Successful Treatment of Rotavirus-induced Diarrhoea in Suckling Mice with Egg Yolk Immunoglobulin

The role of specific immunoglobulins at mucosal sites in imparting protection against disease, such as rotavirus-associated diarrhoea, is well-established. Oral immunoglobulin therapy with egg yolk-derived anti-rotavirus immunoglobulins has previously been shown to achieve moderate therapeutic effect in diarrhoea due to rotavirus in a clinical trial. Here, data on the therapeutic potential of the same immunoglobulin preparation in an infant mouse model of rotavirus-induced diarrhoea is presented. The use of an animal model has allowed therapy to be evaluated with higher doses of immunoglobulins and has suggested that an improved therapeutic effect can be achieved by increasing the dose in the clinical setting

Helicobacter pylori Infection in the Young in Bangladesh: Prevalence, Socioeconomic and Nutritional Aspects

Background The gastric acid barrier, an important host defence against small bowel infection, may be compromised by infection with Helicobacter pylori. In developing countries, H.pylori infection occurs early in life and prevelance of hypochlorhydria is high particularly in the malnourished, which may predispose a child to repeated gastrointestinal Infection and diarrhoea. Diarrhpea being a leading cause a childhood mortality and morbidity in developing countries, we investigated the prevelance of H. pylori infection in children in poor Bangladeshi community and explored its association with socioeconomic and nutritional status. Methods The study was conducted in a poor periurban community among 469 children aged -99months. Parents were interviewed ising a questionnaire. To detect active infection with H. pyloria13 C-urea broath test was performed and weight was recorded on a beam balance with a sensitivity of 20g. Results In all, 61% of 36 infants aged 1-3 months were positive for H. pylori, this rate dropped steadily with increasing age and was 33% in 10-15 month old children and then rose to 84% in 6-9 year olds. Overall H. pylori infection had no association with nutritional state of the child or family income but the infection rate was 2.5 times higher in children of mothers with no schooling. Conclusions The H. pylori infection rate is very high in early infancy in a poor periurban community of Bangladesh. The reason for a drop in the infection rate infancy is unclear but could be due to initial clearance of the infection by the body's defence mechanisms but with possible alteration of the gastric mucosa which sustains infection. Maternal education may be protective and may operate through some underlined proximate behavioural determinants. The rate of H. pylori infection and young children may predispose them to reapeated gastrointestinal infection and diahorrea

Electronic decision support and diarrhoeal disease guideline adherence (mHDM): a cluster randomised controlled trial.

BACKGROUND: Acute diarrhoeal disease management often requires rehydration alone without antibiotics. However, non-indicated antibiotics are frequently ordered and this is an important driver of antimicrobial resistance. The mHealth Diarrhoea Management (mHDM) trial aimed to establish whether electronic decision support improves rehydration and antibiotic guideline adherence in resource-limited settings. METHODS: A cluster randomised controlled trial was done at ten district hospitals in Bangladesh. Inclusion criteria were patients aged 2 months or older with uncomplicated acute diarrhoea. Admission orders were observed without intervention in the pre-intervention period, followed by randomisation to electronic (rehydration calculator) or paper formatted WHO guidelines for the intervention period. The primary outcome was rate of intravenous fluid ordered as a binary variable. Generalised linear mixed-effect models, accounting for hospital clustering, served as the analytical framework; the analysis was intention to treat. The trial is registered with ClinicalTrials.gov (NCT03154229) and is completed. FINDINGS: From March 11 to Sept 10, 2018, 4975 patients (75·6%) of 6577 screened patients were enrolled. The intervention effect for the primary outcome showed no significant differences in rates of intravenous fluids ordered as a function of decision-support type. Intravenous fluid orders decreased by 0·9 percentage points for paper electronic decision support and 4·2 percentage points for electronic decision support, with a 4·2-point difference between decision-support types in the intervention period (paper 98·7% [95% CI 91·8-99·8] vs electronic 94·5% [72·2-99·1]; pinteraction=0·31). Adverse events such as complications and mortality events were uncommon and could not be statistically estimated. INTERPRETATION: Although intravenous fluid orders did not change, electronic decision support was associated with increases in the volume of intravenous fluid ordered and decreases in antibiotics ordered, which are consistent with WHO guidelines. FUNDING: US National Institutes of Health

Safety of a Bioactive Polyphenol Dietary Supplement in Pediatric Subjects with Acute Diarrhoea

The hematological and clinical chemistry profile for children aged 6 months to 5 years with acute diarrhoea was measured in a double blind clinical trial. Subjects were randomized to the study group (N=44) given a bioactive polyphenol dietary supplement in oral rehydration solution (ORS) or to the control group (N=41) given distilled water as a placebo in ORS twice daily for up to 4 days. All subjects received 10 mg zinc daily for the 4 days in the study. Venous blood was collected for complete blood count, electrolytes, liver function, and creatinine upon enrollment (baseline) and at the end of 4 days (end of study); mean values were compared by 95% confidence intervals. Overall, blood factors measured either remained the same over the 4 days or increased or decreased at the same levels between the two groups during the study period. All values were within accepted ranges for paediatric subjects except serum AST (SGOT), where the mean value of the study group approached the upper bound of the range on day 4 but was comparable to the value of the control group. Consumption of this supplement twice daily for 4 days is safe for children and infants

Successful Treatment of Rotavirus-induced Diarrhoea in Suckling Mice with Egg Yolk Immunoglobulin

The role of specific immunoglobulins at mucosal sites in imparting protection against disease, such as rotavirus-associated diarrhoea, is well-established. Oral immunoglobulin therapy with egg yolk-derived anti-rotavirus immunoglobulins has previously been shown to achieve moderate therapeutic effect in diarrhoea due to rotavirus in a clinical trial. Here, data on the therapeutic potential of the same immunoglobulin preparation in an infant mouse model of rotavirus-induced diarrhoea is presented. The use of an animal model has allowed therapy to be evaluated with higher doses of immunoglobulins and has suggested that an improved therapeutic effect can be achieved by increasing the dose in the clinical setting

Bioaccumulation of heavy metals in some commercially important fishes from a tropical river estuary suggests higher potential health risk in children than adults.

The Karnaphuli River estuary, located in southeast coast of Bangladesh, is largely exposed to heavy metal contamination as it receives a huge amount of untreated industrial effluents from the Chottagram City. This study aimed to assess the concentrations of five heavy metals (As, Pb, Cd, Cr and Cu) and their bioaccumulation status in six commercially important fishes, and also to evaluate the potential human health risk for local consumers. The hierarchy of the measured concentration level (mg/kg) of the metals was as follows: Pb (13.88) > Cu (12.10) > As (4.89) > Cr (3.36) > Cd (0.39). The Fulton's condition factor denoted that fishes were in better 'condition' and most of the species were in positive allometric growth. The bioaccumulation factors (BAFs) of the contaminants observed in the species were in the following orders: Cu (1971.42) > As (1042.93) > Pb (913.66) > Cr (864.99) > Cd (252.03), and among the specimens, demersal fish, Apocryptes bato appeared to be the most bioaccumulative organism. Estimated daily intake (EDI), target hazard quotient (THQ), hazard index (HI) and carcinogenic risk (CR) assessed for potential human health risk implications suggest that the values were within the acceptable threshold for both adults and children. However, calculated CR values indicated that both age groups were not far from the risk, and HI values demonstrated that children were nearly 6 times more susceptible to non-carcinogenic and carcinogenic health effects than adults