gastroenteritis
در نشریات گروه پزشکی-
Introduction
This case report presents a rare manifestation of Shigella infection: Acute perforated appendicitis. It emphasizes the importance of differential diagnosis in patients presenting with diarrhea, especially when symptoms overlap with surgical emergencies like appendicitis.
Case PresentationOur case involved a 10-year-old girl who was referred to our hospital with complaints of abdominal pain and non-bloody watery diarrhea. Clinical examinations confirmed acute appendicitis, and an appendectomy was performed. A few days post-surgery, the patient developed dysentery. Stool culture identified Shigella flexneri, and the patient was treated with Piperacillin/tazobactam and ciprofloxacin based on the antibiogram and consultation with the infectious disease team. The patient responded well to treatment and was discharged in good general condition after completing the full course of therapy.
ConclusionsAlthough shigellosis is a common gastrointestinal infection, it is rarely linked to appendicitis. This case highlights the need for thorough evaluation in patients with diarrhea, as infectious conditions like shigellosis can mimic or coexist with acute appendicitis, leading to potential diagnostic and management challenges.
Keywords: Shigellosis, Appendicitis, Dysentery, Gastroenteritis -
Gastroenteritis is associated with high rates of morbidity and mortality in the general population, especially in children. To investigate the predictive role of interleukins (IL-1β and IL-7) in children with viral gastroenteritis as potential diagnostic biomarkers. This cross-sectional study included children who were diagnosed with gastroenteritis at private clinics and Al-Batoul Teaching Hospital for Maternity and Childhood, Diyala, Iraq. The present study was conducted from May 2023 to May 2024. Ninety blood samples were collected from children with gastroenteritis, and 50 blood samples were taken from healthy children and those in the control group. Additionally, 90 samples of the stool were collected. The ELIZA technique was used for exploring IL-1β and IL-7 in blood samples and for detecting viral antigens (Norovirus, Adenovirus and Astrovirus) in stool samples. The data were analyzed statistically via SPSS v. 24 and Prism v. 10. There was a statistically significant increase in the incidence of infectious gastroenteritis in thin children aged 1-3 years who were living in rural areas. As indicated in this study, the most common symptoms were diarrhoea, vomiting and fever, and the differences were significant. Compared with those in the control group, there were significant differences in the levels of IL-1β and IL-7 among the children infected with gastroenteritis. ROC analysis of IL-1β and IL-7 interleukins revealed moderate sensitivity (79% and 88%, respectively) and low specificity (64% and 69%, respectively) at cut-off values of 8.52 and 7.01. The occurrence of norovirus occurred in 30% of the total samples, followed by Adenovirus in 20% and Astrovirus in 11%. The serum levels of IL-1β and IL-7 were high among children infected with gastroenteritis. Nevertheless, these parameters cannot be considered reliable vital indicators that are sufficient for diagnosing infections caused by gastroenteritis.
Keywords: Gastroenteritis, Viral Infections, Interleukins, Interleukin-1 Beta (IL-1 Β), Interleukin-7(IL-7) -
مقدمه
با افزایش بروز عفونت ها در دوران سالمندی، هزینه های درمان و بستری طولانی مدت در بیمارستان ناشی از بیماری های عفونی نیز افزایش می یابد. بنابراین این مطالعه با هدف تعیین علل عفونی منجر به بستری در بیماران سالمند انجام شد.
روش هامطالعه ی حاضر بصورت مقطعی انجام شد. جامعه ی آماری سالمندان (سن بیشتر از 65 سال) بستری در بخش عفونی بیمارستان امام رضا(ع) طی سال های 1400-1395 بود. ابزار جمع آوری اطلاعات چک لیست محقق ساخته بود. چک لیست با استفاده از اطلاعات مندرج در پرونده ی بیماران برای تمامی جامعه ی آماری تکمیل شد.
یافته هادر مطالعه ی حاضر 2092 سالمند مورد بررسی قرار گرفت. مهم ترین علل عفونی در سالمندان بستری به ترتیب 1/33 درصد پنومونی، 22/0 درصد عفونت دستگاه ادراری، 19/5درصد زخم پای دیابتی و 9/1 درصد به سبب کووید-19 بود. در این مطالعه 56/6 درصد از سالمندان بستری مرد و 33/6 درصد از نمونه ها مبتلا به فشارخون بالا و 12/1درصد مبتلا به دیابت بودند. میانگین سنی افراد 15/7 ± 75/2 سال و میانگین روزهای بستری آن ها 3/1 ± 7/2 روز بود. شایع ترین علائم بالینی در هنگام مراجعه در بیماران به ترتیب خلط (51/4 درصد)، تنگی نفس (48/8 درصد) و لرز (35/5 درصد) گزارش شد.
نتیجه گیرینتایج مطالعه نشان داد عفونت های نظیر پنومونی، عفونت دستگاه ادراری، زخم پای دیابتی و کووید-19 از مهم ترین علل عفونی در بستری سالمندان است. بنابراین پیشنهاد می شود مداخلات درمانی و سیاست های مدیریتی برای این عفونت ها صورت گیرد.
کلید واژگان: سالمندان، بروسلوز، پنومونی، گاستروانتریت، بیماری مزمن انسدادی ریهBackgroundAs the incidence of infections rises in older adults, costs and prolonged hospitalization due to these diseases also increase. Consequently, this study aims to identify the infectious causes that lead to hospitalization among elderly patient.
MethodsThe present study was conducted using a cross-sectional design. The statistical population consisted of elderly individuals aged over 65 years who were hospitalized in the infectious disease ward of Imam Reza Hospital between the years 2015 - 1400. Data were collected using a researcher-made checklist, completed by reviewing the information in the patients' file.
FindingsIn the current study, 2,092 elderly individuals were examined. The most important infectious causes for hospitalization among the elderly were pneumonia (33.1%), urinary tract infections (22.0%), diabetic foot ulcers (19.5%), and COVID-19 (9.1%). Of the hospitalized elderly patients, 56.6% were male. Additionally, 33.6% had high blood pressure, and 12.1% had diabetes. The mean age of the participants was 75.2 ± 15.7 years, and the average length of hospitalization was 7.2 ± 3.1 days. The most common clinical symptoms reported upon admission included sputum production (51.4%), shortness of breath (48.8%), and chills (35.5%).
ConclusionThe study's results indicate that infections such as pneumonia, urinary tract infections, diabetic foot ulcers, and COVID-19 are most important causes of hospitalization in the elderly. Therefore, it is recommended that therapeutic interventions and management policies be developed for these infections.
Keywords: Elderly, Brucellosis, Pneumonia, Gastroenteritis, COPD Exacerbation -
BackgroundVomiting and nausea are common symptoms of Gastroenteritis (GE) in children, and high statistics in emergency department visits. Vitamin B6, which plays a significant role in preventing vomiting in pregnant women, is one of the options for controlling GE. This study examines the effect of pyridoxine (vitamin B6) in children with GE.MethodThe study population of this research was a case-control including all children aged 6 months to 12 years with mild to moderate dehydration who were admitted to the children's hospital in Bandar Abbas city between 2021 and 2022. The study included two groups: control and intervention. The intervention group consisted of patients aged 6 months to 14 years of both genders who received pyridoxine to manage nausea and vomiting based on thier weight.ResultsA total of 70 individuals were included in our study, of whom 48.57% were female and 51.43% were male. The percentage of dehydration in patients with gastroenteritis in the control group was 64.6±1.59%, while in the group treated with vitamin B6, it was 32.6±1.46%. There was no significant correlation between the percentage of dehydration in the control and vitamin B6-treated groups. Additionally, there was no significant correlation between the amount of fluid received and the mean length of hospital stay in both group.ConclusionPyridoxine drug was not effective in treating vomiting caused by acute gastroenteritis in children compared to the control sample. Although vitamin B6 is effective in controlling inflammation, it was not able to reduce GE complications.Keywords: Gastroenteritis, Pediatric, Pyridoxine, Vomiting
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The gut ecosystem, comprising the gut microbiota and its interactions, plays a crucial role in human health and disease. This complex ecosystem involves a diverse array of microorganisms such as viruses, fungi, and bacteria, collectively known as the gut microbiota. These microorganisms contribute to various functions, including nutrient metabolism and immune modulation, thereby impacting human health. Dysbiosis, or an imbalance in the gut microbiota, has been associated with the pathogenesis of several diseases, ranging from intestinal disorders such as inflammatory bowel disease to extra?intestinal conditions such as metabolic and neurological disorders. The implications of dysbiosis in the gut ecosystem are far?reaching, affecting not only gastrointestinal health but also contributing to the development and progression of conditions such as autoimmune gastritis and gastric cancer. Furthermore, the burden of antimicrobial use and subsequent side effects, including antibiotic resistance, poses additional challenges in managing gastrointestinal diseases. In light of these complexities, investigating the role of bacteriophages as regulators of the gut ecosystem and their potential clinical applications presents a promising opportunity to tackle antibiotic resistance and fight infectious diseases.
Keywords: Bacteria, Bacteriophage, Gastroenteritis, Gastrointestinal Diseases -
Background
Rotavirus is the most common cause of gastroenteritis among children. Currently, four oral live-attenuated vaccines are available to prevent rotavirus infection. The World Health Organization (WHO) has recommended including rotavirus vaccination in national immunization programs; however, it has not been introduced to the Iranian national immunization program. The study aimed to assess the frequency of rotavirus gastroenteritis in the west of Iran and investigate the necessity of rotavirus vaccination.
Study Design:
A case series study.
MethodsIn this case series study, 284 cases under six years of age who presented with acute gastroenteritis from March 2021 to 2022 to a referral hospital in the west of Iran were evaluated. Data on baseline characteristics, clinical manifestations, results of stool test, ELISA for rotavirus detection, and polymerase chain reaction (PCR) test for genotyping of rotavirus-positive samples were recorded.
ResultsResults showed that the prevalence of rotavirus infection was 36.6%. The highest frequency was observed among children aged 6-12 months and during the autumn. According to the PCR results, G1P[8], G9P[8], G9P[4], and G1P [4] were the dominant genotypes, and 33.75% of samples were infected with multiple rotavirus genotypes.
ConclusionThe study highlights the considerable prevalence of rotavirus infection among cases of acute gastroenteritis in children under six years of age who were referred to a referral hospital in the west of Iran and the high diversity of rotavirus genotypes in the targeted community. Consequently, physicians and health policymakers should prioritize strategies for the prevention and control of this infection, particularly by considering the rotavirus vaccine as a priority for the Iranian national immunization program.
Keywords: Rotavirus, Rotavirus Vaccines, Gastroenteritis, Vaccination, Immunization Programs -
مجله دانشکده پزشکی دانشگاه علوم پزشکی تهران، سال هشتاد و یکم شماره 9 (پیاپی 272، آذر 1402)، صص 676 -684زمینه و هدف
سالمونلا انتریکا زیر گونه انتریکا سرووار انتریتیدیس، یکی از مهمترین عوامل بیماری های منتقله از غذا است که در اثر مصرف فراورده های غذایی آلوده با منشا حیوانی به وجود می آید. گاستروانتریت سالمونلایی یک عفونت خود محدود شونده است که بدون نیاز به درمان آنتی بیوتیکی بهبود می یابد. اما بیماری می تواند به بیماری های سیستمیک تبدیل شود و این افراد نیاز به درمان دارند. هدف از مطالعه ما بررسی الگوی مقاومت آنتی بیوتیکی و ژن های مقاومت به فلوکوئینولون ها می باشد.
روش بررسیدر طی این مطالعه در یک مطالعه مقطعی-توصیفی در فاصله زمانی شهریور 1401 تا شهریور1402، 44 جدایه سالمونلا انتریتیدیس از منابع انسانی مورد بررسی قرار گرفت. پس از تایید ایزوله ها با استفاده از روش های استاندارد میکروبیولوژی ومولکولی، الگوی مقاومت آنتی بیوتیکی جدایه ها و فراوانی ژن های مقاومت تعیین شد.
یافته هادر این مطالعه از 44 جدایه سالمونلا انتریتیدیس مورد مطالعه، 100% سویه ها به ایمی پنم ومروپنم حساس بودند و حساسیت به آنتی بیوتیک های سفتریاکسون، سفتازیدیم و سفوتاکسیم به ترتیب2/93%، 9/90%، 1/94% بودند. 8/81% جدایه ها به کوتریماکسازول حساس بودند، حساسیت به آمپی سیلین 1/84% بود. تنها 1/9% جدایه ها به سیپروفلوکساسین حساس بودند. در بین سویه های مقاوم به سیپروفلوکساسین به روش فنوتیپی هیچ کدام از ژن های و qnrS, qnrA, qnrB مشاهده نگردید. تمام سویه های مقاوم به نالیدیکسیک اسید دارای ژن gyrA بودند.
نتیجه گیریدر این مطالعه نشان داده شد، مقاومت به خانواده فلورکوئینولون ها در بین ایزوله های سالمونلا انتریتیدیس در حال افزایش می باشد. از طرفی شاهد کاهش حساسیت و بروز سویه های مقاوم به سفالوسپورین های وسیع الطیف در بین سرووار انتریتیدیس هستیم، که داروی انتخابی عفونت های خارج روده ای می باشد.
کلید واژگان: گاستروانتریت، سالمونلا انتریتیدیس، مقاومت آنتی بیوتیکی، سیپروفلوکساسینBackgroundSalmonella enterica subspecies enterica serotype Enteritidis (S. Enteritidis) is one of the leading causes of food-borne infections associated with the consumption of contaminated food products of animal origin in humans. gastroenteritis due to Salmonella is usually a self-limiting disease and does not require antibiotic therapy. However, antibiotic treatment for salmonellosis may be lifesaving for patients with severe infections.The objective of the present study was to examine antimicrobial resistance and determine its genetic basis in recently isolated S.Enteritidis strains.
MethodsDuring this study, in a cross-sectional descriptive study, 44 isolates of Salmonella enteritidis from human sources were investigated between September 2021 and September 2022.. After identification of the isolates using phenotypic and molecular methods by Multoplex-PCR, antibiotic resistance testing was performed according CLSI 2023. The strains were examined for the presence of qnrA,qnrB,qnrS and gyrA resistance genes by PCR.
ResultsIn a cross-sectional descriptive study, 44 isolates of Salmonella Enteritidis from human sources were investigated between September 2022 and September 2023. 100% of the strains were sensitive to imipenem and meropenem, and the sensitivity to the antibiotics ceftriaxone, ceftazidime, and cefotaxime were 93.2%, 90.9%, and 94.1%, respectively. 81.8% of isolates were sensitive to cotrimoxazole, sensitivity to ampicillin was 84.1%. Only 9.1% of isolates were sensitive to ciprofloxacin. Based on MIC results, 16 isolates had MIC between 0.002 and 0.064 and were placed in the sensitive area. 28 isolates had MIC between 0.125 and 0.5 and were placed in the area of reduced sensitivity. None of the strains resistant to disk diffusion method were resistant to MIC method. qnrA, qnrB and qnrS genes were not observed among ciprofloxacin resistant strains. All nalidixic acid resistant strains had gyrA gene.
ConclusionIn general, it was shown in this study that the resistance to the fluoroquinolone family is increasing among Salmonella Enteritidis isolates. On the other hand, we see a decrease in the sensitivity and prevalence of strains resistant to broad-spectrum cephalosporins among serovar Enteritidis, which is the drug of choice for extraintestinal infections.
Keywords: Salmonella Enteritidis, Antibiotic Resistance, Gastroenteritis, Ciprofloxacin -
زمینه و هدف اسهال حاد یکی از علل مهم مرگ در میان کودکان در کشورهای درحالتوسعه است. هدف از این مطالعه مقایسهسطح روی در کودکان با گاستروانتریت حاد در مقایسه با کودکان بدون گاستروانتریت بود.روش بررسی در این مطالعه مورد شاهدی، کودکان با گاستروانتریت و کودکان شاهد که از نظر جنس و سن همسان سازیشده بودند مورد بررسی قرار گرفتند.. 80 کودک با گاستروانتریت حاد و 80 کودک بدون گاستروانتریت وارد مطالعه شدند.گروه کنترل از کودکانی انتخاب شدند که در بخش جراحی بهدلیل اعمال جراحی مینور بستری بودند. دو گروه از نظر سن وجنس مشابه بودند. معیارهای ورود شامل اسهال کمتر از 48 ساعت، سن بین شش ماه تا 12 سال و تظاهرات بالینی اسهالبود. شواهد بیماریهای مزمن، استفاده از مکمل روی در طول سه ماه پیش از بستری و طول اسهال بیشتر از هفت روز جزومعیارهای خروج از مطالعه در نظر گرفته شد. این مطالعه توسط کمیته اخلاق دانشگاه مورد تایید قرار گرفت.یافته ها از 160 کودک شرکتکننده) 80 مورد و 80 شاهد(، 89 نفر پسر بودند. متوسط سنی شرکتکنندگان 3.35 ± 2.21سال بود. تفاوتی بین گروه شاهد و مورد از نظر سن و جنس نبود. در کودکان زیر پنج سال سطح روی در گروه مورد نسب بهگروه شاهد به صورت معنیداری کمتر بود. در کودکان بالای پنج سال، تفاوتی بین گروه مورد و شاهد وجود نداشت) p=0.85) . نتیجه گیری سطح روی به صورت معنیداری در کودکان با گاستروانتریت نسبت به کودکان بدون گاستروانتریت پایینتر بود.کلید واژگان: کودکان، اسهال، گاستروانتریت، رویBackground and Objectives Acute gastroenteritis is among the leading causes of mortality in developing countries. The present study aimed to compare zinc levels in children with and without acute gastroenteritis. Subjects and Methods This case-control study was conducted on children with acute gastroenteritis and age and gender-matched control group without gastroenteritis. A total of 80 children with acute gastroenteritis and 80 children without gastroenteritis were included. The control group was selected from among patients admitted to the pediatric surgery ward for a minor surgery. The case and control groups were matched regarding age and gender. The inclusion criteria for the control group were as follows: onset of diarrhea less than 48 hours, the age range of 6-12 years old, and clinical manifestation of diarrhea. On the other hand, evidence of chronic disease, zinc supplementation within three months before hospitalization, and duration of diarrhea more than seven were considered the exclusion criteria. This study was approved by the ethical committee of the university. Results Out of 160 participants (80 cases and 80 control), 89(55.6%) cases were male, and 71(44.4%) subjects were female. The mean age of the participants was 3.35±2.21 years (aged 1-10 years). There was no difference between case and control groups in terms of age and gender. The mean zinc level was significantly lower in cases (72.76±26.39) than in controls (91.15±17.76). Zinc level in children aged < 5 years was significantly less in the case group compared to that in the control group, while in children aged > 5 years, no significant difference was observed(P=0.85). Conclusion As evidenced by the obtained results, serum zinc level was significantly lower in children with gastroenteritis compared to that in their counterparts without this problem.Keywords: children, Diarrhea, Gastroenteritis, zinc
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زمینه و هدف
عفونت دستگاه گوارش با سروتیپ های سالمونلا در سراسر جهان شایع است. یکی از نکات مهم در خصوص جداسازی سالمونلا شباهت آن با سایر فلورهای میکروبی است که جداسازی آن را دشوار می کند. بنابراین،انتخاب روش جداسازی صحیح بسیار مهم است. این مطالعه با هدف مقایسه میزان رشد سالمونلا در محیط های مختلف کشت و تاثیر دما و غنی سازی بر آن انجام شد.
مواد و روش هابرای تهیه نمونه مدفوع حاوی سالمونلاتایفی موریوم،24 قطعه جوجه گوشتی از 36 قطعه جوجه گوشتی نژاد راس به این باکتری آلوده شدند. رقت مک فارلند برای عفونت تجربی به جوجه ها گاواژ شد.پس از تایید عفونت،کشت به مدت 7 روز متوالی آغاز شد.از 3 محیط کشت انتخابی زایلوز لیزین دئوکسی کولات، بریلیانت گرین آگار و مک کانکی آگار و از دو محیط غنی کننده تتراتیونات و سلنیت سیستئین F استفاده شد. تمامی کشت ها در دو دمای 37 درجه سانتی گراد و 42 درجه سانتی گراد از نظر سرعت رشد مورد بررسی قرار گرفتند. برای تجزیه و تحلیل داده ها از آزمون کاپا استفاده شد. یافته ها و
نتیجه گیریبا توجه به نتایج بدست آمده، بین محیط های غنی کننده تتراتیونات و سلنیت سیستئین F تفاوتی وجود نداشت (K=0/81).توافق بین XLD و McC (K=0/33). توافق بین XLD و BG (K=0/57) و توافق بین BG و McC (0/80) بدست آمد. توافق بین 37 درجه سانتی گراد 42 درجه سانتی گراد<0.1 بود. استفاده از محیط کشت XLD در دمای 42 درجه سانتی گراد برای جداسازی سالمونلا تایفی موریم از نمونه های مدفوع توصیه می شود.
کلید واژگان: گاستروانتریت، کشت میکروبی، سالمونلا تیفی موریومBackground and AimsGastrointestinal infection with Salmonella serotypes, especially Typhimurium, is common worldwide. One of the important points regarding the isolation of Salmonella is its similarity with other microbial flora, which makes it difficult to isolate it. Therefore, it is very important to choose the correct separation method. This study aimed to compare the growth rate of Salmonella in different cultural environments and the effect of temperature and enrichment on it.
Materials and Methods24 out of 36 Ross breed broilers were infected with the bacteria to obtain stool samples containing Salmonella Typhimurium. One McFarland dilution was given to chickens for experimental infection. After the confirmation of the infection, the culture was started in days for 7 consecutive days. From 2 media enriched with Tetrathionate broth and Selenite Cysteine broth and 3 selective culture media, Xylose lysine Deoxycholate agar, Brilliant Green agar, and McConkey agar for culture were used. All cultures were examined at 2 temperatures of 37°C and 42°C in terms of growth rate. The Kappa test was used for data analysis.
ResultsThe results showed no difference between tetrathionate and selenite cyane enrichment media (k=0.81). Agreement between Xylose Lysine Deoxycholate and McConkey (k=0.33), agreement between Xylose Lysine Deoxycholate and Brilliant Green (k=0.57), and agreement between Brilliant Green and McConkey (k=0.80), were obtained. The agreement between 37°C and 43°C was < 0.1.
ConclusionAccording to the results obtained, using an Xylose Lysine Deoxycholate culture medium and incubation at 42°C are recommended to isolate Salmonella Typhimurium from fecal samples.
Keywords: Colony count microbial, Gastroenteritis, Pre-enrichment, Salmonella infections -
For better management of acute kidney injury (AKI) and prevention of progressive renal injury, it is extremely important to manage infections such as gastroenteritis. In addition, anuria is considered a risk factor for AKI and even causes death in patients. An 18-month-old boy with vomiting and diarrhea for three days and anuria for 24 hours was referred to Farsan hospital. The patient had bulky and watery diarrhea about 7-8 times a day and vomited 3-4 times a day which was containing food particles. He had a fever on the first and second days. Ultrasound findings revealed that the right kidney did not exist, and the left kidney was affected by compensatory hypertrophy. Disorders in the patient’s blood biochemical factors were also observed. Acidosis and other biochemical disorders were treated with bicarbonate drip, allopurinol, Lasix drip, and dopamine drip. After about 18 hours, anuria was treated.
Keywords: Anuria, Acute kidney injury, Solitary kidney, Gastroenteritis -
COVID-19 has recently become a pandemic. Early diagnosis and the transmission chain cutting off are critical keys to controlling this disease and stopping its spread. In this case report, the significance of proper and on-time diagnosis is discussed. Misdiagnosis of COVID-19 may lead to delay in early diagnosis of the disease. A 78-year-old man with the chief complaint of dark stool and constipation was admitted. Based on the preliminary complaints of the patient, the emergency medical specialist transferred him to the internal caregiving service, but according to radiological findings and his positive Real-time PCR test, COVID-19 was the final diagnosis. Healthcare planners and policymakers should prepare precise clinical guidelines that are compatible with domestic conditions of the country to improve the ability of healthcare providers to diagnose patients with COVID-19 to promote controlling this condition.
Keywords: Coronavirus disease 2019 (COVID-19), Misdiagnosis, Gastroenteritis -
International Journal of Travel Medicine and Global Health, Volume:11 Issue: 1, Winter 2023, PP 234 -242
The most well-known gastrointestinal pathogen and typical component of the microbiota in the human gut is Escherichia coli.Enterotoxigenic,enteroinvasive,enteropathogenic,and enterohemorrhagic E.coli are some of the designated pathotypes that are used to categorize the many types of E. coli that cause diarrhea. Each pathotype's individual strains have a unique collection of virulence-related traits that influence the clinical, pathological, and epidemiological aspects of the illnesses they cause. In this succinct overview, we highlight the important characteristics that set the different pathotypes of diarrheagenic E. coli apart. The development of logical strategies for the management and prevention of E. coli-induced diarrhea has been facilitated by our growing understanding of the pathogenic processes of these bacteria. Investigations investigating the virulence of E. coli are also helping to provide light on the history and development of bacterial pathogens in general.this species also contains primary pathogens that are responsible for a number of different diarrheal illness syndromes. There are presently five unique kinds of diarrheagenic E. coli that exhibit diverse virulence traits, interact with the intestinal mucosa in various ways,induce different clinical syndromes, have different epidemiologies,and belong to different O: H serotypes.The most typical sickness among people who move from parts of the world with abundant resources to those with scarce resources is travelers' diarrhea. the anxiety of getting diarrhea Traveler's diarrhea (TD) episodes are almost always self-limiting and benign, but the dehydration that can exacerbate an episode can be severe and pose a greater health risk than the actual illness.
Keywords: Diarrhea, Escherichia coli, Gastroenteritis, Pathogenesis, Travelers' diarrhea -
مقدمه و اهداف
شناسایی ژنوتیپ های روتاویروس در کودکان از نظر بالینی مهم است. هدف از مطالعه حاضر تعیین تنوع ژنوتیپ های روتاویروس و ارتباط آنها با یافته های دموگرافیک و علایم بالینی کودکان بستری در بیمارستان است.
روش کاربرای مشخص کردن ژنوتیپ های روتاویروس، نمونه های مدفوع روتاویروس-مثبت کودکان علامت دار در آذر 1399 الی اسفند 1400 وارد مطالعه شدند. استخراج RNA از نمونه ها و سنتز cDNA برای ژن های VP7 و VP4 طبق پروتکل استاندارد انجام شد. تعیین ژنوتیپ ها با استفاده از پرایمرهای اختصاصی انجام شد. توالی یابی و تجزیه و تحلیل بیوانفورماتیک برای تایید نتایج انجام شد. داده ها با استفاده از نرم افزار SPSS نسخه 20 و Graphpad نسخه 9.5.0 تجزیه و تحلیل شد.
یافته هااز میان نمونه های بیماران مبتلا، سه ژنوتیپ به عنوان ژنوتیپ غالب در جامعه تحت بررسی تعیین شد. این نتایج رابطه معنی داری را میان فراوانی یک ژنوتیپ و تغییرات فصول (0/0077= p-value) و بین نوع ژنوتیپ ها، مدت بستری و شدت اسهال نشان دادند. در حالی که به طور معنادار با افزایش سن، انواع بیشتری از روتاویروس گروه A تعیین گردید، ارتباطی میان ژنوتیپ های شناسایی شده با جنسیت مشاهده نگردید (0/473 = p-value) همچنین، هیچ ارتباطی بین نوع ژنوتیپ، شدت کم آبی و حضور یا عدم حضور تب وجود نداشت.
نتیجه گیریبه طور کلی، نتایج این مطالعه تنوع نسبتا بالایی از ژنوتیپ های روتاویروس ها را در کودکان نشان داد. جهت تایید همبستگی های یافت شده بین برخی از ژنوتیپ ها و گروه های سنی، فصول، علایم بالینی و اثربخشی واکسن های موجود، مطالعات بیشتری مورد نیاز است.
کلید واژگان: روتاویروس، ژنوتیپ، گاستروانتریت، ایران، کودکانBackground and ObjectivesIdentification of rotavirus genotypes in children is clinically important. This study aimed to determine the spectrum of rotavirus genotypes and assess their correlation with demographic variables and clinical manifestations in hospitalized children.
MethodsTo determine rotavirus genotypes, rotavirus positive stool samples of symptomatic children were included in the study between December 2019 and March 2020. RNA extraction and cDNA synthesis for VP7 and VP4 genes were performed following standard protocols. Genotypes were determined using specific primers. Validation of results was done through sequencing and bioinformatic analysis. Data were statistically analyzed using SPSS version 20 and GraphPad version 9.5.0.
ResultsAmong the infected patients, three genotypes emerged as dominant in the studied population. The study demonstrated a significant correlation between genotype frequency and seasonal variations (p-value=0.0077), as well as between genotypes, hospitalization, and severity of diarrhea. While significantly more types of rotavirus group A were identified with increasing age, no correlation was observed between the genotypes and gender (p-value=0.473). Furthermore, there was no significant association between genotype, dehydration rates, and the presence or absence of fever.
ConclusionThis study revealed a relatively high diversity of rotavirus genotypes in children. The findings suggest the need for further research to validate the identified correlations between certain genotypes and age groups, seasonal variations, clinical symptoms, and the efficacy of available vaccines.
Keywords: Rotavirus, Genotype, Gastroenteritis, Iran, Children -
Background and Objective
Acute gastroenteritis in children is a major cause of morbidity in the world. This study investigated the effect of suspension prepared from date seed in reducing the severity and duration of diarrhea in gastroenteritis pediatrics.
MethodsParticipants in this clinical trial study comprised 140 gastroenteritis pediatrics referred to Abuzar Children’s Hospital in Ahvaz. Eligible patients were randomly assigned to experimental and control groups. The intervention group was given 5% date seed suspension in the amount of 12 mg/kg of body weight orally once every 8 hours for 7 days; the control group was administered a placebo three times a day. Then the two groups were compared for severity and duration of diarrhea as well as stool volume.
FindingsThe duration and severity of diarrhea were significantly less in children in the intervention group than in the control group (p<0.05). The mean duration of diarrhea in the intervention and control groups was 3.508±1.102 and 4.680±4.001 days, respectively. The mean severity of diarrhea, decreased at 24 hours (2.0857±0.607; 1.8571±0.747), 48 hours (1.7429±0.695; 1.2571±0.695), 72 hours (1.1000±0.695; 0.7857±0.814), and 96 hours (0.5429±0.629; 0.4143±0.577) after the intervention and was lower in the intervention group than the control group, and the difference between the two groups was significant (p=0.001). Moreover, stool consistency was higher in the intervention group than in the control group after the consumption of date seed suspension (p<0.05).
ConclusionOur results confirm the effectiveness of the herbal medicine prepared from date seed waste for control and treatment of gastroenteritis.
Keywords: Child, Date seed, Diarrhea, Gastroenteritis -
Background
Diarrheal diseases are the major causes of morbidity and mortality in developing countries and the second most common cause of death in children under five years. The main objective of the study was to determine the prevalence of intestinal parasites in diarrheal patients in Bandar Abbas, Southern Iran.
MethodsThis cross-sectional study was conducted to assess the prevalence of intestinal parasitic infections and associated factors among patients with diarrhea in the major hospitals of Bandar Abbas. A single fecal specimen was collected from 170 diarrheic patients from October 2018 to May 2019. The diagnosis was made based on the direct wet mount and formalin-ether concentration method. Trichrome and modified acid-fast staining methods were used for the better detection of protozoa. The collected data were analyzed using SPSS software.
ResultsA total of 170 stool specimens were collected from diarrheic patients. Of these, 57.6% were males and 42.4% were females. The overall prevalence of intestinal parasites was 12.9%. The most prevalent parasite was Blastocystis spp. 10 (5.9%), followed by Giardia lamblia 7 (4.1%), Cryptosporidium spp. 3 (1.8%), Entamoeba coli 1 (0.6%), and Hymenolepis nana 1 (0.6%).
ConclusionOverall, the results showed that intestinal parasites, especially helminth infections, have significantly decreased in recent years.
Keywords: Diarrhea, Gastroenteritis, Iran, Parasitic diseases, Prevalence -
Background and Objectives
Vibrio fluvialis is a Gram-negative, bacillus-shaped, curved bacterium known as an emerging pathogen. There are reports of outbreaks caused by this bacterium worldwide. Iran, especially Qom province, is an endemic region for gastrointestinal diseases caused by Vibrio species. So, the aim was to isolate V. fluvialis from clinical and environmental samples.
Materials and MethodsDuring six months, 363 clinical and surface water samples were evaluated. The samples were cultured on specific media, and all incubated for 24 hours at 37°C. Suspicious colonies were evaluated by Gram staining and biochemical tests. The BD Phoenix automated microbiology system was used for the final confirmation of the isolated bacteria. Evaluation of antibiotic resistance of isolated strains was also performed according to CLSI standard.
ResultsEight cases (2.2%) of V. fluvialis, including seven from surface water samples (87.5%) and one from clinical samples (12.5%), were isolated. Based on antimicrobial susceptibility testing, all V. fluvialis isolates were susceptible to amikacin, gentamicin, trimethoprim/sulfamethoxazole, ciprofloxacin, tetracycline, ceftazidime, and chloramphenicol. High-level resistance to ampicillin and amoxicillin/clavulanate was also observed. V. fluvialis-infected patient had a mild fever, watery diarrhea, vomiting, nausea, and abdominal cramps that were manifested after drinking contaminated water or eating contaminated vegetables. The patient's symptoms recovered without antibiotic therapy after four days, resulting in self-limiting disease.
ConclusionThe current study is the first human case of V. fluvialis infection isolated in Iran. Therefore, monitoring of water and food samples should be done routinely.
Keywords: Vibrio fluvialis, Gastroenteritis, Drug resistance, Microbial, Iran -
Gastroenterology and Hepatology From Bed to Bench Journal, Volume:15 Issue: 3, Summer 2022, PP 256 -262Aim
The study was performed to determine the prevalence and co-infections with Rotavirus in children under five years of age.
BackgroundGastroenteritis-associated viral infections are a cause of death among young children in Worldwide, especially in developing countries. The species F Adenovirus (40 and 41) is responsible for rang of the cases of acute diarrhea among infants children.
MethodsDuring 9 months, 130 children with intestinal symptoms referred to the pediatric ward of the hospital were enrolled in this study. After collecting fecal samples, viral genomes were extracted; and then amplified and typed using polymerase chain reaction by Adenovirus-specific primers. Rotavirus was detected in our previous study on the same samples and the results were used to evaluate for co-infection.
ResultsMean age of the patients was 32.09±32.68 months. 60% and 40% of the patients were males and females, respectively. Adenovirus infection was identified among 23 cases of the children (17.7%), 21 cases (91%) type 41 and 2 cases (9%) type 40. Fever was the most clinical manifestation and there were no significant relations between the clinical symptoms and the Adenovirus infection. Co-infection was found in only 5 cases (21.7%) of patients.
ConclusionThese data show that Adenovirus infection plays an important role in acute diarrheal infection in Qom. In addition, our findings indicated that there was a co-infection between Adenovirus and Rotavirus, stating a serious problem in children less than five years of age.
Keywords: Adenovirus, Rotavirus, Co-infection, Gastroenteritis -
Background
Gastroenteritis, as a rare and heterogeneous condition, is characterized by patchy or diffuse infiltration of gastrointestinal tissue. Induced azotemia in humans following gastroenteritis has been evaluated in some studies.
ObjectivesThe aim of the present study was to evaluate the effect of montelukast on induced azotemia in humans following gastroenteritis.
MethodsThis study examined children with gastroenteritis with moderate dehydration and more than 3 years of age. The cases had a glomerular filtration rate (GFR) of less than 90 and were evaluated in 2 groups of control (n = 20) and intervention (n = 20). Montelukast (5-mg tablets) was given to patients in the intervention group for 5 days. Normal saline at a rate of 20 cc/kg was given to both groups within 20 minutes until clinical symptoms improved. Finally, the improvement of renal function was evaluated and compared between the 2 groups using SPSS.
ResultsOut of 40 evaluated patients, the mean age of the control and intervention groups was 5.52 and 5.15 years, respectively. Also, 13 cases (65.0%) in the control group and 9 cases (45.0%) in the control group were males. The mean creatinine (Cr) was significantly reduced after treatment in the intervention group (P = 0.001). Also, the mean GFR after treatment was significantly higher in the intervention group (P = 0.001), and GFR improvement duration was significantly lower in the intervention group (P = 0.002).
ConclusionsMontelukast as an add-on drug was effective in reducing the time of GFR enhancement; thus, we can consider it as an add-on drug in azotemia.
Keywords: Montelukast, Azotemia, Gastroenteritis -
زمینه و هدف گاستروانتریت حاد یک بیماری شایع در کودکان است. علل مختلفی باعث تشنج در زمینه اسهال میشود. پژوهش حاضر باهدف بررسی میزان فراوانی، مشخصات بالینی و علل تشنج در کودکان زیر پنج سال بستر یشده با گاستروانتریت حاد انجام شده است.روش بررسی این پژوهش به صورت توصیفی گذشت هنگر در بیمارستان گلستان اهواز روی 339 کودک زیر پنج سال بستر یشده با اسهال حاد و فاقد بیماری نورولوژیک زمین های، طی دو سال(1395 و 1396) انجام و اطلاعات لازم از پرونده بیماران دچار تشنج استخراج شد.یافته ها از 339 بیمار با گاستروانتریت حاد، 59 مورد(4/ 17 درصد) تشنج داشتند که در این موارد، بیشترین گروه سنی 13 تا 24 ماه(28/8 درصد)بودند. در 6/ 74 درصد بیماران نوع اسهال دیسانتری و 4/ 64 درصد میزان دهیدریشن خفیف بود. انسفالوپاتی 7/ 1 درصد،شیگلوز 8/ 6 درصد، هایپوناترمی 2/ 32 درصد و هایپرناترمی در 4/ 3 درصد موارد وجود داشت. در 5/ 52 درصد بیماران تشنج ت بخیز درنظر گرفته شد. بر اساس معیارهای تشخیصی، تشنج در 5 درصد بیماران، تشنج خو شخیم در زمینه گاستروانتریت خفیف محسوب شد.در 7/ 79 درصد موارد تشنج جنرالیزه بود. در مقایسه بین گروه تبدار و بدون تب فقط در متغیر نوع اسهال رابطه معنادار مشاهده شد.نتیج هگیری یافته ها نشان میدهد که تب و اختلالات الکترولیتی بین عوامل عفونی شیگلا از علل مهم بروز تشنج در بیماران مبتلا به گاستروانتریت هستند و در نوع دیسانتری اسهال، احتمال تشنج بیشتر است.
کلید واژگان: گاستروانتریت، اسهال، تشنجBackground and ObjectivesAcute gastroenteritis is a highly prevalent disease in children. Various factorsmay causes seizure in children with gastroenteritis. This study was designed to determine the frequency,clinical characteristics and causes of seizure in children younger than 5 years with acute gastroenteritisadmitted to Ahvaz Golestan hospital.
Subjects and MethodsIn a retrospective descriptive study based on hospital records , 339 children under5 years old who were admitted to Ahvaz Golestan hospital during 2016 - 2017 were assessed. Patientswith underlying neurological disorders were excluded and the recorded information of patients withseizure was reviewed.
ResultsOut of 339 reviewed cases, 59 patients (17.4%) had seizures, most prevalent in13 to 24 monthsage group (28.8%). In 74.6% of cases, type of diarrhea were dysentery. 64.4% had mild dehydration.Encephalopathy was detected in 1.7%, shigellosis in 6.8%, hyponatremia in 32.2% and hypernatremiain 3.4%. Seizures in 52.5% of cases were considered as febrile Seizure. Diagnostic criteria of benign convulsionsassociated with mild gastroenteritis (CwG) were present in 5% of patients. 79.7% of cases hadgeneralized seizures. In comparison, a significant relationship was observed between the febrile andnon-febrile groups only in the variable of diarrhea type.
ConclusionThe results show that fever and electrolyte imbalances and among infectious agents, Shigellaare important causes of seizures in patients with gastroenteritis. In patients with dysentery, seizures aremore likely.
Keywords: Gastroenteritis, Seizure, Fever, Electrolyte Imbalance -
Background and aim
Noroviruses are the most common known cause of non-bacterial acute gastroenteritis in worldwide. Norovirus gastroenteritis most often occurs in the winter with vomiting and diarrhea.
Materials and MethodsThis cross sectional study was done to evaluate the outbreak of gastroenteritis in one of the villages of Kurdistan province, 1-12 February 2019. During this period, 149 people developed joint illness and symptoms of diarrhea, vomiting, abdominal cramps, and their information was recorded. Data analysis was done with Stata7 software.
ResultsAttack rate of the total population in the village was 31.17%. Also, Attack rate in rural men and women was 26.5 percent and 36.24 percent, respectively. The median age of the patients was 26.5 years. The mean and standard deviation of patients' age in the first days of outbreak were less than other days that this relationship was statistically meaningful (P = 0.003). The most common symptoms were non-bloody diarrhea (57.71%), vomiting (52.34%), abdominal cramp (26.17%) and nausea (24.83%). According to the shape of the epidemic curve, the outbreak was a community-wide outbreak caused by the norovirus virus.
ConclusionBased on clinical evidence, epidemiological examination, results of human and water samples analysis, outbreaks occurred due to the consumption of drinking water contaminated with norovirus. To prevent similar outbreaks, it is recommended to fix the bugs observed in the water supply system and implement the water safety program.
Keywords: Norovirus, Outbreak, Gastroenteritis, Kurdistan, Epidemiology
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