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Biomedical subjects

D Mahalanabis

Publications and source records attributed to D Mahalanabis.

At least 127 records · Page 7Linked to original sources
PubMed1992

Decreased food intake in children with severe dysentery due to Shigella dysenteriae 1 infection.

Factors that affect food intake in acute shigellosis were studied in 82 children aged 24-59 months. Children were offered an energy-dense milk-cereal-oil-based diet every 2 h. Food intake was compared between children with Shigella dysenteriae 1 infection and those infected with other Shigella spp (predominantly S. flexneri). Mean energy intake in the first 48 h was 435 kJ/kg.d in children infected with S. dysenteriae 1 and 536 kJ/kg.d in children infected with other Shigella spp (P < 0.001). Febrile children ate significantly (P < 0.05) less food than afebrile ones (469 vs 517 kJ/kg.d). Food intake remained significantly (P < 0.001) less in children infected with S. dysenteriae 1 after controlling for the effect of fever. The results show that food intake is significantly reduced in dysentery due to S. dysenteriae 1 infection compared to that of other Shigella species; however, adequate calorie intake can be maintained by providing frequent energy-dense meals despite anorexia, fever, abdominal pain and diarrhoea.

Body Temperature↗
PubMed1991

Breast feeding and vitamin A deficiency among children attending a diarrhoea treatment centre in Bangladesh: a case-control study.

OBJECTIVE: To determine the effect of breast feeding on the risk of xerophthalmia in children aged 6 months to 3 years attending a diarrhoea treatment centre in Bangladesh. DESIGN: Case-control study based on stratified analysis (Mantel-Haenszel) and multivariate analysis (logistic regression) of data from a treatment centre based surveillance system. SETTING: A large diarrhoea treatment centre in Dhaka, Bangladesh. PATIENTS: 2687 children aged 6 months to 3 years representing a 4% systematic sample of all children in this age group treated yearly at the centre over three consecutive years. 66 of the children were cases of xerophthalmia (that is, they had Bitot's spots or corneal lesions or night blindness or night blindness plus conjunctival xerosis or any combination of these) and the remaining 2621 did not have signs or symptoms of vitamin A deficiency. This second group served as controls. MAIN OUTCOME MEASURE: Xerophthalmia and breast fed at onset of diarrhoea or presentation. RESULTS: The odds ratio relating breast feeding to vitamin A deficiency after adjustment for a large number of confounding variables (0.26 (95% confidence interval 0.14 to 0.49); p less than 0.001) reflected a 74% reduction in the risk of vitamin A deficiency among breast fed children. The estimated reduction of risk did not decline with age, and some 49% of children aged 24-35 months were still being breast fed. The odds ratio relating breast feeding to xerophthalmia in the third year of life (0.35 (95% confidence interval 0.35 to 0.86) reflected a 65% reduced risk of vitamin A deficiency. Other important risk factors or prognostic indicators for xerophthalmia as identified by multivariate analysis were recent measles, prolonged diarrhoea, severe protein energy malnutrition, and poor socioeconomic state. CONCLUSIONS: These results indicate that breast feeding was associated with a substantial reduction of the risk of vitamin A deficiency extending to the third year of life and support the recommendation that mothers in developing countries should be advised to breast feed for as long as possible.

Bangladesh↗
PubMed1991

Prognostic indicators and risk factors for increased duration of acute diarrhoea and for persistent diarrhoea in children.

To identify the prognostic indicators and risk factors for increased duration of acute diarrhoea and for occurrence of persistent diarrhoea (i.e. acute episodes lasting longer than 14 days) in children under three years, a systematic sample (3690) of patients attending a large treatment centre in Bangladesh was analysed using multiple regression, logistic regression and stratified (Mantel-Haenszel) analysis. Significant prognostic indicators or risk factors for increase in duration of acute diarrhoea, after adjusting for confounders, include bloody or mucoid diarrhoea, concomitant signs of chest infection, presence of vitamin A deficiency signs, decreased weight for age, routine use of contaminated surface water, lack of breastfeeding and increasing age; presence of rotavirus or enterotoxigenic Escherichia coli or Vibrio cholerae 01 in stool had negative association. In logistic regression and stratified analysis these factors, except for lack of breastfeeding and age, were also found to be risk factors or prognostic indicators of persistent diarrhoea. Policy implications of these findings for programmes to reduce morbidity and mortality from persistent diarrhoea include development of effective vaccines against dysentery-causing Shigella, programmes to prevent vitamin A deficiency, protein energy malnutrition and acute respiratory infections in children, and long-term programmes to provide clean water for all day-to-day needs.

Acute Disease↗
PubMed1989

Bicarbonate enhances sodium absorption from glucose and glycine rehydration solutions. An in vivo perfusion study of rat small intestine.

Sodium, potassium and water absorption was studied over the whole length of rat jejunum and ileum by an in vivo marker perfusion technique. The composition of solutions were similar to the oral rehydration solution currently in use for the treatment of acute diarrhoeal diseases. The study shows that bicarbonate and chloride containing glucose or glycine electrolyte solutions induce a significantly greater absorption of sodium, potassium and water compared to those containing chloride only. The study also confirms that an amino acid such as glycine is as efficient as glucose in promoting the absorption of sodium, potassium and water from rat small intestine.

Animals↗
PubMed1984

In search of a super solution: controlled trial of glycine-glucose oral rehydration solution in infantile diarrhoea.

In a double blind trial a glycine fortified oral glucose electrolyte solution was evaluated in a group of infants and small children (n=25) with moderate to severe dehydration due to acute diarrhoea, and was compared with a matched control group (n=26) receiving only glucose based oral rehydration solution. It is seen that the diarrhoea stool output, duration of diarrhoea, and volume of oral rehydration fluid required to achieve and maintain hydration are significantly lower in the group receiving glycine fortified glucose electrolyte solution. The possibility of developing an oral rehydration solution which could also act as an absorption promoting drug is discussed.

Administration, Oral↗
PubMed1983

Small intestinal nodular lymphoid hyperplasia in patients with giardiasis and normal serum immunoglobulins.

Nodular lymphoid hyperplasia of the upper small intestine was demonstrated in 25 patients with giardiasis. All had normal serum immunoglobulin levels and seven patients initially presented with clinical findings suggestive of an abdominal lymphoma. In only two, however, was the diagnosis of primary jejunal lymphoma confirmed. It is possible that an aetiological relationship exists between recurrent parasitic infestation and nodular lymphoid hyperplasia of the upper small intestine.

Adolescent↗
PubMed1982

Stimulation of sodium and water absorption by sucrose in the rat small intestine.

This study described the absorption of Na, K, Cl, H2O and sugars from an isosmotic sucrose electrolyte solution and compares it with the absorption of these substances from an isosmotic glucose electrolyte solution and a mannitol electrolyte solution, by an in vivo perfusion technique in the rat jejunum and ileum. The composition of the solutions was similar to the oral rehydrating solutions, currently in use for the treatment of acute diarrhoeal diseases. The study shows that an isosmotic sucrose containing electrolyte solution induces a significantly greater Na, Cl, and K absorption compared to glucose electrolyte solution. Water absorption however, is significantly less from the former solution probably due to osmotic drag of water into the lumen by the slowly absorbed fructose released from sucrose hydrolysis. These findings underline the clinical importance of using hyposmotic sucrose electrolyte solution for oral rehydration.

Animals↗
PubMed1981

Nitrogen balance during recovery from secretory diarrhea of cholera in children.

This study describes nitrogen balance in children during recovery from severe cholera (bacteriologically confirmed). The subjects were six male children aged 12 to 24 months and weighing 6.29 to 9.86 kg (on recovery). They initially presented with dehydration and base deficit acidosis due to acute watery diarrhea. Nitrogen balance promptly improved with milk feeding even before diarrhea was fully controlled and irrespective of the clinical severity of the disease. There was no increase in stool volume and systemic acid base status remained unaffected when milk feeding was introduced. There was little nitrogen loss in the stool and the apparent absorption of protein was substantial. The negative nitrogen balance that occurred was largely due to the lack of intake. Early feeding and liberal intake appears to produce a more favorable impact than the cautious introduction of food. The common practice of restricting food during recovery from acute diarrhea is inappropriate in cholera.

Body Weight↗
PubMed1980

Composition of the intestinal fluid and the functional jejunoileal junction in secretory diarrhea of cholera in children.

The study critically evaluates the changes in the chemical composition of the luminal fluid along the whole length of the small intestine in four children with acute cholera and in one with acute noncholeraic diarrhea. In the children with cholera the total CO2 content rose abruptly from a mean of 7.1 mEq/l to 19.6 mEq/l at about two thirds the tube distance from the ligament of Trietz to the end of the ileum and increased further distally. At around the same point the pH also rose and the chloride fell. It is proposed that this level of the small intestine where a sharp transition in total CO2 content occurs be regarded as the functional jejunoileal junction. Sodium and potassium levels were similar in the jejunum and the ileum and the measured osmolality could be accounted for by them. The child with noncholera diarrhea had a very different small intestinal composition i.e. the total CO2 and pH as well as the sodium level remained low while the measured osmolality was high, indicating a high osmotic gap. The presence of a large amount of organic acid anions of bacterial origin and carbohydrate breakdown products may fully explain the findings in this child. More studies, however, are needed on children with noncholera diarrhea to confirm these findings.

Acute Disease↗
PubMed1979

Malabsorption of water miscible vitamin A in children with giardiasis and ascariasis.

Vitamin A absorption was studied using a water-miscible oral preparation of vitamin A in 19 children ages 1 1/2 to 9 years old with giardiasis and/or ascariasis, both before and after their eradication with appropriate therapy, and in three children without parasites. Marked impairment of vitamin A absorption was noted when administered in a water miscible form in children with 1) combined infection with Giardia lamblia and Ascaris lumbricoides, 2) giardiasis alone, and 3) in a proportion of children with ascariasis alone. In children with both giardiasis and ascarasis eradication of the infections promptly lead to a significant improvement in vitamin A absorption and restored it to normal. Children with giardiasis alone also showed improved vitamin A absorption after therapy. In children with ascariasis alone successful therpay did not lead to a statistically significant improvement.

Ascariasis↗