A Survey on Current Practice of Management of Early Onset Neonatal Sepsis

It was a survey type of cross sectional study where the participants were from different teaching/referral hospital across the country and was done to gather information regarding current practice of management of neonatal sepsis among paediatricians and neonatologists and was conducted on the spot during a national conference of Bangladesh Perinatal Society in December 2013. Specialists in neonatology, paediatrics, and some other disciplines working in different institutes across the country were requested to respond. Out of 150 physicians, 92 (61.33%) were neonatologists. Physicians suspected early onset neonatal sepsis (EONS) when there is history suggestive of prolonged rupture of membrane (74.77%), prolonged labour (9.33%), chorioamnionitis (7.33%) and maternal fever (2%). Clinical sepsis is found commonly (53.33%) which is later proved by laboratory evidences such as Hb%, TC, DC PBF (peripheral blood film), C-reactive protein, chest X-ray etc. Injection Ampicillin and Gentamycin are still the first choice of antibiotics (61.3%). Preferred route was intravenous (95.3%). Antibiotics were given for 7-10 days by most of the physicians (48.77%). However there is lack of uniformity among the participants in regard to taking decision about antibiotics, the choice of first line and the subsequent options of antibiotics. So, neonatal sepsis is the most important cause of neonatal mortality in the community. Therefore a standard protocolized approach for diagnosis and management of Early Onset Neonatal Sepsis may prove critical which is currently not in practice uniformly.

Neonatal Conjunctivitis Leading to Neonatal Sepsis--A Case Report

Neonatal conjunctivitis is the most common occular disease in neonates. Most infections are acquired during vaginal delivery. In spite most of these cases are benign; some of them may progress to systemic complications like loss of vision if left untreated. The authors present a case of a newborn who developed late onset neonatal sepsis from E. coli positive conjunctivitis. The baby was treated with Injection Meropenem and Injection Amikacin for 10 days. The course was uneventful, after that baby responded well and discharged home on 24th day.

Re-DCR with Silicone Tube Intubation: An Effective Method of Management of Failed DCR

This prospective observational study was performed with twenty nine eyes of Twenty eight patients who were operated upon for chronic dacryocystitis eight months to two years six months before, presented with history of persistent watering and discharge. Number of male was 6(21%) and female was 22(79%). Re-DCR with silicone tube intubation was performed in all the patients. Post operative follow up for a period of 12-24 months revealed absence of symptoms in 28 eyes (97%) while 1(3%) eye persisted with watering and discharge despite uncomplicated surgical procedure. There are so many options for management of Failed DCR, among them Re-DCR with Silicone Tube Intubation is the most safe and less cost effective method.

Analysis on the effect of the distances and inclination angles between human head and mobile phone on SAR

The aim of this paper is to investigate the effects of the distances between the human head and internal cellular device antenna on the specific absorption rate (SAR). This paper also analyzes the effects of inclination angles between user head and mobile terminal antenna on SAR values. The effects of the metal-glass casing of mobile phone on the SAR values were observed in the vicinity of the human head model. Moreover, the return losses were investigated in all cases to mark antenna performance. This analysis was performed by adopting finite-difference time-domain (FDTD) method on Computer Simulation Technology (CST) Microwave Studio. The results indicate that by increasing the distance between the user head and antenna, SAR values are decreased. But the increase in inclination angle does not reduce SAR values in all cases. Additionally, this investigation provides some useful indication for future design of low SAR mobile terminal antenna.

Retrobulbar abscess in a child

A 14 months old male child was admitted into Mymensingh Medical College Hospital (MMCH), Bangladesh, with fever, watering, swelling, redness of right eye and running nose. On initial examination, patient was febrile, toxic, right-sided severe proptosis, restricted ocular movement, conjunctival chemosis and exposure keratitis of right eye. A sluggish pupillary light reaction was present in the right eye. Visual acuity was not recordable. CT scan of Brain and Orbit revealed, retrobulbar abscess of right orbit. The left eye was normal. The abscess was drained through a wide bore needle. The extraocular motility improved and pupil became brisk with a reduction in the temperature and toxic signs within 48 hours following surgery. Proptosis at the time of discharge from the hospital was absent in the right eye with no other complication. Post operative 8 months follow up period was excellent.

Placental changes in pregnancy induced hypertension and its impacts on fetal outcome

A descriptive cross sectional study was carried out in the Gynae and Obstetrics & Pathology department of Mymensingh Medical College & Hospital (MMCH) to see the placental changes in normal & pregnancy induced hypertension (PIH) and its impacts on fetus for one year period. Total 80 placentas were collected, 40 from normal pregnant mothers having no hypertension and 40 from PIH group (one from gestational hypertension, 17 from pre-eclampsia and 22 from eclampsia. Macroscopic study of the placenta revealed placental weight, surface area and number of cotyledons were less in study group. Mean placental weight in study group was 419.50gm and in control group was 477.50 (p<0.001). Mean surface area in study group & control group were 232.29cm² and 304.80cm² respectively (p<0.001). Mean number of cotyledons were 15.39 and 17.40 in study & control group respectively (P<0.001) and lower diameter of umbilical cord (p<0.04667). But in the present study placental thickness was not significant (p<0.539). There was a single umbilical artery present in one patient in PIH group .In PIH group syncytial knots (95%), fibrinoid necrosis (80%), VSM (vasculosyncytial membrane) formation, sclerosis, chorangiosis and calcification were more marked. Infarction was present in placenta of PIH 34(85%) and in control group 8(20%). There was a tendency of lowering the weight of neonate 2.47kg in study group and 3.06kg in control group (p<0.001), number of asphyxiated babies and perinatal morbidity and mortality( still birth was 7.5 and neonatal death was 15%) were more marked in PIH group. In PIH group placental changes were related with fetal outcome. Common placental changes were significant in this study.

Purification and Characterization of Peroxidase From Anthracnose Disease Infected Papaya (Carica papaya L.)

Peroxidase enzyme was isolated and purified from the pulp of disease infected ripen papaya of local variety by 90% ammonium sulphate precipitation, chromatography on DEAEcellulose followed by hydrophobic chromatography on Phenyl Sepharose CL-4B and the purifications achieved was about 7.2 fold with 2.5% recovery. The purified enzyme was homogeneous as judged by polyacrylamide slab gel electrophoresis. The purified enzyme had a Mr of about 55,000 and 50 000 as determined by gel filtration on Sephadex G-100 and SDS-PAGE, respectively. The molecular mass of the enzyme was found to be very similar under both reducing and non-reducing conditions indicating that the enzyme contains no subunit. The enzyme has the following characteristics: pH optima at 6.0, temperature optima around 38°C, enzyme activity was found to be strongly inhibited in the presence of potassium cyanide and Fe+2 while the activity was found to be remarkably increased in the presence of ammonium sulphate. The Km value for the peroxidase obtained with pyrogallol as substrate was 0.027 mM. DOI: http://dx.doi.org/10.3329/bjmb.v6i2.17643 Bangladesh J Med Biochem 2013; 6(2): 49-57

Correlation and Path Analysis in Six Strawberry (Fragaria ananassa) Genotypes

A field experiment was conducted at the Horticulture Farm of Sher-e-Bangla Agricultural University, Dhaka with a view to study character association and path analysis in six strawberry genotypes. The trial was laid out in a Randomized Complete Block Design with three replications. Data on crown height, number of flower buds per plant, number of flowers per plant, number of fruits per plant, length and breadth of fruit and fruit yield per plant were collected. All the characters showed significant correlation with fruit yield. Path analysis revealed that crown height, number of flowers per plant and length of fruit had the positive direct effect on yield per plant. Number of flower buds per plant, number of fruits per plant and breadth of fruit had negative direct effect on yield per plant. DOI: http://dx.doi.org/10.3329/agric.v11i2.17491 The Agriculturists 2013; 11(2) 74-78

Prevalence of colour blindness among the first year medical & dental students of Mymensingh Medical College, Bangladesh

The purpose of this study was to detect the etiology, type and prevalence of colour blindness & to create awareness among the blind personnel. A survey of colour blindness among 239 ( male-87 & female-152) Medical and Dental first year students during their medical checkup before admission into Mymensingh Medical College in the session of 2012-2013 was done. Among them 8(male-7, female-1) were colour blind and prevalence was 3.35 % with a marked male predominance (male 8.04%, female 0.66 %). In view of the potential difficulties faced by such personnel in clinical works, detection during medical admission allowed appropriate counseling regarding subject selection for their future carrier.

Placental changes in pregnancy induced hypertension

A descriptive cross sectional study was carried out in Gynae and Obstetrics & Pathology department of Mymensingh Medical College Hospital (MMCH) to see the placental changes in normal pregnant & pregnancy induced hypertensive (PIH) mother. Total 80 placentas were collected, 40 from normal pregnant mothers having no hypertension and 40 from PIH group (one from gestational hypertension, 17 from pre-eclampsia and 22 from eclamptic mother). Macroscopic study of the placenta revealed placental weight, surface area and number of cotyledons were less in study group. Mean placental weight in study group was 419.50gm and in control group was 477.50gm (p<0.001). Mean surface area in study group & control group were 232.29cm² and 304.80cm² respectively (p<0.001). Mean number of cotyledons were 15.39 and 17.40 in study & control group respectively (p<0.001) and lower diameter of umbilical cord p<0.04667. But in the present study placental thickness was not significant p<0.539. In PIH group, macroscopic infractions were more marked. There was a single umbilical artery present in one patient in PIH group. In PIH group syncytial knots (95%), fibrinoid necrosis (80%), VSM formation, sclerosis, chorangiosis and calcification were more marked. Infarction was present in placenta of PIH 34(85%) and in control group 8(20%). Common placental changes were significant in this study. So, early intervention in PIH is rational to get the good perinatal morbidity and mortality.

Guillain-Barre Syndrome Following Dengue Fever in Adult Patient

Guillain-Barre syndrome is a post infectious ascending, usually demyelinationg polyradiculoneuropathy. Dengue fever as an antecedent infection in GBS is uncommon. A 39-year-old female presented with acute flaccid weakness of both upper and lower limbs which developed in ascending and progressive fashion following a febrile illness of three days. During work-up IgM for dengue virus was found positive. Diagnosis of Guillain-Barre syndrome was made based on neurologic manifestations, the typical CSF findings and pattern of electrophysiological study and exclusion of other pathologies. Patient was treated with intravenous immunoglobulins. During the course of illness, she developed lower motor neuron type trigeminal, facial, glossopharyngeal, vagus and hypoglossal nerve palsy and autonomic involvement. She had significant recovery and was able to talk, eat and walk six weeks later. Dengue is endemic in Bangladesh. Post dengue Guillain- Barre syndrome in adult, as shown in previous reports, should now be considered in the part of spectrum of neurological complications of this infection. DOI: http://dx.doi.org/10.3329/jom.v13i2.12772 J Medicine 2012; 13 : 246-249

A follow-up experience of 6 months after treatment of children with severe acute malnutrition in Dhaka, Bangladesh

AIM

As there is lack of information about what happens to children after recovery from severe acute malnutrition (SAM), we report their relapse, morbidity, mortality and referral during follow-up period.

METHODS

From February 2001 to November 2003, 180 children completing acute and nutrition rehabilitation (NR) phases of protocolized management were advised for 6-months follow-up. The mean (SD) age was 12 (5) months, 55% were infants, 53% were male and 68% were breast-fed.

RESULTS

The follow-up compliance rate dropped from 91% at first to 49% at tenth visit. The common morbidities following discharge included fever (26%), cough (24%) and diarrhoea (20%). Successful follow-up done in 124 children [68.9% (95% CI 61.8-75.2%)], partial follow-up in 45 [25% (95% CI 19.2-31.8%)], relapse in 32 [17.8% (95% CI 12.9-24%)] and 5 [2.8% (95% CI 1.2-6.3%)] died.

CONCLUSION

Our findings highlight need for follow-up as part of overall management of SAM and recommend an effective community follow-up.

Pattern of ocular trauma

This prospective observational study was conducted in the department of Ophthalmology Mymensingh Medical College Hospital during the period of November, 2009 to October, 2010. Two hundred & fifty (250) patients of both sexes and all ages with ocular trauma were selected randomly for this study. A detailed history of patients, duration of trauma, relation of trauma with work, visual status prior to injury, any surgery prior to injury & patients were alcoholic or not were taken. Male patients were 190(76%) and female patients were 60(24%). Majority of patients were 11-20 years group (39.2%). Most of patients (40%) attended into hospital within 60 hours of ocular trauma. Accidental occupational trauma were more common (51.2%) and assault injury were less common (12.8%). Greater number of ocular trauma was caused by sharp objects (59.2%) and less number of ocular trauma was caused by chemical injuries (2.4%). Open globe injuries were more common (62%) than closed globe injury (38%). Visual acuity on admission between 6/60 to PL comprises highest number (64%) and also on discharge between 6/60 to PL comprises highest number of cases (50%). Most of the patients came from poor socioeconomic group (60%).

Human thelaziasis in Bangladesh

Very few cases of Human Thelaziasis are reported worldwide. This is the first case of its kind from Bangladesh. A 58 years old man was admitted to Ophthalmology department of Mymensingh Medical College Hospital, Mymensingh, with itching, redness, foreign body sensation, lacrimation & filamentary discharge from right eye (R/E). He had visual acuity <6/60, conjunctival congestion & advanced bi-headed pterygium of R/E. After exposure of R/E ball with universal eye's speculum, a thin white nematode was found into the right lower conjunctival fornix. It was taken out by a plain forceps, placed into a bottle containing Hartman's solution & immediately sent to Microbiology department of Mymensingh Medical College for proper identification. Subsequently with the joint collaboration & detailed examination by the Parasitology department of Bangladesh Agricultural University (BAU), Mymensingh, the nematode was identified as an adult Thelazia callipaeda worm.

Hypoglycaemia in under-five children with diarrhoea

The present study aimed to observe the clinical features of hypoglycaemia, and identify predictors of hypoglycaemia in under-five diarrhoeal children requiring hospitalization for close observation and support. Such information could be useful to the clinicians and policy makers in developing appropriate management protocols both for identification of such children and optimizing their management. We performed a prospective study in 782 under-five children who presented with diarrhoeal illnesses. Blood glucose was determined when hypoglycaemia was suspected in 598 (62%), and 65 (11%) of them were hypoglycaemic (study group). From the other 533 non-hypoglycaemic children, 195 were randomly selected as comparison group. Bacteraemia was significantly (P = 0.026) often detected in 17 out of 260 (7%) children as opposed to 3 out of 184 (2%) children who did not have a rapid glucose test performed. Among hypoglycaemic children, 7 (11%) were bacteraemic and among non-hypoglycaemic children 10 (5%) had bacteraemia. In univariate analysis, history of shorter (<72 h) pre-admission duration of diarrhoea (75 vs. 58%, P = 0.01), documented convulsion (28 vs. 11%, P < 0.001), shorter (<72 h) hospitalization (52 vs. 33%, P = 0.01), higher case fatality rate (28 vs. 14%, P = 0.02) were associated with hypoglycaemia. In logistic regression, bacteraemic children (with clinical sepsis) were 4 times more likely to develop hypoglycaemia (OR = 4.2, 95% CI = 1.4-12.9, P = 0.012). Therefore, in a diarrhoeal disease health care service with limited resources, a rapid bedside glucose test may be considered as an inexpensive alternative in the management decisions of diagnosing bacteraemia and initiating empiric antibiotic treatment.

Day-care management of children with severe malnutrition in an urban health clinic in Dhaka, Bangladesh

Management of severely malnourished children with associated complications relies on hospital-based treatment. Implementation of a standardized protocol at the Dhaka Hospital, ICDDR,B reduced case fatality approximately 50%. We developed and prospectively evaluated a day-care clinic approach that provided antibiotics, micronutrients and feeding during the day with continued care by parents at home at night as an alternative to hospitalization. Severely malnourished children aged 6-23 months denied admission to hospital were enrolled at Radda Clinic, Dhaka and received protocolized management with antibiotics, micronutrients and milk-based diet from 8:00 am to 5:00 pm each day, while mothers were educated on continuation of care at home. They were transitioned to the day-care nutrition rehabilitation (NR) unit of Radda Clinic following resolution of acute illness, received NR diet (Khichuri, halwa and milk-based) daily until children attained 80% weight-for-length. From February 2001 to November 2003, 264 children were enrolled; 52% were boys and 78%, 21% and 1% had marasmus, marasmus-kwashiorkor and kwashiorkor, respectively. Only 13% had severe malnutrition alone while 35% had pneumonia, 35% had diarrhea and 17% had both pneumonia and diarrhea. The mean (SD) duration of acute and NR phases were 8 (4) and 14 (13) days, respectively. Children gained weight [mean (SD) g/kg day] more rapidly during acute 10 (7) than NR phase 6 (5). Successful management was possible in 82% (95% CI 77-86%) children, 12% discontinued treatment and 6% referred to hospitals. Only one child died during NR phase. Severely malnourished children can be successfully managed at existing day-care clinics using a protocolized approach.

Presence of neutral fat in stool and its association with aetiology and presenting features of diarrhoea in children

Enteric infections, impaired digestion, loss of villous cells, and poor absorption of fat may lead to presence of neutral fat in stool, particularly in children with diarrhoea. We aimed to examine the association between presence of neutral fat in stool and aetiology of diarrhoea and nutritional status of the patients at different age groups. A total of 13,171 patients aged 5 days-106 years enrolled in the Diarrhoeal Disease Surveillance System of the Dhaka Hospital of ICDDR,B during 1996-2001 were studied. Presence of neutral fat in faecal specimens, aetiology of diarrhoea, and nutritional status in children below 5 years of age were determined and analysed. Of the total study individuals, 7,671 (58%) had neutral fat in their faecal specimens. Neutral fat was more frequently present in faeces of individuals infected with rotavirus in all age groups or in enterotoxigenic E. coli (ETEC) infection in children 0-23 months old while compared with those who did not have these infections (p=0.005, p=0.014, respectively). Neutral fat was less frequently (p<0.001) present in malnourished 0-23 months old children. Presence of neutral fat in the stool in diarrhoea due to rotavirus and in young childhood ETEC diarrhoea signifies compromised gastrointestinal function due to these infections. The mechanism of persistence of neutral fat in the stool of such patients, and its nutritional and clinical implications require further studies.

Topography and morphometry of the common bile duct and major duodenal papilla of man and principal domesticated animals

A comparative topography and morphometry of the common bile duct and major duodenal papilla was studied on the extrahepatic biliary apparatus of human and major domesticated animals such as horse, ox, Black Bengal (BB) goat, sheep, dog and cat of local breed. In Black Bengal goat, sheep, dog and cat, the extrahepatic biliary system seemed to be the continuation of the cystic duct, which was found to continue as the common hepatic/common bile duct into which all the hepatic/lobar ducts open. In man, the mean length and the mean diameter of the common bile duct were 7.67+/-0.58 cm. and 7.27+/-0.77 mm. respectively. In the ox, these values were 1.57+/-0.72 cm. and 11.82+/-0.79 mm. respectively; in the Black Bengal goat, 7.23+/-0.74 cm. and 4.45+/-0.72 mm. respectively; in the sheep, 5.27+/-0.66 cm. and 3.75+/-0.79 mm. respectively; in the dog, 4.72+/-0.67 cm. and 6.43+/-0.55 mm. respectively and in the cat, 3.26+/-0.87 cm. and 5.63+/-0.43 mm. respectively. In man, the mean length and the mean diameter at the base of the MDP were 4.37+/-0.56 mm. and 3.97+/-0.72 mm. respectively. In horse, these were 52.36+/-0.67 mm. and 12.47+/-0.63 mm. respectively; in ox, 12.53+/-0.73 mm. and 8.83+/-0.68 mm. respectively; in Black Bengal goat, 14.36+/-0.55 mm. and 5.23+/-0.57 mm. respectively; in sheep, 11.27+/-0.69 mm. and 4.51+/-0.74 mm. respectively; in dog, 17.43+/-0.82 mm. and 6.72+/-0.64 mm. respectively and in cat, these values were 12.36+/-0.47 mm. and 7.12+/-0.87 mm. The distance of the Major Duodenal Papilla (MDP) form the pyloric end of the stomach was proportionately shorter in the meat-eaters, i.e., the omnivorous man (9.76+/-0.88 cm), and the carnivores, dog (6.37+/-0.73 cm) and cat (2.75+/-0.87 cm.) when compared to that of the herbivores, i.e., ox (55.37+/-0.68 cm.), BB goat (23.27+/-0.89 cm.) and sheep (25.62+/-0.77 cm.). In the horse, the major duodenal papilla was perpendicular to the duodenal mucosal surface with the largest mean length and the mean diameter. In all other animals, it was obliquely placed on the duodenal surface with its opening directed aborally.

Shigella serotypes among hospitalized patients in urban Bangladesh and their antimicrobial resistance

We studied the isolation of Shigella spp., and their antimicrobial resistance. S. flexneri (54 %) was most frequently isolated, followed by S. dysenteriae (20 %), S. boydii (16 %) and S. sonnei (10 %). Among S. flexneri (n = 122), 29 (24 %) were 2a, and 23 (19 %) were 2b. None of the Shigella strains were resistant to mecillinam or ciprofloxacin. Resistance to nalidixic acid was most frequent among S. dysenteriae type 1 (100%) followed by S. flexneri 2a (69%), and S. flexneri 2b (52 %). Systematic monitoring is needed to identify most prevalent serotypes, and to detect changes in the prevalence and antimicrobial resistance pattern.

Mucoepidermoid carcinoma of the lung--a case report

Mucoepidermoid carcinoma is an uncommon primary lung tumor. Mucoepidermoid carcinomas have been reported in all age group and equally in both sexes. A case of mucoepidermoid carcinoma histologically confirmed by biopsy is reported here. The patient is a 15 years old male presented with cough and dyspnoea for 5 days. Chest roentgenography showed segmental consolidation of right lower lobe. Chest computed tomography revealed a soft tissue mass with calcification within the lumen of lower trachea in precarinal location. The patient underwent thoracotomy for endotracheal mass and resection was done. Following operation, the patient is symptom free and follow-up CT scan shows normal tracheal outline.

Aeromonas-associated diarrhoea in Bangladeshi children: clinical and epidemiological characteristics

We studied the clinical and epidemiological features associated with Aeromonas diarrhoea by a hospital survey of 7,398 children under 5 years of age presenting with diarrhoea. The data were actually based upon two cohorts from this survey, the majority of the data being identified from 405 (5.5%) in whom Aeromonas was the sole enteric pathogen. Aeromonas caviae was the most prevalent species, accounting for 32% (129/405) of all isolates. Eighty-three per cent of children with Aeromonas-associated diarrhoea were younger than 3 years. The majority of the children had acute onset of vomiting and watery diarrhoea resulting in mild to moderate dehydration. Fever, non-watery diarrhoea, age less than 3 years, and diarrhoea of 7-14 days duration were found to be significantly associated with Aeromonas diarrhoea compared with Vibrio cholerae O1 infection after adjusting for confounders. Aeromonas-associated diarrhoea was most common from March to May (during the peak of the hot and humid season), and September to October, similar to Vibrio cholerae O1. Our results indicate that Aeromonas infection is common in young children presenting with diarrhoea in Bangladesh.

Laboratory evaluation of selected larvicides and insect growth regulators against field-collected Culex quinquefasciatus larvae from urban Dhaka, Bangladesh

Five organophosphates (OPs) (chlorpyrifos, chlorpyrifos methyl, fenthion, malathion, and temephos), 3 pyrethroids (bifenthrin, cypermethrin, and permethrin), 1 phenyl pyrazole (fipronil), 2 microbial pesticides (Bacillus thuringiensis serovar. israelensis [B.t.i.] and Bacillus sphaericus), and 3 insect growth regulators (IGRs) (diflubenzuron, methoprene, and pyriproxyfen) were evaluated against field-collected Culex quinquefasciatus larvae from urban Dhaka, Bangladesh. The LC90 values of all OPs, except for temephos (LC90 = 0.0096 ppm), were high, ranging from 0.13 ppm (fenthion) to 2.882 ppm (chlorpyrifos methyl). Pyrethroid LC90 values were 0.021 ppm (bifenthrin), 0.00061 (cypermethrin), and 0.017 ppm (permethrin). Fipronil exhibited a superior activity with LC90 value of 0.000896 ppm. Technical powders of B.t.i. and B. sphaericus (VectoBac TP and VectoLex TP) were considered highly effective against the Cx. quinquefasciatus larvae. The IGRs also were effective with pyriproxyfen (LC90 = 0.0011 ppm), being 3 times and 47 times more active than diflubenzuron (LC90 = 0.0034 ppm) and methoprene (LC90 = 0.052 ppm), respectively. In general, toxicity ranking of chemicals and microbials tested was phenyl pyrazole > IGRs > pyrethroids > microbials > OPs.

Intra- and extracellular water dynamics on rehydration in cholera and noncholera patients

To estimate the intra- and extracellular body water compartments during rehydration of patients with cholera and noncholera diarrhea by bioimpedance analyzer, we studied 30 patients with acute watery diarrhea. Total body water (TBW), intracellular water (ICW), and extracellular water (ECW) of severely dehydrated adult patients were measured with a dual frequency bioimpedance analyzer at different phases of rehydration. Fluid compartments between cholera and noncholera patients were compared. Cholera patients gained more TBW than noncholera patients during recovery. Unlike patients with noncholera diarrhea, the gain in cholera patients was mainly contributed by the ICW (1.5 +/- 1.6 vs 3.0 +/- 1.2 liters, respectively, P < 0.01). It was also observed that the recovery of the ICW compartment in cholera patients occurred rapidly within the first 2 hr after infusion. Differential dynamics of body water compartments in cholera compared to noncholera patients as observed in this study may contribute further to understanding the mechanism of dehydration in diarrheal disease, which might help in improving case management.