BACKGROUND: Diarrhoea is one of the leading causes of morbidity and mortality affecting children in developing countries. We studied the efficacy of zinc therapy in reducing the duration of diarrhoea. MATERIALS AND METHODS: A double-blinded randomized control study was done in 100 children between age groups 1 month to 5 years having acute diarrhoea. These children were randomly divided into 2 groups. Group 1 received oral supplementation of 20mg zinc and ORS from day one of treatment while group 2 received only ORS therapy. Children who received zinc or antibiotics prior to the study were excluded. Clinical profile of children like age, gender, nutritional status and dehydration level was have been taken into consideration. The outcome of the study was assessed by comparing the mean number of watery stools of both the groups during the course of therapy. RESULTS: Out of 100 children based in the study 50 children in group 1 who received oral zinc supplementation showed a 36% reduction in duration of diarrhoea (6.22 days vs. 8.26 days). CONCLUSION: Zinc supplementation help reduce the duration of acute diarrhoea. KEYWORDS: Zinc, Diarrhoea. INTRODUCTION:Diarrhoeal disease is a major cause of childhood morbidity and mortality affecting millions of children worldwide. (1,2) It is estimated that more than 3 million deaths in developing countries each year is caused by diarrhoeal disease and contribute substantially to malnutrition in surviving children. (2) In accordance with the recommendations of WHO and UNICEF over the past 3 decades children of all ages including infants with acute diarrhoea of any etiology have been treated with standard oral rehydrating salt (ORS) solution. (3) Due to proven efficacy, safety and low cost, standard ORS has been widely used. Along with continued feeding, ORS has helped to bring about a decline in the fatality rate of acute dehydrating diarrhoea in children in developing countries (3). However with the use of ORS there is no reduction of stool volume, diarrhoeal duration and frequency of loose stools raising a practical problem of its acceptance and compliance. (4) Studies have reported that daily loss of zinc in the intestinal fluid during acute diarrhoea is as high as 159 mic/kg/day compared to 47 mic/kg/day in control. (5) A simple and sensitive measuring tool for zinc status is lacking, It can however be assumed that because of low bioavailability of zinc from cereal based diet (6) subclinical zinc deficiency is common in developing countries. Few children with acute diarrhoea also have lowered immunity as manifested by the absence of a cell mediated response to common antigen applied to skin. Micronutrient deficiency is the most likely explanation for this phenomenon. (7) Zinc is important for growth of intestinal mucosa and improves the transport of water and electrolytes (8) across the intestinal mucosa. Zinc also is essential in growth, protein synthesis, epithelial repair and synthesis of RNA and DNA. (9)
AIM:To study the various risk factors in hypertensive mothers that contribute to adverse neonatal outcome in the form of low birth weight when compared to non-hypertensive mothers. SETTING: The study was conducted in the Inborn NICU and New born Follow up clinic of Department of Paediatrics in a rural Government medical college Hospital. STUDY DESIGN: Prospective cohort study. MATERIALS AND METHODS: INCLUSION CRITERIA: CASES: Consecutive sample of mothers with pregnancy induced hypertension during the study period who have given consent for the study were interviewed and their live born babies were included as cases. CONTROLS: Consecutive sample of live born babies born to non-hypertensive mothers in the same study period were included as controls. Exclusion Criteria: Babies with major congenital anomalies chromosomal anomalies, intrauterine death were excluded. METHODOLOGY: Details of maternal risk factors were collected. Anthropometric parameters, systemic examination, development and maturity of the babies were assessed. STATISTICAL TESTING: Significance testing was done using chi square test, odds ratio, analysis of risk ratios and correlation testing. P values greater than .05 were considered non-significant. Spss 16 Software package was used for statistical analysis. RESULTS: The incidence of low birth weight in this study was 45.6% which is considerably higher than in controls (16.6%) and in the general population (19.1%). 33.8% of babies were preterm among the cases compared to 6.1% among controls.Among mothers with hypertension detected before 30 weeks, 90.3% had low birth weight babies. Among mothers with severe hypertension, 86.4% had low birth weight babies compared to 29.8% among those with mild hypertension.92.3% pregnancies with Doppler abnormalities had LBW. 70.8% of LBW babies had antenatal intra uterine growth restriction.90.1% of hypertensive mothers with albuminuria had associated LBW. 100% babies had low birth weight when mother had eclampsia and renal function abnormality. CONCLUSION: Risk factors associated with hypertension have a link with low birth weight and adverse outcome in babies.
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