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Biomedical subjects

V Khoshoo

Publications and source records attributed to V Khoshoo.

At least 19 recordsLinked to original sources
PubMed1992

Decrease in gastric emptying time and episodes of regurgitation in children with spastic quadriplegia fed a whey-based formula.

The gastric emptying times associated with three whey-based formulas were significantly shorter than that associated with a casein-based formula in nine gastrostomy-fed patients with spastic quadriplegia (p less than 0.001). Patients fed whey-based formulas had significantly fewer episodes of emesis than when they were fed casein-based formula (p less than 0.001). We conclude that whey-based formulas reduce the frequency of emesis by improving the rate of gastric emptying.

Adolescent↗
PubMed1991

Nutritional manipulation in the management of dumping syndrome.

Two children with Nissen's fundoplication and either gastrocystoplasty or pyloroplasty developed dumping syndrome. Correction of their blood glucose abnormalities, resolution of symptoms, and weight gain were effectively achieved by addition of fats and uncooked corn starch (50 g/l) to their feeds.

Blood Glucose↗
PubMed1990

Salmonella typhimurium-associated severe protracted diarrhea in infants and young children.

Eleven (13.8%) children (4-14 months; mean of 7.8 +/- 3.6 months) presenting with protracted diarrhea (duration greater than 21 days) and weight loss had associated infection with Salmonella typhimurium. All had documented weight loss of 16-25% and progressive clinical deterioration. On admission, they had high purging rates (greater than 4 ml/kg/h), hyponatremia (5/11), mucosal injury, and malabsorption as measured by 1 h blood D-xylose, fecal alpha 1-antitrypsin, and oral fat tolerance test. Diarrhea was secretory in 8 of 11 and fecal sodium was high (54-142 mEq/L; mean of 102 +/- 27 mEq/L). The organism showed multiple drug resistance. All patients received antibiotics (amikacin and nalidixic acid/norfloxacin) for 10-14 days, which was followed by rapid improvement in clinical status and absorption studies. The two youngest patients died. Due to ethical reasons, an untreated control group was not included. Use of appropriate antibiotics may benefit children with S. typhimurium-associated severe protracted diarrhea and rapid progressive weight loss.

Amikacin↗
PubMed1990

Intestinal glucoamylase & other disaccharidases in children with protracted diarrhoea.

Brush border lactase, sucrase and glucoamylase activities were assessed in jejunal mucosal biopsy specimens from 34 children (median age 11 months; range 1.5-38) having protracted diarrhoea with failure to thrive and 8 well nourished children with normal jejunal mucosal histology (median age 10.2 months; range 2-37). All enzymes showed progressive decrease in activity which was directly in relation to increasing degree of mucosal injury (P less than 0.002). Lactase was significantly reduced even in patients with protracted diarrhoea and normal mucosa (P less than 0.05). Glucoamylase and sucrase were significantly reduced only in the presence of mucosal injury (P less than 0.01). Our data suggest that most children with protracted diarrhoea may not tolerate lactose containing feeds and may need lactose-free diets preferably based on starch. A small number of children with protracted diarrhoea, who have severe mucosal injury may not be able to handle even starch and may require diets based on short chain glucose polymers. The findings of this study, need to be corroborated with well-controlled metabolic balance studies.

Child, Preschool↗
PubMed1990

Associated factors of protracted diarrhea.

The associated factors in 80 children (less than 2 yrs) with protracted diarrhea (greater than 21 days duration) and weight loss were: secondary carbohydrate intolerance (36): enteric pathogens (non typhoidal salmonella (11), enteropathogenic E. coli 'EPEC' (6), giardia (4), and shigella (3); cow's milk protein intolerance (3), gluten intolerance (3); miscellaneous (5); and undiagnosed enteropathy (9). Three of the EPEC showed localised pattern of adherence in vitro with HEP-2 cells. Most patients with salmonella and EPEC had severe secretory diarrhea with large fecal sodium losses. All 6 patients who died had secretory diarrhea and very high fecal sodium. All but 4 patients could be effectively managed with a chicken puree-glucose-coconut oil based diet.

Chronic Disease↗
PubMed1989

Association of antecedent malnutrition with persistent diarrhoea: a case-control study.

To determine the effect of nutritional state on persistent diarrhoea a case-control study was carried out on 756 children followed up prospectively for 18 months. Children who developed persistent diarrhoea were compared with population controls and controls with acute diarrhoea. The mean weight for age in the children with persistent diarrhoea (69.9%) was significantly lower than that in the population controls (77.0%) and the diarrhoeal controls (76.2%). Weight for age of less than or equal to 70% was associated with persistent diarrhoea in both case-control analyses (population controls, matched odds ratio 3.25; diarrhoeal controls, matched odds ratio 2.46). The corrected odds (multiple logistic regression) in the two analyses were 3.2 (95% confidence interval 1.3 to 8.1) and 3.4 (1.2 to 9.1). Weight for age of less than or equal to 70% increases the risk of persistent diarrhoea. In an underweight child there is a higher risk of diarrhoea becoming persistent. Prevention of malnutrition and intensive management of acute diarrhoea in malnourished children should help reduce the risk of the diarrhoea persisting.

Age Factors↗
PubMed1989

Enteroaggregative Escherichia coli and Salmonella associated with nondysenteric persistent diarrhea.

A hospital-based case-control study including 92 children with diarrhea for longer than 14 days and 92 controls without gastrointestinal symptoms was performed to describe the association between the excretion of enteric pathogens and persistent diarrhea. In patients the most frequently isolated stool pathogens were enteroaggregative Escherichia coli (19.6%), nontyphoidal Salmonella spp. (17.4%), E. coli with diffuse adherence pattern (7.6%), G. lamblia (7.6%) and enterotoxigenic E. coli (5.4%). The excretion rates in patients were significantly greater than in controls only for nontyphoidal Salmonella spp. (P = 0.0006) and enteroaggregative E. coli (P = 0.016).

Diarrhea, Infantile↗
PubMed1989

Increased faecal alpha-1-antitrypsin excretion in children with persistent diarrhoea associated with enteric pathogens.

The random faecal alpha-1-antitrypsin (AT) excretion (mg/g dry weight of stool) was measured in 30 infants and children (mean age 10.8 +/- 8 mo.) with protracted diarrhoea (duration greater than or equal to 21 days) and failure to thrive and 27 normally nourished children (mean age 13 +/- 4.5 mo.) without any gastrointestinal symptoms in the preceding 12 weeks. The associated factors in patients with protracted diarrhoea and their mean faecal AT during active disease and 3-4 weeks after recovery were as follows: Enteropathogenic E. coli 5 (7.9 +/- 5.5; 3.2 +/- 0.6), Giardia lamblia 4 (3.9 +/- 1.8; 2.5 +/- 0.7), Salmonella typhimurium 3 (4.0 +/- 0.2; 3.8 +/- 0), secondary carbohydrate intolerance 11 (2.5 +/- 0.9; 2.4 +/- 0.8), and others 7 (3.4 +/- 0.7; 3.0 +/- 0.5), respectively. Of all the patients with protracted diarrhoea the mean AT in the E. coli, Giardia and Salmonella groups were significantly higher than the mean in the control group (2.1 +/- 0.8) and following treatment and recovery the values were comparable to that in the controls. All the 6 patients with very high faecal AT (greater than mean + 3 SD of controls) were associated with an enteric pathogen.

Diarrhea, Infantile↗
PubMed1989

Serum anti-gliadin antibody profile in childhood protracted diarrhoea due to coeliac disease and other causes in a developing country.

Serum anti-gliadin antibody (AGA) titres were estimated by diffusion in a gel enzyme-linked immunosorbent assay in children with coeliac disease (n = 11), protracted diarrhoea of non-coeliac causes (n = 110), acute gastroenteritis (n = 20), protein energy malnutrition (n = 20), and asymptomatic, well-nourished children (n = 66). The mean IgG and IgA AGA titres were significantly higher (p less than 0.001) in children with coeliac disease than in any other groups. There was no significant difference (p greater than 0.01) in AGA titres in relation to age, nutritional status, or severity of villous injury. In patients with coeliac disease AGA titres showed a good correlation with disease activity. The specificity and sensitivity of the assay are discussed.

Antibodies, Anti-Idiotypic↗
PubMed1989

Efficacy of nalidixic acid in the treatment of acute bloody diarrhea.

Of sixty four children (mean age 20.1 +/- 1.2 mo) with acute bloody diarrhea and high fever, 47 had infection with non-typhoidal Salmonella (NTS) (20), Shigella (15) and enteropathogenic E. coli (EPEC) (12) and were treated with nalidixic acid (NA). The mean duration (h) of presence of macroscopic blood in the stool following institution of treatment was significantly shorter (p less than 0.05) in those with EPEC (11.5 +/- 4.9) as compared to NTS (30.4 +/- 15.4) or Shigella groups (22.9 +/- 15.6). The number of children having less than or equal to 50% reduction in stool frequency within 72 h was: NTS (17); Shigella (14); EPEC (10). Negative stool cultures on day 5 were obtained in all patients with Shigella and EPEC and 16 (80%) of those with NTS. Two patients with NTS and one with EPEC failed to respond to NA.

Acute Disease↗
PubMed1989

Quantitation and properties of fecal and upper small intestinal aerobic microflora in infants and young children with persistent diarrhea.

The duodenal juice and fecal aerobic microflora was investigated in 54 patients with persistent diarrhea (age less than or equal to 2 years). The duodenal aspirates yielded increased aerobic bacteria (greater than 10(5) organisms/ml) in 28 (51.9%) of the patients. Established enteric pathogens were isolated from the duodenal aspirates of 12 (22.2%) of the 54 patients, viz., enteroadherent Escherichia coli (EAEC) (5), enterotoxigenic E. coli (ETEC) (3), enteropathogenic E. coli (EPEC) (1), nontyphoidal Salmonella (1), and Giardia lamblia (2). The total aerobic bacterial count was greater than 10(5) in all 12 patients positive for specific pathogens apart from one case in whom E. coli showing diffuse adherence to HEp-2 cells were identified. Among the remaining 42 specific pathogen-negative patients, 19 (45.2%) also had greater than 10(5) aerobic organisms/ml in the small bowel. Eight strains of Klebsiella from four of the patients were negative for enterotoxin production in a rabbit ileal loop assay and for adherence to HEp-2 cells. In contrast, 28/54 (51.9%) of the same patients had known enteric pathogens in their stools, viz., nontyphoidal Salmonella (8 or 14.8%), Shigella (2 or 3.7%), Campylobacter (1 or 1.9%), ETEC (4 or 7.4%), EPEC (2 or 3.7%), EAEC (7 or 13.0%), and G. lamblia and Entameba histolytica (3 or 5.6%). Further search for potential virulence factors among aerobic bacteria colonizing the upper small intestine in persistent diarrhea is warranted.

Aerobiosis↗