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Biomedical subjects

Khin-Maung-U

Publications and source records attributed to Khin-Maung-U.

36 records · Page 2Linked to original sources
PubMed1991

Cereal-based oral rehydration therapy. II. Strategic issues for its implementation in national diarrheal disease control programs.

Field studies in Bangladesh demonstrated that after proper training, village mothers were able to prepare and use rice-based, salt-enriched oral rehydration solutions containing safe concentrations of sodium, and were capable of achieving significantly fewer treatment failures and a reduction in the duration of diarrhea than with glucose-based oral rehydration solutions (ORS). An additional longitudinal study showed that improved growth and weight gain occurred with the consistent use of ORS; the effect was greater when rice-based ORS were used. In addition, the following possible limitations and benefits of cereal-based oral rehydration therapy, which are relevant to the strategies for its implementation in national diarrheal disease control programs, are discussed: safety, osmolarity, hypernatremia, spoiling, effectiveness, rehydration ability, reduction in diarrhea volume and duration, nutritional effects, effect on food intake, acceptance and usage by care givers, training of health workers, self-reliance of families, effect on other child survival activities, costs, potential problems in changing to cereal-based ORS, and the role of industrial production in packaged cereal-based ORS.

Bangladesh↗
PubMed1991

Comparison of glucose/electrolyte and maltodextrin/glycine/glycyl-glycine/electrolyte oral rehydration solutions in cholera and watery diarrhoea in adults.

One hundred and eight male adults (mean age 33 +/- 1.7 years) presenting with watery diarrhoea of less than 48 hours duration at home prior to hospitalization and with clinically evident (grade II, severe) dehydration were admitted into a randomized double-blind clinical trial; 54 were treated with standard oral rehydration solution (ORS)--WHO formulation containing citrate--and 54 with an improved ORS formulation which contained, in addition to the standard formula, maltodextrin 20 g (instead of glucose), glycine 4 g and glycyl-glycine 4 g. Patients with clinical cholera were given tetracycline 500 mg q.i.d. Vibrio cholerae was detected in 85 patients. The clinical characteristics of patients in the two groups were comparable. The improved ORS did not reduce the volume of diarrhoeic stools in cholera; indeed, patients with cholera who were treated with improved ORS had larger diarrhoea stool volumes. However, those cholera patients given improved ORS showed significantly greater weight gains during the first six-hour period, at the end of the second day, and at discharge. On the other hand, non-cholera patients treated with improved ORS had significantly smaller diarrhoeic stool volumes during the six to 24-hour significantly smaller diarrhoeic stool volumes during the six to 24-hour period (i.e. during the commencement of maintenance rehydration therapy).

Adult↗
PubMed1991

A pattern of breath hydrogen excretion suggesting small bowel bacterial overgrowth in Burmese village children.

Breath hydrogen tests (BHTs) were performed on 340 Burmese village children aged 1-59 months. Normalization (correction of breath H2 values to a constant mean O2 level) eliminated the variations in H2 levels due to sleep, storage temperature, or duration of storage. After a 10 g lactulose test meal, 145 (42.6%) children produced less than 10 ppm H2 above basal values (non-H2 producers). Of 195 H2 producers, a pattern of breath hydrogen excretion suggesting small bowel bacterial overgrowth (SBBO)--recognized as a transient peak at the 20, 40, or 60 min breath samples following the lactulose test meal and distinguishable from the later colonic peak--was observed in 53 (27.2%), being significantly more frequent in male children, and exhibiting an age-prevalence pattern similar to that of acute childhood diarrhea in these villages. Diarrhea did not alter the state of H2 production (non-H2 producers remain non-H2 producers, and H2 producers remain H2 producers) although the magnitude of peak breath H2 changed.

Breath Tests↗
PubMed1991

Comparison of glucose/electrolyte and maltodextrin/glycine/glycyl-glycine/electrolyte oral rehydration solutions in acute diarrhea in children.

Male children (N = 101) 6-35 months of age presenting with acute watery diarrhea for less than 48 h at home before hospitalization were admitted into a randomized, double-blind clinical trial. Fifty-one children were treated with standard oral rehydration solution (ORS) (World Health Organization [WHO] formulation containing citrate) and 50 were treated with an improved ORS formulation (containing, in addition to the standard formula, 20 g maltodextrin instead of glucose, and 4 g glycine and 4 g glycyl-glycine). None were given antibiotics. No i.v. infusions were given. Rotavirus was detected by enzyme-linked immunosorbent assay in stools of 43 children. Clinical characteristics of children in the two treatment groups were comparable. Improved ORS did not produce significant reduction in the volume of diarrhea stools. Children given improved ORS had greater weight gain than that observed in children treated with standard ORS, but the differences were not statistically significant except at the end of the first 24 h. Among children with rotavirus diarrhea, no significant differences were observed between the 23 children who received improved ORS and the 20 who received standard ORS.

Acute Disease↗
PubMed1991

Effect of cholera toxin on L-[14C]glycine uptake and intestinal cell enzymes in rabbit.

The uptake of L-[14C]glycine and the activities of intracellular marker enzymes of enterocytes were studied in ligated small intestinal segments of rabbits during experimental cholera induced by intra-intestinal injection of pure cholera toxin (CT). No significant difference was observed in the active uptake of L-[14C]glycine between the CT-injected small intestinal segments and the saline-injected control segments, indicating that there is an intact active transport system for intestinal absorption of L-[14C]glycine during experimental cholera in rabbits. Apart from a significant increase in the activity of a brush border marker enzyme (alkaline phosphatase), there was no significant difference between the activities of marker enzymes for lysosomes (acid phosphate), microsomes (glucose-6-phosphatase), mitochondria (succinate dehydrogenase), and a cytosol enzyme (proteinase) in mucosal homogenates of CT-injected small intestinal segments compared to controls. The finding of an intact mitochondrial marker enzyme together with intact L-[14C]glycine absorption provides a scientific basis for considering the use of glycine and other monoamino monocarboxylic amino acids in "improved" oral rehydration solutions for the treatment of acute diarrhea, including cholera.

Alkaline Phosphatase↗
PubMed1990

Effect of short-term intermittent antibiotic treatment on growth of Burmese (Myanmar) village children.

To test the hypothesis that subclinical enteric infection (such as bacterial overgrowth), rice malabsorption, and growth faltering are causally linked, a field trial of low-dose, short-term, intermittent antibiotic treatment was carried out in 142 hydrogen-producing (by lactulose breath hydrogen test) Burmese village children aged 6-59 months. The children were randomly allocated treatment with metronidazole (20 mg/kg or 5 mg/kg daily), amoxycillin (25 mg/kg daily), or placebo given 1 week per month for 6 months. A cooked rice meal breath hydrogen test was done to classify the children as rice absorbers (RA) or rice malabsorbers (RM) before treatment and monthly on the day before each cycle of treatment. There were no differences between the treatment groups, so they were considered together. Factorial analysis showed that antibiotic treatment did not significantly affect the proportion of RM children. The only significant difference between antibiotic-treated and placebo-treated children's growth was in the subgroup of RM children aged 36-47 months; the antibiotic-treated children had significantly greater linear growth. In other age groups antibiotic treatment had no effect on growth.

Age Factors↗
PubMed1990

Absorption of carbohydrate from rice in Burmese village children and adults.

Breath-hydrogen tests (BHTs) were performed on 310 Burmese village children aged 1-59 mo. After a 10-g lactulose test meal, 94 (30.3%) children produced less than 10 ppm H2 above basal values (nonhydrogen producers). Of 216 hydrogen producers, 210 were tested after a cooked rice meal (3 g cooked rice/kg body wt, equivalent to 1 g carbohydrate/kg body wt) with the BHT. Hydrogen peaks greater than or equal to 10 ppm above baseline concentrations were produced by 133 (66.5%) children who were defined as rice malabsorbers. Forty-three percent to 62% of children were less than or equal to -3 SD of the National Center of Health Statistics (NCHS) median weight-for-age and length-for-age and less than -2 SD of the NCHS median weight-for-length. There were no differences between rice absorbers (peak hydrogen less than 10 ppm above baseline) and rice malabsorbers in the allometric indices (the Ehrenberg index and the Dugdale index) of weight-for-length. Rice-carbohydrate malabsorption was also detected by BHTs in 26.7% of 86 school children (aged 5-15 y), 38.5% of 39 young adults (aged 15-39 y), and 50% of 34 older adults (aged 40-70 y).

Adolescent↗
PubMed1990

Malabsorption of carbohydrate from rice and child growth: a longitudinal study with the breath-hydrogen test in Burmese village children.

Breath-hydrogen tests were performed after a rice meal (3 g cooked rice/kg body wt, equivalent to 1 g carbohydrate/kg body wt) at monthly intervals for 6 mo on 75 village children aged 1-59 mo who were known hydrogen producers. The overall rate for rice-carbohydrate malabsorption was 46.7% (range 37.3-56.0%). Anthropometric measurements were made every 3 mo and growth rates were calculated. Forty-six percent to 59% of children were less than or equal to -3 SD of the National Center for Health Statistics (NCHS) median weight-for-age and length-for-age and less than -2 SD of the NCHS median weight-for-length. Rice malabsorbers (ie, those with hydrogen peaks greater than or equal to 10 ppm above baseline concentrations) in the age groups 36-47 mo and 48-59 mo had statistically significant diminished growth expressed as percent gain in length per annum per child (p less than 0.02). Thus, rice malabsorbers had a deficit in linear growth of 2.7 cm/y (range 2.5-2.9 cm/y) for children aged 36-47 mo old and 1.9 cm/y (range 1.7-2.1 cm/y) for children aged 48-59 mo.

Analysis of Variance↗
PubMed1988

Endotoxaemia in complicated falciparum malaria.

In a prospective hospital-based study, endotoxin was detected by amoebocyte limulus lysate test in the blood of 18 of 20 patients with complicated Plasmodium falciparum (16 with cerebral malaria, 2 with blackwater fever, one with acute malarial hepatitis and one with hepatorenal failure) and in all 5 patients with uncomplicated malaria tested, but in none of 5 healthy volunteers. There were 4 deaths among the 18 patients with complicated malaria and endotoxaemia. No correlation between endotoxaemia and presence of complications, clinical severity, or degree of parasitaemia was found. A concomitant bacterial infection could account for endotoxaemia in 11 of the 16 patients with cerebral malaria and endotoxaemia; in the other 5 patients with cerebral malaria, 4 with other complications, and 5 with uncomplicated malaria, endotoxin was detected in the blood without any evidence of bacterial infection.

Adolescent↗
PubMed1988

Effect of enterotoxigenic Escherichia coli heat stable toxin on intestinal lysosomal enzymes in the suckling rat.

A preliminary study on 9 suckling Wistar rats, which received E. coli stable toxin, and on 12 sham-operated controls showed that acid phosphatase, the marker enzyme for lysosome, was significantly increased in the infected group whereas alkaline phosphatase, glucose 6-phosphatase, succinic dehydrogenase, and proteinase, the marker enzymes for brush border, microsome, mitochondria, and the soluble fraction, respectively, remained unaffected. The results suggest that lysosome, the subcellular organelle responsible for intracellular digestion could be modified by E. coli stable toxin. In another set of experiments, where 7 infected suckling rats and 7 sham-operated controls were used, the maximal activities of lysosomal enzymes (released by Triton X-100) were found to be increased in the infected group confirming the results obtained in the preliminary experiment. The values of the ratio between maximal and basal activity (an expression of the degree of retention of enzymes to lysosome) of acid phosphatase and cathepsin D were also significantly increased, indicating that lysosomal membrane may also be stabilized during the infection. The increased activities of lysosomal enzymes and the increased lysosomal membrane stability suggest that intracellular digestion by lysosome could be increased during E. coli stable toxin infection.

Acid Phosphatase↗
PubMed1986

Composition and contamination of oral rehydration solutions prepared with well water by village mothers in Burma.

A field study was carried out at Htaukkyant village in Burma to assess whether village mothers could use condensed milk tins to measure one litre of water with reasonable accuracy for the preparation of oral rehydration solutions (ORS) and whether the extent of bacterial contamination of well water was serious and if this affected the bicarbonate content of the ORS solution. Empty condensed milk tins have a fairly uniform volume around 330 ml and using three condensed milk tins full of water mothers made up one litre quite consistently. Mothers also proved capable of preparing ORS solution by dissolving one packet of oral rehydration salt (ORS) in three condensed milk tins full of water to obtain solutions which contained acceptable and safe concentrations of sodium and potassium. Contamination of well water with faecal coliforms was present. Both storing water in domestic vessels and boiling water reduced the coliform count. Storing could be a good way of reducing the risk of infection if repeated contamination from dipping in to the water could be avoided. The counts on coliforms and faecal coliforms in ORS both increased by about 1 log per day over the first and second 24 hours after the preparation with contaminated well water. Despite this the bicarbonate content of ORS remained stable. In the absence of boiled water, ORS solution can be made using the cleanest available water and using it within 24 hours.

Bicarbonates↗
PubMed1986

Effect of boiled-rice feeding in childhood cholera on clinical outcome.

Forty-eight children, aged 2-5 years, presenting with watery diarrhoea of less than 48 h duration at home prior to hospitalization, were admitted into a randomized controlled clinical trial, 24 children being treated during the first 24 h of admission with oral rehydration solution (ORS) alone and 24 children being given 'ORS plus boiled-rice feeding'. The latter group received boiled-rice to supply at least 55 kcal/kg/d (about 150 g boiled-rice per feed, given four times daily). Vibrio cholerae were isolated by stool culture on admission from all children. No antibiotics were given. Clinical characteristics of children in the two treatment groups were comparable. Among children given 'ORS plus boiled rice', there was a significant increase in volume of diarrhoea stools (P less than 0.05), duration of diarrhoea in hospital (P less than 0.01), and more frequent diarrhoea motions (not significant statistically). However, the children fed boiled rice absorbed and retained 176 ml more fluid, and had gain in body weight comparable to that observed in children who were not fed during the first 24 h of hospitalization.

Body Weight↗
PubMed1985

Clinical trial of berberine in acute watery diarrhoea.

Four hundred adults presenting with acute watery diarrhoea were entered into a randomised, placebo controlled, double blind clinical trial of berberine, tetracycline, and tetracycline and berberine to study the antisecretory and vibriostatic effects of berberine. Of 185 patients with cholera, those given tetracycline or tetracycline and berberine had considerably reduced volume and frequency of diarrhoeal stools, duration of diarrhoea, and volumes of required intravenous and oral rehydration fluid. Berberine did not produce an antisecretory effect. Analysis by factorial design equations, however, showed a reduction in diarrhoeal stools by one litre and a reduction in cyclic adenosine monophosphate concentrations in stools by 77% in the groups given berberine. Considerably fewer patients given tetracycline or tetracycline and berberine excreted vibrios in stools after 24 hours than those given berberine alone. Neither tetracycline nor berberine had any benefit over placebo in 215 patients with non-cholera diarrhoea.

Acute Disease↗
PubMedDate not supplied

Epidemiology and aetiology of acute childhood diarrhoea in Burma: a rural community survey.

Identical epidemiological and microbiological surveys were carried out in a rural community at Intakaw, Burma, in 2 months, one in the hot wet and the other in the cool dry season. The incidence of diarrhoea was highest in children under 3 years old and in the hot wet month when enterotoxigenic Escherichia coli was the predominant pathogen. Rotavirus was the commonest pathogen in the cool dry month but was absent in the hot wet month. Shigellae, salmonellae and campylobacter were isolated in both seasons, but were not significantly commoner in patients than in controls. Vibrios and Yersinia enterocolitica were sought but not found in any specimen.

Animals↗
PubMedDate not supplied

An optimal rice-based oral rehydration solution: the effect of different concentrations of amylase on production of short chain polymers of glucose.

As part of a plan to develop a rice-based oral rehydration solution containing short polymers of glucose instead of glucose, we determined the concentration of amylase that would yield the largest amount of short chain polymers. Thai rice (25 g) was boiled with 500 ml of distilled water for 30 min. Of 200 ml supernatant rice water obtained, 100 ml were digested with different amounts of amylase after cooling to 50 degrees C for 60 min, boiled for 5 min, and centrifuged (10,000 g, 25 degrees C) for 60 min. The resulting supernatant (80 ml) was freeze-dried; 1.75 g of the powder obtained were dissolved in 3.5 ml of water, passed through a Bio-Gel P2 column to separate short chain polymers (2-9 molecules of glucose) and long chain polymers (> 9 molecules of glucose), which were identified by spectrophotometry (lambda = 190 nm) or by high performance liquid chromatography. Ten mg of amylase (equivalent to 12,000 modified Wohlgemath units) per 100 ml of rice water was optimal for the production of short polymers of glucose from rice.

Amylases↗