By Q. Ali. Thomas Jefferson University. 2018.

From the above cases mycelex-g 100mg on line, 272 cases were also performed for the isolation of other aetiologic agents and observed that Shigella isolated from 3 cases; Vibrio species were isolated from 2 cases; and Plesiomonas shigelloides was isolated from 3 cases respectively discount mycelex-g 100mg on-line. Adherence cell assay was done by using Lab Tek chamber slides seeded with Hep- 2 cells purchase mycelex-g 100 mg. Thus a study was conducted on 2522 Escherichia coil isolates from 501 diarrhoeal cases and 374 control cases from the Intakaw survey. Enterotoxigenic stains were isolated from 91 cases of diarrhoea ad from 29 control cases. A total of 923 cases of diarrhoea and 932 cases of control were included in this study. They were Vibrio cholerae O1 (21 cases) and Vibrio cholerae O139 (136 cases) from diarrhoea case attending the Infectious disease Hospital during 29-9-98 to 29-10-98. Salmonella typhi (38cases) and Escheriachia coli (15 cases) from cases with high fever for more than five days admitted to Yangon Children s Hospital during 27-8-98 to 17-8-2000. Biopsy findings of gastric ulcers and, operative findings st of some of the cases were recorded. It was a prospective study of 6 months-period from 1 th April 1994 to 30 September 1994. There were 35 patients with radiologically diagnosed ulcer, 11 cases have gastric and 24 cases have duodenal ulcers. Gastric ulcers are more commonly found at the distal 119 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar part the stomach. The diagnostic radiographic features of duodenal, and both benign and malignant gastric ulcers are studied and discussed in detail. Ten patients treated with sclerotherapy alone and 20 patients treated with propranolol alone. Elective sclerotherapy was performed by using absolute alcohol injection 2 weekly, after that 3 weekly till up to 3 months. Patients treated with propranolol bled significantly less, experienced less bleeding episode per patients (7 vs 28; p<0. Propranolol is cheap, easily available and thus, may prove beneficial and superior to injection sclerotherapy in preventing of upper gastrointestinal bleeding in cirrhotic patients. This study was also carried out to observe the effectiveness of metronidazole on them. The stool samples were collected from diarrhoeal unit of Yangon Children Hospital. If they were present in the stool, the patient was treated with metronidazole and the stool was rechecked again. Intragastric injection of both the argete and unlabelled toxin produced a significant increase of fluid targeted n i ratio over the controls indicating that the biological activity was not lost during radioiodination. In vivo uptake studies of the argete toxin by different parts of the intestine namely duodenum, jejunum and ileum indicated that the uptake by duodenum was highest and the uptake was found to decrease gradually in other parts of the intestine, jejunum and ileum, respectively. The uptake of the argete toxin by subcellular particles of intestinal cells indicated that the toxin uptake was maximum in mitochondrial-lysosomal fraction probably confirming our previous report on lysosomal involvement in the digestion of toxin. The results also seem to be consistent with the short-lived physiologic hypersecretory action of the toxin. Random samples of 396 stool samples from 238 males and 158 females with their ages ranged from one month to ten years old were included in this study. Simultaneously, a set of questions was prepared to ascertain stool characteristics and the duration and motion of diarrhoea of children. Cryptosporidium oocysts were stained by the method of Kinyoun s acid modified Haley and Standard 1973. Socio-economic status, and severity of diarrhoeal diseases, in children under five years of age. The study was a cross sectional survey and standard structured interview schedule was employed. A total of 270 mothers from children with severe, moderate, and mild diarrhoea were interviewed. A high socio- maternal knowledge and attitude but relatively low practices related to diarrhoea were encountered. The study concluded that communication and education for health programmes integrated localized programmes as well as multi- media approach. Defective gastric acid secretion predisposes to abnormal small intestinal bacterial overgrowth and recurrent enteric infection, both conditions may lead to the development of persistent diarrhoea and malabsorption, resulting in malnutrition and growth, failure; and excessive g astric acid secretion may lead to peptic ulceration. Generally, it is measured by aspirating stomach contents with a nasogastric tube after administration gastric stimulant such as pentagastrin.

Reporting suspected cases enables the woreda Health Ofce and other higher bodies to start epidemic investigation and laboratory diagnosis as soon as possible mycelex-g 100mg, and collaborate with you in taking action to control the outbreak before it spreads generic mycelex-g 100mg overnight delivery. You should try to identify everyone who has been in close contact with the source patient (i buy mycelex-g 100mg online. It is particularly important to locate everyone who has been eating the same food or drinking water from the same place as the patient. Give these individuals advice to seek early treatment if the illness starts and to report it immediately. Ensure that everyone in contact with the patient knows that they must be especially careful to wash their hands very thoroughly with soap and water after touching the patient, as well as at all the usual times (after defaecation, before preparing food or eating, etc. Make sure that faeces or vomit from the patient cannot contaminate sources of drinking water, for example, when washing the patient ssoiled clothes, bedding or drinking cups. In a cholera epidemic, everyone in the community must use protected water sources for drinking, and either boil the water or disinfect it by adding chlorine. Disinfection of clothes contaminated with faeces and vomit, and articles used by patients, is essential; they should be boiled or scrubbed with a disinfectant solution such as chlorine bleach. Interruption of foodborne transmission includes cooking food thoroughly before eating, preventing contamination of food by ies and avoiding eating raw vegetables and fruits. Educate carers that a very small number of organisms can cause infection and that strict hygiene precautions are needed when handling the faeces of patients. In addition, patients and carers should understand that anyone with a Shigella infection should not prepare food for others to eat, or care for a young child or a sick person, until a month after recovery. This is because the bacteria continue to be shed from the person in their faeces for several weeks, and can easily be transmitted to vulnerable contacts. In adults, (Photo: Basiro Davey) diarrhoea may be present in the early stage of the illness, but this quickly turns to constipation. If you are trained to palpate the abdomen, you may be able to feel an enlarged liver and spleen. Typhoid fever is a major health problem in poor communities and is endemic (always present at a relatively constant rate) in Ethiopia. Transmission of typhoid fever can occur by the direct faeco-oral route, but it is mainly transmitted indirectly through contaminated water and food. Even after ruling out malaria, you can t be sure of the diagnosis of typhoid fever, because meningitis and relapsing fever can also present with similar symptoms and signs. Therefore, if you suspect typhoid fever, refer the patient to the nearest higher level health facility for laboratory diagnosis and specialist treatment. As with other faeco-oral diseases, your role in the prevention and control of typhoid fever is giving health education to your community on measures that aim to interrupt faeco-oral transmission. In the next study session, we will focus on faeco-oral diseases caused by single-celled parasites and helminths (worms). The technique for conducting the Summary of Study Session 33 test was described in Study Session 8 of this Module. The mother says the child is still partly breastfed, and is eating and drinking normally. In this study session, we will describe the main intestinal parasitoses (pronounced para-sit-oh-seez ), i. You will learn about the intestinal protozoa (single-celled organisms) causing amoebiasis and giardiasis,andthe intestinal helminths known as ascaris worms and hookworms. It is important for you to know about these diseases so that you can treat or refer cases and apply prevention and control measures in your community. The prevention and control measures for these conditions are the same as you have already learned in earlier study sessions in relation to other faeco-oral diseases. However, you will notice that there are signicant differences in the symptoms and treatment of the parasitic diseases described here. Learning Outcomes for Study Session 34 When you have studied this session, you should be able to: 34. Both conditions are also classied as diarrhoeal diseases based on the characteristic symptom of diarrhoea. The prevention and control measures against both diseases are the same as for other faeco-oral diseases described previously (refer back to Study Session 32, Section 32. It is endemic in Ethiopia, and research studies have shown a prevalence of amoeba infection ranging from 4% to 19% in the Ethiopian population. Individuals who develop amoebiasis, experience bloody diarrhoea (so the disease is also known as ameobic dysentery), fever and abdominal cramps, sometimes alternating with periods of constipation. Unlike in cases of bacillary dysentery, the blood and mucus is mixed with solid stool and patients are not usually bedridden.

In addition buy mycelex-g 100mg with visa, non enrolled school age children had higher than school children in the infection rates of Ascaris lumbricoides (66 buy mycelex-g 100mg fast delivery. The policy implicating of this study is that health and nutritional status of non enrolled school aged children needs to be promoted and this should be partly solved by the provision of regular and periodic mass chemotherapy against the nutrition influencing major intestinal parasitoses mycelex-g 100 mg on line. To this end, diarrhoea with subsequent childhood malnutrition, which is prioritized as the fourth national health problem in Myanmar and which demands worldwide concern was selected for a qualitative/quantitative study to assess the effectiveness of health education on the perception and practice of mother regarding diarrhoea. A sample of 345 mothers was selected by systematic random sampling method from a population who had been given self-care sessions. Regardless of the age or educational status most have good knowledge on diarrhoea and its home care procedure (89%). However, maturity, educational status and experience are attributes for the ability to translate knowledge into good practice as 83. This study illustrates the value of primary education in acquiring knowledge of health educational messages. Its also reveals the importance of technical skill of health educators in structuring messages for the public in order to materialize change in the attitude of community and ensure its commitment nd mobilization. Research findings since 1980 on Escherichia coli as an etiologic agent responsible for diarrhoeal diseases in Myanmar are reviewed and presented. The incidence and seasonality of Escherichia coli diarrhea in community and hospital based settings, in adults and children were reported. The review also consisted of studies on pathogenesis of Escherichia coli and on plasmid profiles. They are all sensitive to nalidixic acid but 97 percent to gentamycin, 96 percent to sisomycin and 95 percent to tobramycin respectively. It was observed that one case from diarrhoea cases showed alpha haemolytic activity; none of the control cases showed any haemolytic activity; and 3 cases of urinary tract infection showed beta haemolytic activity. Simultaneously, a set of questions was filled to ascertain the diarrhoea and motion of diarrhoea of children. Random samples of 238 males and 158 females children of age ranging from one month to ten years old were included in this study. From the cases detected, the age range was from ten months to five years and the duration of illness was from 3 to 30 days. It was then serotyped using O antisera by test tube serial dilution technique and found that 33 cases showed agglutination. Most of them were resistant to ampicillin, chloramphenicol, streptomycin, tetracycline and trimethoprim/sulfamethoxazole. Fecal leukocytes were identified under a high power microscope by wet mounting of methylene blue staining method. Those cells clearly identified with either round nucleus or as polymorphonuclear were noted and degenerated cells that could not be clearly identified were ignored. The bacterial pathogens and protozoal pathogens were identified by standard methods. Fecal leukocytes were present 114 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar in 31. The association between the presence of fecal leukocytes and isolated pathogens from the stools was analyzed. It was found that fecal leukocytes were seen in stools which are associated with shigella (25%), Shigella and Entamoeba histolytica 971. A total of 1805 isolates 115 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar of E. It was serotyped by using O antisera using test tube terial dilution technique and observed that 93 isolates showed agglutination. The ingredients (24 plants) present in it were selected singly and tested for their antibacterial activities. A total of 35 strains of bacteria (Escherichia coli=11; Staphylococcus aureus=3; Salmonella species=7; Shigella species=4; Vibrio cholerae=7 and one species each of Bacillus subtilis, Pseudomonas aeruginosa and Proteus morganil) were chosen for testing. Among the 23 plants tested, they were found to be active on one, two or more of the bacteria tested with different patterns 328 Mar Mar Nyein; T. It was also noted that Salmonella and Plesiomonas isolation rates were higher in the control group. Antibiotic susceptibility test revealed that these shigellae were resistant to ampicillin (84 per cent), chloramphenicol (76 per cent). From the above cases, 272 cases were also performed for the isolation of other aetiologic agents and observed that Shigella isolated from 3 cases; Vibrio species were isolated from 2 cases; and Plesiomonas shigelloides was isolated from 3 cases respectively. Adherence cell assay was done by using Lab Tek chamber slides seeded with Hep- 2 cells. Thus a study was conducted on 2522 Escherichia coil isolates from 501 diarrhoeal cases and 374 control cases from the Intakaw survey. Enterotoxigenic stains were isolated from 91 cases of diarrhoea ad from 29 control cases. A total of 923 cases of diarrhoea and 932 cases of control were included in this study.

On the first postoperative day 12% of group A patients and 36% of group B passed flatus order mycelex-g 100mg with amex. Bowel sound was 137 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar st present in 56% of group A and 64% of group B on 1 postoperative day cheap 100mg mycelex-g otc. Ninety four per nd cent of group A and 96% of group B on 2 postoperative day and all cases of both groups rd on 3 postoperative day buy 100 mg mycelex-g fast delivery. Vomiting occurred in 4 cases of group A and one case of group B st in 1 postoperative day. Vomiting nd rd occurred in 2 cases and one case of group A on 2 and 3 postoperative days respectively. None of the patients from group B needed reinsertion of nasogastric suction tube. Conclusion: These findingssuggest that, in uncomplicated acute appendicitis, there is no difference in the return of gastrointestinal motility between those patients with postoperative nasogastric suction and those patients without. Oral fluid feeding is permissible in early postoperative period after emergency appendicectomy for uncomplicated acute appendicitis. Malignant tumours of the gastrointestinal tract were considerable and those of inflammation were equally common. Histological typing of the malignant condition were also studied and inflammatory conditions were analysed for specific and non specific lesions. Prophylactic antibiotic iv ampicillin 500mg just prior to operation and another 2 doses after operation were given and those (34) cases were excluded from this study. The results of peritoneal swab for C&S from all cases of acute appendicitis were sterile. During histopathological examination, there were moderately inflamed appendix in 25 cases and severely inflamed appendix in 8 cases. Postoperative wound sepsis was found in three cases which are superficial in natures are well healed after a few days of dressing. The purpose of submitting this paper is to analyse clinical and histo-pathological findings of acute appendicitis and effective role of using prophylactic antibiotic. Non-operative conservative treatment is safe and effective in preventing continuing leakage and promoting spontaneous st st sealing of the perforation. From 1 July 1990 to 31 October 1991, forty patients with perforated peptic ulcers were admitted to surgical unit of Sao San Htun Hospital, Taunggyi. The protocol for the conservative approach, the outcome of the patients who need surgical intervention and those whose ulcers have sealed spontaneously without operation will be discussed. The prevalence of excretors increases with age until a peak is reached at 41-60 age group and then declines (p<0. Socioeconomic and sanitary factors were not found to significantly influence the prevalence of breath methane excretors. Therefore, a convenient sample of (87) General Practitioners from Yangon Municipal area was requested to answer the self administrated questionnaire. Rectal swabs were also taken and investigated for culture at Bacteriology Research Division of Department of Medical Research. Varieties of clinical presentations; associated conditions and complications were observed among acute diarrhoea cases. It was also found that environmental and personal hygiene are important for prevention of diarrhoea. Maternal literacy and education is one of the important factors for child survival in diarrhoea disease. Permeability was measured by differential sugar absorption tests using lactulose and rhamnose. No significant differences in the sugar ratios were found in between maramus and well nourished children, and between marasmic-kwashiorkor and marasmic children (p>0. It is postulated that reduce L-rhanmose urinary excretion in malnutrition is due to a reduction in absorption area in the small bowel, whereas, increased lactulose excretion indicated leakiness on the abnormal mucosa to large polar molecules. It compares the efficacy of preoperative single dose antibiotic with postoperative routine antibiotic therapy in prevention of wound sepsis. The two groups were not ideal comparison for age, sex and other risk factors due to limitation of study periods and due to emergency operation. There was no significant difference between 2 groups in wound sepsis rate, oher post-operative infection rate and hospital stay. All patients underwent surgery and biopsy was taken for histological confirmation. Most common causes of neoplastic obstruction is adenocarcinoma and accounts for 90%. The common physical signs are anaemia, dehydration, 141 argeted 141n splash and visible peristalsis. Other signs of epigastric mass, and lymph node enlargement are particularly found in neoplastic cases. Mucosal destruction and irregular filling defect are mostly found in neoplastic obstruction. Morphologically, the infiltrating, the polypoid or fungating type are most common.