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Rotavirus is the leading cause of childhood diarrhea worldwide, causing an estimated 600,000 deaths each year. To assess the potential benefits of a national rotavirus immunization program in India, we analyzed 40 published studies of rotavirus that were conducted between 1976 and 1997 and included a total of approximately 13,000 Indian pediatric inpatients. Pediatric studies featuring 100 or more patients and lasting at least 12 months in duration and all neonatal studies were analyzed. Rotavirus was detected in a median of 18% of pediatric patients and 28% of neonates surveyed. Fifty percent of all children hospitalized with rotavirus by age 5 were hospitalized by the age of 6 months, 75% by the age of 9 months, and almost 100% by the age of 2 years. Rotavirus was most prevalent (31%) in children between 7 and 12 months of age, followed by children between 1 and 2 years of age (20%), and children

A case of congenital toxoplasmosis manifesting as hepatosplenomegaly and cholestatic jaundice in a 4 month old child is reported. To the best of our knowledge this is the first report of cholestatic jaundice due to congenital toxoplasmosis from India. The child was successfully treated with sulphadiazine and pyremethamine combination.

World Health Organization (WHO) recommended standard ORS solution has sodium (90 mmol/L) and glucose (111 mmol/L) almost in the ratio of 1∶1 and a total osmolarity of 311 mmol/L. There are concerns that the sodium or glucose concentration and the overall osmolarity in the formulation is not appropriate. Therefore, the efficacy of standard and reduced-osmolarity ORS solutions in young children with acute diarrhea was evaluated in a recent WHO supervised multicentre trial conducted in India (New Delhi), Brazil, Mexico and Peru. The implications of trial results are discussed. In non-cholera diarrhea, both the standard and reduced osmolarity ORS solutions were effective in achieving clinical rehydration. The stool output was 39% higher in the standard ORS solution group as compared to the reduced-osmolarity ORS solution group. The duration of diarrhea was 22% higher in the standard ORS solution group. The risk of requiring supplementary intravenous infusion was increased in children treated with standard ORS solution [relative risk 1.4 (0.9–2.4)]; this benefit was not observed in Indian patients due to high breast feading rate. The mean sodium concentration at 24 hours after admission was lower in the reduced osmolarity ORS solution group [135 (134–136) vs 138 (136–139), p

Acute renal failure develops in about two-thirds of patients dying from hepatic failure, l z Renal failure further complicates the metabolic disorder resulting from the primary liver disease and is associated with a poor prognosis. Renal failure was reported to be the primary cause of death in 11% of 471 patients with cirrhosis, z In fulminant hepatic failure the development of renal failure may be disproportionate to the degree of hepatic damage unlike in cirrhosis. ~ Understanding the pathogenesis of renal failure and associated metabolic disturbances in hepatic failure is essential for its possible prevention and management. In this article, the pathophysiology of renal failure and the therapeutic measures are presented. Type of renal failure

A total of 157 infants and preshool children with acute diarrhea were investigated for Yersinia enterocolitica over a six months period. Only one infant with acute diarrhea (0.6%) was found to have Yersinia enterocolitica in the stool as compared to none from the 65 asymptomatic controls. Clinical features of the child with yersinia diarrhea have been described.

Lactose tolerance test (LTT) was performed in 70 children with idiopathic recurrent abdominal pain (IRAP) and 50 matched controls. The prevalence of lactose malabsorption in the IRAP patients (47.1%) was significantly higher than in controls (18%). When milk was withheld fora 4 week period, 33% (11/33) of lactose malabsorbers and 16.2% (6/37) of lactose absorbers were relieved of their symptoms, the difference being insignificant. The limitations of standard oral lactose tolerance test are discussed.

Le seul mecanisme pathogene present dans la souche de E. coli isolee est l'adherence et celle-ci peut etre impliquee dans la pathogenie de l'enteropathie et de la diarrhee chez ce malade