TRRE@ Solid wood high stool High stool Pakistani chairs Simple modern bar stool (Color : C)

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Traveller's diarrhoea is caused by eating food, or drinking water, containing certain germs (microbes) or their poisons (toxins). The types of germs which may be the cause include: Rawalpindi and Islamabad are the third most populous metropolitan cities of Pakistan. The high population size (4.5 million) strengthen the epidemiological monitoring of infectious diseases including gastroenteritis. Benazir Bhutto Shaheed Hospital Rawalpindi (BBH) is a public sector tertiary care hospital with heavy influx (2500 daily) of patients visiting hospital in OPDs (Out patient departments). The hospital is located on the main road in the crowded population of the city. Pakistan Institute of Medical Sciences (PIMS) is research oriented health sciences institute. This is a leading institute for training of doctors and other health staff from all over Pakistan. It is the major referral tertiary care hospital of Capital city Islamabad. There are 200 hospitalizations with 9000 cases in OPD/day in this hospital. The main target of the hospital is to provide health facilities not only to the residents of Rawalpindi/Islamabad but to the people of Northern Areas, Azad Jammu and Kashmir, NWFP ( North-West Frontier Province) and Northern areas of Punjab. Study design

Ali, S.; Khan, S.; Khan, S.; Rauf, M.; Khan, M.; Majid, A.; Dawar, F.U.; Akbar, N.U.; Ullah, R.; Bari, A.; et al. Molecular detection and prevalence of Rotavirus with acute gastroenteritis among the children of rural and urban areas. Braz. J. Biol. 2021, 83. [ Google Scholar] [ CrossRef] Worldwide, 1 in 9 child deaths are due to diarrheal illnesses and 801,000 children die every year from diarrhea.

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Saudy N, Elshabrawy WO, Megahed A, Foad MF, Mohamed AF. Genotyping and Clinicoepidemiological Characterization of Rotavirus Acute Gastroenteritis in Egyptian Children. Polish J Microbiol. 2016;65(4):433–42 Available from: https://pjm-microbiology.publisherspanel.com/gicid/01.3001.0010.8341. [cited 2019 May 12]. Jakab, F.; Péterfai, J.; Meleg, E.; Bányai, K.; Mitchell, D.K.; Szűcs, G. Comparison of clinical characteristics between astrovirus and rotavirus infections diagnosed in 1997 to 2002 in Hungary. Acta Paediatr. 2005, 94, 667–671. [ Google Scholar] [ CrossRef] Sometimes a child may need to be admitted to hospital for treatment if they are dehydrated. Treatment in hospital usually involves giving rehydration solution via a special tube called a 'nasogastric tube'. This tube passes through your child's nose, down their throat and directly into their stomach. An alternative treatment is with fluids given directly into a vein (intravenous fluids). Eat as normally as possible once any dehydration has been treated The mean age of patients with positive culture was 43 ± 17.3 years while that of negative culture patients was 53 ± 17 years. On univariate logistic regression, it was identified that younger patients were more likely to have positive stool cultures. Likewise, it was also noticed that positive stool culture cases were more likely to present with vomiting, greater number of unformed stools per day, shorter mean duration of diarrhoea, higher creatinine level, lower bicarbonate level and presence of faecal leukocytes. However, they were less likely to have frank blood or Red Blood Cells (RBCs) present in their stool samples. Sixteen patients had acute renal failure due to severe dehydration, out of which nine were culture positive. No marked difference was noted in the serum electrolytes of both groups. Gender was found to have no association with the outcome of stool culture results. Average duration of hospitalization (2.8 vs 2.4 ± 1.4 days) was almost similar for both positive and negative stool culture groups. Almost half of the patients (45%) having positive stool cultures had no abdominal pain on initial presentation. Therapeutic management changed only in three (3%) patients after the stool culture results were available. It remained unchanged in rest of the 94 cases (97%). For detailed comparison of demographic and clinical features of culture positive and culture negative patients, refer to Table-2. In the present study RVA infection was detected mostly in children of 6–11 months of age. These results are in accordance with previous studies from Pakistan showing majority of children effected with RVA infection are <2 years of age [ 33, 35, 38, 39] and other countries of the world [ 40, 41, 42, 43]. The reason of high RVA infection in lower age may be due to low immunity in children of less age.

Sanaei Dashti, A.; Ghahremani, P.; Hashempoor, T.; Karimi, A. Molecular epidemiology of enteric adenovirus gastroenteritis in under-five-year-old children in Iran. Gastroenterol. Res. Pract. 2016, 2016, 2045697. [ Google Scholar] [ CrossRef] [ PubMed][ Green Version] DuPont HL. Guidelines on acute infectious diarrhoea in adults. The Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 1997; 92: 1962-75. Tate JE, Burton AH, Boschi-Pinto C, Parashar UD. Global, Regional, and National Estimates of Rotavirus Mortality in Children <5 Years of Age, 2000–2013. Clin Infect Dis. 2016;62(suppl 2):S96–105 Available from: http://www.ncbi.nlm.nih.gov/pubmed/27059362. [cited 2017 Dec 16];. Hussain I, Shahid Mahmood M, Akhtar M, Khan A. Prevalence of Campylobacter species in meat, milk and other food commodities in Pakistan. Food Microbiol. 2007;24(3):219–22 Available from: http://linkinghub.elsevier.com/retrieve/pii/S0740002006001109. [cited 2018 Sep 23]. Effective Top Tube Length: Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s.Lee G, Pan W, Peñ Ataro Yori P, Olortegui MP, Tilley D, Gregory M, et al. Symptomatic and Asymptomatic Campylobacter Infections Associated with Reduced Growth in Peruvian Children. PLoS One. 2013;7(1):e2036 Available from: www.plosntds.org. [cited 2019 May 3]. There are variations in associations between co-infection and clinical characteristics of study population. Some studies have reported more severe diarrhoea in co-infection cases, while other studies have found no difference between mono-infection and co-infection [ 7, 53]. Significant association was found between dehydration and co-infection. However, there were no significant association in the severity of diarrhea, vomiting and fever among children with single infection and co-infection.

Breastfed babies should continue to be breastfed if they will take it. This will usually be in addition to extra rehydration drinks (described above). The prevalence of C. jejuni was found to be highest in the age group 6–11 months similar to RVA. However, the prevalence of RVA in children of > 18 months of age with diarrhea was 10% compared with 50% in C. jejuni in the current study.. Campylobacter, therefore contributed largely to diarrheal infection in children more than 12 months of age. There is a possibility of repeated exposures to Campylobacter species from different sources for the whole childhood period which may elucidating the high prevalence in children > 1 years of age [ 13]. The mortality rate due to diarrhea is decreasing with increasing age of children however morbidity remain constant in adult population [ 44]. Dey, S.K.; Shimizu, H.; Phan, T.G.; Hayakawa, Y.; Islam, A.; Salim, A.F.M.; Khan, A.R.; Mizuguchi, M.; Okitsu, S.; Ushijima, H. Molecular epidemiology of adenovirus infection among infants and children with acute gastroenteritis in Dhaka City, Bangladesh. Infect. Genet. Evol. 2009, 9, 518–522. [ Google Scholar] [ CrossRef] [ PubMed]Babies under 6 months old are at increased risk of dehydration. You should seek medical advice if they develop acute diarrhoea. Breast feeds or bottle feeds should be encouraged as normal. You may find that your baby's demand for feeds increases. You may also be advised to give extra fluids (either water or rehydration drinks) in between feeds. This sentinel surveillance study included 500 children of less than 5 years of age hospitalized or received treatment for acute diarrhea in the emergency paediatric ward of two hospitals, BBH (Rawalpindi) and PIMS (Islamabad), Pakistan. The Performa for the present study was designed to record the demographical and clinical characteristics of patients including patients day of onset of diarrhoea, date of admission in hospital, date of the collection of stool samples, body temperature (°C or °F), dehydration status, duration and episodes of the diarrhea per day, episode and duration of the vomiting per day, gender, age (months), weight (kg), height (cm) and residence of the patients. Sample collection method

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