Pengaruh Suplementasi Seng Dan Probiotik Pasca Perawatan Diare Akut Cair Anak Terhadap Kejadian Diare Berulang

Background. Diarrhea remains a major health problem among children under five years old in developing countries due to its high morbidity. Prevention of diarrhea is needed to reduce the high incidence. Zinc has a function to shorten duration of diarrhea and the use of probiotics preventing and treat acute diarrhea. Objective. To prove effect of zinc and probiotic suplementation on the incidence of recurrent acute watery diarrhea in children aged 6-24 months post-hospitalization. Method. Seventy five subjects aged 6-24 months with acute diarrhea in Dr. Kariadi Hospital, the subject of study I, was observed. The subjects were randomly divided into four groups and received treatment in the form of zinc supplementation, supplementation with probiotics, or a combination of zinc and probiotics and one group as control. Each group received the standard form of rehydration therapy and dietetic. Survival analysis was used to analyze the incidence of recurrent diarrhea and Kruskal wallis was used to analyze the difference of frequency and duration of recurrent diarrhea between four groups. Result. The group who received zinc in conjunction with probiotics had mean recurrent of diarrhea longer than the other three groups (10.94 weeks 95% CI 9.24 - 12.65). There was no statistically significant difference in the mean survival of diarrhea in the four groups (p = 0.892). No significant differences in frequency and duration of recurrent diarrhea in four groups at first, second and third month postsupplementation. Conclussion. There were no significant differences between groups of zinc, probiotics and a combination of zinc and probiotics on the average recurrent diarrhea, duration and frequency of diarrhea. Keyword : acute watery diarrhea, recurrent diarrhea, zinc, probiotic

Self-partitioning SlipChip for slip-induced droplet formation and human papillomavirus viral load quantification with digital LAMP

Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide, and persistent HPV infection can cause warts and even cancer. Nucleic acid analysis of HPV viral DNA can be very informative for the diagnosis and monitoring of HPV. Digital nucleic acid analysis, such as digital PCR and digital isothermal amplification, can provide sensitive detection and precise quantification of target nucleic acids, and its utility has been demonstrated in many biological research and medical diagnostic applications. A variety of methods have been developed for the generation of a large number of individual reaction partitions, a key requirement for digital nucleic acid analysis. However, an easily assembled and operated device for robust droplet formation without preprocessing devices, auxiliary instrumentation or control systems is still highly desired. In this paper, we present a self-partitioning SlipChip (sp-SlipChip) microfluidic device for the slip-induced generation of droplets to perform digital loop-mediated isothermal amplification (LAMP) for the detection and quantification of HPV DNA. In contrast to traditional SlipChip methods, which require the precise alignment of microfeatures, this sp-SlipChip utilized a design of “chain-of-pearls” continuous microfluidic channel that is independent of the overlapping of microfeatures on different plates to establish the fluidic path for reagent loading. Initiated by a simple slipping step, the aqueous solution can robustly self-partition into individual droplets by capillary pressure-driven flow. This advantage makes the sp-SlipChip very appealing for the point-of-care quantitative analysis of viral load. As a proof of concept, we performed digital LAMP on an sp-SlipChip to quantify human papillomaviruses (HPVs) 16 and 18 and tested this method with fifteen anonymous clinical samples

Zinc supplementation as an adjunct to antibiotics in the treatment of pneumonia in children 2 to 59 months of age

Background:Diarrhoeal disorders and acute respiratory infections (ARIs), especially pneumonia, are the most common causes of death in low-income countries. Studies evaluating the impact of zinc supplementation as an adjunct in the management of pneumonia are limited and have shown variable results.Objectives: To evaluate zinc supplementation, as an adjunct to antibiotics, in the treatment (clinical recovery) of pneumonia in children aged two to 59 months.Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), which contains the Cochrane Acute Respiratory Infections (ARI) Group\u27s and the Cochrane Infectious Diseases Group\u27s Specialised Registers, MEDLINE (1950 to March week 2, 2011), EMBASE (1974 to March 2011), CINAHL (1981 to March 2011), LILACS (1985 to March 2011), AMED (1985 to March 2011), CAB Abstracts (1910 to March 2011) and Web of Science (2000 to March 2011).Selection criteria: Randomised control trials (RCTs) evaluating supplementation of zinc as an adjunct to antibiotics for pneumonia in children aged two to 59 months.Data collection and analysis: Two review authors independently assessed trial eligibility and screened all available titles and abstracts for inclusion. If the relevance could not be ascertained by screening the title and abstract, we retrieved and reviewed the full text of the article.Main results: We included four trials in which 3267 children aged two to 35 months participated. Analysis showed that zinc supplementation in addition to standard antibiotic therapy in children with severe and non-severe pneumonia failed to show a statistically significant effect on clinical recovery (risk ratio (RR) 1.02, 95% confidence interval (CI) 0.93 to 1.11). Similary, zinc supplementation in children with severe pneumonia, as an adjunct to standard antibiotic therapy, did not show a statistically significant effect on clinical recovery measured as resolution of tachypnoea (respiratory rate \u3e 50 breaths per minute) (RR 1.13, 95% CI 0.82 to 1.57) and cessation of chest indrawing (RR 1.08, 95% CI 0.88 to 1.31) as compared to the control group. Zinc supplementation in children with severe pneumonia also showed a non-significant effect on the duration of hospitalization stay as compared to the control (RR 1.04, 95% CI 0.89 to 1.22).Authors\u27 Conclusion: Evidence provided in this review is insufficient to recommend the use of zinc as an adjunct to standard antibiotic therapy for pneumonia in children aged two to 35 months

ORT in diarrhoea: An overview

Abstract: This paper attempts to summarize the development of ORT (Oral Rehydration Therapy) and its role as the major public health intervention for the control of diarrhoeal diseases. It also highlights the large number of scientific studies conducted to assess the safety and efficacy of ORS (Oral Rehydration Solution). Improved ORS formulations trial including hypoosmolar solutions are described as these are areas of recent clinical studies that address the drawbacks in WHO/UNICEF ORS. However, until new ORS formulations are evaluated and implemented, the present glucose-based ORS does still save millions of lives and need to be recommended for all forms of dehydrating diarrhoea. [Ethiop. J. Health Dev. 1995;9(3):192-198

Persepsi Masyarakat Tentang Diare Dan Pencarian Pengobatannya Di Dua Desa Di Kabupaten Boyolali

Diare masih merupakan penyebab penting kematian bayi dan Balita di Indonesia. Telah dipelajari persepsi masyarakat tentang diare serta cara penanggulangannya di desa Manyaran dan Sempulur Boyolali sebagai bahan untuk penanggulangan diare oleh masyarakat. Diare tidak dianggap sebagai penyakit yang terlalu serius. Menurut masyarakat, penyebab diare ada yang langsung terhadap anak yaitu masuk angin, terlalu lama mandi, makan makanan rasa asam (kecut), dan tidak langsung bila ibu menyusui masuk angin atau makan makanan yang pedas-pedas, air susu menjadi jelek dan anak menderita mencret. Tidak ada kepercayaan bahwa diare disebabkan oleh roh halus. Persepsi masyarakat/ibu-ibu tentang diare dan penyebabnya menghasilkan perilaku pengobatan diare pada anak sebagai berikut: Mula-mula ditangani sendiri dengan ramuan tradisional, bila tidak sembuh diobati dengan pil "Ciba" yang dijual bebas di warung-warung yang tersebar di desa, bila tetap belum sembuh baru di bawa ke petugas kesehatan

Directing diarrhoeal disease research towards disease-burden reduction

Despite gains in controlling mortality relating to diarrhoeal disease, the burden of disease remains unacceptably high. To refocus health research to target disease-burden reduction as the goal of research in child health, the Child Health and Nutrition Research Initiative developed a systematic strategy to rank health research options. This priority-setting exercise included listing of 46 competitive research options in diarrhoeal disease and their critical and quantitative appraisal by 10 experts based on five criteria for research that reflect the ability of the research to be translated into interventions and achieved disease-burden reduction. These criteria included the answerability of the research questions, the efficacy and effectiveness of the intervention resulting from the research, the maximal potential for disease-burden reduction of the interventions derived from the research, the affordability, deliverability, and sustainability of the intervention supported by the research, and the overall effect of the research-derived intervention on equity. Experts scored each research option independently to delineate the best investments for diarrhoeal disease control in the developing world to reduce the burden of disease by 2015. Priority scores obtained for health policy and systems research obtained eight of the top 10 rankings in overall scores, indicating that current investments in health research are significantly different from those estimated to be the most effective in reducing the global burden of diarrhoeal disease by 2015

An investigation of the breadth of neutralising antibody response in cats naturally infected with feline immunodeficiency virus

Neutralising antibodies (NAbs) are believed to comprise an essential component of the protective immune response induced by vaccines against FIV and HIV infections. However, relatively little is known about the role of NAbs in controlling FIV infection and subsequent disease progression. Here we present studies examining the neutralisation of HIV-luciferase pseudotypes bearing homologous and heterologous FIV Envs (n=278) by sequential plasma samples collected at 6 month intervals from naturally infected cats (n=38) over a period of 18 months. We evaluated the breadth of the NAb response against non-recombinant homologous and heterologous clade A and clade B viral variants as well as recombinants and assessed the results, testing for evidence of an association between the potency of the NAb response and the duration of infection, CD4 T lymphocyte numbers, health status and survival times of the infected cats. Neutralisation profiles varied significantly between FIV infected cats and strong autologous neutralisation, assessed using luciferase based in vitro assays, did not correlate with the clinical outcome. No association was observed between strong NAb responses and either improved health status or increased survival time of infected animals, implying that other protective mechanisms are likely to be involved. Similarly, no correlation was observed between the development of autologous NAbs and the duration of infection. Furthermore, cross-neutralising antibodies were evident in only a small proportion (13%) of cats

Profile of Neonatal Septicaemia at a District-level Sick Newborn Care Unit

Although sepsis is a major cause of morbidity and mortality among newborns in resource-poor countries, little data are available from rural areas on culture-proven sepsis. The aim of the present study was to provide information in this regard. The study reports results on the incidence and aetiology of neonatal sepsis cases admitted to a facility in a rural area in eastern India. Blood culture was done for all babies, with suspected clinical sepsis, who were admitted to the sick newborn care unit at Suri where the study was conducted during March 2009–August 2010. A standard form was used for collecting clinical and demographic data. In total, 216 neonatal blood culture samples were processed, of which 100 (46.3%) grew potential pathogens. Gram-negative infection was predominant (58/100 cases) mainly caused by enteric Gram-negative bacteria. Klebsiella pneumoniae was the most common Gram-negative isolate. The emergence of fungal infection was observed, with 40% of the infection caused by yeast. Gram-negative organisms exhibited 100% resistance to ampicillin, cefotaxime, and gentamicin. Amikacin and co-trimoxazole showed 95% (n=57) resistance, and ciprofloxacin showed 83.3% (n=50) resistance among the Gram-negative bacteria. Carbapenem showed emerging resistance (n=4; 6.6%). Results of analysis of risk factors showed an extremely significant association between gestation and sepsis and gender and sepsis. Gastrointestinal symptoms were highly specific for fungal infections. One-third of babies (n=29), who developed culture-positive sepsis, died. Blood culture is an investigation which is frequently unavailable in rural India. As a result, empirical antibiotic therapy is commonly used. The present study attempted to provide data for evidence-based antibiotic therapy given to sick newborns in such rural units. The results suggest that there is a high rate of antibiotic resistance in rural India. Urgent steps need to be taken to combat this resistance