dysbiosis. Antibiotic-associated diarrhea mice models were established by treating them with broad-spectrum antibiotics in drinking water for seven days. Mice in two groups treated with probiotics and polysaccharide were given Bifico capsules (4.2 g/kg/d) and PCP (250 mg/kg/d) for seven days using intragastric gavage, respectively. To observe the regulatory effects of PCP on gut microbiota and intestinal mucosal barrier, we conducted the following experiments: intestinal flora analysis (16S rDNA sequencing), histology (H&E staining) and tight junction proteins (immunofluorescence staining). The levels of mRNA expression of receptors associated with inflammation and gut metabolism were assessed by real-time reverse transcription-polymerase chain reaction (RT-PCR). The study revealed that PCP can comprehensively improve the clinical symptoms of AAD mice, including fecal traits, mental state, hair quality, etc., similar to the effect of probiotics. Based on histology observation, PCP significantly improved the substantial structure of the intestine of AAD mice by increasing the expression levels of colonic tight junction protein zonula-occludens 1 (ZO-1) and its mRNA. Moreover, PCP not only increased the abundance of gut microbiota, but also increased the diversity of gut microbiota in AAD mice, including alpha diversity and beta diversity. Further analysis found that PCP can modulate seven characteristic species of intestinal flora in AAD mice, including Parabacteroides_distasonis, Akkermansia_muciniphila, Clostridium_saccharolyticum, Ruminoc-occus_gnavus, Lactobacillus_salivarius, Salmonella_enterica and Mucispirillum_schaedleri. Finally, enrichment analysis predicted that PCP may affect intestinal mucosal barrier function, host immune response and metabolic function by regulating the microbiota. RT-PCR experiments showed that PCP can participate in immunomodulatory and modulation on metabolic by regulating the mRNA expression of forkhead-box protein 3 (FOXP3) and G protein-coupled receptor 41 (GPR41). These results indicated that Poria cocos polysaccharide may ameliorate antibiotic-associated diarrhea in mice by regulating the homeostasis of the gut microbiota and intestinal mucosal barrier. In addition, polysaccharide-derived changes in intestinal microbiota were involved in the immunomodulatory activities and modulation of the metabolism.

Integrated untargeted and targeted metabolomics to reveal therapeutic effect and mechanism of Alpiniae oxyphyllae fructus on Alzheimer's disease in APP/PS1 mice.

Introduction: Alpiniae oxyphyllae Fructus (AOF) has been abundantly utilized for the treatment of diarrhea, dyspepsia, kidney asthenia, and abdominal pain in China. AOF is effective for treating AD in clinical trials, but its exact mode of action is yet unknown. Methods: In this study, metabolomics was combined to ascertain the alterations in plasma metabolism in APP/PS1 transgenic mice, the therapy of AOF on model mice, and the dynamic variations in 15 bile acids (BAs) concentration. Results: 31 differential biomarkers were finally identified in APP/PS1 group vs. the WT group. The levels of 16 metabolites like sphinganine (Sa), lyso PE (20:2), lysoPC (17:0), glycocholic acid (GCA), deoxycholicacid (DCA) were increased in APP/PS1 group, and those of 15 metabolites like phytosphingosine, cer (d18:0/14:0), and fumaric acid were reduced in APP/PS1 group. After AOF treatment, 29 of the 31 differential metabolites showed a tendency to be back-regulated, and 15 metabolites were significantly back-regulated, including sphinganine (Sa), lyso PE (20:2), glycocholic acid (GCA), deoxycholic acid (DCA). The relationship between BAs level and AD had been received increasing attention in recent years, and we also found notable differences between DCA and GCA in different groups. Therefore, a BAs-targeted metabonomic way was established to determine the level of 15 bile acids in different groups. The consequence demonstrated that primary BAs (CA, CDCA) declined in APP/PS1 model mice. After 3 months of AOF administration, CA and CDCA levels showed an upward trend. Conjugated primary bile acids (TCA, GCA, TCDCA, GCDCA), and secondary bile acids (DCA, LCA, GDCA, TDCA, TLCA GLCA) ascended in APP/PS1 group. After 3 months of AOF treatment, the levels of most BAs decreased to varying degrees. Notably, the metabolic performance of DCA and GCA in different groups was consistent with the predictions of untargeted metabolomics, validating the correctness of untargeted metabolomics. Discussion: According to metabolic pathways of regulated metabolites, it was prompted that AOF ameliorated the symptom of AD mice probably by regulating bile acids metabolism. This study offers a solid foundation for further research into the AOF mechanism for the therapy of AD.

The Roots of Neorautanenia mitis (A. Rich) Verdcourt: Further Evidence of Its Antidiarrhoeal Activity.

Despite the current management options and therapeutics used in the treatment of diarrhoea, in Africa and Asia, diarrhoea remains a major concern, especially in children under the age of 5 years. Traditional knowledge of medicinal plants used in the management of diarrhoea symptoms can be explored for their efficacy. In Nigeria, the TMPs (Traditional Medicine Practitioners) have, over the years, employed medicinal plants in the management of diarrhoea symptoms. In our current and previous studies, we aimed at validating the effectiveness of Neorautanenia mitis in the management of diarrhoea as claimed by the TMPs. Out of the 20 compounds isolated from N. mitis, the compounds neodulin, pachyrrhizine, neotenone and dolineone were the most abundant, and in this study, neodulin showed a pronounced relaxation of the rhythmic contraction of the isolated rabbit jejunum in an organ bath in a concentration-dependent manner, with a complete relaxation at 60 µg/mL. Neotenone and dolineone showed a dose-dependent inhibition of defecation of 65.07%, and 50.01%, respectively, at 20 mg/kg in a castor-oil-induced diarrhoea model. This is a strong indication that compounds from N. mitis possess antidiarrhoeal properties, thereby giving credence to its traditional usage in diarrhoea therapy, and therefore validating its antidiarrhoeal activity and its being worthy of further investigation.

Piperine as potential therapy of post-weaning porcine diarrheas: an in vitro study using a porcine duodenal enteroid model

Post-weaning diarrhea in piglets is a major problem, resulting in a significant loss in pig production. This study aimed to investigate the effects of piperine, an alkaloid abundantly found in black peppers, on biological activities related to the pathogenesis of post-weaning diarrhea using a porcine duodenal enteroid model, a newly established intestinal stem cell-derived in vitro model recapitulating physiology of porcine small intestinal epithelia. Porcine duodenal enteroid models were treated with disease-relevant pathological inducers with or without piperine (8 μg/mL and/or 20 μg/mL) before measurements of oxidative stress, mRNA, and protein expression of proinflammatory cytokines, nuclear factor-kappa B (NF-κB) nuclear translocation, barrier leakage, and fluid secretion. We found that piperine (20 μg/mL) inhibited H2O2-induced oxidative stress, TNF-α-induced mRNA, and protein expression of proinflammatory cytokines without affecting NF-κB nuclear translocation, and prevented TNF-α-induced barrier leakage in porcine duodenal enteroid monolayers. Importantly, piperine inhibited fluid secretion induced by both forskolin and heat-stable toxins (STa) in a three-dimensional model of porcine duodenal enteroids. Collectively, piperine possesses both anti-inflammatory and anti-secretory effects in porcine enteroid models. Further research and development of piperine may provide novel interventions for the treatment of post-weaning porcine diarrhea.

Atractylodin Ameliorates Colitis via PPARα Agonism.

Atractylodin is a major compound in the rhizome of Atractylodes lancea, an oriental herbal medicine used for the treatment of gastrointestinal diseases, including dyspepsia, nausea, and diarrhea. Recent studies have shown that atractylodin exerts anti-inflammatory effects in various inflammatory diseases. Herein, we investigated the anti-colitis effects of atractylodin and its molecular targets. We determined the non-cytotoxic concentration of atractylodin (50 μM) using a cell proliferation assay in colonic epithelial cells. We found that pretreatment with atractylodin significantly inhibits tumor necrosis factor-α-induced phosphorylation of nuclear factor-κ-light-chain-enhancer of activated B in HCT116 cells. Through docking simulation analysis, luciferase assays, and in vitro binding assays, we found that atractylodin has an affinity for peroxisome proliferator-activated receptor alpha (PPARα). Daily administration of atractylodin (40 mg/kg) increased the survival rate of mice in a dextran sodium sulfate-induced colitis mouse model. Thus, atractylodin can be a good strategy for colitis therapy through inducing PPARα-dependent pathways.

Research Progress of Traditional Chinese Medicine in Pediatric Diarrhea

Traditional Chinese medicine has a long history and definite efficacy in the treatment of pediatric diarrhea, there are also unique clinical experiences and treatments, this article reviews a large number of relevant literature to discuss the research progress of traditional Chinese medicine in the treatment of pediatric diarrhea for clinical reference, and is summarized.

Household Survey on Access to Medicines Used for the Treatment of Diarrhoea in Musoma Municipal Council, Tanzania

Background: Access to medicines is part of the human right to health. According to WHO, access to medicine is measured by how easily households obtain medicines for acute and chronic conditions including diarrhoea through household surveys. Diarrhoea is among the top ten leading causes of death. Anti-diarrhoea medicines save lives but, should be available and obtainable to do so. The objectives of this study were to determine anti-diarrhoea medicines used by households, their sources and factors affecting their accessibility in Musoma Municipal. Methods: A cross-section survey was conducted in Musoma Municipal Council, Mara, Tanzania. The lottery method of simple random sampling was used to select three wards and pick three streets from each ward. The study population was 255 household heads from households selected by systematic random sampling from each street. A structured questionnaire was used to obtain information from household heads. Results and Discussion: Males (51.8%) had more diarrhoea illnesses than females (48.2%). Distinctive household heads (52.6%) had primary education. The majority, (79.1%) of all diarrhoea patients were recommended/prescribed anti-diarrhoea medicines. Of those whom anti-diarrhoea medicines were prescribed/recommended, 63.5% adhered to the prescriber’s/dispenser’s instructions and obtained and used anti-diarrhoea medicines. The most frequent source of anti-diarrhoea medicines was ADDO (38%). Widely used anti-diarrhoea medicines were antimicrobials (77.5%) followed by ORS (17.5%). Reasons not to seek or obtain anti-diarrhoea medicines were; Patient started feeling better (56.3%), Alternative treatment (26%), Financial reasons (10%), Decided medicines weren’t needed (3.5%), Distance from source (2.2%), Reactions to medicine (1%). Utilization of primary health care services was only 21.5%. Under-fives were mostly prescribed with antimicrobials (62.5%) than ORS (31.2%) and Zinc (6.3%) in mild to moderate dehydration contrary to Standard treatment guidelines (STG) in Tanzania. Conclusion: Anti-diarrhoea medicines are moderately easily obtainable in Musoma Municipal (50% of all diarrhoea patients obtained medicines). Alternative treatment (26%) and financial reasons (10%) were vivid factors hindering access. Treatment of diarrhoea in under-five years old is not adhered to in Musoma Municipal (use of 62.5% of antimicrobials and only 31.2% of ORS in mild diarrhoea cases).

An insight into the health-promoting effects of foods to prevent Antibiotic- associated Diarrhoea: A Review

The random use of antibiotics leads to gastrointestinal diseases with complications ranging from mild diarrhea to Pseudomembranous colitis, which is called antibiotic-associated diarrhea. Outbreaks of antibiotic-associated diarrhea are generally found in 10% to 30% of patients taking antibiotics, depending on the particular antibiotic used, and are caused by Clostridium difficile in general and Klebsiella oxytoca, Staphylococcus aureus, Clostridium perfringens, etc. in particular. Functional disturbances of intestinal carbohydrates, harmful effects of antibiotics on the intestinal mucosa, and allergic effects are responsible for mild antibiotic-associated diarrhea. In COVID-19, caused by SARS-CoV-2, patients treated with a variety of antibiotics have been noticed to suffer from severe antibiotic-associated diarrhea. Probiotics have been shown to play a significant role in preventing antibiotic- associated diarrhea in both COVID-19 patients and general patients. Prebiotics and dietary approaches also play a vital role in combating antibiotic-associated diarrhea. Given the increased demand for food associated with the treatment of antibiotic-associated diarrhoea, the current review paper attempted to orchestrate the effect of probiotics such as yogurt, kefir, cheese, probiotic milk, and dietary foods such as ripe papaya, bananas, and other fermented foods in developing an immune system capable of effectively combating antibiotic-associated diarrhea.

Retracted: Traditional Chinese Medicine Moxibustion in the Treatment of Infantile Diarrhea.

[This retracts the article DOI: 10.1155/2022/9749606.].

Study on efficacy of probiotic use in pediatric acute diarrhea: A prospective open-labeled study

Background: More than three stools per day during a period of fewer than 14 days, along with loose stools, is considered acute diarrhea. Viral infections are the most frequent cause of pediatric diarrhea, and the most common form of treatment is the replacement of lost fluid and electrolyte balance. Probiotic supplementation in conventional therapy is likely to result in improved outcomes. Aim and Objective: To study the efficacy of Saccharomyces boulardii (a probiotic) as add-on treatment for pediatric acute diarrhea. Materials and Methods: This was an open-label prospective study. We have included a total of 40 children (n = 40) who met the inclusion criteria for admission and were randomly divided into two groups. One group (group 1: n = 20) received standard treatment, while group 2: n = 20 received probiotics in addition to standard treatment. Before administering the probiotic powder to the children, the parents were advised to add it to some water or milk. The duration of the diarrhea and the consistency of the stools were used as outcome indicators. Results: The duration of diarrhea in the probiotic-treated group was 3.8 days and 5.1 days in the standard therapy group. The first semi-liquid stools typically appear after 3.3–1.6 days in the standard therapy group and 2.0–0.56 days in the probiotic treatment group. The outcomes were statistically significant. Conclusion: S. boulardii, a probiotic, is beneficial in shortening the length of diarrhea and the time it takes for the first semi-liquid stools to develop by 1 day.

Online Microextraction Coupled with HPLC-ABTS for Rapid Analysis of Antioxidants from the Root of Polygonum bistorta.

The root of Polygonum bistorta (PB) is a traditional Chinese medicinal plant material widely used in China. It has been commonly used for the treatment of hemostasis, detumescence, diarrhea, snake bite, and acute gastroenteritis. However, the research on the antioxidant properties and bioactive compounds from PB is inadequate. In the current research, an online microextraction (OLME) coupled with a high-performance liquid chromatography coupled with the 2,2-nitrogen-di (3-ethyl-benzothiazole-6-sulfonic acid) diammonium salt antioxidant assay (HPLC-ABTS) system for rapid analysis of antioxidants from PB was proposed. The PB sample (0.17 mg) was online extracted by mobile phase (acetonitrile and 0.2% acetic acid); a Poroshell 120 SB-Aq column was used for separation; then, an online ABTS assay system was used for screening the antioxidants. Finally, ten components were found in PB, and among them, eight components possessed antioxidant activities. Furthermore, five components (gallic acid, neochlorogenic acid, caffeic acid, chlorogenic acid, and an unknown compound) were proved as major antioxidants when compared with rutin as an antioxidant marker. The results showed that the developed OLME-HPLC-ABTS system was a simple, rapid, green, and efficient instrument for the screening of antioxidants from PB, which provides a powerful tool for the discovery of natural antioxidants in Chinese medicines.

Medicinal plants used against poultry diseases in Zimbabwe: A systematic review

The current study was aimed at documenting ethnoveterinary medicines (EVMs) used against poultry diseases in Zimbabwe and local ecological knowledge (LEK) associated with the docu¬mented plant species. Information related to EVMs used against poultry diseases in Zimbabwe was systematically collected using relevant keywords from online databases such as BioMed Central, Web of Science, SpringerLink, Google Scholar, Scielo, PubMed, Science Direct, ACS Publications, Scopus and JSTOR, books, dissertations, theses, and scientific reports. This study showed that 69 species are traditionally used to manage poultry diseases in Zimbabwe. Most of the plant species (79.01%) that are used in poultry treatment and management are wild and 29.0% are exotic, cultivated, or naturalized. These species are used against 22 medical conditions, mainly in the treatment and management of coccidiosis, Newcastle, cough, diarrhea, wounds, and ectopar¬asites. Adenia gummifera, Aloe arborescens, Aloe chabaudii, Aloe greatheadii, Actaea spicata, Bobgunnia madagascariensis, Capsicum annuum, Capsicum frutescens, Cynanchum viminale, and Erythrina abyssinica have the highest number of EVM uses. This review highlights the importance of EVMs for the healthcare of poultry in Zimbabwe. Therefore, detailed ethnopharmacological evaluations of the species focusing on their phytochemistry, pharmacological properties, toxico¬logical evaluations, in vivo and clinical research investigations are recommended.

Antimicrobial Prescription Habits among Community Pharmacists and Patent and Proprietary Medicine Vendors in Nigeria: A Rational Use of Drugs Survey

Introduction Antimicrobial Resistance (AMR) poses a global health threat, exacerbated by the misuse and overuse of antimicrobials. The need to investigate knowledge, attitudes, and practices among Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs) in Nigeria cannot be overemphasized. This study addresses the gaps in understanding antimicrobial dispensing practices among CPs and PPMVs in Nigeria. Materials/Methods A Community-based Antimicrobial Stewardship survey was conducted across five Nigerian states. A total of 384 PPMVs and 135 CPs were interviewed using a well-structured questionnaire covering demographic information, knowledge, attitudes, and practices related to antimicrobial use. The survey utilized descriptive statistics, and the data were analyzed to identify strengths, weaknesses, threats, and opportunities in addressing AMR. Results The study revealed inadequate knowledge regarding AMR among both PPMVs and CPs. Despite educational backgrounds, a significant proportion believed antibiotics were the best treatment for fever and diarrhea. Dispensing practices included selling antibiotics without prescriptions and, in some cases, dispensing medicines by proxy. The Safety Net Protocol, involving patient education and follow-up, was often neglected by both PPMVs and CPs. Conclusion The findings underscore the importance of enhancing knowledge, attitudes, and practices related to antimicrobial prescription among PPMVs and CPs in Nigeria. Regulatory authorities should enforce strict guidelines to curb non-prescription antibiotic sales. Patient education and follow-up initiatives should be prioritized to mitigate AMR risks. In order to develop strategies to improve antimicrobial dispensing practices we recommend the following: AMR education for PPMVs and CPs, Enforce rules to prevent antibiotic sales without prescriptions through regulatory compliance, public awareness on antibiotic risks and prescription importance, implement Safety Net Protocol for post-purchase education to prevent antibiotic misuse and provision of ongoing professional development for PPMVs and CPs with updated practices that will sustain learning.