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Aetiology and Epidemiology of Sever Infantile Diarrhoea in Baghdad, Iraq 364 Percentage 40 35 30 25 20 15 10 5 0 37.5 30 Figure 3: Types of feeding 17 15.5 Artificial Breast Mixed Solid Column 1 Antimicrobial intake prior and after admission: 47.5% of the cases, antimicrobial agent was used prior to admission, 34.5% had one, 12% had two and 1% had three (Figure 4).After admission 15% had specific antimicrobial treatment because their stool examination revealed campylobacter species, shigella species, Giardia lamblia and Entamoeba histolytica. Three patients received antimicrobial treatment for they shows blood culture positive results. percentage 50 45 40 35 30 25 20 15 10 5 0 47.5 total Figure 4: Antibiotics intake prior admission 34.5 one antibiotics 12 two antibiotics 1 three antibiotics Column 1 Macroscopic examination of 200 diarrhoeic stool specimens revealed that: Blood were found in 7.5%, pus in 11% and mucus in 6% in stool specimens of liquid consistency as compared to semiliquid (Table 2)
365 E. N. Al-kaissi, M. Makki and M. Al- Khoja Table 2: Macroscopic appearance of stool specimens Visual examination Stool consistency Total Liquid Semi-liquid No. % No. % No. % Blood 15 7.5 5 2.5 20 10 Pus 22 11 13 6.5 35 17.5 Mucus 12 6 4 2 16 8 Blood+Pus+Mucus 4 2 1 0.5 5 2.5 None 26 13 98 49 124 62 Methods of feeding: Table (3) shows that 30% of the admitted cases of diarrhea were exclusively on breast milk. The rate gets higher 35.5% when children over one year of age were excluded. Table 3: Methods of feeding 12 months of age in mild, moderate-severe cases Methods of feeding Mid cases Moderate sever cases Control cases Number Percentage Number Percentage Number Percentage Artificial 568 28 68 44.4 25.4 39 Mixed 405 20 31 20.1 13.4 20 Breast 1055 52 54 35.5 61.2 94 Total 2028 100 143 100 100 153 Staying in hospital and outcome: No single mortality was reported in this study, the range of the staying in the hospital was 1-7 days, with an average of 3.1 days. The family responding toward staying is recorded in Table (4) were 66% of the families had stay for adequate time and 13% refused to stay. Table 4: family behavior toward staying in ORT center Family behavior Number of families Pecentage Refuse to stay in the ORT center 26 13% Stay inadequate time ≤2h 36 18% Stay inadequate time≥2h 132 66% Referred to hospital ORT failure 6 3% Total 200 100 Blood culture: It was able to draw enough blood for blood culture in 78.5% of the cases. Three cultures only turned out significantly positive and Salmonella typhi, Salmonella paratyphi and E. coli were isolate. The rest of the cultures were either negative or contaminated bacteria were isolated. Aetiology of diarrhea (A) Isolation of enteric pathogens and quality control specimens Enteric pathogens contained in the quality control specimens who were transported through the specimen delivery system were regularly recovered. These included the more fastidious organisms such as Shigella and Campylobacter. Most of bacterial pathogens can be re-isolated at concentrations of 10 2 or higher organisms per gram of stool except Campylobacter which were usually isolated at concentration of 10 4 or higher organisms per gram of stool. These procedures were employed to assess the effect of transportation on the efficiency of isolation of enteric pathogens in the laboratory and also to act as an internal control for the methods of isolation of these pathogens.
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A Comparative Analysis of Gibberell
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