Clinical Management of Infectious Diarrhea

Effects of Dietary Supplementation with Tea Residue on Growth Performance, Digestibility, and Diarrhea in Piglets

Thirty-six healthy 21-day-old weaned ternary piglets (Duroc × Landrace × Yorkshire) were randomly divided into two treatments with 18 replicates per treatment and one pig per replicate. The control group was fed with a basal diet and the test group was fed with diets supplemented with 1 kg/t tea residue. The test period was 28 days. The results are as follows: The addition of tea residue in the diet had no significant effect on the growth performance of weaned piglets (p > 0.05), but it could significantly reduce the diarrhea rate of piglets from 1 to 7 days and 1 to 28 days (p < 0.05). Compared with the control group, the dietary supplementation of tea residue had no significant effect on nutrient apparent digestibility, plasma biochemical indexes and plasma immune indexes (p > 0.05) but increased the content of glutathione in plasma (p < 0.05). Tea residue had no significant effect on the morphology of the jejunum and ileum of piglets (p > 0.05), but it could significantly reduce the content of chloride ions in feces (p < 0.05). Compared with the basal diet group, there was no significant difference in the relative expression of TMEM16A and CFTR mRNA in the colon of weaned piglets (p > 0.05). The whole-cell patch clamp recording showed that the TMEM16A and CFTR ion channels could be activated by ionomycin and forskolin, respectively. However, when HT-29 cells transfected with TMEM16A and CFTR channels were treated with tea residue extract, it could significantly inhibit the chloride current of the TMEM16A and CFTR ion channels (p < 0.05).

A review of Brucea javanica: metabolites, pharmacology and clinical application

This review examines advances in the metabolites, pharmacological research, and therapeutic applications of the medicinal fruit of Brucea javanica (L.) Merr. Brucea javanica (BJ) is derived from the fruit of the Brucea javanica (L.) Merr. There are nearly 200 metabolites present in BJ, and due to the diversity of its metabolites, BJ has a wide range of pharmacological effects. The traditional pharmacological effects of BJ include anti-dysentery, anti-malaria, etc. The research investigating the contemporary pharmacological impacts of BJ mainly focuses on its anti-tumor properties. In the article, the strong monomeric metabolites among these pharmacological effects were preliminarily screened. Regarding the pharmacological mechanism of action, current research has initially explored BJ's pharmacological agent and molecular signaling pathways. However, a comprehensive system has yet to be established. BJ preparations have been utilized in clinical settings and have demonstrated effectiveness. Nevertheless, clinical research is primarily limited to observational studies, and there is a need for higher-quality research evidence to support its clinical application. There are still many difficulties and obstacles in studying BJ. However, it is indisputable that BJ is a botanical drugs with significant potential for application, and it is expected to have broader global usage.

Combatting infectious diarrhea: innovations in treatment and vaccination strategies

INTRODUCTION

The escalating prevalence of infectious diseases is an important cause of concern in society. Particularly in several developing countries, infectious diarrhea poses a major problem, with a high fatality rate, especially among young children. The condition is divided into four classes, namely, acute diarrhea, invasive diarrhea, acute bloody diarrhea, and chronic diarrhea. Various pathogenic agents, such as bacteria, viruses, protozoans, and helminths, contribute to the onset of this condition.

AREAS COVERED

The review discusses the scenario of infectious diarrhea, the prevalent types, as well as approaches to management including preventive, therapeutic, and vaccination strategies. The vaccination techniques are extensively discussed including the available vaccines, their advantages as well as limitations.

EXPERT OPINION

There are several approaches available to develop new-improved vaccines. In addition, route of immunization is important and aerosols/nasal sprays, oral route, skin patches, powders, and liquid jets to minimize needles can be used. Plant-based vaccines, such as rice, might save packing and refrigeration costs by being long-lasting, non-refrigerable, and immunogenic. Future research should utilize predetermined PCR testing intervals and symptom monitoring to identify persistent pathogens after therapy and symptom remission.

Clinical characteristics and influencing factors of infectious diarrhea in preschool children: An observational study

Infectious diarrhea is a common disease in preschool children, but the pathogenic species, origins, and influencing factors remain debatable. Therefore, more studies are required to solve these debatable topics. A number of 260 eligible preschool children diagnosed with infectious diarrhea in our hospital were enrolled in the infection group. Meanwhile, a number of 260 matched healthy children from the health center were enrolled in the control group. The pathogenic species and origins, the time of onset of infectious diarrhea in the infection group, demographic data, exposure history, hygiene habits, dietary habits, and other variables in both groups were initially collected from medical documents. In addition, a questionnaire was used to complete and confirm study variables through face-to-face or telephone interviews. Then, the univariate and multivariate regression analyses were used to screen the influencing factors of infectious diarrhea. Among 260 infected children, salmonella (15.77%), rotavirus (13.85%), shigella (11.54%), vibrio (10.38%), and norovirus (8.85%) were the top 5 common pathogens; January (13.85%), December (12.69%), August (12.31%), February (11.92%), and July (8.46%) were the top 5 frequent times of infectious diarrhea. The distribution of onset time for infectious diarrhea was commonly found in winter and summer, and the pathogens always originated from foods. The results of multivariate regression analysis showed that recent exposure to diarrhea, flies, and/or cockroaches indoors were the 2 risk factors for infectious diarrhea; Meanwhile, rotavirus vaccination, regular hand-washing, tableware disinfection, separate preparation of cooked and raw foods, and regular intake of lactobacillus products were the 5 protective factors for infectious diarrhea in preschool children. Infectious diarrhea has a diversity of pathogenic species, origins, and influencing factors in preschool children. Activities focusing on these influencing factors such as rotavirus vaccination, consumption of lactobacillus products, and other conventional factors would be beneficial to preschool children's health.

Analysis of the epidemiological characteristics between 2004 and 2017 and prediction of the changing pattern of other infectious diarrhea (OID) under COVID-19 in China

The study describes epidemiological features and transmission of other infectious diarrhea (OID) before and during the epidemic of COVID-19 in China, which lays a foundation for OID prevention and control. Incidence rate and mortality data of OID containing detailed epidemiological information such as date, age and region from 2004 to 2017, and total OID case number from 2018 to 2020 were obtained from the Data Center of China's Public Health Science and the National Bureau of Statistics' statistical yearbook. The Joinpoint regression model and Z test was used to analyze, while R language and ArcGIS 10.5 for drawing. The autoregressive integrated moving average model was used to predict the influence of COVID-19 on OID. The OID incidence rate increased from 31.69/10 million in 2004 to 92.42/10 million in 2017, and the mortality rate decreased from 1.82/10,000 to 0.14/10,000. The male to female incidence ratio was 1.39:1 (P < .001). The patients' age showed a decreased trend with age (P < .001). The scattered children devoted the most OID incidence rate. The bimodal distribution of OID incidence was summer peak in northern China, 2 apparent peaks in central and eastern, and winter peak in southern. The autoregressive integrated moving average model predicted 1,406,557 in 2020, comparing the actual OID cases in 2020 to 1,062,277. Affected by the epidemic control measures of COVID-19, the number of OID cases declined by 32.4% (Absolute percentage error = 32.4%). The OID incidence rate in China continuously increased and showed a bimodal distribution in summer and winter with inconspicuous regional characteristics, gender and age susceptibility differences, and occupational differences. Meanwhile, COVID-19 significantly reduced OID incidence in 2020. The discoveries might bring a beneficial effect on OID prevention and control policies.

Intestinal Parasitic Infections Among Pediatric Patients in a Metropolitan City of Bangladesh With Emphasis on Cryptosporidiosis

Introduction

Gastrointestinal parasitic infections are one of the global health concerns in developing countries like Bangladesh. Among them, Cryptosporidium spp. plays an essential role in causing diarrhea, malnutrition, and poor cognitive function, especially in children. This study was conducted to identify the frequency of Cryptosporidium cases and other parasitic agents. 

Methods

A cross-sectional observational study was conducted among 219 hospitalized children with diarrhea. The conventional microscopic technique was applied for parasitic detection. Particular staining (modified Ziehl-Neelsen) procedure was performed to identify oocysts of Cryptosporidium spp. A polymerase chain reaction (PCR) was performed to determine the SSU rRNA and gp60 gene of Cryptosporidium. 

Results

Cysts of Giardia duodenalis (2.3%), ova of Ascaris lumbricoides (1.4%,), Trichuris trichiura (0.5%), and both A. lumbricoides and T. trichiura (0.9%) were identified in samples through wet mount preparation. The distribution of Cryptosporidium spp. as detected by the staining method and nested PCR was 1.4% and 4.1%, respectively. 

Conclusion

Factors independently associated with Cryptosporidium infection are unsafe water, lack of regular hand washing, and insufficiency of exclusive breastfeeding. This study reports, presumably for the first time, the detection of Cryptosporidium oocysts in Chattogram metropolitan city of Bangladesh.