Sunday, March 24, 2013

Rotavirus Vaccine Integration in the EPI hopes to reflect US Data

Because of the work of Cortese MM et. al. in 2010 Pediatric Infectious Diseases Journal, Rotavirus vaccine has been integrated as a basic requirement for the Expanded Program on Immunization. This US study showed that gastroenteritis was reduced in more than 90% of infants studied in all care settings. It also showed a 70% reduction in those ages 1-4.

The vaccine was slowly introduced in Asia. The pioneer program was started in the Philippines as it was integrated in the EPI program. Target beneficiaries of high priority were those living as "poorest of the poor." They were stratified by the Department of Social Welfare's 4P's program.

Saturday, March 23, 2013

What is the Stool Osmotic Gap or the Stool Ion Gap?

You have severe diarrhea and you've been advised by your doctor for a workup. Asides from the routine fecalysis, your doctor orders stool electrolytes. They are not cheap. But even if your insurance covers for it, you want to know what they are for. Or probably you were given a reason that he needed to know about your Stool Ion Gap, also known as the Stool Osmotic Gap. And you are like lost in the wilderness with an explanation that seem to be clear to him but not to you.

Instant Coffee Experiment

The following figure did come out of a chemistry book. But you don't need to understand the various symbols to understand osmosis.

Say for example you had one container with a division in the center that only passes water on both sides. If you have a sachet of instant coffee, which contains creamer, coffee, and sugar, you will notice that asides from the beautiful aroma coming from one side, the other's water got sucked in.

The creamer, coffee and sugar are the electrolytes. They have the power to suck out water from another compartment. That is osmosis explained.

Friday, March 22, 2013

Acute Gastroenteritis is a Misnomer, Use the Term Diarrhea Instead

I remember an esteemed gastroenterologist lecturing to us about the incorrect use of the word "diarrhea" and he would point out that it's a broad diagnosis or in his words, garbage can diagnosis. He would tell us that diagnosis such as "acute viral illness" is like a homework unfinished. He advocated the use of "acute gastroenteritis" instead because it sounds better and it sounds like a really intelligent diagnosis. I hate to say it but I just found out he could be wrong.

Not everybody has an inflammation

Thursday, March 21, 2013

How much stool do you need to define diarrhea?

In a patient who has frequent bowel movements per day, diarrhea may go unnoticed. In infants where bowel movements are watery, some parents are in denial when it comes to diarrhea. So how much should watery bowel movement be to start treatment?

Augmented water content above the normal for a child or adult is diarrhea. The normal water in stool for an infant is 10mL per kilogram in a single day. So for a 9kg baby spurting out a total content of more than 90mL in a single day can be considered diarrhea. That's about less than half a glass of water!

In the adult or teenager, more than 200g of watery stool is enough to call it diarrhea. That amount is equivalent to two cups of rice. Although some may have stools amounting to more than this. These are people who don't have daily bowel movements as regular. It's the quality of the stool that has to be important. It has to be watery.

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What is Diarrhea? How do you define it?

My Doctor is asking me if I had 3 or more episodes?

A loose bowel movement may be limited in nature. One episode can be brought about by stress or the content of fat on the last three meals. It may also be just an acute viral episode that your body can handle depending on the nature of your immunity to the pathogen. It can also be brought about by taking a high dose or a very potent antibiotic.

All of these can be managed by you or your doctor by using oral rehydration salts! It's an overthe counter drug that is very effective! Another thing your doctor can prescribe you is Zinc Sulfate tablets. They both reduce the severity of your diarrhea and is highly recommended for infants.

Tuesday, March 19, 2013

Adventure Medical Kits Oral Rehydration Salts: Product Review

WHO-approved Oral Rehydration Salts
You don't need to be camping to get one of these in your medical kit. This is essential for anybody serious enough to stop effects of dehydration. Drinking up one sachet in one liter is almost equivalent or better than being hooked up to a liter of Lactated Ringer's Solution! Lactated Ringers Solution is the IV fluid you see placed on patients in TV shows such as ER or House.

The formula is actually better than IV!

Tuesday, March 12, 2013

Podcast: What Causes Diarrhea?


Howcast Original

Medical Matters: What Causes Diarrhea?

Dr. Lisa Gandjhu Gastroenterologist, Hepatologist [Spoken]Ok, so you can have either acute diarrhea and chronic diarrhea. Basically, acute diarrhea is something a lot of people can have intermittently. If they eat now, they say they got food poisoning or they travel somewhere, and usually those are short-lived and gets out after a couple of days.