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Sample records for defecation

  1. Constipation and Defecation Problems

    Science.gov (United States)

    ... emptied their bowels. The American College of Gastroenterology defines constipation based upon symptoms including unsatisfactory defecation with ... first step. Vegetables, fruit (especially prunes), whole-grain breads, and high-fiber cereals are excellent sources of ...

  2. Imaging of obstructed defecation

    International Nuclear Information System (INIS)

    Ganeshan, A.; Anderson, E.M.; Upponi, S.; Planner, A.C.; Slater, A.; Moore, N.; D'Costa, H.; Bungay, H.

    2008-01-01

    Constipation is a common problem in the western world, which occurs as a consequence of impaired colonic transit and/or due to obstructed defecation. Imaging plays an important role in distinguishing structural from functional causes of constipation. In this article a description of common imaging techniques for diagnosing structural causes of constipation with illustrations of abnormal defecographic findings in patients with obstructive defecation are presented

  3. Imaging of obstructed defecation

    Energy Technology Data Exchange (ETDEWEB)

    Ganeshan, A. [Radiology Department, John Radcliffe Hospital, Oxford (United Kingdom); Anderson, E.M. [Radiology Department, John Radcliffe Hospital, Oxford (United Kingdom)], E-mail: eanderson@doctors.org.uk; Upponi, S.; Planner, A.C.; Slater, A.; Moore, N.; D' Costa, H.; Bungay, H. [Radiology Department, John Radcliffe Hospital, Oxford (United Kingdom)

    2008-01-15

    Constipation is a common problem in the western world, which occurs as a consequence of impaired colonic transit and/or due to obstructed defecation. Imaging plays an important role in distinguishing structural from functional causes of constipation. In this article a description of common imaging techniques for diagnosing structural causes of constipation with illustrations of abnormal defecographic findings in patients with obstructive defecation are presented.

  4. Management of obstructed defecation.

    Science.gov (United States)

    Podzemny, Vlasta; Pescatori, Lorenzo Carlo; Pescatori, Mario

    2015-01-28

    The management of obstructed defecation syndrome (ODS) is mainly conservative and mainly consists of fiber diet, bulking laxatives, rectal irrigation or hydrocolontherapy, biofeedback, transanal electrostimulation, yoga and psychotherapy. According to our experience, nearly 20% of the patients need surgical treatment. If we consider ODS an "iceberg syndrome", with "emerging rocks", rectocele and rectal internal mucosal prolapse, that may benefit from surgery, at least two out of ten patients also has "underwater rocks" or occult disorders, such as anismus, rectal hyposensation and anxiety/depression, which mostly require conservative treatment. Rectal prolapse excision or obliterative suture, rectocele and/or enterocele repair, retrograde Malone's enema and partial myotomy of the puborectalis muscle are effective in selected cases. Laparoscopic ventral sacral colporectopexy may be an effective surgical option. Stapled transanal rectal resection may lead to severe complications. The Transtar procedure seems to be safer, when dealing with recto-rectal intussusception. A multidisciplinary approach to ODS provides the best results.

  5. Effects of biofeedback on obstructive defecation--reconditioning of the defecation reflex?

    Science.gov (United States)

    Papachrysostomou, M; Smith, A N

    1994-01-01

    Twenty two patients with obstructive defecation were recruited for relaxation training by domiciliary self regulatory biofeedback. Each patient served as his or her own control for anorectal and proctographic assessments. Biofeedback training improved the obstructive symptoms of the patients and showed significant change in various parameters related to the obstructive defecation syndrome. As examined by isotope dynamic proctography: the defecation rate (% of evacuation/defecation time) was significantly increased (p anismus index (p < 0.0001). The rectal sensation was improved (p < 0.05), concomitantly. Biofeedback thus improves the defecation act in patients suffering from inappropriate contraction of the pelvic floor and sphincter musculature. Furthermore, this study has shown that biofeedback objectively influences the defecation reflex leading to an improved quality of higher control of bowel function. PMID:8307478

  6. Voluntary suppression of defecation delays gastric emptying

    NARCIS (Netherlands)

    Tjeerdsma, H. C.; Smout, A. J.; Akkermans, L. M.

    1993-01-01

    We wished to test the hypothesis that colonic loading with fecal material leads to delayed gastric emptying. Twelve healthy male volunteers were studied. Each of these subjects went through two randomized study periods of four days. In one of these, the subjects defecated upon urge, in the other

  7. MR defecography for obstructed defecation syndrome

    Directory of Open Access Journals (Sweden)

    Ravikumar B Thapar

    2015-01-01

    Full Text Available Patients with obstructed defecation syndrome (ODS form an important subset of patients with chronic constipation. Evaluation and treatment of these patients has traditionally been difficult. Magnetic resonance defecography (MRD is a very useful tool for the evaluation of these patients. We evaluated the scans and records of 192 consecutive patients who underwent MRD at our center between January 2011 and January 2012. Abnormal descent, rectoceles, rectorectal intussusceptions, enteroceles, and spastic perineum were observed in a large number of these patients, usually in various combinations. We discuss the technique, its advantages and limitations, and the normal findings and various pathologies.

  8. Health related quality of life in disorders of defecation: the Defecation Disorder List

    Science.gov (United States)

    Voskuijl, W; van der Zaag-Loon..., H J; Ketel, I; Grootenhuis, M; Derkx, B; Benninga, M

    2004-01-01

    Background: Constipation and encopresis frequently cause problems with respect to emotional wellbeing, and social and family life. Instruments to measure Health Related Quality of Life (HRQoL) in these disorders are not available. Methods: A disease specific HRQoL instrument, the "Defecation Disorder List" (DDL) for children with constipation or functional non-retentive faecal soiling (FNRFS) was developed using accepted guidelines. For each phase of the process, different samples of patients were used. The final phase of development included 27 children. Reliability was assessed in two ways: internal consistency of domains with Cronbach's alpha, and test-retest reliability with intra-class correlation coefficients (ICC). To assess validity, comparable items and domains were correlated with Tacqol, a generic HRQoL instrument for children (TNO-AZL). Results: In the final phase of the development, 27 children completed the instrument. It consisted of 37 items in four domains. The response rate was 96%. Reliability was good for all domains, with Cronbach's alpha values ranging from 0.61 to 0.76. Measures of test-retest stability were good for all four domains with ICCs ranging from 0.82 to 0.92. Validity based on comparison with the Tacqol instrument was moderate. Conclusion: The DDL is promising as a measure of HRQoL in childhood defecation disorders. PMID:15557046

  9. Stressful Life Events in Children With Functional Defecation Disorders.

    Science.gov (United States)

    Philips, Elise M; Peeters, Babette; Teeuw, Arianne H; Leenders, Arnold G E; Boluyt, Nicole; Brilleslijper-Kater, Sonja N; Benninga, Marc A

    2015-10-01

    The aim of the study was to determine the prevalence of stressful life events including (sexual) abuse in children with functional defecation disorders by performing a systematic review. We searched MEDLINE, EMBASE, and PsycINFO for cohort, case-control and cross-sectional studies investigating the prevalence of stressful life events, including (sexual) abuse in children with functional defecation disorders. The search yielded 946 articles, of which 8 were included with data from 654 children with functional constipation and 1931 children with (constipation-associated) fecal incontinence (FI). Overall, children with functional defecation disorders had been significantly more exposed to stressful life events than healthy children, with prevalence rates ranging from 1.6% to 90.9%. Being bullied, being a relational victim, interruption of toilet training, punishment by parents during toilet training, and hospitalization were significantly related to FI, whereas separation from the best friend, failure in an examination, severe illness in a close family member, loss of job by a parent, frequent punishment, and living in a war-affected area were significantly related to constipation. Only 1 study measured the prevalence of child abuse, which reported a significantly higher prevalence of child (sexual) abuse in children with FI compared with controls. The prevalence of stressful life events, including (sexual) abuse is significantly higher in children with functional defecation disorders compared with healthy children. To gain more insight into the true prevalence of child (sexual) abuse in children with functional defecation disorders, more studies are clearly needed.

  10. Scintigraphic study on disordered defecation after low anterior resection

    International Nuclear Information System (INIS)

    Yoshikawa, Shusaku; Fujii, Hisao; Nakano, Hiroshige

    1997-01-01

    This study was designed to clarify the mechanism of disordered defecation after low anterior resection (LAR). Twenty four patients were divided into two groups, the poor motility group (Group I), including 12 subjects who defecated over four times per day, and the good motility group (Group II), including 12 subjects who defecated under three times per day. At first, a polyethylene-tube was inserted into the cecum using a colonoscope and a guide wire. 37 MBq 99m TcDTPA in 50 ml of tepid saline containing 5 mg of bisacodyl was infused into the cecum through the tube. Transit time and expulsion ratio from the rectum (ERr) were studied. The average times of propelling RI-solution from the transverse colon to the descending colon, from the descending colon to the rectum, and from the rectum to defecation were 37.5 seconds and 163.7 seconds, 48.7 and 293.5, 47.7 and 215.5, respectively in Group I and Group II. ERr was 84.3% in Group I and 94.5% in Group II. There are significant differences between these two groups. Colonic transit time in Group I was shorter than that in Group II, and ERr in Group I was less than that in Group II. These results suggest that the disordered defecation after LAR may be partly caused by poor colonic motility and dysfunction of the neorectum. (author)

  11. Treating Pelvic Floor Disorders of Defecation: Management or Cure?

    Science.gov (United States)

    Rao, Satish S.C.; Go, Jorge T.

    2013-01-01

    Pelvic floor disorders that affect defecation consist of structural disorders such as rectocele and functional disorders such as dyssynergic defecation. Evaluation includes a good history and physical examination, a careful digital rectal exam, as well as physiological tests such as anorectal manometry, colonic transit study and balloon expulsion test. Defecography and dynamic magnetic resonance imaging may facilitate detection of structural defects. Their management consists of education and counseling regarding bowel function, diet, laxatives and behavioral therapies. Recently, several randomized clinical trials have shown that biofeedback therapy is effective in dyssynergic defecation. Dyssynergia may also co-exist in structural disorders such as solitary rectal ulcer syndrome or rectocele. Hence, before proceeding with surgery, neuromuscular training or biofeedback should be considered. Several surgical approaches including stapled transanal rectal resection (STARR) have been advocated, but there is lack of well controlled randomized studies and their efficacy is unproven. PMID:19615303

  12. Attention Deficit Hyperactivity Disorder and Functional Defecation Disorders in Children

    NARCIS (Netherlands)

    Kuizenga-Wessel, Sophie; Koppen, Ilan J. N.; Vriesman, Mana H.; Di Lorenzo, Carlo; van Dijk, Marieke; Beelen, Maureen L. R.; Groeneweg, Michael; Stoffelsen, Reino J.; Benninga, Marc A.

    2018-01-01

    Objectives: The aim of the study was to assess the prevalence of attention deficit hyperactivity disorder (ADHD) in children presenting with functional defecation disorders (FDDs) and to assess the prevalence of FDDs in children with ADHD. Methods: A cross-sectional cohort study was carried out

  13. Autism Spectrum Disorders in Children with Functional Defecation Disorders

    NARCIS (Netherlands)

    Peeters, B.; Noens, I.; Philips, E.M.; Kuppens, S.P.E.; Benninga, M.A.

    2013-01-01

    Objective: To prospectively assess the prevalence of autism spectrum disorder (ASD) symptoms in children presenting with functional defecation disorders. Study design: Children (age 4-12 years) with functional constipation or functional non-retentive fecal incontinence according to the Rome III

  14. Autism spectrum disorders in children with functional defecation disorders

    NARCIS (Netherlands)

    Peeters, Babette; Noens, Ilse; Philips, Elise M.; Kuppens, Sofie; Benninga, Marc A.

    2013-01-01

    To prospectively assess the prevalence of autism spectrum disorder (ASD) symptoms in children presenting with functional defecation disorders. Children (age 4-12 years) with functional constipation or functional non-retentive fecal incontinence according to the Rome III criteria referred to a

  15. Stressful Life Events in Children With Functional Defecation Disorders

    NARCIS (Netherlands)

    Philips, Elise M.; Peeters, Babette; Teeuw, Arianne H.; Leenders, Arnold G. E.; Boluyt, Nicole; Brilleslijper-Kater, Sonja N.; Benninga, Marc A.

    2015-01-01

    The aim of the study was to determine the prevalence of stressful life events including (sexual) abuse in children with functional defecation disorders by performing a systematic review. We searched MEDLINE, EMBASE, and PsycINFO for cohort, case-control and cross-sectional studies investigating the

  16. Colorectal transport during defecation in subjects with supraconal spinal cord injury

    DEFF Research Database (Denmark)

    Rasmussen, Mikkel Mylius; Krogh, Klaus; Clemmensen, Dorte

    2013-01-01

    Hospital, Denmark. Methods: Colorectal contents were marked by oral intake of 111In-coated resin pellets. Movement of stools at defecation was assessed by comparing scintigrams performed before and just after defecation. Results from 15 subjects with SCI (14 males, median age¼47 years (range: 22–74 years...... at defecation was associated with the St Mark’s fecal incontinence score (P¼0.02) but not with the Cleveland constipation score (P¼0.17), the neurogenic bowel dysfunction score (P¼0.12) or GITT (P¼0.99). Conclusion: Supraconal SCI results in significantly reduced emptying of stools at defecation...

  17. Comparing the Efficacy of Biofeedback and Balloon-Assisted Training in the Treatment of Dyssynergic Defecation

    Directory of Open Access Journals (Sweden)

    Abbs Ali Pourmomeny

    2011-01-01

    Full Text Available BACKGROUND: Dyssynergic defecation does not respond appropriately to routine treatments for constipation. Recently, research has shown that biofeedback therapy is useful in anorectal dyssynergia.

  18. Nest sanitation through defecation: antifungal properties of wood cockroach feces

    Science.gov (United States)

    Rosengaus, Rebeca B.; Mead, Kerry; Du Comb, William S.; Benson, Ryan W.; Godoy, Veronica G.

    2013-11-01

    The wood cockroach Cryptocercus punctulatus nests as family units inside decayed wood, a substrate known for its high microbial load. We tested the hypothesis that defecation within their nests, a common occurrence in this species, reduces the probability of fungal development. Conidia of the entomopathogenic fungus, Metarhizium anisopliae, were incubated with crushed feces and subsequently plated on potato dextrose agar. Relative to controls, the viability of fungal conidia was significantly reduced following incubation with feces and was negatively correlated with incubation time. Although the cockroach's hindgut contained abundant β-1,3-glucanase activity, its feces had no detectable enzymatic function. Hence, these enzymes are unlikely the source of the fungistasis. Instead, the antifungal compound(s) of the feces involved heat-sensitive factor(s) of potential microbial origin. When feces were boiled or when they were subjected to ultraviolet radiation and subsequently incubated with conidia, viability was "rescued" and germination rates were similar to those of controls. Filtration experiments indicate that the fungistatic activity of feces results from chemical interference. Because Cryptocercidae cockroaches have been considered appropriate models to make inferences about the factors fostering the evolution of termite sociality, we suggest that nesting in microbe-rich environments likely selected for the coupling of intranest defecation and feces fungistasis in the common ancestor of wood cockroaches and termites. This might in turn have served as a preadaptation that prevented mycosis as these phylogenetically related taxa diverged and evolved respectively into subsocial and eusocial organizations.

  19. MRI anatomy of anteriorly displaced anus: what obstructs defecation?

    International Nuclear Information System (INIS)

    AbouZeid, Amr Abdelhamid; Mohammad, Shaimaa Abdelsattar; Khairy, Khaled Talaat

    2014-01-01

    Anteriorly displaced anus is an anomaly that is debated with regard to its nomenclature, diagnosis and management. To describe MRI anatomy of the anal canal in children with anteriorly displaced anus and its impact on the process of defecation. We prospectively examined ten children (7 girls, 3 boys; age range 7 months to 8 years, mean 3 years) with anteriorly displaced anus between August 2009 and April 2012. Noncontrast MRI examinations were performed on a 1.5-T magnet. T1- and T2-weighted turbo spin-echo images were acquired in axial, sagittal and coronal planes of the pelvis. The anorectal angle and the relative hiatal distance were measured in mid-sagittal images, and compared with those of a control group using the Mann-Whitney test. In children with anteriorly displaced anus, no anatomical abnormality was depicted at the level of the proximal anal canal. However, the distal anal canal was displaced anteriorly, running out its external muscle cuff, which remained un-displaced at the usual site of the anus. This changes the orientation of the central axis of the anal canal by passing across instead of along the fibers of the longitudinal muscle coat. Children with anteriorly displaced anus had a more obtuse anorectal angle (mean 112.1 ), which was significantly greater than that of the control group (mean 86.2 ). MRI is a valuable tool in studying the anatomy of the anal canal in children with anteriorly displaced anus. The abnormal orientation of the longitudinal muscle across the anal canal can explain the obstructed defecation in these children. Based on this study, it might be of interest to use MRI in studying equivocal cases and children with unexplained constipation. (orig.)

  20. MRI anatomy of anteriorly displaced anus: what obstructs defecation?

    Energy Technology Data Exchange (ETDEWEB)

    AbouZeid, Amr Abdelhamid [Ain-Shams University, Department of Pediatric Surgery, Cairo (Egypt); Mohammad, Shaimaa Abdelsattar; Khairy, Khaled Talaat [Ain-Shams University, Department of Radiodiagnosis, Cairo (Egypt)

    2014-07-15

    Anteriorly displaced anus is an anomaly that is debated with regard to its nomenclature, diagnosis and management. To describe MRI anatomy of the anal canal in children with anteriorly displaced anus and its impact on the process of defecation. We prospectively examined ten children (7 girls, 3 boys; age range 7 months to 8 years, mean 3 years) with anteriorly displaced anus between August 2009 and April 2012. Noncontrast MRI examinations were performed on a 1.5-T magnet. T1- and T2-weighted turbo spin-echo images were acquired in axial, sagittal and coronal planes of the pelvis. The anorectal angle and the relative hiatal distance were measured in mid-sagittal images, and compared with those of a control group using the Mann-Whitney test. In children with anteriorly displaced anus, no anatomical abnormality was depicted at the level of the proximal anal canal. However, the distal anal canal was displaced anteriorly, running out its external muscle cuff, which remained un-displaced at the usual site of the anus. This changes the orientation of the central axis of the anal canal by passing across instead of along the fibers of the longitudinal muscle coat. Children with anteriorly displaced anus had a more obtuse anorectal angle (mean 112.1 ), which was significantly greater than that of the control group (mean 86.2 ). MRI is a valuable tool in studying the anatomy of the anal canal in children with anteriorly displaced anus. The abnormal orientation of the longitudinal muscle across the anal canal can explain the obstructed defecation in these children. Based on this study, it might be of interest to use MRI in studying equivocal cases and children with unexplained constipation. (orig.)

  1. Evidence that central pathways that mediate defecation utilize ghrelin receptors but do not require endogenous ghrelin.

    Science.gov (United States)

    Pustovit, Ruslan V; Callaghan, Brid; Ringuet, Mitchell T; Kerr, Nicole F; Hunne, Billie; Smyth, Ian M; Pietra, Claudio; Furness, John B

    2017-08-01

    In laboratory animals and in human, centrally penetrant ghrelin receptor agonists, given systemically or orally, cause defecation. Animal studies show that the effect is due to activation of ghrelin receptors in the spinal lumbosacral defecation centers. However, it is not known whether there is a physiological role of ghrelin or the ghrelin receptor in the control of defecation. Using immunohistochemistry and immunoassay, we detected and measured ghrelin in the stomach, but were unable to detect ghrelin by either method in the lumbosacral spinal cord, or other regions of the CNS In rats in which the thoracic spinal cord was transected 5 weeks before, the effects of a ghrelin agonist on colorectal propulsion were significantly enhanced, but defecation caused by water avoidance stress (WAS) was reduced. In knockout rats that expressed no ghrelin and in wild-type rats, WAS-induced defecation was reduced by a ghrelin receptor antagonist, to similar extents. We conclude that the ghrelin receptors of the lumbosacral defecation centers have a physiological role in the control of defecation, but that their role is not dependent on ghrelin. This implies that a transmitter other than ghrelin engages the ghrelin receptor or a ghrelin receptor complex. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  2. Exploring changes in open defecation prevalence in sub-Saharan Africa based on national level indices.

    Science.gov (United States)

    Galan, Deise I; Kim, Seung-Sup; Graham, Jay P

    2013-05-30

    In sub-Saharan Africa, it is estimated that 215 million people continue to engage in open defecation. This practice facilitates the transmission of diarrheal diseases - one of the leading causes of mortality in children under 5 in sub-Saharan Africa. The main purpose of this study is to: estimate changes in open defecation prevalence between 2005 and 2010 across countries in sub-Saharan Africa; examine the association between national level indices and changes in open defecation prevalence; and assess how many countries can achieve 'open defecation free status' by 2015. After applying selection criteria, this study analyzed country-level data for 34 sub-Saharan African countries. Seven country-level indices were collected: 1) presence of a national sanitation policy; 2) budget line for sanitation; 3) budget allocated to sanitation; 4) annual per capita GDP; 5) GDP growth; 6) implementation of total sanitation approaches; and 7) per capita aid disbursement for water supply and sanitation. The relationships between these country-level indices and the change in open defecation from 2005 to 2010 were investigated using Wilcoxon Signed-Rank test and Spearman's rank correlation test. Only 3 countries (i.e. Ethiopia, Angola and Sao Tome and Principe) decreased open defecation by 10% or more between 2005 and 2010. No significant associations were observed between the change in open defecation prevalence and all of national level indices except per capita aid disbursement. Per capita aid disbursement for water and sanitation was positively associated with a reduction in open defecation (p-value = 0.02) for a subset of 29 low-income countries from 2005 to 2010. Only one country in our analysis, Angola, is on track to end open defecation by 2015 based on their performance between 2000 and 2010. Most of the national level indices, including a country's economic status, were not associated with the change in the open defecation prevalence. Based on current trends, the goal

  3. Colonic irrigation for defecation disorders after dynamic graciloplasty.

    Science.gov (United States)

    Koch, Sacha M; Uludağ, Ozenç; El Naggar, Kadri; van Gemert, Wim G; Baeten, Cor G

    2008-02-01

    Dynamic graciloplasty (DGP) improves anal continence and quality of life for most patients. However, in some patients, DGP fails and fecal incontinence is unsolved or only partially improved. Constipation is also a significant problem after DGP, occurring in 13-90%. Colonic irrigation can be considered as an additional or salvage treatment for defecation disorders after unsuccessful or partially successful DGP. In this study, the effectiveness of colonic irrigation for the treatment of persistent fecal incontinence and/or constipation after DGP is investigated. Patients with defecation disorders after DGP visiting the outpatient clinic of the University Hospital Maastricht were selected for colonic irrigation as additional therapy or salvage therapy in the period between January 1999 and June 2003. The Biotrol(R) Irrimatic pump or the irrigation bag was used for colonic irrigation. Relevant physical and medical history was collected. The patients were asked to fill out a detailed questionnaire about colonic irrigation. Forty-six patients were included in the study with a mean age of 59.3 +/- 12.4 years (80% female). On average, the patients started the irrigation 21.39 +/- 38.77 months after the DGP. Eight patients started irrigation before the DGP. Fifty-two percent of the patients used the irrigation as additional therapy for fecal incontinence, 24% for constipation, and 24% for both. Irrigation was usually performed in the morning. The mean frequency of irrigation was 0.90 +/- 0.40 times per day. The mean amount of water used for the irrigation was 2.27 +/- 1.75 l with a mean duration of 39 +/- 23 min. Four patients performed antegrade irrigation through a colostomy or appendicostomy, with good results. Overall, 81% of the patients were satisfied with the irrigation. Thirty-seven percent of the patients with fecal incontinence reached (pseudo-)continence, and in 30% of the patients, the constipation completely resolved. Side effects of the irrigation were

  4. Gallium colonic transit study patterns in obstructive defecation

    International Nuclear Information System (INIS)

    Bartholomeusz, F.D.L.; Sun, W.M.; Gaffney, R.; Ganesananthan, S.

    1999-01-01

    Full text: Idiopathic constipation may be due to delayed colonic transit or ano-rectal dysfunction and obstructive defecation. The aim of this study was to relate patterns of colonic transit to results of ano-rectal manometry. Sixteen patients (4 males, 12 females, age 20-58 years) were studied. All underwent ano-rectal manometric studies and colonic transit studies. The transit studies were performed following the oral ingestion of 4 MBq 67 Gacitrate with images performed at 6, 24, 48 and 72 h. Computed data on half clearance times (T 1/2 ), mean activity positions (MAP) and segmental tracer retention were obtained. Five patients had normal ano-rectal manometry, 7 decreased rectal sensation and 4 absent or paradoxical ano-rectal reflex (anismus). The T 1/2 for subjects with normal manometry was 78.5 ± 11.9 h, decreased rectal sensation 73 ± 4.9 h and the anismus group 52 ± 12.1 h (P < 0.05). Total retention at 72 h was less at 56 ± 3.73 h in the anismus group compared to normal manometry (74.7 ± 12.2) and decreased rectal sensation (90.7 ± 12.1), with higher MAP and less tracer in the right colon at 48 h in the anismus group (P < 0.05). The results indicate that colonic transit studies in constipated patients with anismus have different patterns to those with normal anorectal manometry or decreased rectal sensation

  5. Biofeedback-guided pelvic floor exercise therapy for obstructive defecation: An effective alternative

    Science.gov (United States)

    ba-bai-ke-re, Ma-Mu-Ti-Jiang A; Wen, Ni-Re; Hu, Yun-Long; Zhao, Liang; Tuxun, Tuerhongjiang; Husaiyin, Aierhati; Sailai, Yalikun; Abulimiti, Alimujiang; Wang, Yun-Hai; Yang, Peng

    2014-01-01

    AIM: To compare biofeedback-guided pelvic floor exercise therapy (BFT) with the use of oral polyethylene glycol (PEG) for the treatment of obstructive defecation. METHODS: A total of 88 subjects were assigned to treatment with either BFT (n = 44) or oral PEG (n = 44). Constipation symptoms (including difficult evacuation, hard stool, digitation necessity, incomplete emptying sensation, laxative dependence, perianal pain at defecation, and constipation satisfaction), Wexner Scores, and quality of life scores were assessed after 1, 3, and 6 mo. RESULTS: At the 6 mo follow-up, the symptoms of the BFT group patients showed significantly greater improvements compared with the PEG group regarding difficult evacuation, hard stools, digitation necessity, laxative dependence, perianal pain at defecation, constipation satisfaction, Wexner Constipation Score, and quality of life score (P biofeedback-guided pelvic floor exercise training is superior to oral polyethylene glycol therapy for obstructive defecation. PMID:25083090

  6. Study on the Excretion Behaviour in Romanian Black and White Primiparous Cows. Number of Defecations

    Directory of Open Access Journals (Sweden)

    Silvia Erina

    2012-10-01

    Full Text Available The study was carried out on 9 Romanian Black and White cows in their first hundred days of lactation. The aim ofthis study was to measure the main aspects that characterized the excretion behaviour (defecation of the cows in 24hours that were divided into 3 day periods: 07:00-14:00 (I1, 14:00-2:001 (I2, 21:00-07:00 (I3. During theexperiments, the following defecation behaviour aspects were determined: total number of defecations, number ofdefecations in the three intervals, number of defecations according to administration order of forages (fibroussucculentsand succulents-fibrous. Data was computed by ANOVA/MANOVA. Results showed that the differencesbetween intervals I1-I2 and I1-I3 were statistically very significant (p< 0.01. In fibrous – succulent order thedefecation were 0.69 higher than in succulent- fibrous order (p< 0.01. Total number of defecation resulted bysumming the defecation from the three intervals, was 14.67 in the first administration order (fibrous-succulent and12.61 in the second administration order (succulent-fibrous.

  7. Open defecation and childhood stunting in India: an ecological analysis of new data from 112 districts.

    Science.gov (United States)

    Spears, Dean; Ghosh, Arabinda; Cumming, Oliver

    2013-01-01

    Poor sanitation remains a major public health concern linked to several important health outcomes; emerging evidence indicates a link to childhood stunting. In India over half of the population defecates in the open; the prevalence of stunting remains very high. Recently published data on levels of stunting in 112 districts of India provide an opportunity to explore the relationship between levels of open defecation and stunting within this population. We conducted an ecological regression analysis to assess the association between the prevalence of open defecation and stunting after adjustment for potential confounding factors. Data from the 2011 HUNGaMA survey was used for the outcome of interest, stunting; data from the 2011 Indian Census for the same districts was used for the exposure of interest, open defecation. After adjustment for various potential confounding factors--including socio-economic status, maternal education and calorie availability--a 10 percent increase in open defecation was associated with a 0.7 percentage point increase in both stunting and severe stunting. Differences in open defecation can statistically account for 35 to 55 percent of the average difference in stunting between districts identified as low-performing and high-performing in the HUNGaMA data. In addition, using a Monte Carlo simulation, we explored the effect on statistical power of the common practice of dichotomizing continuous height data into binary stunting indicators. Our simulation showed that dichotomization of height sacrifices statistical power, suggesting that our estimate of the association between open defecation and stunting may be a lower bound. Whilst our analysis is ecological and therefore vulnerable to residual confounding, these findings use the most recently collected large-scale data from India to add to a growing body of suggestive evidence for an effect of poor sanitation on human growth. New intervention studies, currently underway, may shed more

  8. Differences in Symptom Severity and Quality of Life in Patients With Obstructive Defecation and Colonic Inertia.

    Science.gov (United States)

    Chou, Adriana B; Cohan, Jessica N; Varma, Madhulika G

    2015-10-01

    Little is known about how obstructive defecation and colonic inertia symptoms contribute to constipation-related quality of life. We sought to characterize the differences in quality of life in patients with severe obstructive defecation and colonic inertia symptoms. This study was a cross-sectional analysis of a prospective database. Patients were enrolled at a single tertiary referral center. We included consecutive adults with severe symptoms of obstructive defecation (n = 115) or colonic inertia (n = 90) as measured by the Constipation Severity Instrument. The primary outcomes measured were the Pelvic Floor Distress Inventory, Constipation-Related Quality of Life instrument, Pelvic Floor Impact Questionnaire, and 12-item Short Form Health Survey. Although physical examination and anorectal physiology testing were similar between groups, patients with severe obstructive defecation symptoms reported worse pain, distress, and constipation-specific quality of life than patients with severe colonic inertia symptoms (all p < 0.001). Specifically, patients with severe obstructive defecation symptoms showed greater quality-of-life impairment related to eating, bathroom habits, and social functioning (all p ≤ 0.01). Furthermore, patients with severe obstructive defecation symptoms had inferior global quality of life on the 12-item Short Form Health Survey physical component score (p = 0.03) and mental component score (p = 0.06). The use of patient self-report instruments resulted in a proportion of patients with incomplete data. Quality of life was impaired in both groups of patients; however, patients with severe obstructive defecation symptoms were affected to a significantly greater extent. The fact that there were no differences in objective findings on physical examination or anorectal physiology studies highlights the importance of assessing quality of life during the evaluation and treatment of constipated patients.

  9. [Effects of low anterior resection on colonic motor activity and defecation. An experimental study].

    Science.gov (United States)

    Iikura, M

    1995-06-01

    The functional disorder of defecation after low anterior resection (LAR) was studied from the aspect of colonic motility in an experiment with dogs using a strain gage transducer, and the following results were obtained: 1) In early phase after LAR, the frequency of the colonic contractile waves increased at the proximal and distal sites of the anastomosis in both subgroups of dogs denervated and innervated of hypogastric and pelvic nerves. The increase was more remarkable at the distal site of the anastomosis. Also, the contractile waves were not propagated across the anastomosis. 2) After LAR, strong colonic contractions occurred during defecation only at the distal anastomosis. Various patterns of contraction time required for defecation were demonstrated as compared to a single pattern in control dogs. 3) The frequency of the occurrence of colonic contractile waves and the propagation of the contraction tended to be normalized with time after LAR both in denervated and innervated groups, though the recovery was faster in the latter subgroup. 4) The frequency of defecation increased after LAR both in denervated and innervated groups compared to be in the control dogs, though more remarkable in the denervated groups. Although tended to be gradually normalized with time after LAR, the colectomized dogs required a long time for normalization of the frequency of defecation. These results suggested the significant effect of reduction in reservoir space and disturbed continuity of intramural plexus caused by colectomy. Less severity, however, of functional disorder of defecation and earlier recovery from colonic motility disorder in the subgroup of the dogs innervated of autonomic nerves indicated usefulness of retaining autonomic nerves in colectomy.

  10. The application of percutaneous endoscopic colostomy to the management of obstructed defecation.

    Science.gov (United States)

    Heriot, A G; Tilney, H S; Simson, J N L

    2002-05-01

    We describe the case of a 52-year woman with a 17-year history of obstructed defecation in whom all other standard treatments had failed and the patient had refused a colostomy. Her symptoms were controlled by percutaneous endoscopic colostomy with antegrade colonic irrigation. A percutaneous endoscopic colostomy tube was placed in the sigmoid colon endoscopically using a colonoscope and the patient irrigated two liters of water through the percutaneous endoscopic colostomy twice each day and was able to successfully evacuate her rectum without excess straining or discomfort. Percutaneous endoscopic colostomy is an alternative option to colostomy in the management of obstructed defecation.

  11. Use of Rome II criteria in childhood defecation disorders: Applicability in clinical and research practice

    NARCIS (Netherlands)

    Voskuijl, Wieger P.; Heijmans, Jarom; Heijmans, Hugo S. A.; Taminiau, Jan A. J. M.; Benninga, Marc A.

    2004-01-01

    Objectives To evaluate the prevalence of pediatric functional gastrointestinal disorders with the use of the Rome II criteria and to compare these data with the classic Iowa criteria. Study design Patients recorded defecation and encopresis frequency. A standard history was taken and a physical

  12. Toilet training in children with a functional defecation disorder and concomitant symptoms of autism spectrum disorder

    NARCIS (Netherlands)

    Peeters, Babette; Noens, Ilse; Kuppens, Sofie; Benninga, Marc A.

    2016-01-01

    The purpose of this study was to determine the association between the presence of symptoms of Autism Spectrum Disorder (ASD) and the time of completion of toilet training in pediatric patients with a Functional Defecation Disorder (FDD). Consecutive children (4-12 yrs) presenting with FDD according

  13. Efficacy of Biofeedback Therapy in the Treatment of Dyssynergic Defecation in Community-Dwelling Elderly Women.

    Science.gov (United States)

    Simón, Miguel A; Bueno, Ana M

    The aim of this study was to evaluate the efficacy of biofeedback therapy in the treatment of dyssynergic defecation in chronically constipated community-dwelling elderly women. After an initial assessment phase carried out during 1 month, 20 chronically constipated women with dyssynergic defecation were randomly assigned to either electromyographic biofeedback (EMG-BF) group (n=10) or control group (n=10). Outcome measures used to evaluate the efficacy of treatment were weekly stool frequency, sensation of incomplete evacuation, difficulty evacuation level, mean EMG-activity (μV) of the external anal sphincter during straining to defecate and Anismus index. The results obtained in this randomized controlled trial showed significant differences between the groups in all the dependent variables after 1 month of treatment. Moreover, there was no difference between the groups neither in age nor in the duration of chronic constipation symptoms. At the follow-up, 3 months later, clinical gains were maintained. This study demonstrates that the EMG-BF is an effective behavioral therapy for the treatment of dyssynergic defecation in community-dwelling elderly women.

  14. Investigation of the utility of colorectal function tests and Rome II criteria in dyssynergic defecation (Anismus).

    Science.gov (United States)

    Rao, S S C; Mudipalli, R S; Stessman, M; Zimmerman, B

    2004-10-01

    Although 30-50% of constipated patients exhibit dyssynergia, an optimal method of diagnosis is unclear. Recently, consensus criteria have been proposed but their utility is unknown. To examine the diagnostic yield of colorectal tests, reproducibility of manometry and utility of Rome II criteria. A total of 100 patients with difficult defecation were prospectively evaluated with anorectal manometry, balloon expulsion, colonic transit and defecography. Fifty-three patients had repeat manometry. During attempted defecation, 30 showed normal and 70 one of three abnormal manometric patterns. Forty-six patients fulfilled Rome criteria and showed paradoxical anal contraction (type I) or impaired anal relaxation (type III) with adequate propulsion. However, 24 (34%) showed impaired propulsion (type II). Forty-five (64%) had slow transit, 42 (60%) impaired balloon expulsion and 26 (37%) abnormal defecography. Defecography provided no additional discriminant utility. Evidence of dyssynergia was reproducible in 51 of 53 patients. Symptoms alone could not differentiate dyssynergic subtypes or patients. Dyssynergic patients exhibited three patterns that were reproducible: paradoxical contraction, impaired propulsion and impaired relaxation. Although useful, Rome II criteria may be insufficient to identify or subclassify dyssynergic defecation. Symptoms together with abnormal manometry, abnormal balloon expulsion or colonic marker retention are necessary to optimally identify patients with difficult defecation.

  15. Dyssynergic defecation may aggravate constipation : results of mostly pediatric cases with congenital anorectal malformation

    NARCIS (Netherlands)

    van Meegdenburg, Maxime M.; Heineman, Erik; Broens, Paul M. A.

    BACKGROUND: Most patients with congenital anorectal malformation suffer from mild chronic constipation. To date, it is unclear why a subgroup of patients develops a persistent form of constipation. Because dyssynergic defecation is a common cause of constipation in the general population, we

  16. Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

    Directory of Open Access Journals (Sweden)

    Sthela Maria Murad-Regadas

    2012-06-01

    Full Text Available CONTEXT: Management of patients with obstructed defecation syndrome is still controversial. OBJECTIVE: To analyze the efficacy of clinical, clinical treatment followed by biofeedback, and surgical treatment in patients with obstructed defecation, rectocele and multiple dysfunctions evaluated with echodefecography. METHODS: The study included 103 females aged 26-84 years with obstructed defecation, grade-II/III rectocele and multiple dysfunctions on echodefecography. Patients were distributed into three treatment groups and constipation scores were assigned. Group I: 34 (33% patients with significant improvement of symptoms through clinical management only. Group II: 14 (14% with improvement through clinical treatment plus biofeedback. Group III: 55 (53% referred to surgery due to treatment failure. RESULTS: Group I: 20 (59% patients had grade-II rectocele, 14 (41% grade-III. Obstructed defecation syndrome was associated with intussusception (41%, mucosal prolapse (41%, anismus (29%, enterocele (9% or 2 dysfunctions (23%. The average constipation score decreased significantly from 11 to 5. Group II: 11 (79% grade-II rectocele, 3 (21% grade-III, associated with intussusception (7%, mucosal prolapse (43%, anismus (71% or 2 dysfunctions (29%. There was significant decrease in constipation score from 13 to 6. Group III: 8 (15% grade-II rectocele, 47 (85% grade-III, associated with intussusception (42%, mucosal prolapse (40% or 2 dysfunctions (32%. The constipation score remained unchanged despite clinical treatment and biofeedback. Twenty-three underwent surgery had a significantly decrease in constipation score from 12 to 4. The remaining 32 (31% patients which 22 refused surgery, 6 had low anal pressure and 4 had slow transit. CONCLUSIONS: Approximately 50% of patients with obstructed defecation, rectocele and multiple dysfunctions presented a satisfactory response to clinical treatment and/or biofeedback. Surgical repair was mainly required in

  17. Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome.

    Science.gov (United States)

    Murad-Regadas, Sthela Maria; Regadas, Francisco Sergio P; Rodrigues, Lusmar Veras; Fernandes, Graziela Olivia da Silva; Buchen, Guilherme; Kenmoti, Viviane T

    2012-01-01

    Management of patients with obstructed defecation syndrome is still controversial. To analyze the efficacy of clinical, clinical treatment followed by biofeedback, and surgical treatment in patients with obstructed defecation, rectocele and multiple dysfunctions evaluated with echodefecography. The study included 103 females aged 26-84 years with obstructed defecation, grade-II/III rectocele and multiple dysfunctions on echodefecography. Patients were distributed into three treatment groups and constipation scores were assigned. Group I: 34 (33%) patients with significant improvement of symptoms through clinical management only. Group II: 14 (14%) with improvement through clinical treatment plus biofeedback. Group III: 55 (53%) referred to surgery due to treatment failure. Group I: 20 (59%) patients had grade-II rectocele, 14 (41%) grade-III. Obstructed defecation syndrome was associated with intussusception (41%), mucosal prolapse (41%), anismus (29%), enterocele (9%) or 2 dysfunctions (23%). The average constipation score decreased significantly from 11 to 5. Group II: 11 (79%) grade-II rectocele, 3 (21%) grade-III, associated with intussusception (7%), mucosal prolapse (43%), anismus (71%) or 2 dysfunctions (29%). There was significant decrease in constipation score from 13 to 6. Group III: 8 (15%) grade-II rectocele, 47 (85%) grade-III, associated with intussusception (42%), mucosal prolapse (40%) or 2 dysfunctions (32%). The constipation score remained unchanged despite clinical treatment and biofeedback. Twenty-three underwent surgery had a significantly decrease in constipation score from 12 to 4. The remaining 32 (31%) patients which 22 refused surgery, 6 had low anal pressure and 4 had slow transit. Approximately 50% of patients with obstructed defecation, rectocele and multiple dysfunctions presented a satisfactory response to clinical treatment and/or biofeedback. Surgical repair was mainly required in patients with grade-III rectocele whose constipation

  18. Effect of eliminating open defecation on diarrhoeal morbidity: an ecological study of Nyando and Nambale sub-counties, Kenya

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    John Njuguna

    2016-08-01

    Full Text Available Abstract Background Defecating in the open predisposes people to soil transmitted helminthes and diarrhoeal diseases. An estimated 5.6 million Kenyans defecate in the open. Kenya launched a program to eradicate open defecation by 2013 in the rural areas. By end of 2013, only two sub-counties had eliminated open defecation. These are Nambale and Nyando. The study looked at the impact of eradicating open defecation on diarrhea prevalence among children in these two sub-counties. Methods Data on diarrhoea morbidity among children under 5 years was extracted from the Kenya Health Information System for all the sub-counties in Busia and Kisumu counties for 2012, 2013 and 2014 respectively. Prevalence was calculated for each sub-county in Kisumu for comparison with Nyando’s. Prevalence was also calculated for each sub-county in Busia County and compared to that of Nambale sub-county. A Mann–Whitney U Test was done to test the null hypothesis that diarrhoea prevalence was similar in both open defecation and open defecation free sub-counties. Results A Mann–Whitney U Test revealed significant difference in diarrhoeal prevalence of open defecation sub-counties (Md = 18.4, n = 34 and open defecation free sub-counties (Md = 9.8, n = 5, U = 9, z = −3.2, p = .001. Among the two Counties, Nambale had the lowest prevalence. It recorded a decline from 9.8 to 5.7 % across the three years. Prevalence for diarrhoea cases in Nyando declined from 19.1 to 15.2 % across the three years. Nyando initially had the second highest prevalence in Kisumu County and by 2014 it had the lowest prevalence. Conclusions The two sub-counties with open defecation free status had lower prevalence of diarrhoea cases compared to sub-counties which were yet to attain open defecation free status. This suggests that elimination of open defecation may reduce the number of diarrhoea cases.

  19. DEFECATION RATE IN CAPTIVE DEER IN “LOS CAPOMOS”, MUNICIPALITY OF El FUERTE, SINALOA

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    Héctor Gibrán Ochoa-Álvarez

    2014-01-01

    Full Text Available The sustainable use of white-tailed deer in Mexico can only be performed in Management Units for the Conservation of Wildlife (UMA , for its acronym in Spanish , based on a management plan for legal operation. Among the methods for population estimate harvest rates, highlights fecal count groups, depending on the frequency at which a deer excretes daily, and whose values are estimated from captive specimens and tolerant observer, but considering subspecies and different from the northern Sinaloa conditions. Using these rates of defecation can lead to overharvesting. This research was conducted in the farmed deer of the indigenous ejido (Mayo-Yoreme ethnic group called “Los Capomos”, in the municipality of El Fuerte, Sinaloa, between October 2011 and May 2012, to estimate the rate of defecation counts from fecal groups, obtained from a confined deer population and in apparent equilibrium with its environment through adjustments to the model of Eberhardt and Van Etten. It was found that the lowest rate published defecation (12.7 deer fecal groups per day, the estimated population accounted for half of the known population, which would prevent excessive use of native deer in the wild. However, the pattern of random grouping of excreta in confinement, makes it advisable that it be used in conditions of freedom, since it presupposes the mathematical model used aggregate grouping patterns.

  20. The influence of age on posterior pelvic floor dysfunction in women with obstructed defecation syndrome.

    Science.gov (United States)

    Murad-Regadas, S M; Rodrigues, L V; Furtado, D C; Regadas, F S P; Olivia da S Fernandes, G; Regadas Filho, F S P; Gondim, A C; de Paula Joca da Silva, R

    2012-06-01

    Knowledge of risk factors is particularly useful to prevent or manage pelvic floor dysfunction but although a number of such factors have been proposed, results remain inconsistent. The purpose of this study was to evaluate the impact of aging on the incidence of posterior pelvic floor disorders in women with obstructed defecation syndrome evaluated using echodefecography. A total of 334 patients with obstructed defecation were evaluated using echodefecography in order to quantify posterior pelvic floor dysfunction (rectocele, intussusception, mucosal prolapse, paradoxical contraction or non-relaxation of the puborectalis muscle, and grade III enterocele/sigmoidocele). Patients were grouped according to the age (Group I = patients up to 50 years of age; Group II = patients over 50 years of age) to evaluate the isolated and associated incidence of dysfunctions. To evaluate the relationship between dysfunction and age-related changes, patients were also stratified into decades. Group I included 196 patients and Group II included 138. The incidence of significant rectocele, intussusception, rectocele associated with intussusception, rectocele associated with mucosal prolapse and 3 associated disorders was higher in Group II, whereas anismus was more prevalent in Group I. The incidence of significant rectocele, intussusception, mucosal prolapse and grade III enterocele/sigmoidocele was found to increase with age. Conversely, anismus decreased with age. Aging was shown to influence the incidence of posterior pelvic floor disorders (rectocele, intussusception, mucosa prolapse and enterocele/sigmoidocele), but not the incidence of anismus, in women with obstructed defecation syndrome.

  1. Life Cycle, Feeding, and Defecation Patterns of Panstrongylus chinai (Hemiptera: Reduviidae: Triatominae) Under Laboratory Conditions.

    Science.gov (United States)

    Mosquera, Katherine D; Villacís, Anita G; Grijalva, Mario J

    2016-07-01

    Chagas disease is caused by the protozoan Trypanosoma cruzi Panstrongylus chinai (Del Ponte) is highly domiciliated in the Peruvian and Ecuadorian Andes and has been found naturally infected with T. cruzi The objective of this study was to describe the life cycle, feeding, and defecation patterns of P. chinai in the Loja province within southern Ecuador. To characterize its life cycle, a cohort of 70 individuals was followed from egg to adult. At each stage of development, prefeeding time, feeding time, weight of ingested meal, proportional weight increase, and the time to the first defecation were recorded. Panstrongylus chinai completed its development in 371.4 ± 22.3 d, (95% CI 355.4-387.4), which means that it is likely a univoltine species. Prefeeding time, feeding time, and weight of ingested meal increased as individuals developed through nymphal stages. Moreover, time to first defecation was shortest in the early nymphal stages, suggesting higher vector potential in the early developmental stages. Data obtained in this study represent an important advance in our knowledge of the biology of P. chinai, which should be considered as a secondary Chagas disease vector species in the Andean valleys of Loja (Ecuador) and in the north of Peru, and included in entomological surveillance programs. © The Authors 2016. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Inhibitory effect of the Kampo medicinal formula Yokukansan on acute stress-induced defecation in rats

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    Kanada Y

    2018-04-01

    Full Text Available Yasuaki Kanada, Ayami Katayama, Hideshi Ikemoto, Kana Takahashi, Mana Tsukada, Akio Nakamura, Shogo Ishino, Tadashi Hisamitsu, Masataka Sunagawa Department of Physiology, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan Objectives: Irritable bowel syndrome (IBS is a functional gastrointestinal disorder with symptoms of abnormal defecation and abdominal discomfort. Psychological factors are well known to be involved in onset and exacerbation of IBS. A few studies have reported effectiveness of traditional herbal (Kampo medicines in IBS treatment. Yokukansan (YKS has been shown to have anti-stress and anxiolytic effects. We investigated the effect of YKS on defecation induced by stress and involvement of oxytocin (OT, a peptide hormone produced by the hypothalamus, in order to elucidate the mechanism of YKS action. Methods and results: Male Wistar rats were divided into four groups; control, YKS (300 mg/kg PO-treated non-stress (YKS, acute stress (Stress, and YKS (300 mg/kg PO-treated acute stress (Stress+YKS groups. Rats in the Stress and Stress+YKS groups were exposed to a 15-min psychological stress procedure involving novel environmental stress. Levels of plasma OT in the YKS group were significantly higher compared with those in the Control group (P < 0.05, and OT levels in the Stress+YKS group were remarkably higher than those in the other groups (P < 0.01. Next, rats were divided into four groups; Stress, Stress+YKS, Atosiban (OT receptor antagonist; 1 mg/kg IP-treated Stress+YKS (Stress+YKS+B, and OT (0.04 mg/kg IP-treated acute stress (Stress+OT groups. Rats were exposed to acute stress as in the previous experiment, and defecation during the stress load was measured. Administration of YKS or OT significantly inhibited defecation; however, administration of Atosiban partially abolished the inhibitory effect of YKS. Finally, direct action of YKS on motility of isolated colon was assessed. YKS (1 mg/mL, 5 mg/mL did not

  3. Ending Open Defecation in Rural Tanzania: Which Factors Facilitate Latrine Adoption?

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    Stephen Sara

    2014-09-01

    Full Text Available Diarrheal diseases account for 7% of deaths in children under five years of age in Tanzania. Improving sanitation is an essential step towards reducing these deaths. This secondary analysis examined rural Tanzanian households’ sanitation behaviors and attitudes in order to identify barriers and drivers to latrine adoption. The analysis was conducted using results from a cross-sectional study of 1000 households in five rural districts of Tanzania. Motivating factors, perceptions, and constraints surrounding open defecation and latrine adoption were assessed using behavioral change theory. Results showed a significant association between use of improved sanitation and satisfaction with current sanitation facility (OR: 5.91; CI: 2.95–11.85; p = 0.008. Livestock-keeping was strongly associated with practicing open defecation (OR: 0.22; CI 0.063–0.75; p < 0.001. Of the 93 total households that practiced open defecation, 79 (85% were dissatisfied with the practice, 62 (67% had plans to build a latrine and 17 (18% had started saving for a latrine. Among households that planned to build a latrine, health was the primary reason stated (60%. The inability to pay for upgrading sanitation infrastructure was commonly reported among the households. Future efforts should consider methods to reduce costs and ease payments for households to upgrade sanitation infrastructure. Messages to increase demand for latrine adoption in rural Tanzania should integrate themes of privacy, safety, prestige and health. Findings indicate a need for lower cost sanitation options and financing strategies to increase household ability to adopt sanitation facilities.

  4. Colon manometry proves that perception of the urge to defecate is present in children with functional constipation who deny sensation.

    Science.gov (United States)

    Firestone Baum, Carrie; John, Anub; Srinivasan, Kavitha; Harrison, Prince; Kolomensky, Andrew; Monagas, Javier; Cocjin, Jose; Hyman, Paul E

    2013-01-01

    Children with functional constipation often state an inability to sense an urge to defecate and/or inability to feel incontinence. We used colon manometry to assess whether there was a sensory abnormality in patients who denied sensation. A physician observed all of the colon manometries in the preceding 20 years, and included behavioral observations in the procedure reports. We reviewed the charts of these patients. Of 150 subjects with normal manometry and a diagnosis of functional constipation, 56 volunteered that they had no urge to defecate or complained of abdominal pain. For all who denied sensation, the first high-amplitude propagating colonic contraction (HAPC) was associated with retentive posturing and facial grimaces. When queried, all reported they felt nothing. The examiner explained the HAPC was causing pain, and informed the child that the pain would resolve if they defecated. With subsequent HAPCs, every patient acknowledged an urge to defecate and successfully defecated. Most agreed that a similar pain sensation was present daily, but was misinterpreted to be abdominal pain. Colon manometry may be useful not only for objective findings to discriminate neuromuscular disease from functional symptoms but also to understand psychological issues and aid in helping the child and family understand the maladaptive behaviors in functional constipation.

  5. Transabdominal ultrasound measurement of rectal diameter is dependent on time to defecation in constipated children

    DEFF Research Database (Denmark)

    Modin, Line; Dalby, Kasper; Walsted, Anne-Mette

    2015-01-01

    AIM: To study whether diurnal variations and time in relation to defecation has to be taken into account when measurements of rectal diameter are used to determine faecal impaction in constipated children. METHODS: Repeated ultrasound measures of rectal diameter were performed in 28 children (14...... constipated/14 healthy, aged between 4 and 12 years) every third hour during 24 h. After defecation, three additional scans were performed at 1-h intervals. RESULTS: No diurnal variation in rectal diameter was found in the healthy group. In the constipated group, mean rectal diameter was significantly larger...... at 2 pm (P = 0.038) and 5 pm (P = 0.006). There were significant differences between rectal diameter in the healthy group and the constipated group at 2 pm (P = 0.016) and 5 pm (P = 0.027). When we omitted the rectal diameter of five constipated children who had their first bowel movement after 5 pm...

  6. Transanal repair of rectocele corrects obstructed defecation if it is not associated with anismus.

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    Tjandra, J J; Ooi, B S; Tang, C L; Dwyer, P; Carey, M

    1999-12-01

    Rectocele is often associated with anorectal symptoms. Various surgical techniques have been described to repair the rectocele. The surgical results are variable. This study evaluated the results of transanal repair of rectocele, with particular emphasis on the impact of concomitant anismus on postoperative functional outcome. Fifty-nine consecutive females who underwent transanal repair of rectocele for obstructed defecation were prospectively reviewed. All 59 patients were parous with a median parity of 2 (range, 1-6) and a median age of 58 (range, 46-68) years. The median length of follow-up was 19 (range, 6-40) months. Anismus was detected by anorectal physiology and defecography. The functional outcome was assessed by a standard questionnaire, physical examination, anorectal manometry, neurophysiology, and defecography. The quality-of-life index was obtained using a visual analog scale (from 1-10, with 10 being the best). The functional outcome of transanal repair of rectocele was superior in patients without anismus. Forty (93 percent) of the 43 patients without anismus showed improved evacuation after repair compared with 6 (38 percent) of the 16 patients with anismus (Panismus was not present (Panismus, effectively corrects obstructed defecation.

  7. Ultrasound in the investigation of posterior compartment vaginal prolapse and obstructed defecation.

    Science.gov (United States)

    Dietz, H P; Beer-Gabel, M

    2012-07-01

    Recent developments in diagnostic imaging have made gynecologists, colorectal surgeons and gastroenterologists realize as never before that they share a common interest in anorectal and pelvic floor dysfunction. While we often may be using different words to describe the same phenomenon (e.g. anismus/vaginismus) or attributing different meanings to the same words (e.g. rectocele), we look after patients with problems that transcend the borders of our respective specialties. Like no other diagnostic modality, imaging helps us understand each other and provides new insights into conditions we all need to learn to investigate better in order to improve clinical management. In this review we attempt to show what modern ultrasound imaging can contribute to the diagnostic work-up of patients with posterior vaginal wall prolapse, obstructed defecation and rectal intussusception/prolapse. In summary, it is evident that translabial/perineal ultrasound can serve as a first-line diagnostic tool in women with such complaints, replacing defecation proctography and MR proctography in a large proportion of female patients. This is advantageous for the women themselves because ultrasound is much better tolerated, as well as for healthcare systems since sonographic imaging is much less expensive. However, there is a substantial need for education, which currently remains unmet. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

  8. Laparoscopic correction of enterocele associated to stapled transanal rectal resection for obstructed defecation syndrome.

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    Carriero, Alfonso; Picchio, Marcello; Martellucci, Jacopo; Talento, Pasquale; Palimento, Domenico; Spaziani, Erasmo

    2010-03-01

    We report our experience of concomitant laparoscopic treatment for enterocele and stapled transanal rectal resection (STARR) for rectocele and/or rectal prolapse in patients with complex obstructed defecation syndrome (ODS). From June 2005 to June 2007, we submitted 20 patients with ODS due to rectal prolapse and/or rectocele, combined with stable enterocele, to STARR and laparoscopic correction of the enterocele. Preoperative assessment included symptom evaluation with standardized questionnaires, clinical examination, colonoscopy, proctoscopy, anal sphincter ultrasonography, video-defecography with synchronous opacification of the ileal loops in all patients and colpography in female patients, and anorectal manometry. Follow-up was performed in the first, third, sixth, 12th, and 24th month after surgery. Eighteen (90%) patients were submitted to both procedures, simultaneously. One patient, previously submitted to STARR, underwent laparoscopic treatment of the enterocele. Postoperative complications occurred in two (10%) patients: one case of postoperative rectal bleeding and one case of retropneumoperitoneum. Median (range) preoperative and postoperative Altomare's obstructed defecation score was ten (6-14) and two (0-14), respectively (p<0.001). Median (range) preoperative and postoperative quality of life score was 79 (39-109) and 109 (50-126), respectively (p<0.001). No symptom related to ODS was detected at 6-month follow-up (19 patients) and at 24-month follow-up (19 patients). The combination of STARR and laparoscopy provides a safe and effective method to treat ODS caused by rectal internal prolapse and/or rectocele combined with enterocele.

  9. Defecation of dimethylsulfoniopropionate (DMSP) by the copepod Acartia tonsa as functions of ambient food concentration and body DMSP content

    DEFF Research Database (Denmark)

    Tang, K.W.

    2001-01-01

    The dimethylsulfoniopropionate (DMSP) defecation rate of Acartia tonsa (calanoid copepod)feeding on Tetraselmis impellucida (prasinophyte) was correlated with food concentration and copepod body DMSP content. Copepod fecal pellets represent a highly concentrated source of DMSP and thus play...... an important role in DMSP flux and microbial processes in the ocean....

  10. Triatoma rubrovaria (Blanchard, 1843 (Hemiptera-Reduviidae-Triatominae III: patterns of feeding, defecation and resistance to starvation

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    Carlos Eduardo Almeida

    2003-04-01

    Full Text Available Data from the Chagas Disease Control Program indicate a growing domiciliary and peridomiciliary invasion of Triatoma rubrovaria in the State of Rio Grande do Sul, where it has become the most frequent triatomine species captured there since the control of T. infestans. Bionomic characteristics that could influence the vectorial capacity of T. rubrovaria as vector of Trypanosoma cruzi were evaluated: patterns of (i feeding, (ii defecation, and (iii resistance to starvation, using insects fed on mice. Fifty three percent of the females showed a defecation pattern conducive to chagasic transmission, defecating either on or near the bite site. The averages of the resistance to starvation varied from 48.1 to 179 days, for the first and fifth nymphal stages, respectively. Our study shows that with respect to the patterns of feeding, defecation and resistance to fasting, T. rubrovaria presented similar rates to the ones observed for other effective vector species, such as T. infestans. Thus, based on our studies we conclude that T. rubrovaria has biological characteristics that can positively influence its capacity to become infected and transmit T. cruzi, and also to keep residual populations after chemical control interventions.

  11. Feeding, defecation, and development times of Meccus longipennis Usinger, 1939 (Hemiptera: Reduviidae: Triatominae under laboratory conditions

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    José Alejandro Martínez-Ibarra

    2003-10-01

    Full Text Available Aspects related to hatching, time-lapse between presenting the blood-meal and beginning of feeding, feeding time, postfeed defecation delay, mortality, and fecundity for each stage of Meccus longipennis life-cycle were evaluated. The bugs were maintained in a dark incubator at 27 ± 1ºC and 80 ± 5% rh, were fed weekly and checked daily for ecdysis or death. The hatching rate observed for 300 eggs was 76.7% and the average time of hatching was 19.8 days. Mean time-lapse between presentation of the blood meal and the beginning of feeding was under 5 min in nymphal stages and postfeed defecation delay was under 10 min in most stages, except in fourth and fifth stages. Mean feeding time was longer than 10 min in most stages, except in fourth stage. One hundred thirty-one nymphs (N (65.5% completed the cycle and the average time from NI to adult was 192.6 ± 34.8 days. The average span in days for each stage was 18.1 for NI, 21.4 for NII, 29.5 for NIII, 45.5 for NIV and 55.9 for NV. The number of bloodmeals at each nymphal stage varied from 1 to 5. The mortality rate was 3.29 for NI, 6.8 for NII, 2.92 for NIII 3.76 for NIV, and 10.16 for NV nymphs. The average number of eggs laid per female in a 9-month period was 615.6. Based on our results, we conclude that M. longipennis has some biological and behavioral characteristics which influence its capacity of becoming infected and transmitting Trypanosoma cruzi to human populations in those areas of Mexico where it is currently present.

  12. Anorectal manometry with and without ketamine for evaluation of defecation disorders in children.

    Science.gov (United States)

    Keshtgar, A S; Choudhry, M S; Kufeji, D; Ward, H C; Clayden, G S

    2015-03-01

    Anorectal manometry (ARCM) provides valuable information in children with chronic constipation and fecal incontinence but may not be tolerated in the awake child. This study aimed to evaluate the effect of ketamine anesthesia on the assessment of anorectal function by manometry and to evaluate defecation dynamics and anal sphincter resting pressure in the context of pathophysiology of chronic functional (idiopathic) constipation and soiling in children. This was a prospective study of children who were investigated for symptoms of chronic constipation and soiling between April 2001 and April 2004. We studied 52 consecutive children who had awake ARCM, biofeedback training and endosonography (awake group) and 64 children who had ketamine anesthesia for ARCM and endosonography (ketamine group). We age matched 31 children who had awake anorectal studies with 27 who had ketamine anesthesia. The children in awake and ketamine groups were comparable for age, duration of bowel symptoms and duration of laxative treatments. ARCM profile was comparable between the awake and the ketamine groups with regard to anal sphincter resting pressure, rectal capacity, amplitude of rectal contractions, frequency of rectal and IAS contractions and functional length of anal canal. Of 52 children who had awake ARCM, dyssynergia of the EAS muscles was observed in 22 (42%) and median squeeze pressure was 87mm Hg (range 25-134). The anal sphincter resting pressure was non-obstructive and comparable to healthy normal children. Rectoanal inhibitory reflex was seen in all children excluding diagnosis of Hirschsprung disease. Ketamine anesthesia does not affect quantitative or qualitative measurements of autonomic anorectal function and can be used reliably in children who will not tolerate the manometry while awake. Paradoxical contraction of the EAS can only be evaluated in the awake children and should be investigated further as the underlying cause of obstructive defecation in patients with

  13. TrpA1 Regulates Defecation of Food-Borne Pathogens under the Control of the Duox Pathway.

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    Eun Jo Du

    2016-01-01

    Full Text Available Pathogen expulsion from the gut is an important defense strategy against infection, but little is known about how interaction between the intestinal microbiome and host immunity modulates defecation. In Drosophila melanogaster, dual oxidase (Duox kills pathogenic microbes by generating the microbicidal reactive oxygen species (ROS, hypochlorous acid (HOCl in response to bacterially excreted uracil. The physiological function of enzymatically generated HOCl in the gut is, however, unknown aside from its anti-microbial activity. Drosophila TRPA1 is an evolutionarily conserved receptor for reactive chemicals like HOCl, but a role for this molecule in mediating responses to gut microbial content has not been described. Here we identify a molecular mechanism through which bacteria-produced uracil facilitates pathogen-clearing defecation. Ingestion of uracil increases defecation frequency, requiring the Duox pathway and TrpA1. The TrpA1(A transcript spliced with exon10b (TrpA1(A10b that is present in a subset of midgut enteroendocrine cells (EECs is critical for uracil-dependent defecation. TRPA1(A10b heterologously expressed in Xenopus oocytes is an excellent HOCl receptor characterized with elevated sensitivity and fast activation kinetics of macroscopic HOCl-evoked currents compared to those of the alternative TRPA1(A10a isoform. Consistent with TrpA1's role in defecation, uracil-excreting Erwinia carotovora showed higher persistence in TrpA1-deficient guts. Taken together, our results propose that the uracil/Duox pathway promotes bacteria expulsion from the gut through the HOCl-sensitive receptor, TRPA1(A10b, thereby minimizing the chances that bacteria adapt to survive host defense systems.

  14. Pelvic floor function following ventral rectopexy versus STARR in the treatment of obstructed defecation.

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    Altomare, D F; Picciariello, A; Memeo, R; Fanelli, M; Digennaro, R; Chetta, N; De Fazio, M

    2018-04-01

    Obstructed defecation syndrome (ODS), most commonly found in females, can be treated by a transanal or abdominal approach with good success rate. Nevertheless, patients may experience de novo or persisting pelvic floor dysfunctions after surgery. The aim of this study was to compare the functional outcome of stapled transanal rectal resection (STARR) and ventral rectopexy (VRP) in a series of ODS patients. Forty-nine female patients who had surgery for ODS between 2006 and 2016 were retrospectively evaluated: 28 (median age 60 years, IQR 54-69 years) had VRP and 21 (median age 58 years, IQR 51-66 years) had STARR. ODS was scored with the ODS score while the overall pelvic floor function was assessed with the three axial perineal evaluation (TAPE) score. Quality-of-life was evaluated by the patient assessment of constipation quality-of-life (PAC-Qol) questionnaire administered preoperatively and after 1 year of follow-up. The preoperative median ODS score and TAPE score were comparable in both groups. After a median follow-up of 12 months (range 12-18 months), the median ODS score was 12 (range 10-20) in the STARR group and 9 (range 3-15) in the VRP one (p = 0.02), while the median TAPE score was 70.5 (IQR 60.6-77.3) in the former and 76.8 (IQR 70.2-89.7) in the latter (p = 0.01). Postoperatively the physical domain of the PAC-QoL score had a median value of 2.74 (IQR 1.7-3.75) in the STARR group compared to 1.5 (IQR 1-2.5) in the VRP group (p = 0.03). No major complications were recorded in either group. VRP and STARR can improve defecation in patients with ODS with minimal complications, but the overall pelvic wellness evaluated by the TAPE score improves significantly only after VRP, suggesting a better performance of VRP than STARR when overall pelvic floor function is concerned.

  15. A prospective evaluation of occult disorders in obstructed defecation using the 'iceberg diagram'.

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    Pescatori, M; Spyrou, M; Pulvirenti d'Urso, A

    2007-06-01

    Surgical treatment of constipation and obstructed defecation (OD) carries frequent recurrences, as OD is an 'iceberg syndrome' characterized by 'underwater rocks' or occult diseases which may affect the outcome of surgery. The aim of this study was to evaluate occult disorders, in order to alert the clinician of these and minimize failures. One hundred consecutive constipated patients with OD symptoms, 81 women, median age 52 years, underwent perineal examination, proctoscopy, anorectal manometry and anal/vaginal ultrasound (US). Anorectal physiology and imaging tests were also carried out when indicated, as well as psychological and urogynaecological consultations. Symptoms were graded using a modified 1-20 constipation score. Both evident (e.g. rectocele) and occult (e.g. anismus) diseases were prospectively evaluated using a novel 'iceberg diagram'. The type of treatment, whether conservative or surgical, was also recorded. Fifty-four (54%) patients had both mucosal prolapse and rectocele. All patients had at least two occult OD-related diseases, 66 patients had at least three of them: anxiety-depression, anismus and rectal hyposensation were the most frequent (66%, 44% and 33%, respectively). The median constipation score was 11 (range 2-20), the median number of 'occult disorders' was 5 (range 2-8). Conservative treatment was carried out in most cases. Surgery was carried out in 14 (14%) patients. The novel 'iceberg diagram' allowed the adequate evaluation of OD-related occult diseases and better selection of patients for treatment. Most were managed conservatively, and only a minority were treated by surgery.

  16. Role of enterocele in the obstructed defecation syndrome (ODS): a new radiological point of view.

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    Morandi, C; Martellucci, J; Talento, P; Carriero, A

    2010-08-01

    The aim of this study was to understand the role of enterocele in the pathogenesis of the obstructed defecation syndrome (ODS) a new defecographic classification based on function. A total of 597 patients (551 women, 46 men) who underwent cinedefecography between November 2001 and November 2005 were studied. A total of 567 (95%) underwent cinedefecography as they had symptoms of ODS. Enterocele was classified into three types. Enterocele was found in 127 (23%) female and one (2.2%) male patients. Thirty-eight (6.9%) patients had type A, 38(6.9%) type B, and 27(4.9%) type C enterocele. A total of 24 patients (4.35%) had sigmoidocele. In patients with type C enterocele, the finding of a radiological pattern of ODS was higher (26/27) than that in the other groups (A + B + Sigmoidocele) (23/100) (P ODS and usually presents as an isolated condition. Type B is less frequently associated with ODS and is more frequently accompanied by other pathological conditions.

  17. Radiographic findings of post-operative double stapled trans anal rectal resection (STARR) in patient with obstructed defecation syndrome (ODS).

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    Grassi, Roberto; Romano, Stefania; Micera, Osvaldo; Fioroni, Claudio; Boller, Brigitta

    2005-03-01

    Longo's procedure of double stapled trans anal rectal resection (STARR) has been evocated as surgical treatment of the obstructed defecation syndrome (ODS) in patients with rectal mucosal prolapse. The aim of this study was to investigate the post-interventional findings of this technique, to help radiologist in knowledge of the changed morphology of the rectal lumen, also in attempt to recognize some potential related complications.

  18. A new type of defecation disorder due to insufficient fixation of the rectum to the sacrum is improved by rectopexy: A report of three cases

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    Wataru Sumida

    2016-07-01

    Full Text Available Chronic constipation is the most common clinical disorder in children. However, some cases of constipation do not meet the criteria defined by Rome III. We encountered such defecation disorders in three patients who presented with constipation as a chief complaint along with excessive strain and bleeding hemorrhoids during defecation despite normal stools. Contrast enema revealed that the rectum was separated from the sacrum in each patient, which may have been caused by insufficient fixation of the rectum. Conservative treatment with laxatives and suppositories failed to achieve improvement. Therefore, all underwent a laparoscopic rectopexy. After surgery, each patient was able to evacuate without strain and the hemorrhoids disappeared. Insufficient fixation of the rectum should be considered as a potential cause of defecation disorders. Rectopexy is effective for this type of defecation disorder.

  19. Feeding and defecation behavior of Triatoma rubida (Uhler, 1894) (Hemiptera: Reduviidae) under laboratory conditions, and its potential role as a vector of Chagas disease in Arizona, USA.

    Science.gov (United States)

    Reisenman, Carolina E; Gregory, Teresa; Guerenstein, Pablo G; Hildebrand, John G

    2011-10-01

    Chagas disease is caused by the parasite Trypanosoma cruzi, which is transmitted to humans by blood-sucking triatomine insects. This disease is endemic throughout Mexico and Central and South America, but only a few autochthonous cases have been reported in the United States, despite the fact that infected insects readily invade houses and feed on humans. Competent vectors defecate during or shortly after feeding so that infective feces contact the host. We thus studied the feeding and defecation behaviors of the prevalent species in southern Arizona, Triatoma rubida. We found that whereas defecation during feeding was frequent in females (93%), it was very rare in immature stages (3%), and absent in males. Furthermore, more than half of the immature insects that exhibited multiple feeding bouts (62%) defecated during interruptions of feeding, i.e., while likely on or near the host. These results indicate that T. rubida potentially could transmit T. cruzi to humans.

  20. Caenorhabditis elegans Male Copulation Circuitry Incorporates Sex-Shared Defecation Components To Promote Intromission and Sperm Transfer

    Science.gov (United States)

    LeBoeuf, Brigitte; Garcia, L. Rene

    2016-01-01

    Sexual dimorphism can be achieved using a variety of mechanisms, including sex-specific circuits and sex-specific function of shared circuits, though how these work together to produce sexually dimorphic behaviors requires further investigation. Here, we explore how components of the sex-shared defecation circuitry are incorporated into the sex-specific male mating circuitry in Caenorhabditis elegans to produce successful copulation. Using behavioral studies, calcium imaging, and genetic manipulation, we show that aspects of the defecation system are coopted by the male copulatory circuitry to facilitate intromission and ejaculation. Similar to hermaphrodites, male defecation is initiated by an intestinal calcium wave, but circuit activity is coordinated differently during mating. In hermaphrodites, the tail neuron DVB promotes expulsion of gut contents through the release of the neurotransmitter GABA onto the anal depressor muscle. However, in the male, both neuron and muscle take on modified functions to promote successful copulation. Males require calcium-dependent activator protein for secretion (CAPS)/unc-31, a dense core vesicle exocytosis activator protein, in the DVB to regulate copulatory spicule insertion, while the anal depressor is remodeled to promote release of sperm into the hermaphrodite. This work shows how sex-shared circuitry is modified in multiple ways to contribute to sex-specific mating. PMID:28031243

  1. Importance of endorectal US, CT of the pelvic floor, and defecography in the evaluation of defecation disorders

    International Nuclear Information System (INIS)

    Stuckmann, G.; Antonucci, F.; Hirsig, J.; Zollifofer, C.L.

    1989-01-01

    This paper presents a radiologic evaluation of defecation disorders. Twenty-five patients with symptoms of defecation disorders who presented clinically the findings of dysplasia of the external anal sphincter were examined with endorectal US, defecography, and CT. The findings were compared with those of 15 patients who were given a radiologic examination of the pelvis for other reasons. All patients of the first group underwent surgery. The radiological findings are as follows: defecography: a short anal canal (below 1 cm) and a dorsal anocele; CT: a failure of attachment of the external and sphincter to the coccyx; Endorectal US and CT: absence of posterior parts of the external anal sphincter. None of these findings were demonstrated in the comparison group. All patients of the first group underwent surgery and were proved intraoperatively to have dysplasia of the external anal sphincter, which was corrected subsequently. The authors' results show that at least two kinds of external and anal sphincter dysplasia exist. The results of the radiologic examinations correspond with the intraoperative findings. The authors believe that in chronic constipation in children or adults the radiologic examinations mentioned above should be done because surgical correction of anal sphincter dysplasia leads to an immediate improvement of defecation disorders

  2. Prospective multicenter trial comparing echodefecography with defecography in the assessment of anorectal dysfunction in patients with obstructed defecation.

    Science.gov (United States)

    Regadas, F Sergio P; Haas, Eric M; Abbas, Maher A; Marcio Jorge, J; Habr-Gama, Angelita; Sands, Dana; Wexner, Steven D; Melo-Amaral, Ingrid; Sardiñas, Carlos; Lima, Doryane M; Sagae, Univaldo E; Sagae, Evaldo U; Murad-Regadas, Sthela M

    2011-06-01

    Defecography is the gold standard for assessing functional anorectal disorders but is limited by the need for a specific radiologic environment, exposure of patients to radiation, and inability to show all anatomic structures involved in defecation. Echodefecography is a 3-dimensional dynamic ultrasound technique developed to overcome these limitations. This study was designed to validate the effectiveness of echodefecography compared with defecography in the assessment of anorectal dysfunctions related to obstructed defecation. Multicenter, prospective observational study. Women with symptoms of obstructed defecation. Six centers for colorectal surgery (3 in Brazil, 1 in Texas, 1 in Florida, and 1 in Venezuela). Defecography was performed after inserting 150 mL of barium paste in the rectum. Echodefecography was performed with a 2050 endoprobe through 3 automatic scans. The κ statistic was used to assess agreement between echodefecography and defecography in the evaluation of rectocele, intussusception, anismus, and grade III enterocele. Eighty-six women were evaluated: median Wexner constipation score, 13.4 (range, 6-23); median age, 53.4 (range, 26-77) years. Rectocele was identified with substantial agreement between the 2 methods (defecography, 80 patients; echodefecography, 76 patients; κ = 0.61; 95% CI = 0.48-0.73). The 2 techniques demonstrated identical findings in 6 patients without rectocele, and in 9 patients with grade I, 29 with grade II, and 19 patients with grade III rectoceles. Defecography identified rectal intussusception in 42 patients, with echodefecography identifying 37 of these cases, plus 4 additional cases, yielding substantial agreement (κ = 0.79; 95% CI = 0.57-1.0). Intussusception was associated with rectocele in 28 patients for both methods (κ = 0.62; 95% CI = 0.41-0.83). There was substantial agreement for anismus (κ = 0.61; 95% CI = 0.40-0.81) and for rectocele combined with anismus (κ = 0.61; 95% CI = 0.40-0.82). Agreement for

  3. How much crude oil can zooplankton ingest? Estimating the quantity of dispersed crude oil defecated by planktonic copepods

    International Nuclear Information System (INIS)

    Almeda, Rodrigo; Connelly, Tara L.; Buskey, Edward J.

    2016-01-01

    We investigated and quantified defecation rates of crude oil by 3 species of marine planktonic copepods (Temora turbinata, Acartia tonsa, and Parvocalanus crassirostris) and a natural copepod assemblage after exposure to mechanically or chemically dispersed crude oil. Between 88 and 100% of the analyzed fecal pellets from three species of copepods and a natural copepod assemblage exposed for 48 h to physically or chemically dispersed light crude oil contained crude oil droplets. Crude oil droplets inside fecal pellets were smaller (median diameter: 2.4–3.5 μm) than droplets in the physically and chemically dispersed oil emulsions (median diameter: 6.6 and 8.0 μm, respectively). This suggests that copepods can reject large crude oil droplets or that crude oil droplets are broken into smaller oil droplets before or during ingestion. Depending on the species and experimental treatments, crude oil defecation rates ranged from 5.3 to 245 ng-oil copepod"−"1 d"−"1, which represent a mean weight-specific defecation rate of 0.026 μg-oil μg-C_c_o_p_e_p_o_d"1 d"−"1. Considering a dispersed crude oil concentration commonly found in the water column after oil spills (1 μl L"−"1) and copepod abundances in high productive coastal areas, copepods may defecate ∼1.3–2.6 mg-oil m"−"3 d"−"1, which would represent ∼0.15%–0.30% of the total dispersed oil per day. Our results indicate that ingestion and subsequent defecation of crude oil by planktonic copepods has a small influence on the overall mass of oil spills in the short term, but may be quantitatively important in the flux of oil from surface water to sediments and in the transfer of low-solubility, toxic petroleum hydrocarbons into food webs after crude oil spills in the sea. - Highlights: • Copepods exposed to dispersed crude oil produced fecal pellets contained numerous small oil droplets (2.4 to 3.5 µm). • Copepods could reject large oil droplets or oil droplets are broken into

  4. Interpretation of Overall Colonic Transit in Defecation Disorders in Males and Females

    Science.gov (United States)

    Shin, Andrea; Camilleri, Michael; Nadeau, Ashley; Nullens, Sara; Rhee, Jong Chul; Jeong, In Du; Burton, Duane D.

    2013-01-01

    Background There is little information regarding gender-specific measurements of colonic transit and anorectal function in patients with defecation disorders (DD). Aim To compare overall colonic transit by gender in DD. Methods In 407 patients with constipation due to DD diagnosed by a single gastroenterologist (1994– 2012), DD was characterized by anorectal manometry, balloon expulsion test, and colonic transit by scintigraphy. The primary endpoint was overall colonic transit (geometric center, GC) at 24hours (GC24). Effects of gender in DD on colonic transit, and comparison with transit in 208 healthy controls were assessed by Mann-Whitney rank sum test. Secondary endpoints were maximum anal resting (ARP) and squeeze (ASP) pressures. We also tested association of the physiological endpoints among DD females by pregnancy history and among DD patients by colectomy history. Results The DD patients were 67 males (M) and 340 females (F). Significant differences by gender in DD patients were observed in GC24 (median: M: 2.2; F: 1.8; p=0.01), ARP (median: M: 87.8mmHg; F: 82.4mmHg; p=0.04), and ASP (median: M: 182.4mmHg; F: 128.7mmHg; p<0.001). GC24 was slower in DD compared to same gender healthy controls. GC24 did not differ among DD females by pregnancy history. Anorectal functions and upper GI transit did not differ among DD patients by colectomy history. Conclusions Patients with DD have slower colonic transit compared to gender-matched controls. Among DD patients, males have higher ARP and ASP, and females have slower colonic transit. Although the clinical significance of these differences may be unclear, findings suggest that interpretation of these tests in suspected DD should be based on same gender control data. PMID:23406422

  5. Dyssynergic defecation: a treatable cause of persistent symptoms when inflammatory bowel disease is in remission.

    Science.gov (United States)

    Perera, Lilani P; Ananthakrishnan, Ashwin N; Guilday, Corinne; Remshak, Kristin; Zadvornova, Yelena; Naik, Amar S; Stein, Daniel J; Massey, Benson T

    2013-12-01

    Introduction of biologic agents in inflammatory bowel disease (IBD) has increased the likelihood of disease remission. Despite resolution of active inflammation, a subset of IBD patients report persistent defecatory symptoms. To evaluate a group of patients with inflammatory bowel disease with suspected functional defecatory disorders, by use of anorectal manometric testing and subsequent biofeedback therapy. A group of IBD patients with persistent defecatory problems despite clinical improvement were included in this study. These patients had no evidence of left-sided disease. Endoscopic and radiographic study findings and timing in relation to the manometry study were recorded. Anorectal manometry was performed by the standard protocol and included rectal sensory assessment, ability to expel a balloon, and pressure dynamics with simulated defecation. Thirty IBD patients (Crohn's 23 patients; ulcerative colitis six patients) presented with defecatory disorders including constipation (67%) increased stooling (10%), and rectal urgency and/or incontinence and rectal pain (6%). All but one patient had anorectal manometric criteria of dyssynergia (presence of anismus motor pattern and inability to expel the balloon). Of the patients who completed biofeedback therapy, 30% had a clinically significant (≥7-point) improvement in SIBDQ score, with a reduction in health-care utilization after a six-month period (p=0.02). Despite remission, some inflammatory bowel disease patients have persistent defecatory symptoms. Defecatory symptoms may not be predictive of an underlying inflammatory disorder. Lack of inflammatory activity and absence of left-sided disease should prompt investigation of functional disorders. Anorectal manometric testing and biofeedback therapy for patients with a diagnosis of dyssynergia may be a useful therapy.

  6. RENZI SCORE FOR OBSTRUCTED DEFECATION SYNDROME - VALIDATION OF THE PORTUGUESE VERSION ACCORDING TO THE COSMIN CHECKLIST.

    Science.gov (United States)

    Caetano, Ana Celia; Dias, Sara; Santa-Cruz, André; Rolanda, Carla

    2018-01-01

    Recently, the Obstructed Defecation Syndrome score (ODS score) was developed and validated by Renzi to assess clinical staging and to allow evaluation and comparison of the efficacy of treatment of this disorder. Our goal is to validate the Portuguese version of Renzi ODS score, according to the Consensus based Standards for the selection of the Health Measurement Instruments (COSMIN) checklist. Following guidelines for cross-cultural validity, Renzi ODS score was translated into the Portuguese language. Then, a group of patients and healthy controls were invited to fill in the Renzi ODS score at baseline, after 2 weeks and 3 months, respectively. We assessed internal consistency, reliability and measurement error, content and construct validity, responsiveness and interpretability. A total of 113 individuals (77 patients; 36 healthy controls) completed the questionnaire. Seventy and 30 patients repeated the Renzi ODS score after 2 weeks and 3 months respectively. Factor analysis confirmed the unidimensionality of the scale. Cronbach's α coefficient of 0.77 supported item's homogeneity. Weighted quadratic kappa of 0.89 established test-retest reliability. The smallest detectable change at the individual level was 2.66 and at the group level was 0.30. Renzi ODS score and the total (-0.32) and physical (-0.43) SF-36 scores correlated negatively. Patient and control's groups significantly differed (11 points). The change score of Renzi ODS score between baseline and 3 months correlated negatively with the clinical evolution (-0.86). ROC analysis showed minimal important change of 2.00 with AUC 0.97. Neither floor nor ceiling effects were observed. This work validated the Portuguese version of Renzi ODS score. We can now use this reliable, responsive, and interpretable (at the group level) tool to evaluate Portuguese ODS patients.

  7. A pilot study on disturbed gastric myoelectric activity in obstructed defecation syndrome.

    Science.gov (United States)

    Farid, Mohamed; Emile, Sameh Hany; Haleem, Magdy; El-Hak, Nabil Gad

    2018-07-01

    Electrogastrography (EGG) is a noninvasive technique for recording gastric myoelectric activity. The aim of this study was to measure and record gastric myoelectric activity in patients with obstructed defecation syndrome (ODS) and to compare their results with those of normal individuals. Forty-two patients (22 male) with ODS and a mean age of 41.02 y were enrolled in this prospective study after thorough clinical and physiologic assessment. Eleven normal subjects (six female) with a mean age of 39.2 ± 8.4 y were assigned to the control group. Both patients and controls were subjected to surface EGG in fasting and postprandial states. Data were recorded and analyzed via a computer system to reveal the EGG pattern in both groups. Abnormalities in the EGG were found in 24 (57.1%) of the 42 patients with ODS. EGG in ODS patients showed alterations in the fasting state in the form of a significant decrease of the normal gastric slow wave (P = 0.03) and a nonsignificant increase in gastric dysrhythmias. The EGG alterations of ODS patients were significantly improved in the postprandial state as the normal gastric slow waves significantly (P = 0.006) increased and the gastric bradycardia declined significantly (P = 0.02). No significant differences were observed in the power distribution between the ODS patients and the healthy controls. Patients with ODS showed an altered EGG pattern compared with that of healthy control subjects. The alterations in ODS patients were more clearly observed during the fasting state and improved significantly after eating. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Bowel habits and behaviors related to defecation in 10- to 16-year-olds: impact of socioeconomic characteristics and emotional stress.

    Science.gov (United States)

    Devanarayana, Niranga Manjuri; Rajindrajith, Shaman

    2011-05-01

    Bowel habits vary depending on food consumption and genetic factors. The knowledge regarding this physiological phenomenon is limited. Thorough understanding of normal bowel habits is essential for correct diagnosis of defecation disorders. This study evaluated the normal bowel habits of Sri Lankan children. Children ages 10 to 16 years were randomly selected from 5 schools in 4 districts. Those without defecation disorders were recruited. Details regarding their bowel habits during previous 2 months were collected using a validated, self-administered questionnaire. A total of 2273 children were enrolled (mean age 13.2 years, SD 1.7 years, boys 49.7%). Of them, 1748 (76.9%) opened bowels once daily, whereas 149 (6.6%) and 11 (0.5%) had 3/day defecations, respectively. Stool consistency was normal in 1997 (87.9%), hard in 86 (3.8%), and changing consistency in 163 (7.1%). Straining was present in 639 (28.1%), painful defecation in 241 (10.6%), and bleeding in 49 (2.2%). One hundred six (4.7%) children reported stool withholding. Bulky stool was present in 158 (7.0%). Straining, bulky stools, and withholding posture were more common in boys, whereas painful defecation and bleeding were reported more often in girls (Pwar-affected areas (P < 0.05). Bowel frequency < 3/week, bulky stools, painful defecation, straining, and withholding posture were more common in those exposed to stressful life events (P < 0.05). The present study provides data on normal bowel habits of Sri Lankan schoolchildren and provides a firm platform to evaluate defecation disorders in them.

  9. Enabling Factors for Sustaining Open Defecation-Free Communities in Rural Indonesia: A Cross-Sectional Study.

    Science.gov (United States)

    Odagiri, Mitsunori; Muhammad, Zainal; Cronin, Aidan A; Gnilo, Michael E; Mardikanto, Aldy K; Umam, Khaerul; Asamou, Yameha T

    2017-12-14

    Community Approaches to Total Sanitation (CATS) programmes, like the Sanitasi Total Berbasis Masyarakat (STBM) programme of the Government of Indonesia, have played a significant role in reducing open defecation though still little is known about the sustainability of the outcomes. We assessed the sustainability of verified Open Defecation Free (ODF) villages and explored the association between slippage occurrence and the strength of social norms through a government conducted cross-sectional data collection in rural Indonesia. The study surveyed 587 households and held focus group discussions (FGDs) in six ODF villages two years after the government's ODF verification. Overall, the slippage rate (i.e., a combination of sub-optimal use of a latrine and open defecation at respondent level) was estimated to be 14.5% (95% CI 11.6-17.3). Results of multivariate logistic regression analyses indicated that (1) weaker social norms, as measured by respondents' perceptions around latrine ownership coverage in their community, (2) a lack of all-year round water access, and (3) wealth levels (i.e., not being in the richest quintile), were found to be significantly associated with slippage occurrence. These findings, together with qualitative analysis, concluded that CATS programmes, including a combination of demand creation, removal of perceived constraints through community support mechanisms, and continued encouragement to pursue higher levels of services with post-ODF follow-up, could stabilize social norms and help to sustain longer-term latrine usage in study communities. Further investigation and at a larger scale, would be important to strengthen these findings.

  10. Use of dynamic 3-dimensional transvaginal and transrectal ultrasonography to assess posterior pelvic floor dysfunction related to obstructed defecation.

    Science.gov (United States)

    Murad-Regadas, Sthela M; Regadas Filho, Francisco Sergio Pinheiro; Regadas, Francisco Sergio Pinheiro; Rodrigues, Lusmar Veras; de J R Pereira, Jacyara; da S Fernandes, Graziela Olivia; Dealcanfreitas, Iris Daiana; Mendonca Filho, Jose Jader

    2014-02-01

    New ultrasound techniques may complement current diagnostic tools, and combined techniques may help to overcome the limitations of individual techniques for the diagnosis of anorectal dysfunction. A high degree of agreement has been demonstrated between echodefecography (dynamic 3-dimensional anorectal ultrasonography) and conventional defecography. Our aim was to evaluate the ability of a combined approach consisting of dynamic 3-dimensional transvaginal and transrectal ultrasonography by using a 3-dimensional biplane endoprobe to assess posterior pelvic floor dysfunctions related to obstructed defecation syndrome in comparison with echodefecography. This was a prospective, observational cohort study conducted at a tertiary-care hospital. Consecutive female patients with symptoms of obstructed defecation were eligible. Each patient underwent assessment of posterior pelvic floor dysfunctions with a combination of dynamic 3-dimensional transvaginal and transrectal ultrasonography by using a biplane transducer and with echodefecography. Kappa (κ) was calculated as an index of agreement between the techniques. Diagnostic accuracy (sensitivity, specificity, and positive and negative predictive values) of the combined technique in detection of posterior dysfunctions was assessed with echodefecography as the standard for comparison. A total of 33 women were evaluated. Substantial agreement was observed regarding normal relaxation and anismus. In detecting the absence or presence of rectocele, the 2 methods agreed in all cases. Near-perfect agreement was found for rectocele grade I, grade II, and grade III. Perfect agreement was found for entero/sigmoidocele, with near-perfect agreement for rectal intussusception. Using echodefecography as the standard for comparison, we found high diagnostic accuracy of transvaginal and transrectal ultrasonography in the detection of posterior dysfunctions. This combined technique should be compared with other dynamic techniques and

  11. Understanding and defining sanitation insecurity: women’s gendered experiences of urination, defecation and menstruation in rural Odisha, India

    Science.gov (United States)

    Clasen, Thomas F; Hadley, Craig; Yount, Kathryn M; Haardörfer, Regine; Rout, Manaswini; Dasmohapatra, Munmun; Cooper, Hannah LF

    2017-01-01

    Background Research suggests that the lived experience of inadequate sanitation may contribute to poor health outcomes above and beyond pathogen exposure, particularly among women. The goal of this research was to understand women’s lived experiences of sanitation by documenting their urination-related, defecation-related and menstruation-related concerns, to use findings to develop a definition of sanitation insecurity among women in low-income settings and to develop a conceptual model to explain the factors that contribute to their experiences, including potential behavioural and health consequences. Methods We conducted 69 Free-List Interviews and eight focus group discussions in a rural population in Odisha, India to identify women’s sanitation concerns and to build an understanding of sanitation insecurity. Findings We found that women at different life stages in rural Odisha, India have a multitude of unaddressed urination, defecation and menstruation concerns. Concerns fell into four domains: the sociocultural context, the physical environment, the social environment and personal constraints. These varied by season, time of day, life stage and toilet ownership, and were linked with an array of adaptations (ie, suppression, withholding food and water) and consequences (ie, scolding, shame, fear). Our derived definition and conceptual model of sanitation insecurity reflect these four domains. Discussion To sincerely address women’s sanitation needs, our findings indicate that more is needed than facilities that change the physical environment alone. Efforts to enable urinating, defecating and managing menstruation independently, comfortably, safely, hygienically, privately, healthily, with dignity and as needed require transformative approaches that also address the gendered, sociocultural and social environments that impact women despite facility access. This research lays the groundwork for future sanitation studies to validate or refine the proposed

  12. Effects of hygiene and defecation behavior on helminths and intestinal protozoa infections in Taabo, Côte d'Ivoire.

    Science.gov (United States)

    Schmidlin, Thomas; Hürlimann, Eveline; Silué, Kigbafori D; Yapi, Richard B; Houngbedji, Clarisse; Kouadio, Bernadette A; Acka-Douabélé, Cinthia A; Kouassi, Dongo; Ouattara, Mamadou; Zouzou, Fabien; Bonfoh, Bassirou; N'Goran, Eliézer K; Utzinger, Jürg; Raso, Giovanna

    2013-01-01

    More than 1 billion people are currently infected with soil-transmitted helminths and schistosomes. The global strategy to control helminthiases is the regular administration of anthelmintic drugs to at-risk populations. However, rapid re-infection occurs in areas where hygiene, access to clean water, and sanitation are inadequate. In July 2011, inhabitants from two villages and seven hamlets of the Taabo health demographic surveillance system in south-central Côte d'Ivoire provided stool and urine samples. Kato-Katz and ether-concentration methods were used for the diagnosis of Schistosoma mansoni, soil-transmitted helminths (Ascaris lumbricoides, Trichuris trichiura, and hookworm), and intestinal protozoa. Urine samples were subjected to a filtration method for the diagnosis of Schistosoma haematobium. A questionnaire was administered to households to obtain information on knowledge, attitude, practice, and beliefs in relation to hygiene, sanitation, and defecation behavior. Logistic regression models were employed to assess for associations between questionnaire data and parasitic infections. A total of 1,894 participants had complete data records. Parasitological examinations revealed prevalences of hookworm, S. haematobium, T. trichiura, S. mansoni, and A. lumbricoides of 33.5%, 7.0%, 1.6%, 1.3% and 0.8%, respectively. Giardia intestinalis and Entamoeba histolytica/E. dispar were detected in 15.0% and 14.4% of the participants, respectively. Only one out of five households reported the presence of a latrine, and hence, open defecation was common. Logistic regression analysis revealed that age, sex, socioeconomic status, hygiene, and defecation behavior are determinants for helminths and intestinal protozoa infections. We found that inadequate sanitation and hygiene behavior are associated with soil-transmitted helminths and intestinal protozoa infections in the Taabo area of south-central Côte d'Ivoire. Our data will serve as a benchmark to monitor the

  13. MR-defecography in obstructed defecation syndrome (ODS): technique, diagnostic criteria and grading.

    Science.gov (United States)

    Piloni, V; Tosi, P; Vernelli, M

    2013-10-01

    The aim of this study was to evaluate the use of a magnetic resonance (MR)-based classification system of obstructive defecation syndrome (ODS) to guide physicians in patient management. The medical records and imaging series of 105 consecutive patients (90 female, 15 male, aged 21-78 years, mean age 46.1 ± 5.1 years) referred to our center between April 2011 and January 2012 for symptoms of ODS were retrospectively examined. After history taking and a complete clinical examination, patients underwent MR imaging according to a standard protocol using a 0.35 T permanent field, horizontally oriented open-configuration magnet. Static and dynamic MR-defecography was performed using recognized parameters and well-established diagnostic criteria. Sixty-seven out of 105 (64 %) patients found the prone position more comfortable for the evacuation of rectal contrast while 10/105 (9.5 %) were unable to empty their rectum despite repeated attempts. Increased hiatus size, anterior rectocele and focal or extensive defects of the levator ani muscle were the most frequent abnormalities (67.6, 60.0 and 51.4 %, respectively). An MR-based classification was developed based on the combinations of abnormalities found: Grade 1 = functional abnormality, including paradoxical contraction of the puborectalis muscle, without anatomical defect affecting the musculo-fascial structures; Grade 2 = functional defect associated with a minor anatomical defect such as rectocele ≤ 2 cm in size and/or first-degree intussusception; Grade 3 = severe defects confined to the posterior anatomical compartment, including >2 cm rectocele, second- or higher-degree intussusception, full-thickness external rectal prolapse, poor mesorectal posterior fixation, rectal descent >5 cm, levator ani muscle rupture, ballooning of the levator hiatus and focal detachment of the endopelvic fascia; Grade 4 = combined defects of two or three pelvic floor compartments, including cystocele, hysterocele, enlarged urogenital

  14. A Cerebral Air Embolism That Developed Following Defecation in a Patient with Extensive Pulmonary Tuberculosis: A Case Report

    International Nuclear Information System (INIS)

    Oh, Ji Young; Park, Dong Woo; Hahm, Chang Kok; Park, Choong Ki; Lee, Seung Ro; Lee, Young Jun

    2010-01-01

    Cerebral air embolisms generally result from invasive procedures such as a percutaneous needle biopsy, chest tube insertion, central venous catheter access or removal, operations and so on. Likewise, they are mostly iatrogenically induced and present various degrees of severity depending on the number of air bubbles. With the exception of divers, the occurrence of a cerebral air embolism in the absence of invasive procedures is very rare. We report a case of a cerebral air embolism that developed following defecation and was detected by CT in a patient with extensive pulmonary tuberculosis

  15. A Cerebral Air Embolism That Developed Following Defecation in a Patient with Extensive Pulmonary Tuberculosis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Ji Young; Park, Dong Woo; Hahm, Chang Kok; Park, Choong Ki; Lee, Seung Ro; Lee, Young Jun [Hanyang University College of Medicine, Guri Hospital, Guri (Korea, Republic of)

    2010-08-15

    Cerebral air embolisms generally result from invasive procedures such as a percutaneous needle biopsy, chest tube insertion, central venous catheter access or removal, operations and so on. Likewise, they are mostly iatrogenically induced and present various degrees of severity depending on the number of air bubbles. With the exception of divers, the occurrence of a cerebral air embolism in the absence of invasive procedures is very rare. We report a case of a cerebral air embolism that developed following defecation and was detected by CT in a patient with extensive pulmonary tuberculosis

  16. The clinical value of magnetic resonance defecography in males with obstructed defecation syndrome.

    Science.gov (United States)

    Piloni, V; Bergamasco, M; Melara, G; Garavello, P

    2018-03-01

    The aim of the present study was to assess the relationship between symptoms of obstructed defecation and findings on magnetic resonance (MR) defecography in males with obstructed defecation syndrome (ODS). Thirty-six males with ODS who underwent MR defecography at our institution between March 2013 and February 2016 were asked in a telephone interview about their symptoms and subsequent treatment, either medical or surgical. Patients were divided into 2 groups, one with anismus (Group 1) and one with prolapse without anismus (Group 2). The interaction between ODS type and symptoms with MR findings was assessed by multivariate analysis for categorical data using a hierarchical log-linear model. MR imaging findings included lateral and/or posterior rectocele, rectal prolapse, intussusception, ballooning of levator hiatus with impingement of pelvic organs and dyskinetic puborectalis muscle. There were 21 males with ODS due to anismus (Group 1) and 15 with ODS due to rectal prolapse/intussusception (Group 2). Mean age of the entire group was 53.6 ± 4.1 years (range 18-77 years). Patients in Group 1 were slightly older than those in Group 2 (age peak, sixth decade in 47.6 vs 20.0%, p < 0.05). Symptoms most frequently associated with Group 1 patients included small volume and hard feces (85.0%, p < 0.01), excessive strain at stool (81.0%, p < 0.05), tenesmus and fecaloma formation (57.1 and 42.9%, p < 0.05); symptoms most frequently associated with Group 2 patients included mucous discharge, rectal bleeding and pain (86.7%, p < 0.05), prolonged toilet time (73.3%, p < 0.05), fragmented evacuation with or without digitation (66.7%, p < 0.005). Voiding outflow obstruction was more frequent in Group 1 (19.0 vs 13.3%; p < 0.05), while non-bacterial prostatitis and sexual dysfunction prevailed in Group 2 (26.7 and 46.7%, p < 0.05). At MR defecography, two major categories of findings were detected: a dyskinetic pattern (Type 1), seen in all Group 1

  17. Defecation mechanisms after anterior resection with J-pouch-anal and side-to-end anastomosis in dogs.

    Science.gov (United States)

    Willis, S; Hölzl, F; Wein, B; Tittel, A; Schumpelick, V

    2007-02-01

    Colonic J-pouch-anal anastomosis or colonic side-to-end anastomosis is the reconstruction of choice after low anterior resection. However, the mechanisms of defecation after both reconstruction forms are still speculative. Low anterior rectal resections were performed in 12 dogs with six colonic J-pouch-anal (pouch) and six coloanal side-to-end (SE) reconstructions. Four months postoperative stool frequency, intestinal transit time, and neorectal compliance were determined by radiography and barostat. Defecation mechanisms were evaluated radiographically during expulsion of artificial stool. One dog with pouch reconstruction could not be evaluated due to an anastomotic leak, while the others had uncomplicated course. Spontaneous stool frequency was significantly increased with both reconstruction methods (control 2.0+/-0.9, pouch 2.7+/-1.2, SE 3.3+/-0.9 day; panastomosis. Our results show that pouch evacuation is passive and independent from pouch motility. The functional principle of the colonic J-pouch is not its reservoir function but a delay of colonic motility.

  18. Effects of hygiene and defecation behavior on helminths and intestinal protozoa infections in Taabo, Côte d'Ivoire.

    Directory of Open Access Journals (Sweden)

    Thomas Schmidlin

    Full Text Available BACKGROUND: More than 1 billion people are currently infected with soil-transmitted helminths and schistosomes. The global strategy to control helminthiases is the regular administration of anthelmintic drugs to at-risk populations. However, rapid re-infection occurs in areas where hygiene, access to clean water, and sanitation are inadequate. METHODOLOGY: In July 2011, inhabitants from two villages and seven hamlets of the Taabo health demographic surveillance system in south-central Côte d'Ivoire provided stool and urine samples. Kato-Katz and ether-concentration methods were used for the diagnosis of Schistosoma mansoni, soil-transmitted helminths (Ascaris lumbricoides, Trichuris trichiura, and hookworm, and intestinal protozoa. Urine samples were subjected to a filtration method for the diagnosis of Schistosoma haematobium. A questionnaire was administered to households to obtain information on knowledge, attitude, practice, and beliefs in relation to hygiene, sanitation, and defecation behavior. Logistic regression models were employed to assess for associations between questionnaire data and parasitic infections. PRINCIPAL FINDINGS: A total of 1,894 participants had complete data records. Parasitological examinations revealed prevalences of hookworm, S. haematobium, T. trichiura, S. mansoni, and A. lumbricoides of 33.5%, 7.0%, 1.6%, 1.3% and 0.8%, respectively. Giardia intestinalis and Entamoeba histolytica/E. dispar were detected in 15.0% and 14.4% of the participants, respectively. Only one out of five households reported the presence of a latrine, and hence, open defecation was common. Logistic regression analysis revealed that age, sex, socioeconomic status, hygiene, and defecation behavior are determinants for helminths and intestinal protozoa infections. CONCLUSIONS/SIGNIFICANCE: We found that inadequate sanitation and hygiene behavior are associated with soil-transmitted helminths and intestinal protozoa infections in the Taabo

  19. Role of the intraluminal contents and the continuity of intrinsic neurons in intracolonic capsaicin-induced contraction and defecation in dogs.

    Science.gov (United States)

    Kikuchi, Daisuke; Shibata, Chikashi; Imoto, Hirofumi; Someya, Soutoku; Miyachi, Tomohiro; Miura, Koh; Naitoh, Takeshi; Unno, Michiaki

    2014-01-01

    We, herein, examined the role of the intraluminal contents and continuity of colonic intrinsic neurons in intracolonic capsaicin-induced enhancement of colonic motility and defecation. Five beagle dogs were equipped with three strain gauge force transducers throughout the colon. The colonic contractile activity in response to intracolonic capsaicin was studied in intact dogs, dogs after colonic cleansing and dogs with transection/re-anastomosis (T/R) between the proximal and middle colon. The effects of intravenous yohimbine, a α2 adrenergic antagonist, on the colonic motility and defecation were also studied in the same models. In intact dogs, capsaicin (10 mg) and yohimbine (2 mg/kg) immediately induced contractions throughout the colon, with defecation occurring in all experiments. In dogs after colonic cleansing and T/R, the capsaicin (10 mg)-induced enhancement of colonic motility was decreased in the middle and distal colon, and capsaicin-induced defecation was observed in 0-20 % of experiments (p continuity of the colonic intrinsic nerves as well as the intraluminal contents appear to play an important role in the colonic motor response to intracolonic capsaicin.

  20. Dyssynergic defecation may play an important role in postoperative Hirschsprung's disease patients with severe persistent constipation: analysis of a case series.

    Science.gov (United States)

    Meinds, Rob J; Eggink, Maura C; Heineman, Erik; Broens, Paul M A

    2014-10-01

    After surgery for Hirschsprung's disease (HD) the majority of patients have satisfactory clinical outcomes. Nevertheless, a substantial number of patients remain who suffer from severe persistent constipation. Current consensus attributes these complaints to the hallmarks of HD. In non-HD patients a cause for severe constipation is dyssynergic defecation. Retrospectively, we reviewed the medical records of ten postoperative HD patients with severe persistent constipation who had undergone extensive anorectal function tests to diagnose the reason for the constipation. We analyzed the results of these tests. During the last three years, ten postoperative HD patients with severe persistent constipation were given extensive anorectal function tests. All ten patients were diagnosed with dyssynergic defecation. The ages at the time of diagnosis ranged from 7 to 19years with a median age of 12years. Signs of an enlarged rectum were seen in all ten patients, with a maximum measured value of 845mL. Patients with HD may also suffer from dyssynergic defecation. It is important to consider this possibility when dealing with severe persistent constipation in postoperative HD patients. Viable options for treating dyssynergic defecation are available that could prevent irreversible long-term complications. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Lactitol and the maintenance of normal defecation: evaluation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Sjödin, Anders Mikael

    2015-01-01

    that the maintenance of normal defecation is a beneficial physiological effect. A total of 15 human intervention studies were identified as pertinent to the health claim. Twelve studies with various methodological limitations consistently showed that consumption of at least 10 g/day lactitol increases stool frequency......Following an application from DuPont Nutrition BioSciences ApS, submitted pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of the United Kingdom, the Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific...... substantiation of a health claim related to lactitol and the maintenance of normal defecation. The food constituent that is the subject of the claim is lactitol. The Panel considers that the food constituent lactitol, which is the subject of the claim, is sufficiently characterised. The Panel considers...

  2. Community-Led Total Sanitation, Open Defecation Free Status, and Ebola Virus Disease in Lofa County, Liberia.

    Science.gov (United States)

    Capps, Jean Meyer; Njiru, Haron; deVries, Pieter

    2017-01-01

    The Ebola virus disease (EVD) epidemic entered Liberia through Lofa County in February 2014 and spread to two health districts where the nongovernmental organization Global Communities had been implementing community-led total sanitation (CLTS) since 2012. By December 2014 the county had 928 Ebola cases (422 of them confirmed) and 648 deaths. Before the epidemic, CLTS was triggered in 155 communities, and 98 communities were certified as Open Defecation Free (ODF). Using mixed quantitative and qualitative methods, we determined that no cases of EVD were found in ODF communities and in only one CLTS community that had not reached ODF status. No differences were found between EVD and non-EVD communities in tribe, religion, ethnic group, or major sources of Ebola information. Radio was the most common source of information for all communities, but health workers were the most trusted information sources. CLTS ODF communities attributed their avoidance of EVD to Water, Sanitation, and Hygiene behaviors, especially hand washing with soap and disposal of feces that they learned from CLTS prior to the epidemic. Communities that got EVD blamed their strong initial resistance to Ebola response messages on their distrust that Ebola was real and their reliance on friends and family for advice. A strong inverse correlation between EVD and CLTS with or without ODF emerged from the regression analysis (R = -.6).

  3. An N-myristoylated globin with a redox-sensing function that regulates the defecation cycle in Caenorhabditis elegans.

    Directory of Open Access Journals (Sweden)

    Lesley Tilleman

    Full Text Available Globins occur in all kingdoms of life where they fulfill a wide variety of functions. In the past they used to be primarily characterized as oxygen transport/storage proteins, but since the discovery of new members of the globin family like neuroglobin and cytoglobin, more diverse and complex functions have been assigned to this heterogeneous family. Here we propose a function for a membrane-bound globin of C. elegans, GLB-26. This globin was predicted to be myristoylated at its N-terminus, a post-translational modification only recently described in the globin family. In vivo, this globin is found in the membrane of the head mesodermal cell and in the tail stomato-intestinal and anal depressor muscle cells. Since GLB-26 is almost directly oxidized when exposed to oxygen, we postulate a possible function as electron transfer protein. Phenotypical studies show that GLB-26 takes part in regulating the length of the defecation cycle in C. elegans under oxidative stress conditions.

  4. Magnetic resonance defecography versus videodefecography in the study of obstructed defecation syndrome: Is videodefecography still the test of choice after 50 years?

    Science.gov (United States)

    Martín-Martín, G P; García-Armengol, J; Roig-Vila, J V; Espí-Macías, A; Martínez-Sanjuán, V; Mínguez-Pérez, M; Lorenzo-Liñán, M Á; Mulas-Fernández, C; González-Argenté, F X

    2017-10-01

    The aim of the present study was to evaluate the diagnostic accuracy of magnetic resonance (MR) defecography and compare it with videodefecography in the evaluation of obstructed defecation syndrome. This was a prospective cohort test accuracy study conducted at one major tertiary referral center on patients with a diagnosis of obstructed defecation syndrome who were referred to the colorectal surgery clinic in a consecutive series from 2009 to 2012. All patients underwent a clinical examination, videodefecography, and MR defecography in the supine position. We analyzed diagnostic accuracy for MR defecography and performed an agreement analysis using Cohen's kappa index (κ) for each diagnostic imaging examination performed with videodefecography and MR defecography. We included 40 patients with Rome III diagnostic criteria of obstructed defecation syndrome. The degree of agreement between the two tests was as follows: almost perfect for anismus (κ = 0.88) and rectal prolapse (κ = 0.83), substantial for enterocele (κ = 0.80) and rectocele grade III (κ = 0.65), moderate for intussusception (κ = 0.50) and rectocele grade II (κ = 0.49), and slight for rectocele grade I (κ = 0.30) and excessive perineal descent (κ = 0.22). Eighteen cystoceles and 11 colpoceles were diagnosed only by MR defecography. Most patients (54%) stated that videodefecography was the more uncomfortable test. MR defecography could become the imaging test of choice for evaluating obstructed defecation syndrome.

  5. Provision of healthy toilet for low income community based on community empowerment in Kelurahan Kebonsari, Surabaya City, towards Indonesia open defecation free (ODF) in 2019

    Science.gov (United States)

    Soedjono, Eddy Setiadi; Fitriani, Nurina; Yuniarto, Adhi; Wijaya, I. Made Wahyu

    2017-11-01

    One of the causes of open defecation (OD) is low awareness of local community towards open defecation free behavior. This community does not have a healthy toilet and usually defecate in the river. This poor environment is coupled with poverty and small footprint. Therefore, the tr.iggering methods should be modified by including the finance concept in form of stimulant funds to accelerate ODF targets by using appropriate technology for land limitations. The construction of healthy toilet in Kelurahan Kebonsari, Jambangan sub-district, was conducted in RW2 which consisted of RT 6 (4 units) and RT 7 (1 unit) and 2 units in RT 2 of RW 3. Construction was initiated with focus group discussion and indepth interview to locate the proper location to be triggered. Healthy toilet construction was conducted in cooperation among self-help community, Institut Teknologi Sepuluh Nopember (ITS), and the community itself. Every month the users had to pay the toilet construction (capacity of 0.75 m3) of IDR 100,000 for 10 months. Therefore, with this healthy toilet construction, KelurahanKebonsari becomes one of ODF village in Surabaya City.

  6. The Effect of India's Total Sanitation Campaign on Defecation Behaviors and Child Health in Rural Madhya Pradesh: A Cluster Randomized Controlled Trial

    Science.gov (United States)

    Patil, Sumeet R.; Arnold, Benjamin F.; Salvatore, Alicia L.; Briceno, Bertha; Ganguly, Sandipan; Colford, John M.; Gertler, Paul J.

    2014-01-01

    Background Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC) is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs), defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth). Methods and Findings We conducted a cluster-randomized, controlled trial in 80 rural villages. Field staff collected baseline measures of sanitation conditions, behaviors, and child health (May–July 2009), and revisited households 21 months later (February–April 2011) after the program was delivered. The study enrolled a random sample of 5,209 children <5 years old from 3,039 households that had at least one child <24 months at the beginning of the study. A random subsample of 1,150 children <24 months at enrollment were tested for soil transmitted helminth and protozoan infections in stool. The randomization successfully balanced intervention and control groups, and we estimated differences between groups in an intention to treat analysis. The intervention increased percentage of households in a village with improved sanitation facilities as defined by the WHO/UNICEF Joint Monitoring Programme by an average of 19% (95% CI for difference: 12%–26%; group means: 22% control versus 41% intervention), decreased open defecation among adults by an average of 10% (95% CI for difference: 4%–15%; group means: 73% intervention versus 84% control). However, the intervention

  7. The effect of India's total sanitation campaign on defecation behaviors and child health in rural Madhya Pradesh: a cluster randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Sumeet R Patil

    2014-08-01

    Full Text Available Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs, defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth.We conducted a cluster-randomized, controlled trial in 80 rural villages. Field staff collected baseline measures of sanitation conditions, behaviors, and child health (May-July 2009, and revisited households 21 months later (February-April 2011 after the program was delivered. The study enrolled a random sample of 5,209 children <5 years old from 3,039 households that had at least one child <24 months at the beginning of the study. A random subsample of 1,150 children <24 months at enrollment were tested for soil transmitted helminth and protozoan infections in stool. The randomization successfully balanced intervention and control groups, and we estimated differences between groups in an intention to treat analysis. The intervention increased percentage of households in a village with improved sanitation facilities as defined by the WHO/UNICEF Joint Monitoring Programme by an average of 19% (95% CI for difference: 12%-26%; group means: 22% control versus 41% intervention, decreased open defecation among adults by an average of 10% (95% CI for difference: 4%-15%; group means: 73% intervention versus 84% control. However, the intervention did not improve child health

  8. The effect of India's total sanitation campaign on defecation behaviors and child health in rural Madhya Pradesh: a cluster randomized controlled trial.

    Science.gov (United States)

    Patil, Sumeet R; Arnold, Benjamin F; Salvatore, Alicia L; Briceno, Bertha; Ganguly, Sandipan; Colford, John M; Gertler, Paul J

    2014-08-01

    Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC) is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs), defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth). We conducted a cluster-randomized, controlled trial in 80 rural villages. Field staff collected baseline measures of sanitation conditions, behaviors, and child health (May-July 2009), and revisited households 21 months later (February-April 2011) after the program was delivered. The study enrolled a random sample of 5,209 children village with improved sanitation facilities as defined by the WHO/UNICEF Joint Monitoring Programme by an average of 19% (95% CI for difference: 12%-26%; group means: 22% control versus 41% intervention), decreased open defecation among adults by an average of 10% (95% CI for difference: 4%-15%; group means: 73% intervention versus 84% control). However, the intervention did not improve child health measured in terms of multiple health outcomes (diarrhea, HCGI, helminth infections, anemia, growth). Limitations of the study included a relatively short follow-up period following implementation, evidence for contamination in ten of the 40 control villages, and bias possible in self-reported outcomes for diarrhea, HCGI, and open defecation behaviors. The intervention led to modest increases in availability of IHLs and even more modest reductions in open

  9. Use of Biofeedback Combined With Diet for Treatment of Obstructed Defecation Associated With Paradoxical Puborectalis Contraction (Anismus): Predictive Factors and Short-term Outcome.

    Science.gov (United States)

    Murad-Regadas, Sthela M; Regadas, Francisco S Pinheiro; Bezerra, Carla C Rocha; de Oliveira, Maura T Coutinho Cajazeiras; Regadas Filho, Francisco S Pinheiro; Rodrigues, Lusmar Veras; Almeida, Saulo Santiago; da Silva Fernandes, Graziela O

    2016-02-01

    Numerous studies have described the use of biofeedback therapy for the treatment of anismus. Success rates vary widely, but few data are available regarding factors predictive of success. Our aim was to evaluate short-term results of biofeedback associated with diet in patients with obstructed defecation because of anismus and to investigate factors that may affect the results. Patients were identified from a single-institution prospectively maintained database. This study was conducted in a tertiary hospital. Consecutive patients who had obstructed defecation associated with anismus and were treated with biofeedback associated with diet were eligible. Each patient underwent anal manometry and/or dynamic anal ultrasound. Patients with anismus and were treated with biofeedback associated with diet. Patients classed as having a satisfactory response to therapy and those classed as having an unsatisfactory response were compared with regard to sex, age, Cleveland Clinic Florida constipation score, functional factors (anal resting and squeeze pressures and reversal of paradoxical puborectalis contraction on manometry), and anatomic factors in women (history of vaginal delivery, number of vaginal deliveries, menopause, hysterectomy, and previous anorectal surgery). A total of 116 patients were included (75 women and 41 men). Overall, 59% were classed as having a satisfactory response (decrease in constipation score, >50%). Patients with satisfactory responses to biofeedback plus diet did not differ from those with unsatisfactory responses with regard to clinical, anatomic, and physiological factors. This was not a randomized controlled trial. Biofeedback combined with diet is a valuable treatment option for patients with obstructed defecation syndrome associated with anismus, and more than half of our patients of both sexes achieved a satisfactory response. Improvement was not related to reversal of paradoxical contraction of puborectalis muscles at manometry. Patient

  10. Improvement of defecation in healthy individuals with infrequent bowel movements through the ingestion of dried Mozuku powder: a randomized, double-blind, parallel-group study

    Directory of Open Access Journals (Sweden)

    Masaki Matayoshi

    2017-09-01

    Full Text Available Background: Okinawa mozuku (Cladosiphon okamuranu is a type of edible seaweed of the family Chordariaceae that typically contains the polysaccharide fucoidan as a functional ingredient. In Okinawa, raw mozuku is eaten as vinegared mozuku together with vinegar or as tempura (deep-fried in batter. Polysaccharides such as fucoidan are generally known to regulate intestinal function, which is why we have used Okinawa mozuku to investigate this intestinal regulatory effect. Methods: The study was designed as a randomized, double-blind, parallel group study. Dried Okinawa mozuku powder at a dose of 2.4 g/day (1.0 g/day of fucoidan and a placebo not containing any dried Okinawa mozuku powder were each made into capsules and given to healthy men and women with infrequent weekly bowel movements (2–4 movements a week to ingest for eight weeks. We then investigated changes in the defecation situation, blood tests, and adverse events. Results: In the group that ingested the capsules containing dried Okinawa mozuku powder, the number of days with a bowel movement significantly increased compared with the placebo group after four weeks of ingestion (p < 0.05. Furthermore, after eight weeks of ingestion, the same increasing trend was seen compared with the placebo group (p = 0.0964. The volume of stool also increased significantly in the dried Okinawa mozuku powder group after eight weeks compared with the placebo group. In terms of blood tests and adverse events, no adverse events occurred that were the result of the test food. Conclusions: Ingestion of Okinawa mozuku was found to have a regulatory effect on intestinal function by promoting defecation in healthy individuals with a tendency for constipation. This demonstrated that Okinawa mozuku is a functional food capable of making defecation smoother and increasing the volume of stool.

  11. Assessment of the effectiveness of biofeedback in children with dyssynergic defecation and recalcitrant constipation/encopresis: does home biofeedback improve long-term outcomes.

    Science.gov (United States)

    Croffie, Joseph M; Ammar, M Samer; Pfefferkorn, Marian D; Horn, Debra; Klipsch, Ann; Fitzgerald, Joseph F; Gupta, Sandeep K; Molleston, Jean P; Corkins, Mark R

    2005-01-01

    The purpose of this study was to determine whether biofeedback benefits children with dyssynergic defecation and constipation/encopresis, and whether home biofeedback improves long-term outcomes. Thirty-six patients with chronic constipation who had failed at least 6 months of conventional treatment and demonstrated dyssynergic defecation at anorectal manometry were randomized to biofeedback in the laboratory alone (group 1, n=24) or in the laboratory and at home (group 2, n=12) and followed up at 2, 4, and a mean of 44 months. Thirty patients were available for long-term follow-up. Bowel movements increased in all from a mean of 1.4/week to 5.1, 5.8, and 5.1 per week at 2 months, 4 months, and long-term, respectively (p < or = 0.001). Soiling decreased in all from a mean of 5.5/week to 0.6, 0.1, and 1 per week at 2 months, 4 months, and long-term, respectively (p < or = 0.001). Laxative use decreased from a mean of 4.1 days/week to 0.6, 0.3, and 0.7 per week at 2 months, 4 months, and long-term, respectively (p < or = 0.001). Twenty-seven of 30 parents ranked their satisfaction a mean of 2.2 (range 1-excellent to 3-good). There were no significant differences in outcomes between the laboratory alone group and the laboratory plus home group. Biofeedback is beneficial for some children with chronic constipation and dyssynergic defecation. Supplemental home biofeedback does not improve long-term outcomes.

  12. Enhancement of the intrinsic defecation reflex by mosapride, a 5-HT4 agonist, in chronically lumbosacral denervated guinea pigs.

    Science.gov (United States)

    Kojima, Yu; Fujii, Hisao; Katsui, Renta; Nakajima, Yoshiyuki; Takaki, Miyako

    2006-10-01

    The defecation reflex is composed of rectal distension-evoked rectal (R-R) reflex contractions and synchronous internal anal sphincter (R-IAS) reflex relaxations in guinea pigs. These R-R and R-IAS reflexes are controlled via extrinsic sacral excitatory nerve pathway (pelvic nerves), lumbar inhibitory nerve pathways (colonic nerves) and by intrinsic cholinergic excitatory and nitrergic inhibitory nerve pathways. The effect of mosapride (a prokinetic benzamide) on the intrinsic reflexes, mediated via enteric 5-HT(4) receptors, was evaluated by measuring the mechanical activity of the rectum and IAS in anesthetized guinea pigs using an intrinsic R-R and R-IAS reflex model resulting from chronic (two to nine days) lumbosacral denervation (PITH). In this model, the myenteric plexus remains undamaged and the distribution of myenteric and intramuscular interstitial cells of Cajal is unchanged. Although R-R and R-IAS reflex patterns markedly changed, the reflex indices (reflex pressure or force curve-time integral) of both the R-R contractions and the synchronous R-IAS relaxations were unchanged. The frequency of the spontaneous R and IAS motility was also unchanged. Mosapride (0.1-1.0 mg/kg) dose-dependently increased both intrinsic R-R (maximum: 1.82) and R-IAS reflex indices (maximum: 2.76) from that of the control (1.0) 6-9 days following chronic PITH. The dose-response curve was similar to that in the intact guinea pig, and had shifted to the left from that in the guinea pig after acute PITH. A specific 5-HT(4) receptor antagonist, GR 113808 (1.0 mg/kg), decreased both reflex indices by approximately 50% and antagonized the effect of mosapride 1.0 mg/kg. This was quite different from the result in the intact guinea pig where GR 113808 (1.0 mg/kg) did not affect either of the reflex indices. The present results indicate that mosapride enhanced the intrinsic R-R and R-IAS reflexes and functionally compensated for the deprivation of extrinsic innervation. The actions of

  13. Life cycle, feeding and defecation patterns of Rhodnius ecuadoriensis (Lent & León 1958 (Hemiptera: Reduviidae: Triatominae under laboratory conditions

    Directory of Open Access Journals (Sweden)

    Anita G Villacís

    2008-11-01

    Full Text Available Rhodnius ecuadoriensis is the second most important vector of Chagas Disease (CD in Ecuador. The objective of this study was to describe (and compare the life cycle, the feeding and defecation patterns under laboratory conditions of two populations of this specie [from the provinces of Manabí (Coastal region and Loja (Andean region]. Egg-to-adult (n = 57 development took an average of 189.9 ± 20 (Manabí and 181.3 ± 6.4 days (Loja. Mortality rates were high among Lojan nymphs. Pre-feeding time (from contact with host to feeding initiation ranged from 4 min 42 s [nymph I (NI] to 8 min 30 s (male; feeding time ranged from 14 min 45 s (NI-28 min 25 s (male (Manabí and from 15 min 25 s (NI-28 min 57 s (nymph V (Loja. The amount of blood ingested increased significantly with instar and was larger for Manabí specimens (p < 0.001. Defecation while feeding was observed in Manabí specimens from stage nymph III and in Lojan bugs from stage nymph IV. There was a gradual, age-related increase in the frequency of this behaviour in both populations. Our results suggest that R. ecuadoriensis has the bionomic traits of an efficient vector of Trypanosoma cruzi. Together with previous data on the capacity of this species to infest rural households, these results indicate that control of synanthropic R. ecuadoriensis populations in the coastal and Andean regions may have a significant impact for CD control in Ecuador and Northern Peru.

  14. Stapled trans-anal rectal resection (STARR) in the surgical treatment of the obstructed defecation syndrome: results of STARR Italian Registry.

    Science.gov (United States)

    Stuto, Angelo; Renzi, Adolfo; Carriero, Alfonso; Gabrielli, Francesco; Gianfreda, Valeria; Villani, Roberto Dino; Pietrantoni, Carmine; Seria, Giovanni; Capomagi, Antonio; Talento, Pasquale

    2011-09-01

    This study was designed to evaluate the safety and efficacy of stapled trans-anal rectal resection (STARR) in the treatment of obstructed defecation syndrome ODS by the analysis of the data collected in the STARR Italian Registry (SIR) with a special emphasis on the analysis of symptoms and quality of life. Collected data included, preoperative tests findings, and the evaluation of symptoms; the latter was obtained by using dedicated tools such as the Obstructed Defecation Syndrome Score (ODS-S), the Severity Symptom Score (SSS), and the Continence Grading Scale (CGS). Data on the quality of life were collected by Patient Assessment of Constipation Quality of Life (PAC-QoL) and the Euro Quality of Life-5 Domains Visual Analogue Scale (EQ-5D VAS). The evaluation of the symptoms and the quality of life was repeated 6 and 12 months after surgery. The SIR had collected data on 2171 patients (1653 females, 76.1%; mean age 56.2 years; range 20-96 years). A significant improvement (P < .0001) was seen between preoperative and 12-month follow-up in all scores: ODS-S (16.7 vs. 5.0), SSS (15.6 vs. 2.6), CGS (2.0 vs. 0.7), PAC-QoL (51.0 vs. 22.1), and EQ-5D VAS (57.5 vs. 85.7). Complications included defecatory urgency (4.5% at 12 months), bleeding (3.6%), perineal sepsis (3.4%), and one case of rectovaginal fistula (0.05%). The analysis of SIR data seems to confirm that STARR is a safe and effective procedure in the treatment of ODS. However, further studies are required to evaluate the long-term stability of results.

  15. Scientific Opinion on the substantiation of a health claim related to “native chicory inulin” and maintenance of normal defecation by increasing stool frequency pursuant to Article 13.5 of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Tetens, Inge

    2015-01-01

    claim related to “native chicory inulin” and maintenance of normal defecation by increasing stool frequency. The food constituent that is a subject of a claim is “native chicory inulin”. The Panel considers that “native chicory inulin”, a non-fractionated mixture of monosaccharides (...%), disaccharides, inulin-type fructans and inulin extracted from chicory, with a mean DP ≥ 9, is sufficiently characterised in relation to the claimed effect. The Panel considers that maintenance of normal defecation by increasing stool frequency (provided that it does not result in diarrhoea) is a beneficial...... physiological effect. Six studies involving 86 subjects consistently showed that consumption of “native chicory inulin” at an amount of at least 12 g/day increases stool frequency. The Panel also notes the plausible mechanisms by which inulin and inulin-type fructans in “native chicory inulin” could exert...

  16. Life cycle, feeding and defecation patterns of Rhodnius ecuadoriensis (Lent & León 1958) (Hemiptera: Reduviidae: Triatominae) under laboratory conditions.

    Science.gov (United States)

    Villacís, Anita G; Arcos-Terán, Laura; Grijalva, Mario J

    2008-11-01

    Rhodnius ecuadoriensis is the second most important vector of Chagas Disease (CD) in Ecuador. The objective of this study was to describe (and compare) the life cycle, the feeding and defecation patterns under laboratory conditions of two populations of this specie [from the provinces of Manabí (Coastal region) and Loja (Andean region)]. Egg-to-adult (n = 57) development took an average of 189.9 +/- 20 (Manabí) and 181.3 +/- 6.4 days (Loja). Mortality rates were high among Lojan nymphs. Pre-feeding time (from contact with host to feeding initiation) ranged from 4 min 42 s [nymph I (NI)] to 8 min 30 s (male); feeding time ranged from 14 min 45 s (NI)-28 min 25 s (male) (Manabí) and from 15 min 25 s (NI)-28 min 57 s (nymph V) (Loja). The amount of blood ingested increased significantly with instar and was larger for Manabí specimens (p Ecuador and Northern Peru.

  17. Standardized Application of Laxatives and Physical Measures in Neurosurgical Intensive Care Patients Improves Defecation Pattern but Is Not Associated with Lower Intracranial Pressure

    Directory of Open Access Journals (Sweden)

    Martin Kieninger

    2014-01-01

    Full Text Available Background. Inadequate bowel movements might be associated with an increase in intracranial pressure in neurosurgical patients. In this study we investigated the influence of a structured application of laxatives and physical measures following a strict standard operating procedure (SOP on bowel movement, intracranial pressure (ICP, and length of hospital stay in patients with a serious acute cerebral disorder. Methods. After the implementation of the SOP patients suffering from a neurosurgical disorder received pharmacological and nonpharmacological measures to improve bowel movements in a standardized manner within the first 5 days after admission to the intensive care unit (ICU starting on day of admission. We compared mean ICP levels, length of ICU stay, and mechanical ventilation to a historical control group. Results. Patients of the intervention group showed an adequate defecation pattern significantly more often than the patients of the control group. However, this was not associated with lower ICP values, fewer days of mechanical ventilation, or earlier discharge from ICU. Conclusions. The implementation of a SOP for bowel movement increases the frequency of adequate bowel movements in neurosurgical critical care patients. However, this seems not to be associated with reduced ICP values.

  18. Standardized application of laxatives and physical measures in neurosurgical intensive care patients improves defecation pattern but is not associated with lower intracranial pressure.

    Science.gov (United States)

    Kieninger, Martin; Sinner, Barbara; Graf, Bernhard; Grassold, Astrid; Bele, Sylvia; Seemann, Milena; Künzig, Holger; Zech, Nina

    2014-01-01

    Background. Inadequate bowel movements might be associated with an increase in intracranial pressure in neurosurgical patients. In this study we investigated the influence of a structured application of laxatives and physical measures following a strict standard operating procedure (SOP) on bowel movement, intracranial pressure (ICP), and length of hospital stay in patients with a serious acute cerebral disorder. Methods. After the implementation of the SOP patients suffering from a neurosurgical disorder received pharmacological and nonpharmacological measures to improve bowel movements in a standardized manner within the first 5 days after admission to the intensive care unit (ICU) starting on day of admission. We compared mean ICP levels, length of ICU stay, and mechanical ventilation to a historical control group. Results. Patients of the intervention group showed an adequate defecation pattern significantly more often than the patients of the control group. However, this was not associated with lower ICP values, fewer days of mechanical ventilation, or earlier discharge from ICU. Conclusions. The implementation of a SOP for bowel movement increases the frequency of adequate bowel movements in neurosurgical critical care patients. However, this seems not to be associated with reduced ICP values.

  19. Types of pelvic floor dysfunctions in nulliparous, vaginal delivery, and cesarean section female patients with obstructed defecation syndrome identified by echodefecography.

    Science.gov (United States)

    Murad-Regadas, Sthela M; Regadas, Francisco Sérgio P; Rodrigues, Lusmar V; Oliveira, Leticia; Barreto, Rosilma G L; de Souza, Marcellus H L P; Silva, Flavio Roberto S

    2009-10-01

    This study aims to show pelvic floor dysfunctions in women with obstructed defecation syndrome (ODS), comparing nulliparous to those with vaginal delivery or cesarean section using the echodefecography (ECD). Three hundred seventy female patients with ODS were reviewed retrospectively and were divided in Group I-105 nulliparous, Group II-165 had at least one vaginal delivery, and Group III-comprised of 100 patients delivered only by cesarean section. All patients had been submitted to ECD to identify pelvic floor dysfunctions. No statistical significance was found between the groups with regard to anorectocele grade. Intussusception was identified in 40% from G I, 55.0% from G II, and 30.0% from G III, with statistical significance between Groups I and II. Intussusception was associated with significant anorectocele in 24.8%, 36.3%, and 18% patients from G I, II, and III, respectively. Anismus was identified in 39.0% from G I, 28.5% from G II, and 60% from G III, with statistical significance between Groups I and III. Anismus was associated with significant anorectocele in 22.8%, 15.7%, and 24% patients from G I, II, and III, respectively. Sigmoidocele/enterocele was identified in 7.6% from G I, 10.9% G II, and was associated with significant rectocele in 3.8% and 7.3% patients from G I and II, respectively. The distribution of pelvic floor dysfunctions showed no specific pattern across the groups, suggesting the absence of a correlation between these dysfunctions and vaginal delivery.

  20. Comparative study of Contour Transtar and STARR procedure for the treatment of obstructed defecation syndrome (ODS)--feasibility, morbidity and early functional results.

    Science.gov (United States)

    Isbert, C; Reibetanz, J; Jayne, D G; Kim, M; Germer, C-T; Boenicke, L

    2010-09-01

    Stapled transanal rectal resection (STARR) is a promising new treatment for obstructed defecation syndrome (ODS). It may be performed using either a double-stapling technique (PPH-STARR) or with the new Contour Transtar (CT) device. The aim of this study was to evaluate the two techniques with respect to morbidity and functional outcomes. Patients presenting with ODS were evaluated using standardized clinical and radiological investigations and prospectively entered into a database. A total of 150 Patients were treated with either PPH-STARR (n = 68) or CT (n = 82) and further evaluated at 12 month postoperatively. The mean size of the resected specimen was 27 cm(2) (SD +/-4.86 cm(2)) in the PPH-STARR group and 46 cm(2) (SD +/-10.6 cm(2)) in the CT group [P < 0.001]. Morbidity was 7.3% (n = 5) in the PPH-STARR group and 7.5% (n = 6) in the CT group. The most common complication was minor postoperative bleeding in both groups (PPH-STARR: n = 2, 2.9%; CT: n = 2, 2.4%) Overall there were no septic complications and no surgical re-interventions. There was a tendency for more postoperative pain following CT (n = 3, 3.6%) as compared with PPH-STARR (n = 1, 1.4%). Constipation Scores (CCS) were 15.50 +/- 5.71 in the PPH-STARR group and 15.70 +/- 5.84 in the CT group preoperatively and decreased significantly to 8.25 (SD +/-1.45) and 8.01 (SD +/-2.31) 12-months after surgery. Values did not differ significantly between the two groups. Contour Transtar is as safe and effective as PPH-STARR and provides a true circumferential resection of rectal intussusception. This may benefit selected patients and result in improved long-term durability of the technique.

  1. EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies), 2013. Scientific Opinion on the substantiation of a health claim related to Lactobacillus rhamnosus GG and maintenance of normal defecation during antibiotic treatment pursuant to Article 13(5) of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Tetens, Inge

    claim related to Lactobacillus rhamnosus GG and maintenance of normal defecation during antibiotic treatment. The food constituent, Lactobacillus rhamnosus GG, which is the subject of the health claim, is sufficiently characterised. The claimed effect proposed by the applicant is “help to maintain...... normal defecation during antibiotic treatment” and the target population proposed by the applicant is “healthy outpatient adults and children on oral antibiotic treatment”. Maintenance of normal defecation during antibiotic treatment is a beneficial physiological effect. The Panel notes...... human intervention studies, from which conclusions could be drawn for the scientific substantiation of the claim, did not show an effect of Lactobacillus rhamnosus GG on the incidence of diarrhoea resulting from antibiotic treatment. The Panel concludes that a cause and effect relationship has not been...

  2. Influencia de los defecaderos de camélidos sobre el desarrollo vegetal y riqueza de especies en morrenas glaciales, Tierra del Fuego Camelid defecation influences vegetation development and species richnesss on glacial moraines, Tierra del Fuego

    Directory of Open Access Journals (Sweden)

    JUAN M. HENRÍQUEZ

    2004-09-01

    Full Text Available Los escasos trabajos de interacción planta-herbívoro en ambientes severos han concluido que los herbívoros tienen un rol menor sobre el proceso de colonización en los estados tempranos de la sucesión. Aquí se documentan los efectos de defecaderos de un herbívoro ungulado (Lamma guanicoe sobre los patrones vegetales en una intermorrena glacial reciente. Se evaluó la composición florística, frecuencia y síndrome de dispersión de las especies presentes sobre los defecaderos y sitios control. Parámetros de suelo fueron analizados en ambos substratos. La riqueza y diversidad de especies vasculares fueron significativamente mayores sobre los defecaderos. El síndrome de dispersión dominante es la anemocoría en la vegetación de ambos tipos de substratos. Los defecaderos presentan valores superiores de materia orgánica, nitrógeno y fósforo, indicando condiciones localmente más favorables para el establecimiento de plántulas en este ambiente pobre en nutrientes y materia orgánica. Finalmente, se discute acerca de los posibles mecanismos que originan la mayor riqueza y diversidad de especies sobre los defecaderos de guanaco, concluyendo que constituyen una fuente potencial de propágulos que puede acelerar el proceso de colonización en morrenas glaciaresThe few studies of herbivore-plant interaction in severe environments have concluded that the herbivores have a minor role on the process of colonization in the early states of the succession. This paper describes the effects of camelid (Lamma guanicoe dung heaps on vegetation patterns on a recent glacial moraine. Floristic composition, diversity, abundance and dispersion syndrome spectra of the vegetation growing on dung heaps was compared with that of control sites unaffected by camelid defecation. Soil parameters of both substrates were analyzed. Vascular species riches and diversity were significantly higher on dung heaps. Anemochory was the dominant dispersion syndrome on both

  3. Scientific Opinion on the substantiation of a health claim related to SYNBIO®, a combination of Lactobacillus rhamnosus IMC 501® and Lactobacillus paracasei IMC 502®, and maintenance of normal defecation pursuant to Article 13(5) of Regulation (EC) No

    DEFF Research Database (Denmark)

    Tetens, Inge

    2015-01-01

    Following an application from Synbiotec S.r.l., submitted for authorisation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of Italy, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the s......Following an application from Synbiotec S.r.l., submitted for authorisation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of Italy, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion...... on the scientific substantiation of a health claim related to SYNBIO®, a combination of Lactobacillus rhamnosus IMC 501® and Lactobacillus paracasei IMC 502®, and maintenance of normal defecation. The Panel considers that the food, SYNBIO®, which is the subject of the health claim, is sufficiently characterised...... that no evidence was provided that the tools used to assess changes in bowel habits in response to an intervention were valid. Therefore, no conclusions could be drawn from these studies for the scientific substantiation of a claim on SYNBIO® and maintenance of normal defecation. In the absence of evidence...

  4. Anal endosonography and manometry: comparison in patients with defecation problems.

    Science.gov (United States)

    Schäfer, R; Heyer, T; Gantke, B; Schäfer, A; Frieling, T; Häussinger, D; Enck, P

    1997-03-01

    Correlations between anal sphincter function as assessed by anorectal manometry and anal sphincter anatomy measured by endoluminal ultrasound have been reported in the literature both for patients and for healthy individuals but have not been confirmed by other authors. For a larger series of patients (152 consecutive patients, mean age 54.1 +/- 15.5 years; female:male ratio, 111:41) with anorectal dysfunctions such as incontinence (n = 92), constipation (n = 37), and other symptoms (n = 23), diagnostic work-up included conventional multilumen anorectal manometry to evaluate internal sphincter pressure at rest, maximum external sphincter squeeze pressure during contraction, and endoanal sonography to determine anal sphincter integrity and to measure dorsal, left lateral, and right lateral diameter of the internal anal sphincter (IAS) and external anal sphincter (EAS) muscles. Maximum squeeze pressure was significantly correlated to muscle thickness of the EAS (P = 0.001). No association was found between resting pressure and IAS diameter. Women had significantly lower resting and squeeze pressures than men (P = 0.008 and P = 0.003, respectively), but age-related changes of function were only found for resting pressure. Endosonographic values of IAS and EAS did not differ between genders but were significantly correlated with age (P = 0.008 and P = 0.02, respectively). Because all correlations were rather weak, they only can explain a small portion of data variance. Anal manometry and anal ultrasound, therefore, are of complementary value and are both indicated in adequate clinical problems.

  5. Defecation of a colon cast as a rare presentation of acute graft-versus-host disease

    International Nuclear Information System (INIS)

    Al Ashgar, Hamad; Peedikayil, Musthafa; Chaudhri, Naeem; AlGhamdi, Abdulmonem

    2009-01-01

    Diffuse involvement of the gastrointestinal tract by graft versus host disease (GVHD) is a common complication of allogeneic hematopoietic stem cell transplant (HSCT). Gastrointestinal GVHD usually presents 3 or more weeks after HSCT and is characterized by profuse diarrhea, anorexia, nausea, vomiting, abdominal pain and gastrointestinal bleeding. We report a case of a 23 year old male who had undergone allogeneic HSCT and presented with bloody diarrhea on the 90th day post-HSCT. On the fourth day of admission, the patient passed per rectum a 27-cm long pinkish colored fleshy material recognized as a colon cast. Sigmoidoscopy showed a congested and erythematous rectum with the remaining portion of the colon cast attached to the proximal part of the sigmoid colon. A biopsy from the rectal wall was suggestive of grade 4 GVHD. The patient was treated with methylprednisolone, cyclosporine and mycophenolate mofetil, with a partial response (diarrhea and abdominal pain improved), but then he developed multiple other medical complications and died after 3 months. (author)

  6. Geographically weighted lasso (GWL) study for modeling the diarrheic to achieve open defecation free (ODF) target

    Science.gov (United States)

    Arumsari, Nurvita; Sutidjo, S. U.; Brodjol; Soedjono, Eddy S.

    2014-03-01

    Diarrhea has been one main cause of morbidity and mortality to children around the world, especially in the developing countries According to available data that was mentioned. It showed that sanitary and healthy lifestyle implementation by the inhabitants was not good yet. Inadequacy of environmental influence and the availability of health services were suspected factors which influenced diarrhea cases happened followed by heightened percentage of the diarrheic. This research is aimed at modelling the diarrheic by using Geographically Weighted Lasso method. With the existence of spatial heterogeneity was tested by Breusch Pagan, it was showed that diarrheic modeling with weighted regression, especially GWR and GWL, can explain the variation in each location. But, the absence of multi-collinearity cases on predictor variables, which were affecting the diarrheic, resulted in GWR and GWL modelling to be not different or identical. It is shown from the resulting MSE value. While from R2 value which usually higher on GWL model showed a significant variable predictor based on more parametric shrinkage value.

  7. Addressing Open Defecation Sanitation Problem: The case of Dry Toilet Implementation in the WA Municipality, Ghana

    OpenAIRE

    Musa, Essuman

    2015-01-01

    Although Ghana ranks 152 out of 182 on the Human Development Index, it has the 4th lowest rate of sanitation coverage worldwide (UNICEF/WHO 2010). The Wa municipality is no exception. Lack of toilet facilities in many homes in the municipality is something that cannot be ignored, and as a result, people form long queues early in the morning to have access to the few existing public toilets, whereby putting extreme pressure on these facilities. The worst part of the sanitation problem is that ...

  8. Prevalence of Functional Defecation Disorders in Children: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Koppen, Ilan J N; Vriesman, Mana H; Saps, Miguel; Rajindrajith, Shaman; Shi, Xiaoxia; van Etten-Jamaludin, Faridi S; Di Lorenzo, Carlo; Benninga, Marc A; Tabbers, Merit M

    2018-04-12

    To systematically review the literature regarding the epidemiology of functional constipation and functional nonretentive fecal incontinence (FNRFI) in children. Secondary objectives were to assess the geographical, age, and sex distribution of functional constipation and FNRFI and to evaluate associated factors. The Cochrane Library, PubMed, and Embase databases were searched from 2006 until September 2017. The following inclusion criteria were applied: (1) prospective studies of population-based samples; (2) reporting on the prevalence of functional constipation or FNRFI according to the Rome III/IV criteria; (3) in children aged 0-18 years; and (4) published in full manuscript form. A quality assessment of included studies was conducted. Random effect meta-analyses with meta-regression analyses of study characteristics were performed. Thirty-seven studies were included, of which 35 reported on the prevalence of functional constipation and 15 of FNRFI. The reported prevalence of functional constipation ranged from 0.5% to 32.2%, with a pooled prevalence of 9.5% (95% CI 7.5-12.1). The prevalence of FRNFI ranged from 0.0% to 1.8%, with a pooled prevalence of 0.4% (95% CI 0.2-0.7). The prevalence of functional constipation was 8.6% in boys compared with 8.9% in girls (OR 0.99, 95% CI 0.9-1.4). Geographical location, dietary habits, and exposure to stressful life events were reported to be associated with the prevalence of functional constipation. Data on FNRFI were scarce and no associated factors were identified. Functional constipation is common in childhood and is associated with geographical location, lifestyle factors, and stressful life events. FNRFI is rare, and no associated factors were identified. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. OPEN DEFECATION- A THREAT TO PROTECTED WATER SOURCES OF GAJAPATINAGARAM MANDAL OF VIZIANAGARAM DISTRICT, ANDHRA PRADESH, INDIA

    OpenAIRE

    Gompana Sajeeth; Ankura Vijaya Durga; A. Janaki Bai

    2011-01-01

    Human health has been severely impacted by gastro intestinal diseases caused by the presence of pathogenic organisms in tap water and the lack of appropriate hygiene habits among the rural populations of Vizianagaram district. The lack of household water management and waste water treatment infrastructure has resulted in the majority of the children’s population and a portion of the adult population showing a high incidence of diseases caused by microbial pathogens such as E.coli and Salmonel...

  10. Emesis and Defecations Induced by the 5-Hydroxytryptamine (5-HT3) Receptor Anatagonist Zacopride in the Ferret

    Science.gov (United States)

    1990-02-16

    TERMS 8. NUMBER OF PAGES 8 16. PRICE CODE 17 SECURITY CLASSIFICATION is. SECURITY CLASSIFICATION 19. SECURITY CLASSIFICATION 20. LIMITATION OF OP...the Defense Nuclear erties, i.e., granisetron [BRL43694; Endo-N-[9-methyl-9-aza- Agency has been given or should be inferred. Research was conducted...BMY25801, batanopride; BRL43694, granisetron ; GI, gastrointestinal; ACh, acetylcholine. 1034 1990 Emetic Properties of Zacopnde 1035 benzamide HCI; Gylys et

  11. Clinical outcomes of stapled transanal rectal resection (STARR) for obstructed defecation syndrome (ODS): a single institution experience in South Korea.

    Science.gov (United States)

    Song, Kee Ho; Lee, Du Seok; Shin, Jong Keun; Lee, So Jin; Lee, Jae Bum; Yook, Eui Gon; Lee, Doo Han; Kim, Do Sun

    2011-06-01

    The purpose of this study was to assess both the short- and long-term functional outcomes of stapled transanal rectal resection (STARR) in ODS patients. We performed a retrospective review of data that were collected from January 2005 to October 2008. Between January 2005 to June 2006, 58 patients who underwent STARR were enrolled in this study. Follow-up was scheduled for 3 months and 1 year after surgery with the Cleveland Clinic Florida (CCF) constipation score and satisfaction grade. To evaluate the long-term functional outcome, we interviewed the patients by telephone using questionnaires for the CCF score and satisfaction grade on October 2008. The median follow-up period was 34 months (range, 27-46 months). The mean age and sex ratio were 54 years (range, 19-85 years) and 8:50 (M/F). The mean CCF constipation scores were 17.6 before the surgery, 9.5 at 3 months, 9.6 at 12 months, and 10.3 at the time of the latest interview. The satisfaction grade, which was rated as excellent and good by 63.4% of the patients at the time of the latest interview, was worse than that at 3 months (37.8%). Among the cases of the excellent group (19 cases) at postoperative 3 months, 13 cases (68.4%) were classified as excellent or good at the time of the latest interview. The STARR is a safe and effective surgical procedure for restoring the anatomy and function in ODS patients. Strict selection of patients is needed in enhancing and maintaining the patients' satisfaction after the procedure.

  12. How much crude oil can zooplankton ingest? Estimating the quantity of dispersed crude oil defecated by planktonic copepods

    DEFF Research Database (Denmark)

    Almeda, Rodrigo; Connelly, Tara L.; Buskey, Edward J.

    2016-01-01

    % of the analyzed fecal pellets from three species of copepods and a natural copepod assemblage exposed for 48 h to physically or chemically dispersed light crude oil contained crude oil droplets. Crude oil droplets inside fecal pellets were smaller (median diameter: 2.4-3.5 mu m) than droplets in the physically...

  13. Polydextrose and maintenance of normal defecation: evaluation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Sjödin, Anders Mikael

    2016-01-01

    Following an application from Tate & Lyle PLC submitted for authorisation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of the United Kingdom, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion...

  14. Dyssynergic defecation may play an important role in postoperative Hirschsprung's disease patients with severe persistent constipation Analysis of a case series

    NARCIS (Netherlands)

    Meinds, Rob J.; Eggink, Maura C.; Heineman, Erik; Broens, Paul M. A.

    2014-01-01

    Background: After surgery for Hirschsprung's disease (HD) the majority of patients have satisfactory clinical outcomes. Nevertheless, a substantial number of patients remain who suffer from severe persistent constipation. Current consensus attributes these complaints to the hallmarks of HD. In

  15. Comparative study between surgical and non-surgical treatment of anismus in patients with symptoms of obstructed defecation: a prospective randomized study.

    Science.gov (United States)

    Faried, Mohamed; El Nakeeb, Ayman; Youssef, Mohamed; Omar, Waleed; El Monem, Hisham Abd

    2010-08-01

    This study came to compare the results of biofeedback retraining biofeedback (BFB), botulinum toxin botulinum type A (BTX-A) injection and partial division of puborectalis (PDPR) in the treatment of anismus patients. Consecutive patients treated for anismus fulfilled Rome II criteria for functional constipation at our institution were evaluated for inclusion. Participants were randomly allocated to receive BFB, BTX-A injection, and PDPR. All patients underwent anorectal manometry, balloon expulsion test, defecography, and electromyography activity of the anal sphincter. Follow up was conducted weekly in the first month then monthly for about 1 year. Study variables included clinical improvement, patient satisfaction, and objective improvement. Sixty patients with anismus were randomized and completed the study. The groups differed significantly regarding clinical improvement at 1 month (50% for BFB, 75%BTX-A injection, and 95% for PDPR, P = 0.006) and differences persisted at 1 year (30% for BFB, 35%BTX-A injection, and 70% for PDPR, P = 0.02). Constipation score of the patients significantly improved postPDPR and BTX-A injection. Manometric relaxation was achieved significantly in the three groups. Biofeedback retraining has a limited therapeutic effect, BTX-A injection seems to be successful for temporary treatment but PDPR is found to be an effective with lower morbidity in contrast to its higher success rate in treating anismus.

  16. Short-chain fructooligosaccharides from sucrose and maintenance of normal defecation: evaluation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Sjödin, Anders Mikael

    2016-01-01

    Following an application from Beghin-Meiji and Tereos Syral, submitted for authorisation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924/2006 via the Competent Authority of France, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA Panel) was asked to deliver...

  17. The effect of biofeedback therapy on dyssynergic constipation in patients with or without Irritable Bowel Syndrome

    OpenAIRE

    Tannaz Ahadi; Faezeh Madjlesi; Bahar Mahjoubi; Rezvan Mirzaei; Bijan Forogh; Seyedeh Somayeh Daliri; Seyed Majid Derakhshandeh; Roxana Bazaz Behbahani; G Reza Raissi

    2014-01-01

    Background: The Rome II and III diagnostic criteria for dyssynergic defecation recommended the exclusion of irritable bowel syndrome (IBS). This study determined the effect of biofeedback therapy on dyssynergic constipation in patients with or without IBS. Materials and Methods: This study was a nonrandomized, single blinded, semi experimental study. Dyssynergic defecation patients with and without IBS were asked to undergo biofeedback therapy 8 sessions. The defecation dynamics and balloon e...

  18. Benchmarking Local Government Performance on Rural Sanitation : Learning from Himachal Pradesh, India

    OpenAIRE

    World Bank

    2010-01-01

    Open defecation is a traditional behavior in rural India. Conventional rural sanitation programs have been based on the assumption that people defecate in the open because they are too poor to afford the cost of constructing a toilet. Therefore, subsidies for upfront capital costs were provided to generate demand for 'sanitation,' interpreted narrowly as a pour-flush toilet. These programs...

  19. The Honey Bee Parasite Nosema ceranae: Transmissible via Food Exchange?

    NARCIS (Netherlands)

    Smith, M.L.

    2012-01-01

    Nosema ceranae, a newly introduced parasite of the honey bee, Apis mellifera, is contributing to worldwide colony losses. Other Nosema species, such as N. apis, tend to be associated with increased defecation and spread via a fecal-oral pathway, but because N. ceranae does not induce defecation, it

  20. Defecography

    International Nuclear Information System (INIS)

    Goei, R.

    1990-01-01

    A simplified and standardized technique of defecography is described and its role in the detection of abnormalities of anorectal function in patients with defecation disorders, wether or not in connection with 'Irritable Bower Syndroms' (IBS), is evaluated. Defecography is a radiologic physiologic method in which the function of the anorectum during actual defecation is visualized. (H.W.). 144 refs.; 35 figs.; 12 tabs

  1. Descending perineum syndrome: new perspectives.

    Science.gov (United States)

    Pucciani, F

    2015-08-01

    The classical clinical profile of descending perineum syndrome (DPS) has been replaced by new pathophysiological, diagnostic, and therapeutic acquisitions. This paper will focus on trigger factors ranging from dyssynergic defecation to excessive straining, fecal incontinence against the backdrop of obstructed defecation, attendant rectal diseases, and therapy tailored to evolving stages of DPS.

  2. Therapeutic effect of He-Wei-Tong-Xie decoction on acute ...

    African Journals Online (AJOL)

    Gastrointestinal function scores (stomach ache, abdominal distension, borborygmus and defecation), and ..... and erosion of digestive tract mucosa, resulting in the damage of ... and reproduction in any medium, provided the original work is ...

  3. 33 CFR 159.131 - Safety: Incinerating device.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) POLLUTION MARINE SANITATION DEVICES Design, Construction, and Testing § 159.131 Safety.... Unitized incineration devices must completely burn to a dry, inert ash, a simultaneous defecation and...

  4. Correlation of bowel symptoms with colonic transit, length, and faecal load in functional faecal retention

    DEFF Research Database (Denmark)

    Raahave, Dennis; Christensen, Elsebeth; Loud, Franck B.

    2009-01-01

    INTRODUCTION: Abdominal pain, bloating, and defecation disturbances are common complaints in gastrointestinal functional disorders. This study explores whether bowel symptoms are correlated to colon transit time (CTT), faecal loading (coprostasis), and colon length; and whether prokinetic interve...

  5. Magnetic resonance imaging of the lumbosacral spine in children with chronic constipation or non-retentive fecal incontinence: A prospective study

    NARCIS (Netherlands)

    Bekkali, N.; Hagebreuk, E. E. O.; Bongers, E. M.; van Rijn, R. R.; van Wijk, M. P.; Benninga, M. A.

    2010-01-01

    Objective To determine the prevalence of lumbosacral spine (LSS) abnormalities in children with defecation disorders, intractable constipation, or non-retentive fecal incontinence (NRFI) and evaluate whether LSS abnormalities on magnetic resonance imaging (MRI) are clinically detected by neurologic

  6. Diarrheal Diseases - Acute and Chronic

    Science.gov (United States)

    ... include abdominal cramps fever, nausea, vomiting, fatigue and urgency. Chronic diarrhea can be accompanied by weight loss, ... bloating, abdominal pain relieved with defecation and a sense of incomplete evacuation. Risk Factors Exposure to infectious ...

  7. A Rare Presentation of Lower Back Swelling as Tailgut Cyst

    African Journals Online (AJOL)

    defecation, rectal bleeding, urinary frequency, etc.[7] Furthermore, ... tomography or magnetic resonance imaging has a crucial role in ... 8 cm × 7 cm, posterior to the uterus. .... presence of abnormal histology, serial perineal examination, and.

  8. Is Bifidobacterium breve effective in the treatment of childhood constipation? Results from a pilot study

    NARCIS (Netherlands)

    Tabbers, M. M.; de Milliano, I.; Roseboom, M. G.; Benninga, M. A.

    2011-01-01

    Probiotics are increasingly used in the treatment of functional gastrointestinal disorders. Studies in constipated adults with a Bifidus yoghurt (containing Bifidobacterium breve, Bifidobacterium bifidum and Lactobacillus acidophilus) showed a significant increase in defecation frequency. The aim of

  9. Anismus: the cause of constipation? Results of investigation and treatment.

    Science.gov (United States)

    Duthie, G S; Bartolo, D C

    1992-01-01

    Anismus, or failure of the somatic sphincter apparatus to relax at defecation, has been implicated as a major contributor to the problem of obstructed defecation. Current diagnostic methods depend on laboratory measurements of attempted defecation and the most complex, dynamic proctography has been the mainstay of diagnosis. Using a new computerized ambulatory method of recording sphincter function in these patients at home, we report an 80% reduction in our diagnostic rate suggesting that conventional tests fail to accurately diagnose this condition, probably because they poorly represent the natural physiology of defecation. Treatment of this distressing condition is more complex and a variety of surgical and pharmacological measures have failed. Biofeedback retraining of anorectal function of these patients has been very successful and represents the management of choice.

  10. Research Article Special Issue

    African Journals Online (AJOL)

    pc

    2017-11-24

    Nov 24, 2017 ... defecation problems and abdominal pain were more detected in patients with ovarian cancer. (p=0.05). ... lung, breast, colon, and pancreatic cancer (1-4). ... Diagnosis of ovarian cancer in early stages is very important and.

  11. Anal fissure - series (image)

    Science.gov (United States)

    Anal fissures are tears in the skin overlying the anal sphincter, usually due to increased tone of the anal sphincter muscles, and a failure of these muscle to relax. Anal fissures cause pain during defecation and bleeding from the anus.

  12. Toxoplasmosis: An Important Message for Cat Owners

    Science.gov (United States)

    ... role do cats play in the spread of toxoplasmosis? Cats get Toxoplasma infection by eating infected rodents, ... an infected cat may have defecated. What is toxoplasmosis? Toxoplasmosis is an infection caused by a microscopic ...

  13. 28 CFR 552.12 - Close observation.

    Science.gov (United States)

    2010-07-01

    ... prescribed and given by hospital personnel. No laxatives may be given except natural laxatives, i.e., coffee, prune juice, etc. (9) When the inmate needs to urinate and/or defecate, the inmate will be furnished an...

  14. Treatment of Encopresis in a Classroom Setting: A Case Study

    Science.gov (United States)

    Scott, E.

    1977-01-01

    This study describes the procedure and results of a behavior modification program carried out in the classroom and aimed at eliminating encopresis (involuntary defecation) in an 8-year-old boy. (Editor/RK)

  15. ANMS-ESNM position paper and consensus guidelines on biofeedback therapy for anorectal disorders

    NARCIS (Netherlands)

    Rao, S. S. C.; Benninga, M. A.; Bharucha, A. E.; Chiarioni, G.; Di Lorenzo, C.; Whitehead, W. E.

    2015-01-01

    Anorectal disorders such as dyssynergic defecation, fecal incontinence, levator ani syndrome, and solitary rectal ulcer syndrome are common, and affect both the adult and pediatric populations. Although they are treated with several treatment approaches, over the last two decades, biofeedback

  16. Visceral hypersensitivity in Irritable Bowel Syndrome:pathophysiological mechanisms

    NARCIS (Netherlands)

    Kerckhoffs, A.P.M.

    2009-01-01

    Irritable Bowel Syndrome (IBS) is a functional bowel disease characterized by abdominal pain or discomfort associated with a disordered defecation. No unique pathophysiological mechanism has been identified. It is most likely a multifactorial disease involving alterations in intestinal microbiota

  17. The Effects of Preoperative Oral Pregabalin and Perioperative Intravenous Lidocaine Infusion on Postoperative Morphine Requirement in Patients Undergoing Laparatomy

    Directory of Open Access Journals (Sweden)

    Senniye Ulgen Zengin

    2015-01-01

    Full Text Available OBJECTIVES: To evaluate and compare the effects of preoperative oral pregabalin and perioperative intravenous lidocaine infusion on postoperative morphine requirement, adverse effects, patients’ satisfaction, mobilization, time to first defecation and time to discharge in patients undergoing laparotomy.

  18. Study Protocol Effect of the consumption of a fermented dairy product containing Bifidobacterium lactis DN-173 010 on constipation in childhood: a multicentre randomised controlled trial (NTRTC: 1571)

    NARCIS (Netherlands)

    Tabbers, Merit M.; Chmielewska, Ania; Roseboom, Maaike G.; Boudet, Claire; Perrin, Catherine; Szajewska, Hania; Benninga, Marc A.

    2009-01-01

    ABSTRACT: BACKGROUND: Constipation is a frustrating symptom affecting 3% of children worldwide. Randomised controlled trials show that both polyethylene glycol and lactulose are effective in increasing defecation frequency in children with constipation. However, in 30-50%, these children reported

  19. Vapor Inhalation Exposure to Soman in Conscious Untreated Rats: Preliminary Assessment of Neurotoxicity

    Science.gov (United States)

    2015-12-22

    cholinergic crises including salivation , lacrimation, increased urination and defecation, and tremors were observed in all soman-exposed animals. Soman...Clinical/observational signs and body weight loss Clinical signs, including salivation , lacrimation, defecation, urination, facial clonus, tremors...additional 290 mL of working solution consisting of 50mM sodium phosphate buffer ( pH 8.0), 1mM acetylthio- choline iodide (ATC) and 0.2mM of the chromophore

  20. Factors determining outcome in children with chronic constipation and faecal soiling.

    Science.gov (United States)

    Loening-Baucke, V

    1989-07-01

    To evaluate factors which might contribute to treatment failure in children with chronic constipation and soiling, we evaluated the history, physical findings, defecation dynamics, and anorectal function in 97 patients. We treated them with milk of magnesia, high fibre diet, and bowel training techniques and evaluated outcome at one year when 43% had recovered. Recovery rates were similar for boys and girls. Fifty seven per cent of the patients had not recovered. This group at the outset had more frequent soiling episodes, more severe constipation, were less likely to defecate water filled rectal balloons and to relax the external sphincter during defecation. In general girls had more severe constipation, abdominal pain, and a previous urinary tract infection than boys. Girls were more compliant during treatment and had less frequent soiling episodes at one year. Stepwise logistic regression showed that severe constipation, abnormal contraction of the external sphincter and pelvic floor during attempted defecation, and inability to defecate the 100 ml balloon in less than or equal to 1 min was significantly related to treatment failure. Defecation of smaller balloons, volumes for threshold of rectal sensation, critical volume and rectal contraction, and compliance with treatment could not predict treatment failure.

  1. Switching to sanitation: Understanding latrine adoption in a representative panel of rural Indian households.

    Science.gov (United States)

    Coffey, Diane; Spears, Dean; Vyas, Sangita

    2017-09-01

    Open defecation, which is still practiced by about a billion people worldwide, is one of the most compelling examples of how place influences health in developing countries. Efforts by governments and development organizations to address the world's remaining open defecation would be greatly supported by a better understanding of why some people adopt latrines and others do not. We analyze the 2005 and 2012 rounds of the India Human Development Survey (IHDS), a nationally representative panel of households in India, the country which is home to 60% of the people worldwide who defecate in the open. Among rural households that defecated in the open in 2005, we investigate what baseline properties and what changes over time are associated with switching to latrine use between 2005 and 2012. We find that households that are richer or better educated, that have certain demographic properties, or that improved their homes over this period were more likely to switch to using a latrine or toilet. However, each of these effect sizes is small; overall switching to latrine use from open defecation is low; and no ready household-level mechanisms are available for sanitation programs to widely influence these factors. Our research adds to a growing consensus in the literature that the social context should not be overlooked when trying to understand and bring about change in sanitation behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Role of Community in Swachh Bharat Mission. Their Knowledge, Attitude and Practices of Sanitary Latrine Usage in Rural Areas, Tamil Nadu.

    Science.gov (United States)

    Anuradha, R; Dutta, Ruma; Raja, J Dinesh; Lawrence, D; Timsi, J; Sivaprakasam, P

    2017-01-01

    In most developing countries, open defecation is the 'way of life'. This practice is considered as the most serious health and environmental hazard. Prime Minister of India launched the "Swachh Bharat Mission" to accelerate the efforts for achieving universal sanitation coverage and to put focus on sanitation. To find the knowledge, attitude and practices of sanitary latrines usage in rural area, Tamil Nadu. This was a cross sectional study conducted among rural population in Kuthambakkam village, Tamil Nadu. There were a total of 1175 households in Kuthambakkam village. These households were serially numbered and of these a sample of 275 households were selected for the study using simple random sampling technique by lottery method. A structured questionnaire was used to collect information regarding the background characteristics, their knowledge, attitude and practices towards sanitary latrines usage. Descriptive statistics were calculated for background variables, the prevalence of sanitary latrines usage and open air defecation. Association between factors responsible for open air defecation was found by using chi square test. The prevalence of usage of household sanitary latrine and community latrines was 62.5% and 4.3% respectively. The prevalence of open air defecation among the study participants was 33.1%.Significant association was found between low standard of living and open air defecation practice. To solve the problem of underutilization of sanitary latrines, planning and conducting Information Education Communication activities is very essential. Effective political and administrative support is needed to scale up the sanitation program.

  3. Is Bifidobacterium breve effective in the treatment of childhood constipation? Results from a pilot study.

    Science.gov (United States)

    Tabbers, M M; de Milliano, I; Roseboom, M G; Benninga, M A

    2011-02-23

    Probiotics are increasingly used in the treatment of functional gastrointestinal disorders. Studies in constipated adults with a Bifidus yoghurt (containing Bifidobacterium breve, Bifidobacterium bifidum and Lactobacillus acidophilus) showed a significant increase in defecation frequency. The aim of this pilot study was to determine if Bifidobacterium breve is effective in the treatment of childhood constipation. Children, 3 to 16 years of age, with functional constipation according to the Rome III criteria were eligible for this study. During 4 weeks, children received one sachet of powder daily, containing 108- 1010 CFU Bifidobacterium breve. Furthermore, children were instructed to try to defecate on the toilet for 5-10 minutes after each meal and to complete a standardized bowel diary daily. The primary outcome measure was change in defecation frequency. Secondary outcome measures were stool consistency using the Bristol stool scale frequency of episodes of faecal incontinence, pain during defecation, frequency of abdominal pain, frequency of adverse effects (nausea, diarrhoea and bad taste), and frequency of intake of bisacodyl. Twenty children (75% male, mean age 7.4) were included in this pilot study. The defecation frequency per week significantly increased from 0.9 (0-2) at baseline to 4.9 (0-21) in week 4 (p Bifidobacterium breve is effective in increasing stool frequency in children with functional constipation. Furthermore it has a positive effect with respect to stool consistency, decreasing the number of faecal incontinence episodes and in diminishing abdominal pain. A randomized placebo controlled trial is required to confirm these data.

  4. Observed practices and perceived advantages of different hand cleansing agents in rural Bangladesh: ash, soil, and soap.

    Science.gov (United States)

    Nizame, Fosiul A; Nasreen, Sharifa; Halder, Amal K; Arman, Shaila; Winch, Peter J; Unicomb, Leanne; Luby, Stephen P

    2015-06-01

    Bangladeshi communities have historically used ash and soil as handwashing agents. A structured observation study and qualitative interviews on the use of ash/soil and soap as handwashing agents were conducted in rural Bangladesh to help develop a handwashing promotion intervention. The observations were conducted among 1,000 randomly selected households from 36 districts. Fieldworkers observed people using ash/soil to wash their hand(s) on 13% of occasions after defecation and on 10% after cleaning a child's anus. This compares with 19% of people who used soap after defecation and 27% after cleaning a child who defecated. Using ash/soil or soap was rarely (soap. © The American Society of Tropical Medicine and Hygiene.

  5. Clinical anatomy of fecal incontinence in women.

    Science.gov (United States)

    Kadam-Halani, Priyanka K; Arya, Lily A; Andy, Uduak U

    2017-10-01

    Fecal incontinence is a devastating condition that has a severe impact on quality of life. This condition disproportionately affects women and its incidence is increasing with the aging United States population. Fecal continence is maintained by coordination of a functioning anal sphincter complex, intact sensation of the anorectum, rectal compliance, and the ability to consciously control defecation. Particularly important are the puborectalis sling of the levator ani muscle complex and intact innervation of the central and peripheral nervous systems. An understanding of the intricate anatomy required to maintain continence and regulate defecation will help clinicians to provide appropriate medical and surgical management and diminish the negative impact of fecal incontinence. In this article, we describe the anatomic and neural basis of fecal continence and normal defecation as well as changes that occur with fecal incontinence in women. Clin. Anat. 30:901-911, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  6. The corner of the coloproctologist: What to ask to radiologist

    International Nuclear Information System (INIS)

    Bove, Antonio; Ciamarra, Paola

    2007-01-01

    Defecation disorders, fecal incontinence, often associated to urinary and genital dysfunction, represent symptoms of a large number of functional and structural alterations of pelvic floor. They can be evaluated by functional and morphologic tests. A perfect anatomic and functional knowledge of the anorectum and pelvic floor is indispensable for a correct diagnostic and therapeutic path. Incontinence due to sphincter lesions can be diagnosed only by imaging techniques. In defecation disorders the issue is complex because functional and anatomic alterations can coexist. The radiological diagnosis of dyssynergic defecation is a diagnosis of confidence that enhances its value when manometric and electromyographic evidence of pelvic dyssynergia are detected. When anatomical alterations are detected the aim is to understand their physiopathology, to make a more precise diagnosis and treatment, and to minimize the errors of an inappropriate therapy. Our attention is focused on the information provided by imaging techniques about anorectum and pelvic floor abnormalities for optimal therapeutic planning

  7. Disorders of the pelvic floor and anal sphincters; a gastroenterologist’s perspective

    Directory of Open Access Journals (Sweden)

    Eamonn M.M. Quigley, MD FRCP FACP FACG FRCPI

    2013-03-01

    Full Text Available The integration and coordination of the musculature of the pelvic floor and the anal sphincters is critical to two important physiological functions: defecation and continence. Consequently, disorders affecting the pelvic floor muscles, the anal sphincters, their innervation or their precise coordination will, depending on their nature, result either in obstructed defecation or fecal incontinence. Both of these disorders are much more common in females and the latter, in particular, is linked with parity. While the symptomatology, presentation and optimal mode of investigation of fecal incontinence are well standardized, considerable debate and controversy continues to surround the contributions of pelvic floor and anal sphincter dysfunction to chronic constipation and the optimal clinical approach to their investigation remains to be defined. In appropriately chosen cases surgical intervention may provide the best outcome for sufferers from incontinence; biofeedback approaches may be of value in both incontinence and obstructed defecation and surgery has little role to play in the latter.

  8. Clinical significance of anismus in encopresis.

    Science.gov (United States)

    Catto-Smith, A G; Nolan, T M; Coffey, C M

    1998-09-01

    Treatments designed to relieve paradoxical contraction of the anal sphincters during defecation (anismus) have had limited success in children with encopresis. This has raised doubts as to the clinical relevance of this diagnosis in childhood as anorectal dysfunction. Our aim was to determine whether, in patients who had treatment-resistant encopresis, the presence of electromyographic anismus was associated with increased faecal retention. Sixty-eight children with soiling (mean age 8.7+/-2.06 years) were assessed by clinical examination, abdominal radiography and then with anorectal manometry. Patients with electromyographic anismus (n=32; 47%) had significantly increased radiographic rectal faecal retention and were significantly less likely to be able to defecate water-filled balloons. There were no significant differences in response to prior therapy, history of primary encopresis, behavioural adjustment or in sociodemographic data. Our results suggest that electromyographic anismus is associated with obstructed defecation and faecal retention.

  9. Evaluation of postoperative anal functions using endoanal ultrasonography and anorectal manometry in children with congenital anorectal malformations.

    Science.gov (United States)

    Wang, Zhichao; Hu, Lijun; Jin, Xianqing; Li, Xiaoqing; Xu, Lixia

    2016-03-01

    The aim of this study was to assess the postoperative anorectal anatomy and function in children with congenital anorectal malformations (ARM) using endoanal ultrasonography (EUS) and anorectal manometry. This study included 47 children who had undergone posterior sagittal anorectoplasty (PSARP) or transperineal anorectoplasty for the repair of an ARM. Children were grouped according to symptoms of defecation disorder, including normal defecation, fecal soiling, fecal incontinence, and constipation. Ten children with no history of anal or rectal diseases served as healthy controls. A well-established scoring system was used for the evaluation of anal function and defecation disorder. EUS showed significant differences in the thickness of the interior sphincter between the ARM patients and the healthy controls (Pinterior sphincters between the PSARP group and transperineal anorectoplasty group (P>0.05). Anorectal manometry showed that the balloon volumes were significantly different between the surgical group and the control group (Pchildren with ARM. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. [Functional childhood gastrointestinal disorders. II. Constipation and solitary encopresis: physiology and pathophysiology].

    Science.gov (United States)

    van Ginkel, R; Büller, H A; Heymans, H S; Taminiau, J A; Boeckxstaens, G E; Benninga, M A

    2003-06-28

    The childhood prevalences of constipation and encopresis are 0.3-8% and 1-3% respectively. Following a recent stricter definition and classification, constipation and solitary encopresis are now recognised to be two separate entities. Constipation is characterised by infrequent defecation, often in combination with involuntary loss of faeces. Solitary encopresis most often occurs once a day after school hours. When there is no defecation, the frequency of encopresis increases, the abdominal pain becomes more severe and the appetite becomes less, until a large quantity of faeces is produced (often once per week). The physiology of the defecation and continence mechanism is complex and has only been unravelled in part. The multiple physiological mechanisms involved have a complementary and compensatory effect on each other. This makes it difficult to determine the underlying pathophysiological mechanisms of these functional disorders.

  11. The corner of the coloproctologist: What to ask to radiologist

    Energy Technology Data Exchange (ETDEWEB)

    Bove, Antonio [U.O. ' Gastroenterologia ed Endoscopia Digestiva' A.O.R.N. ' A. Cardarelli' , via Cardarelli 9, 80131 Naples (Italy)]. E-mail: Antonio.bove.50@alice.it; Ciamarra, Paola [U.O. ' Gastroenterologia ed Endoscopia Digestiva' A.O.R.N. ' A. Cardarelli' , via Cardarelli 9, 80131 Naples (Italy)

    2007-03-15

    Defecation disorders, fecal incontinence, often associated to urinary and genital dysfunction, represent symptoms of a large number of functional and structural alterations of pelvic floor. They can be evaluated by functional and morphologic tests. A perfect anatomic and functional knowledge of the anorectum and pelvic floor is indispensable for a correct diagnostic and therapeutic path. Incontinence due to sphincter lesions can be diagnosed only by imaging techniques. In defecation disorders the issue is complex because functional and anatomic alterations can coexist. The radiological diagnosis of dyssynergic defecation is a diagnosis of confidence that enhances its value when manometric and electromyographic evidence of pelvic dyssynergia are detected. When anatomical alterations are detected the aim is to understand their physiopathology, to make a more precise diagnosis and treatment, and to minimize the errors of an inappropriate therapy. Our attention is focused on the information provided by imaging techniques about anorectum and pelvic floor abnormalities for optimal therapeutic planning.

  12. Two thrush species as dispersers of Miconia prasina (Sw. DC. (Melastomataceae: an experimental approach

    Directory of Open Access Journals (Sweden)

    MAS. Alves

    Full Text Available We carried out a seed germination experiment using two thrush species in captivity. We compared the number of germinated seeds and germination time of control seeds (manually removed from fruits and ingested seeds of Miconia prasina by two bird species, Turdus albicollis and T. amaurochalinus, and also compared retention times of seeds by both thrush species. Control seeds germinated more frequently than those ingested for one species, T. albicollis. The germination time of ingested seeds by T. amaurochalinus was similar to the control seeds but seeds ingested by T. albicollis took longer to germinate than the controls. Both thrush species had a similar seed defecation pattern. The cumulative number of defecated seeds increased by 2 hours after fruit ingestion. At the end of the first 30 minutes both species had already defecated approximately 50% of the seeds ingested Our results suggest that both species could act as disperser agents of M. prasina.

  13. Efficacy of Lactic Acid Bacteria (LAB supplement in management of constipation among nursing home residents

    Directory of Open Access Journals (Sweden)

    Kim Jung

    2010-02-01

    Full Text Available Abstract Background Constipation is a significant problem in the elderly, specifically nursing home and/or extended-care facility residents are reported to suffer from constipation. Lactic acid bacteria (LAB are beneficial probiotic organisms that contribute to improved nutrition, microbial balance, and immuno-enhancement of the intestinal tract, as well as diarrhea and constipation effect. The objective of this study was to investigate the efficacy of this LAB supplement in the management of nursing home residents. Methods Nineteen subjects (8M, 11F; mean age 77.1 ± 10.1 suffering with chronic constipation were assigned to receive LAB (3.0 × 1011 CFU/g twice (to be taken 30 minutes after breakfast and dinner a day for 2 weeks in November 2008. Subjects draw up a questionnaire on defecation habits (frequency of defecation, amount and state of stool, and we collected fecal samples from the subjects both before entering and after ending the trial, to investigate LAB levels and inhibition of harmful enzyme activities. Results were tested with SAS and Student's t-test. Results Analysis of questionnaire showed that there was an increase in the frequency of defecation and amount of stool excreted in defecation habit after LAB treatment, but there were no significant changes. And it also affects the intestinal environment, through significantly increase (p p Conclusion LAB, when added to the standard treatment regimen for nursing home residents with chronic constipation, increased defecation habit such as frequency of defecation, amount and state of stool. So, it may be used as functional probiotics to improve human health by helping to prevent constipation.

  14. Effect of the consumption of a fermented dairy product containing Bifidobacterium lactis DN-173 010 on constipation in childhood: a multicentre randomised controlled trial (NTRTC: 1571).

    Science.gov (United States)

    Tabbers, Merit M; Chmielewska, Ania; Roseboom, Maaike G; Boudet, Claire; Perrin, Catherine; Szajewska, Hania; Benninga, Marc A

    2009-03-18

    Constipation is a frustrating symptom affecting 3% of children worldwide. Randomised controlled trials show that both polyethylene glycol and lactulose are effective in increasing defecation frequency in children with constipation. However, in 30-50%, these children reported abdominal pain, bloating, flatulence, diarrhoea, nausea and bad taste of the medication. Two recent studies have shown that the fermented dairy product containing Bifidobacterium lactis strain DN-173 010 is effective in increasing stool frequency in constipation-predominant irritable bowel syndrome patients with a defecation frequency fermented dairy product is effective in the treatment of constipated children with a defecation frequency fermented dairy product containing Bifidobacterium lactis DN-173 010 or a control product, twice a day, for 3 weeks. During the study all children are instructed to try to defecate on the toilet for 5-10 minutes after each meal (3 times a day) and daily complete a standardized bowel diary. Primary endpoint is stool frequency. Secondary endpoints are stool consistency, faecal incontinence frequency, pain during defecation, digestive symptoms (abdominal pain, flatulence), adverse effects (nausea, diarrhoea, bad taste) and intake of rescue medication (Bisacodyl). Rate of success and rate of responders are also evaluated, with success defined as > or = 3 bowel movements per week and or = 3 on the last week of product consumption. To demonstrate that the success percentage in the intervention group will be 35% and the success percentage in the control group (acidified milk without ferments, toilet training, bowel diary) will be 15%, with alpha 0.05 and power 80%, a total sample size of 160 patients was calculated. This study is aimed to show that the fermented dairy product containing Bifidobacterium lactis strain DN-173 010 is effective in increasing stool frequency after 3 weeks of product consumption in children with functional constipation and a defecation

  15. Epidemiology of Taenia solium in Nepal: is it influenced by the social characteristics of the population and the presence of Taenia asiatica?

    Science.gov (United States)

    Devleesschauwer, Brecht; Aryal, Arjun; Joshi, Durga Datt; Rijal, Suman; Sherchand, Jeevan Bahadur; Praet, Nicolas; Speybroeck, Niko; Duchateau, Luc; Vercruysse, Jozef; Dorny, Pierre

    2012-08-01

    The transmission of the zoonotic pork tapeworms Taenia solium and T. asiatica depends on a combination of specific risk factors, such as open defecation, backyard pig raising and the consumption of raw or undercooked pork and viscera. A community-based survey was conducted among 289 households in south-eastern Nepal to study the heterogeneity of these risk factor frequencies as a function of the social composition of the population. The frequency of open defecation, backyard pig raising and pork consumption differed significantly (P solium in Nepal, which appears to be more complex than thought so far. © 2012 Blackwell Publishing Ltd.

  16. 6-year-old girl with anorectal malformation: what is more important – anatomy or function?

    Directory of Open Access Journals (Sweden)

    Dmitry A. Morozov

    2018-02-01

    Full Text Available 6-year-old girl with first revealed anorectal malformation with perineal fistula was investigate. She did not have any complaints or history of constipation/soiling. Resting and squeeze anal pressure by anorectal manometry was normal. Recto-anal inhibitory reflex registered. There was no signs of dyssynergic defecation. The diameter of the colon by contrast enema was normal, megarectum did not detect, barium all came out after defecation. Muscles electro-identification confirmed external anal sphincter located posterior to the anus. After examination, council for Pediatric Surgery decided not to perform the surgery. Monitoring of the patient continued.

  17. Aganglionosis of rectum present in the adult

    International Nuclear Information System (INIS)

    Lorenzo Rodriguez, Tulio; Marti Corunna, Maria; Ferreira Moreno, Victor

    2009-01-01

    We report the case a female patient referred with the diagnostic criterion of colon tumor. Patients had a marked abdominal distension from more than a month, without defecation, although with gases ejection, and neither reports of pain nor vomits. At admission and to study in depth the anamnesis, she expressed that during its childhood had a delay to defecate. She was operated on with a rectum biopsy, and its study defined la presence of aganglionosis. The non habitual documentation of this disease present in adults emphasizes the singularity of this case. (author)

  18. [Comparison of efficacy on functional constipation treated with electroacupuncture of different acupoint prescriptions: a randomized controlled pilot trial].

    Science.gov (United States)

    Wu, Jia-Ni; Zhang, Bi-Ying; Zhu, Wen-Zeng; Du, Ruo-Sang; Liu, Zhi-Shun

    2014-06-01

    To evaluate preliminarily the efficacy on functional constipation treated with electroacupuncture of different acupoint prescriptions. One hundred and four patients were randomized into a front-mu and back-shu points group (19 cases), a he-sea points group (34 cases), a he-sea, front-mu and back-shu points group (26 cases) and a western medication control group (25 cases). In the front-mu and back-shu points group, electroacupuncture was applied at bilateral Tianshu (ST 25) and Dachangshu (BL 25). In the he-sea points group, electroacupuncture was applied at bilateral Quchi (LI 11) and Shangjuxu (ST 37). In the he-sea, front-mu and back-shu points group, electroacupuncture was applied at unilateral Tianshu (ST 25), Dachangshu (BL 25), Quchi (LI 11) and Shangjuxu (ST 37). In the three groups above, the treatment was given 5 times a week in the first two weeks and 3 times a week in the next two weeks. In the western medication control group, mosapride citrate tablets were prescribed for oral administration, 1 table (5 mg) each time, 3 times a day, continuously for 4 weeks. The period of research was 9 weeks, including 1 week for baseline evaluation, 4 weeks for treatment and 4 weeks for follow-up. The weekly defecation frequency was taken as primary index, while the defecation difficulty and life quality score were taken as the secondary indices for the efficacy evaluation after treatment and in follow-up. According to the intention-to-treat (ITT) analytic principle, 104 cases were all enrolled in the final analysis. (1) After treatment, the weekly frequency of defecation was all increased significantly in the four groups (P electroacupuncture groups was similar to that of western medication control group (P > 0.05). In follow-up, the increasing effect on the weekly frequency of defecation was maintained in the he-sea points group (P 0.05). (2) After treatment, defecation difficulty was relieved in the he-sea points group, the he-sea, front-mu and back-shu points

  19. '*Nigerian Veterinary Journal

    African Journals Online (AJOL)

    caught from different sampling sites in .... N and longitude 4· 25' - 4· 45' E and ... collected from the six sampling sites in the ... general methods of visual inspection of the .... drink and defecate in and around the lakeat ... hosts a big fish market. ... Practice in tropical countries. Cambridge University. Press, Cambridge: 434.

  20. Laxation of critically ill patients with lactulose or polyethylene glycol : a two-center randomized, double-blind, placebo-controlled trial

    NARCIS (Netherlands)

    van der Spoel, Johan I; Oudemans-van Straaten, Heleen M; Kuiper, Michael A; van Roon, Eric N; Zandstra, Durk F; van der Voort, Peter H J

    2007-01-01

    OBJECTIVE: To study whether lactulose or polyethylene glycol is effective to promote defecation in critically ill patients, whether either of the two is superior, and whether the use of enteral laxatives is related to clinical outcome. DESIGN: Double-blind, placebo-controlled, randomized study.

  1. Performance and behavioural characteristics of Pigs as affected by ...

    African Journals Online (AJOL)

    Behavioural attributes (%) observed include Lateral Lying (LL), Huddling (HD), Frequency of Defecating in Resting Area (FDRA), Frequency of Visiting Water Trough (FVWT) and Frequency of Using Wallow or Shower (FUWS). Also, Respiratory Rate (RR, breath per minute bpm), Rectal Temperature (RT, °C) and Skin ...

  2. Functionele gastro-intestinale ziektebeelden op de kinderleeftijd. II. Obstipatie en solitaire encopresis; fysiologie en pathofysiologie

    NARCIS (Netherlands)

    van Ginkel, R.; Büller, H. A.; Heymans, H. S.; Taminiau, J. A.; Boeckxstaens, G. E.; Benninga, M. A.

    2003-01-01

    The childhood prevalences of constipation and encopresis are 0.3-8% and 1-3% respectively. Following a recent stricter definition and classification, constipation and solitary encopresis are now recognised to be two separate entities. Constipation is characterised by infrequent defecation, often in

  3. Functionele gastro-intestinale ziektebeelden op de kinderleeftijd. III. Obstipatie en solitaire encopresis; diagnostiek en therapie

    NARCIS (Netherlands)

    van Ginkel, R.; Büller, H. A.; Heymans, H. S.; Taminiau, J. A.; Boeckxstaens, G. E.; Benninga, M. A.

    2003-01-01

    A detailed medical history in combination with a thorough physical examination, including rectal examination, form the cornerstone in the diagnostic work-up for children with functional defecation disorders. Additional investigations are often not informative and have only minor diagnostic or

  4. Clinical results of a brindley procedure: sacral anterior root stimulation in combination with a rhizotomy of the dorsal roots

    NARCIS (Netherlands)

    Martens, F.M.J.; Heesakkers, J.P.F.A.

    2011-01-01

    The Brindley procedure consists of a stimulator for sacral anterior-root stimulation and a rhizotomy of the dorsal sacral roots to abolish neurogenic detrusor overactivity. Stimulation of the sacral anterior roots enables micturition, defecation, and erections. This overview discusses the technique,

  5. Effect of Progesterone Therapy versus Diet Modification on ...

    African Journals Online (AJOL)

    2016 Journal of Basic and Clinical Reproductive Sciences | Published by Wolters Kluwer - Medknow. 82. Effect of ... stools is a common cause of painful defecation and fecal ... This is an open access article distributed under the terms of the Creative Commons ... constipation in pregnant women compared with placebo.

  6. TERRITORIAL BEHAVIOUR OF THE TSESSEBE (DAMALISCUS ...

    African Journals Online (AJOL)

    This paper forms part of a general bio-ecological study of the tsessebe .... The habit of tsessebe to defecate on their "stamping grounds" and ..... If a connict between two males is laken beyond the display sequence the two will break from the.

  7. Personal hygienic concerns in long term space flight

    Science.gov (United States)

    1973-01-01

    Data from numerous experiments and hardware inventories were scanned for Skylab personal hygiene use. A computer program was formulated for predicting the degree of man's involvement with personal hygiene needs. A tabulation was kept for such events as water intake, frequency of urination and defecation, accidents or events requiring clean-up, methods of clean-up, microbiological environment and shower water contamination.

  8. Usage and Barriers to Use of Latrines in a Ghanaian Peri-Urban Community

    DEFF Research Database (Denmark)

    Obeng, Peter A.; Keraita, Bernard; Oduro-Kwarteng, Sampson

    2015-01-01

    to latrines at home while the rest depended on communal latrines or practised open defecation. The ventilated improved pit latrine was the commonest technology used by 47 % of households with private latrines. The residents ranked safety and privacy as the most important factors that influenced their decision...

  9. Human waste

    NARCIS (Netherlands)

    Amin, Md Nurul; Kroeze, Carolien; Strokal, Maryna

    2017-01-01

    Many people practice open defecation in south Asia. As a result, lot of human waste containing nutrients such as nitrogen (N) and phosphorus (P) enter rivers. Rivers transport these nutrients to coastal waters, resulting in marine pollution. This source of nutrient pollution is, however, ignored in

  10. The biogeochemical role of baleen whales and krill in Southern Ocean nutrient cycling.

    Directory of Open Access Journals (Sweden)

    Lavenia Ratnarajah

    Full Text Available The availability of micronutrients is a key factor that affects primary productivity in High Nutrient Low Chlorophyll (HNLC regions of the Southern Ocean. Nutrient supply is governed by a range of physical, chemical and biological processes, and there are significant feedbacks within the ecosystem. It has been suggested that baleen whales form a crucial part of biogeochemical cycling processes through the consumption of nutrient-rich krill and subsequent defecation, but data on their contribution are scarce. We analysed the concentration of iron, cadmium, manganese, cobalt, copper, zinc, phosphorus and carbon in baleen whale faeces and muscle, and krill tissue using inductively coupled plasma mass spectrometry. Metal concentrations in krill tissue were between 20 thousand and 4.8 million times higher than typical Southern Ocean HNLC seawater concentrations, while whale faecal matter was between 276 thousand and 10 million times higher. These findings suggest that krill act as a mechanism for concentrating and retaining elements in the surface layer, which are subsequently released back into the ocean, once eaten by whales, through defecation. Trace metal to carbon ratios were also higher in whale faeces compared to whale muscle indicating that whales are concentrating carbon and actively defecating trace elements. Consequently, recovery of the great whales may facilitate the recycling of nutrients via defecation, which may affect productivity in HNLC areas.

  11. Urinary incontinence in the Netherlands : Prevalence and associated risk factors in adults

    NARCIS (Netherlands)

    Linde, J. Marleen; Nijman, Rien J. M.; Trzpis, Monika; Broens, Paul M. A.

    AimsTo determine the prevalence and risk factors associated with urinary incontinence (UI) among adults in the Netherlands. MethodsIn this cross-sectional study, we included 1257 respondents aged18 years, who completed the validated Groningen Defecation and Fecal Continence Checklist. UI was defined

  12. Factors associated with cholera in Kenya, 2008-2013 | Cowman ...

    African Journals Online (AJOL)

    The data were analyzed using a zero-inflated negative binomial regression model. Results: Multivariate analysis indicated that the risk of cholera was associated with open defecation, use of unimproved water sources, poverty headcount ratio and the number of health facilities per 100,000 population (p < 0.05).

  13. 7 CFR 1530.101 - Definitions.

    Science.gov (United States)

    2010-01-01

    ... obligation under this part falls on a weekend or Federal holiday, the obligation may be completed on the next... cane sugar and that can be marketed as commercial, industrial or retail sugar. Refiner means any person in the U.S. Customs Territory that refines raw cane sugar through affination or defecation...

  14. Colonic surgery with accelerated rehabilitation or conventional care

    DEFF Research Database (Denmark)

    Basse, Linda; Thorbøl, Jens Erik; Løssl, Kristine

    2004-01-01

    ) in another hospital. Outcomes were time to first defecation after surgery, postoperative hospital stay, and morbidity during the first postoperative month. RESULTS: Median age was 74 years (group 1) and 72 years (group 2). American Society of Anesthesiologists (ASA) score was significantly higher in group 2...

  15. Endozoochory by free-ranging, large herbivores : Ecological correlates and perspectives for restoration

    NARCIS (Netherlands)

    Mouissie, Albert; Vos, P; Verhagen, HMC; Bakker, JP

    2005-01-01

    Seed dispersal via ingestion and defecation by large herbivores provides a possible aid for ecological restoration of plant communities, by connecting source communities of target species with habitat restoration sites. It is also a possible threat due to invasion of weeds, grasses or exotic

  16. Clinical practice Diagnosis and treatment of functional constipation

    NARCIS (Netherlands)

    Tabbers, Merit M.; Boluyt, Nicole; Berger, Marjolein Y.; Benninga, Marc A.

    Childhood functional constipation has an estimated prevalence of 3% in the Western world and is probably the most common gastrointestinal complaint in children. It is characterized by infrequent painful defecation, faecal incontinence and abdominal pain. Only less than 5% of children with

  17. 54 1.Jerry George Mwakanyamale, 2Richard K.A Towett,3Fariji ...

    African Journals Online (AJOL)

    defecate as well as lay eggs to the environment 1. The female flea remains in the skin for up to five .... simple remedies. 2. Medical personnel in Korogwe should be empowered with knowledge and budget for controlling the disease. 3. More research is needed to establish the prevalence of the problem in Tanzania as a.

  18. Development and validation of a childhood self-efficacy for functional constipation questionnaire.

    Science.gov (United States)

    Santucci, N R; Hyman, P E; Karpinski, A; Rosenberg, A; Garguilo, D; Rein, L E; Amado-Feeley, A; Stoops, E; Herdes, R E; van Tilburg, M A L

    2018-03-01

    Children with functional constipation fear painful bowel movements leading to stool withholding behavior. Self-efficacy is the belief that an individual can accomplish a given goal. If children with constipation avoid defecation because they think that they are unable defecate comfortably, this low self-efficacy may prevent treatment success. The aim of the current study was to develop and validate a constipation specific self-efficacy scale. The self-efficacy for functional constipation questionnaire (SEFCQ) was developed by the authors and evaluated by 10 children and seven experts. Ninety-nine healthy children and 122 children with functional constipation completed the SEFCQ and three other questionnaires measuring related constructs. Minor changes were made in wording based on feedback from experts and children. Factor analysis showed two scales, a 7 item Action scale (Cronbach's α = 0.88) and a 7 item Emotion scale (Cronbach α = 0.86). The SEFCQ total scale correlated positively with general self-efficacy (r = .32, P self-efficacy questionnaire with good initial internal reliability, excellent face validity and adequate content validity. A low self-efficacy for defecation, may make the child resist their physical urge to defecate and hence, the need for further studies to assess its effect on treatment outcomes. © 2017 John Wiley & Sons Ltd.

  19. Regional analysis of sanitation performance in India

    NARCIS (Netherlands)

    Bose, Debasree; Dutta, Arijita

    2017-01-01

    India bears a disproportionate burden of open defecation in spite of investing more and more funds and ushering in several institutional efforts including the Swachh Bharat Mission in the recent past. A large share of rural households still lack basic sanitation facilities in India and members

  20. Anismus as a cause of functional constipation: Experience from Serbia

    Directory of Open Access Journals (Sweden)

    Jovanović Igor

    2015-01-01

    Full Text Available Backround/Aim. Anismus is paradoxal pressure increase or pressure decrease less than 20% of external anal sphincter during defecation straining. This study analyzed the presence of anismus as within a group of patients with the positive Rome III criteria for functional constipation. We used anorectal manometry as the determination method for anismus. Methods. We used anorectal waterperfused manometry in 60 patients with obstructive defecation defined by the Rome III criteria for functional constipation. We also analyzed anorectal function in 30 healthy subjects. Results. The presence of anismus is more frequent in the group of patients with obstructive defecation compared to the control group (a highly statistically significant difference, p < 0.01. Furthermore, we found that the Rome III criteria for functional constipation showed 90% accuracy in predicting obstructive defecation. We analyzed the correlation of anismus with the presence of weak external anal sphincter, rectal sensibility disorders, enlarged piles, diverticular disease and anatomic variations of colon. We found no correlation between them in any of these cases. Conclusion. There is a significant correlation between anismus and positive Rome III criteria for functional constipation. Anorectal manometry should be performed in all patients with the positive Rome III criteria for functional constipation.

  1. Treatment of Acute Fissure in Ano using Topical Glycerine Trinitrate ...

    African Journals Online (AJOL)

    RICHY

    longitudinal tear of the lower anal canal. It is one of the painful anal conditions resulting in a lot of ... constipation, doing so with a fresh tear more likely during next defecation. The aetiology varies from precipitous ... increases NO (nitric oxide) which is a very potent muscle relaxant. It acts on vascular smooth muscle there by.

  2. Development for Children, or Children for Development? Examining Children's Participation in School-Led Total Sanitation Programmes

    NARCIS (Netherlands)

    Joshi, Deepa; Kooy, Michelle; Ouden, van den Vincent

    2016-01-01

    The Community-Led Total Sanitation (CLTS) approach is said to have radically revolutionized a poorly performing sanitation sector. The claims of CLTS programmes successfully stopping practices of open defecation have only recently begun to be critically reviewed: scholars and practitioners are

  3. Effect of Progesterone Therapy versus Diet Modification on ...

    African Journals Online (AJOL)

    progesterone therapy) compared to Group A (diet modification) (54% [154/281] and 62.98% [177/281] vs. 89.76% [614/684] and 91.08% [623/684], respectively) (P = 0.04 and 0.03, respectively). Straining during defecation and manual maneuvers ...

  4. When the going gets tough: pediatric constipation and encopresis.

    Science.gov (United States)

    Philichi, Lisa

    2008-01-01

    Constipation and encopresis are two common conditions seen in the pediatric gastroenterology setting. Organic causes cannot be excluded although they are rarely diagnosed in infants and children with defecation disorders. To successfully treat these disorders, a combination of family education, disimpaction and maintenance medications, a well-balanced diet, and behavior management is essential.

  5. Weight loss in Oystercatchers Haematopus ostralegus on the roost and after capture

    NARCIS (Netherlands)

    Zwarts, L; Hulscher, JB; Zegers, PM

    1996-01-01

    This paper analyses the weight loss in Oystercatchers on the roost and after capture and attempts to investigate to what degree this weight loss is due to defecation of digested food, to dehydration and to utilisation of nutrient stores. The study emphasizes the need to record weight changes

  6. Biofeedback treatment of chronic constipation: myths and misconceptions.

    Science.gov (United States)

    Chiarioni, G

    2016-09-01

    Chronic constipation is a prevalent disorder with considerable impact on healthcare costs and quality of life. Most patients would respond to conservative measures in primary care. Patients with refractory constipation are commonly referred to dedicated centers for appropriate investigations and management. After testing, three main subtypes of constipation are commonly identified: normal colon transit, slow transit, and functional defecation disorders. The etiology of functional defecation disorders is consistent with maladaptive behavior, and biofeedback therapy has been considered a valuable treatment option. Being safe and only marginally invasive, retraining has been historically employed to manage all types of refractory constipation. There are a number of strongly held beliefs about biofeedback therapy that are not evidence-based. The aim of this review was to address these beliefs concerning protocols, efficacy, indications, and safety, with a special focus on the relevance of identifying patients with a functional defecation disorder who are ideal candidates for retraining. Randomized controlled trials support the effectiveness of biofeedback therapy for severe, refractory constipation due to functional defecation disorders. Limitations of the treatment are discussed, but biofeedback remains the safest option to successfully manage this hard-to-treat subtype of constipation.

  7. In Vivo Evaluation of Antidiarrhoeal Activity of the Seed of Swietenia ...

    African Journals Online (AJOL)

    Methods: Petroleum ether extract of the seeds of this plant, at graded doses (25, 50 & 100mg/kg body weight) was investigated for anti-diarrhoeal activity in term of reduction in the rate of defecation and consistency of faeces in castor oil induced diarrhoea. To understand the mechanism of its anti-diarrhoeal activity, its effect ...

  8. Pelvic floor function during and after first pregnancy

    NARCIS (Netherlands)

    Brummen, H.J. van

    2006-01-01

    This study evaluated the effects the first pregnancy and childbirth on the pelvic floor. Pregnancy and vaginal delivery can negatively affect pelvic floor function. Micturition symptoms, defecation symptoms and sexual dysfunction are all signs of an impaired pelvic floor function. These symptoms are

  9. Potential of endozoochorous seed dispersal by sheep in calcareous grasslands: correlations with seed traits.

    NARCIS (Netherlands)

    Kuiters, A.T.; Huiskes, H.P.J.

    2010-01-01

    Questions: What is the potential of sheep to serve as seed dispersers via ingestion and defecation in calcareous grasslands? Is the presence of viable seeds from dung correlated with specific seed traits? Location: Calcareous grasslands, South Limburg, the Netherlands/Belgium. Methods: Dung samples

  10. Absorption Kinetics of Subcutaneously Administered Ceftazidime in Hypoperfused Guinea Pigs

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Ebihara, MS

    2015-12-01

    Conclusions: The application of MWCs or WCs enhanced subcutaneous CAZ absorption by increasing blood flow. MWCs and WCs are considered to be safe and routine methods to induce defecation after surgery on the digestive system; thus, the combination of these methods and subcutaneous CAZ administration is a potential method for treating pneumonia in patients with SMID.

  11. Pathophysiology of pediatric fecal incontinence

    NARCIS (Netherlands)

    Di Lorenzo, Carlo; Benninga, Marc A.

    2004-01-01

    This article addresses the diagnosis and treatment of pediatric fecal incontinence in 4 main categories: (1) Functional fecal retention, the withholding of feces because of fear of painful defecation, results in constipation and overflow soiling. Treatment includes dietary changes, use of laxatives,

  12. Defoliation and Soil Compaction Jointly Drive Large-Herbivore Grazing Effects on Plants and Soil Arthropods on Clay Soil

    NARCIS (Netherlands)

    van Klink, R.; Schrama, M.; Nolte, S.; Bakker, J. P.; WallisDeVries, M. F.; Berg, M. P.

    In addition to the well-studied impacts of defecation and defoliation, large herbivores also affect plant and arthropod communities through trampling, and the associated soil compaction. Soil compaction can be expected to be particularly important on wet, fine-textured soils. Therefore, we

  13. Defoliation and Soil Compaction Jointly Drive Large-Herbivore Grazing Effects on Plants and Soil Arthropods on Clay Soil

    NARCIS (Netherlands)

    van Klink, R.; Schrama, M.; Nolte, S.; Bakker, Jan P.; WallisDeVries, M.F.; Berg, M.P.

    2015-01-01

    In addition to the well-studied impacts of defecation and defoliation, large herbivores also affect plant and arthropod communities through trampling, and the associated soil compaction. Soil compaction can be expected to be particularly important on wet, fine-textured soils. Therefore, we

  14. Transient gut retention and persistence of Salmonella through metamorphosis in the lesser mealworm, Alphitobius diaperinus (Coleoptera: Tenebrionidae)

    Science.gov (United States)

    his study was undertaken to determine the retention of Salmonella through Alphitobius diaperinus metamorphosis and the contribution of defecation to external contamination. Adults and larvae were exposed to a tagged Salmonella enterica and evaluated for external elimination. Each day for three wee...

  15. A PET study on cortical and subcortical control of pelvic floor musculature in women

    NARCIS (Netherlands)

    Blok, Bertil F.M.; Sturms, Leontien M.; Holstege, Gert

    1997-01-01

    The pelvic floor musculature plays an important role in behaviors such as defecation, micturition, mating behavior, and vomiting. A recent positron emission tomography (PET) study revealed that structures belonging to the emotional motor system are involved in the control of the pelvic floor during

  16. Role of community in swachh bharat mission. their knowledge, attitude and practices of sanitary latrine usage in rural areas, Tamil Nadu

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    R Anuradha

    2017-01-01

    Full Text Available Background: In most developing countries, open defecation is the 'way of life'. This practice is considered as the most serious health and environmental hazard. Prime Minister of India launched the “Swachh Bharat Mission” to accelerate the efforts for achieving universal sanitation coverage and to put focus on sanitation. Objective: To find the knowledge, attitude and practices of sanitary latrines usage in rural area, Tamil Nadu. Materials and Methods: This was a cross sectional study conducted among rural population in Kuthambakkam village, Tamil Nadu. There were a total of 1175 households in Kuthambakkam village. These households were serially numbered and of these a sample of 275 households were selected for the study using simple random sampling technique by lottery method. A structured questionnaire was used to collect information regarding the background characteristics, their knowledge, attitude and practices towards sanitary latrines usage. Descriptive statistics were calculated for background variables, the prevalence of sanitary latrines usage and open air defecation. Association between factors responsible for open air defecation was found by using chi square test. Results: The prevalence of usage of household sanitary latrine and community latrines was 62.5% and 4.3% respectively. The prevalence of open air defecation among the study participants was 33.1%.Significant association was found between low standard of living and open air defecation practice. Conclusions: To solve the problem of underutilization of sanitary latrines, planning and conducting Information Education Communication activities is very essential. Effective political and administrative support is needed to scale up the sanitation program.

  17. Is Bifidobacterium breve effective in the treatment of childhood constipation? Results from a pilot study

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    Roseboom MG

    2011-02-01

    Full Text Available Abstract Background Probiotics are increasingly used in the treatment of functional gastrointestinal disorders. Studies in constipated adults with a Bifidus yoghurt (containing Bifidobacterium breve, Bifidobacterium bifidum and Lactobacillus acidophilus showed a significant increase in defecation frequency. The aim of this pilot study was to determine if Bifidobacterium breve is effective in the treatment of childhood constipation. Methods Children, 3 to 16 years of age, with functional constipation according to the Rome III criteria were eligible for this study. During 4 weeks, children received one sachet of powder daily, containing 108- 1010 CFU Bifidobacterium breve. Furthermore, children were instructed to try to defecate on the toilet for 5-10 minutes after each meal and to complete a standardized bowel diary daily. The primary outcome measure was change in defecation frequency. Secondary outcome measures were stool consistency using the Bristol stool scale frequency of episodes of faecal incontinence, pain during defecation, frequency of abdominal pain, frequency of adverse effects (nausea, diarrhoea and bad taste, and frequency of intake of bisacodyl. Results Twenty children (75% male, mean age 7.4 were included in this pilot study. The defecation frequency per week significantly increased from 0.9 (0-2 at baseline to 4.9 (0-21 in week 4 (p Conclusion Bifidobacterium breve is effective in increasing stool frequency in children with functional constipation. Furthermore it has a positive effect with respect to stool consistency, decreasing the number of faecal incontinence episodes and in diminishing abdominal pain. A randomized placebo controlled trial is required to confirm these data.

  18. The effect of biofeedback therapy on dyssynergic constipation in patients with or without Irritable Bowel Syndrome.

    Science.gov (United States)

    Ahadi, Tannaz; Madjlesi, Faezeh; Mahjoubi, Bahar; Mirzaei, Rezvan; Forogh, Bijan; Daliri, Seyedeh Somayeh; Derakhshandeh, Seyed Majid; Behbahani, Roxana Bazaz; Raissi, G Reza

    2014-10-01

    The Rome II and III diagnostic criteria for dyssynergic defecation recommended the exclusion of irritable bowel syndrome (IBS). This study determined the effect of biofeedback therapy on dyssynergic constipation in patients with or without IBS. This study was a nonrandomized, single blinded, semi experimental study. Dyssynergic defecation patients with and without IBS were asked to undergo biofeedback therapy 8 sessions. The defecation dynamics and balloon expulsion time were evaluated before, at the end and 1 month after the biofeedback therapy. IBS symptoms were graded using a 4-point Likert scale. Mann-Whitney U-test, Wilcoxon test and Friedman test were applied to analyze data using SPSS software package (SPSS Inc., Chicago, IL, USA). After the biofeedback therapy, the IBS symptoms have been decreased significantly (the median of 2 before and 1 after therapy, P anismus index in IBS group by the mean of 0.75 ± 0.31, 0.28 ± 0.07 and 0.28 ± 0.06 in three phases, respectively. Similar results were found in non-IBS patients (the mean of 0.74 ± 0.32, 0.28 ± 0.08, 0.27 ± 0.08 in three phases, respectively). The symptoms of constipation (sensation of incomplete evacuation, difficult and painful defecation), defecation facilitative manual maneuver frequency, pelvic floor muscles resting amplitude and strain amplitude decreased and squeezing amplitude improved significantly after biofeedback therapy in both groups with and without IBS (P 0.05) with respect to outcome. No complication was observed in treatment groups. Dyssynergic constipation patients with and without IBS will likely benefit from biofeedback therapy.

  19. Assessment of the implementation of community-led total sanitation, hygiene, and associated factors in Diretiyara district, Eastern Ethiopia.

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    Roba Argaw Tessema

    Full Text Available Based on the sustainable development goals, the United Nations plans to achieve equitable sanitation and hygiene for all and to end open defecation by 2030. In Ethiopia, 60% to 80% of health problems are due to communicable diseases attributable to unsafe water supply, unhygienic and unsanitary waste management, which are directly linked to the practice of open defecation. This study has aimed at assessing the implementation of community-led total sanitation and hygiene (CLTSH and associated factors. A community-based cross-sectional study design involving 420 of the 7,225 households found in Diretiyara district was conducted in June 2014. Both quantitative and qualitative data were collected. Using Logistic Regressions, bivariate and multivariate analyses were computed. This study showed that 66% of the respondents have knowledge of CLTSH. Eighty-nine percent of the respondents have latrine, of which 78% were constructed after the introduction of CLTSH. Eleven percent of the respondents reported to have defected in the open field and 15% of them reported that they had been recently exposed to diarrhea diseases. The occurrence of diarrheal disease was significantly associated with the extent of latrine ownership [AOR = 2.48; 95% CI 1.00, 6.12]. Attitude and perception parameters were significantly associated with consistent latrine utilization. Respondents who agreed that "Open defecation is preferred due to the unpleasant smell and heat from the Latrine'' [COR = 0.58; 95% CI 0.34, 0.99] were 58% less likely to use the latrine consistently. In conclusion, CLTSH has increased the extent of latrine ownership and decreased practice of open defecation, and yet, intermittent latrine use and poor hygienic practice were reported. Although some fundamental misconceptions were reported, the majority of the respondents have accepted CLTSH approach as a means to ending open defecation in their village. Health extension workers and local authorities should

  20. Impact of Indian Total Sanitation Campaign on latrine coverage and use: a cross-sectional study in Orissa three years following programme implementation.

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    Sharmani Barnard

    Full Text Available BACKGROUND: Faced with a massive shortfall in meeting sanitation targets, some governments have implemented campaigns that use subsidies focused on latrine construction to overcome income constraints and rapidly expand coverage. In settings like rural India where open defecation is common, this may result in sub-optimal compliance (use, thereby continuing to leave the population exposed to human excreta. METHODS: We conducted a cross-sectional study to investigate latrine coverage and use among 20 villages (447 households, 1933 individuals in Orissa, India where the Government of India's Total Sanitation Campaign had been implemented at least three years previously. We defined coverage as the proportion of households that had a latrine; for use we identified the proportion of households with at least one reported user and among those, the extent of reported use by each member of the household. RESULTS: Mean latrine coverage among the villages was 72% (compared to <10% in comparable villages in the same district where the Total Sanitation Campaign had not yet been implemented, though three of the villages had less than 50% coverage. Among these households with latrines, more than a third (39% were not being used by any member of the household. Well over a third (37% of the members of households with latrines reported never defecating in their latrines. Less than half (47% of the members of such households reported using their latrines at all times for defecation. Combined with the 28% of households that did not have latrines, it appears that most defecation events in these communities are still practiced in the open. CONCLUSION: A large-scale campaign to implement sanitation has achieved substantial gains in latrine coverage in this population. Nevertheless, gaps in coverage and widespread continuation of open defecation will result in continued exposure to human excreta, reducing the potential for health gains.

  1. Is encopresis always the result of constipation?

    Science.gov (United States)

    Benninga, M A; Büller, H A; Heymans, H S; Tytgat, G N; Taminiau, J A

    1994-01-01

    Encopresis is often the result of chronic constipation in the majority of paediatric patients. In clinical practice, however, encopresis is also seen without constipation and it is unknown whether these two clinical variants are based on similar or different pathophysiological mechanisms, requiring different therapeutic approaches. We analysed clinical symptoms, colonic transit time (CTT), orocaecal transit time (OCTT), anorectal manometric profiles, and behavioural scores. Patients were divided into two groups, one consisted of 111 children with paediatric constipation, and another group of 50 children with encopresis and/or soiling without constipation. Significant clinical differences in children with encopresis/soiling existed compared with children with paediatric constipation regarding: bowel movements per week, the number of daytime soiling episodes, the presence of night time soiling, the presence and number of encopresis episodes, normal stools, pain during defecation, abdominal pain, and good appetite. Total and segmental CTT were significantly prolonged in paediatric constipation compared with encopresis/soiling, 62.4 (3.6-384) and 40.2 (10.8-104.4) hours, respectively. No significant differences were found in OCTT. Among the two groups, all manometric parameters were comparable, except for a significantly higher threshold of sensation in children with paediatric constipation. The defecation dynamics were abnormal in 59% and 46% in paediatric constipation and encopresis/soiling, respectively, and were significantly different from controls. Using the child behaviour checklist no significant differences were found when comparing children with paediatric constipation and encopresis/soiling, while both patient groups differed significantly from controls. In conclusion, our findings support the concept of the existence of encopresis as a distinct entity in children with defecation disorders. Identification of such children is based on clinical symptoms, that

  2. Effect of the consumption of a fermented dairy product containing Bifidobacterium lactis DN-173 010 on constipation in childhood: a multicentre randomised controlled trial (NTRTC: 1571

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    Perrin Catherine

    2009-03-01

    Full Text Available Abstract Background Constipation is a frustrating symptom affecting 3% of children worldwide. Randomised controlled trials show that both polyethylene glycol and lactulose are effective in increasing defecation frequency in children with constipation. However, in 30–50%, these children reported abdominal pain, bloating, flatulence, diarrhoea, nausea and bad taste of the medication. Two recent studies have shown that the fermented dairy product containing Bifidobacterium lactis strain DN-173 010 is effective in increasing stool frequency in constipation-predominant irritable bowel syndrome patients with a defecation frequency Methods/design It is a two nation (The Netherlands and Poland double-blind, placebo-controlled randomised multicentre trial in which 160 constipated children (age 3–16 years with a defecation frequency Bifidobacterium lactis DN-173 010 or a control product, twice a day, for 3 weeks. During the study all children are instructed to try to defecate on the toilet for 5–10 minutes after each meal (3 times a day and daily complete a standardized bowel diary. Primary endpoint is stool frequency. Secondary endpoints are stool consistency, faecal incontinence frequency, pain during defecation, digestive symptoms (abdominal pain, flatulence, adverse effects (nausea, diarrhoea, bad taste and intake of rescue medication (Bisacodyl. Rate of success and rate of responders are also evaluated, with success defined as ≥ 3 bowel movements per week and ≤1 faecal incontinence episode over the last 2 weeks of product consumption and responder defined as a subject reporting a stool frequency ≥ 3 on the last week of product consumption. To demonstrate that the success percentage in the intervention group will be 35% and the success percentage in the control group (acidified milk without ferments, toilet training, bowel diary will be 15%, with alpha 0.05 and power 80%, a total sample size of 160 patients was calculated. Conclusion This

  3. Anismus in chronic constipation.

    Science.gov (United States)

    Preston, D M; Lennard-Jones, J E

    1985-05-01

    Among patients complaining of constipation, a group can be defined in which there is slow whole gut transit shown by retention of radiopaque markers but a rectum and colon of normal width judged by measurements of barium enema radiographs compared with control observations. It is not known whether their symptoms are due to an abnormality of colonic motility or to a failure of the defecatory mechanism. Defecation was simulated experimentally in a group of these patients by asking them to expel a water-filled rectal balloon. The constipated patients were not able to expel the balloon, whereas normal subjects could do so. Electromyography of the striated pelvic floor muscles during attempts at expulsion of the balloon in the constipated patients showed failure of the normal inhibition of resting activity. Failure of external and sphincter relaxation on attempted defecation may contribute to the symptoms of some patients who complain of constipation.

  4. [Therapy of hemorrhoidal disease].

    Science.gov (United States)

    Herold, A

    2006-08-01

    Hemorrhoidal disease is one of the most frequent disorders in western countries. The aim of individual therapy is freedom from symptoms achieved by normalisation of anatomy and physiology. Treatment is orientated to the stage of disease: haemorrhoids 1 are treated conservatively. In addition to high-fibre diet, sclerotherapy is used. Haemorrhoids 2 prolapse during defecation and return spontaneously. First-line treatment is rubber band ligation. Haemorrhoids 3 that prolapse during defecation have to be digitally reduced, and the majority need surgery. For segmental disorders, haemorrhoidectomy according to Milligan-Morgan or Ferguson is recommended. In circular disease, Stapler hemorrhoidopexy is now the procedure of choice. Using a therapeutic regime according to the hemorrhoidal disease classification offers high healing rates and low rates of complications and recurrence.

  5. [Functional childhood gastrointestinal disorders. III. Constipation and solitary encopresis; diagnostic work-up and therapy].

    Science.gov (United States)

    van Ginkel, R; Büller, H A; Heymans, H S; Taminiau, J A; Boeckxstaens, G E; Benninga, M A

    2003-06-28

    A detailed medical history in combination with a thorough physical examination, including rectal examination, form the cornerstone in the diagnostic work-up for children with functional defecation disorders. Additional investigations are often not informative and have only minor diagnostic or therapeutic implications. Medical therapy in children with functional constipation and solitary encopresis is primarily based on clinical experience. In both patient groups, the role of education, the use of diary cards and toilet training is important. In some patients behaviour interventions are important. Oral laxatives are the basis of treatment of children with functional constipation, whereas they are contra-indicated in children with solitary encopresis. In both groups, biofeedback training appears to be of little additional benefit. Long-term follow-up of children with functional defecation disorders shows that complaints continue far beyond puberty in many children.

  6. Polyethylene Glycol 3350 With Electrolytes Versus Polyethylene Glycol 4000 for Constipation: A Randomized, Controlled Trial

    OpenAIRE

    Bekkali, Noor L.H.; Hoekman, Daniël R.; Liem, Olivia; Bongers, Marloes E.J.; van Wijk, Michiel P.; Zegers, Bas; Pelleboer, Rolf A.; Verwijs, Wim; Koot, Bart G.P.; Voropaiev, Maksym; Benninga, Marc A.

    2017-01-01

    ABSTRACT Objective: The long-term efficacy and safety of polyethylene glycol (PEG) in constipated children are unknown, and a head-to-head comparison of the different PEG formulations is lacking. We aimed to investigate noninferiority of PEG3350 with electrolytes (PEG3350 + E) compared to PEG4000 without electrolytes (PEG4000). Methods: In this double-blind trial, children aged 0.5 to 16 years with constipation, defined as a defecation frequency of

  7. Combinations of laxatives and green banana biomass on the treatment of functional constipation in children and adolescents: a randomized study.

    Science.gov (United States)

    Cassettari, Vanessa Mello Granado; Machado, Nilton Carlos; Lourenção, Pedro Luiz Toledo de Arruda; Carvalho, Marry Assis; Ortolan, Erika Veruska Paiva

    2018-01-05

    Evaluate the effect of combinations of green banana biomass and laxatives in children and adolescents with chronic constipation. This was a randomized study of 80 children and adolescents with functional constipation according to the Rome IV Criteria, who were divided into five groups: (1) green banana biomass alone; (2) green banana biomass plus PEG 3350 with electrolytes; (3) green banana biomass plus sodium picosulfate; (4) PEG 3350 with electrolytes alone; and (5) sodium picosulfate alone. Primary outcome measure was the reduction of the proportion of patients with Bristol Stool Form Scale ratings 1 or 2. Secondary outcome measures were: increase of the proportion of >3 bowel movements/week and reduction of the proportion of fecal incontinence, straining on defecation, painful defecation, blood in stool, abdominal pain, and decreased laxative doses. On consumption of green banana biomass alone, a statistically significant reduction was observed in the proportion of children with Bristol Stool Form Scale rating 1 or 2, straining on defecation, painful defecation, and abdominal pain. Conversely, no reduction was observed in fecal incontinence episodes/week, blood in stool, and no increase was observed in the proportion of children with >3 bowel movements/week. The percentage of children who required decreased laxative dose was high when green banana biomass was associated with sodium picosulfate (87%), and PEG 3350 with electrolytes (63%). Green banana biomass alone and associated with laxatives was well tolerated, and no adverse effects were reported. Green banana biomass is advantageous as an adjunct therapy on functional constipation, mainly for reducing doses of laxatives. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  8. A RANDOMISED TRIAL OF LIQUID PARAFFIN VERSUS LACTULOSE IN THE TREATMENT OF CHRONIC FUNCTIONAL CONSTIPATION IN CHILDREN

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    F. Farahmand

    2007-07-01

    Full Text Available "nLiquid paraffin has been suggested as a good laxative comparing to lactulose as a treatment option in pediatric constipation. This study was performed to compare liquid paraffin with lactulose in pediatric constipation. A total of 247 patients (127 males and 120 females aged 2-12 years (mean 4.1 ± 2.7 years with chronic functional constipation were included in an 8 week, randomized, controlled trial. After faecal disimpaction, patients received oral liquid paraffin (1-2 cc/kg/day or lactulose (1-2 cc/kg/day. Primary outcome measures were: defecation and encopresis frequency per week and successful treatment after 8 weeks. Success was defined as a defecation frequency ≥ 3 per week and encopresis ≤ 1 every two weeks. Secondary outcome measures were side effects during 8 weeks of treatment. A significant increase in defecation frequency, liquid paraffin group, 3 pre, versus, 12 post treatment per week and lactulose group: 3 pre, versus 8 post, per week was found. A significant decrease in encopresis frequency, liquid paraffin: 10 pre, versus 1 post per week; lactulose: 9 pre, versus 3 post per week, was found in both groups. However success was significantly higher in the liquid paraffin group (85% compared with the lactulose group (29%. Liquid paraffin patients reported less abdominal pain, straining and pain at defecation than children using lactulose. Liquid paraffin is more effective than lactulose in the treatment of chronic functional constipation of childhood. It provided a higher success rate with fewer side effects. Liquid paraffin should be the laxative of first choice in childhood functional constipation.

  9. There is an agreement between constipation referred and that documented by objective criteria?

    OpenAIRE

    Isaac José Felippe Corrêa Neto; Ana Luiza Chaves Maneira; Noelle Breda Teixeira; Beatriz Doine Vettorato; Mariana Campello de Oliveira; Tatielle Alves Trivelato Menezes; Laercio Robles

    2016-01-01

    Introduction: Chronic constipation is the most common digestive complaint at the doctor's office, with high prevalence in the population. However, many patients – and even those physicians not so familiar with pelvic floor disorders–define and consider constipation based on intestinal functionality and stool consistency. But symptoms of incomplete defecation, digital maneuvers, abdominal discomfort, and straining should not be overlooked. Objectives: To investigate the correlation between con...

  10. There is an agreement between constipation referred and that documented by objective criteria?

    OpenAIRE

    Neto, Isaac José Felippe Corrêa; Maneira, Ana Luiza Chaves; Teixeira, Noelle Breda; Vettorato, Beatriz Doine; de Oliveira, Mariana Campello; Menezes, Tatielle Alves Trivelato; Robles, Laercio

    2016-01-01

    Abstract Introduction Chronic constipation is the most common digestive complaint at the doctor's office, with high prevalence in the population. However, many patients – and even those physicians not so familiar with pelvic floor disorders–define and consider constipation based on intestinal functionality and stool consistency. But symptoms of incomplete defecation, digital maneuvers, abdominal discomfort, and straining should not be overlooked. Objectives To investigate the co...

  11. The estimation of the value and mobility of Parks' angle in case-series of patients with defecatory disorders. Prospective clinical examination supplemented with the defecographic examination

    International Nuclear Information System (INIS)

    Kolodziejczak, M.; Grochowicz, M.; Sudol-Szopinska, I.; Bochenek, A.; Swiatlowska, M.

    2006-01-01

    Background. Defecography is used by a majority of colorectal surgeons for it is the only method for anatomic and dynamic studies of the act of defecation. The method provides information on different aspects of anorectal and pelvic floor function and offers the possibility of visualizing the development of anatomic abnormalities. Methods. We analyzed the defecography findings carried out at 56 patients (50 female and 6 male) from 24 to 83 years of age (the average age 58.3 years) with proctologic ailments such as: faecal incontinence, sensation of obstruction in the rectum, constipations, rectal prolapse, solitary ulceration of rectum. The values of Parks' angle (ARA - the anorectal angle) were measured at rest, at strain and during defecation. Other parameters measured included: duration of sphincter relaxation, overall duration of defecation, mobility of the pelvic diaphragm. Results. Abnormal values of Parks' angle at rest and at strain were found in patients with the following problems: faecal incontinence, sensation of obstruction in rectum and constipation. However, they did not turn out to be characteristic for patients with rectal prolapse. Defecography has helped to detect concomitant rectocele in patients suffering from constipation and sensation of obstruction in the rectum. Defecography has also proved to be effective in the evaluation of patients who suffered from solitary ulceration of rectum. During the examination of these patients it has been observed that Parks' angle in various phases of defecation has flattened. The duration of sphincter relaxation in the studied group was changeable and did not depend on the kind of pathology. Conclusions. Defecography is one of the examinations which can be helpful in the evaluation of patient's motor functions both before and after the operation. (author)

  12. An Unusual Cause of Rectal Stenosis

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    Maja Gruber

    2016-08-01

    Full Text Available Solitary rectal ulcer syndrome (SRUS is a benign disease that is often misdiagnosed. It is characterized by a combination of symptoms, endoscopic findings and histology. Patients present with constipation, rectal bleeding, mucous discharge, pain and a sensation of incomplete defecation. There are many different manifestations of this disease, with or without rectal prolapse. We report an unusual presentation of SRUS as a circular stenosis in a middle-aged male.

  13. [Observation on therapeutic effect of electroacupuncture at Tianshu (ST 25) with deep needling technique on functional constipation].

    Science.gov (United States)

    Wang, Cheng-Wei; He, Hong-Bo; Li, Ning; Wen, Qian; Liu, Zhi-Shun

    2010-09-01

    To probe into a better therapeutic method for functional constipation. Ninety-five cases of functional constipation were randomly divided into deep puncture at ST 25 group (48 cases), shallow puncture at ST 25 group (24 cases) and medication group (23 cases). In deep puncture at ST 25 group, Tianshu (ST 25) was punctured deeply to the peritoneum, with electric stimulation. In shallow puncture at ST 25 group, Tianshu (ST 25) was punctured shallowly, 5 mm beneath the skin, with electric stimulation. In medication group, Duphalac was administered orally. These cases were treated continuously for 4 weeks in 3 groups and followed up for 6 months. It was to observe the numbers of person who had defecation 4 times a week, difference in weekly defecation frequency and the difference in the Cleveland Clinic Score (CCS). In deep puncture at ST 25 group, the frequency of weekly defecation and the numbers of person who had defecation 4 times a week increased and CCS decreased, which were similar to the efficacy in shallow puncture at ST 25 group (all P > 0.05). But the efficacy of both ST 25 groups was superior to that in medication group (both P deep puncture at ST 25 group acted more quickly than either shallow puncture at ST 25 group or medication group and its efficacy remained much longer. The deep puncture at ST 25 with electric stimulation presents similar efficacy on functional constipation as shallow puncture at ST 25, but it acts more quickly than shallow puncture at ST 25, both of them are more advantageous than medication and the long-term efficacy is better.

  14. Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction

    OpenAIRE

    Faubion, Stephanie S.; Shuster, Lynne T.; Bharucha, Adil E.

    2012-01-01

    Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and ...

  15. An ethological study of young horses

    OpenAIRE

    Pavla Šišková; Iva Jiskrová; Vladimír Mikule

    2006-01-01

    In the present study called “An Ethological Study of Young Horses” we focused on the behaviour of foals from their birth to separation from their mother. We observed and analysed their behaviour and daily activities, and from the achieved results we drew conclusions for practical horse breeding. We studied the following forms of behaviour of the foals: feeding behaviour (sucking, drinking, eating roughage and concentrates, gleaning, coprophagia), defecation and micturition, comfortable behavi...

  16. Cyclical constipation

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    C K Adarsh

    2014-01-01

    Full Text Available Intestinal endometriosis is a rare disease. It can have a varied presentation. It is difficult to differentiate it from malignancy by clinical, endoscopic or imaging features. We present a 35-year-old nulliparous married lady, who presented to us with constipation, painful defecation and bled per rectum for last 3 years. She was diagnosed to have endometriosis with gold standard laparoscopy and managed with medical line of therapy.

  17. Pendekatan Cart untuk Mendapatkan Faktor yang Mempengaruhi Terjangkitnya Penyakit Demam Tifoid di Aceh Utara

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    Dina Yuanita

    2010-05-01

    research conducted to find factors that influence the outbreak of typhoid fever in NAD. research using the CART Method. The results of the analysis indicate that the main factor causing typhoid fever was drinking water reservoirs. The other factors are waste water reservoirs, the physical quality of drinking water, a habit washing hands with soap before eating, the bowel, the dump, gender, socioeconomic status, habits of washing hands with soap after defecation and health education.

  18. Atresia coli in a Japanese black calf diagnosed by a barium sulphate enema contrast radiograph in the standing position: a case report

    International Nuclear Information System (INIS)

    Abouelnasr, K.; Ishii, M.; Inokuma, H.; Kobayashi, Y.; Lee, K.; Yamada, K.

    2012-01-01

    A three day-old Japanese black calf was admitted with a history of abdominal distension and absence of defecation. Dilated loops of the small intestine and hypoplasia of the colon and rectum was observed upon a contrast radiographic examination in the standing position. At necropsy atresia coli with undeveloped rectum and patent anal opening was found. We conclude that a contrast radiograph in the standing position is useful for diagnosing atresia coli in such cases

  19. RUSSIAN AND INTERNATIONAL RECOMMENDATIONS ON MANAGEMENT OF CONSTIPATIONS IN CHILDREN

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    I. N. Zakharova

    2014-01-01

    Full Text Available Among various disorders of gastrointestinal tract deserving special attention of pediatricians constipations play one of the main roles. In Russian pediatrics there are no unified criteria to assessment of the normal frequency of defecation in children. The article contains recommendations on diagnostics and treatment of constipations in children according to the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN, as well as updated recommendations of the British National Institute for Health and Care Excellence.

  20. Research Note. Occurrence of gastrointestinal helminths in commensal rodents from Tabasco, Mexico

    OpenAIRE

    Cigarroa-Toledo N.; Santos-Martinez Y. De Los; Zaragoza-Vera C. V.; Garcia-Rodriguez M. M.; Baak-Baak C. M.; Machain-Williams C.; Garcia-Rejon J. E.; Panti-May J. A.; Torres-Chable O. M.

    2017-01-01

    The aim of this study was to determine the prevalence and species composition of helminths in commensal rodents captured inside private residences in the city of Villahermosa in Tabasco, Mexico. Trapping was performed at each house for three consecutive nights from October to December 2015. Fifty commensal rodents were captured: 23 Rattus norvegicus, 16 Mus musculus and 11 Rattus rattus. Rodents were transported alive to the laboratory and held in cages until they defecated. Feces were analyz...

  1. Selected problems associated with the treatment and care for patients with colostomy – part 2

    OpenAIRE

    Muzyczka, Katarzyna; Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and maste...

  2. Treatment of hemorrhoids: A coloproctologist’s view

    OpenAIRE

    Lohsiriwat, Varut

    2015-01-01

    Hemorrhoids is recognized as one of the most common medical conditions in general population. It is clinically characterized by painless rectal bleeding during defecation with or without prolapsing anal tissue. Generally, hemorrhoids can be divided into two types: internal hemorrhoid and external hemorrhoid. External hemorrhoid usually requires no specific treatment unless it becomes acutely thrombosed or causes patients discomfort. Meanwhile, low-graded internal hemorrhoids can be effectivel...

  3. Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions

    Directory of Open Access Journals (Sweden)

    Sthela Maria Murad-Regadas

    2011-12-01

    Full Text Available CONTEXT: The correlation between vaginal delivery, age and pelvic floor dysfunctions involving obstructed defecation is still a matter of controversy. OBJECTIVES: To determine the influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions in women with obstructed defecation syndrome. METHODS: Four hundred sixty-nine females with obstructed defecation syndrome were retrospectively evaluated using dynamic 3D ultrasonography to quantify posterior pelvic floor dysfunctions (rectocele grade II or III, rectal intussusception, paradoxical contraction/non-relaxation of the puborectalis and entero/ sigmoidocele grade III. In addition, sphincter damage was evaluated. Patients were grouped according to age (50y and stratified by mode of delivery and parity: group I (50y: 251 patients, 60 nulliparous, 148 vaginal delivery and 43 only caesarean section. Additionally, patients were stratified by number of vaginal deliveries: 0 - nulliparous (n = 135, 1 - vaginal (n = 46, >1 - vaginal (n = 166. RESULTS: Rectocele grade II or III, intussusception, rectocele + intussusception and sphincter damage were more prevalent in Group II (P = 0.0432; P = 0.0028; P = 0.0178; P = 0.0001. The stratified groups (nulliparous, vaginal delivery and cesarean did not differ significantly with regard to rectocele, intussusception or anismus in each age group. Entero/sigmoidocele was more prevalent in the vaginal group 50y. No correlation was found between rectocele and the number of vaginal deliveries. CONCLUSION: Higher age (>50 years was shown to influence the prevalence of significant rectocele, intussusception and sphincter damage in women. However, delivery mode and parity were not correlated with the prevalence of rectocele, intussusception and anismus in women with obstructed defecation.

  4. Defecography - analysis of qualitative findings

    International Nuclear Information System (INIS)

    Schott, U.; Braunschweig, R.; Claussen, C.D.

    1994-01-01

    The defectography is an examination of the anorectal function in defecatory disorder. The defecography has a diagnostic impact on disease, which only emerge during defecation as intussusception, enterocele, prolapse or sphincter dysfunction. Other findings as rectocele or descending pelvic floor are ambiguous concerning clinical relevance. The interpretation of defecography should include patient's history and clinical findings and - if available -endoscopic and manometric findings. (orig.) [de

  5. Excellent response rate of anismus to botulinum toxin if rectal prolapse misdiagnosed as anismus ('pseudoanismus') is excluded.

    Science.gov (United States)

    Hompes, R; Harmston, C; Wijffels, N; Jones, O M; Cunningham, C; Lindsey, I

    2012-02-01

    Anismus causes obstructed defecation as a result of inappropriate contraction of the puborectalis/external sphincter. Proctographic failure to empty after 30 s is used as a simple surrogate for simultaneous electromyography/proctography. Botulinum toxin is theoretically attractive but efficacy is variable. We aimed to evaluate the efficacy of botulinum toxin to treat obstructed defecation caused by anismus. Botulinum toxin was administered, under local anaesthetic, into the puborectalis/external sphincter of patients with proctographic anismus. Responders (resolution followed by recurrence of obstructed defecation over a 1- to 2-month period) underwent repeat injection. Nonresponders underwent rectal examination under anaesthetic (EUA). EUA-diagnosed rectal prolapse was graded using the Oxford Prolapse Grade 1-5. Fifty-six patients were treated with botulinum toxin. Twenty-two (39%) responded initially and 21/22 (95%) underwent repeat treatment. At a median follow up of 19.2 (range, 7.0-30.4) months, 20/21 (95%) had a sustained response and required no further treatment. Isolated obstructed defecation symptoms (OR = 7.8, P = 0.008), but not proctographic or physiological factors, predicted response on logistic regression analysis. In 33 (97%) of 34 nonresponders, significant abnormalities were demonstrated at EUA: 31 (94%) had a grade 3-5 rectal prolapse, one had internal anal sphincter myopathy and one had a fissure. Exclusion of these alternative diagnoses revised the initial response rate to 96%. Simple proctographic criteria overdiagnose anismus and underdiagnose rectal prolapse. This explains the published variable response to botulinum toxin. Failure to respond should prompt EUA seeking undiagnosed rectal prolapse. A response to an initial dose of botulinum toxin might be considered a more reliable diagnosis of anismus than proctography. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

  6. Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions.

    Science.gov (United States)

    Murad-Regadas, Sthela Maria; Regadas, Francisco Sergio P; Rodrigues, Lusmar Veras; Furtado, Débora Couto; Gondim, Ana Cecília; Dealcanfreitas, Iris Daiana

    2011-01-01

    The correlation between vaginal delivery, age and pelvic floor dysfunctions involving obstructed defecation is still a matter of controversy. To determine the influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions in women with obstructed defecation syndrome. Four hundred sixty-nine females with obstructed defecation syndrome were retrospectively evaluated using dynamic 3D ultrasonography to quantify posterior pelvic floor dysfunctions (rectocele grade II or III, rectal intussusception, paradoxical contraction/non-relaxation of the puborectalis and entero/ sigmoidocele grade III). In addition, sphincter damage was evaluated. Patients were grouped according to age (≤50y x >50y) and stratified by mode of delivery and parity: group I (≤50y): 218 patients, 75 nulliparous, 64 vaginal delivery and 79 only cesarean section and group II (>50y): 251 patients, 60 nulliparous, 148 vaginal delivery and 43 only caesarean section. Additionally, patients were stratified by number of vaginal deliveries: 0 - nulliparous (n = 135), 1 - vaginal (n = 46), >1 - vaginal (n = 166). Rectocele grade II or III, intussusception, rectocele + intussusception and sphincter damage were more prevalent in Group II (P = 0.0432; P = 0.0028; P = 0.0178; P = 0.0001). The stratified groups (nulliparous, vaginal delivery and cesarean) did not differ significantly with regard to rectocele, intussusception or anismus in each age group. Entero/sigmoidocele was more prevalent in the vaginal group 50y. No correlation was found between rectocele and the number of vaginal deliveries. Higher age (>50 years) was shown to influence the prevalence of significant rectocele, intussusception and sphincter damage in women. However, delivery mode and parity were not correlated with the prevalence of rectocele, intussusception and anismus in women with obstructed defecation.

  7. Randomised controlled trial of biofeedback training in persistent encopresis with anismus

    OpenAIRE

    Nolan, T.; Catto-Smith, T.; Coffey, C.; Wells, J.

    1998-01-01

    BACKGROUND—Paradoxical external anal sphincter contraction during attempted defecation (anismus) is thought to be an important contributor to chronic faecal retention and encopresis in children. Biofeedback training can be used to teach children to abolish this abnormal contraction.
METHODS—A randomised controlled trial in medical treatment resistant and/or treatment dependent children with anismus using surface electromyographic (EMG) biofeedback training to determine wh...

  8. Synthesis of ZnO Nanowires via Hotwire Thermal Evaporation of Brass (CuZn) Assisted by Vapor Phase Transport of Methanol

    OpenAIRE

    Tamil Many K. Thandavan; Siti Meriam Abdul Gani; Chiow San Wong; Roslan Md Nor

    2014-01-01

    Zinc oxide (ZnO) nanowires (NWs) were synthesized using vapor phase transport (VPT) and thermal evaporation of Zn from CuZn. Time dependence of ZnO NWs growth was investigated for 5, 10, 15, 20, 25, and 30 minutes. Significant changes were observed from the field electron scanning electron microscopy (FESEM) images as well as from the X-ray diffraction (XRD) profile. The photoluminescence (PL) profile was attributed to the contribution of oxygen vacancy, zinc interstitials, and hydrogen defec...

  9. deep-orange and carnation define distinct stages in late endosomal biogenesis in Drosophila melanogaster

    OpenAIRE

    Sriram, V.; Krishnan, K.S.; Mayor, Satyajit

    2003-01-01

    Endosomal degradation is severely impaired in primary hemocytes from larvae of eye color mutants of Drosophila. Using high resolution imaging and immunofluorescence microscopy in these cells, products of eye color genes, deep-orange (dor) and carnation (car), are localized to large multivesicular Rab7-positive late endosomes containing Golgi-derived enzymes. These structures mature into small sized Dor-negative, Car-positive structures, which subsequently fuse to form tubular lysosomes. Defec...

  10. Colectomy for refractory constipation

    DEFF Research Database (Denmark)

    Raahave, Dennis; Loud, Franck Bjørn; Christensen, Elsebeth

    2010-01-01

    OBJECTIVE: This study evaluated the type of colectomy, postoperative complications, functional results, and satisfaction in patients with constipation refractory to conservative therapy. Further, colonic transit time (CTT), faecal load (coprostasis), and colon length (redundancies) were compared...... had at hemicolectomy, 11 patients a subtotal colectomy and 3 patients an ileostomy. Two patients had an anastomotic leak and one died. In 11 patients, further surgery was necessary, because of recurrent constipation. Abdominal pain disappeared and defecation patterns improved significantly to 1-4 per...

  11. Assessing the Impact of Leveraging Traditional Leadership on Access to Sanitation in Rural Zambia.

    Science.gov (United States)

    Tiwari, Amy; Russpatrick, Scott; Hoehne, Alexandra; Matimelo, Selma M; Mazimba, Sharon; Nkhata, Ilenga; Osbert, Nicolas; Soloka, Geoffrey; Winters, Anna; Winters, Benjamin; Larsen, David A

    2017-11-01

    Open defecation is practiced by more than one billion people throughout the world and leads to significant public health issues including infectious disease transmission and stunted growth in children. Zambia implemented community-led total sanitation (CLTS) as an intervention to eliminate open defecation in rural areas. To support CLTS and the attainment of open defecation free communities, chiefs were considered key agents of change and were empowered to drive CLTS and improve sanitation for their chiefdom. Chiefs were provided with data on access to sanitation in the chiefdom during chiefdom orientations prior to the initiation of CLTS within each community and encouraged to make goals of universal sanitation access within the community. Using a survival regression, we found that where chiefs were orientated and mobilized in CLTS, the probability that a village would achieve 100% coverage of adequate sanitation increased by 23% (hazard ratio = 1.263, 95% confidence interval = 1.080-1.478, P = 0.003). Using an interrupted time series, we found a 30% increase in the number of individuals with access to adequate sanitation following chiefdom orientations (95% confidence interval = 28.8-32.0%). The mobilization and support of chiefs greatly improved the uptake of CLTS, and empowering them with increased CLTS knowledge and authority of the program in their chiefdom allowed chiefs to closely monitor village sanitation progress and follow-up with their headmen/headwomen. These key agents of change are important facilitators of public health goals such as the elimination of open defecation in Zambia by 2020.

  12. Anorectal Physiology/Pathophysiology in the Elderly

    OpenAIRE

    Yu, Siegfried W.B.; Rao, SSC

    2014-01-01

    The U.S. elderly population (≥85 years old) is estimated to increase from 5 to 20 million people between the years 2000 to 2050. Among the medical disorders facing the elderly, anorectal problems are not only highly prevalent, but cause significant morbidity and mortality, and have deleterious effects on health care burden and quality of life. These include disorders such as fecal incontinence, fecal impaction with overflow fecal incontinence, chronic constipation, dyssynergic defecation, hem...

  13. Factors determining outcome in children with chronic constipation and faecal soiling.

    OpenAIRE

    Loening-Baucke, V

    1989-01-01

    To evaluate factors which might contribute to treatment failure in children with chronic constipation and soiling, we evaluated the history, physical findings, defecation dynamics, and anorectal function in 97 patients. We treated them with milk of magnesia, high fibre diet, and bowel training techniques and evaluated outcome at one year when 43% had recovered. Recovery rates were similar for boys and girls. Fifty seven per cent of the patients had not recovered. This group at the outset had ...

  14. The diet of bushpigs in a sugarcane agro-ecosystem.

    OpenAIRE

    Melton, D.A.; Cooper, S.M.; Whittington, Andrew E.

    1989-01-01

    Bushpigs, Potamochoerus porcus, in a sugar-farming area of Natal, South Africa, were found to be omnivorous, but plant material dominated their diet year round. Sugar-cane stem was the main item identified in faeces collected on farmland during all seasons and in faeces from adjacent forest during winter and spring. Fruits were probably preferred to sugar cane by animals defecating in the forest during summer and autumn.

  15. Does Sacral Nerve Stimulation Improve Continence Through Enhanced Sensitivity of the Anal Canal?

    DEFF Research Database (Denmark)

    Haas, S; Brock, C; Krogh, K

    2016-01-01

    . DESIGN: This is an explorative study. PATIENTS: Fifteen women with idiopathic fecal incontinence (mean age, 58 ± 12.2 years) were selected. INTERVENTIONS: Cortical evoked potentials were recorded during repeated rapid balloon distension of the rectum and the anal canal both before and during temporary...... the threshold for urge to defecate elicited from the anal canal, whereas supraspinal responses remained unaltered. This may suggest that sacral nerve stimulation, at least in part, acts via somatic afferent fibers enhancing anal sensation....

  16. Dolichocolon revisited

    DEFF Research Database (Denmark)

    Raahave, Dennis

    2018-01-01

    The objective of this review is to examine whether a redundant colon gives rise to symptoms like constipation and volvulus. In 1820, Monterossi made drawings of colons with displacements and elongation of the colon found during autopsy. In 1912, Kienböeck first visualized a redundant colon using...... and infrequent defecation. The diagnosis of dolichocolon is established by barium enema or CT-colonography. Treatment is conservative, or surgical in case of volvulus or refractory constipation....

  17. PERAN IBU DALAM TOILET TRAINING PADA ANAK USIA TODDLER DI KECAMATAN KEMLAGI KABUPATEN MOJOKERTO

    Directory of Open Access Journals (Sweden)

    Veryudha Eka Prameswari1

    2018-01-01

    Full Text Available Background : Toilet training in children was an effort to train children to be able to control the conduct defecation and urination. Exercise of defecation and urination in children need preparation, both physically, psychologically and intellectually, through this preparation expected that child was able to control defecation and urination independently. Objective : Purpose of this research to describe the role of mother in toilet training on children toddler olds in the Mojodadi village Kemlagi District of Mojokerto. Methods : Design of research was used descriptive research design. The method of sampling used total sampling (nonprobability sampling. Sample was taken all respondents as many as 82 respondents who have a toddler old of children in the Mojodadi village Kemlagi District of Mojokerto in June 2015. Data was collected by questionnaire instrument and then the data though as editing, coding, scoring, tabulating and was analyzed by T score then the results presented with Frequency Distribution Table. Results : The results was showed that the discribe role of mother in the toilet training on children toddler olds in the Mojodadi village Kemlagi District of Mojokerto as the respondents who had a negative role as much as 44 respondents (53.7% while having a positive role as much as 38 respondents (46.3% . Conclusions : A negative role due to the lack of information on how to train toilet training and the role of mother is also influenced their knowledge, education, age and occupation held by the respondents related to toilet training.

  18. [Efficacy and safety of lactulose on the treatment of puerperal constipation].

    Science.gov (United States)

    Meng, Shan; Pan, Yinglian; Deng, Qingchun; Wang, Lina; Chang, Qing

    2015-07-28

    To observe the therapeutic effects and security of oral lactulose solution on treatment of puerperal constipation. A total of 200 patients with puerperal constipation who received regular antenatal cares from early pregnancy in our department and delivered in our hospital from January 2013 to October 2013, were randomly divided into two groups. The patients in control group (n = 100) received defecation habits training, diet management and drinking adequate water etc. The patients in therapy group (n = 100) received 20 ml oral lactulose solution, twice a day and constantly treatment for 4 weeks. The frequency of defecation per week were recorded (including before treatment, period during the treatment, and the first week after finish the whole treatment). The adverse reactions and recurrence of constipation after treatment were analyzed. The frequency of defecation per week in the therapy group was higher than that in the control group at the first week after treatment (t = 2.178, P = 0.869), and significantly increase in the fourth week (t = 8.390, P = 0.000). The efficiency of the lactulose groups was 92%, and the control group was 21% (χ² = 112.530, P = 0.000). The total recurrence of constipation in lactulose group was lower than that in the control group by follow up 120 days (4% vs 18%, χ² = 10.010, P = 0.001). Oral lactulose solution is effective and safe for puerperal consipation.

  19. New concept of functional anorectal disorders. In relation to newly published ROME III

    International Nuclear Information System (INIS)

    Takano, Masahiro

    2007-01-01

    In newly published Rome III, Functional anorectal disorders are divided into 7 disorders. F1 Functional fecal incontinence is divided into staining, soiling, seepage and leakage in the degree and urge and passive incontinences in the dynamics, of which the former is dysfunction of the rectum and the latter of the anus. For the treatment, the most effective is biofeedback therapy (BF). F2 Functional anorectal pain is divided into F2a Chronic proctalgia, F2a1 Levator ani syndrome, F2a2 Unspecified functional anorectal pain and F2b Proctalgia fugax. F2a1 Levator ani syndrome is defined as a pain caused by traction of the levator ani, but in my experience, only 4 (3.5%) among 116 cases accorded to the criteria making us dubious of the definition. As for F2b Proctalgia fugax, the cause has not yet been found. In these two F2a, various treatments are tried without significant effectiveness due perhaps to the unknown pathogenesis which I assume to be the neuralgia of pudendal nerve. F3 Functional defecation disorders consist of F3a Dyssynergic defecation and F3b Inadequate defecatory propulsion of which, the former is caused by paradoxical contraction or inadequate relaxation of the pelvic floor muscles and the latter caused by inadequate propulsive force in defecation. Their treatments are BF and defecatory enforcement. (author)

  20. Anorectal Disorders

    Science.gov (United States)

    Rao, Satish S. C.; Bharucha, Adil E.; Chiarioni, Giuseppe; Felt-Bersma, Richelle; Knowles, Charles; Malcolm, Allison; Wald, Arnold

    2016-01-01

    This report defines criteria and reviews the epidemiology, pathophysiology, and management of the following common anorectal disorders: fecal incontinence (FI), functional anorectal pain, and functional defecation disorders. FI is defined as the recurrent uncontrolled passage of fecal material for at least 3 months. The clinical features of FI are useful for guiding diagnostic testing and therapy. Anorectal manometry and imaging are useful for evaluating anal and pelvic floor structure and function. Education, antidiarrheals, and biofeedback therapy are the mainstay of management; surgery may be useful in refractory cases. Functional anorectal pain syndromes are defined by clinical features and categorized into 3 subtypes. In proctalgia fugax, the pain is typically fleeting and lasts for seconds to minutes. In levator ani syndrome and unspecified anorectal pain, the pain lasts more than 30 minutes, but in levator ani syndrome there is puborectalis tenderness. Functional defecation disorders are defined by ≥2 symptoms of chronic constipation or irritable bowel syndrome with constipation, and with ≥2 features of impaired evacuation, that is, abnormal evacuation pattern on manometry, abnormal balloon expulsion test, or impaired rectal evacuation by imaging. It includes 2 subtypes: dyssynergic defecation and inadequate defecatory propulsion. Pelvic floor biofeedback therapy is effective for treating levator ani syndrome and defecatory disorders. PMID:27144630

  1. Functional Anorectal Disorders.

    Science.gov (United States)

    Rao, Satish Sc; Bharucha, Adil E; Chiarioni, Giuseppe; Felt-Bersma, Richelle; Knowles, Charles; Malcolm, Allison; Wald, Arnold

    2016-03-25

    This report defines criteria and reviews the epidemiology, pathophysiology, and management of common anorectal disorders: fecal incontinence (FI), functional anorectal pain and functional defecation disorders. FI is defined as the recurrent uncontrolled passage of fecal material for at least 3 months. The clinical features of FI are useful for guiding diagnostic testing and therapy. Anorectal manometry and imaging are useful for evaluating anal and pelvic floor structure and function. Education, antidiarrheals and biofeedback therapy are the mainstay of management; surgery may be useful in refractory cases. Functional anorectal pain syndromes are defined by clinical features and categorized into three subtypes. In proctalgia fugax, the pain is typically fleeting and lasts for seconds to minutes. In levator ani syndrome (LAS) and unspecified anorectal pain the pain lasts more than 30 minutes, but in LAS there is puborectalis tenderness. Functional defecation disorders are defined by >2 symptoms of chronic constipation or irritable bowel syndrome with constipation, and with >2 features of impaired evacuation i.e., abnormal evacuation pattern on manometry, abnormal balloon expulsion test or impaired rectal evacuation by imaging. It includes two subtypes; dyssynergic defecation and inadequate defecatory propulsion. Pelvic floor biofeedback therapy is effective for treating LAS and defecatory disorders. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

  2. Advancing treatment options for chronic idiopathic constipation.

    Science.gov (United States)

    Quigley, Eamonn M M; Neshatian, Leila

    2016-01-01

    Chronic constipation is a global problem affecting all ages and associated with considerable morbidity and significant financial burden for society. Though formerly defined on the basis of a single symptom, infrequent defecation; constipation is now viewed as a syndrome encompassing several complaints such as difficulty with defecation, a sense of incomplete evacuation, hard stools, abdominal discomfort and bloating. The expanded concept of constipation has inevitably led to a significant change in outcomes in clinical trials, as well as in patient expectations from new therapeutic interventions. The past decades have also witnessed a proliferation in therapeutic targets for new agents. Foremost among these have been novel prokinetics, a new category, prosecretory agents and innovative approaches such as inhibitors of bile salt transport. In contrast, relatively few effective therapies exist for the management of those anorectal and pelvic floor problems that result in difficult defecation. Though constipation is a common and often troublesome disorder, many of those affected can resolve their symptoms with relatively simple measures. For those with more resistant symptoms a number of novel, effective and safe options now exist. Those with defecatory difficulty (anismus, pelvic floor dysfunction) continue to represent a significant management challenge.

  3. The effect of biofeedback therapy on dyssynergic constipation in patients with or without Irritable Bowel Syndrome

    Directory of Open Access Journals (Sweden)

    Tannaz Ahadi

    2014-01-01

    Full Text Available Background: The Rome II and III diagnostic criteria for dyssynergic defecation recommended the exclusion of irritable bowel syndrome (IBS. This study determined the effect of biofeedback therapy on dyssynergic constipation in patients with or without IBS. Materials and Methods: This study was a nonrandomized, single blinded, semi experimental study. Dyssynergic defecation patients with and without IBS were asked to undergo biofeedback therapy 8 sessions. The defecation dynamics and balloon expulsion time were evaluated before, at the end and 1 month after the biofeedback therapy. IBS symptoms were graded using a 4-point Likert scale. Mann-Whitney U-test, Wilcoxon test and Friedman test were applied to analyze data using SPSS software package (SPSS Inc., Chicago, IL, USA. Results: After the biofeedback therapy, the IBS symptoms have been decreased significantly (the median of 2 before and 1 after therapy, P 0.05 with respect to outcome. No complication was observed in treatment groups. Conclusion: Dyssynergic constipation patients with and without IBS will likely benefit from biofeedback therapy.

  4. Outlet obstruction constipation (anismus) managed by biofeedback.

    Science.gov (United States)

    Kawimbe, B M; Papachrysostomou, M; Binnie, N R; Clare, N; Smith, A N

    1991-10-01

    Fifteen subjects presenting with intractable constipation due to obstructive defecation, mean (SEM) duration 8.8 (1.8) years, had the inappropriate contraction and electromyographic changes in the pelvic floor muscles and external and sphincter typical of this condition. An electromyographically derived index was used to grade its severity. A self applied biofeedback device was used to allow electromyographic recording of the abnormal external anal sphincter. The subjects were encouraged to reduce the abnormal electromyographic activity on straining after instruction and training. The procedure was intended as a relearning process in which the non-relaxing activity of the pelvic floor was gradually suppressed. Biofeedback training was maintained on a domiciliary basis for a mean time of 3.1 weeks and resulted in a significant reduction in the anismus index (mean (SEM) 69.9 (7.8)% before biofeedback, mean 14 (3.9)% after biofeedback, p less than 0.01). There was an associated reduction in the time spent straining at stool and in the difficulty of defecation and an increased frequency of defecation. Defecatory video proctograms in six subjects showed improvements in the anorectal angle during straining and evacuation. The clinical benefit to the patients persisted after a mean follow up of 6.2 months.

  5. Anismus as a cause of functional constipation--experience from Serbia.

    Science.gov (United States)

    Jovanović, Igor; Jovanović, Dragana; Uglješić, Milenko; Milinić, Nikola; Cvetković, Mirjana; Branković, Marija; Nikolić, Goran

    2015-01-01

    BACKROUND/AIM: Anismus is paradoxal pressure increase or pressure decrease less than 20% of external anal sphincter during defecation straining. This study analyzed the presence of anismus as within a group of patients with the positive Rome III criteria for functional constipation. We used anorectal manometry as the determination method for anismus. We used anorectal water-perfused manometry in 60 patients with obstructive defecation defined by the Rome III criteria for functional constipation. We also analyzed anorectal function in 30 healthy subjects. The presence of anismus is more frequent in the group of patients with obstructive defecation compared to the control group (a highly statistically significant difference, p anismus with the presence of weak external anal sphincter, rectal sensibility disorders, enlarged piles, diverticular disease and anatomic variations of colon. We found no correlation between them in any of these cases. There is a significant correlation between anismus and positive Rome III criteria for functional constipation. Anorectal manometry should be performed in all patients with the positive Rome III criteria for functional constipation.

  6. Bowel Management and Quality of Life in Children With Spina Bifida in South Korea.

    Science.gov (United States)

    Choi, Eun Kyoung; Im, Young Jae; Han, Sang Won

    Bowel management is a concern in patients with spina bifida. We evaluated the status of bowel management in children with spina bifida (SB) and the effects on quality of life (QoL) of children and their caregivers. Data were collected from 173 children with SB between January and June 2011, whose bowel management status and QoL were assessed using a self-administered questionnaire. Of the 173 children, 38 (22.0%) reported normal defecation, 73 (42.2%) reported constipation only, and 62 (35.8%) reported fecal incontinence with/without constipation. For defecation, 59 children (34.1%) used digital stimulation or manual extraction, 28 (16.2%) used suppositories or enemas, 35 (20.3%) used laxatives, 4 (2.3%) used an antegrade continence enema, and 3 (1.7%) used transanal irrigation. There were significant differences in QoL, depending on defecation symptoms. Children with fecal incontinence and their caregivers had difficulties in travel and socialization (p children with SB and their caregivers. Therefore, more attention should be paid to bowel problems and help should be provided to children and their caregivers to improve QoL.

  7. Development of A Multidimensional Scale to Assess Attitudinal Determinants of Sanitation Uptake and Use.

    Science.gov (United States)

    Dreibelbis, Robert; Jenkins, Marion; Chase, Rachel P; Torondel, Belen; Routray, Parimita; Boisson, Sophie; Clasen, Thomas; Freeman, Matthew C

    2015-11-17

    Over 1 billion people still practice open defecation. Low uptake and use of new sanitation technologies in a number of settings has underscored our current limited understanding of the complex attitudinal factors that influence a household's decision to adopt and use new sanitation technologies. Mokken scaling techniques were applied to series of population-based surveys in Odisha, India between September 2011 and October 2013 (sample sizes 120, 500, 2200). Surveys contained simple, agree/disagree statements about attitudes toward sanitation use and sanitation technologies. Analysis produced two scales-a 10-question General Scale, reflecting attitudes toward defecation and norms regarding latrine use for all respondents, and a 6-question Experiential Scale, reflecting personal experiences with and perceived convenience of sanitation technologies targeted at respondents with a latrine. Among all respondents, a one-point change in the General Scale was associated with a 5-percentage point change in the marginal probability of having access to a functioning latrine. Among respondents with a functional latrine at home, a one-point increase in the General and Experiential Scales were associated with a 4- and 8-percentage point decrease in the probability of engaging in any open defecation in the last 7 days, respectively.

  8. Effectiveness of Lactobacillus helveticus and Lactobacillus rhamnosus for the management of antibiotic-associated diarrhoea in healthy adults: a randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Evans, Malkanthi; Salewski, Ryan P; Christman, Mary C; Girard, Stephanie-Anne; Tompkins, Thomas A

    2016-07-01

    Broad-spectrum antibiotic use can disrupt the gastrointestinal microbiota resulting in diarrhoea. Probiotics may be beneficial in managing this type of diarrhoea. The aim of this 10-week randomised, double-blind, placebo-controlled, parallel study was to investigate the effect of Lactobacillus helveticus R0052 and Lactobacillus rhamnosus R0011 supplementation on antibiotic-associated diarrhoea in healthy adults. Subjects were randomised to receive 1 week of amoxicillin-clavulanic acid (875 mg/125 mg) once per day, plus a daily dose of 8×109 colony-forming units of a multi-strain probiotic (n 80) or placebo (n 80). The probiotic or placebo intervention was maintained for 1 week after completion of the antibiotic. Primary study outcomes of consistency and frequency of bowel movements were not significantly different between the probiotic and placebo groups. The secondary outcomes of diarrhoea-like defecations, Gastrointestinal Symptoms Rating Scale scores, safety parameters and adverse events were not significantly different between the probiotic intervention and the placebo. A post hoc analysis on the duration of diarrhoea-like defecations showed that probiotic intervention reduced the length of these events by 1 full day (probiotic, 2·70 (sem 0·36) d; placebo, 3·71 (sem 0·36) d; P=0·037; effect size=0·52). In conclusion, this study provides novel evidence that L. helveticus R0052 and L. rhamnosus R0011 supplementation significantly reduced the duration of diarrhoea-like defecations in healthy adults receiving antibiotics.

  9. Holistic approach to functional constipation: Perspective of traditional Persian medicine.

    Science.gov (United States)

    Nimrouzi, Majid; Zarshenas, Mohammad M

    2015-11-23

    Traditional Persian medicine (TPM) proposes a different viewpoint to the chronic diseases. Diagnosis and implemented treatment are based on individual differences among patients. Constipation or Ea'teghal-e-batn is a condition in which the patient develops difficult or painful defecation. Based on TPM concepts, the fifirst digestion step starts from halq (oral cavity), and ends via defecation from the maq'ad (anus). Avicenna believed that four faculties, ha'zemeh (digestive), ja'zebeh (absorptive), ma'sekeh (retentive) and da'fe'eh (propulsive), are involved in the process of digestion and absorption of the ingested food and expelling the waste materials. The bowel movement and appearance of the stool is a measure for evaluating the gastrointestinal healthy function. Defecation should be with no pain and fecal material should have no burning and acuity. Low food intake or foods with dry temperament, dryness of gastrointestinal tract, diaphoresis and heavy exercise as well as intestine sensory loss were discussed as main causes of constipation. Management of constipation in TPM includes dietary schemes, oil massages and subsequently simple herbal medicines. According to TPM theories, the fifirst step in treating a disease is the elimination of disease causes (asbabe- maraz) and also providing the causes of health (asbab-e-sehhat). Health care providers should know the proper condition which the herbal medicines should be administered in and be able to guide the patients about the benefifits and hazards of herbal remedies, commonly used in their living origin.

  10. The impact of gender and physical environment on the handwashing behaviour of university students in Ghana.

    Science.gov (United States)

    Mariwah, Simon; Hampshire, Kate; Kasim, Adetayo

    2012-04-01

    To establish levels of handwashing after defecation among students at the University of Cape Coast in Ghana, and to test hypotheses that gender and washroom environment affect handwashing behaviour. Data on students' handwashing behaviour after defecation were collected by structured observations in washrooms. Eight hundred and six observations were made (360 female students and 446 males) in 56 washrooms over 496 observation periods. Observers recorded gender, duration of handwashing, use of soap, and physical characteristics of the washroom (cleanliness, availability of soap, tap flow and presence of handwashing posters). Fewer than half the students observed washed their hands or bathed after defecation. Of these, only two-thirds washed both hands and a minority (20%) used soap; only 16 students (all men) washed their hands for the recommended 15 s or longer. Female students were more likely to wash their hands at all, and were more likely to wash both hands, than males. Cleanliness of the washroom was strongly associated with improved handwashing behaviour for both women and men, as was tap flow quality for female students. Handwashing behaviour is generally poor among UCC students, mirroring results from North American Universities. The findings underline the plasticity of handwashing behaviour among this population, and highlight the need for ensuring that the physical environment in washrooms on university campuses is conducive to handwashing. © 2012 Blackwell Publishing Ltd.

  11. Efficacy and tolerability of tegaserod in constipation dominant irritable bowel syndrome

    International Nuclear Information System (INIS)

    Shah, S.H.A.; Jafri, S.W.; Gul, M.; Butt, J.A.; Naqvi, A.; Rasheed, I.

    2004-01-01

    Objective: To determine the efficacy and tolerability of tegaserod in the treatment of symptoms of irritable bowel syndrome (IBS) IBS-C patients. Patients and Methods: Tegaserod was administered in a dose of 6 mg (twice-a-day) orally for a period of 6 weeks. Symptoms were assessed before and during treatment using a questionnaire. Results: The mean age of patients was 37.5 years and 81 (69.2%) were males. The study enrolled 117 patients and 101 patients completed the study. Number of bowel movements, symptoms of straining at defecation, stool consistency, bloating, urgency and abdominal pain improved significantly following treatment (p<0.05). Analysis of data in both genders separately showed statistically significant improvement in symptoms of urgency, straining at defecation, abdominal pain and number of bowel movements following treatment. Side effects of diarrhea and vertigo (6 and 1 patients respectively) necessitating discontinuation of treatment were infrequent. Conclusion: Tegaserod given in a dose of 6 mg b.d. is effective and well tolerated in IBS-C patients. It is equally effective in males and females in relieving the symptoms of abdominal pain, bloating, straining at defecation as well as increased in the mean number of bowel movements per week. (author)

  12. MR defecography at 1.5 Tesla with radial real-time imaging at a reduced FOV

    International Nuclear Information System (INIS)

    Tacke, J.; Nolte-Ernsting, C.; Glowinski, A.; Adam, G.; Guenther, R.W.

    1999-01-01

    Purpose: To evaluate a new technique for MR defecography with real-time imaging using radial k-space profiles. Materials and Methods: A catheter-mounted condom was inserted into the rectum of 16 patients and filled in situ by a mixture of Nestargel trademark and Gadolinium. After multiplanar imaging of the pelvis by high resolution T 2 -weighted turbo-spin echo sequences, defecation was imaged by a gradient echo sequence with radial k-space filling using a reduced field of view (rFOV) in real-time. The documentation was performed on an S-VHS recorder. Results: At a constant background signal, radial k-space filling yields a real-time impression. An interactive software allowed the operator to modify the slice thickness, slice plane, flip angle and slice angulation during scanning, resulting in an optimum imaging quality of the defecation. Conclusions: This new imaging technique allows real-time MR defecography in a high-field scanner and provides all anatomical and functional information of the defecation. (orig.) [de

  13. Do olfactory behaviour and marking responses of Konik polski stallions to faeces from conspecifics of either sex differ?

    Science.gov (United States)

    Jezierski, Tadeusz; Jaworski, Zbigniew; Sobczyńska, Magdalena; Ensminger, John; Górecka-Bruzda, Aleksandra

    2017-09-27

    The aim of the study was to assess whether adult stallions differentiate their olfactory and marking behaviour towards the excreta of their potential male rivals and mares. Four Konik polski stallions were individually exposed simultaneously to their own and each others' faeces as well as faeces of mares in oestrus vs. dioestrus. Five series of 30min observation sessions were conducted in a round pen each on two consecutive days from March to July, totaling in 5h observation per stallion. Stallions sniffed and displayed flehmen reaction towards mares' faeces significantly longer (P<0.01) than towards stallions' faeces. No significant differences were found in marking by defecations upon stallions' vs. mares' faeces. The stallions urinated exclusively on mares' faeces. Sniffing, flehmen, defecations and urinations performed towards faeces of mares in oestrus vs. dioestrus did not differ significantly. The results showed that stallions differentiate their olfactory behaviour towards excreta of conspecifics of different sex but perhaps not towards faeces of females in different reproductive status. This for the first time establishes that stallions exhibit different marking behaviour upon stallions' vs. mares' faeces. It is hypothesized that marking of other stallions' faeces by defecation may advertise presence of the stallion, whereas marking of mares' faeces by urination may serve to mask the presence of a mare to prevent potential rivals from locating the mare in an area where mares' faeces are found. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Intra-specific downsizing of frugivores affects seed germination of fleshy-fruited plant species

    Science.gov (United States)

    Pérez-Méndez, Néstor; Rodríguez, Airam; Nogales, Manuel

    2018-01-01

    The loss of largest-bodied individuals within species of frugivorous animals is one of the major consequences of defaunation. The gradual disappearance of large-bodied frugivores is expected to entail a parallel deterioration in seed dispersal functionality if the remaining smaller-sized individuals are not so effective as seed dispersers. While the multiple impacts of the extinction of large bodied species have been relatively well studied, the impact of intraspecific downsizing (i.e. the extinction of large individuals within species) on seed dispersal has rarely been evaluated. Here we experimentally assessed the impact of body-size reduction in the frugivorous lizard Gallotia galloti (Lacertidae), an endemic species of the Canary Islands, on the seed germination patterns of two fleshy-fruited plant species (Rubia fruticosa and Withania aristata). Seed germination curves and the proportions of germinated seeds were compared for both plant species after being defecated by large-sized individuals and small-sized individuals. The data show that seeds of W. aristata defecated by larger-sized lizards germinated faster and in a higher percentage than those defecated by small-sized lizards, while no differences were found for R. fruticosa seeds. Our results suggest that disappearance of the largest individuals of frugivorous species may impair recruitment of some plant species by worsening seed germination. They also warn us of a potential cryptic loss of seed dispersal functionality on defaunated ecosystems, even when frugivorous species remain abundant.

  15. Índice de defecación y éxito reproductivo de Triatoma maculata (Hemiptera:Reduviidaeen condiciones de laboratorio

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    E Aldana

    2004-12-01

    Full Text Available Se estudió el comportamiento reproductivo y de defecación de Triatoma maculata (Erichson 1848alimentando artificialmente con sangre humana.Los estadios II y III mostraron mayor frecuencia de defecaciones (ID=0.6 n=40,el estadio V no alcanzó la diferenciación sexual, la fertilidad fue 55%(n=865,fecundidad 8 huevos/hembra/semana (n=26,22 días de desarrollo embrionario (n=477,longevidad de hembras 51 días (n=26,el tiempo intermuda aumenta progresivamente desde 35 días en el estadio I hasta 46 días en el estadio IV,el porcentaje de muda varió desde 0%en el estadio V hasta 63%en el estadio III,la mortalidad varió desde 8%en el estadio III hasta 100%en el estadio V (n=40.Los resultados del presente trabajo aportan evidencias que explican la menor capacidad vectorial y la baja densidad de T.maculata en el domicilio humano.Defecation index and reproductive success of Triatoma maculata (Hemiptera: Reduviidae under laboratory conditions.The reproductive and defecating behavior of Triatoma maculata (Erichson 1848was studied on animals from an university culture in Venezuela.This species does not reach the importance of Rhodnius prolixus Stal 1859 as Chagas disease vector in Venezuela.This study addressed the role of defecating frequency,an index of how dangerous the animals are for the human population,and its relationship with why T.maculata is a less important vector than R.prolixus .Human blood was fed to the insects through an artificial feeding device.The 2nd and 3rd instar nymphs defecated more frequently (Id=0.6,n=40,and our Vth instar nymphs did not complete sexual differentiation.Fertility was 55%(n=865and fecundity 8 eggs/female/week (n=26. Egg incubation lasted 22 days (n=477.Female longevity was 51 days (n=26.Intermould time grew progressively from 35 days for 1st to 40 days for 4th instar nymphs (n=40.Mould percentage varied from 0% for Vth to 63%for 3rd instar nymphs.Mortality varied from 8% for 3rd to 100% for Vth instar nymphs

  16. The effectiveness of moxibustion for the treatment of functional constipation: a randomized, sham-controlled, patient blinded, pilot clinical trial

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    Park Ji-Eun

    2011-12-01

    Full Text Available Abstract Background Moxibustion is an ancient traditional medicine using burning mugworts to stimulate acupuncture points. The aim of this study was to investigate the safety and efficacy of moxibustion for the treatment of constipation using a randomized, sham-controlled, participant-blinded, pilot trial. Methods Twenty-six participants (identified with either qi (vital energy deficiency or qi excess syndrome were randomly divided into either a moxibustion or sham group. Participants were treated with real or sham moxibustion at 4 acupuncture points, ST23 and ST27, bilaterally, 3 times per week for four weeks. The primary outcome was the frequency of defecations; secondary outcomes were the Bristol stool form scale (BSS and the constipation assessment scale (CAS. Results Of the 26 participants that were randomized, 24 completed the study. Defecation frequency, BSS, and CAS showed no difference between the moxibustion and sham groups. The differences were -0.25 (95% CI: -2.08, 1.58, p = 0.78, -1.22 (95% CI: -2.7, 0.26, p = 0.1, 0.91 (95% CI: -1.46, 3.28, p = 0.44 in defecation frequency, BSS, CAS, respectively. The defecation frequency increased from an average of 3.3 to 4.6 times per week in the moxibustion group (1.5[-0.5, 2], p = 0.06 and from 2.7 to 3.7 stools per week in the sham group (1[-1, 2], p = 0.15 after four weeks of treatment. The difference between participants with a deficiency or an excess syndrome, determined based on assessment of sweat, facial features, pain, body energy, and pulse type, was significant in only defecation frequency. The difference was 3.3 (95% CI: 0.41, 6.19, p = 0.03. Conclusion Moxibustion treatment appears safe, but showed no positive effect on constipation. The effectiveness of moxibustion treatment may depend on the syndrome pattern, and further long-term studies with a larger number of subjects are warranted. Trial registration Clinical Research Information Service, KCT0000168

  17. Pengaruh Pelvic Floor Muscle Training terhadap Pengembalian Fungsi Miksi dan Defekasi pada Ibu Postpartum Spontan

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    Mustika Dewi

    2014-09-01

    Full Text Available AbstrakPersalinan membawa dampak terhadap fungsi miksi dan defekasi pada ibu postpartum. Stimulasi dini yang dapat dilakukan guna memulihkan fungsi miksi dan defekasi, antara lain dengan Pelvic Floor Muscle Training (PFMT atau latihan yang dilakukan khusus untuk otot dasar panggul. Tujuan penelitian ini adalah untuk mengetahui pengaruh PFMT terhadap pengembalian fungsi miksi dan defekasi pada ibu postpartum spontan (tanpa bantuan alat penolong persalinan. Penelitian ini merupakan studi kuasi eksperimen dengan post test only control group design. PFMT dilakukan setelah 2 jam persalinan sebanyak 3 sesi selama 3 hari postpartum. Selanjutnya mewawancarai kelompok yang melakukan PFMT maupun kelompok yang tidak melakukan PFMT untuk mengetahui miksi dan defekasi pertama kali dimasa postpartum. Data dianalisis secara statistik menggunakan uji chi-square dan nilai p < 0.05 dianggap bermakna secara statistik. Hasil penelitian didapatkan persentase miksi spontan lebih tinggi pada ibu yang melakukan PFMT dari pada ibu yang tidak melakukan PFMT (83.3% : 58.3%, Secara statistik perbedaan tersebut tidak signifikan (p > 0.05, maka dapat dinyatakan tidak terdapat pengaruh PFMT terhadap miksi pada ibu postpatum spontan. Persentase defekasi normal lebih tinggi pada ibu yang melakukan PFMT dari pada ibu yang tidak melakukan PFMT (87.5% : 16.7%. Secara statistik perbedaan tersebut signifikan (p < 0.05, maka dapat dinyatakan ada pengaruh PFMT terhadap defekasi pada ibu postpartum spontan. Dari hasil penelitian disimpulkan tidak terdapat pengaruh PFMT terhadap miksi pada ibu postpartum spontan dan terdapat pengaruh PFMT terhadap defekasi pada ibu postpartum.Kata Kunci: PFMT, miksi, defekasi, postpartum spontanAbstractLabour have an impact on the function of micturition and defecation in postpartum. Early stimulation that can be done to restore the function of micturition and defecation, among others, with Pelvic Floor Muscle Training (PFMT. The purpose of this study

  18. PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial.

    Science.gov (United States)

    Voskuijl, W; de Lorijn, F; Verwijs, W; Hogeman, P; Heijmans, J; Mäkel, W; Taminiau, J; Benninga, M

    2004-11-01

    Recently, polyethylene glycol (PEG 3350) has been suggested as a good alternative laxative to lactulose as a treatment option in paediatric constipation. However, no large randomised controlled trials exist evaluating the efficacy of either laxative. To compare PEG 3350 (Transipeg: polyethylene glycol with electrolytes) with lactulose in paediatric constipation and evaluate clinical efficacy/side effects. One hundred patients (aged 6 months-15 years) with paediatric constipation were included in an eight week double blinded, randomised, controlled trial. After faecal disimpaction, patients PEG 3350 (2.95 g/sachet) or lactulose (6 g/sachet) while children > or =6 years started with 2 sachets/day. Primary outcome measures were: defecation and encopresis frequency/week and successful treatment after eight weeks. Success was defined as a defecation frequency > or =3/week and encopresis PEG 3350: 3 pre v 7 post treatment/week; lactulose: 3 pre v 6 post/week) and a significant decrease in encopresis frequency (PEG 3350: 10 pre v 3 post/week; lactulose: 8 pre v 3 post/week) was found in both groups (NS). However, success was significantly higher in the PEG group (56%) compared with the lactulose group (29%). PEG 3350 patients reported less abdominal pain, straining, and pain at defecation than children using lactulose. However, bad taste was reported significantly more often in the PEG group. PEG 3350 (0.26 (0.11) g/kg), compared with lactulose (0.66 (0.32) g/kg), provided a higher success rate with fewer side effects. PEG 3350 should be the laxative of first choice in childhood constipation.

  19. High novelty-seeking rats are resilient to negative physiological effects of the early life stress.

    Science.gov (United States)

    Clinton, Sarah M; Watson, Stanley J; Akil, Huda

    2014-01-01

    Exposure to early life stress dramatically impacts adult behavior, physiology, and neuroendocrine function. Using rats bred for novelty-seeking differences and known to display divergent anxiety, depression, and stress vulnerability, we examined the interaction between early life adversity and genetic predisposition for high- versus low-emotional reactivity. Thus, bred Low Novelty Responder (bLR) rats, which naturally exhibit high anxiety- and depression-like behavior, and bred High Novelty Responder (bHR) rats, which show low anxiety/depression together with elevated aggression, impulsivity, and addictive behavior, were subjected to daily 3 h maternal separation (MS) stress postnatal days 1-14. We hypothesized that MS stress would differentially impact adult bHR/bLR behavior, physiology (stress-induced defecation), and neuroendocrine reactivity. While MS stress did not impact bHR and bLR anxiety-like behavior in the open field test and elevated plus maze, it exacerbated bLRs' already high physiological response to stress - stress-induced defecation. In both tests, MS bLR adult offspring showed exaggerated stress-induced defecation compared to bLR controls while bHR offspring were unaffected. MS also selectively impacted bLRs' (but not bHRs') neuroendocrine stress reactivity, producing an exaggerated corticosterone acute stress response in MS bLR versus control bLR rats. These findings highlight how genetic predisposition shapes individuals' response to early life stress. Future work will explore neural mechanisms underlying the distinct behavioral and neuroendocrine consequences of MS in bHR/bLR animals.

  20. Why latrines are not used: communities' perceptions and practices regarding latrines in a Taenia solium endemic rural area in Eastern Zambia.

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    Séverine Thys

    2015-03-01

    Full Text Available Taenia solium cysticercosis is a neglected parasitic zoonosis occurring in many developing countries. Socio-cultural determinants related to its control remain unclear. Studies in Africa have shown that the underuse of sanitary facilities and the widespread occurrence of free-roaming pigs are the major risk factors for porcine cysticercosis. The study objective was to assess the communities' perceptions, practices and knowledge regarding latrines in a T. solium endemic rural area in Eastern Zambia inhabited by the Nsenga ethno-linguistic group, and to identify possible barriers to their construction and use. A total of 21 focus group discussions on latrine use were organized separately with men, women and children, in seven villages of the Petauke district. The themes covered were related to perceived latrine availability (absence-presence, building obstacles and perceived latrine use (defecation practices, latrine management, socio-cultural constraints.The findings reveal that latrines were not constructed in every household because of the convenient use of existing latrines in the neighborhood. Latrines were perceived to contribute to good hygiene mainly because they prevent pigs from eating human feces. Men expressed reluctance to abandon the open-air defecation practice mainly because of toilet-associated taboos with in-laws and grown-up children of the opposite gender. When reviewing conceptual frameworks of people's approach to sanitation, we found that seeking privacy and taboos hindering latrine use and construction were mainly explained in our study area by the fact that the Nsenga observe a traditionally matrilineal descent. These findings indicate that in this local context latrine promotion messages should not only focus on health benefits in general. Since only men were responsible for building latrines and mostly men preferred open defecation, sanitation programs should also be directed to men and address related sanitary taboos in

  1. Therapeutic Effect of Activated Carbon-Induced Constipation Mice with Lactobacillus fermentum Suo on Treatment

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    Huayi Suo

    2014-11-01

    Full Text Available The aim of this study was to investigate the effects of Lactobacillus fermentum Suo (LF-Suo on activated carbon-induced constipation in ICR (Institute of Cancer Research mice. ICR mice were orally administered with lactic acid bacteria for 9 days. Body weight, diet intake, drinking amount, defecation status, gastrointestinal transit and defecation time, and the serum levels of MTL (motilin, Gas (gastrin, ET (endothelin, SS (somatostatin, AChE (acetylcholinesterase, SP (substance P, VIP (vasoactive intestinal peptide were used to evaluate the preventive effects of LF-Suo on constipation. Bisacodyl, a laxative drug, was used as a positive control. The normal, control, 100 mg/kg bisacodyl treatment, LB (Lactobacillus bulgaricus-, LF-Suo (L- and LF-Suo (H-treated mice showed the time to the first black stool defecation at 90, 218, 117, 180, 155 and 137 min, respectively. By the oral administration of LB-, LF-Suo (L, LF-Suo (H or bisacodyl (100 mg/kg, the gastrointestinal transit was reduced to 55.2%, 72.3%, 85.5% and 94.6%, respectively, of the transit in normal mice, respectively. In contrast to the control mice, the serum levels of MTL, Gas, ET, AChE, SP and VIP were significantly increased and the serum levels of SS were reduced in the mice treated with LF-Suo (p < 0.05. By the RT-PCR (reverse transcription–polymerase chain reaction and western blot assays, LF-Suo increased the c-Kit, SCF (stem cell factor, GDNF (glial cell line-derived neurotrophic factor and decreased TRPV1 (transient receptor potential vanilloid 1, NOS (nitric oxide synthase expressions of small intestine tissue in mice. These results demonstrate that lactic acid bacteria has preventive effects on mouse constipation and LF-Suo demonstrated the best functional activity.

  2. Update on the management of constipation in the elderly: new treatment options

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    Satish SC Rao

    2010-06-01

    Full Text Available Satish SC Rao, Jorge T GoSection of Neurogastroenterology, Division of Gastroenterology-Hepatology, Department of Internal Medicine, Iowa City, University of Iowa Carver College of Medicine, Iowa City, IowaAbstract: Constipation disproportionately affects older adults, with a prevalences of 50% in community-dwelling elderly and 74% in nursing-home residents. Loss of mobility, medications, underlying diseases, impaired anorectal sensation, and ignoring calls to defecate are as important as dyssynergic defecation or irritable bowel syndrome in causing constipation. Detailed medical history on medications and co-morbid problems, and meticulous digital rectal examination may help identify causes of constipation. Likewise, blood tests and colonoscopy may identify organic causes such as colon cancer. Physiological tests such as colonic transit study with radio-opaque markers or wireless motility capsule, anorectal manometry, and balloon expulsion tests can identify disorders of colonic and anorectal function. However, in the elderly, there is usually more than one mechanism, requiring an individualized but multifactorial treatment approach. The management of constipation continues to evolve. Although osmotic laxatives such as polyethylene glycol remain mainstay, several new agents that target different mechanisms appear promising such as chloride-channel activator (lubiprostone, guanylate cyclase agonist (linaclotide, 5HT4 agonist (prucalopride, and peripherally acting μ-opioid receptor antagonists (alvimopan and methylnaltrexone for opioid-induced constipation. Biofeedback therapy is efficacious for treating dyssynergic defecation and fecal impaction with soiling. However, data on efficacy and safety of drugs in elderly are limited and urgently needed.Keywords: constipation, elderly, treatment

  3. Stable gastric pentadecapeptide BPC 157 heals rat colovesical fistula.

    Science.gov (United States)

    Grgic, Tihomir; Grgic, Dora; Drmic, Domagoj; Sever, Anita Zenko; Petrovic, Igor; Sucic, Mario; Kokot, Antonio; Klicek, Robert; Sever, Marko; Seiwerth, Sven; Sikiric, Predrag

    2016-06-05

    To establish the effects of BPC 157 on the healing of rat colovesical fistulas, Wistar Albino male rats were randomly assigned to different groups. BPC 157, a stable gastric pentadecapeptide, has been used in clinical applications-specifically, in ulcerative colitis-and was successful in treating both external and internal fistulas. BPC 157 was provided daily, perorally, in drinking water (10µg/kg, 12ml/rat/day) until sacrifice or, alternatively, 10µg/kg or 10ng/kg intraperitoneally, with the first application at 30min after surgery and the last at 24h before sacrifice. Controls simultaneously received an equivolume of saline (5.0ml/kg ip) or water only (12ml/rat/day). Assessment (i.e., colon and vesical defects, fistula leaking, fecaluria and defecation through the fistula, adhesions and intestinal obstruction as healing processes) took place on days 7, 14 and 28. Control colovesical fistulas regularly exhibited poor healing, with both of the defects persisting; continuous fistula leakage; fecaluria and defecation through the fistula; advanced adhesion formation; and intestinal obstruction. By contrast, BPC 157 given perorally or intraperitoneally and in µg- and ng-regimens rapidly improved the whole presentation, with both colon and vesical defects simultaneously ameliorated and eventually healed. The maximal instilled volume was continuously raised until it reached the values of healthy rats, there were no signs of fecaluria and no defecation through the fistula, there was counteraction of advanced adhesion formation or there was an intestinal obstruction. In conclusion, BPC 157 effects appear to be suited to inducing full healing of colocutaneous fistulas in rats. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Prebiotics for the management of hyperbilirubinemia in preterm neonates.

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    Armanian, Amir Mohammad; Barekatain, Behzad; Hoseinzadeh, Maryam; Salehimehr, Nima

    2016-09-01

    We evaluated if prebiotics have benefits for the management of hyperbilirubinemia in preterm neonates. Preterm neonates were entered into the study when enteral feeding volume met 30 mL/kg/day. They randomly received a mixture of short-chain galacto-oligosacarids/long-chain fructo-oligosacarids or distilled water (placebo) for 1 week. Total serum bilirubin level was measured by transcutaneous bilirubinometry. Stool frequency and meeting full enteral feeding during the study period were considered as secondary outcomes. Twenty-five neonates in each group completed the trial. Bilirubin level was decreased with the prebiotic (-1.3 ±  1.8 mg/dL, p = 0.004), but not placebo (-0.1 ± 3.3 mg/dL, p = 0.416). Peak bilirubin level was lower with the prebiotic than placebo (8.3 ± 1.7 versus 10.1 ± 2.2 mg/dL, p = 0.003). Stool frequency was increased with the prebiotic (0.7 ± 1.9 defecation/day, p = 0.014), but not with placebo (0.6 ±  1.5 defecation/day, p = 0.133). Average stool frequency (2.4 ±  0.4 versus 1.9 ± 0.5 defecation/day, p = 0.003) and frequently of meeting full enteral feeding (60% versus 16%, p = 0.002) were higher with the prebiotic than placebo. Prebiotic oligosaccharides increase stool frequency, improve feeding tolerance and reduce bilirubin level in preterm neonates and therefore can be efficacious for the management of neonatal hyperbilirubinemia.

  5. Child feces disposal practices in rural Orissa: a cross sectional study.

    Directory of Open Access Journals (Sweden)

    Fiona Majorin

    Full Text Available BACKGROUND: An estimated 2.5 billion people worldwide lack access to improved sanitation facilities. While large-scale programs in some countries have increased latrine coverage, they sometimes fail to ensure optimal latrine use, including the safe disposal of child feces, a significant source of exposure to fecal pathogens. We undertook a cross-sectional study to explore fecal disposal practices among children in rural Orissa, India in villages where the Government of India's Total Sanitation Campaign had been implemented at least three years prior to the study. METHODS AND FINDINGS: We conducted surveys with heads of 136 households with 145 children under 5 years of age in 20 villages. We describe defecation and feces disposal practices and explore associations between safe disposal and risk factors. Respondents reported that children commonly defecated on the ground, either inside the household (57.5% for pre-ambulatory children or around the compound (55.2% for ambulatory children. Twenty percent of pre-ambulatory children used potties and nappies; the same percentage of ambulatory children defecated in a latrine. While 78.6% of study children came from 106 households with a latrine, less than a quarter (22.8% reported using them for disposal of child feces. Most child feces were deposited with other household waste, both for pre-ambulatory (67.5% and ambulatory (58.1% children. After restricting the analysis to households owning a latrine, the use of a nappy or potty was associated with safe disposal of feces (OR 6.72, 95%CI 1.02-44.38 though due to small sample size the regression could not adjust for confounders. CONCLUSIONS: In the area surveyed, the Total Sanitation Campaign has not led to high levels of safe disposal of child feces. Further research is needed to identify the actual scope of this potential gap in programming, the health risk presented and interventions to minimize any adverse effect.

  6. Underreporting of high-risk water and sanitation practices undermines progress on global targets.

    Science.gov (United States)

    Vedachalam, Sridhar; MacDonald, Luke H; Shiferaw, Solomon; Seme, Assefa; Schwab, Kellogg J

    2017-01-01

    Water and sanitation indicators under the Millennium Development Goals failed to capture high-risk practices undertaken on a regular basis. In conjunction with local partners, fourteen rounds of household surveys using mobile phones with a customized open-source application were conducted across nine study geographies in Asia and Africa. In addition to the main water and sanitation facilities, interviewees (n = 245,054) identified all water and sanitation options regularly used for at least one season of the year. Unimproved water consumption and open defecation were targeted as high-risk practices. We defined underreporting as the difference between the regular and main use of high-risk practices. Our estimates of high-risk practices as the main option matched the widely accepted Demographic and Health Surveys (DHS) estimates within the 95% confidence interval. However, estimates of these practices as a regular option was far higher than the DHS estimates. Across the nine geographies, median underreporting of unimproved water use was 5.5%, with a range of 0.5% to 13.9%. Median underreporting of open defecation was much higher at 9.9%, with a range of 2.7% to 11.5%. This resulted in an underreported population of 25 million regularly consuming unimproved water and 50 million regularly practicing open defecation. Further examination of data from Ethiopia suggested that location and socio-economic factors were significant drivers of underreporting. Current global monitoring relies on a framework that considers the availability and use of a single option to meet drinking water and sanitation needs. Our analysis demonstrates the use of multiple options and widespread underreporting of high-risk practices. Policies based on current monitoring data, therefore, fail to consider the range of challenges and solutions to meeting water and sanitation needs, and result in an inflated sense of progress. Mobile surveys offer a cost-effective and innovative platform to rapidly

  7. PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial

    Science.gov (United States)

    Voskuijl, W; de Lorijn, F; Verwijs, W; Hogeman, P; Heijmans, J; Mäkel, W; Taminiau, J; Benninga, M

    2004-01-01

    Background: Recently, polyethylene glycol (PEG 3350) has been suggested as a good alternative laxative to lactulose as a treatment option in paediatric constipation. However, no large randomised controlled trials exist evaluating the efficacy of either laxative. Aims: To compare PEG 3350 (Transipeg: polyethylene glycol with electrolytes) with lactulose in paediatric constipation and evaluate clinical efficacy/side effects. Patients: One hundred patients (aged 6 months–15 years) with paediatric constipation were included in an eight week double blinded, randomised, controlled trial. Methods: After faecal disimpaction, patients encopresis frequency/week and successful treatment after eight weeks. Success was defined as a defecation frequency ⩾3/week and encopresis ⩽1 every two weeks. Secondary outcome measures were side effects after eight weeks of treatment. Results: A total of 91 patients (49 male) completed the study. A significant increase in defecation frequency (PEG 3350: 3 pre v 7 post treatment/week; lactulose: 3 pre v 6 post/week) and a significant decrease in encopresis frequency (PEG 3350: 10 pre v 3 post/week; lactulose: 8 pre v 3 post/week) was found in both groups (NS). However, success was significantly higher in the PEG group (56%) compared with the lactulose group (29%). PEG 3350 patients reported less abdominal pain, straining, and pain at defecation than children using lactulose. However, bad taste was reported significantly more often in the PEG group. Conclusions: PEG 3350 (0.26 (0.11) g/kg), compared with lactulose (0.66 (0.32) g/kg), provided a higher success rate with fewer side effects. PEG 3350 should be the laxative of first choice in childhood constipation. PMID:15479678

  8. Comparison of Bloodmeal Digestion and the Peritrophic Matrix in Four Sand Fly Species Differing in Susceptibility to Leishmania donovani.

    Science.gov (United States)

    Pruzinova, Katerina; Sadlova, Jovana; Seblova, Veronika; Homola, Miroslav; Votypka, Jan; Volf, Petr

    2015-01-01

    The early stage of Leishmania development in sand flies is closely connected with bloodmeal digestion. Here we compared various parameters of bloodmeal digestion in sand flies that are either susceptible (Phlebotomus argentipes and P. orientalis) or refractory (P. papatasi and Sergentomyia schwetzi) to Leishmania donovani, to study the effects on vector competence. The volume of the bloodmeal ingested, time of defecation of bloodmeal remnants, timing of formation and degradation of the peritrophic matrix (PM) and dynamics of proteolytic activities were compared in four sand fly species. Both proven vectors of L. donovani showed lower trypsin activity and slower PM formation than refractory species. Interestingly, the two natural L. donovani vectors strikingly differed from each other in secretion of the PM and midgut proteases, with P. argentipes possessing fast bloodmeal digestion with a very high peak of chymotrypsin activity and rapid degradation of the PM. Experimental infections of P. argentipes did not reveal any differences in vector competence in comparison with previously studied P. orientalis; even the very low initial dose (2×103 promastigotes/ml) led to fully developed late-stage infections with colonization of the stomodeal valve in about 40% of females. We hypothesise that the period between the breakdown of the PM and defecation of the bloodmeal remnants, i.e. the time frame when Leishmania attach to the midgut in order to prevent defecation, could be one of crucial parameters responsible for the establishment of Leishmania in the sand fly midgut. In both natural L. donovani vectors this period was significantly longer than in S. schwetzi. Both vectors are equally susceptible to L. donovani; as average bloodmeal volumes taken by females of P. argentipes and P. orientalis were 0.63 μl and 0.59 μl, respectively, an infective dose corresponding to 1-2 parasites was enough to initiate mature infections.

  9. Pattern analysis of defecography in patients with chronic functional constipation: is it predictable for the responsiveness of biofeedback therapy?

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Hye Rin; Kim, Ah Young; Hong, Seong Sook; Byun, Jae Ho; Myung Seung Jae; Ha, Hyun Kwon [University of Ulsan of Medicine, Seoul (Korea, Republic of)

    2005-08-15

    To determine of pattern analysis of defecography can predict the responsiveness of biofeedback therapy in patients with chronic functional constipation. Over a two-year period, 104 patients with chronic functional constipation underwent defecography and biofeedback therapy. Two blinded readers analyzed the defecographic findings and classified them into six types; I = normal defecation, II = hypertonic lower anal sphincter (poor anal opening due to a persistent contraction of the lower anal sphincter), III dyskinetic puborectal sling (inadequate laxity of the puborectal sling), IV spastic pelvic floor syndrome (persistent contraction of both the puborectal sling and the lower and sphincter), V unclassified (including paradoxical contraction of the anal sphincter), VI anatomical obstruction. In addition, the degree of rectal contraction during defecation was scored (grade 0 to 3). After biofeedback therapy, the differences in the defecography patterns or rectal contraction between the two groups, the responsive or non-responsive group, were analyzed. The defecograms revealed that the type IV of the spastic pelvic floor syndrome was most common (50 of 104 patients, 48%), followed by II (21/104, 20%), III (12/104, 11.5%), V (9/104, 9%) and VI (12/104, 11.5%). Biofeedback therapy showed a therapeutic response in 71 out of 104 patients (68%) but failed in 33 patients (32%). However, there were no significant differences in the defecographic pattern between the responsive and non-responsive groups ({rho} = 0.630). The defecograms revealed contractions in 78 patients (75%) and moderate to vigorous contractions (more than grade 2) in 66 patients. Most of the biofeedback-responsive group showed rectal contractions (66 of 71 patients, 93%, {rho} < 0.001). In patients with chronic functional constipation, there was no significant difference in the morphological patterns of the defecogram between the responsive and non-responsive biofeedback groups. However, the presence of

  10. Pattern analysis of defecography in patients with chronic functional constipation: is it predictable for the responsiveness of biofeedback therapy?

    International Nuclear Information System (INIS)

    Yang, Hye Rin; Kim, Ah Young; Hong, Seong Sook; Byun, Jae Ho; Myung Seung Jae; Ha, Hyun Kwon

    2005-01-01

    To determine of pattern analysis of defecography can predict the responsiveness of biofeedback therapy in patients with chronic functional constipation. Over a two-year period, 104 patients with chronic functional constipation underwent defecography and biofeedback therapy. Two blinded readers analyzed the defecographic findings and classified them into six types; I = normal defecation, II = hypertonic lower anal sphincter (poor anal opening due to a persistent contraction of the lower anal sphincter), III dyskinetic puborectal sling (inadequate laxity of the puborectal sling), IV spastic pelvic floor syndrome (persistent contraction of both the puborectal sling and the lower and sphincter), V unclassified (including paradoxical contraction of the anal sphincter), VI anatomical obstruction. In addition, the degree of rectal contraction during defecation was scored (grade 0 to 3). After biofeedback therapy, the differences in the defecography patterns or rectal contraction between the two groups, the responsive or non-responsive group, were analyzed. The defecograms revealed that the type IV of the spastic pelvic floor syndrome was most common (50 of 104 patients, 48%), followed by II (21/104, 20%), III (12/104, 11.5%), V (9/104, 9%) and VI (12/104, 11.5%). Biofeedback therapy showed a therapeutic response in 71 out of 104 patients (68%) but failed in 33 patients (32%). However, there were no significant differences in the defecographic pattern between the responsive and non-responsive groups (ρ = 0.630). The defecograms revealed contractions in 78 patients (75%) and moderate to vigorous contractions (more than grade 2) in 66 patients. Most of the biofeedback-responsive group showed rectal contractions (66 of 71 patients, 93%, ρ < 0.001). In patients with chronic functional constipation, there was no significant difference in the morphological patterns of the defecogram between the responsive and non-responsive biofeedback groups. However, the presence of rectal

  11. Electroacupuncture reduces duration of postoperative ileus after laparoscopic surgery for colorectal cancer.

    Science.gov (United States)

    Ng, Simon S M; Leung, Wing Wa; Mak, Tony W C; Hon, Sophie S F; Li, Jimmy C M; Wong, Cherry Y N; Tsoi, Kelvin K F; Lee, Janet F Y

    2013-02-01

    We investigated the efficacy of electroacupuncture in reducing the duration of postoperative ileus and hospital stay after laparoscopic surgery for colorectal cancer. We performed a prospective study of 165 patients undergoing elective laparoscopic surgery for colonic and upper rectal cancer, enrolled from October 2008 to October 2010. Patients were assigned randomly to groups that received electroacupuncture (n = 55) or sham acupuncture (n = 55), once daily from postoperative days 1-4, or no acupuncture (n = 55). The acupoints Zusanli, Sanyinjiao, Hegu, and Zhigou were used. The primary outcome was time to defecation. Secondary outcomes included postoperative analgesic requirement, time to ambulation, and length of hospital stay. Patients who received electroacupuncture had a shorter time to defecation than patients who received no acupuncture (85.9 ± 36.1 vs 122.1 ± 53.5 h; P electroacupuncture also had a shorter time to defecation than patients who received sham acupuncture (85.9 ± 36.1 vs 107.5 ± 46.2 h; P = .007). Electroacupuncture was more effective than no or sham acupuncture in reducing postoperative analgesic requirement and time to ambulation. In multiple linear regression analysis, an absence of complications and electroacupuncture were associated with a shorter duration of postoperative ileus and hospital stay after the surgery. In a clinical trial, electroacupuncture reduced the duration of postoperative ileus, time to ambulation, and postoperative analgesic requirement, compared with no or sham acupuncture, after laparoscopic surgery for colorectal cancer. ClinicalTrials.gov number, NCT00464425. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

  12. GPS Tracking of Free-Ranging Pigs to Evaluate Ring Strategies for the Control of Cysticercosis/Taeniasis in Peru.

    Directory of Open Access Journals (Sweden)

    Ian W Pray

    2016-04-01

    Full Text Available Taenia solium, a parasitic cestode that affects humans and pigs, is the leading cause of preventable epilepsy in the developing world. T. solium eggs are released into the environment through the stool of humans infected with an adult intestinal tapeworm (a condition called taeniasis, and cause cysticercosis when ingested by pigs or other humans. A control strategy to intervene within high-risk foci in endemic communities has been proposed as an alternative to mass antihelminthic treatment. In this ring strategy, antihelminthic treatment is targeted to humans and pigs residing within a 100 meter radius of a pig heavily-infected with cysticercosis. Our aim was to describe the roaming ranges of pigs in this region, and to evaluate whether the 100 meter radius rings encompass areas where risk factors for T. solium transmission, such as open human defecation and dense pig activity, are concentrated.In this study, we used Global Positioning System (GPS devices to track pig roaming ranges in two rural villages of northern Peru. We selected 41 pigs from two villages to participate in a 48-hour tracking period. Additionally, we surveyed all households to record the locations of open human defecation areas. We found that pigs spent a median of 82.8% (IQR: 73.5, 94.4 of their time roaming within 100 meters of their homes. The size of home ranges varied significantly by pig age, and 93% of the total time spent interacting with open human defecation areas occurred within 100 meters of pig residences.These results indicate that 100 meter radius rings around heavily-infected pigs adequately capture the average pig's roaming area (i.e., home range and represent an area where the great majority of exposure to human feces occurs.

  13. GPS Tracking of Free-Ranging Pigs to Evaluate Ring Strategies for the Control of Cysticercosis/Taeniasis in Peru.

    Science.gov (United States)

    Pray, Ian W; Swanson, Dallas J; Ayvar, Viterbo; Muro, Claudio; Moyano, Luz M; Gonzalez, Armando E; Garcia, Hector H; O'Neal, Seth E

    2016-04-01

    Taenia solium, a parasitic cestode that affects humans and pigs, is the leading cause of preventable epilepsy in the developing world. T. solium eggs are released into the environment through the stool of humans infected with an adult intestinal tapeworm (a condition called taeniasis), and cause cysticercosis when ingested by pigs or other humans. A control strategy to intervene within high-risk foci in endemic communities has been proposed as an alternative to mass antihelminthic treatment. In this ring strategy, antihelminthic treatment is targeted to humans and pigs residing within a 100 meter radius of a pig heavily-infected with cysticercosis. Our aim was to describe the roaming ranges of pigs in this region, and to evaluate whether the 100 meter radius rings encompass areas where risk factors for T. solium transmission, such as open human defecation and dense pig activity, are concentrated. In this study, we used Global Positioning System (GPS) devices to track pig roaming ranges in two rural villages of northern Peru. We selected 41 pigs from two villages to participate in a 48-hour tracking period. Additionally, we surveyed all households to record the locations of open human defecation areas. We found that pigs spent a median of 82.8% (IQR: 73.5, 94.4) of their time roaming within 100 meters of their homes. The size of home ranges varied significantly by pig age, and 93% of the total time spent interacting with open human defecation areas occurred within 100 meters of pig residences. These results indicate that 100 meter radius rings around heavily-infected pigs adequately capture the average pig's roaming area (i.e., home range) and represent an area where the great majority of exposure to human feces occurs.

  14. Knowledge, attitude and practice related to liver fluke infection in northeast Thailand

    Institute of Scientific and Technical Information of China (English)

    Natthawut Kaewpitoon; Soraya J Kaewpitoon; Prasit Pengsaa; Chutigan Pilasri

    2007-01-01

    AIM:To investigate the knowledge,attitude and practice (KAP) in prevention and control of liver fluke infection in northeast Thailand.METHODS:A descriptive KAP survey pertaining to liver fluke infection was carried out in June 2005 to October 2006 using structured questionnaires. Data were collected by questionnaires consisting of general parameters,knowledge,attitude,practice,and a history of participation in the prevention and control of liver fluke infection.RESULTS:A total of 1077 persons who were interviewed and completed the questionnaires were enrolled in the study. The majority were females (69.5%) and many of them were 15-20 years of age (37.26%). The questionnaires revealed that information resources on Uver fluke infection included local public health volunteers (31.37%),public health officers (18.72%),televisions (14.38%),local heads of sub-districts (12.31%),doctors and nurses (9.18%),newspaper (5.72),internets (5.37%),and others (12.95%). Fifty-five point eleven percent of the population had a good level of liver fluke knowledge concerning the mode of disease transmission and 79.72% of the population had a good level of prevention and control knowledge with regards to defecation and consumption. The attitude and practice in liver fluke prevention and control were also at a good level with a positive awareness,participation,and satisfaction of 72.1% and 60.83% of the persons studied. However,good health behavior was found in 39.26% and 41.42% of the persons studied who had unhygienic defecation and ate raw cyprinoid's fish. Theresult also showed that 41.25% of the persons studied previously joined prevention and control campaigns.CONCLUSION:The persons studied have a high level of liver fluke knowledge and positive attitude. However,improvement is required regarding personal hygiene specifically with hygienic defecation and consumption of undercooked fish.

  15. From menarche to menopause: A population-based assessment of water, sanitation, and hygiene risk factors for reproductive tract infection symptoms over life stages in rural girls and women in India.

    Science.gov (United States)

    Baker, Kelly K; Padhi, Bijaya; Torondel, Belen; Das, Padmalaya; Dutta, Ambarish; Sahoo, Krushna Chandra; Das, Bhabani; Dreibelbis, Robert; Caruso, Bethany; Freeman, Matthew C; Sager, Lauren; Panigrahi, Pinaki

    2017-01-01

    Women face greater challenges than men in accessing water, sanitation, and hygiene (WASH) resources to address their daily needs, and may respond to these challenges by adopting unsafe practices that increase the risk of reproductive tract infections (RTIs). WASH practices may change as women transition through socially-defined life stage experiences, like marriage and pregnancy. Thus, the relationship between WASH practices and RTIs might vary across female reproductive life stages. This cross-sectional study assessed the relationship between WASH exposures and self-reported RTI symptoms in 3,952 girls and women from two rural districts in India, and tested whether social exposures represented by reproductive life stage was an effect modifier of associations. In fully adjusted models, RTI symptoms were less common in women using a latrine without water for defecation versus open defecation (Odds Ratio (OR) = 0.69; Confidence Interval (CI) = 0.48, 0.98) and those walking shorter distances to a bathing location (OR = 0.79, CI = 0.63, 0.99), but there was no association between using a latrine with a water source and RTIs versus open defecation (OR = 1.09; CI = 0.69, 1.72). Unexpectedly, RTI symptoms were more common for women bathing daily with soap (OR = 6.55, CI = 3.60, 11.94) and for women washing their hands after defecation with soap (OR = 10.27; CI = 5.53, 19.08) or ash/soil/mud (OR = 6.02; CI = 3.07, 11.77) versus water only or no hand washing. WASH practices of girls and women varied across reproductive life stages, but the associations between WASH practices and RTI symptoms were not moderated by or confounded by life stage status. This study provides new evidence that WASH access and practices are associated with self-reported reproductive tract infection symptoms in rural Indian girls and women from different reproductive life stages. However, the counterintuitive directions of effect for soap use highlights that causality and mechanisms of effect cannot

  16. Efficacy of an Iranian herbal preparation (Lax-Asab in treating functional constipation: A randomized, placebo-controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Somi

    2015-07-01

    Full Text Available Functional constipation is a common clinical complaint of patients with unsatisfactory treatment outcome. We designed this study to evaluate the efficiency of a traditional herbal preparation (Lax-Asab in treating chronic constipation. In this double-blind, randomized, placebo-controlled clinical trial, participants with chronic constipation (n = 48 were randomly selected to receive either the Lax-Asab powder (n = 24 or placebo (n = 24 on alternative days for 4 weeks. The Lax-Asab powder contains equal amounts of Cassia angustifolia Vahl. (狹葉番瀉葉 xiá yè fān xiè yè, Mentha piperita L. (胡椒薄荷 hú jiāo bò hé, Zingiber officinale Rosc. (生薑 shēng jiāng, Glycyrrhiza glabra L. (甘草 gān cǎo. A total of 40 patients completed the study. We determined the severity of constipation based on defecation frequency (per week and defecation difficulties. Of the total of 48 patients who participated, 40 completed the trial [24 men (60%, mean age, 21.0 ± 4.2 years; 16 women (40%, mean age, 20.1 ± 4.3 years]. The mean of weekly defecation frequency increased in both groups; from 1.8 ± 0.41 to 4.8 ± 1.12 times in patients who received Lax-Asab and from 1.7 ± 0.44 to 2.2 ± 0.61 times in patients who received placebo. A time–treatment interaction showed that this increase was significantly higher in the intervention group. Defecation difficulties improved significantly more in patients who received Lax-Asab than patients who received placebo. There was no statistically significant difference between the two groups with regard to the side effects observed. This study confirms the efficacy and tolerability of an Iranian herbal preparation, Lax-Asab, in treating patients with chronic functional constipation.

  17. Teenage constipation: a case study.

    Science.gov (United States)

    Streeter, Bonnie L

    2002-01-01

    Constipation is a problem of significant magnitude. It can have a devastating impact on a patient's personal life. There are many causes of constipation. Among them are dietary factors such as decreased fiber and low fluid intake, decreased activity, lack of privacy for defecation, pharmacologic agents, physiologic problems such as bowel obstruction or metabolic disorders, and psychosocial distress. A young teenage boy is followed through a series of emergency room visits, office visits, and a hospitalization related to his experiences with constipation. A bowel program was identified and instituted with successful outcomes.

  18. Gastrointestinal Autonomic Dysfunction in Patients with Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Joong-Seok Kim

    2015-05-01

    Full Text Available Currently, gastrointestinal dysfunctions in Parkinson’s disease (PD are well-recognized problems and are known to be an initial symptom in the pathological process that eventually results in PD. Gastrointestinal symptoms may result from the involvement of either the central or enteric nervous systems, or these symptoms may be side effects of antiparkinsonian medications. Weight loss, excessive salivation, dysphagia, nausea/gastroparesis, constipation, and defecation dysfunction all may occur. Increased identification and early detection of these symptoms can result in a significant improvement in the quality of life for PD patients.

  19. Assessment of beet quality using a refractometric method. Ruebenqualitaetsbewertung mit Hilfe einer refraktometrischen Methode

    Energy Technology Data Exchange (ETDEWEB)

    Pollach, G; Hein, W; Roesner, G; Berninger, H; Kernchen, W

    1992-04-20

    We tested on 40 beet samples how far it might be possible to assess beet quality using refractometric and densimetric methods. Regarding the parameter molasses non-sugar on beet, a combination of Aluminum defecation and refractometry proved to be almost equivalent to methods based on non-sugar components. As well as for thick juice purity and molasses non-sugar on beet, formulae are given, assuming low Ca molasses, for molasses sugar and corrected sugar, respectively, on beet. By assuming a relative loss between beet and thick juice, very simple relationships were found. Practical tests in beet laboratories have not yet been carried out. (orig.)

  20. The distorting effect of varying diets on fecal glucocorticoid measurements as indicators of stress

    DEFF Research Database (Denmark)

    Kalliokoski, Otto; Teilmann, A. Charlotte; Abelson, Klas S. P.

    2015-01-01

    The physiological stress response is frequently gauged in animals, non-invasively, through measuring glucocorticoids in excreta. A concern with this method is, however, the unknown effect of variations in diets on the measurements. With an energy dense diet, leading to reduced defecation, will low...... concentrations of glucocorticoids be artificially inflated? Can this effect be overcome by measuring the total output of glucocorticoids in excreta? In a controlled laboratory setting we explored the effect in mice. When standard mouse chow – high in dietary fiber – was replaced with a 17% more energy-dense diet...

  1. Osteopathic Manipulative Treatment Limits Chronic Constipation in a Child with Pitt-Hopkins Syndrome

    Directory of Open Access Journals (Sweden)

    Alessandro Aquino

    2017-01-01

    Full Text Available Pitt-Hopkins Syndrome (PTHS is a rare genetic disorder caused by insufficient expression of the TCF4 gene. Children with PTHS typically present with gastrointestinal disorders and early severe chronic constipation is frequently found (75%. Here we describe the case of a PTHS male 10-year-old patient with chronic constipation in whom Osteopathic Manipulative Treatment (OMT resulted in improved bowel functions, as assessed by the diary, the QPGS-Form A Section C questionnaire, and the Paediatric Bristol Stool Form Scale. The authors suggested that OMT may be a valid tool to improve the defecation frequency and reduce enema administration in PTHS patients.

  2. Maternal and fetal toxicity of poison hemlock (Conium maculatum) in sheep.

    Science.gov (United States)

    Panter, K E; Bunch, T D; Keeler, R F

    1988-02-01

    Poison hemlock (Conium maculatum) was toxic to pregnant ewes and their fetuses when fed during gestation days 30 through 60. Maternal effects included trembling, muscular weakness in the neck initially, then progressing to the limbs, ataxia, frequent urination and defecation, and death. Convulsive seizures were not observed. Fetotoxic effects included excessive flexure of the carpal joints with lateral deviation in the front limbs and kinked tails. At term, 7 of 11 lambs had varying degrees of the limb abnormalities, but all lambs appeared clinically normal at 8 weeks after parturition.

  3. On park design : looking beyond the wars

    OpenAIRE

    Oneka, M.

    1996-01-01


    The present book opens with an account of a buffalo hunt in the company of soldiers in one of the national parks in Uganda. One buffalo was hit close to the heart but fled away as if it was not fatally wounded. The soldiers seeing it flee, fired more rounds of ammunition at it until, with limbs broken, the buffalo fell down. This account is used to demonstrate some of the ravages of wars on parks. It is argued that most parks around the world are destined to perish because of defec...

  4. Selected problems associated with the treatment and care for patients with colostomy – part 2

    Science.gov (United States)

    Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and mastering them in practice is to provide ostomy patients not only with highest-standard care and help but also to prepare them for dealing with problems independently, i.e. for self-care. PMID:24596509

  5. Selected problems associated with the treatment and care for patients with colostomy - part 2.

    Science.gov (United States)

    Muzyczka, Katarzyna; Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and mastering them in practice is to provide ostomy patients not only with highest-standard care and help but also to prepare them for dealing with problems independently, i.e. for self-care.

  6. Adequate dietary fiber supplement and TONE can help avoid surgery in most patients with advanced hemorrhoids.

    Science.gov (United States)

    Garg, Pankaj; Singh, Pratiksha

    2017-06-01

    The root cause of hemorrhoids resides in three deranged defecation habits (DDH), namely increased straining, prolonged defecation-time, and frequent bowel-motions. These DDH are responsible for the development of new hemorrhoids, progression of existing one and hemorrhoidal rupture (bleeding). DDH can be corrected with the help of the "TONE" mnemonic. TONE entails specifying exact treatment goals: T, three minutes at defecation; O, once-a-day defecation frequency; N, no straining during passing motions; E, enough fiber. TONE can be implemented by proper counseling and by prescribing fiber supplement appropriately (5-6 teaspoonfuls of psyllium husk with 600 mL of water daily. Corrected DDH would prevent the progression of hemorrhoids and bleeding episodes. An office procedure may be done to further downgrade the hemorrhoids. Patients with advanced hemorrhoids (grades III and IV) who were referred for surgery were prescribed fiber supplement and were counseled to follow TONE. The outcome parameters evaluated were improvement in prolapse, bleeding episodes, satisfaction levels. A total of 102 patients (75 males and 10 females, mean age 46.0±13.5 years, 17 lost to follow-up) with advanced hemorrhoids (41 with early grade III, 38 with late grade III, and 6 with grade IV) were included in the study. All patients had symptoms of prolapsed hemorrhoids and bleeding episodes were present in 71.8% (61/85) of patients. After the follow-up of 40 (12-96) months, 68.2% (58/85) patients were highly satisfied, 12.9% (11/85) were moderately satisfied and 18.9% (16/85) were not satisfied with treatment. Prolapse improved in 56.5% (48/85), did not progress over time in 25.9 (22/85) and continued to progress in 4.7% (4/85) patients. 12.9% (11/85) underwent operation for hemorrhoids. Bleeding episodes decreased from 71.8% (61/85) to 29.4% (25/85) (Phemorrhoids and bleeding, and preventing surgery in most patients with advanced hemorrhoids.

  7. Does water-perfused catheter overdiagnose anismus compared to balloon probe?

    Science.gov (United States)

    Savoye, G; Leroi, A M; Bertot-Sassigneux, P; Touchais, J Y; Devroede, G; Denis, P

    2002-12-01

    The purpose of this study was to compare the manometric assessment of straining effort as if to defecate and rectoanal inhibitory reflex obtained with a rectosphincteric balloon probe and with a water-perfused catheter in the same subject. Twelve healthy volunteers underwent two manometric assessments of anal sphincter function and electromyographic (EMG) surface recordings. one with a rectosphincteric balloon and one with a water-perfused catheter, 7 days apart in random order. Increased EMG activity in the external anal sphincter in the midst of the rectoanal inhibitory reflex (P anismus, particularly if pelvic floor EMG is only taken into account for the diagnosis of anismus.

  8. The value of the abdominal radiograph in children with functional gastrointestinal disorders

    Energy Technology Data Exchange (ETDEWEB)

    Bongers, Marloes E.J. [Department of Pediatric Gastroenterology and Nutrition, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)]. E-mail: mbongers@uva.amc.nl; Voskuijl, Wieger P. [Department of Pediatric Gastroenterology and Nutrition, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Rijn, Rick R. van [Department of Pediatric Radiology, Emma Children' s Hospital/Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Benninga, Marc A. [Department of Pediatric Gastroenterology and Nutrition, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

    2006-07-15

    Functional gastrointestinal disorder is a common problem in childhood. The symptoms vary from a relative mild gastrointestinal problem such as abdominal pain or infrequent defecation to severe problems with fecal impaction and fecal incontinence. The aim of this review is to describe and evaluate the value of the different existing methods to assess fecal loading on an abdominal radiograph with or without the use of radio-opaque markers in the diagnosis of functional abdominal pain, functional constipation and functional non-retentive fecal incontinence. In our opinion, the abdominal radiograph has limited value in the diagnostic work-up of children with functional gastrointestinal disorders.

  9. Taenia solium cysticercosis - an emerging foodborne zoonosis in sub-Saharan Africa

    DEFF Research Database (Denmark)

    Johansen, Maria Vang; Lekule, Faustin; Pondja, Alberto

    -funded projects have addressed the problem, first by assessing the prevalence, risks and impacts of T. solium taeniosis/cysticercosis in both humans and pigs in Mozambique and Tanzania from 2006-2009, and, through an on-going project, by trying to develop sustainable solutions for control of the disease...... infections included poor pig husbandry practices especially free ranging of pigs, open defecation, age of pigs, pork cooking practices, lack of meat inspection, and lack of knowledge regarding transmission of the disease. The on-going project focuses on health education and proper pig management as means...

  10. ILEOCOLIC INTUSSUSCEPTION IN A COCKER SPANIEL DOG: A CASE REPORT

    OpenAIRE

    M. A. Khan, M. M. Ali, S. Azeem, A. Safdar, Ijaz A. Ziaullah and M. T. Sajjad

    2011-01-01

    A four-years-old female cocker spaniel dog was presented with a history of vomiting and tenesmus for the last six days. There was no defecation, only fresh blood was coming from rectum and the animal was taking only a few sips of water for last two days. Physical examination revealed that the animal was dehydrated. Tenderness was appreciable on abdominal palpation while a firm, painful mass was felt in the mid-caudal abdomen. The clinical history and physical examination was suggestive of int...

  11. Effect of an integrated intervention package of preventive chemotherapy, community-led total sanitation and health education on the prevalence of helminth and intestinal protozoa infections in Côte d'Ivoire.

    Science.gov (United States)

    Hürlimann, Eveline; Silué, Kigbafori D; Zouzou, Fabien; Ouattara, Mamadou; Schmidlin, Thomas; Yapi, Richard B; Houngbedji, Clarisse A; Dongo, Kouassi; Kouadio, Bernadette A; Koné, Siaka; Bonfoh, Bassirou; N'Goran, Eliézer K; Utzinger, Jürg; Acka-Douabélé, Cinthia A; Raso, Giovanna

    2018-02-27

    Preventive chemotherapy with donated anthelminthic drugs is the cornerstone for the control of helminthiases. However, reinfection can occur rapidly in the absence of clean water and sanitation coupled with unhygienic behaviour. The purpose of this study was to assess the effect of an integrated package of interventions, consisting of preventive chemotherapy, community-led total sanitation (CLTS) and health education, on the prevalence of helminth and intestinal protozoa infections and on participants' knowledge, attitude, practice and beliefs (KAPB) towards these diseases including water, sanitation and hygiene (WASH). A cross-sectional survey was carried out in nine communities of south-central Côte d'Ivoire to assess people's infection with helminths and intestinal protozoa and KAPB. Subsequently, interventions were targeted to five communities, while the remaining communities served as control. The intervention encouraged latrine construction and an evaluation was done 6-7 months later to determine open defecation status of the respective communities. Anthelminthic treatment was provided to all community members. A follow-up cross-sectional survey was conducted approximately one year later, using the same procedures. Overall, 810 people had complete baseline and follow-up data and were given anthelminthic treatment. The baseline prevalence of hookworm, Schistosoma haematobium, Trichuris trichiura, Schistosoma mansoni and Ascaris lumbricoides was 31.1%, 7.0%, 2.0%, 1.0% and 0.3%, respectively. Four of the five intervention communities were classified open-defecation free. For hookworm infection, we observed higher negative changes in terms of proportion of decrease (-0.10; 95% confidence interval (CI): - 0.16, -0.04) and higher egg reduction rate (64.9 vs 15.2%) when comparing intervention with control communities. For intestinal protozoa, prevalence reduction was higher in intervention compared to control communities (8.2 vs 2.6%) and WASH indicators and

  12. The value of the abdominal radiograph in children with functional gastrointestinal disorders

    International Nuclear Information System (INIS)

    Bongers, Marloes E.J.; Voskuijl, Wieger P.; Rijn, Rick R. van; Benninga, Marc A.

    2006-01-01

    Functional gastrointestinal disorder is a common problem in childhood. The symptoms vary from a relative mild gastrointestinal problem such as abdominal pain or infrequent defecation to severe problems with fecal impaction and fecal incontinence. The aim of this review is to describe and evaluate the value of the different existing methods to assess fecal loading on an abdominal radiograph with or without the use of radio-opaque markers in the diagnosis of functional abdominal pain, functional constipation and functional non-retentive fecal incontinence. In our opinion, the abdominal radiograph has limited value in the diagnostic work-up of children with functional gastrointestinal disorders

  13. Elaboración y gestión de un programa de mantenimiento para una fábrica de lentes oftálmicos

    OpenAIRE

    Garrafa Ayquipa, Henry Calixto; Garrafa Ayquipa, Henry Calixto

    2007-01-01

    La fabricación de lentes oftálmicos es una industria de poco desarrollo en el Perú. Sin embargo, Topsa se ha preocupado por ser una empresa competitiva, realizando inversiones en tecnología y mejora de sus procesos, convirtiéndola en una empresa lideren la industria. En la última década, las ventas de Topsa crecieron a razón del 20 % anual, por ello se amplió la capacidad de planta adquiriendo nuevas maquinarias. También, se incrementaron los reclamos de los clientes por productos defec...

  14. An Internet intervention as adjunctive therapy for pediatric encopresis.

    Science.gov (United States)

    Ritterband, Lee M; Cox, Daniel J; Walker, Lynn S; Kovatchev, Boris; McKnight, Lela; Patel, Kushal; Borowitz, Stephen; Sutphen, James

    2003-10-01

    This study evaluated the benefits of enhanced toilet training delivered through the Internet for children with encopresis. Twenty-four children with encopresis were randomly assigned to the Internet intervention group (Web) or no Internet intervention group (No-Web). All participants continued to receive routine care from their primary care physician. The Web participants demonstrated greater improvements in terms of reduced fecal soiling, increased defecation in the toilet, and increased unprompted trips to the toilet (ps<.02). Both groups demonstrated similar improvements in knowledge and toileting behaviors. Internet interventions may be an effective way of delivering sophisticated behavioral interventions to a large and dispersed population in a convenient format.

  15. From menarche to menopause: A population-based assessment of water, sanitation, and hygiene risk factors for reproductive tract infection symptoms over life stages in rural girls and women in India

    Science.gov (United States)

    Padhi, Bijaya; Torondel, Belen; Das, Padmalaya; Dutta, Ambarish; Sahoo, Krushna Chandra; Freeman, Matthew C.; Sager, Lauren; Panigrahi, Pinaki

    2017-01-01

    Women face greater challenges than men in accessing water, sanitation, and hygiene (WASH) resources to address their daily needs, and may respond to these challenges by adopting unsafe practices that increase the risk of reproductive tract infections (RTIs). WASH practices may change as women transition through socially-defined life stage experiences, like marriage and pregnancy. Thus, the relationship between WASH practices and RTIs might vary across female reproductive life stages. This cross-sectional study assessed the relationship between WASH exposures and self-reported RTI symptoms in 3,952 girls and women from two rural districts in India, and tested whether social exposures represented by reproductive life stage was an effect modifier of associations. In fully adjusted models, RTI symptoms were less common in women using a latrine without water for defecation versus open defecation (Odds Ratio (OR) = 0.69; Confidence Interval (CI) = 0.48, 0.98) and those walking shorter distances to a bathing location (OR = 0.79, CI = 0.63, 0.99), but there was no association between using a latrine with a water source and RTIs versus open defecation (OR = 1.09; CI = 0.69, 1.72). Unexpectedly, RTI symptoms were more common for women bathing daily with soap (OR = 6.55, CI = 3.60, 11.94) and for women washing their hands after defecation with soap (OR = 10.27; CI = 5.53, 19.08) or ash/soil/mud (OR = 6.02; CI = 3.07, 11.77) versus water only or no hand washing. WASH practices of girls and women varied across reproductive life stages, but the associations between WASH practices and RTI symptoms were not moderated by or confounded by life stage status. This study provides new evidence that WASH access and practices are associated with self-reported reproductive tract infection symptoms in rural Indian girls and women from different reproductive life stages. However, the counterintuitive directions of effect for soap use highlights that causality and mechanisms of effect cannot

  16. The development of Panstrongylus herreri under fluctuating environmental conditions

    Directory of Open Access Journals (Sweden)

    Edson Franzim Junior

    Full Text Available Abstract: INTRODUCTION: Panstrongylus herreri is a main Chagas disease vector, and its success as a vector stems from its ability to establish domiciliated colonies; we aimed to explore its biology and reproduction. METHODS: The average amount of blood ingested and the time from the beginning of a blood meal to the production of feces were recorded. RESULTS: Females exhibited a higher blood ingestion rate than males, but similar defecation times and frequencies were observed. CONCLUSIONS: Despite the detected decrease in oviposition rates, P. herreri’s potential as a Chagas disease vector in environments other than the Amazon forest cannot be discounted.

  17. Cloacolith in a blue-fronted amazon parrot (Amazona aestiva).

    Science.gov (United States)

    Beaufrère, Hugues; Nevarez, Javier; Tully, Thomas N

    2010-06-01

    A 4-year-old blue-fronted Amazon parrot (Amazona aestiva) was admitted for vocalization secondary to constipation. Saline infusion cloacoscopy revealed the presence of a 2-cm-diameter cloacolith within the coprodeum that was obstructing the rectal opening. The cloacolith was fragmented with a pair of biopsy forceps and the pieces removed. The cloacolith was subsequently analyzed and was composed of 100% uric acid salts. The bird improved completely and was able to defecate normally after the procedure. Cloacoliths are relative uncommon cloacal conditions, and this case documents cloacoscopic findings, rectal obstruction, and confirmation of its uric acid composition by urolith analysis.

  18. Whole-grain rye and wheat affect some markers of gut health without altering the fecal microbiota in healthy overweight adults

    DEFF Research Database (Denmark)

    Vuholm, Stine; Nielsen, Dennis Sandris; Iversen, Kia Nøhr

    2017-01-01

    % CI: 0.18, 0.80) and WGR (OR: 0.34, 95% CI: 0.16, 0.72). Stool frequency increased following WGR but not WGW, compared to RW in weeks 2 (0.4 defecations/d, P = 0.049) and 4 (0.5 defecations/d, P = 0.043), but not in week 6. The WGW and WGR groups did not differ from each other in any of the variables......Background: Whole grains have shown potential for improving gut health, but evidence comparing different whole-grain types is lacking.Objective: We investigated whether whole-grain wheat (WGW) and whole-grain rye (WGR) improve gut health in different ways compared to refined wheat (RW...... tested.Conclusion: Regular consumption of WGR and WGW affected fecal butyrate concentration and gastrointestinal symptoms in healthy overweight adults, supporting the hypothesis that WGR and WGW can be included in the diet equally to maintain gut health. This trial was registered at clinicaltrials...

  19. Effectiveness of Acupuncture for Early Recovery of Bowel Function in Cancer: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Liu, Yi-Hua; Dong, Guang-Tong; Ye, Yang; Zheng, Jia-Bin; Zhang, Ying; Lin, Hong-Sheng; Wang, Xue-Qian

    2017-01-01

    The aim of this study was to evaluate the effects of acupuncture therapy to reduce the duration of postoperative ileus (POI) and to enhance bowel function in cancer patients. A systematic search of electronic databases for studies published from inception until January 2017 was carried out from six databases. Randomized controlled trials (RCTs) involving the use of acupuncture and acupressure for POI and bowel function in cancer patients were identified. Outcomes were extracted from each study and pooled to determine the risk ratio and standardized mean difference. 10 RCTs involving 776 cancer patients were included. Compared with control groups (no acupuncture, sham acupuncture, and other active therapies), acupuncture was associated with shorter time to first flatus and time to first defecation. A subgroup analysis revealed that manual acupuncture was more effective on the time to first flatus and the time to first defecation; electroacupuncture was better in reducing the length of hospital stay. Compared with control groups (sham or no acupressure), acupressure was associated with shorter time to first flatus. However, GRADE approach indicated a low quality of evidence. Acupuncture and acupressure showed large effect size with significantly poor or inferior quality of included trials for enhancing bowel function in cancer patients after surgery. Further well-powered evidence is needed.

  20. Social constraints before sanitation improvement in tea gardens of Sylhet, Bangladesh.

    Science.gov (United States)

    Ahmed, M; Begum, Anwara; Chowdhury, M A I

    2010-05-01

    Sylhet, the northeastern divisional city of Bangladesh, is the major tea-producing region of the country where a large number of low-income workers completely depending on extremely labor-intensive economic activity for their bread and butter, live in and around the tea gardens. The living conditions of these communities are remarkably meager due to the lack of proper utility facilities, especially in water supply and sanitation sectors. A study was conducted at Lakkatura and Ali Bahar Tea Estates to assess the deteriorated sanitation condition of the tea garden workers community and to determine the constraints before the improvement of the condition. It was found that the existing sanitary condition of both of the tea garden slums is very poor because of the same topographical condition and socioeconomic and cultural status of the dwellers. About 50% to 60% tea garden workers still are used to open defecation causing various excreta related diseases and not practiced with washing hand after defecation. Lack of knowledge and awareness about health and hygiene, unwillingness, poverty, superstitions, etc. are responsible for the deteriorated condition of the sanitation system. Based on the analysis, providing latrines free of costs, undertaking extensive motivational and awareness programs and publicity, regular consultation of tea garden workers with the health specialists, and vector control staff of concerned utilities as well as an integrated water supply, sanitation, and hygiene promotion programs should be considered as the priority in order to improve the deteriorated sanitary conditions in two tea gardens.

  1. Food hygiene behaviour and childhood diarrhoea in Lagos, Nigeria: a case-control study.

    Science.gov (United States)

    Ekanem, E E; Akitoye, C O; Adedeji, O T

    1991-09-01

    We investigated food hygiene-related behaviour as well as other risk factors for diarrhoea in children 6-36 months of age in Iwaya community in Lagos, Nigeria. Between April and July 1989, a bi-weekly diarrhoea surveillance was maintained in 672 households. Following the surveillance, 273 (case = 67 and control = 206) families were visited twice, each visit lasting for 3-4 hours. Detailed observations on food hygiene, water sanitation, and sanitary conditions of the home were made. There was no significant association between any of the observed food hygiene behaviours and the occurrence of diarrhoea. The presence of faeces in and around the toilet area (RR = 1.79), habit of defecating and urinating in chamber pots in dwelling units (RR = 1.80), indiscriminate disposal of waste (RR = 2.48), and source of domestic water (RR = 2.94) were the main factors significantly associated with the occurrence of diarrhoea in this community. These findings imply that diarrhoea might be reduced through an education programme which focuses on the proper care, handling and storage of defecation pots and proper disposal of waste.

  2. Local anaesthetic refinement of pentobarbital euthanasia reduces abdominal writhing without affecting immunohistochemical endpoints in rats.

    Science.gov (United States)

    Khoo, Shaun Y-S; Lay, Belinda P P; Joya, Josephine; McNally, Gavan P

    2018-04-01

    Sodium pentobarbital is a commonly used agent for euthanizing laboratory rats, however its high pH can cause abdominal discomfort after intraperitoneal injection. Previous studies suggest that the addition of a local anaesthetic may alleviate this discomfort, but the practice has not been widely adopted. We examined the effect of combining lidocaine with pentobarbital on abdominal writhing, defecation, ultrasonic vocalizations, the rat grimace scale and immunohistochemical staining for c-Fos in the nucleus accumbens and basolateral amygdala of the brain. We also compared the amount of abdominal writhing following intraperitoneal administration of pentobarbital-lidocaine with that of pentobarbital-bupivacaine. Our results show that lidocaine reduces abdominal writhing and defecation without affecting immunohistochemistry for c-Fos or latency to loss of posture. However, scores on the rat grimace scale were low in both situations and almost no ultrasonic vocalizations were recorded. Additionally, we found that the amount of abdominal writhing was not significantly different when bupivacaine was used rather than lidocaine. Our results suggest that pentobarbital-induced euthanasia can be refined with the addition of lidocaine or other local anaesthetics.

  3. STUDI KASUS HUBUNGAN SENAM NIFAS DENGAN STATUS KESEHATAN IBU NIFAS

    Directory of Open Access Journals (Sweden)

    Gurendro Putro

    2012-11-01

    Full Text Available Background: During pregnancy and birth period there are physical changes, some of muscle experiencing lengthening, especially uterus muscle and stomach muscle. After bearing, uterus was not back quickly like before, but through a process. Health recover process at post-partum was important thing for mother after birth period. Therefore, for turning back at early condition or recover period better so that body always health needed a exercise which popular as post-partum exercise. Methods: This research executed was prospective cohort design with quantitative approach. Interview was executed at 30 respondents post-partum mother. Subject got from population with simple random sampling. Depth interview was executed to get depth information about research which observed. Independent variables at this research were participation postparfum exercise and dependent variables are complication, narrow of uterus, swell oedema, treatment of stitching hurt loctation, early ambulation, urinate, defecate, drink and eat pattern. Results: Chi square result indicated difference health status between does exercise and neither was only early ambulation and defecates from other some variable. Variables early ambulation (p = 0.001 and deficate (p = 0.001 significant with exercise. But variables involution utery, oedema treatment of stitching hurt and drink and eat pattern not significant with exercise.Key words: post-parfum exercise, health status

  4. The honey bee parasite Nosema ceranae: transmissible via food exchange?

    Directory of Open Access Journals (Sweden)

    Michael L Smith

    Full Text Available Nosema ceranae, a newly introduced parasite of the honey bee, Apis mellifera, is contributing to worldwide colony losses. Other Nosema species, such as N. apis, tend to be associated with increased defecation and spread via a fecal-oral pathway, but because N. ceranae does not induce defecation, it may instead be spread via an oral-oral pathway. Cages that separated older infected bees from young uninfected bees were used to test whether N. ceranae can be spread during food exchange. When cages were separated by one screen, food could be passed between the older bees and the young bees, but when separated by two screens, food could not be passed between the two cages. Young uninfected bees were also kept isolated in cages, as a solitary control. After 4 days of exposure to the older bees, and 10 days to incubate infections, young bees were more likely to be infected in the 1-Screen Test treatment vs. the 2-Screen Test treatment (P=0.0097. Young bees fed by older bees showed a 13-fold increase in mean infection level relative to young bees not fed by older bees (1-Screen Test 40.8%; 2-Screen Test 3.4%; Solo Control 2.8%. Although fecal-oral transmission is still possible in this experimental design, oral-oral infectivity could help explain the rapid spread of N. ceranae worldwide.

  5. Assessing Potential Environmental Contamination by Baylisascaris procyonis Eggs from Infected Raccoons in Southern Texas.

    Science.gov (United States)

    Ogdee, Jacob L; Henke, Scott E; Wester, David B; Fedynich, Alan M

    2017-03-01

    Baylisascaris procyonis is a large ascarid of raccoons (Procyon lotor) and is a zoonotic threat. We documented the potential rate a raccoon population can contaminate their environment with B. procyonis eggs. We estimated the population size of raccoons using a 9 × 7 trapping grid of Havahart traps, identified locations of raccoon scats through systematic searches, and enumerated the distance B. procyonis eggs passively travel from site of origin upon scat decay. During an 8-week capture period, the raccoon population was estimated to be 19.6 ± 1.3 raccoons within the 63-ha study area (1 raccoon/3.2 ha). There were 781 defecation sites, of which 744 (95.3%) were isolated sites and 37 (4.7%) were latrine sites. Fifty-three (6.8%) defecation sites occurred in areas associated with human structures (commensal zone). Of the noncommensal sites, 9 (1.2%) and 719 (98.8%) sites were identified as latrine sites and isolated scats, respectively. More latrine sites were located within the commensal zone (p contaminate 0.03 ± 0.01 ha/year with B. procyonis eggs. Our findings indicate that B. procyonis represents a substantial risk to humans in areas where infected raccoons and humans co-occur.

  6. Effect of Gum Chewing on Intestinal Functions after Gynecological Operations: A Randomized Controlled Study

    Directory of Open Access Journals (Sweden)

    Taylan Şenol

    2016-12-01

    RESULTS: There was no difference between groups in terms of age, duration of operation, intraoperative blood loss, pre and postoperative serum hemoglobin levels, duration to first bowel sound, flatulence and defecation (p>0.05. Age (r=0.234, p=0.032, type of incision (r=0.228, p=0.037 were significantly correlated with the time to first bowel sound. Type of incision (r=0.295, p=0.006, duration of operation (r=0.277, p=0.01 and intraoperative blood loss (r=0.298, p=0.006 were significantly correlated with the time to first flatulence. In multivariate regression analyses, none of the variables were found to be significant parameter for time to first bowel sound (p>0.05. CONCLUSION: Gum chewing does not affect some of the gastrointestinal functions after gynecological operations and there is no single parameter for time to first bowel sound, first flatulence and first defecation, individual surgical and medical condition differences should be kept in mind while evaluating intestinal functions.

  7. The biology of three Mexican-American species of Triatominae (Hemiptera: Reduviidae: Triatoma recurva, Triatoma protracta and Triatoma rubida

    Directory of Open Access Journals (Sweden)

    José Alejandro Martínez-Ibarra

    2012-08-01

    Full Text Available The values of biological parameters related to hatching, lifespan, the number of blood meals between moults, mortality, time lapse before the beginning of feeding, feeding time and defecation delay for each instar of three Mexican-American species of Triatominae, Triatoma recurva, Triatoma protracta (former subspecies protracta and Triatoma rubida (former subspecies uhleri, were evaluated and compared. No significant (p > 0.05 differences were recorded among the three species with respect to the average time required to hatch. This time was approximately 19 days. The average egg-to-adult development time was significantly (p < 0.05 shorter for T. rubida. The number of blood meals at each nymphal instar varied from one-five for each species. The mortality rates were higher for the first-instar nymphs of the three species studied. The mean time lapse before the beginning of feeding was between 0.3-3 min for most nymphs of all instars of each species studied. The mean feeding time was the longest for T. recurva, followed by T. protracta. The defecation delay was less than 10 min for T. recurva and T. rubida. Given these results, only T. rubida should be considered an important potential vector of Trypanosoma cruzi transmission to humans in areas of Mexico where these species exist, whereas T. recurva and T. protracta would be of secondary importance.

  8. Longitudinal Study of Intestinal Symptoms and Fecal Continence in Patients With Conformal Radiotherapy for Prostate Cancer

    International Nuclear Information System (INIS)

    Geinitz, Hans; Thamm, Reinhard; Keller, Monika; Astner, Sabrina T.; Heinrich, Christine; Scholz, Christian; Pehl, Christian; Kerndl, Simone; Prause, Nina; Busch, Raymonde; Molls, Michael; Zimmermann, Frank B.

    2011-01-01

    Purpose: To prospectively assess the intestinal symptoms and fecal continence in patients who had undergone conformal radiotherapy (CRT) for prostate cancer. Methods and Materials: A total of 78 men who had undergone definitive CRT for prostate cancer were evaluated. The patients were assessed before, during (treatment Weeks 4 and 6), and 2, 12, and 24 months after CRT completion. The intestinal symptoms and fecal continence were evaluated with comprehensive standardized questionnaires. Results: The intestinal symptoms were mostly intermittent, with only a small minority of patients affected daily. Defecation pain, fecal urge, and rectal mucous discharge increased significantly during therapy. Defecation pain and rectal mucous discharge had returned to baseline levels within 8 weeks and 1 year after CRT, respectively. However, fecal urge remained significantly elevated for ≤1 year and then returned toward the pretreatment values. The prevalence of rectal bleeding was significantly elevated 2 years after CRT. Fecal continence deteriorated during CRT and remained impaired at 1 year after treatment. Incontinence was mostly minor, occurring less than once per week and predominantly affecting incontinence for gas. Conclusion: Intestinal symptoms and fecal incontinence increased during prostate CRT. Except for rectal bleeding, the intestinal symptoms, including fecal incontinence, returned to baseline levels within 1-2 years after CRT. Thus, the rate of long-term late radiation-related intestinal toxicity was low.

  9. Risk factors of diarrhoea among flood victims: a controlled epidemiological study.

    Science.gov (United States)

    Mondal, N C; Biswas, R; Manna, A

    2001-01-01

    The concept and practice of 'disaster preparedness and response', instead of traditional casualty relief, is relatively new. Vulnerability analysis and health risks assessment of disaster prone communities are important prerequisites of meaningful preparedness and effective response against any calamity. In this community based study, the risk of diarrhoeal disease and its related epidemiological factors were analysed by collecting data from two selected flood prone block of Midnapur district of West Bengal. The information was compared with that of another population living in two non-flood prone blocks of the same district. The study showed that diarrhoeal disease was the commonest morbidity in flood prone population. Some behaviours, like use of pond water for utensil wash and kitchen purpose, hand washing after defecation without soap, improper hand washing before eating, open field defecation, storage of drinking water in wide mouth vessels etc. were found to be associated with high attack rate of diarrhoea, in both study and control population during flood season compared to pre-flood season. Attack rates were also significantly higher in flood prone population than that of population in non-flood prone area during the same season. Necessity of both community education for proper water use behaviour and personal hygiene along with ensuring safe water and sanitation facilities of flood affected communities were emphasized.

  10. Effects and Safety of Aqueous Extract of Poncirus fructus in Spinal Cord Injury with Neurogenic Bowel

    Directory of Open Access Journals (Sweden)

    Ji Hee Kim

    2016-01-01

    Full Text Available Objective. To investigate the effects and safety of the aqueous extract of the dried, immature fruit of Poncirus trifoliata (L. Raf., known as Poncirus fructus (PF, in spinal cord injury (SCI patients with neurogenic bowel. Methods. Thirty-one SCI patients with neurogenic bowel were recruited. Patients were evaluated based on clinical information, constipation score, Bristol Stool Form Scale, stool retention score using plain abdominal radiograph, and colon transit time. PF was administered in dosages of 800 mg each prior to breakfast and lunch for 14 days. Results. The morphological feature of the stool before and after administration indicated a statistically significant difference from 3.52 ± 1.33 to 4.32 ± 1.44 points (p<0.05. Stool retention score before and after administration of PF was represented with low significance (7.25 ± 1.60 to 6.46 ± 1.53 points in the whole colon (p<0.05, and the colon transit time was significantly shortened (57.41 ± 20.7 to 41.2 ± 25.5 hours in terms of the whole transit time (p<0.05. Side effects were observed in 7 people (28.0% consisting of 2 people with soft stools and 5 people with diarrhea. Conclusion. For SCI patients, PF administration significantly improved defecation patterns, defecation retention, and colon transit time. PF could be an effective aid to improve colonic motility and constipation.

  11. Epidemiology and Risk Factors of Functional Constipation in Pregnant Women.

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    Wenjun Shi

    Full Text Available To understand the prevalence of functional constipation in pregnant women and to analyze the impact of its risk factors.We searched hospital databases for women who were 37-41 weeks pregnant (1698 cases from July 2012 to January 2014 in four hospitals in Shanghai. We reviewed factors including general data, living and eating habits, psychological history, past history of defecation in the 6 months before pregnancy and defecation after pregnancy. Data were analyzed using SPSS software.Pregnant women who were more than 35 years old, with a pre-pregnancy body mass index >24, who were highly educated and employed in a sedentary occupation, showed a higher prevalence of functional constipation. Multivariate logistic regression analysis indicated that the prevalence of functional constipation among pregnant women was related to age, pre-pregnancy body mass index, diet, exercise, occupation, psychological factors, threatened abortion in early pregnancy and constipation history.The prevalence rate of functional constipation in pregnant women was significantly higher than in the general population.

  12. Lactic Acid Bacteria Protects Caenorhabditis elegans from Toxicity of Graphene Oxide by Maintaining Normal Intestinal Permeability under different Genetic Backgrounds

    Science.gov (United States)

    Zhao, Yunli; Yu, Xiaoming; Jia, Ruhan; Yang, Ruilong; Rui, Qi; Wang, Dayong

    2015-11-01

    Lactic acid bacteria (LAB) is safe and useful for food and feed fermentation. We employed Caenorhabditis elegans to investigate the possible beneficial effect of LAB (Lactobacillus bulgaricus) pretreatment against toxicity of graphene oxide (GO) and the underlying mechanisms. LAB prevented GO toxicity on the functions of both primary and secondary targeted organs in wild-type nematodes. LAB blocked translocation of GO into secondary targeted organs through intestinal barrier by maintaining normal intestinal permeability in wild-type nematodes. Moreover, LAB prevented GO damage on the functions of both primary and secondary targeted organs in exposed nematodes with mutations of susceptible genes (sod-2, sod-3, gas-1, and aak-2) to GO toxicity by sustaining normal intestinal permeability. LAB also sustained the normal defecation behavior in both wild-type nematodes and nematodes with mutations of susceptible genes. Therefore, the beneficial role of LAB against GO toxicity under different genetic backgrounds may be due to the combinational effects on intestinal permeability and defecation behavior. Moreover, the beneficial effects of LAB against GO toxicity was dependent on the function of ACS-22, homologous to mammalian FATP4 to mammalian FATP4. Our study provides highlight on establishment of pharmacological strategy to protect intestinal barrier from toxicity of GO.

  13. Involvement of Corticotropin-Releasing Factor and Receptors in Immune Cells in Irritable Bowel Syndrome

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    Mahanand Chatoo

    2018-02-01

    Full Text Available Irritable bowel syndrome (IBS is a common functional gastrointestinal disorder defined by ROME IV criteria as pain in the lower abdominal region, which is associated with altered bowel habit or defecation. The underlying mechanism of IBS is not completely understood. IBS seems to be a product of interactions between various factors with genetics, dietary/intestinal microbiota, low-grade inflammation, and stress playing a key role in the pathogenesis of this disease. The crosstalk between the immune system and stress in IBS mechanism is increasingly recognized. Corticotropin-releasing factor (CRF, a major mediator in the stress response, is involved in altered function in GI, including inflammatory processes, colonic transit time, contractile activity, defecation pattern, pain threshold, mucosal secretory function, and barrier functions. This mini review focuses on the recently establish local GI-CRF system, its involvement in modulating the immune response in IBS, and summarizes current IBS animal models and mapping of CRF, CRFR1, and CRFR2 expression in colon tissues. CRF and receptors might be a key molecule involving the immune and movement function via brain–gut axis in IBS.

  14. Commentary on community-led total sanitation and human rights: should the right to community-wide health be won at the cost of individual rights?

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    Bartram, Jamie; Charles, Katrina; Evans, Barbara; O'Hanlon, Lucinda; Pedley, Steve

    2012-12-01

    The Millennium Development Goals (MDGs) set out to halve the proportion of the population without access to basic sanitation between 1990 and 2015. The slow pace of progress has lead to a search for innovative responses, including social motivation approaches. One example of this type of approach is 'Community-led Total Sanitation' (CLTS). CLTS represents a major shift for sanitation projects and programmes in recognising the value of stopping open-defecation across the whole community, even when the individual toilets built are not necessarily wholly hygienic. However, recent publications on CLTS document a number of examples of practices which fail to meet basic ethical criteria and infringe human rights. There is a general theme in the CLTS literature encouraging the use of 'shame' or 'social stigma' as a tool for promoting behaviours. There are reported cases where monetary benefits to which individuals are otherwise entitled or the means to practice a livelihood are withheld to create pressures to conform. At the very extreme end of the scale, the investigation and punishment of violence has reportedly been denied if the crime occurred while defecating in the open, violating rights to a remedy and related access to justice. While social mobilisation in general, and CLTS in particular, have drastically and positively changed the way we think about sanitation, they neither need nor benefit from an association with any infringements of human rights.

  15. The molecular basis of the genesis of basal tone in internal anal sphincter

    Science.gov (United States)

    Zhang, Cheng-Hai; Wang, Pei; Liu, Dong-Hai; Chen, Cai-Ping; Zhao, Wei; Chen, Xin; Chen, Chen; He, Wei-Qi; Qiao, Yan-Ning; Tao, Tao; Sun, Jie; Peng, Ya-Jing; Lu, Ping; Zheng, Kaizhi; Craige, Siobhan M.; Lifshitz, Lawrence M.; Keaney Jr, John F.; Fogarty, Kevin E.; ZhuGe, Ronghua; Zhu, Min-Sheng

    2016-01-01

    Smooth muscle sphincters exhibit basal tone and control passage of contents through organs such as the gastrointestinal tract; loss of this tone leads to disorders such as faecal incontinence. However, the molecular mechanisms underlying this tone remain unknown. Here, we show that deletion of myosin light-chain kinases (MLCK) in the smooth muscle cells from internal anal sphincter (IAS-SMCs) abolishes basal tone, impairing defecation. Pharmacological regulation of ryanodine receptors (RyRs), L-type voltage-dependent Ca2+ channels (VDCCs) or TMEM16A Ca2+-activated Cl− channels significantly changes global cytosolic Ca2+ concentration ([Ca2+]i) and the tone. TMEM16A deletion in IAS-SMCs abolishes the effects of modulators for TMEM16A or VDCCs on a RyR-mediated rise in global [Ca2+]i and impairs the tone and defecation. Hence, MLCK activation in IAS-SMCs caused by a global rise in [Ca2+]i via a RyR-TMEM16A-VDCC signalling module sets the basal tone. Targeting this module may lead to new treatments for diseases like faecal incontinence. PMID:27101932

  16. Complete colonic duplication in children.

    Science.gov (United States)

    Khaleghnejad Tabari, Ahmad; Mirshemirani, Alireza; Khaleghnejad Tabari, Nasibeh

    2012-01-01

    Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in 15% of gastrointestinal duplication. We report two cases of complete colonic duplications, and their characteristics. We present two patients with complete colonic duplication with different types and presentations. Case 1: A 2- year old boy presented to the clinic with abdominal protrusion, difficulty to defecate, chronic constipation and mucosal prolaps covered bulging (rectocele) since he was 6 months old. The patient had palpable pelvic mass with doughy consistency. Rectal exam confirmed perirectal mass with soft consistency. The patient underwent a surgical operation that had total tubular colorectal duplication with one blind end and was treated with simple fenestration of distal end, and was discharged without complication. After two years follow up, he had normal defecation and good weight gain. Case 2: A 2 -day old infant was referred with imperforate anus and complete duplication of recto-sigmoid colon, diphallus, double bladder, and hypospadiasis. After clinical and paraclinical investigations, he underwent operations in several stages in different periods, and was discharged without complications. After four years follow up, he led a normal life. The patients with complete duplication have to be examined carefully because of the high incidence of other systemic anomalies. Treatment includes simple resection of distal common wall, fenestration, and repair other associated anomalies.

  17. Effects of seasonal meteorological variables on E. coli persistence in livestock faeces and implications for environmental and human health.

    Science.gov (United States)

    Oliver, David M; Page, Trevor

    2016-11-15

    Agriculture contributes significant volumes of livestock faeces to land. Understanding how faecal microbes respond to shifts in meteorological patterns of contrasting seasons is important in order to gauge how environmental (and human health) risks may alter under a changing climate. The aim of this study was to: (i) quantify the temporal pattern of E. coli growth within dairy faeces post defecation; and (ii) derive E. coli seasonal population change profiles associated with contrasting environmental drivers. Evaluation of the die-off dynamics of E. coli revealed that a treatment mimicking drought and warming conditions significantly enhanced persistence relative to E. coli in faeces that were exposed to field conditions, and that this pattern was consistent across consecutive years. The internal temperature of faeces was important in driving the rate of change in the E. coli population in the immediate period post defecation, with most E. coli activity (as either die-off or growth) occurring at low dry matter content. This study highlighted that the use of seasonal E. coli persistence profiles should be approached with caution when modelling environmental and human health risks given the increased likelihood of atypical seasonal meteorological variables impacting on E. coli growth and die-off.

  18. Clinical trial: marine lipid suppositories as laxatives.

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    Ormarsson, Orri Thor; Geirsson, Thormodur; Bjornsson, Einar Stefan; Jonsson, Tomas; Moller, Pall; Loftsson, Thorsteinn; Stefansson, Einar

    2012-09-01

    Cod-liver oil and other marine products containing polyunsaturated fatty acids have anti-inflammatory, anti-bacterial and anti-viral effects and may be useful in the treatment of various inflammatory and infectious diseases. We developed suppositories and ointment with 30% free fatty acid (FFA) extract from omega-3 fish oil. Our purpose was to evaluate the safety of marine lipid suppositories and ointment in healthy volunteers and to explore the laxative effect of the suppositories. Thirty healthy volunteers were randomized either to a study group administrating 30% FFA suppositories and applying 30% FFA ointment to the perianal region twice per day for two weeks, or to a control group using placebo suppositories and ointment in a double blinded manner. No serious toxic effects or irritation were observed. In the study group 93% felt the urge to defecate after administration of the suppositories as compared to 37% in the control group (P = 0.001). Subsequently 90% in the study group defecated, compared to 33% in the control group (P = 0.001). The marine lipid suppositories and ointment were well tolerated with no significant toxic side effects observed during the study period. The suppositories have a distinct laxative effect and we aim to explore this effect in further clinical trials.

  19. Efficacy of polyethylene glycol 4000 on constipation of

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    ZHANG Lian-yang

    2010-06-01

    Full Text Available Constipation is one of themost common chronic gastrointestinal problems. The estimated incidence of constipation in the United States is3% to 19% in general population.1,2 Patientswith head injuries, spinal cord injuries, pelvic fractures, lower extremity fractures ormultiple traumas require a long-term bed rest, during which the incidence of constipation reached as high as 50%.3,4 Constipation always brings inconvenience and tremendous suffering to patientsand strongly influences the recovery from primary disease. Irritants or lubricants can relieve the symptoms, but long-term application of them may lead to side effects like melanosis coli5 and cathartic colon6. The absorption of fat soluble vitamins is also affected.7 Polyethylene glycol 4000 (trade name: Forlax®, a long chain polymer with a high molecular weight, can conjugate withwater molecule through hydrogen bond to increase the water content and volume of stools, thereby, facilitate bowelmovement and defecation.8,9 It is neither absorbed nor metabolized in the digestive tract, hence it is highly safe and well tolerable. Thus, long-term medication of polyethylene glycol 4000 is conducive to the reconstruction of normal defecation pattern. Therefore, polyethylene glycol 4000 is now being widely used as the mainstay adult chronic functional constipation management.10,11 The aim of this study was to verify the efficacy and safety of polyethylene glycol 4000 on adult functional constipation of posttraumatic bedridden patients.

  20. Transanal Pull-Through Procedure with Delayed versus Immediate Coloanal Anastomosis for Anus-Preserving Curative Resection of Lower Rectal Cancer: A Case-Control Study.

    Science.gov (United States)

    Xiong, Yong; Huang, Ping; Ren, Qing-Gui

    2016-06-01

    This case-control study compared the effectiveness and safety of transanal pull-through procedure (TPP) with delayed or immediate coloanal anastomosis (CAA) for anus-preserving curative resection of lower rectal cancer. Lower rectal cancer patients (n = 128) were hospitalized between January 2003 and December 2013 for elective anus-preserving curative resection through a TPP with delayed (n = 72) or immediate (n = 56) CAA. Main outcome measures including surgical safety, resection radicality, and defecation function were assessed. The two groups were comparable in age, sex, gross pathology, histology, and tumor-node-metastasis staging. Both the delayed and immediate CAA TPPs had similar resection radicality and safety profiles. The immediate CAA was associated with a significantly higher risk of anastomotic leakage and defecation impairment. None of patients in the delayed CAA group experienced anastomotic leakage. In conclusion, TPP with delayed CAA may be superior to immediate CAA in minimizing the risk of anastomotic leakage and relevant surgical morbidities, and does not require a temporary ileostomy and second-look restoration of ostomy.

  1. Sanitation, Stress, and Life Stage: A Systematic Data Collection Study among Women in Odisha, India.

    Science.gov (United States)

    Hulland, Kristyna R S; Chase, Rachel P; Caruso, Bethany A; Swain, Rojalin; Biswal, Bismita; Sahoo, Krushna Chandra; Panigrahi, Pinaki; Dreibelbis, Robert

    2015-01-01

    Emerging evidence demonstrates how inadequate access to water and sanitation is linked to psychosocial stress, especially among women, forcing them to navigate social and physical barriers during their daily sanitation routines. We examine sanitation-related psychosocial stress (SRPS) across women's reproductive lives in three distinct geographic sites (urban slums, rural villages, and rural tribal villages) in Odisha, India. We explored daily sanitation practices of adolescent, newly married, pregnant, and established adult women (n = 60) and identified stressors encountered during sanitation. Responding to structured data collection methods, women ranked seven sanitation activities (defecation, urination, menstruation, bathing, post-defecation cleaning, carrying water, and changing clothes) based on stress (high to low) and level of freedom (associated with greatest freedom to having the most restrictions). Women then identified common stressors they encountered when practicing sanitation and sorted stressors in constrained piles based on frequency and severity of each issue. The constellation of factors influencing SRPS varies by life stage and location. Overall, sanitation behaviors that were most restricted (i.e., menstruation) were the most stressful. Women in different sites encountered different stressors, and the level of perceived severity varied based on site and life stage. Understanding the influence of place and life stage on SRPS provides a nuanced understanding of sanitation, and may help identify areas for intervention.

  2. The Role of Perceived Social Norms in Rural Sanitation: An Explorative Study from Infrastructure-Restricted Settings of South Ethiopia.

    Science.gov (United States)

    Novotný, Josef; Kolomazníková, Jana; Humňalová, Helena

    2017-07-17

    The perception of social sanitation norms (PSSNs) around unacceptability of open defecation has been a key aspect of recent sanitation interventions. However, underlying mechanisms through which "reconstructed" PSSNs affect sanitation outcomes have been a black box. This explorative cross-sectional study examines direct and indirect links between PSSNs and sanitation safety using data from structured interviews and observations in 368 households in rural South Ethiopia. In addition to a positive association between PSSNs and sanitation safety, we propose and examine the following two mechanisms: First, we confirm a potentially adverse feedback of PSSNs on future sanitation safety by enhancing the emotional satisfaction with current sanitation practice (satisfaction independent of the functionality of sanitation facilities). Second, inspired by the social amplification/attenuation of risk framework, we demonstrate that PSSNs work as a "social filter" that can amplify or attenuate the effects of other variables targeted in sanitation interventions such as perceived health-related and non-health risks and benefits associated with open defecation and private latrine ownership, respectively, and factual hygiene and sanitation knowledge. These findings imply that PSSNs are not only important per se, but they are also important instrumentally because sanitation outcomes depend upon the capacity of social influences to shape the perception of sanitation risks and benefits and sanitation-related awareness in desirable ways. The mechanisms outlined in this paper as well as the sustainability of sanitation outcomes depend on whether and how social sanitation norms are internalized.

  3. Sanitation, Stress, and Life Stage: A Systematic Data Collection Study among Women in Odisha, India.

    Directory of Open Access Journals (Sweden)

    Kristyna R S Hulland

    Full Text Available Emerging evidence demonstrates how inadequate access to water and sanitation is linked to psychosocial stress, especially among women, forcing them to navigate social and physical barriers during their daily sanitation routines. We examine sanitation-related psychosocial stress (SRPS across women's reproductive lives in three distinct geographic sites (urban slums, rural villages, and rural tribal villages in Odisha, India. We explored daily sanitation practices of adolescent, newly married, pregnant, and established adult women (n = 60 and identified stressors encountered during sanitation. Responding to structured data collection methods, women ranked seven sanitation activities (defecation, urination, menstruation, bathing, post-defecation cleaning, carrying water, and changing clothes based on stress (high to low and level of freedom (associated with greatest freedom to having the most restrictions. Women then identified common stressors they encountered when practicing sanitation and sorted stressors in constrained piles based on frequency and severity of each issue. The constellation of factors influencing SRPS varies by life stage and location. Overall, sanitation behaviors that were most restricted (i.e., menstruation were the most stressful. Women in different sites encountered different stressors, and the level of perceived severity varied based on site and life stage. Understanding the influence of place and life stage on SRPS provides a nuanced understanding of sanitation, and may help identify areas for intervention.

  4. The effect of aqueous Elaeagnus angustifolia extract on acute non-inflammatory diarrhea in 1-5 year old children

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    Khoshdel Abofazl

    2014-01-01

    Full Text Available Introduction: Acute diarrhea is one of the most important causes of global childhood mortality and morbidity. The most common complication of acute diarrhea is dehydration. The aim of this study was to evaluate the use of aqueous Elaeagnus angustifolia extract in controlling non-inflammatory diarrhea in a hospital setting. Methods: In this case–controlled randomized double blind clinical trial 80 children in age range of 1-5 years were admitted in pediatric ward with diagnosis of non-inflammatory diarrhea. The patients were randomly divided into two equal groups of 40 cases. The subject in the first group received aqueous Elaeagnus angustifolia extract, 1.2 ml/Kg single dose for 4 days duration and the second group (control group 1.2 cm/Kg distilled water single dose for 4 days duration. Data analysis were performed by Chi-square and t-tests, using SPSS software. Results: The groups were similar regarding gender, mean age, and frequency, and consistency of defecation (p> 0.05. Although the children seemed better in regard to frequency and consistency of defecation, however the results showed that aqueous extract of Elaeagnus angustifolia was not significantly effective in the treatment of non-inflammatory diarrhea. Conclusion: The results of this study demonstrated that the use of aqueous extract of Elaeagnus angustifolia was not effective in the treatment of non-inflammatory diarrhea in children.

  5. Behavioral effects of antiepileptic drugs in rats: Are the effects on mood and behavior detectable in open-field test?

    Science.gov (United States)

    Zimcikova, Eva; Simko, Julius; Karesova, Iva; Kremlacek, Jan; Malakova, Jana

    2017-11-01

    Behavioral side effects of antiepileptic drugs (AEDs) are common including both positive and negative effects on mood, anxiety, depression, and psychosis. We aimed to evaluate behavioral patterns in rats after administration of lamotrigine, levetiracetam, phenytoin, topiramate, carbamazepine, gabapentin, pregabalin, and zonisamide. The open-field test was performed and locomotion, rearing, grooming, central latency and defecation were recorded over a 5min interval for each rat (8 rats in each group receiving AED and 16 controls). Kruskal-Wallis nonparametric test or ANOVA were used to assess differences among the groups. The experimental groups did not differ in latency to enter the center compartment, neither in the decline of locomotor activity in the 1st and the 5th minute of the observation, nor in number of rears. Significant differences among groups were observed in the total number of lines crossed, grooming, as well in the number of fecal pellets. Locomotor activity was significantly increased in lamotrigine, if compared with gabapentin and pregabalin (ANOVA; p <0.05). Rats exposed to topiramate displayed a significantly increased number of grooming (when compared to pregabalin: p<0.01). Defecation (the number of fecal pellets) significantly increased in the gabapentin and carbamazepine group. There are significant differences between AEDs in terms of their behavioral profile. It is of great importance to evaluate these effects in clinical practice to bring more clear insight into these positive or negative side effects of AEDs. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  6. [Effect of genotype and day or night time of testing on mice behavior in the light-dark box and the open-field tests].

    Science.gov (United States)

    Morozova, M V; Kulikov, A V

    2010-01-01

    The light-dark box (LDB) and the open-field (OF) tests are widespread experimental models for studying locomotion and anxiety in laboratory rats and mice. The fact that rodents are nocturnal animals and more active at night raises a critical question of whether behavioral experiments carried out in the light phase are methodologically correct. Parameters of behavior of four mouse strains (C57BL/6J, DBA2/J, AKR/J and CBA/LacJ) in the light-dark box and open-field tests in the light and dark phases were compared. No significant influence of the phase of testing on anxiety in LDB and OF tests was revealed. In the OF test CBA mice showed increased locomotor activity, whereas AKR and C57BL/6 mice showed increased defecation in the dark phase. It was concluded that: 1) the phase of testing is not crucial for the expression of anxiety in LDB and OF; 2) the sensitivity to the phase of testing depends on the genotype; 3) the indices of behavior in the genotypes sensitive to the phase of testing (locomotion in the CBA and defecation in the AKR and C57BL/6 mouse strains) are increased in the dark phase.

  7. Comparison of multi-modal early oral nutrition for the tolerance of oral nutrition with conventional care after major abdominal surgery: a prospective, randomized, single-blind trial.

    Science.gov (United States)

    Sun, Da-Li; Li, Wei-Ming; Li, Shu-Min; Cen, Yun-Yun; Xu, Qing-Wen; Li, Yi-Jun; Sun, Yan-Bo; Qi, Yu-Xing; Lin, Yue-Ying; Yang, Ting; Lu, Qi-Ping; Xu, Peng-Yuan

    2017-02-10

    Early oral nutrition (EON) has been shown to improve recovery of gastrointestinal function, length of stay and mortality after abdominal surgery; however, early oral nutrition often fails during the first week after surgery. Here, a multi-modal early oral nutrition program is introduced to promote recovery of gastrointestinal function and tolerance of oral nutrition. Consecutive patients scheduled for abdominal surgery were randomized to the multimodal EON group or a group receiving conventional care. The primary endpoint was the time of first defecation. The secondary endpoints were outcomes and the cost-effectiveness ratio in treating infectious complications. The rate of infectious-free patients was regarded as the index of effectiveness. One hundred seven patients were randomly assigned to groups. Baseline characteristics were similar for both groups. In intention-to-treat analysis, the success rate of oral nutrition during the first week after surgery in the multimodal EON group was 44 (83.0%) versus 31 (57.4%) in the conventional care group (P = 0.004). Time to first defecation, time to flatus, recovery time of bowel sounds, and prolonged postoperative ileus were all less in the multimodal EON group (P oral nutrition group (P oral nutrition program was an effective way to improve tolerance of oral nutrition during the first week after surgery, decrease the length of stay and improve cost-effectiveness after abdominal surgery. Registration number: ChiCTR-TRC-14004395 . Registered 15 March 2014.

  8. Ascaris and hookworm transmission in preschool children from rural Panama: role of yard environment, soil eggs/larvae and hygiene and play behaviours.

    Science.gov (United States)

    Krause, Rachel J; Koski, Kristine G; Pons, Emérita; Sandoval, Nidia; Sinisterra, Odalis; Scott, Marilyn E

    2015-10-01

    This study explored whether the yard environment and child hygiene and play behaviours were associated with presence and intensity of Ascaris and hookworm in preschool children and with eggs and larvae in soil. Data were collected using questionnaires, a visual survey of the yard, soil samples and fecal samples collected at baseline and following re-infection. The presence of eggs/larvae in soil was associated negatively with water storage (eggs) but positively with dogs (eggs) and distance from home to latrine (larvae). Baseline and re-infection prevalences were: hookworm (28.0%, 3.4%); Ascaris (16.9%, 9.5%); Trichuris (0.9%, 0.7%). Zero-inflated negative binomial regression models revealed a higher baseline hookworm infection if yards had eggs or larvae, more vegetation or garbage, and if the child played with soil. Baseline Ascaris was associated with dirt floor, dogs, exposed soil in yard, open defecation and with less time playing outdoors, whereas Ascaris re-infection was associated with water storage, vegetation cover and garbage near the home and not playing with animals. Our results show complex interactions between infection, the yard environment and child behaviours, and indicate that transmission would be reduced if latrines were closer to the home, and if open defecation and water spillage were reduced.

  9. Peptide YY, neuropeptide Y and corticotrophin-releasing factor modulate gastrointestinal motility and food intake during acute stress.

    Science.gov (United States)

    Forbes, Sarah C; Cox, Helen M

    2014-11-01

    Peripheral neuropeptide Y (NPY) provides protection against the endocrine, feeding and gastrointestinal (GI) responses to stress; however, it is not yet established how it interacts with corticotrophin-releasing factor (CRF) to mediate these effects. Peptide YY (PYY) also has significant roles in GI motility and food intake but little is known about its role in stress responses. Upper GI transit, fecal pellet output (FPO) and feeding responses, and the role of CRF1 receptors, during restraint or a novel environment stress, were ascertained in PYY-/-, NPY-/- and wild type (WT) mice, with CRF and the CRF1 antagonist, antalarmin, injected intraperitoneally. Upper GI transit and FPO were significantly increased in PYY-/- mice during restraint stress. Exogenous CRF increased defecation during placement in a novel environment in WT mice through CRF1 , while CRF1 blockade reduced defecation in WT and NPY-/- mice but had no effect in PYY-/- mice. In addition, CRF1 blockade had no effect on upper GI transit in WT mice, or on food intake in PYY-/- or NPY-/- mice, but it significantly increased food intake in WT mice. Endogenous NPY appears to inhibit the colonic motor response induced by CRF1 activation, unlike PYY, while both peptides are required for CRF1 modulation of feeding behavior during stress. Overall, these results provide new insights into the mechanism by which PYY and NPY affect stress responses. © 2014 John Wiley & Sons Ltd.

  10. [Clinical effect of Saccharomyces boulardii powder combined with azithromycin sequential therapy in treatment of children with diarrhea secondary to Mycoplasma pneumoniae pneumonia].

    Science.gov (United States)

    Chen, Qi-Fen; Zhang, Yi-Wei

    2018-02-01

    To investigate the clinical effect of Saccharomyces boulardii powder combined with azithromycin sequential therapy in the treatment of children with diarrhea secondary to Mycoplasma pneumoniae pneumonia. A total of 88 children with diarrhea secondary to Mycoplasma pneumoniae pneumonia between June 2015 and March 2017 were divided into control group and study group using a random number table, with 44 children in each group. The children in the control group were given routine treatment combined with azithromycin sequential therapy, and those in the study group were given oral Saccharomyces boulardii powder in addition to the treatment in the control group until the end of azithromycin sequential therapy. After the treatment ended, the two groups were compared in terms of time to improvement of clinical symptoms, length of hospital stay, clinical outcome, defecation frequency before and after treatment, condition of intestinal dysbacteriosis, and incidence of adverse events. Compared with the control group, the study group had significantly shorter time to improvement of clinical symptoms and length of hospital stay (P0.05). In the treatment of children with diarrhea secondary to Mycoplasma pneumoniae pneumonia, Saccharomyces boulardii powder combined with azithromycin sequential therapy can improve clinical symptoms, shorten the length of hospital stay, reduce defecation frequency and the incidence of intestinal dysbacteriosis, and improve clinical outcomes, and does not increase the risk of adverse events.

  11. Changes in the Diurnal Rhythms during a 45-Day Head-Down Bed Rest

    Science.gov (United States)

    Liang, Xiaodi; Zhang, Lin; Wan, Yufeng; Yu, Xinyang; Guo, Yiming; Chen, Xiaoping; Tan, Cheng; Huang, Tianle; Shen, Hanjie; Chen, Xianyun; Li, Hongying; Lv, Ke; Sun, Fei; Chen, Shanguang; Guo, Jinhu

    2012-01-01

    In spaceflight human circadian rhythms and sleep patterns are likely subject to change, which consequently disturbs human physiology, cognitive abilities and performance efficiency. However, the influence of microgravity on sleep and circadian clock as well as the underlying mechanisms remain largely unknown. Placing volunteers in a prone position, whereby their heads rest at an angle of −6° below horizontal, mimics the microgravity environment in orbital flight. Such positioning is termed head-down bed rest (HDBR). In this work, we analysed the influence of a 45-day HDBR on physiological diurnal rhythms. We examined urinary electrolyte and hormone excretion, and the results show a dramatic elevation of cortisol levels during HDBR and recovery. Increased diuresis, melatonin and testosterone were observed at certain periods during HDBR. In addition, we investigated the changes in urination and defecation frequencies and found that the rhythmicity of urinary frequency during lights-off during and after HDBR was higher than control. The grouped defecation frequency data exhibits rhythmicity before and during HDBR but not after HDBR. Together, these data demonstrate that HDBR can alter a number of physiological processes associated with diurnal rhythms. PMID:23110150

  12. Systematic review of type-specific pathophysiological symptoms of Sasang typology

    Directory of Open Access Journals (Sweden)

    Yoo Ri Han

    2016-06-01

    Full Text Available Previous studies on the Sasang typology have focused on the differential diagnosis of each Sasang type with type-specific pathophysiological symptoms (TSPS. The purpose of this study was to elucidate the latent physiological mechanism related to these clinical indicators. We searched six electronic databases for articles published from 1990 to 2015 using the Sasang typology-related keywords, and found and analyzed 35 such articles. The results were summarized into six TSPS categories: perspiration, temperature preference, sleep, defecation, urination, and susceptibility to stress. The Tae-Eum and So-Eum types showed contrasting features with TSPS, and the So-Yang type was in the middle. The Tae-Eum type has good digestive function, regular bowel movement and defecation, high sleep quality, and low susceptibility to stress and cold. The Tae-Eum type has relatively large volumes of sweat and feels fresh after sweating; however, the urine is highly concentrated. These clinical features might be related to the biopsychological traits of the Tae-Eum type, including a low trait anxiety level and high ponderal and body mass indices. This study used the autonomic reactivity hypothesis for explaining the pathophysiological predispositions in the Sasang typology. The Tae-Eum and So-Eum Sasang types have a low threshold in parasympathetic and sympathetic activation, respectively. This study provides a foundation for integrating traditional Korean personalized medicine and Western biomedicine.

  13. Function-preserving surgery for rectal cancer

    International Nuclear Information System (INIS)

    Moriya, Yoshihiro

    2006-01-01

    When total mesorectal excision (TME) is accurately performed, dysfunction, theoretically, does not occur. However, there are differences among individuals in the running patterns and the volumes of nerve fibers, and if obesity or a narrow pelvis is present, nerve identification is difficult. Currently, the rate of urinary dysfunction after rectal surgery ranges from 33% to 70%. Many factors other than nerve preservation play a role in minor incontinence. Male sexual function shows impotence rates ranging from 20% to 46%, while 20%-60% of potent patients are unable to ejaculate. In women, information on sexual function is not easily obtained, and there are more unknown aspects than in men. As urinary, sexual, and defecation dysfunction due to adjuvant radiotherapy have been reported to occur at a high frequency, the creation of a protocol that enables analysis of long-term functional outcome will be essential for future clinical trials. In the treatment of rectal cancer, surgeon-related factors are extremely important, not only in achieving local control but also in preserving function. This article reviews findings from recent studies investigating urinary, sexual, and defecation dysfunction after rectal cancer surgery and discusses questions to be studied in the future. (author)

  14. Provision of private, piped water and sewerage connections and directly observed handwashing of mothers in a peri-urban community of Lima, Peru.

    Science.gov (United States)

    Oswald, William E; Hunter, Gabrielle C; Kramer, Michael R; Leontsini, Elli; Cabrera, Lilia; Lescano, Andres G; Gilman, Robert H

    2014-04-01

    To estimate the association between improved water and sanitation access and handwashing of mothers living in a peri-urban community of Lima, Peru. We observed 27 mothers directly, before and after installation of private, piped water and sewerage connections in the street just outside their housing plots, and measured changes in the proportion of faecal-hand contamination and hand-to-mouth transmission events with handwashing. After provision of water and sewerage connections, mothers were approximately two times more likely to be observed washing their hands within a minute of defecation, compared with when they relied on shared, external water sources and non-piped excreta disposal (RR = 2.14, 95% CI = 0.99-4.62). With piped water and sewerage available at housing plots, handwashing with or without soap occurred within a minute after 48% (10/21) of defecation events and within 15 min prior to 8% (11/136) of handling food events. Handwashing increased following installation of private, piped water and sewerage connections, but its practice remained infrequent, particularly before food-related events. Infrastructural interventions should be coupled with efforts to promote hygiene and ensure access to water and soap at multiple on-plot locations convenient to mothers. © 2014 John Wiley & Sons Ltd.

  15. Correlation between Colon Transit Time Test Value and Initial Maintenance Dose of Laxative in Children with Chronic Functional Constipation

    Science.gov (United States)

    Kim, Mock Ryeon; Park, Hye Won; Son, Jae Sung; Lee, Ran

    2016-01-01

    Purpose To evaluate the correlation between colon transit time (CTT) test value and initial maintenance dose of polyethylene glycol (PEG) 4000 or lactulose. Methods Of 415 children with chronic functional constipation, 190 were enrolled based on exclusion criteria using the CTT test, defecation diary, and clinical chart. The CTT test was performed with prior disimpaction. The laxative dose for maintenance was determined on the basis of the defecation diary and clinical chart. The Shapiro-Wilk test and Pearson's and Spearman's correlations were used for statistical analysis. Results The overall group median value and interquartile range of the CTT test was 43.8 (31.8) hours. The average PEG 4000 dose for maintenance in the overall group was 0.68±0.18 g/kg/d; according to age, the dose was 0.73±0.16 g/kg/d (encopresis, abnormal CTT test subtype) for either laxative. Even in the largest group (overall, n=109, younger than 8 years and on PEG 4000), the correlation was weak (Pearson's correlation coefficient [R]=0.268, p=0.005). Within the abnormal transit group, subgroup (n=73, younger than 8 years and on PEG 4000) correlation was weak (R=0.267, p=0.022). Conclusion CTT test value cannot predict the initial maintenance dose of PEG 4000 or lactulose with linear correlation. PMID:27738600

  16. Early constipation and toilet training in children with encopresis.

    Science.gov (United States)

    Fishman, Laurie; Rappaport, Leonard; Cousineau, Dominique; Nurko, Samuel

    2002-04-01

    To evaluate the frequency of predisposing factors for encopresis before and during toilet training, comparing children with primary and secondary encopresis. In this retrospective study, questionnaires from the initial evaluation at an encopresis clinic at a tertiary care pediatric hospital were reviewed for the presence or absence of factors in the first 2 years of life, for toilet training practices, and for disruptive events during the training process. Children younger than 48 months or those with organic defecation disorders were excluded. In 411 children with encopresis, the reported frequency of predisposing factors included constipation in 35%, and previous treatment for constipation in 24%. Toilet training was initiated before age 2 years in 26% and after age 3 years in 14%. Interruption of toilet training and punishment were seen more in primary encopresis than in secondary encopresis (50% versus 23%; P encopresis as was fear of the toilet (47% versus 10%; P encopresis, early difficult defecation, previous treatment for constipation, and early initiation of toilet training were less common than expected. Children with primary encopresis did not have an increased incidence of early constipation or invasive treatments compared with those with secondary encopresis. However, children with primary encopresis did have more difficult and disruptive toilet training experiences.

  17. Prognosis of constipation: clinical factors and colonic transit time

    Science.gov (United States)

    de Lorijn, F; van Wijk, M P; Reitsma, J; van Ginkel, R; Taminiau, J; Benninga, M

    2004-01-01

    Background: Measurement of colonic transit time (CTT) is sometimes used in the evaluation of patients with chronic constipation. Aim: To investigate the relation between symptoms and CTT, and to assess the importance of symptoms and CTT in predicting outcome. Methods: Between 1995 and 2000, 169 consecutive patients (median age 8.4 years, 65% boys) fulfilling the criteria for constipation were enrolled. During the intervention and follow up period, all kept a diary to record symptoms. CTT was measured at entry to the study. Results: At entry, defecation frequency was lower in girls than in boys, while the frequency of encopresis episodes was higher in boys. CTT values were significantly higher in those with a low defecation frequency (⩽1/week) and a high frequency of encopresis (⩾2/day). However, 50% had CTT values within the normal range. Successful outcome occurred more often in those with a rectal impaction. CTT results 100 hours were less likely to have had a successful outcome. Conclusion: The presence of a rectal impaction at presentation is associated with a better outcome at one year. A CTT >100 hours is associated with a poor outcome at one year. PMID:15269069

  18. Effectiveness of Acupuncture for Early Recovery of Bowel Function in Cancer: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Yi-Hua Liu

    2017-01-01

    Full Text Available Objectives. The aim of this study was to evaluate the effects of acupuncture therapy to reduce the duration of postoperative ileus (POI and to enhance bowel function in cancer patients. Methods. A systematic search of electronic databases for studies published from inception until January 2017 was carried out from six databases. Randomized controlled trials (RCTs involving the use of acupuncture and acupressure for POI and bowel function in cancer patients were identified. Outcomes were extracted from each study and pooled to determine the risk ratio and standardized mean difference. Results. 10 RCTs involving 776 cancer patients were included. Compared with control groups (no acupuncture, sham acupuncture, and other active therapies, acupuncture was associated with shorter time to first flatus and time to first defecation. A subgroup analysis revealed that manual acupuncture was more effective on the time to first flatus and the time to first defecation; electroacupuncture was better in reducing the length of hospital stay. Compared with control groups (sham or no acupressure, acupressure was associated with shorter time to first flatus. However, GRADE approach indicated a low quality of evidence. Conclusions. Acupuncture and acupressure showed large effect size with significantly poor or inferior quality of included trials for enhancing bowel function in cancer patients after surgery. Further well-powered evidence is needed.

  19. Efficacy of electroacupuncture compared with transcutaneous electric nerve stimulation for functional constipation: Study protocol for a randomized, controlled trial.

    Science.gov (United States)

    Zeng, Yuxiao; Zhang, Xuecheng; Zhou, Jing; Wang, Xinwei; Jiao, Ruimin; Liu, Zhishun

    2018-05-01

    To treat functional constipation, both electroacupuncture (EA) therapy and transcutaneous electric nerve stimulation (TENS) are safe and effective. However, no head-to-head comparison trial has been conducted. This trial compares the efficacy of electroacupuncture relative to transcutaneous electric nerve stimulation for functional constipation. Individuals with functional constipation will be randomly allocated to receive either EA or TENS (n = 51, each), 3 times per week for 8 weeks. The primary outcome is the percentage of participants with an average increase from baseline of 1 or more complete spontaneous bowel movements at week 8. The secondary outcome measures are the following: at the time of visits, changes in the number of complete spontaneous bowel movements, number of spontaneous bowel movements, stool character, difficulty in defecation, patients' assessment of quality of life regarding constipation (self-report questionnaire), and use of auxiliary defecation methods. The results of this trial should verify whether EA is more efficacious than TENS for relieving symptoms of functional constipation. The major limitation of the study is the lack of blinding of the participants and acupuncturist.

  20. A randomized controlled trial evaluating early versus traditional oral feeding after colorectal surgery

    Directory of Open Access Journals (Sweden)

    Ahmet Dag

    2011-01-01

    Full Text Available OBJECTIVE: This prospective randomized clinical study was conducted to evaluate the safety and tolerability of early oral feeding after colorectal operations. METHODS: A total of 199 patients underwent colorectal surgery and were randomly assigned to early feeding (n = 99 or a regular diet (n = 100. Patients’ characteristics, diagnoses, surgical procedures, comorbidity, bowel movements, defecation, nasogastric tube reinsertion, time of tolerance of solid diet, complications, and length of hospitalization were assessed. RESULTS: The two groups were similar in terms of gender, age, diagnosis, surgical procedures, and comorbidity. In the early feeding group, 85.9% of patients tolerated the early feeding schedule. Bowel movements (1.7±0.89 vs. 3.27±1.3, defecation (3.4±0.77 vs. 4.38±1.18 and time of tolerance of solid diet (2.48±0.85 vs. 4.77±1.81 were significantly earlier in the early feeding group. There was no change between the groups in terms of nasogastric tube reinsertion, overall complication or anastomotic leakage. Hospitalization (5.55±2.35 vs. 9.0±6.5 was shorter in the early feeding group. CONCLUSIONS: The present study indicated that early oral feeding after elective colorectal surgery was not only well tolerated by patients but also affected the postoperative outcomes positively. Early postoperative feeding is safe and leads to the early recovery of gastrointestinal functions.

  1. Behavioral and physiologic effects of early nutrition and social factors in the rat.

    Science.gov (United States)

    Gamallo, A; Trancho, G J; Alario, P

    1988-01-01

    Two experimental methods to provoke caloric restriction during suckling were used. Each of the methods utilized two different rat groups: Low Growth (LG) and High Growth (HG). In one method, the groups also differed in a social factor, litter size: crowded (Cr) and control (Co). Growth differences and high levels of social competition were found among pups of the crowded group with Low Growth (CrLG) compared to the group with High Growth and small litters (CoHG). Both methods resulted in growth differences between respective groups from the first week of suckling. Differences in animal groups persisted forty days after weaning. LG animals had higher defecation scores with lower activity in the open-field test, higher susceptibility to restraint ulcers and adrenal hypertrophy than HG rats, in litters of equal size. However, early stimulation from social competition among pups in larger different litters in CrLG group counteracted nutritional factor effects. Elevated open-field defecation and ulceration scores with adrenal hypertrophy were found in CoHG rats.

  2. Bowel habit reference values and abnormalities in young Iranian healthy adults.

    Science.gov (United States)

    Adibi, Peyman; Behzad, Ebrahim; Pirzadeh, Shahryar; Mohseni, Masood

    2007-08-01

    The purpose of this study was to estimate the prevalence of self-reported, ROME II-defined constipation and determine the average defecation frequency and stool types in the Iranian population. A self-reported questionnaire was distributed to 1045 participants, including items intended to identify the presence of ROME II-defined functional constipation and the dominant form of stool based on the Bristol Scale. The weekly mean bowel movement frequency in men and women was 12.5 +/- 7.3 and 13.8 +/- 8.0, respectively (p < 0.05). A total of 87.4% of participants had a stool frequency of between 3 and 21 times per week. The prevalence of functional constipation was 32.9%, whereas only 9.6% of participants reported themselves to be constipated (level of agreement kappa = 0.21, 95% confidence interval: 0.15 to 0.27). Soft or formed stool was reported in 75.7% of individuals. Functional constipation is common in the Iranian population, but its diagnosis could not rely on subjective patient complaints. Despite a higher average of bowel frequency, the previously reported normal range of defecation frequency can be applied for the Iranian population.

  3. PSYCHOLOGICAL ASPECTS OF ENCOPRESIS WITHOUT ORGANIC ETHIOLOGY

    Directory of Open Access Journals (Sweden)

    Vesna Košir

    2016-11-01

    Full Text Available Encopresis is defined as a voluntary or involuntary passage of stool in inappropriate places, causing soiling of clothes by a child aged four years or above whenbowelcontrolcannormally be expected. It affects 1 to 3% of paediatric population. This article focuses on retentive encopresis that is related to chronic constipation and overflow incontinence. Absence of bowel control has an important impact on physical health, psychosocial functioning and family life. Personal and contextual predisposing, precipitating, maintaining and protective factors for encopresis in a context of etiological hypotheses are discussed.Most children with encopresis have no physical problems to explain the disorder. Text is focusingon chronic constipation, chaotic family environment, parent-child interaction, developmental delay, and avoidance of defecation, the role of family, stressors and anxiety over toileting. Common causes of encopresis include a low fibre diet, lack of hydration, little or no exercise and premature toilet training.There is comorbidity with cognitive delays, learning disabilities, attention deficit disorder, conduct or oppositional disorders. In treatment the most effective outcome is shown cases where medical and psychological treatment programmes are used in conjoint manner. The main components are psychoeducation, clearing the faecal mass with laxative use and bowel retraining with toileting, accident management, diet and exercise. In cases, where children don't recognise when they are about to defecate, biofeedback may be a useful adjunct. With effective strategies encopresis can be eliminated, but relapses may occur.

  4. Quality of Life Assessment Using EuroQOL EQ-5D Questionnaire in Patients with Deep Infiltrating Endometriosis: The Relation with Symptoms and Locations

    Science.gov (United States)

    Touboul, C.; Amate, P.; Ballester, M.; Bazot, M.; Fauconnier, A.; Daraï, E.

    2013-01-01

    The objective of this study was to evaluate the quality of life (QOL) of patients with deep infiltrating endometriosis (DIE) using EuroQOL (EQ-5D) and its correlation with symptoms and locations of endometriotic lesions. One hundred and fifty-nine patients referred for DIE from January 2011 to April 2011 were prospectively invited to complete questionnaires evaluating symptoms associated with endometriosis as well as the EQ-5D questionnaire and health state. Patients also had locations of DIE evaluated by clinical examination and magnetic resonance imaging (MRI). All 159 patients completed the questionnaires. Item response rate was 91.1%. The most intense symptoms were dysmenorrhea (7.1/10), painful defecation (6.3/10), and fatigue (6.0/10). Mean (SD) scores were 77 (14) for the EQ-5D questionnaire and 63.4 (21) for the health state. A relation was observed between the EQ-5D questionnaire and the presence of dysmenorrhea, dyspareunia, cyclic pelvic pain, painful defecation, and diarrhea or constipation. Vaginal and rectal infiltrations were significantly associated with altered EQ-5D and health state scores. The EQ-5D questionnaire is easy to complete and well related to symptoms of DIE. Rectal and vaginal infiltrations were found to be determinant factors of altered QOL by the EQ-5D questionnaire and health state. PMID:26464845

  5. Biofeedback therapy for chronic constipation in a patient with Prader-Willi syndrome.

    Science.gov (United States)

    Corral, Juan E; Kataria, Rahul; Vickers, Dawn; Koutouby, Raghad; Moshiree, Baharak

    2015-01-01

    Constipation is a common feature of Prader-Willi syndrome. Research exploring the prevalence, cause and treatment options for constipation is limited and lacks objective measurements such as anorectal manometry. We report a case of a 16-year-old lady with Prader-Willi syndrome presenting with rectal pain and constipation for 2 years despite multiple medications and weekly enemas. She also noted passive fecal incontinence that required frequent manual disimpactions. Anorectal manometry revealed an abnormal relaxation of the puborectalis and external sphincter muscles on push maneuvers suggesting dyssynergic defecation and rectal hypersensitivity. Contraction and relaxation of her pelvic muscles were recorded with electromyography. Relaxation of the puborectalis muscle improved significantly after three biofeedback sessions. Patient was successfully tapered off laxatives and has been maintained on linaclotide only. Dyssynergic defecation may be a common finding in Prader-Willi syndrome. In selected cases we recommend anorectal manometry to identify neuromuscular dysfunction and subsequent biofeedback therapy depending on the degree of mental retardation to minimize overuse of laxatives.

  6. Effect of a fermented milk containing Bifidobacterium lactis DN-173010 on Chinese constipated women.

    Science.gov (United States)

    Yang, Yue-Xin; He, Mei; Hu, Gang; Wei, Jie; Pages, Philippe; Yang, Xian-Hua; Bourdu-Naturel, Sophie

    2008-10-28

    To investigate the effect of a fermented milk containing Bifidobacterium lactis DN-173010 and yogurt strains (BIO(R)) on adult women with constipation in Beijing. A total of 135 adult females with constipation were randomly allocated to consume for 2 wk either 100 g of the test fermented milk or 100 g of an acidified milk containing non-living bacteria (control). Stool frequency, defecation condition scores, stool consistency and food intake were recorded at baseline and after 1 and 2 wk in an intention-to-treat population of 126 subjects. In parallel, safety evaluation parameters were performed. At baseline, no differences were found between groups. Following consumption of test product, stool frequency was significantly increased after 1 wk (3.5 +/- 1.5 vs 2.4 +/- 0.6, P food intake did not change between the two groups, and safety parameters of the subjects were within normal ranges. This study suggests a beneficial effect of a fermented milk containing B. lactis DN-173010 on stool frequency, defecation condition and stool consistency in adult women with constipation constipated women after 1 and 2 wk of consumption.

  7. COMPORTAMENTO INGESTIVO DE TOURINHOS ALIMENTADOS COM DIETAS CONTENDO NÍVEIS DE GÉRMEN DE MILHO INTEGRAL

    Directory of Open Access Journals (Sweden)

    Fabrícia Rocha Chaves Miotto

    2014-03-01

    Full Text Available This research was conducted to assess the ingestive behavior during 24 hours in eight periods of the day of 24 Limousin x Nellore young bulls in feedlot, fed with diets containing 0; 15; 30 and 45% of whole corn germ. At 9 a.m. and 4:30 p.m., the animals were fed with a roughage:concentrate ratio of 25:75. The inclusion of whole corn germ in the diets did not affect the time spent with food intake, sleeping and other activities, neither the frequencies of water drinking, urination and defecation. Food intake occurred more often during the periods when animals were fed, spending in average 137.10 minutes with this activity. Animals slept more during the night, from 2 to 5 a.m., whereas the time spent with other activities was higher from 5 to 8 p.m. Whole corn germ levels affected the rumination and leisure time in a quadratic form, with the 30% level showing higher rumination time (28.3% of the daily time, and lower leisure time (42.24% of the daily time. Animals submitted to different levels of whole corn germ showed distinct behavior for rumination, leisure, food intake, sleeping and other activities, and frequencies of water drinking, urination and defecation, during the different periods of the day. The inclusion of whole corn germ to the diet of bovines provides greater rumination time and modifies the distribution of this activity during the day.

  8. Tourist cottages in the Arctic: Possibilities of wastewater treatment

    DEFF Research Database (Denmark)

    Gunnarsdottir, Ragnhildur; Ingeman-Nielsen, Thomas; Jenssen, Petter Deinboll

    2009-01-01

    The sanitary situation in the cottages in the area around Sisimiut and on the recommended route for wanderers between Sisimiut and Kangerlussuaq needs to be improved. Today there are toilets in 7 out of a total of 27 cottages. Open defecation is the general practice, and for the cottages with toi...... being changes in climate and thereby also changes of permafrost, which can be a serious problem. Geological and logistical aspects will also have to be taken into consideration, and they vary dependent on the location of each cottage.......The sanitary situation in the cottages in the area around Sisimiut and on the recommended route for wanderers between Sisimiut and Kangerlussuaq needs to be improved. Today there are toilets in 7 out of a total of 27 cottages. Open defecation is the general practice, and for the cottages...... with toilets problems with hygienically and environmentally safe disposal of the excreta exist. The current situation is unacceptable from a health and sanitary point of view. There are several factors that have to be taken into consideration when planning wastewater treatment in cold regions, one of them...

  9. Clinicopathological features and managements of radiation enterocolitis

    Energy Technology Data Exchange (ETDEWEB)

    Takashima, Shigeki; Kinami, Yoshio [Kanazawa Medical Univ., Ishikawa (Japan)

    1990-11-01

    During the past 12 years, delayed radiation enterocolitis developed in 22 patients treated for uterine cervical cancer or endometrial cancer. Their ages ranged from 36 to 77 years with an average age of 62. Ten patients received external irradiation and the other 12 patients received the combined external and internal irradiation. Radiation doses were 50 Gy-156 Gy with an average dose of 80 Gy. All patients had early radiation effects manifested by myxoid bloody stool (82%), diarrhea (46%), defecation disorder (18%), and tenesmus like symptoms (9%). These symptoms resolved within one month after irradiation. The most common symptom for delayed radiation effects was anal hemorrhage and melena (73%), followed by ileus like symptoms and abdominal pain (14%). Defecation disorder, diarrhea, and anemia were observed in one each patient (5%). Latency period ranged from 4 months to 13 years after radiation treatment, with the greatest number (86%) having it within one year and 3 months. There was no definitive correlation between radiation doses and latency period. Histopathological features included marked proliferation extending from the submucosal layer to the muscular layer, endometrial thickening of the small vessels, and thrombopoiesis. Although surgical treatment was performed in 20 patients, favorable outcome was not achieved. (N.K.).

  10. Risk of Adverse Pregnancy Outcomes among Women Practicing Poor Sanitation in Rural India: A Population-Based Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Bijaya K Padhi

    2015-07-01

    Full Text Available The importance of maternal sanitation behaviour during pregnancy for birth outcomes remains unclear. Poor sanitation practices can promote infection and induce stress during pregnancy and may contribute to adverse pregnancy outcomes (APOs. We aimed to assess whether poor sanitation practices were associated with increased risk of APOs such as preterm birth and low birth weight in a population-based study in rural India.A prospective cohort of pregnant women (n = 670 in their first trimester of pregnancy was enrolled and followed until birth. Socio-demographic, clinical, and anthropometric factors, along with access to toilets and sanitation practices, were recorded at enrolment (12th week of gestation. A trained community health volunteer conducted home visits to ensure retention in the study and learn about study outcomes during the course of pregnancy. Unadjusted odds ratios (ORs and adjusted odds ratios (AORs and 95% confidence intervals for APOs were estimated by logistic regression models. Of the 667 women who were retained at the end of the study, 58.2% practiced open defecation and 25.7% experienced APOs, including 130 (19.4% preterm births, 95 (14.2% births with low birth weight, 11 (1.7% spontaneous abortions, and six (0.9% stillbirths. Unadjusted ORs for APOs (OR: 2.53; 95% CI: 1.72-3.71, preterm birth (OR: 2.36; 95% CI: 1.54-3.62, and low birth weight (OR: 2.00; 95% CI: 1.24-3.23 were found to be significantly associated with open defecation practices. After adjustment for potential confounders such as maternal socio-demographic and clinical factors, open defecation was still significantly associated with increased odds of APOs (AOR: 2.38; 95% CI: 1.49-3.80 and preterm birth (AOR: 2.22; 95% CI: 1.29-3.79 but not low birth weight (AOR: 1.61; 95% CI: 0.94-2.73. The association between APOs and open defecation was independent of poverty and caste. Even though we accounted for several key confounding factors in our estimates, the

  11. Risk of Adverse Pregnancy Outcomes among Women Practicing Poor Sanitation in Rural India: A Population-Based Prospective Cohort Study.

    Science.gov (United States)

    Padhi, Bijaya K; Baker, Kelly K; Dutta, Ambarish; Cumming, Oliver; Freeman, Matthew C; Satpathy, Radhanatha; Das, Bhabani S; Panigrahi, Pinaki

    2015-07-01

    The importance of maternal sanitation behaviour during pregnancy for birth outcomes remains unclear. Poor sanitation practices can promote infection and induce stress during pregnancy and may contribute to adverse pregnancy outcomes (APOs). We aimed to assess whether poor sanitation practices were associated with increased risk of APOs such as preterm birth and low birth weight in a population-based study in rural India. A prospective cohort of pregnant women (n = 670) in their first trimester of pregnancy was enrolled and followed until birth. Socio-demographic, clinical, and anthropometric factors, along with access to toilets and sanitation practices, were recorded at enrolment (12th week of gestation). A trained community health volunteer conducted home visits to ensure retention in the study and learn about study outcomes during the course of pregnancy. Unadjusted odds ratios (ORs) and adjusted odds ratios (AORs) and 95% confidence intervals for APOs were estimated by logistic regression models. Of the 667 women who were retained at the end of the study, 58.2% practiced open defecation and 25.7% experienced APOs, including 130 (19.4%) preterm births, 95 (14.2%) births with low birth weight, 11 (1.7%) spontaneous abortions, and six (0.9%) stillbirths. Unadjusted ORs for APOs (OR: 2.53; 95% CI: 1.72-3.71), preterm birth (OR: 2.36; 95% CI: 1.54-3.62), and low birth weight (OR: 2.00; 95% CI: 1.24-3.23) were found to be significantly associated with open defecation practices. After adjustment for potential confounders such as maternal socio-demographic and clinical factors, open defecation was still significantly associated with increased odds of APOs (AOR: 2.38; 95% CI: 1.49-3.80) and preterm birth (AOR: 2.22; 95% CI: 1.29-3.79) but not low birth weight (AOR: 1.61; 95% CI: 0.94-2.73). The association between APOs and open defecation was independent of poverty and caste. Even though we accounted for several key confounding factors in our estimates, the possibility

  12. Chronic effects of therapeutic irradiation for localized prostatic carcinoma on anorectal function

    International Nuclear Information System (INIS)

    Yeoh, Eric E.K.; Botten, Rochelle; Russo, Antonietta; McGowan, Roz; Fraser, Robert; Roos, Daniel; Penniment, Michael; Borg, Martin; Sun Weiming

    2000-01-01

    Purpose: To evaluate prospectively the prevalence and pathophysiology of anorectal dysfunction following radiation therapy (RTH) for localized carcinoma of the prostate. Methods and Materials: The following parameters of anorectal function were evaluated in each of 35 patients (aged 55-82 years) with localized prostatic carcinoma treated with RTH either to a dose of 55 Gy/20 fractions/4 weeks (18 patients) or 64 Gy/32 fractions/6.5 weeks (17 patients), before RTH and 4-6 weeks and at a mean (± SD) of 1.4 (± 0.2) years after its completion: (1) anorectal symptoms (questionnaire), (2) anorectal pressures at rest and in response to voluntary squeeze and increases in intra-abdominal pressure (multiport anorectal manometry), (3) rectal sensation (balloon distension) and (4) anal sphincteric morphology (endoanal ultrasound). Results: All but 1 patient completed three series of measurements. RTH had no effect on anal sphincteric morphology. The increase in frequency of defecation and fecal urgency and incontinence scores previously reported in the patients 4-6 weeks after RTH were sustained 1 year later (p < 0.001, p < 0.001, and p < 0.05, cf. baseline, respectively). At this time, 56% (19 of 34), 50% (17 of 34) and 26% (9 of 34) of the patients had increased frequency of defecation, fecal urgency, and incontinence, respectively. Decreases in anal sphincteric pressures at rest and in response to voluntary squeeze recorded in the patients 4-6 weeks after RTH were not sustained 1 year later but the volumes of rectal distension associated with perception of the stimulus and desire to defecate were lower compared with baseline volumes (p < 0.01 and p < 0.05, respectively), reflecting heightened rectal sensitivity in the patients. There was no difference in measurements between the two radiation dose regimens. Univariate logistical regression analysis was performed on patients who had experienced increased symptom scores or decreases in recorded motor and sensory manometric

  13. Prevalence and intensity of soil transmitted helminths among school children of Mendera Elementary School, Jimma, Southwest Ethiopia.

    Science.gov (United States)

    Tefera, Ephrem; Belay, Tariku; Mekonnen, Seleshi Kebede; Zeynudin, Ahmed; Belachew, Tefera

    2017-01-01

    Soil transmitted helminths are wide spread in developing countries and in Ethiopia the prevalence of STHs varies in different parts of the country. The aim of this study was to determine the prevalence and intensity of soil transmitted helminths among school children of Mendera Elementary School Jimma town, Southwestern Ethiopia. A cross-sectional study was conducted between March 29 and April 9, 2010 to determine the prevalence and intensity of soil transmitted helminths among elementary school children. The study participants were randomly selected from class enrollment list after proportional allocation of the total sample size to each grade. Data about the background characteristics were collected using structured questionnaire. The stool samples were examined by McMaster method for the egg count which was used to determine intensity of infection. Data were analyzed using SPSS for windows version 16 and p-value less than 5% was considered as statistically significant. Of the total 715 stool specimens examined, 346 were positive for at least one intestinal parasite making the prevalence 48.4%. The most prevalent parasites were Ascaris lumbricoides 169 (23.6%) and Trichuris trichiura 165 (23.1%). The prevalence of soil transmitted helminth in this study was 45.6% (326/715). There was statistically significant difference in the prevalence of Trichuriasis between those who use latrine always and who use sometimes (p = 0.010). Females are two times more likely to be positive for Ascaris than males (p = 0.039). Majority of the students had light infection of soil transmitted helminths and none of them had heavy intensity of infection of Trichuriasis and hookworms. Nearly half of the school children were infected with at least one STHs and majority of the students had light infection of soil transmitted helminths. Students who did not wash their hands after defecation were three times more likely to be positive for Ascaris infection than those who washed their hands

  14. Scent-marking by coyotes, Canis latrans: the influence of social and ecological factors

    Science.gov (United States)

    Gese; Ruff

    1997-11-01

    We observed 49 coyotes, Canis latransfrom five resident packs for 2456 h and five transient coyotes for 51 h from January 1991 to June 1993 in the Lamar River Valley, Yellowstone National Park, Wyoming, U.S.A. During these observations we recorded 3042 urinations, 451 defecations, 446 ground scratches and 743 double-marks. The rate of scent-marking (via urination) was influenced by the social organization (resident versus transient) to which the coyote belonged, the social class (alpha, beta or pup) of the animal and the time of the year. Transient coyotes scent-marked at a lower rate than did members of a resident pack. Within the resident packs, alpha coyotes scent-marked at a higher rate than beta coyotes (adults and yearlings subordinant to alphas, but dominant over pups) and pups. Alpha coyotes increased their rate of marking during the breeding season; beta and pup coyotes performed scent-marks at a relatively constant rate throughout the year. There was no influence of social class or time of year on the rate of defecation. The rate of double-marking was highest among alpha coyotes with a peak during the breeding season. Alpha coyotes ground-scratched at a higher rate than did beta and pup coyotes. Alpha and beta coyotes scent-marked more than expected along the periphery of the territory compared to the interior; pups marked in the interior and edge in proportion to expected frequencies. Double-marking and ground-scratching were higher than expected along the periphery of the territory. The distribution of defecations was not different from expected along the edge versus the interior of the territory. Pack size did not influence the rate of scent-marking performed by individuals in the pack or by the alpha pair. We concluded that alpha coyotes were the primary members of the resident pack involved in scent-marking. The large coyote packs and the high rate of marking by the alpha pairs were parallel to the scent-marking behaviour displayed by wolves, C

  15. Accuracy of Four Imaging Techniques for Diagnosis of Posterior Pelvic Floor Disorders.

    Science.gov (United States)

    van Gruting, Isabelle M A; Stankiewicz, Aleksandra; Kluivers, Kirsten; De Bin, Riccardo; Blake, Helena; Sultan, Abdul H; Thakar, Ranee

    2017-11-01

    To establish the diagnostic test accuracy of evacuation proctography, magnetic resonance imaging (MRI), transperineal ultrasonography, and endovaginal ultrasonography for detecting posterior pelvic floor disorders (rectocele, enterocele, intussusception, and anismus) in women with obstructed defecation syndrome and secondarily to identify the most patient-friendly imaging technique. In this prospective cohort study, 131 women with symptoms of obstructed defecation syndrome underwent evacuation proctogram, MRI, and transperineal and endovaginal ultrasonography. Images were analyzed by two blinded observers. In the absence of a reference standard, latent class analysis was used to assess diagnostic test accuracy of multiple tests with area under the curve (AUC) as the primary outcome measure. Secondary outcome measures were interobserver agreement calculated as Cohen's κ and patient acceptability using a visual analog scale. No significant differences in diagnostic accuracy were found among the imaging techniques for all the target conditions. Estimates of diagnostic test accuracy were highest for rectocele using MRI (AUC 0.79) or transperineal ultrasonography (AUC 0.85), for enterocele using transperineal (AUC 0.73) or endovaginal ultrasonography (AUC 0.87), for intussusception using evacuation proctography (AUC 0.76) or endovaginal ultrasonography (AUC 0.77), and for anismus using endovaginal (AUC 0.95) or transperineal ultrasonography (AUC 0.78). Interobserver agreement for the diagnosis of rectocele (κ 0.53-0.72), enterocele (κ 0.54-0.94) and anismus (κ 0.43-0.81) was moderate to excellent, but poor to fair for intussusception (κ -0.03 to 0.37) with all techniques. Patient acceptability was better for transperineal and endovaginal ultrasonography as compared with MRI and evacuation proctography (P<.001). Evacuation proctography, MRI, and transperineal and endovaginal ultrasonography were shown to have similar diagnostic test accuracy. Evacuation proctography

  16. Hypoxia and inactivity related physiological changes precede or take place in absence of significant rearrangements in bacterial community structure: The PlanHab randomized trial pilot study.

    Directory of Open Access Journals (Sweden)

    Robert Šket

    Full Text Available We explored the assembly of intestinal microbiota in healthy male participants during the randomized crossover design of run-in (5 day and experimental phases (21-day normoxic bed rest (NBR, hypoxic bed rest (HBR and hypoxic ambulation (HAmb in a strictly controlled laboratory environment, with balanced fluid and dietary intakes, controlled circadian rhythm, microbial ambiental burden and 24/7 medical surveillance. The fraction of inspired O2 (FiO2 and partial pressure of inspired O2 (PiO2 were 0.209 and 133.1 ± 0.3 mmHg for NBR and 0.141 ± 0.004 and 90.0 ± 0.4 mmHg for both hypoxic variants (HBR and HAmb; ~4000 m simulated altitude, respectively. A number of parameters linked to intestinal environment such as defecation frequency, intestinal electrical conductivity (IEC, sterol and polyphenol content and diversity, indole, aromaticity and spectral characteristics of dissolved organic matter (DOM were measured (64 variables. The structure and diversity of bacterial microbial community was assessed using 16S rRNA amplicon sequencing. Inactivity negatively affected frequency of defecation and in combination with hypoxia increased IEC (p < 0.05. In contrast, sterol and polyphenol diversity and content, various characteristics of DOM and aromatic compounds, the structure and diversity of bacterial microbial community were not significantly affected over time. A new in-house PlanHab database was established to integrate all measured variables on host physiology, diet, experiment, immune and metabolic markers (n = 231. The observed progressive decrease in defecation frequency and concomitant increase in IEC suggested that the transition from healthy physiological state towards the developed symptoms of low magnitude obesity-related syndromes was dose dependent on the extent of time spent in inactivity and preceded or took place in absence of significant rearrangements in bacterial microbial community. Species B. thetaiotamicron, B. fragilis, B

  17. Development of a health education intervention strategy using an implementation research method to control taeniasis and cysticercosis in Burkina Faso.

    Science.gov (United States)

    Ngowi, Helena; Ozbolt, Ivan; Millogo, Athanase; Dermauw, Veronique; Somé, Télesphore; Spicer, Paul; Jervis, Lori L; Ganaba, Rasmané; Gabriel, Sarah; Dorny, Pierre; Carabin, Hélène

    2017-06-01

    Taeniasis and cysticercosis are two diseases caused by Taenia solium, a parasite transmitted between humans and pigs, leading to considerable economic loss and disabilities. Transmission of the parasite is linked to environmental and behavioural factors such as inadequate sanitation and hygiene, poor pig management, and consumption of infected pork. This study used implementation research method to design a health education intervention strategy for reducing T. solium infections in Burkina Faso, a country endemic for the parasite. Eighteen group discussions were conducted with 8-18 participants each in three villages. In addition, structured interviews were conducted among 4 777 participants and 2 244 pig owners, who were selected through cluster random sampling in 60 villages of three provinces of Burkina Faso. Both approaches assessed knowledge and practices related to T. solium. The information obtained was used to develop a community-adapted health education intervention strategy to control taeniasis and cysticercosis in Burkina Faso. The group discussions revealed that participants had a poor quality of life due to the diseases as well as inadequate access to latrines, safe water, and healthcare services. In addition, it was found that pig production was an important economic activity, especially for women. Furthermore, financial and knowledge constraints were important limitations to improved pig management and latrine construction. The survey data also showed that open defecation and drinking unboiled water were common behaviours, enhanced by a lack of knowledge regarding the transmission of the parasite, perceived financial barriers to the implementation of control measures, lack of public sensitization, as well as a lack of self-efficacy towards control of the parasite. Nevertheless, the perceived financial benefits of controlling porcine cysticercosis could be emphasized by an education program that discourages open defecation and encourages drinking safe

  18. Clinical, haematobiochemical, radiographic and ultrasonographic features of traumatic reticuloperitonitis in bovines

    International Nuclear Information System (INIS)

    Mohindroo, J.; Singh, Kiranjeet; Kumar, Ashwani; Randhawa, C.S.

    2010-01-01

    Study was conducted to compare the clinical, haematobiochemical, radiographic and ultrasonographic features of traumatic reticuloperitonitis in bovines. Clinical cases (4 cows and 17 buffaloes) presented with a history of anorexia, fever, decreased milk yield and loss of defecation/scant faeces, were used. Haematological picture revealed neutrophilic leucocytosis with left shift and blood biochemical status showed elevated levels of total protein, albumin, and fibrinogen. Decreased plasma concentration of sodium, potassium and chloride was observed in majority of the cases. Radiographic examination revealed presence of multiple metallic foreign densities in the reticulum of the bovines. Ultrasonographically, morphological changes of reticular wall and reticulophrenic adhesions in cases of localised peritonitis were visualized. The presence of anechoic fluid without echogenic margins, not restricted to reticulum and sometimes with floating fibrinous shreds was observed in cases of diffuse peritonitis. Ultrasonography in B mode and B+ mode found helpful for the diagnosis of traumatic reticuloperitonitis and differentiation of localised peritonitis from diffuse peritonitis

  19. What is bioturbation? The need for a precise definition for fauna in aquatic sciences

    DEFF Research Database (Denmark)

    Kristensen, Erik; Penha-Lopes, Gil; Delefosse, Matthieu

    2012-01-01

    referred to as particle reworking, while water movement (if considered) is re ferred to as bioirrigation in many cases. For consistency, we therefore propose that, for contemporary aquatic scientific disciplines, faunal bioturbation in aquatic environments includes all transport processes carried out...... by animals that directly or indirectly affect sediment matrices. These processes include both particle reworking and burrow ventilation. With this definition, bioturbation acts as an ‘umbrella’ term that covers all transport processes and their physical effects on the substratum. Particle reworking occurs...... through burrow construction and maintenance, as well as ingestion and defecation, and causes biomixing of the substratum. Organic matter and microorganisms are thus displaced vertically and laterally within the sediment matrix. Particle reworking animals can be categorized as biodiffusors, upward...

  20. Treatment of Infantile Diarrhea by Acupuncture and Laser Irradiation - A Report of 60 Cases

    Institute of Scientific and Technical Information of China (English)

    丁渡明

    2004-01-01

    @@ Infantile diarrhea is a common disease in babies of less than 2 years old in summer or autumn. It is due to acute dyspepsia mainly caused by improper feeding or attack of cold or damp pathogens.Clinically, it is characterized by increased times of defecation (5-6, or even dozens of times a day),yellow-green or blue-green thin feces intermingled with mucus, milk-mass and indigested food which have a sour and fetid odor, accompanied with loss of appetite, abdominal distending pain, nausea,vomiting, and even fever, irritability, dehydration and electrolyte disturbance in severe cases. The microscopy reveals that there are leukocytes and fat globules in feces. We have treated 60 cases of infantile diarrhea with acupuncture and He-Ne laser point irradiation and obtained satisfactory therapeutic results.

  1. Fecal corticosterone reflects serum corticosterone in Florida sandhill cranes.

    Science.gov (United States)

    Ludders, J W; Langenberg, J A; Czekala, N M; Erb, H N

    2001-07-01

    Florida sandhill cranes (Grus canadensis pratensis) were conditioned to confinement 6 hr/day for 7 days. On day 8, each bird's jugular vein was catheterized, blood samples were drawn, and each crane was confined for 6 hr. Using a randomized, restricted cross-over design, cranes were injected intravenously with either 0.9% NaCl solution or ACTH (cosyntropin; Cortrosyn; 0.25 mg). During the 6 hr of confinement, fecal samples (feces and urine) were collected from each of five cranes immediately after defecation. Individual fecal samples were collected approximately at hourly intervals and assayed for corticosterone. We showed previously that serum corticosterone did not vary significantly following saline injection, but peaked significantly 60 min after ACTH injection. Maximal fecal corticosterone concentrations (ng/g) were greater (P cranes under controlled conditions, fecal corticosterone concentration reflects serum corticosterone levels, fecal corticosterone, Grus canadensis pratensis, sandhill cranes, serum corticosterone levels.

  2. Scintigraphic small intestinal transit time and defaecography in patients with J-pouch

    DEFF Research Database (Denmark)

    Kjær, Mie Dilling; Simonsen, Jane Angel; Hvidsten, Svend

    2015-01-01

    Objective methods for examination of pouch function are warranted for a better understanding of the functional result and treatment of dysfunction. The objective of this study was to evaluate the results of scintigraphic intestinal transit time and defaecography compared to the results of pouch...... function, mucosal condition and a questionnaire on quality of life (QoL). This cross-sectional study included 21 patients. Scintigraphic transit time and defaecography was determined with the use of Tc-99m. Pouch function was assessed by number of bowel movements, pouch volume, and continence. Pouch...... mucosal condition was evaluated by endoscopy and histology. Median transit time was 189 min (105–365). Median ejection fraction at defaecography (EF) was 49% (3–77) and 62% (17–98) after first and second defecation. Median pouch volume was 223 mL (100–360). A median daily stool frequency of nine (4...

  3. Leishmania infantum nicotinamidase is required for late-stage development in its natural sand fly vector, Phlebotomus perniciosus.

    Science.gov (United States)

    Gazanion, Elodie; Seblova, Veronika; Votypka, Jan; Vergnes, Baptiste; Garcia, Déborah; Volf, Petr; Sereno, Denis

    2012-04-01

    Leishmania infantum nicotinamidase, encoded by the Lipnc1 gene, converts nicotinamide into nicotinicacid to ensure Nicotinamide–Adenine–Dinucleotide (NAD+) biosynthesis. We were curious to explore the role of this enzyme during L. infantum development in its natural sand fly vector, Phlebotomus perniciosus (Diptera, Phlebotominae), using null mutants with a deleted Lipnc1 gene. The null mutants developed as well as the wild type L. infantum at the early time points post their ingestion within the bloodmeal. In contrast, once the blood meal digestion was completed, the null mutants were unable to develop further and establish late-stage infections. Data highlight the importance of the nicotinamide degradation pathway for Leishmania development in sand flies. They indicate that the endogenous nicotinamidase is essential for Leishmania development in the sand fly after the blood meal has been digested and the remnants defecated.

  4. Successful management of a benign anastomotic colonic stricture with self-expanding metallic stents: A case report

    Science.gov (United States)

    Guan, Yong-Song; Sun, Long; Li, Xiao; Zheng, Xiao-Hua

    2004-01-01

    AIM: To assess the effectiveness of and complications associated with metallic stent placement for treatment of anastomotic colonic strictures. METHODS: A 46-year-old man underging two procedures of surgery for perforation of descending colon due to a traffic accident presented with pain, abdominal distention, and inability to defecate. Single-contrast barium enema radiograph showed a severe stenosis in the region of surgical anastomosis and the patient was too weak to accept another laparotomy. Under fluoroscopic and endoscopic guidance, we placed two metallic stents in the stenosis site of the anastomosis of the patient with anastomotic colonic strictures. RESULTS: In this case of postsurgical stenosis, the first stent relieved the symptoms of obstruction, but stent migration happened on the next day so an additional stent was required to deal with the stricture and relieve the symptoms. CONCLUSION: This case confirms that metallic stenting may represent an effective treatment for anastomotic colonic strictures in the absence of other therapeutic alternatives. PMID:15526381

  5. Spatial Localization and Binding of the Probiotic Lactobacillus farciminis to the Rat Intestinal Mucosa: Influence of Chronic Stress.

    Directory of Open Access Journals (Sweden)

    Stéphanie Da Silva

    Full Text Available The present study aimed at detecting the exogenously applied probiotic Lactobacillus farciminis in rats, after exposure to IBS-like chronic stress, based on 4-day Water Avoidance Stress (WAS. The presence of L. farciminis in both ileal and colonic mucosal tissues was demonstrated by FISH and qPCR, with ileum as the preferential niche, as for the SFB population. A different spatial distribution of the probiotic was observed: in the ileum, bacteria were organized in micro-colonies more or less close to the epithelium whereas, in the colon, they were mainly visualized far away from the epithelium. When rats were submitted to WAS, the L. farciminis population substantially decreased in both intestinal regions, due to a stress-induced increase in colonic motility and defecation, rather than a modification of bacterial binding to the intestinal mucin Muc2.

  6. Clinical Study on a Case of Transverse Myelitis

    Directory of Open Access Journals (Sweden)

    Kim Jeong-eun

    2008-06-01

    Full Text Available Objectives : This report intended to estimate effect taken by using Oriental medical method on the patient with Tranverse Myelitis. Methods : From 28th April, 2006 to 19th June, 2006. The patient dignosed as a Transverse Myelitis receive acupuncture, moxibustion, cupping and physical therapy and herbal medication by estimating arthralgia syndrome(痺證. Results : The patient's incipient symptoms-both lower limb paresthesia and weakness, voluntary urination and defecation-all were improved. Conclusions : This study demonstrates that oriental medical treatment has respectable effect in improving as though we didn’t exclude effect of western medical therapy on the patient with transverse myelitis. More research of transverse myelitis is needed.

  7. Colonic resection with early discharge after combined subarachnoid-epidural analgesia, preoperative glucocorticoids, and early postoperative mobilization and feeding in a pulmonary high-risk patient

    DEFF Research Database (Denmark)

    Møiniche, S; Dahl, J B; Rosenberg, J

    1994-01-01

    BACKGROUND AND OBJECTIVES. A pulmonary high-risk patient undergoing right hemicolectomy for cancer was treated with a combination of intense afferent neural block with subarachnoid-epidural local anesthetics followed by continuous epidural analgesia, preoperative high-dose glucocorticoids......) with unchanged pulmonary function. Nocturnal episodic oxygen desaturation, hyperthermia, and postoperative fatigue were prevented. Defecation occurred on the first postoperative day and oral caloric intake was normal after 24 hours with no postoperative weight loss. Self care was normalized on the third...... postoperative day and the patient discharged from the hospital 80 hours after surgery. CONCLUSIONS. The technique of combined neural and humoral mediator block should be evaluated in other high-risk patients undergoing major surgical procedures, where minimal invasive techniques are not possible....

  8. Histamine as an emergent indoor contaminant: Accumulation and persistence in bed bug infested homes.

    Science.gov (United States)

    DeVries, Zachary C; Santangelo, Richard G; Barbarin, Alexis M; Schal, Coby

    2018-01-01

    Histamine is used in bronchial and dermal provocation, but it is rarely considered an environmental risk factor in allergic disease. Because bed bugs defecate large amounts of histamine as a component of their aggregation pheromone, we sought to determine if histamine accumulates in household dust in bed bug infested homes, and the effects of bed bug eradication with spatial heat on histamine levels in dust. We collected dust in homes and analyzed for histamine before, and up to three months after bed bug eradication. Histamine levels in bed bug infested homes were remarkably high (mean = 54.6±18.9 μg/100 mg of sieved household dust) and significantly higher than in control homes not infested with bed bugs (mean emergent contaminant and pose a serious health risk in the indoor environment.

  9. Prevalence of Functional Gastrointestinal Disorders in Schoolchildren in Ecuador.

    Science.gov (United States)

    Játiva, Edgar; Velasco-Benítez, Carlos A; Koppen, Ilan J N; Játiva-Cabezas, Zahira; Saps, Miguel

    2016-07-01

    The prevalence of functional gastrointestinal disorders (FGIDs) in children in Ecuador is unknown. We describe a survey study in 2 schools in Quito, Ecuador, using a Spanish translation of the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III Version (QPGS-RIII). A total of 417 children (51% boys) with a mean age of 12.0 years were included. FGIDs were present in 95 children (22.8%) and occurred in 25% of girls and in 20.7% of boys (P = 0.296). Functional defecation disorders were found in 12.0% of children, 9.4% had an abdominal pain-related FGID and 3.8% was diagnosed with a vomiting or aerophagia FGID.

  10. A urethrorectal fistula due to prostatic abscess associated with urolithiasis in a dog.

    Science.gov (United States)

    Agut, A; Lucas, X; Castro, A; De Membiela, F; Soler, M; Belda, E

    2006-06-01

    An 8-year-old, entire male crossbreed dog had a 2-day history of abdominal pain and straining to urinate and defecate. A diagnosis of urolithiasis with urinary retention, and probable prostatitis was made. The dog was treated with fluids and enrofloxacin. Five days later, ultrasonography of the prostate showed two hypoechoic areas compatible with abscesses. Twelve hours later, the patient started to urinate from the rectum during micturition and urethrorectal fistula was diagnosed. The omentalization of the prostatic abscesses and castration were performed and calculi were removed. The urethrorectal fistula was treated conservatively with an indwelling urinary catheter, a low residue diet and antibiotics. The dog recovered uneventfully without recurrence of the fistula.

  11. Targeted interventions of ultra-poor women in rural Rangpur, Bangladesh: do they make a difference to appropriate cooking practices, food habits and sanitation?

    Science.gov (United States)

    Yeasmin, Lubna; Akter, Shamima; Shahidul Islam, A M; Mizanur Rahman, Md; Akashi, Hidechika; Jesmin, Subrina

    2014-07-01

    This study aimed to assess whether teaching good cooking practices, food habits and sanitation to ultra-poor rural women in four rural communities of Rangpur district, Bangladesh, with a high density of extremely poor households, would improve the overall health of the community. The sample size was 200 respondents combined from the target and control areas. In the target area, twelve in-depth interviews and four focus group discussions were undertaken for knowledge dissemination. Descriptive and mixed-model analyses were performed. The results show that washing hands with soap was 1.35 times more likely in the target than the control group (ppreparing food, feeding a child and eating, and after defecating and cleaning a baby (pcooking vegetables than the control group (pfood preparation and increases their hygiene through hand-washing in every-day life.

  12. Functional abdominal pain syndrome.

    Science.gov (United States)

    Clouse, Ray E; Mayer, Emeran A; Aziz, Qasim; Drossman, Douglas A; Dumitrascu, Dan L; Mönnikes, Hubert; Naliboff, Bruce D

    2006-04-01

    Functional abdominal pain syndrome (FAPS) differs from the other functional bowel disorders; it is less common, symptoms largely are unrelated to food intake and defecation, and it has higher comorbidity with psychiatric disorders. The etiology and pathophysiology are incompletely understood. Because FAPS likely represents a heterogeneous group of disorders, peripheral neuropathic pain mechanisms, alterations in endogenous pain modulation systems, or both may be involved in any one patient. The diagnosis of FAPS is made on the basis of positive symptom criteria and a longstanding history of symptoms; in the absence of alarm symptoms, an extensive diagnostic evaluation is not required. Management is based on a therapeutic physician-patient relationship and empirical treatment algorithms using various classes of centrally acting drugs, including antidepressants and anticonvulsants. The choice, dose, and combination of drugs are influenced by psychiatric comorbidities. Psychological treatment options include psychotherapy, relaxation techniques, and hypnosis. Refractory FAPS patients may benefit from a multidisciplinary pain clinic approach.

  13. Irritable Bowel Syndrome: Yoga as Remedial Therapy

    Directory of Open Access Journals (Sweden)

    Vijaya Kavuri

    2015-01-01

    Full Text Available Irritable bowel syndrome (IBS is a group of symptoms manifesting as a functional gastrointestinal (GI disorder in which patients experience abdominal pain, discomfort, and bloating that is often relieved with defecation. IBS is often associated with a host of secondary comorbidities such as anxiety, depression, headaches, and fatigue. In this review, we examined the basic principles of Pancha Kosha (five sheaths of human existence concept from an Indian scripture Taittiriya Upanishad and the pathophysiology of a disease from the Yoga approach, Yoga Vasistha’s Adhi (originated from mind and Vyadhi (ailment/disease concept. An analogy between the age old, the most profound concept of Adhi-Vyadhi, and modern scientific stress-induced dysregulation of brain-gut axis, as it relates to IBS that could pave way for impacting IBS, is emphasized. Based on these perspectives, a plausible Yoga module as a remedial therapy is provided to better manage the primary and secondary symptoms of IBS.

  14. Hibernation in black bears: independence of metabolic suppression from body temperature.

    Science.gov (United States)

    Tøien, Øivind; Blake, John; Edgar, Dale M; Grahn, Dennis A; Heller, H Craig; Barnes, Brian M

    2011-02-18

    Black bears hibernate for 5 to 7 months a year and, during this time, do not eat, drink, urinate, or defecate. We measured metabolic rate and body temperature in hibernating black bears and found that they suppress metabolism to 25% of basal rates while regulating body temperature from 30° to 36°C, in multiday cycles. Heart rates were reduced from 55 to as few as 9 beats per minute, with profound sinus arrhythmia. After returning to normal body temperature and emerging from dens, bears maintained a reduced metabolic rate for up to 3 weeks. The pronounced reduction and delayed recovery of metabolic rate in hibernating bears suggest that the majority of metabolic suppression during hibernation is independent of lowered body temperature.

  15. Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction

    Science.gov (United States)

    Faubion, Stephanie S.; Shuster, Lynne T.; Bharucha, Adil E.

    2012-01-01

    Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and anal sphincters. These symptoms may adversely affect quality of life. Focus on the global symptom complex, rather than the individual symptoms, may help the clinician identify the condition. The primary care provider is in a position to intervene early, efficiently, and effectively by (1) recognizing the range of symptoms that might suggest nonrelaxing pelvic floor dysfunction, (2) educating patients, (3) performing selective tests when needed to confirm the diagnosis, and (4) providing early referral for physical therapy. PMID:22305030

  16. An ethological study of young horses

    Directory of Open Access Journals (Sweden)

    Pavla Šišková

    2006-01-01

    Full Text Available In the present study called “An Ethological Study of Young Horses” we focused on the behaviour of foals from their birth to separation from their mother. We observed and analysed their behaviour and daily activities, and from the achieved results we drew conclusions for practical horse breeding. We studied the following forms of behaviour of the foals: feeding behaviour (sucking, drinking, eating roughage and concentrates, gleaning, coprophagia, defecation and micturition, comfortable behaviour and mutual comfort behaviour, manifestations of relaxation (resting posture, lying down, movement manifestations, playful behaviour, stereotype behaviour, other manifestations (acoustic, olfactory etc.As a result we recommended several changes in the technology, e.g. larger stables, salt-lick out of reach of the foals, more frequent exchange of bedding, shelter for horses grazing in the open.

  17. [Colon and rectum histoplasmosis in a patient from Peru].

    Science.gov (United States)

    Alcántara Figueroa, Christian; Sánchez Cerna, Víctor

    2016-01-01

    We report a case of a male patient of 52 years old with a 3 months history of pushing, tenesmus, hematochezia, pain while defecating, lost of 18 kg of weight, fever, fecaloid and purulent discharge through an perianal hole. During the colonoscopy procedure, we found many ulcers in the ascending, transverse and descending colon.We also found an elevated lesion of about 5 cm in the rectum. We used hematoxylin - eosin and Gomori-Grocott stain in the biopsies and identified many microorganisms inside macrophages which were compatible with histoplasmosis. ELISA tests for HIV, HTLV I- II were negative. Colon and rectal histoplasmosis in an immunocompetent patient is extremely rare. There are few cases of colonic histoplasmosis reported.

  18. Chronic perineal pain: current pathophysiological aspects, diagnostic approaches and treatment.

    Science.gov (United States)

    Andromanakos, Nikolaos P; Kouraklis, Grigorios; Alkiviadis, Kostakis

    2011-01-01

    Chronic perineal pain is the anorectal and perineal pain without underlying organic disease, anorectal or endopelvic, which has been excluded by careful physical examination, radiological and endoscopic investigations. A variety of neuromuscular disorders of the pelvic floor lead to the different pathological conditions such as anorectal incontinence, urinary incontinence and constipation of obstructed defecation, sexual dysfunction and pain syndromes. The most common functional disorders of the pelvic floor muscles, accompanied by perineal pain are levator ani syndrome, proctalgia fugax, myofascial syndrome and coccygodynia. In the diagnosis of these syndromes, contributing to a thorough history, physical examination, selected specialized investigations and the exclusion of organic disease with proctalgia is carried out. Accurate diagnosis of the syndromes helps in choosing an appropriate treatment and in avoiding unnecessary and ineffective surgical procedures, which often are performed in an attempt to alleviate the patient's symptoms.

  19. [Zoonosis transmission risk factors according to population habits inIlha Solteira city, Brazil].

    Science.gov (United States)

    Sánchez-Ortiz, Iván A; Leite, Maurício A

    2011-06-01

    Determining conditions regarding possible zoonosis transmission risk based on Ilha Solteira-São Paulo citizens' habits aimed at establishing concrete recommendations for the corresponding local authorities to reduce some risk factors. 100 focalized interviews were held on Ilha Solteira's urban perimeter during April 2008. The people interviewed were adults who lived or worked in houses in the study area. This research found a significant number of cat and/or dog owners who allowed their pets to stay in internal areas of their houses. They did not define a specific place for animals to defecate and/or urinate or did not arrange appropriate final disposal of such waste. Local authorities must make greater efforts at educating Ilha Solteira pets' owners and providing them with information and encouraging greater citizen commitment and awareness to improve habits related to caring for pets/animal sand reducing zoonosis transmission risk factors.

  20. Irritable Bowel Syndrome: Yoga as Remedial Therapy

    Science.gov (United States)

    Kavuri, Vijaya; Raghuram, Nagarathna; Malamud, Ariel; Selvan, Senthamil R.

    2015-01-01

    Irritable bowel syndrome (IBS) is a group of symptoms manifesting as a functional gastrointestinal (GI) disorder in which patients experience abdominal pain, discomfort, and bloating that is often relieved with defecation. IBS is often associated with a host of secondary comorbidities such as anxiety, depression, headaches, and fatigue. In this review, we examined the basic principles of Pancha Kosha (five sheaths of human existence) concept from an Indian scripture Taittiriya Upanishad and the pathophysiology of a disease from the Yoga approach, Yoga Vasistha's Adhi (originated from mind) and Vyadhi (ailment/disease) concept. An analogy between the age old, the most profound concept of Adhi-Vyadhi, and modern scientific stress-induced dysregulation of brain-gut axis, as it relates to IBS that could pave way for impacting IBS, is emphasized. Based on these perspectives, a plausible Yoga module as a remedial therapy is provided to better manage the primary and secondary symptoms of IBS. PMID:26064164

  1. Is anorectal endosonography valuable in dyschesia?

    Science.gov (United States)

    Van Outryve, S M; Van Outryve, M J; De Winter, B Y; Pelckmans, P A

    2002-01-01

    Aims: Dyschesia can be provoked by inappropriate defecation movements. The aim of this prospective study was to demonstrate dysfunction of the anal sphincter and/or the musculus (m.) puborectalis in patients with dyschesia using anorectal endosonography. Methods: Twenty consecutive patients with a medical history of dyschesia and a control group of 20 healthy subjects underwent linear anorectal endosonography (Toshiba models IUV 5060 and PVL-625 RT). In both groups, the dimensions of the anal sphincter and the m. puborectalis were measured at rest, and during voluntary squeezing and straining. Statistical analysis was performed within and between the two groups. Results: The anal sphincter became paradoxically shorter and/or thicker during straining (versus the resting state) in 85% of patients but in only 35% of control subjects. Changes in sphincter length were statistically significantly different (panismus”. PMID:12377809

  2. Defecography - analysis of qualitative findings; Evakuationsproktographie - Analyse qualitativer Befunde

    Energy Technology Data Exchange (ETDEWEB)

    Schott, U. [Tuebingen Univ. (Germany). Abt. Radiologische Diagnostik; Braunschweig, R. [Tuebingen Univ. (Germany). Abt. Radiologische Diagnostik; Claussen, C.D. [Tuebingen Univ. (Germany). Abt. Radiologische Diagnostik

    1994-12-31

    The defectography is an examination of the anorectal function in defecatory disorder. The defecography has a diagnostic impact on disease, which only emerge during defecation as intussusception, enterocele, prolapse or sphincter dysfunction. Other findings as rectocele or descending pelvic floor are ambiguous concerning clinical relevance. The interpretation of defecography should include patient`s history and clinical findings and - if available - endoscopic and manometric findings. (orig.) [Deutsch] Die Evakuationsproktographie ist eine Funktionsuntersuchung des Anorektums beim Symptomenkreis der Defaekationsbeschwerden. Die Domaene der Evakuationsproktographie sind Erkrankungen, die sich nur unter den Provokationsbedingungen der Defaekation manifestieren, wie die Intussuzeption, Enterocele, temporaerer Wandprolaps oder Anismus. Andere Befunde wie eine Rektocele oder Beckenbodenschwaeche sind in ihrer klinischen Relevanz umstritten. Die Bewertung der Evakuationsproktographie im Rahmen des Beschwerdebildes des Patienten sollte in Zusammenschau von vollstaendiger anamnestischer und klinischer Information und - sofern vorhanden - Befunden von Rektoskopie und Rektummanometrie erfolgen. (orig.)

  3. Evacuation proctography - examination technique and method of evaluation

    International Nuclear Information System (INIS)

    Braunschweig, R.; Schott, U.; Starlinger, M.

    1993-01-01

    Evacuation proctography is the most important imaging technique to supplement findings of physical examination, manometry, and endoscopy in patients presenting with pathologies in anorectal morphology and function. Indications for evacuation proctography include obstructed defecation or incomplete evacuation, imaging of ileal pouches following excision of the rectum, and suspected anorectal fistulae. Evacuation proctography with thick barium sulfate is performed under fluoroscopy. Documentation of the study can either be done by single-shot X-rays, video recording, or imaging with a 100-mm spot-film camera. Evacuation proctography shows morphologic changes such as spastic pelvic floor, rectocele, enterocele, intussusception and anal prolapse. Measurements can be performed to obtain the anorectal angle, location and mobility of the pelvic floor, and size as well as importance of a rectocele. Qualitative and quantitative data can only be interpreted along with clinical and manometric data. (orig.) [de

  4. Type C botulism in swine fed on restaurant waste

    Directory of Open Access Journals (Sweden)

    Djeison L. Raymundo

    2012-11-01

    Full Text Available The paper addresses the epidemiologic data of the death of pigs during the period of 2002 to 2009 following the ingestion of botulinum neurotoxin type C. This neurotoxin was present in food residues originating from restaurant and hotel kitchens, stored in barrels without shelter from the sun and administered in a collective trough without prior thermal treatment. Animals which died at different ages showed clinical signs of botulism characterized by flaccid paralysis, weight loss, anorexia, weakness, lack of coordination, locomotion difficulties with the evolution of lateral recumbency with involuntary urination and defecation. No alterations were observed at postmortem and histological examination. The bioassay with serum neutralization in mice was carried out on samples of intestinal contents from pigs affected and revealed the presence of large quantities of botulinum toxin type C.

  5. The spreading of radiolabelled fatty suppository bases in the human rectum

    International Nuclear Information System (INIS)

    Sugito, Keiko; Ogata, Hiroyasu; Noguchi, Masahiro; Kogure, Takahashi; Takano, Masaaki; Maruyama, Yuzo; Sasaki, Yasuhito

    1988-01-01

    The purpose of this study was to develop a radiolabelling method for assessing the spreading of fatty suppository bases (Witepsol H-5, W-35 and S-55), and to apply this technique to the evaluation of suppository disposition in the human rectum. 99m/Tc was bound chemically to the bases Witepsol H-5 and W-35, and mixed physically with Witepsol S-55. The spreading of each suppository base was monitored by gamma-scintigraphy following rectal administration. The mean radioactivity remaining at the inserted region 4 h after administration was 44.2% of total activity. The mean perpendicular maximum spreading distance from this region was 7.7 cm on the scintigram near to the sigmoid colon. Defecation was suggested to be a factor influencing the spread of suppository bases. However, there was no clear relationship between the type of suppository base used and the extent of its spread within the rectum. 6 refs.; 4 figs.; 1 table

  6. Pharmacological evaluation of anxiolytic property of aqueous root extract of Cymbopogon citratus in mice

    Directory of Open Access Journals (Sweden)

    David Arome

    2014-01-01

    Full Text Available Aim: This study was designed to evaluate the anxiolytic property of aqueous root extract of Cymbopogon citratus in mice. Materials and Methods: In this study, stress induced hyperthermia (SIH, elevated plus maze (EPM and open field experimental models were employed. Results: In SIH model, the extract caused a significant (P 0.05 effect. In open field model, 200 mg/kg and 600 mg/kg extract doses significantly (P < 0.05 increased locomotion of the mice more than the standard, while rearing and defecation were less in the extract groups. Conclusion: In different experimental models used significant anxiolytic effect was observed of the aqueous extract at different dose levels in comparison to reference standard and normal saline group. This clearly justified its folkloric application in the treatment of anxiety disorders.

  7. Non-invasive body temperature measurement of wild chimpanzees using fecal temperature decline.

    Science.gov (United States)

    Jensen, Siv Aina; Mundry, Roger; Nunn, Charles L; Boesch, Christophe; Leendertz, Fabian H

    2009-04-01

    New methods are required to increase our understanding of pathologic processes in wild mammals. We developed a noninvasive field method to estimate the body temperature of wild living chimpanzees habituated to humans, based on statistically fitting temperature decline of feces after defecation. The method was established with the use of control measures of human rectal temperature and subsequent changes in fecal temperature over time. The method was then applied to temperature data collected from wild chimpanzee feces. In humans, we found good correspondence between the temperature estimated by the method and the actual rectal temperature that was measured (maximum deviation 0.22 C). The method was successfully applied and the average estimated temperature of the chimpanzees was 37.2 C. This simple-to-use field method reliably estimates the body temperature of wild chimpanzees and probably also other large mammals.

  8. Rectovaginal fistula after low anterior resection for rectal cancer healed by nonoperative treatment

    Directory of Open Access Journals (Sweden)

    Shigenobu Emoto

    Full Text Available Background: Rectovaginal fistula (RVF is a serious complication after colorectal anastomosis using a double-stapling technique. RVF following this procedure has been considered to be refractory to conservative treatment. Case presentation: A 75-year-old woman who underwent laparoscopy-assisted low anterior resection for early rectal cancer developed RVF on the 12th postoperative day. Conservative treatment was chosen and was successful. She was discharged from the hospital after 3 weeks with a normal oral diet. Colonoscopy on the 50th postoperative day showed that the RVF was closed. Conclusion: Conservative treatment may be effective for RVF after colorectal anastomosis using a double-stapling technique when there is no evidence of defecation through the vagina. Keywords: Rectovaginal fistula, Low anterior resection, Double-stapling technique

  9. Breath hydrogen analysis in patients with ileoanal pouch anastomosis

    DEFF Research Database (Denmark)

    Bruun, E; Meyer, J N; Rumessen, J J

    1995-01-01

    The possible influence on functional outcomes of hydrogen production in the ileoanal pouch after restorative proctocolectomy was investigated by means of lactulose H2 breath tests. Eight of 15 patients had significant increases in breath hydrogen after 10 g lactulose. One patient declined...... to participate in further investigations, the remaining seven responders had no evidence of small bowel bacterial overgrowth after glucose H2 breath tests. The ability to produce hydrogen by anaerobic fermentation of lactulose in the pouch was unrelated to the age of the patients or of the pouch. Seven of eight...... responders had successive breath tests after ingestion of lactulose 20 g and wheat starch 100 g. Five of seven had significant increases after lactulose but none after wheat starch. The overall function of the pouch continence, spontaneity of defecation, and 24 hour stool frequency was significantly better...

  10. Uncommon Human Urinary Tract Myiasis Due to Psychoda Sp. Larvae, Kashan, Iran: A Case Report.

    Science.gov (United States)

    Rasti, Sima; Dehghani, Rouhullah; Khaledi, Hassan Naeimi; Takhtfiroozeh, Sayed Mahdi; Chimehi, Elahe

    2016-01-01

    Contamination of human and animal body tissues with flies' larvae and diptera cause myiasis. A 26 yr old female patient refers to Kashan Shahid Beheshti Hospital, central Iran because of urogenital infection, pain in the right part of stomach, smelly and reddish vaginal discharge and frequent urination. In the first checking, urine sample was taken. In the sample, active and alive larvae were seen. The live samples were taken to the Environmental Health Department Lab of Kashan University of Medical Sciences in clean glass jars. In the morphological survey, Psychoda sp larvae were identified. In Iran, this study is the first report of this species of larva that causes urinary myiasis. This fly larva is not carnivore or bloodsucker and feeds on bacterial agents. Observance of personal hygiene especially during defecation and urination is essential to prevent contamination of this type of myiasis.

  11. Uncommon Human Urinary Tract Myiasis Due to Psychoda Sp. Larvae, Kashan, Iran: A Case Report

    Directory of Open Access Journals (Sweden)

    Sima RASTI

    2016-10-01

    Full Text Available Contamination of human and animal body tissues with flies’ larvae and diptera cause myiasis. A 26 yr old female patient refers to Kashan Shahid Beheshti Hospital, central Iran because of urogenital infection, pain in the right part of stomach, smelly and reddish vaginal discharge and frequent urination. In the first checking, urine sample was taken. In the sample, active and alive larvae were seen. The live samples were taken to the Environmental Health Department Lab of Kashan University of Medical Sciences in clean glass jars. In the morphological survey, Psychoda sp larvae were identified. In Iran, this study is the first report of this species of larva that causes urinary myiasis. This fly larva is not carnivore or bloodsucker and feeds on bacterial agents. Observance of personal hygiene especially during defecation and urination is essential to prevent contamination of this type of myiasis.

  12. Case Record of a Teaching Hospital in Karaj; A 35-Year Old Man With Taenia saginata Infection Treated With Niclosamide

    Directory of Open Access Journals (Sweden)

    Aliehsan Heidari

    2016-11-01

    Full Text Available Taeniasaginata can cause severe health and economic problems particularly in endemic areas. The disease cause by this cestode is related to poor sanitary conditions, inadequate hygiene, open defecation, inadequately cooked beef and poverty. A 35 years man found yellowish white tapeworm proglottids moving in his feces and consulted to the Department of Emergency, ShahidRajaei hospital, Karaj, Iran. He complained of lower abdominal discomfort, anal itching and moving something in the stomach. He was given wrong prescription. The patients had the history of eating undercooked beef. We report one case of T. saginata infection based on adult tapeworm recovery from the patients. The specific identification of the worm was based on based on standard procedures. Three months after expelling the tapeworm, the man felt better and returned to his normal life.

  13. Prepartum and postpartum open-field behavior and maternal responsiveness in mice bidirectionally selected for open-field thigmotaxis.

    Science.gov (United States)

    Leppänen, Pia K; Ravaja, Niklas; Ewalds-Kvist, S Béatrice M

    2008-01-01

    The authors examined pre- and postpartum open-field (OF) behavior and maternal responsiveness in mice that they bidirectionally selected for OF thigmotaxis. The authors tested 40 female mice under 3 conditions: prepartum OF, postpartum OF, and a pup retrieval test. In both OF conditions, the high OF thigmotaxis (HOFT) mice were more thigmotactic but explored and reared less than the low OF thigmotaxis (LOFT) mice, indicating that the HOFT mice were more emotional. In the postpartum condition, the HOFT mothers also defecated more and ambulated less than the LOFT mothers. The increase in grooming after parturition was more conspicuous among the LOFT mothers than among the HOFT mothers. The LOFT mothers were also more attracted to their pups in the OF, but the retrieval test did not show any substantial line differences. The results suggested that the line difference in emotionality was more pronounced during lactation than during pregnancy, although parturition exerted no effect on thigmotaxis.

  14. Antinociceptive Activity of the Chloroform Fraction of Dioclea virgata (Rich. Amshoff (Fabaceae in Mice

    Directory of Open Access Journals (Sweden)

    Vanine Gomes Mota

    2011-01-01

    Full Text Available Acute treatment with the chloroform fraction of Dioclea virgata (Rich. Amshoff (CFDv in mice produced decreased ambulation and sedation in the behavioral pharmacological screening. Doses of 125 and 250 mg/kg CFDv decreased latency of sleep onset in the test of sleeping time potentiation. In the open field, animals treated with CFDv reduced ambulation and rearing (250 mg/kg, as well as defecation (125; 250 mg/kg. Regarding the antinociceptive activity, CFDv (125, 250, 500 mg/kg increased latency to first writhing and decreased the number of writhings induced by acetic acid. In the formalin test, CFDv (250 mg/kg decreased paw licking time in the first and second phases indicating antinociceptive activity that can be mediated both peripherally and at the central level. CFDv did not affect motor coordination until 120 minutes after treatment. CFDv shows psychopharmacological effects suggestive of CNS-depressant drugs with promising antinociceptive activity.

  15. Crossfostering in mice selectively bred for high and low levels of open-field thigmotaxis.

    Science.gov (United States)

    Leppänen, Pia K; Ewalds-Kvist, S Béatrice M

    2005-02-01

    The main purpose of this research was to investigate whether the difference in open-field (OF) thigmotaxis between mice selectively bred for high and low levels of wall-seeking behavior originated from genetic or acquired sources. Unfostered, infostered, and crossfostered mice were compared in two experiments in which the effects of strain, sex, and fostering on ambulation, defecation, exploration, grooming, latency to move, radial latency, rearing, thigmotaxis, and urination were studied. These experiments revealed that OF thigmotaxis was unaffected by the foster condition and thus genetically determined. The selected strains of mice also diverged repeatedly with regard to exploration and rearing. The findings are in line with the previously described existence of an inverse relationship between emotionality and exploration.

  16. Mice selectively bred for open-field thigmotaxis: life span and stability of the selection trait.

    Science.gov (United States)

    Leppänen, Pia K; Ewalds-Kvist, S Béatrice M; Selander, Ritva-Kajsa

    2005-04-01

    In 2 experiments, the authors examined 69 mice selectively bred for high or low levels of open-field (OF) thigmotactic behavior (high open-field thigmotaxis [HOFT] and low open-field thigmotaxis [LOFT], respectively). They found that the strains differed in defecation during the 60-min exposure to the OF. Furthermore, the strains differed with regard to their life spans: The more thigmotactic HOFT mice lived longer than the LOFT mice. The strains were not differentiated by food intake or excretion. The strain difference in thigmotaxis was not age dependent, and it persisted in the home-cage condition as well. Neither the location (center or wall) of the starting point nor the shape (circular or square) of the OF arena affected the difference in wall-seeking behavior between the two strains. The authors concluded that the difference in thigmotaxis (or emotionality) between the HOFT and LOFT mice is a stable and robust feature of these animals.

  17. Chemoembolization through intercostal arteries in hepatocellular carcinoma: Report of a case of transient spinal cord injury

    International Nuclear Information System (INIS)

    Moon, Tae Yong; Hwang, In Tae; Kim, Byung Soo; Ko, Hyun Yoon; Yang, Ung Suk; Kim, Hak Jin

    1994-01-01

    Liver has a dual blood supply from portal vein and hepatic artery. Hepatocellular carcinoma receive their blood supply almost exclusively from hepatic artery. Thus, the concept of treating hepatocellular carcinoma by chemoembolization through these arteries is very effective . However, there may be several collateral or parasitic vessels feeding them in case of huge tumor or previous chemoembolization. We experienced a case of huge tumor involving right upper posterior portion of liver fed by 9th, 10th, 11th right posterior intercostal arteries and an anomalous hepatic artery. We tried chemoembolization with Adriamycin-Lipiodol suspension and Gelfoam material through the right posterior intercostal arteries to treat the lesion. After the procedure, the patient(55 years old female) became paraplegic with voiding and defecation difficulty which could be due to spinal cord infarction by anterior spinal arterial occlusion caused by embolic material through the artery of Adamkiewicz from a posterior intercostal artery. She recovered completely after 20 days of treatment

  18. Anorectal function orientated surgery for rectal prolapse

    International Nuclear Information System (INIS)

    Takao, Yoshihiko; Tsujizuka, Kazuyuki; Kikuchi, Kiyoshi; Okuda, Makoto

    2007-01-01

    Until quite recently, rectal prolapse was regarded as being a simple condition to treat. Surgical control of the prolapse was largely regarded as a successful outcome. However, recent detailed clinical assessment indicate that many patients have a rectal prolapse which is successfully controlled by surgical operation, yet suffer severe symptoms of disordered defecation, which either persists, or develops as a result of operative treatment. Difficulty with rectal evacuation, persistent incontinence and continuing mucus discharge are recognized as important, despite successful repair of the prolapse itself. There are two major theory of the pathology; circumferential intussusception and sliding hernia. However, many other multifarious factors are concomitant with the condition. These factors often need to be balanced against one another. Usually, a single surgical procedure will not be able to solve the problems. Therefore, the choice of treatment tailored for the individual patient. (author)

  19. Human waste: An underestimated source of nutrient pollution in coastal seas of Bangladesh, India and Pakistan.

    Science.gov (United States)

    Amin, Md Nurul; Kroeze, Carolien; Strokal, Maryna

    2017-05-15

    Many people practice open defecation in south Asia. As a result, lot of human waste containing nutrients such as nitrogen (N) and phosphorus (P) enter rivers. Rivers transport these nutrients to coastal waters, resulting in marine pollution. This source of nutrient pollution is, however, ignored in many nutrient models. We quantify nutrient export by large rivers to coastal seas of Bangladesh, India and Pakistan, and the associated eutrophication potential in 2000 and 2050. Our new estimates for N and P inputs from human waste are one to two orders of magnitude higher than earlier model calculations. This leads to higher river export of nutrients to coastal seas, increasing the risk of coastal eutrophication potential (ICEP). The newly calculated future ICEP, for instance, Godavori river is 3 times higher than according to earlier studies. Our modeling approach is simple and transparent and can easily be applied to other data-poor basins. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Novel insight into the role of heterotrophic dinoflagellates in the fate of crude oil in the sea

    DEFF Research Database (Denmark)

    Almeda, Rodrigo; Connelly, Tara L.; Buskey, Edward J.

    2014-01-01

    Although planktonic protozoans are likely to interact with dispersed crude oil after a spill, protozoan-mediated processes affecting crude oil pollution in the sea are still not well known. Here, we present the first evidence of ingestion and defecation of physically or chemically dispersed crude...... to 0.37 mu g-oil mg-C-dino (-1) d(-1), which could represent similar to 17% to 100% of dispersed oil in surface waters when heterotrophic dinoflagellates are abundant or bloom. Egestion of faecal pellets containing crude oil by heterotrophic dinoflagellates could contribute to the sinking and flux...... of toxic petroleum hydrocarbons in coastal waters. Our study indicates that crude oil ingestion by heterotrophic dinoflagellates is a noteworthy route by which petroleum enters marine food webs and a previously overlooked biological process influencing the fate of crude oil in the sea after spills....

  1. [Perineal hernia in dogs--colopexy, vasopexy, cystopexy and castration as elective therapies in 32 dogs].

    Science.gov (United States)

    Maute, A M; Koch, D A; Montavon, P M

    2001-07-01

    In 32 male dogs colopexy, vasopexy, cystopexy and castration was performed for the treatment of perineal hernia. Recurrence rate in this study is 22%, what is comparable to other studies using different methods. The degree of severity and the number of complications is lower with this technique than with others. Enlargement of the prostate was evident in 59% and bladder retroflexion in 22% of the dogs. A celiotomy allows to recognize, assess, reduce and fix displaced organs which is not possible by using other methods. The aim is to regain the tubular structure of the ampulla recti and to fix prostate and bladder cranioventrally to the pelvic entrance. The castration performed at the same time causes the prostate gland to atrophy within 2-3 weeks, what makes the pelvic entrance even wider and the dogs return to normal defecation.

  2. Pesticide-induced quadriplegia in a 55-year-old woman.

    Science.gov (United States)

    Beavers, Charles T; Parker, Joseph J; Flinchum, Dane A; Weakley-Jones, Barbara A; Jortani, Saeed A

    2014-12-01

    Acephate is a commercial organophosphate pesticide formerly used in households and now used primarily for agriculture. Poisoning symptoms include salivation, lacrimation, urination, defecation, gastrointestinal illness, and emesis. In addition to these classic symptoms, neurodegeneration can result from increased and continued exposure of organophosphates. This 55-year-old woman presented with organophosphate-induced delayed neuropathy in the form of quadriplegia due to the commonly used pesticide acephate. She was exposed to this pesticide through multiple sprayings in her work office with underrecognized poisoning symptoms. She presented to her primary care physician with neuropathic pain and paralysis in her arm following the sprayings and eventual complete paralysis. The patient lived for 2 years following her toxic exposure and quadriplegia. A complete autopsy after her death confirmed a transverse myelitis in her spinal cord. We conclude that in susceptible individuals, acephate in excessive amounts can produce severe delayed neurotoxicity as demonstrated in animal studies.

  3. Treatment tactics in patient with rectal cancer complicating ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Yu. A. Barsukov

    2012-01-01

    Full Text Available A successful treatment of a young patient with a 15-year anamnesis of ulcerative colitis, who has been diagnosed with rectal cancer, is presented in this case report. A non-standard surgical intervention has been performed following all principles of oncologic surgery. A subtotal colectomy has been performed with ultra-low anterior resection of rectum. Ascendoanal anastomosis has been performed forming the neo-rectum. There were no complications in postoperative period. Considering disease stage (T3N1M0 adjuvant XELOX was administered for 6 months along with 2 cycles of prophylactic treatment with 5-aminosalycilic acid. During 2-years follow-up there are no signs of rectal cancer and ulcerative colitis progression. After pelvic electrostimulation defecation frequency decreased to 3–4 times per day, a patient has complete social rehabilitation.

  4. Quantification and variability in colonic volume with a novel magnetic resonance imaging method

    DEFF Research Database (Denmark)

    Nilsson, M; Sandberg, Thomas Holm; Poulsen, Jakob Lykke

    2015-01-01

    Background: Segmental distribution of colorectal volume is relevant in a number of diseases, but clinical and experimental use demands robust reliability and validity. Using a novel semi-automatic magnetic resonance imaging-based technique, the aims of this study were to describe: (i) inter......-individual and intra-individual variability of segmental colorectal volumes between two observations in healthy subjects and (ii) the change in segmental colorectal volume distribution before and after defecation. Methods: The inter-individual and intra-individual variability of four colorectal volumes (cecum...... (p = 0.02). Conclusions & Inferences: Imaging of segmental colorectal volume, morphology, and fecal accumulation is advantageous to conventional methods in its low variability, high spatial resolution, and its absence of contrast-enhancing agents and irradiation. Hence, the method is suitable...

  5. Alguns aspectos da biologia de Triatoma pseudomaculata Corrêa & Espínola, 1964, em condições de laboratório (Hemiptera:Reduviidae:Triatominae

    Directory of Open Access Journals (Sweden)

    Teresa Cristina M Gonçalves

    1997-03-01

    Full Text Available Biology of Triatoma pseudomaculata Corrêa & Espínola, 1964, under Laboratory Conditions (Hemiptera:Reduviidae:Triatominae - Observations were made on the evolutive cycle of Triatoma pseudomaculata, held under laboratory conditions, fed weekly on bird (pigeon. Of 60 eggs obtained, only 34 nymphs reached the adult stage in a period of X(S=398±76 days. The following parameters were observed: the time immature stages took to develop from egg to adult emergence; the occurrence of the first meal; the time-lapse between the presenting of the blood-meal and the begining of feeding; time of feeding; amount of blood ingested; variation of weight 24 hr after the blood-meal and until the next blood-meal; and the defecation pattern. The experiment was carried out for 20 months, held in BOD incubator with the average of temperature and humidity of 28±1ºC and 80±5% RU, respectively

  6. Jejuno-jejunal intussusception in a guinea pig (Cavia porcellus

    Directory of Open Access Journals (Sweden)

    Tara J. Fetzer

    2017-09-01

    Full Text Available An approximately four-year-old male castrated guinea pig (Cavia porcellus was presented for painful defecation with a 24-hour history of hyporexia and intermittent episodes of rolling behavior. Upon presentation the patient was quiet, alert, and responsive, and mildly hypothermic. Abdominal palpation revealed an approximately 2-cm long oblong mass within the caudal abdomen. Abdominal radiographs revealed gastric dilation without volvulus and a peritoneal mass effect. The patient was euthanized following gastric reflux of brown malodorous fluid from his nares and oral cavity. A necropsy was performed and revealed a jejuno-jejunal intussusception causing mechanical gastrointestinal ileus, and gastric dilatation without volvulus. While non-obstructive gastrointestinal stasis is common and obstructive ileus is uncommon in guinea pigs, this report shows that intestinal intussusception is a differential in guinea pigs with ileus and gastric dilatation.

  7. Treatment guidelines for primary nonretentive encopresis and stool toileting refusal.

    Science.gov (United States)

    Kuhn, B R; Marcus, B A; Pitner, S L

    1999-04-15

    Nonretentive encopresis refers to inappropriate soiling without evidence of fecal constipation and retention. This form of encopresis accounts for up to 20 percent of all cases. Characteristics include soiling accompanied by daily bowel movements that are normal in size and consistency. An organic cause for nonretentive encopresis is rarely identified. The medical assessment is usually normal, and signs of constipation are noticeably absent. A full developmental and behavioral assessment should be made to establish that the child is ready for intervention to correct encopresis and to identify any barriers to success, particularly disruptive behavior problems. Successful interventions depend on the presence of soft, comfortable bowel movements and addressing toilet refusal behavior. Daily scheduled positive toilet sits are recommended. Incentives may be used to reinforce successful defecation during these sits. A plan for management of stool withholding should be agreed on by the parents/caretakers and the family physician before intervention.

  8. BIOFEEDBACK THERAPY FOR CONSTIPATION IN ADULTS

    Science.gov (United States)

    Rao, Satish S.C.

    2011-01-01

    Dyssynergic defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stools. Today, it is possible to diagnose this problem and treat this effectively with biofeedback therapy, history, prospective stool diaries, and anorectal physiological tests. Several randomized controlled trails have demonstrated that biofeedback therapy using neuromuscular training and visual and verbal feedback is not only efficacious but superior to other modalities such as laxative or sham training. Also the symptom improvement is due a change in the underlying pathophysiology. Development of user friendly approaches to biofeedback therapy and use of home biofeedback programs will significantly enhance the adoption of this treatment by gastroenterologists and colorectal surgeons in the future. Improved reimbursement for this proven and relatively inexpensive treatment will carry a significant impact on the problem. PMID:21382587

  9. Validation of the Danish version of the disease specific instrument EORTC QLQ-CR38 to assess Health-related quality of life in patients with colorectal cancer

    DEFF Research Database (Denmark)

    Thaysen, Henriette Vind; Jess, Per; Laurberg, Søren

    2012-01-01

    ABSTRACT: BACKGROUND: The European Organisation for Research and Treatment of Cancer (EORTC) quality of life colorectal questionnaire module (QLQ-CR38) was developed in 1999, and an update, the QLQ CR29 was published recently. To date the Danish version of the questionnaire has not been validated....... The aim of this study was to examine the psychometric properties of the Danish version of EORTC QLQ-CR38. METHODS: EORTC QLQ-CR38 was administered to 190 patients with colorectal cancer in two Danish hospitals, one month after their operation. A psychometric evaluation of the questionnaire's structure......, reliability, convergent, divergent and known-groups validity was performed. RESULTS: Data from 164 (86.3%) patients were available for analysis. The Danish version of EORTC QLQ-CR38 showed satisfactory psychometric properties for the scales: body image, sexual functioning, male sexual problems and defecations...

  10. Health-related Quality of Life after complex rectal surgery for primary advanced rectal cancer and locally recurrent rectal cancer

    DEFF Research Database (Denmark)

    Thaysen, Henriette Vind

    2013-01-01

    postoperative morbidity, Health-related Quality of Life (HRQoL) is an important issue. The overall aim of this thesis was therefore to evaluate HRQoL in patients with PARC and LRRC treated with COMP-RCS and curative intent. In study I a review of the literature was undertaken to provide an overview of HRQo......Advances in the treatment of rectal cancer, have made it possible to perform complex rectal cancer surgery (COMP-RCS) with curative intent in patients with primary advanced rectal caner (PARC) and local recurrent rectal cancer (LRRC). Due to the complexity of the treatment and its high...... in the study was 164 (86%) patients treated with standard rectal cancer surgery (STAN-RCS). The Danish version showed satisfactory psychometric properties for the scales concerning body image, sexual functioning, male sexual problems and defecations problems. Reduced psychometric properties were found...

  11. Avaliação do ângulo ano-retal por meio de defecograma em voluntárias assintomáticas nulíparas e multíparas Measurement of the anorectal angle by defecography in asymptomatic nulliparous and multiparous volunteers

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    José Eduardo Mourão Santos

    2003-08-01

    Full Text Available OBJETIVO: Fizemos um protocolo para compararmos as medidas dos ângulos ano-retais em três situações diferentes, em voluntárias assintomáticas nulíparas e multíparas. CASUÍSTICA E MÉTODOS: Foram realizados defecogramas em 30 mulheres (15 nulíparas e 15 multíparas, de maio de 1997 a dezembro de 1998, e obtidas incidências radiográficas em perfil do reto após introdução de contraste baritado texturizado: em repouso, durante contração do músculo puborretal e durante a evacuação. Na análise estatística foi utilizada a análise de medidas repetidas. RESULTADOS: A média do ângulo não apresentou diferença significante entre as voluntárias nulíparas e multíparas. O ângulo mediu, nas nulíparas, 92,9° em repouso, 78,8° durante a contração do músculo puborretal e 117,9° durante a evacuação, e nas multíparas mediu 94,3° em repouso, 79,7° durante a contração do músculo puborretal e 121,4° durante a evacuação. Foi observada diferença significante entre os ângulos em repouso, durante a contração do músculo puborretal e durante a evacuação. CONCLUSÃO: Não houve diferença significante entre os dois grupos examinados.OBJECTIVE: We developed a protocol to compare the measurements of the anorectal angle in nulliparous and multiparous asymptomatic volunteers in three different situations. SUBJECTS AND METHODS: Defecograms were carried out in 30 women (15 nulliparous and 15 multiparous from May, 1997 to December, 1998. After rectal administration of texturized barium contrast media, lateral radiographic views of the rectum were obtained at rest, during contraction of the puborectal muscle and during defecation. A repeated measures model was used for the statistical analysis. RESULTS: There were no significant differences between the mean anorectal angles of nulliparous and multiparous volunteers. Measurements were as follows: 92.9° at rest, 78.8° during the contraction of the puborectal muscle and 117.9

  12. Study on Dendrobium officinale O-Acetyl-glucomannan (Dendronan). 7. Improving Effects on Colonic Health of Mice.

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    Zhang, Guan-ya; Nie, Shao-ping; Huang, Xiao-jun; Hu, Jie-lun; Cui, Steve W; Xie, Ming-yong; Phillips, Glyn O

    2016-03-30

    This research was aimed to study the effect of Dendrobium officinale polysaccharide (Dendronan) on colonic health. Mice were fed Dendronan at doses of 40, 80, and 160 mg/kg body weight for 0, 10, 20, and 30 days, respectively. Results showed that Dendronan, which has a special structure formed by mannose and glucose, rich in O-acetyl groups, exhibited improving effects on colonic and fecal parameters of Balb/c mice. After Dendronan feeding, the content of short-chain fatty acids (SCFAs), colon length and index, and fecal moisture were increased, whereas colonic pH was decreased and defecation time was shortened. All of these changes were significantly different between polysaccharide-treated groups and the control group (p < 0.05). These findings suggested that an adequate intake of Dendronan is beneficial to the process of fermentation and regulation of colonic microenvironment, thus playing a role in the maintenance of colonic health.

  13. Image diagnostic of colonic diseases - controversial questions

    International Nuclear Information System (INIS)

    Pomakov, P.; Rizov, A.; Stancheva, I.

    2013-01-01

    In the system of colonic diseases' diagnostic algorithm, fibrocolonoscopy (FCS) is defined as 'Golden Standard'. By this reason some X-ray diagnostic methods - irrigography, etc. are currently not being used in a number of health institutions. The aim of this study is a comparative analysis of FCS and irrigography diagnostic efficacy in various colonic diseases. For 10-years period, in cooperation with a gastroenterologist-gastroscopist, 2151 patients with various colonic diseases were evaluated by FCS and irrigography with pharmaco-diagnostics/when necessary. Advantage of FCS was established in diagnosing diseases with patho-morfologic changes on the inner surface of the colon - benign and malignant neoplastic processes, chronic inflammatory diseases, etc. At the same time functional changes - irritated colon syndrome, changes in defecation act, etc., are not an object of diagnosis through FCS. Correction in colonic diseases diagnostic algorithm is necessary. FCS should be mandatory. If result is negative - irrigography with pharmaco-diagnostics should be done. (authors)

  14. Penrose Drain Migration After Laparoscopic Surgery

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    Pazouki AbdolReza

    2009-05-01

    Full Text Available Laparoscopy has made a revolution in surgical procedures and treatment of various diseases but its complications are still under investigation. Intra-abdominal visceral and vessel injuries, trocar site hernia, and leaving foreign bodies into the peritoneal cavity are among some laparoscopic surgery complications. This is a rare report of Penrose drain migration following incomplete laparoscopic Fundoplication surgery. The patient was a 47- year- old woman, who was a candidate for Touplet Fundoplication via laparoscopic approach due to refractory gastro-esophageal reflux disease (GERD. While wrapping a Penrose drain around the esophagus, the patient had a cardiorespiratory arrest. Attempts to remove the Penrose drain were unsuccessful and the surgical procedure was terminated due to patient's condition. Four months later, after a long period of dysphagia and abdominal pain, the Penrose drain was defecated via rectum.

  15. Awareness about taeniasis and neurocysticercosis among municipal schoolteachers in Delhi.

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    Mishra, D; Kalra, V; Aggarwal, K

    2007-12-01

    Taenia solium is the commonest parasitic infection of CNS and an important cause of new-onset seizures and epilepsy in children and adults. Human activities impact on almost every one of the stages of the lifecycle of the worm as man is responsible for dispersion of the parasite's egg through outdoor defecation and indiscriminate disposal of feces. Health education to cause behavioral changes in these practices can therefore be an effective intervention strategy. We conducted a study to assess KAP regarding taeniasis and neurocysticercosis among municipal school teachers in Delhi. The findings are presented in this communication. The study revealed that, general information related to personal food hygiene was known to majority of the teachers but core information in the context of taeniasis/cysticercosis and seizure prevention was lacking.

  16. Water Stream in Bidet Toilet Commode as a Cause of Anterior Anal Fissure: A Case-Control Study

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    Pankaj Garg

    2017-03-01

    Full Text Available Background Water used as a single sharp stream in toilet commode for post defecation cleansing is a common practice in several countries across the globe including India. Repeated hitting of the anus by water stream could potentially cause injury to the anal canal epithelium and lead to development of fissure-in-ano. As the water stream is emanating from the backside of the toilet commode, the possible injury, if any, would be on the anterior anal canal. Objectives The present study aimed at determining whether water stream usage in toilet commodes increased the incidence of anterior fissure-in-ano; this was determined by the incidence of anterior fissure-in-ano the study and control groups. Methods All consecutive fissure-in-ano patients referring to a colorectal clinic from February 2012 to 2015 were included in the study. The patients were classified as a study group (who were using water stream for cleansing purposes in toilet commodes and a control group (patients who were not using water stream. The characteristics and location (position of the fissure-in-ano was noted. Results In this study, 165 patients were prospectively enrolled. Male/female ratio was 96/69, and the mean age was 36.3 ± 11.2 years. The anterior fissure-in-ano in the study group was 55.9% (47/84, while it was 17.3 % (14/81 in the control group (P < 0.0001, odds ratio: 6.08, 95% CI: 2.96 - 12.47]. Conclusions Water used as a single sharp stream to cleanse after defecation in toilet commodes is hazardous and should be avoided.

  17. Intragastric Dai-Kenchu-To, a Japanese herbal medicine, stimulates colonic motility via transient receptor potential cation channel subfamily V member 1 in dogs.

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    Kikuchi, Daisuke; Shibata, Chikashi; Imoto, Hirofumi; Naitoh, Takeshi; Miura, Koh; Unno, Michiaki

    2013-08-01

    Japanese herbal medicine, also known as Kampo, is used for various diseases in Japan. One of those medicines, Dai-Kenchu-To (DKT), is considered clinically effective for adhesive bowel obstruction and chronic constipation. Although scientific evidence of DKT to improve adhesive bowel obstruction was shown in several previous reports, mechanism of DKT to improve constipation remains unknown. Our aim was to study the effect of intragastric DKT on colonic motility and defecation, and the involvement of various receptors in DKT-induced colonic contractions. Five beagle dogs were instructed with serosal strain-gauge force transducers to measure circular muscle activity at the proximal, middle, and distal colon. Dogs are suitable for a present study to administer the drugs repeatedly to the same individual and look at its effect on colonic motility. We studied the effects of DKT (2.5 or 5 g) administered into the stomach on colonic motility. Muscarinic receptor antagonist atropine, nicotinic receptor antagonist hexamthonium, or 5-hydroxytryptamine-3 receptor antagonist ondansetron was injected intravenously 10 min before DKT administration. Capsazepine, an antagonist to transient receptor potential cation channel subfamily V member 1 (TRPV1), was administered into the stomach 5 min before DKT administration. Intragastric DKT (2.5 or 5 g) induced colonic contractions within 10 min after administration but did not induce defecation. Pretreatment with atropine, hexamthonium, ondansetron, or capsazepine inhibited DKT-induced colonic contractions. These results indicate that orally administered DKT stimulates colonic motility via TRPV1, muscarinic, nicotinic, and 5-hydroxytryptamine-3 receptors, thereby providing scientific support for the efficacy of oral DKT in chronic constipation.

  18. Prevalence of intestinal parasites among food handlers at cafeteria of Jimma University Specialized Hospital, Southwest Ethiopia

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    Hundaol Girma

    2017-08-01

    Full Text Available Objective: To assess the prevalence of intestinal parasites and associated risk factors among food-handlers working at cafeteria of Jimma University Specialized Hospital, Jimma, Ethiopia. Methods: Socio-demographic and associated risk factors data were collected using a pretested structured questionnaire. Stool and finger-nail specimens were screened for intestinal parasites using direct wet mount and formol-ether concentration sedimentation techniques. Data were edited, cleaned, entered and analyzed using statistical package for social science (SPSS version 20. P ≤ 0.05 was taken as statistically significant. Results: A total of 94 food-handlers working at cafeteria of Jimma University Specialized Hospital were participated in the study. From the total 148 samples (94 stool and 54 fingernails content examined, 31 (33% were positive for one or more parasites. Over all eight types of intestinal parasites were identified. The most prevalent parasite identified was Ascaris lumbricoides (16% followed by Entamoeba histolytica/dispar (4.3%. There was significant association between parasitic infection and food handlers who did not practice hand washing after defecation and before serving food. Conclusions: Relatively high prevalence of intestinal parasites is detected indicating poor hygiene practice of the food-handlers at the study site. The study also identified finger-nail status, hand washing after defecation and before serving food as determinants of intestinal parasitic infection. It is crucial for provision of regular training on strict adherence to good personal hygiene and hygienic food-handling practices as well as regular inspection and medical checkup of food-handlers.

  19. Toward a definition of a threshold for harmless doses to the anal-sphincter region and the rectum

    International Nuclear Information System (INIS)

    Al-Abany, Massoud; Helgason, Asgeir R.; Agren Cronqvist, Anna-Karin; Lind, Bengt; Mavroidis, Panayiotis; Wersaell, Peter; Lind, Helena; Qvanta, Eva; Steineck, Gunnar

    2005-01-01

    Purpose: To investigate dysfunction caused by unwanted radiation to the anal-sphincter region and the rectum. Methods and materials: A questionnaire assessing bowel symptoms, sexual function, and urinary symptoms was sent to 72 patients with clinically localized prostatic adenocarcinoma treated by external beam radiation therapy at the Radiumhemmet, Karolinska Hospital, in Stockholm, Sweden, 2-4 years after treatment. The mean percentage dose-volume histograms for patients with and without the specific symptom were calculated. Results: Of the 65 patients providing information, 9 reported fecal leakage, 10 blood and mucus in stools, 10 defecation urgency, and 7 diarrhea or loose stools. None of the 19 and 13 patients who received, respectively, a dose of ≥35 Gy to ≤60% or ≥40 Gy to ≤40% of the anal-sphincter region volume reported fecal leakage (p < 0.05). In dose-volume histograms, a statistically significant correlation was found between radiation to the anal-sphincter region and the risk of fecal leakage in the interval 45-55 Gy. There was also a statistically significant correlation between radiation to the rectum and the risk of defecation urgency and diarrhea or loose stools in the interval 25-42 Gy. No relationship was found between anatomic rectal wall volume and the investigated late effects. Conclusions: Although the limited data in this study prevent the definition of a conclusive threshold regarding volume and dose to the anal-sphincter region and untoward morbidity, it seems that careful monitoring of unnecessary irradiation to this area should be done because it can potentially help reduce the risk of adverse effects, such as fecal leakage. Future studies should pay more attention to the anal-sphincter region and help to more rigorously define its radiotherapeutic tolerance

  20. Use acupuncture to treat functional constipation: study protocol for a randomized controlled trial

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    Li Ying

    2012-07-01

    Full Text Available Abstract Background Whether acupuncture is effective for patients with functional constipation is still unclear. Therefore, we report the protocol of a randomized controlled trial of using acupuncture to treat functional constipation. Design A randomized, controlled, four-arm design, large-scale trial is currently undergoing in China. Seven hundred participants are randomly assigned to three acupuncture treatment groups and Mosapride Citrate control group in a 1:1:1:1 ratio. Participants in acupuncture groups receive 16 sessions of acupuncture treatment, and are followed up for a period of 9 weeks after randomization. The acupuncture groups are: (1 Back-Shu and Front-Mu acupoints of Large Intestine meridians (Shu-Mu points group; (2 He-Sea and Lower He-Sea acupoints of Large Intestine meridians (He points group; (3 Combining used Back-Shu, Front-Mu, He-Sea, and Lower He-Sea acupoints of Large Intestine meridians (Shu-Mu-He points group. The control group is Mosapride Citrate group. The primary outcome is frequency of defecation per week at the fourth week after randomization. The secondary outcomes include Bristol stool scale, the extent of difficulty during defecating, MOS 36-item Short Form health survey (SF-36, Self-Rating Anxiety Scale (SAS, and Self-rating Depression Scale (SDS. The first two of second outcomes are measured 1 week before randomization and 2, 4, and 8 weeks after randomization. Other second outcomes are measured 1 week before randomization and 2 and 4 weeks after randomization, but SF-36 is measured at randomization and 4 weeks after randomization. Discussion The result of this trial (which will be available in 2012 will confirm whether acupuncture is effective to treat functional constipation and whether traditional acupuncture theories play an important role in it. Trials registration Clinical Trials.gov NCT01411501

  1. Post-training scopolamine treatment induced maladaptive behavior in open field habituation task in rats.

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    Natalija Popović

    Full Text Available The effects of scopolamine on memory consolidation are controversial and depend on several factors (i.e. site of administration, time of administration and testing, dose, cognitive task, experimental protocol, specie, strain, etc.. Generally, the range dose of systemic administered scopolamine, used in memory consolidation studies, has varied from 0.05 to 50 mg/kg. However, according to the literature, the most frequently used doses of scopolamine efficient on memory consolidation, are 1 and 30 mg/kg, low and high doses, respectively. In open field habituation studies only lower doses of scopolamine were used to test memory consolidation. Therefore, in the present study we compared the effects of low (1 mg/kg and high (30 mg/kg scopolamine dose, on the open field habituation task, in male Wistar rats. Scopolamine was administered immediately after the acquisition task and animals were retested 48 h later on. On the retested day, the ambulation and rearing in the open field decreased in the same manner in all tested groups. In saline- and 1 mg/kg scopolamine-treated animals, the time spent in grooming significantly decreased in the habituation task, while the same parameter significantly increased in animals treated with 30 mg/kg of scopolamine. The defecation rate significantly decreased (control group, maintained (1 mg/kg of scopolamine treated animals or significantly increased (30 mg/kg of scopolamine treated group on retention test. In conclusion, the present data suggest that post-training scopolamine administration does not affect locomotion neither exploration in the habituation to a novel environment, but increases defecation and grooming, two behaviours associated with fearful and stressful situations.

  2. Highly Palatable Food during Adolescence Improves Anxiety-Like Behaviors and Hypothalamic-Pituitary-Adrenal Axis Dysfunction in Rats that Experienced Neonatal Maternal Separation

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    Jong-Ho Lee

    2014-06-01

    Full Text Available BackgroundThis study was conducted to examine the effects of ad libitum consumption of highly palatable food (HPF during adolescence on the adverse behavioral outcome of neonatal maternal separation.MethodsMale Sprague-Dawley pups were separated from dam for 3 hours daily during the first 2 weeks of birth (maternal separation, MS or left undisturbed (nonhandled, NH. Half of MS pups received free access to chocolate cookies in addition to ad libitum chow from postnatal day 28 (MS+HPF. Pups were subjected to behavioral tests during young adulthood. The plasma corticosterone response to stress challenge was analyzed by radioimmunoassay.ResultsDaily caloric intake and body weight gain did not differ among the experimental groups. Ambulatory activities were decreased defecation activity and rostral grooming were increased in MS controls (fed with chow only compared with NH rats. MS controls spent less time in open arms, and more time in closed arms during the elevated plus maze test, than NH rats. Immobility duration during the forced swim test was increased in MS controls compared with NH rats. Cookie access normalized the behavioral scores of ambulatory and defecation activities and grooming, but not the scores during the elevated plus maze and swim tests in MS rats. Stress-induced corticosterone increase was blunted in MS rats fed with chow only, and cookie access normalized it.ConclusionProlonged access to HPF during adolescence and youth partly improves anxiety-related, but not depressive, symptoms in rats that experienced neonatal maternal separation, possibly in relation with improved function of the hypothalamic-pituitary-adrenal (HPA axis.

  3. Usefulness of colon transit time and defecography in patients with chronic constipation

    International Nuclear Information System (INIS)

    Park, Kyoung Seuk; Chung, Jae Joon; Kim, Myung Hyun; Park, Su Mi; Yang, Hee Chul

    2006-01-01

    We wanted to evaluate whether both the colonic transit time (CTT) and defecography are necessary for diagnosing constipated patients, and we also wanted to assess the defecographic findings of patients with outlet obstruction on CTT. Over the recent 3 years, 26 patients (21 women and 5 men, mean age: 59 years) underwent both CTT and defecography because of their chronic constipations or defecation difficulty. The mean interval between the 2 studies was 48 days. Colonoscopy, barium enema and manometry were performed in 22, 8 and all the patients, respectively. On CTT, 13 patients (50.0%) were normal and 13 patients (50.0%) were abnormal; the abnormal results were composed of outlet obstruction (n = 8, 30.8%), outlet obstruction and colon inertia (n = 2, 7.7%), colon inertia (n = 2, 7.7%), and outlet obstruction and hindgut dysfunction (n = 1, 3.8%). On defecography, 6 patients (23.1%) were normal and 20 patients (76.9%) were abnormal; the results were composed of rectocele (n = 8, 30.7%), rectocele and perineal descent syndrome (PDS; n = 4, 15.4%), PDS and rectal intussusception (n = 3, 11.5%), spastic pelvic floor syndrome (SPFS; n = 3, 11.5%), rectocele and SPFS (n = 1, 3.8%), and rectal intussusception (n = 1, 3.8%). Of the 11 patients with outlet obstruction on CTT, rectocele (n = 4, 36.4%), SPFS (n = 1, 9.1%), rectocele and PDS (n = 1, 9.1%), and PDS and rectal intussusception (n = 1, 9.1%) were demonstrated on defecography, except for the 4 normal cases. Both CTT and defecography were necessary for diagnosing the patients with chronic constipation in compensation, and 63.6% of the patients with pelvic outlet obstruction showed an abnormal pelvic defecation function

  4. Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome.

    Science.gov (United States)

    Forootan, Mojgan; Shekarchizadeh, Masood; Farmanara, Hamedreza; Esfahani, Ahmad Reza Shekarchizadeh; Esfahani, Mansooreh Shekarchizadeh

    2018-01-12

    Solitary rectal ulcer syndrome (SRUS) is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy. Endoscopic response to biofeedback treatment and clinical symptoms were investigated. Duration of symptoms was 43.11±36.42 months in responder and 63.9 ± 45.74 months in non-responder group (P=0.22). There were more ulcers in non-responder group than responder group (1.50 ±0.71 versus 1.33±- 0.71 before and 1.30 ± 0.95 versus 0.67 ±0.50 after biofeedback), although the difference was not significant (P=0.604, 0.10 respectively). The most prevalent symptoms were constipation (79%), rectal bleeding (68%) and anorectal pain (53%). The most notable improvement in symptoms after biofeedback occured in abdominal pain and incomplete evacuation, and the least was seen in mucosal discharge and toilet waiting as shown in the bar chart. Endoscopic cure was observed in 4 of 10 patients of the non-responder group while 8 patients in responder group experienced endoscopic improvement. It seems that biofeedback has significant effect for pathophysiologic symptoms such as incomplete evacuation and obstructive defecation. Improvement of clinical symptoms does not mean endoscopic cure; so to demonstrate remission the patients have to go under rectosigmoidoscopy.

  5. Unpredictable neonatal stress enhances adult anxiety and alters amygdala gene expression related to serotonin and GABA.

    Science.gov (United States)

    Sarro, E C; Sullivan, R M; Barr, G

    2014-01-31

    Anxiety-related disorders are among the most common psychiatric illnesses, thought to have both genetic and environmental causes. Early-life trauma, such as abuse from a caregiver, can be predictable or unpredictable, each resulting in increased prevalence and severity of a unique set of disorders. In this study, we examined the influence of early unpredictable trauma on both the behavioral expression of adult anxiety and gene expression within the amygdala. Neonatal rats were exposed to unpaired odor-shock conditioning for 5 days, which produces deficits in adult behavior and amygdala dysfunction. In adulthood, we used the Light/Dark box test to measure anxiety-related behaviors, measuring the latency to enter the lit area and quantified urination and defecation. The amygdala was then dissected and a microarray analysis was performed to examine changes in gene expression. Animals that had received early unpredictable trauma displayed significantly longer latencies to enter the lit area and more defecation and urination. The microarray analysis revealed over-represented genes related to learning and memory, synaptic transmission and trans-membrane transport. Gene ontology and pathway analysis identified highly represented disease states related to anxiety phenotypes, including social anxiety, obsessive-compulsive disorders, post-traumatic stress disorder and bipolar disorder. Addiction-related genes were also overrepresented in this analysis. Unpredictable shock during early development increased anxiety-like behaviors in adulthood with concomitant changes in genes related to neurotransmission, resulting in gene expression patterns similar to anxiety-related psychiatric disorders. Copyright © 2013 IBRO. Published by Elsevier Ltd. All rights reserved.

  6. A conceptual model of people's approach to sanitation

    International Nuclear Information System (INIS)

    Avvannavar, Santosh M.; Mani, Monto

    2008-01-01

    Sanitation is a term primarily used to characterize the safe and sound handling (and disposal) of human excreta - or simply, people's approach to take-care of their (unavoidable) primal urge. According to the recent Human Development Report 2006 Global access to proper sanitation stands at approximately 58% with 37% being a conservative estimate both for South Asia and Sub-Saharan Africa. Various multi-million dollar sanitation programmes the world over have had little success, often due to inadequate understanding of people's sanitation approach. Sanitation approach includes the perception, feel and practices involved in satisficing the primal need to defecate and urinate (and their disposal). This paper presents a structure to understand the nature of psycho-socio-economic influences that determine societal approach to sanitation. Societies across the globe have evolved imbibing diverse influences attributed to the local environment, religion, cultural practices, war, etc. While a civilization's living environment reflects these influences in their built-environment characteristics, the influences are often deep-rooted and can be traced to the way the community members satisfice their need to defecate and urinate (sanitation approach). The objective of this paper is to trace the various approaches that diverse societies/civilizations, over time, across the world have had towards sanitation, and present a structure to articulate and understand determining factors. Sanitation also involves other domestic (solid and liquid) waste disposal but in the context of this paper the scope of sanitation has been restricted to human excreta alone. The structure presented and discussed in this paper would be useful in understanding a community better in terms of providing appropriate sanitation. It is hoped that this structure be considered as a basis for further refinement and detailed research into each of the factors determining people's sanitation approach

  7. Effects of by-product feed-based silage on feeding, rumination, and excretion in growing Hanwoo heifers.

    Science.gov (United States)

    Kim, Young-Il; Lee, Sang Moo; Lee, Youn Hee; Lee, Myeon; Choi, Do Young; Kwak, Wan Sup

    2015-01-01

    This study investigated the effects of feeding by-product feed (BF)-based silage on the behavior of growing Hanwoo heifers. Twelve Hanwoo heifers (13.2 months-old, 315 kg body weight; four heifers per pen) were assigned to three diets: a rice straw (RS) diet (concentrate mix and free access to RS), a RS and BF-based silage (RSBFS) diet (concentrate mix and free access to RS and BF-based silage), and a BF-based silage (BFS) diet (concentrate mix and free access to BF-based silage). Behavior was recorded for 5 days using camcorders. Compared to the RS group, the BFS group showed 21.7% higher dry matter intake, shorter feeding, rumination, and chewing times, as well as longer resting time (p < 0.05). Although all groups exhibited similar drinking, urination, and defecation frequencies, the BFS group exhibited higher feeding rates, rumination efficiency, and chewing efficiency than the RS group (p < 0.05). Compared to the BFS group, the RSBFS group showed higher peNDF8.0 intake (15.2% vs. 25.0% dry matter intake), longer feeding and sitting times, lower defecation frequency (p < 0.05), and similar rumination efficiency. In conclusion, complete replacement of conventional RS with BF-based silage reduced rumination and chewing activity in growing Hanwoo heifers, and BF-based silage feeding with large-particle straw is an effective approach in improving heifer behavior.

  8. [Robot assisted Frykman-Goldberg procedure. Case report].

    Science.gov (United States)

    Zubieta-O'Farrill, Gregorio; Ramírez-Ramírez, Moisés; Villanueva-Sáenz, Eduardo

    2017-12-01

    Rectal prolapse is defined as the protrusion of the rectal wall through the anal canal; with a prevalence of less than 0.5%. The most frequent symptoms include pain, incomplete defecation sensation with blood and mucus, fecal incontinence and/or constipation. The surgical approach can be perineal or abdominal with the tendency for minimal invasion. Robot-assisted procedures are a novel option that offer technique advantages over open or laparoscopic approaches. 67 year-old female, who presented with rectal prolapse, posterior to an episode of constipation, that required manual reduction, associated with transanal hemorrhage during defecation and occasional fecal incontinence. A RMI defecography was performed that reported complete rectal and uterine prolapse, and cystocele. A robotic assisted Frykman-Goldberg procedure wass performed. There are more than 100 surgical procedures for rectal prolapse treatment. We report the first robot assisted procedure in Mexico. Robotic assisted surgery has the same safety rate as laparoscopic surgery, with the advantages of better instrument mobility, no human hand tremor, better vision, and access to complicated and narrow areas. Robotic surgery as the surgical treatment is a feasible, safe and effective option, there is no difference in recurrence and function compared with laparoscopy. It facilitates the technique, improves nerve preservation and bleeding. Further clinical, prospective and randomized studies to compare the different minimal invasive approaches, their functional and long term results for this pathology are needed. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  9. The effect of handwashing at recommended times with water alone and with soap on child diarrhea in rural Bangladesh: an observational study.

    Science.gov (United States)

    Luby, Stephen P; Halder, Amal K; Huda, Tarique; Unicomb, Leanne; Johnston, Richard B

    2011-06-01

    Standard public health interventions to improve hand hygiene in communities with high levels of child mortality encourage community residents to wash their hands with soap at five separate key times, a recommendation that would require mothers living in impoverished households to typically wash hands with soap more than ten times per day. We analyzed data from households that received no intervention in a large prospective project evaluation to assess the relationship between observed handwashing behavior and subsequent diarrhea. Fieldworkers conducted a 5-hour structured observation and a cross-sectional survey in 347 households from 50 villages across rural Bangladesh in 2007. For the subsequent 2 years, a trained community resident visited each of the enrolled households every month and collected information on the occurrence of diarrhea in the preceding 48 hours among household residents under the age of 5 years. Compared with children living in households where persons prepared food without washing their hands, children living in households where the food preparer washed at least one hand with water only (odds ratio [OR]=0.78; 95% confidence interval [CI]=0.57-1.05), washed both hands with water only (OR=0.67; 95% CI=0.51-0.89), or washed at least one hand with soap (OR=0.30; 95% CI=0.19-0.47) had less diarrhea. In households where residents washed at least one hand with soap after defecation, children had less diarrhea (OR=0.45; 95% CI=0.26-0.77). There was no significant association between handwashing with or without soap before feeding a child, before eating, or after cleaning a child's anus who defecated and subsequent child diarrhea. These observations suggest that handwashing before preparing food is a particularly important opportunity to prevent childhood diarrhea, and that handwashing with water alone can significantly reduce childhood diarrhea.

  10. Analyzing time-ordered event data with missed observations.

    Science.gov (United States)

    Dokter, Adriaan M; van Loon, E Emiel; Fokkema, Wimke; Lameris, Thomas K; Nolet, Bart A; van der Jeugd, Henk P

    2017-09-01

    A common problem with observational datasets is that not all events of interest may be detected. For example, observing animals in the wild can difficult when animals move, hide, or cannot be closely approached. We consider time series of events recorded in conditions where events are occasionally missed by observers or observational devices. These time series are not restricted to behavioral protocols, but can be any cyclic or recurring process where discrete outcomes are observed. Undetected events cause biased inferences on the process of interest, and statistical analyses are needed that can identify and correct the compromised detection processes. Missed observations in time series lead to observed time intervals between events at multiples of the true inter-event time, which conveys information on their detection probability. We derive the theoretical probability density function for observed intervals between events that includes a probability of missed detection. Methodology and software tools are provided for analysis of event data with potential observation bias and its removal. The methodology was applied to simulation data and a case study of defecation rate estimation in geese, which is commonly used to estimate their digestive throughput and energetic uptake, or to calculate goose usage of a feeding site from dropping density. Simulations indicate that at a moderate chance to miss arrival events ( p  = 0.3), uncorrected arrival intervals were biased upward by up to a factor 3, while parameter values corrected for missed observations were within 1% of their true simulated value. A field case study shows that not accounting for missed observations leads to substantial underestimates of the true defecation rate in geese, and spurious rate differences between sites, which are introduced by differences in observational conditions. These results show that the derived methodology can be used to effectively remove observational biases in time-ordered event

  11. Spoiled breast milk and bad water; local understandings of diarrhea causes and prevention in rural Sierra Leone.

    Science.gov (United States)

    McMahon, Shannon A; George, Asha S; Yumkella, Fatu; Diaz, Theresa

    2013-12-13

    Globally, diarrhea remains a leading killer of young children. In Sierra Leone, one in seven children die before their fifth birthday and diarrhea is a leading cause. Studies that emphasize the demand-side of health interventions -- how caregivers understand causation and prevention of diarrhea -- have been neglected in research and programming. We undertook applied qualitative research including 68 in-depth interviews and 36 focus group discussions with mothers, fathers and older female caretakers to examine the causes and prevention of childhood diarrhea in villages near and far from health facilities across four rural districts. Verbal consent was obtained. Respondents reported multiple, co-existing descriptions of causation including: contaminated water and difficulties accessing clean water; exposure to an unclean environment and poor food hygiene; contaminated breast milk due to sexual intercourse, overheated breast milk or bodily maternal conditions such as menstruation or pregnancy; and dietary imbalances and curses. Respondents rarely discussed the role of open defecation or the importance of handwashing with soap in preventing diarrhea. Categorizing behaviors as beneficial, harmful, non-existent or benign enables tailored programmatic recommendations. For example, respondents recognized the value of clean water and we correspondingly recommend interventions that reinforce consumption of and access to clean water. Second, respondents report denying "contaminated" breast milk to breastfeeding children. This is a harmful practice that merits attention. Third, the role of open defecation and poor hygiene in causing diarrhea is less understood and warrants introduction or clarification. Finally, the role of exposed feet or curses in causing diarrhea is relatively benign and does not necessitate programmatic attention. Further research supportive of communication and social mobilization strategies building on these findings is required to ensure that improved

  12. Improvement Effect of Dewaxed Brown Rice on Constipation in Antibiotic-treated Mice.

    Science.gov (United States)

    Inagawa, Hiroyuki; Saika, Toshiyuki; Nishiyama, Naoki; Nisizawa, Takashi; Kohchi, Chie; Uenobe, Maya; Soma, Gen-Ichiro

    2017-01-01

    A decrease in gastrointestinal motility causing weakened lipopolysaccharide (LPS) - toll-like receptor (TLR)4 signaling along with a decline in the number of enteric bacteria is known to be a cause of constipation due to the administration of antibiotics. A new type of brown rice with its wax layer removed, resulting in quick-cooking and tasty product, contains 100-times more LPS than polished white rice. In this study, the improvement effect on constipation due to intake of dewaxed brown rice was examined. Dewaxed brown rice was prepared at Toyo Rice from brown rice. Mice were given powdered feed to which powdered rice containing 0-50% of dewaxed brown rice was added. Antibiotics were administered for 10 or 27 days in drinking water containing vancomycin, metronidazole and neomycin. LPS, used as a control, was freely provided in drinking water. The defecation frequency, stool weight per hour and body weight were determined on the last day. Although the 10-day administration of antibiotics reduced the stool weight per hour to half, the dewaxed brown rice and LPS groups showed a trend towards improvement at a level comparable to the group receiving no antibiotics. The body weight significantly decreased after the 27-day administration of antibiotics but was improved in the 50% dewaxed brown rice group at a level comparable to the group receiving no antibiotics. Though the defecation frequency and wet and dry stool weights per hour were reduced by as much as 50% in the group receiving antibiotics, a significant improvement in constipation was observed in the 50% dewaxed brown rice group. As the improvement effect of dewaxed brown rice on body weight loss and constipation caused by the long-term administration of antibiotics has been confirmed in animal experimentation, the introduction of dewaxed brown rice as a staple food to patients under long-term antibiotic treatment may improve constipation. Copyright© 2017, International Institute of Anticancer Research (Dr

  13. Agroecological Substantiation for the Use of Treated Wastewater for Irrigation of Agricultural Land

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    Yulia Domashenko

    2018-01-01

    Full Text Available The objective of this work is the agroecological substantiation of the use of treated wastewater for irrigation of agricultural land. As the result of the experimental research, it was established that the soil microfloraplays an essential role in strengthening or weakening the biological activity of soil. Therefore, with an irrigation rate of 250 m 3 /ha of wastewater, a 1.5 times increase in the number of microbiota colonies is observed on average both in hog farms and cattle breeding complexes; with a rate of 350 m 3 /ha – a 2-fold increase; with a rate of 450 m 3 /ha – a 3.5–4-fold increase. An increase in nitrifying soil features has also been observed. Thus, if the value on the control in the soil layer from 0 cm to 60 cm is 27.2 mg of nitrate per 1 kg of arid soil, in the version with wastewater irrigation it reaches 46.7 mg. According to the research results, the use of defecate, the waste of sugar production, in the treatment of wastewater of livestock farms does not have a negative agroecological impact on the soil. Therefore, the method of wastewater treatment of pig-breeding complexes and farms can be recommended for use in irrigation reclamation, which includes treatment of wastewater with burnt defecate in the dose of 50–200 mg/dm 3 , with the pH value varying in the range of 7.5–8.5. After settling-out of the obtained mixture in settlers, it is divided into a transparent liquid fraction and the sediment, i.e. an organomineral fertilizer. Afterwards, the fluidbody is fed to irrigation of agricultural land, and its excess is discharged into waterways and reservoirs. The sediment is fed to the vortex layer equipment with mobile ferromagnetic particles or thermolized, where their complete disinfection takes place.

  14. A standardised faecal collection protocol for intestinal helminth egg counts in Asian elephants, Elephas maximus

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    Carly L. Lynsdale

    2015-12-01

    Full Text Available The quantitative assessment of parasite infection is necessary to measure, manage and reduce infection risk in both wild and captive animal populations. Traditional faecal flotation methods which aim to quantify parasite burden, such as the McMaster egg counting technique, are widely used in veterinary medicine, agricultural management and wildlife parasitology. Although many modifications to the McMaster method exist, few account for systematic variation in parasite egg output which may lead to inaccurate estimations of infection intensity through faecal egg counts (FEC. To adapt the McMaster method for use in sampling Asian elephants (Elephas maximus, we tested a number of possible sources of error regarding faecal sampling, focussing on helminth eggs and using a population of over 120 semi-captive elephants distributed across northern Myanmar. These included time of day of defecation, effects of storage in 10% formalin and 10% formol saline and variation in egg distribution between and within faecal boluses. We found no significant difference in the distribution of helminth eggs within faecal matter or for different defecation times, however, storage in formol saline and formalin significantly decreased egg recovery. This is the first study to analyse several collection and storage aspects of a widely-used traditional parasitology method for helminth parasites of E. maximus using known host individuals. We suggest that for the modified McMaster technique, a minimum of one fresh sample per elephant collected from any freshly produced bolus in the total faecal matter and at any point within a 7.5 h time period (7.30am–2.55 pm will consistently represent parasite load. This study defines a protocol which may be used to test pre-analytic factors and effectively determine infection load in species which produce large quantities of vegetative faeces, such as non-ruminant megaherbivores.

  15. Increasing serotonin concentrations alter calcium and energy metabolism in dairy cows.

    Science.gov (United States)

    Laporta, Jimena; Moore, Spencer A E; Weaver, Samantha R; Cronick, Callyssa M; Olsen, Megan; Prichard, Austin P; Schnell, Brian P; Crenshaw, Thomas D; Peñagaricano, Francisco; Bruckmaier, Rupert M; Hernandez, Laura L

    2015-07-01

    A 4×4 Latin square design in which varied doses (0, 0.5, 1.0, and 1.5 mg/kg) of 5-hydroxy-l-tryptophan (5-HTP, a serotonin precursor) were intravenously infused into late-lactation, non-pregnant Holstein dairy cows was used to determine the effects of serotonin on calcium and energy metabolism. Infusion periods lasted 4 days, with a 5-day washout between periods. Cows were infused at a constant rate for 1 h each day. Blood was collected pre- and 5, 10, 30, 60, 90, and 120 min post-infusion, urine was collected pre- and post-infusion, and milk was collected daily. All of the 5-HTP doses increased systemic serotonin as compared to the 0 mg/kg dose, and the 1.0 and 1.5 mg/kg doses increased circulating glucose and non-esterified fatty acids (NEFA) and decreased beta-hydroxybutyrate (βHBA) concentrations. Treatment of cows with either 1.0 or 1.5 mg/kg 5-HTP doses decreased urine calcium elimination, and the 1.5 mg/kg dose increased milk calcium concentrations. No differences were detected in the heart rates, respiration rates, or body temperatures of the cows; however, manure scores and defecation frequency were affected. Indeed, cows that received 5-HTP defecated more, and the consistency of their manure was softer. Treatment of late-lactation dairy cows with 5-HTP improved energy metabolism, decreased loss of calcium into urine, and increased calcium secretion into milk. Further research should target the effects of increasing serotonin during the transition period to determine any benefits for post-parturient calcium and glucose metabolism. © 2015 Society for Endocrinology.

  16. Knowledge and Practice of Personal Hygiene and Sanitation: A Study in Selected Slums of Dhaka City

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    Shayela Farah

    2015-07-01

    Full Text Available Background: : Slum dwellers are likely to be among the most deprived people in urban areas. Poor hygiene practices and inadequate sanitary conditions play major roles in the increased burden of communicable diseases within developing countries like ours. Objective: To assess the knowledge and practice about personal hygiene and environmental sanitation in selected slums of Dhaka city. Materials and method: This cross sectional study was conducted in purposively selected urban slum areas of Moghbazar slum, Bashabo slum and T&T slum of Dhaka city during February 2014 to April 2014. Convenient sampling technique was applied. Semi-structured pre-tested questionnaire was used and face to face interview was conducted. Total 475 subjects, irrespective of age and sex, were included in this study. Results: Out of 475 respondents, more than fifty percent slum dwellers resided in tin shaded room while 21.7% in ‘kacha’ houses. Sixty six percent of the respondents used to drink water from tube-well and 24% used supplied water provided by the city corporation. The study revealed that near 59% of the respondents used sanitary latrine. About 67% slum dwellers regularly practiced hand washing before taking meal and 59.2% respondents used soap after defecation. About fifty percent respondents brushed their teeth regularly with tooth paste. Regarding personal cleanliness, 81% subjects took bath regularly while 78% washed clothes irregularly. A statistically significant relation was found between washing of hands before meal (p=0.001, washing of hands after defecation (p=0.02, tooth brushing (p=0.001, bathing (p=0.009, washing of cloths (p=0.001, use of footwear (p=0.63 with knowledge of personal hygiene of the slum dwellers. Conclusion: Continuous community hygiene education along with adequate access to water supply and sanitation improves hygiene behaviour and policy makers and health care providers should have definite strategy and implementation.

  17. A survey of domestic wells and pit latrines in rural settlements of Mali: Implications of on-site sanitation on the quality of water supplies.

    Science.gov (United States)

    Martínez-Santos, P; Martín-Loeches, M; García-Castro, N; Solera, D; Díaz-Alcaide, S; Montero, E; García-Rincón, J

    2017-10-01

    On-site sanitation is generally advocated as a means to eradicate the health hazards associated with open defecation. While this has provided a welcome upgrade to the livelihoods of millions of people in low-income countries, improved sanitation facilities are increasingly becoming a threat to domestic groundwater-based supplies. Within this context, a survey of pit latrines, domestic wells and improved water sources was carried out in a large rural village of southern Mali. All households were surveyed for water, sanitation and hygiene habits. Domestic wells and improved water sources were georeferenced and sampled for water quality (pH, electric conductivity, temperature, turbidity, total dissolved solids, thermotolerant coliforms, chloride and nitrate) and groundwater level, while all latrines were inspected and georeferenced. A GIS database was then used to evaluate the proportion of water points within the influence area of latrines, as well as to underpin multiple regression models to establish the determinants for fecal contamination in drinking supplies. Moreover, an appraisal of domestic water treatment practices was carried out. This revealed that nearly two-thirds of the population uses bleach to purify drinking supplies, but also that domestic-scale treatment as currently implemented by the population is far from effective. It is thus concluded that existing habits could be enhanced as a means to make water supplies safer. Furthermore, population, well and latrine density were all identified as statistically significant predictors for fecal pollution at different spatial scales. These findings are policy-relevant in the context of groundwater-dependent human settlements, since many countries in the developing world currently pursue the objective of eliminating open defecation. Copyright © 2017 Elsevier GmbH. All rights reserved.

  18. The MRI study of the sphincter muscle complex in congenital anorectal malformations

    International Nuclear Information System (INIS)

    Tang Shaotao; Mao Yongzhong; Wang Yong; Dong Ning; Ruan Qinglan; Peng Zhenjun; Kong Xiangquan; Liu Dingxi

    2007-01-01

    Objective: To evaluate the development of the sphincter muscle complex (SMC) and defecation function in pediatric patients with congenital anorectal malformations (ARM). Methods: A total of 64 children underwent MRI, among whom 39 were patients with ARM, and the others were patients without ARM undergoing MRI because of other dieases. The dimensions of the SMC in different planes were evaluated with different sequences and coils. The relationship between the SMC development and the defecation function was investigated. Results: In control group, the absolute value of SMC width was (3.63 ± 0.22)mm, which had a high correlation with age (r=0.998, P 0.05). The SMCs in intermediate ARM patients [muscle index (MI)=0.47 ± 0.05] and low ARM patients (MI=0.49 ± 0.05) were well developed. The SMCs in a portion of patients with high ARM (MI=0.28 ± 0.06) were poorly developed, when MI≤0.18, anorectal contraction pressure was significantly lower (t=3.55, P 0.18[(0.85 ± 0.20) vs (2.24 ± 1.02) kPa]. The length of anal canal with high-pressure[(10.88 ± 3.64) vs (20.26 ± 4.34)mm] was shorter (t= 5.18, P 0.18, the anorectal angle was less than 90 degrees, and normal continent function was found in 21 of 23 cases (91%). Conclusion: MRI can be employed to evaluate the development of SMC in patients with ARM, MI was an objective criteria to evaluate the development of SMC. When MI≤0.18, maldevelopment of SMC will be highly suspected. (authors)

  19. Safety and efficacy of fast-track surgery in perioperative nursing for biliary calculi surgery: a meta-analysis

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    LI Qinan

    2015-10-01

    Full Text Available ObjectiveTo systematically review the efficacy and safety of fast-track surgery (FTS in perioperative nursing for biliary calculi surgery. MethodsOnline databases of PubMed, Cochrane Library, CBM, CNKI, VIP, and Wanfang Data were comprehensively searched for relevant randomized controlled trials (RCTs. Potential bias was evaluated by Cochrane tools and data were analyzed by RevMan 5.3. ResultsA total of 11 RCTs with 1455 patients were included (738 cases in FTS group and 717 cases in control group. The results of meta-analysis showed that FTS significantly reduced the length of postoperative hospital stay (MD=-4.10, 95% CI: -5.68 to -2.52, P<0.000 01 and hospital costs (MD=-0.47, 95%CI: -0.60 to -0.34, P<0.000 01; meanwhile, FTS shortened the time to gastrointestinal recovery (SMD=-2.05, 95%CI: -2.84 to -1.27, P<0.000 01, as well as the time to first defecation (SMD=-1.27, 95% CI: -2.08 to -0.46, P<0.000 01. As for safety, FTS significantly reduced the total complications of choledocholithiasis (RR=0.53, 95%CI: 0.43-0.65, P<0.000 01 and hepatolithiasis (RR=0.52, 95% CI: 0.35-0.77, P=0.001. ConclusionFTS is effective and safe in perioperative nursing for biliary calculi surgery. It can significantly reduce the length of postoperative hospital stay, enhance gastrointestinal recovery, shorten the time to first defecation, and reduce total complications.

  20. Low Dose Mesalazine Plus Bismuth Regimen and Symptoms of Irritable Bowel Syndrome in Patients with Bloating: A Quasi-Experimental Study

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    Alavinejad

    2016-08-01

    Full Text Available Background The current study aimed to evaluate the efficacy of mesalazine plus bismuth on patients with irritable bowel syndrome (IBS and chief complaint of bloating. Methods The current quasi-experimental study, included patients with IBS and chief complaint of bloating and incomplete defecation. They were treated with masalazine and bismuth subcitrate and followed regularly based on monthly visits. The rate of symptoms relief, patients' satisfaction and any side effects were recorded during the surveillance. Results Overall, 42 patients (33 females and 9 males were included. The mean age of the patients was 35.9 years (ranged 22 - 67 years; 32%, 44% and 24% had high, medium and low socioeconomic levels, respectively; 96% of the patients were nonsmokers and just two patients had a history of alcohol consumption. Two patients had glucose intolerance, four had hypothyroidism and four had past history of valvular heart disease. In 20% of the patients, the family history for intestinal bowl disease (IBD was positive. Ten patients had a history of bloody diarrhea and no one had a history of any significant liver diseases. The most common symptoms of patients included incomplete defecation and tenesmus (41 patients, 97.6%, bloating (39 patients, 92.8%, abdominal fullness (35 patients, 83.3% and mucus discharge (30 patients, 71.4%. After an average six months of treatment (3 - 11 months, 69.1% of patients reported improvement of symptoms more than 50% (38.1%, ranged 75% - 100%, and 31% (ranged 50% - 75% indicated overall symptoms relief. The most significant improvement was reported for bloating (85%. There were no major side effects except minor degrees of diarrhea among 26% of the subjects. Conclusions The results of the study were indicative of improvement and symptom relief in the majority of patients and it seems that treatment prolongation up to six months could be a key factor to achieve better clinical responses. It is recommended that further

  1. Randomised double blind placebo controlled trial on Lactobacillus reuteri DSM 17938: improvement in symptoms and bowel habit in functional constipation.

    Science.gov (United States)

    Riezzo, G; Orlando, A; D'Attoma, B; Linsalata, M; Martulli, M; Russo, F

    2018-01-29

    Dysbiosis may contribute to constipation and its symptoms, therefore probiotic administration could improve significantly gut health and functions. The aim of the study was to investigate the effects of a long-lasting administration of Lactobacillus reuteri DSM 17938 (LR DSM 17938) on symptoms and quality of life (QoL) score in patients with functional constipation (FC). 56 FC patients with normal colonic transit time and without anorectal disorders and pelvic floor dysfunctions completed the study. LR DSM 17938 was administered for 105 days in a randomised double-blind clinical trial (28 patients per arm). Individual and cumulative scores including the Constipaq, a modified Constipation Scoring System (CSS) that considers the patient assessment of constipation-QoL (PAC-QoL), were calculated during the preliminary visit (V0), at day 15 (end of the induction period with a LR DSM 17938 double dosage, 4×10 8 cfu), day 60 (intermediate evaluation) and day 105 (V4) after a standard dosage (2×10 8 cfu). At the end of treatment, the beneficial effect of LR DSM 17938 compared to placebo was significantly evident for symptoms related to gas content and dysbiosis (abdominal discomfort, pain and bloating), incomplete defecation and helps for defecation (PDSM 17938 treatment, a marked and positive effect on both the CSS single and the cumulative items was evident with the exception of unfruitful attempt and Bristol score. Present findings indicate that LR DSM 17938 has an effect on symptoms different from stool consistency, and they suggest that this probiotic can effectively be used in association therapy rather than as single-drug therapy in the management of FC.

  2. Effects of Prebiotics and Synbiotics on Functional Constipation.

    Science.gov (United States)

    Yu, Ting; Zheng, Yong-Ping; Tan, Jia-Cheng; Xiong, Wen-Jie; Wang, Yun; Lin, Lin

    2017-03-01

    The objective was to determine the effects of prebiotics and synbiotics on adults with functional constipation (FC). Medline, Embase and the Cochrane Library were searched for literature published up to February 2015. We selected randomized controlled trials (RCTs) that reported administration of prebiotics or synbiotics to adults with FC. The end points included stool frequency, stool consistency and other symptoms related to constipation. Mean differences (MD) or standard mean differences (SMD) were used for continuous outcomes and risk ratios for discontinuous outcomes using a random-effects model. The Cochrane Risk of Bias Tool was used to determine the quality of the trials. Funnel plots and Egger's test were used to analyze for publication bias. We included 5 RCTs involving 199 patients who were administered prebiotics and 8 RCTs involving 825 patients who were administered synbiotics. Prebiotics increased weekly stool frequency (MD: 1.01bowel movements/week, 95% CI: 0.04-1.99) and improved stool consistency (SMD: -0.59, 95% CI: -1.16 to -0.02). Subgroup analysis showed specific effects for galacto-oligosaccharides on stool frequency, consistency, ease of defecation and abdominal pain. Synbiotics significantly improved stool frequency (MD: 1.15bowel movements/week, 95% CI: 0.58-1.71), consistency (SMD: 0.63, 95% CI: 0.33-0.92) and reduced whole-gut transit time (MD: 13.52, 95% CI: -26.56 to -0.49) in patients with FC. Subgroup analysis showed specific effects for fructo-oligosaccharides and probiotic combinations on stool frequency, consistency, straining defecation and bloating. Galacto-oligosaccharides and synbiotics made up of fructo-oligosaccharides with probiotic combinations may improve stool frequency, consistency and some other symptoms related to constipation. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  3. Analysis of behavioral change techniques in community-led total sanitation programs.

    Science.gov (United States)

    Sigler, Rachel; Mahmoudi, Lyana; Graham, Jay Paul

    2015-03-01

    The lack of sanitation facilitates the spread of diarrheal diseases-a leading cause of child deaths worldwide. As of 2012, an estimated 1 billion people still practiced open defecation (OD). To address this issue, one behavioral change approach used is community-led total sanitation (CLTS). It is now applied in an estimated 66 countries worldwide, and many countries have adopted this approach as their main strategy for scaling up rural sanitation coverage. While it appears that many of the activities used in CLTS-that target community-level changes in sanitation behaviors instead of household-level changes-have evolved out of existing behavior change frameworks and techniques, it is less clear how these activities are adapted by different organizations and applied in different country contexts. The aims of this study are to (i) show which behavior change frameworks and techniques are the most common in CLTS interventions; (ii) describe how activities are implemented in CLTS interventions by region and context; and (3) determine which activities program implementers considered the most valuable in achieving open defecation free (ODF) status and sustaining it. The results indicate that a wide range of activities are conducted across the different programs and often go beyond standard CLTS activities. CLTS practitioners ranked follow-up and monitoring activities as the most important activities for achieving an ODF community, yet only 1 of 10 organizations conducted monitoring and follow-up throughout their project. Empirical studies are needed to determine which specific behavioral change activities are most effective at ending OD and sustaining it. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Alimentación y defecación en triatominos del género Rhodnius (Hemiptera: Reduviidae alimentados con sangre humana

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    E. Aldana

    2001-06-01

    Full Text Available Se estudió el comportamiento alimenticio y de defecación de Rhodnius prolixus Stal, 1859, R. robustus Larrousse, 1927, R. neivai Lent, 1953 y R. pictipes Stal, 1872 alimentados artificialmente con sangre humana en condiciones de laboratorio. La ninfa I de todas las especies no defecaron en la primera media hora después de haber iniciado la ingesta. R. pictipes no se acercó a picar en el alimentador artificial aunque si lo hizo cuando el alimento se ofreció directamente sobre el cuerpo humano. Las ninfas y adultos de R. prolixus mostraron índices de defecación (ID superiores a los correspondientes de las otras especies, y la ninfa III presentó el mayor ID=1.62. La mayoría de individuos de todos los estadíos de desarrollo aceptaron el alimento en un tiempo entre 0 y 3 min y se alimentaron en menos de 15 minutos.Feeding and defecaction behavior of Rhodnius prolixus Stal, 1859, R. robustus Larrousse, 1927, R. neivai Lent, 1953 and R. pictipes Stal, 1872, artificially fed on human blood, were studied under laboratory conditions. In all species, first instar nymphs did not defecate in the first 30 minutes after feeding. R. pictipes did not accept artificial feeding but fed directly on humans. Nymph and adult R. prolixus had a higher defecation index (DI than other species; third instar nymphs had the highest DI=1.62. In all instars, most individuals accepted the food in £ 3 minutes and finished feeding in less than 15 minutes.

  5. Circular Stapler-Assisted Extraperitoneal Colostomy in Laparoscopic Abdominoperineal Resection: a Single Surgeon Experience.

    Science.gov (United States)

    Zhang, Peng; Bai, Jie; Shuai, Xiaoming; Chang, Weilong; Gao, Jinbo; Liu, Xinghua; Wang, Guobin; Tao, Kaixiong

    2016-03-01

    Nowadays, laparoscopic abdominoperineal resection (LAPR) not only has the same oncologic safety of open surgery and but also has the common advantages of laparoscopic surgery. However, given the difficulty in operation and long operative time, laparoscopic extraperitoneal colostomy construction is rarely practiced and reported. In this study, we describe technique of extraperitoneal colostomy using circular stapler following LAPR and demonstrate its efficacy and safety. This is a retrospective analysis of prospectively maintained data of 42 patients who underwent LAPR with circular stapler-assisted extraperitoneal colostomy in our department between July 2011 and June 2014. The mean time for extraperitoneal colostomy construction was 25 min (18-33 min). The mean operative time, estimated blood loss, postoperative gastrointestinal function recovery time, and duration of postoperative hospital stay were 160 min (115-225 min), 45 ml (10-250 ml), 33 h (26-45 h), and 8.6 days (6-13 days), respectively; 4.8 % of the patients had postoperative short-term complications. There were no stenosis, prolapse, and parastomal hernia observed in follow-up period. At 6 months after operation, 26 patients (62 %) claimed to be satisfied with their postoperative stool habits, 29 patients (69 %) had sensation to defecate per stoma, and 11 (26.2 %) patients had the ability to defer defecation for solid or liquid stool per stoma. Circular stapler-assisted extraperitoneal colostomy is an easy, effective, and safe technique following LAPR and appears to minimize the occurrence of stomal complications and improve the quality of life for patients.

  6. Efficacy of 10% sucralfate ointment after anal fistulotomy: A prospective, double-blind, randomized, placebo-controlled trial.

    Science.gov (United States)

    Alvandipour, Mina; Ala, Shahram; Tavakoli, Hasan; Yazdani Charati, Jamshid; Shiva, Afshin

    2016-12-01

    The most frequent problems after anal fistulotomy are pain, bleeding, and delayed or impaired wound healing. Topical Sucralfate preparation has been used to treat a wide variety of wounds. In this study, we investigate effects of 10% sucralfate ointment on wound healing and postoperative pain after fistulotomy. A total of 41 patients undergoing anorectal fistulotomy were included in this randomized, blinded, controlled trial and were randomly allocated to either sucralfate ointment (every 12 h) or placebo. The patients were visited weekly for up to 5 weeks. The intensity of pain and the wound healing were assessed. The sucralfate group had significantly less pain at rest (1.92 ± 0.88 vs 2.96 ± 0.98; P = 0.002) and on defecation (1.68 ± 0.92 vs 3.08 ± 1.12; p < 0.001) than the placebo group from 1st to 5th post-operative visits. Complete wound healing was achieved after 8.15 ± 1 weeks in placebo group versus 5.9 ± 0.8 weeks in sucralfate group (p < 0.001). There were no significant differences in the frequencies of postoperative complications between the two groups. Compared with placebo, sucralfate ointment reduced postoperative pain at rest and on defecation and improves wound healing in patients undergoing fistulotomy. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  7. Coccygeal movement: Assessment with dynamic MRI

    International Nuclear Information System (INIS)

    Grassi, Roberto; Lombardi, Giulio; Reginelli, Alfonso; Capasso, Francesco; Romano, Francesco; Floriani, Irene; Colacurci, Nicola

    2007-01-01

    Purpose: Chronic coccygodynia is a difficult problem diagnostically and therapeutically. Moreover, there is no deep knowledge especially in the field of imaging of chronic coccygodynia. In this study several possible measurements are proposed, which all are able to demonstrate coccygeal movement during defecation, in order to assess coccygeal mobility using dynamic MRI during maximum contraction and during straining-evacuation. Materials and methods: A dynamic MRI study of the pelvic floor was performed in 112 patients. Five methods of measurement were assessed. Coccygeal movements were determined through the evaluation of three angles pair and two different distances measured during the phase of maximum contraction and during the phase of straining-evacuation. Results were compared according to age, sex, parity and experience of minor trauma. No patient included in the study had coccygodynia. Measurements taken by two radiologist were compared to determine interobserver agreement. Results: The maximum measurement values of the two distances are homogeneous, between 9 and 9.4 mm. The maximum measurement values of the three angles showed a difference that is between 21 deg. and 38 deg. Two of three angles showed a major measurement values in the funtional texts. In only one patient the coccyx was not mobile. Conclusion: Our dynamic MRI study indicates that the coccyx is mobile during defecation and that it is possible to demonstrate coccygeal excursions by assessing the difference between its positions at maximum contraction and during straining-evacuation. The measurement methods used in this study for evaluating coccygeal movements resulted in variably sized observed differences, but all yielded statistically significant results in demonstrating coccygeal excursion. Among the five measurement methods, two resulted in the largest differences. Our data indicate no correlation between coccygeal movements and age, sex, parity, minor trauma and coccygodynia

  8. The effect of early ambulation on the incidence of neurological complication after spinal anesthesia with lidocaine

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    Reihanak Talakoub

    2015-01-01

    Full Text Available Background: Transient neurological symptoms (TNS, was described in patients recovering from spinal anesthesia with lidocaine but its etiology remains unknown this study was evaluated the influence of ambulation time on the occurrence of TNSs after spinal anesthesia with lidocaine 5%. Materials and Methods: This randomized clinical trial was conducted on 60 patients with American Society of Anesthesiologists Grades I and II, who were candidates for lower abdominal surgery in supine or lithotomy positions. Patients were randomly divided into early ambulation group (Group A who were asked to start walking as soon as the anesthesia was diminished or to the late ambulation group (Group B who walked after at least 12 h bedridden. Participants were contacted 2 days after spinal anesthesia to assess any type of pain at surgical or anesthesia injection site, muscle weakness, fatigue, vertigo, nausea, vomiting, headache, and difficult urination or defecation. Results: Four subjects (13.3% in Group A and two patients (6.7% in Group B had pain at anesthesia injection site (P = 0.019. Fourteen patients in Group A (46.7% and six patients in Group B (20% had post-dural puncture headache (P = 0.014. Participants in Group B reported difficult urination more than Group A (P = 0.002. there were not statistically significant differences between two groups regarding frequency of fatigue, muscle weakness, vertigo, nausea, vomiting, difficult defecation, paresthesia, and the mean of visual analogue scale at the surgical site. Conclusion: Early ambulation after spinal anesthesia with lidocaine did not increase the risk of neurologic complication.

  9. Usefulness of colon transit time and defecography in patients with chronic constipation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kyoung Seuk; Chung, Jae Joon; Kim, Myung Hyun; Park, Su Mi; Yang, Hee Chul [NHIC Ilsan Hospital, Ilsan (Korea, Republic of)

    2006-05-15

    We wanted to evaluate whether both the colonic transit time (CTT) and defecography are necessary for diagnosing constipated patients, and we also wanted to assess the defecographic findings of patients with outlet obstruction on CTT. Over the recent 3 years, 26 patients (21 women and 5 men, mean age: 59 years) underwent both CTT and defecography because of their chronic constipations or defecation difficulty. The mean interval between the 2 studies was 48 days. Colonoscopy, barium enema and manometry were performed in 22, 8 and all the patients, respectively. On CTT, 13 patients (50.0%) were normal and 13 patients (50.0%) were abnormal; the abnormal results were composed of outlet obstruction (n = 8, 30.8%), outlet obstruction and colon inertia (n = 2, 7.7%), colon inertia (n = 2, 7.7%), and outlet obstruction and hindgut dysfunction (n = 1, 3.8%). On defecography, 6 patients (23.1%) were normal and 20 patients (76.9%) were abnormal; the results were composed of rectocele (n = 8, 30.7%), rectocele and perineal descent syndrome (PDS; n = 4, 15.4%), PDS and rectal intussusception (n = 3, 11.5%), spastic pelvic floor syndrome (SPFS; n = 3, 11.5%), rectocele and SPFS (n = 1, 3.8%), and rectal intussusception (n = 1, 3.8%). Of the 11 patients with outlet obstruction on CTT, rectocele (n = 4, 36.4%), SPFS (n = 1, 9.1%), rectocele and PDS (n = 1, 9.1%), and PDS and rectal intussusception (n = 1, 9.1%) were demonstrated on defecography, except for the 4 normal cases. Both CTT and defecography were necessary for diagnosing the patients with chronic constipation in compensation, and 63.6% of the patients with pelvic outlet obstruction showed an abnormal pelvic defecation function.

  10. The effect of a natural food based tube feeding in minimizing diarrhea in critically ill neurological patients.

    Science.gov (United States)

    Schmidt, Simone B; Kulig, Willibald; Winter, Ralph; Vasold, Antje S; Knoll, Anette E; Rollnik, Jens D

    2018-01-09

    Diarrhea has negative consequences for patients, health care staff and health care costs when neurological patients are fed enterally over long periods. We examined the effect of tube feeding with natural foods in reducing the number of fluid stool evacuations and diarrhea in critically ill neurological patients. A multicenter, prospective, open-label and randomized controlled trial (RCT) was conducted at facilities in Germany specializing in early rehabilitation after neurological damage. Patients of the INTERVENTION group were fed by tube using a commercially available product based on real foods such as milk, meat, carrots, whereas CONTROL patients received a standard tube-feed made of powdered raw materials. All received enteral nutrition over a maximum of 30 days. The number of defecations and the consistency of each stool according to the Bristol Stool Chart (BSC) were monitored. In addition, daily calories, liquids and antibiotic-use were recorded. 118 Patients who had suffered ischemic stroke, intracerebral hemorrhage, traumatic brain injury or hypoxic brain damage and requiring enteral nutrition were enrolled; 59 were randomized to receive the intervention and 59 control feed. There were no significant differences in clinical screening data, age, sex, observation period or days under enteral nutrition between the groups. Patients in both groups received equivalent amount of calories and fluids. In both groups antibiotics were frequently prescribed (69.5% in the INTERVENTION group and 75.7% in the CONTROL group) for 10-11 days on average. In comparison to the CONTROL group, patients in the INTERVENTION group had a significant reduction of the number of watery stool evacuations (type 7 BSC) (minus 61%, IRR = 0.39, p natural based food was effective in reducing the number of watery defecations and diarrhea in long term tube-fed critically ill neurological patients, compared to those fed with standard tube feeding. Copyright © 2018 The Authors. Published

  11. User perceptions of shared sanitation among rural households in Indonesia and Bangladesh.

    Science.gov (United States)

    Nelson, Kali B; Karver, Jonathan; Kullman, Craig; Graham, Jay P

    2014-01-01

    The practice of sharing sanitation facilities does not meet the current World Health Organization/UNICEF definition for what is considered improved sanitation. Recommendations have been made to categorize shared sanitation as improved sanitation if security, user access, and other conditions can be assured, yet limited data exist on user preferences with respect to shared facilities. This study analyzed user perceptions of shared sanitation facilities in rural households in East Java, Indonesia, and Bangladesh. Cross-sectional studies of 2,087 households in East Java and 3,000 households in Bangladesh were conducted using questionnaires and observational methods. Relative risks were calculated to analyze associations between sanitation access and user perceptions of satisfaction, cleanliness, and safety. In East Java, 82.4% of households with private improved sanitation facilities reported feeling satisfied with their place of defecation compared to 68.3% of households with shared improved facilities [RR 1.19, 95% CI 1.09, 1.31]. In Bangladesh, 87.7% of households with private improved facilities reported feeling satisfied compared to 74.5% of households with shared improved facilities [RR 1.15, 95% CI 1.10, 1.20]. In East Java, 79.5% of households who reported a clean latrine also reported feeling satisfied with their place of defecation; only 38.9% of households who reported a dirty latrine also reported feeling satisfied [RR 1.74, 95% CI 1.45, 2.08]. Simple distinctions between improved and unimproved sanitation facilities tend to misrepresent the variability observed among households sharing sanitation facilities. Our results suggest that private improved sanitation is consistently preferred over any other sanitation option. An increased number of users appeared to negatively affect toilet cleanliness, and lower levels of cleanliness were associated with lower levels of satisfaction. However, when sanitation facilities were clean and shared by a limited number

  12. Clinical Evaluation of Commiphora Mukul, a Botanical resin, in the Management of Hemorrhoids: A randomized controlled trial

    Science.gov (United States)

    Yousefi, Mahdi; Mahdavi, Mohammad Reza Vaez; Hosseini, Seyed Mousalreza; Bahrami, Abdollah; Davati, Ali; Kamalinejad, Mohammad; Faghihzadeh, Sograt

    2013-01-01

    Background: Hemorrhoids complaint is one of the most common problems in most society, especially in Asian countries. Current drug treatment protocols cannot cure the disease, and they are palliative. According to Persian traditional medicine, Commiphora Mukul (CM) resin is a medication choice. Aim: This randomized study was undertaken to evaluate the efficacy and safety of crude CM resin compared to a combination of lactolose and anti-hemorrhoid (LandA) in patients with uncomplicated hemorrhoids grade 1 and 2. Materials and Methods: This trial was carried out on 99 patients with hemorrhoids, in Ghaem and Imam Reaza Hospitals of the Mashhad University of Medical Sciences, Iran. They randomly received CM 3 g/d for 4 weeks (as study group) or LandA (Lactolose syrup in laxative dose for 1 month and anti-hemorrhoid suppository daily for 10 days) as control group. Subjective and objectives variables including painful defecation, flatulence, constipation, gastro-esophageal reflux (GER), dyspepsia, proctorrhagia, anal protrusion, and colonoscopic grading were assessed before, immediately after, and 4 weeks after the treatment period. An intent-to-treat analysis was used. Safety was assessed with evaluation of clinical adverse effects by common toxicity criteria version 4.0. Forty-nine patients were assigned randomly to receive LandA and 50 to receive CM. After 4 weeks, flatulence, dyspepsia, GER, and colonoscopic grading scores significantly decreased in study group, whereas in control group constipation, painful defecation, and proctorrhagia showed better but not significant improvement. After 4-weak follow-up, the rate of constipation, and proctorrhagia also showed significantly improvement in study group. Constipation and proctorrhagia in control group recurred significantly in 4-week follow-up than after the treatment, whereas this recurrence in test group was not seen. Conclusion: CM was more effective than LandA in 4-week treatment of patients with uncomplicated

  13. A unique resource mutualism between the giant Bornean pitcher plant, Nepenthes rajah, and members of a small mammal community.

    Directory of Open Access Journals (Sweden)

    Melinda Greenwood

    Full Text Available The carnivorous pitcher plant genus Nepenthes grows in nutrient-deficient substrates and produce jug-shaped leaf organs (pitchers that trap arthropods as a source of N and P. A number of Bornean Nepenthes demonstrate novel nutrient acquisition strategies. Notably, three giant montane species are engaged in a mutualistic association with the mountain treeshrew, Tupaia montana, in which the treeshrew defecates into the pitchers while visiting them to feed on nectar secretions on the pitchers' lids.Although the basis of this resource mutualism has been elucidated, many aspects are yet to be investigated. We sought to provide insights into the value of the mutualism to each participant. During initial observations we discovered that the summit rat, R. baluensis, also feeds on sugary exudates of N. rajah pitchers and defecates into them, and that this behavior appears to be habitual. The scope of the study was therefore expanded to assess to what degree N. rajah interacts with the small mammal community.We found that both T. montana and R. baluensis are engaged in a mutualistic interaction with N. rajah. T .montana visit pitchers more frequently than R. baluensis, but daily scat deposition rates within pitchers do not differ, suggesting that the mutualistic relationships are of a similar strength. This study is the first to demonstrate that a mutualism exists between a carnivorous plant species and multiple members of a small mammal community. Further, the newly discovered mutualism between R. baluensis and N. rajah represents only the second ever example of a multidirectional resource-based mutualism between a mammal and a carnivorous plant.

  14. Knowledge, attitudes and practices among parents and teachers about soil-transmitted helminthiasis control programs for school children in Guimaras, Philippines.

    Science.gov (United States)

    Parikh, Divya Sinha; Totañes, Francis I G; Tuliao, Alex H; Ciro, Raezelle N T; Macatangay, Bernard J C; Belizario, Vicente Y

    2013-09-01

    We determined the attitudes toward and practices regarding soil-transmitted helminthes (STH) control among parents and school teachers to identify reasons behind attitudes and practices that do not promote STH control. Written knowledge, attitudes and practices surveys were distributed to parents (N = 531) and teachers (N = 105) of students at 11 elementary schools in Guimaras Province, the Philippines. The survey addressed attitudes about mass drug administration (MDA), knowledge about STH control, hygienic practices, and acceptability of distributing deworming tablets among teachers. More than 90% of parents and teachers held favorable attitudes towards MDA. Sixty-nine percent of parents and 75.5% of teachers believed stool exams were necessary before MDA. Thirty-seven percent of parents stated they would not allow teachers to administer deworming tablets and 91.5% of parents feared teachers would not detect side effects of the medication. Forty-eight percent of teachers felt they could safely give deworming tablets and 81.4% of teachers were afraid of managing the side effects of deworming tablets. Forty-seven point eight percent of parents and 42.2% of teachers stated defecation in the open occured in their community. Although attitudes toward STH control were largely favorable, misconceptions about the MDA strategy, lack of support for teachers giving deworming tablets, and the practice of open defecation still exist as barriers to STH control efforts. The next step to achieve effective STH control will be to clarify misconceptions in education campaigns, to train teachers about medication administration, campaign to improve sanitation and hygiene and begin targeted mass treatment in Guimaras, the Philippines.

  15. The effect of two different Individually Ventilated Cage systems on anxiety-related behaviour and welfare in two strains of laboratory mouse.

    Science.gov (United States)

    Burman, O; Buccarello, L; Redaelli, V; Cervo, L

    2014-01-30

    The environment in which a laboratory animal is housed can significantly influence its behaviour and welfare, acting as a potential confounding factor for those studies in which it is utilised. This study investigated the impact of two Individually Ventilated Cage (IVC) housing systems on anxiety-related behaviour and welfare indicators in two common strains of laboratory mice. Subjects were juvenile female C57BL/6J and BALB/c mice (N=128) housed in groups of four in two different IVC systems for 7weeks. System One had air delivery at the cage 'cover' level at 75 ACH (Air Changes/Hour) and System Two had air delivery at the 'animal' level at 50 ACH. Mice were assessed twice a week (e.g. bodyweight) or at the end of the study (e.g. anxiety tests). Our results showed significant differences in anxiety-related behaviour between strains and housing systems. Mice in System Two, regardless of strain, defecated more in the Elevated Plus Maze (EPM), spent less time in the open arms of the EPM, and less time in the central zone of the Open Field (OF). Strain differences in anxiety-like behaviour were seen in the increased defecation by BALB/c mice in the OF and EPM and less time spent in the open arms of the EPM compared to C57BL/6J mice. These results suggest that different IVC housing systems can influence mouse behaviour in different ways, with mice of both strains studied exhibiting more anxiety-related behaviour when housed in System Two (air entry at the 'animal' level at 50 ACH), which could impact upon experimental data. © 2013. Published by Elsevier Inc. All rights reserved.

  16. Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome

    Directory of Open Access Journals (Sweden)

    Mojgan Forootan

    2018-03-01

    Full Text Available Solitary rectal ulcer syndrome (SRUS is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy. Endoscopic response to biofeedback treatment and clinical symptoms were investigated. Duration of symptoms was 43.11±36.42 months in responder and 63.9±45.74 months in non-responder group (P=0.22. There were more ulcers in non-responder group than responder group (1.50±0.71 versus 1.33±-0.71 before and 1.30 ± 0.95 versus 0.67±0.50 after biofeedback, although the difference was not significant (P=0.604, 0.10 respectively. The most prevalent symptoms were constipation (79%, rectal bleeding (68% and anorectal pain (53%. The most notable improvement in symptoms after biofeedback occured in abdominal pain and incomplete evacuation, and the least was seen in mucosal discharge and toilet waiting as shown in the bar chart. Endoscopic cure was observed in 4 of 10 patients of the non-responder group while 8 patients in responder group experienced endoscopic improvement. It seems that biofeedback has significant effect for pathophysiologic symptoms such as incomplete evacuation and obstructive defecation. Improvement of clinical symptoms does not mean endoscopic cure; so to demonstrate remission the patients have to go under rectosigmoidoscopy.

  17. The effect of perioperative probiotics treatment for colorectal cancer: short-term outcomes of a randomized controlled trial.

    Science.gov (United States)

    Yang, Yongzhi; Xia, Yang; Chen, Hongqi; Hong, Leiming; Feng, Junlan; Yang, Jun; Yang, Zhe; Shi, Chenzhang; Wu, Wen; Gao, Renyuan; Wei, Qing; Qin, Huanlong; Ma, Yanlei

    2016-02-16

    This study was designed to mainly evaluate the anti-infective effects of perioperative probiotic treatment in patients receiving confined colorectal cancer (CRC) respective surgery. From November 2011 to September 2012, a total of 60 patients diagnosed with CRC were randomly assigned to receive probiotic (n = 30) or placebo (n = 30) treatment. The operative and post-operative clinical results including intestinal cleanliness, days to first - flatus, defecation, fluid diet, solid diet, duration of pyrexia, average heart rate, length of intraperitoneal drainage, length of antibiotic therapy, blood index changes, rate of infectious and non-infectious complications, postoperative hospital stay, and mortality were investigated. The patient demographics were not significantly different (p > 0.05) between the probiotic treated and the placebo groups. The days to first flatus (3.63 versus 3.27, p = 0.0274) and the days to first defecation (4.53 versus 3.87, p = 0.0268) were significantly improved in the probiotic treated patients. The incidence of diarrhea was significantly lower (p = 0.0352) in probiotics group (26.67%, 8/30) compared to the placebo group (53.33%, 16/30). There were no statistical differences (p > 0.05) in other infectious and non-infectious complication rates including wound infection, pneumonia, urinary tract infection, anastomotic leakage, and abdominal distension. In conclusion, for those patients undergoing confined CRC resection, perioperative probiotic administration significantly influenced the recovery of bowel function, and such improvement may be of important clinical significance in reducing the short-term infectious complications such as bacteremia.

  18. Antidiarrheal activities of isovanillin, iso-acetovanillon and Pycnocycla spinosa Decne ex.Boiss extract in mice

    Science.gov (United States)

    Sadraei, H.; Ghanadian, M.; Asghari, G.; Azali, N.

    2014-01-01

    Isovanillin and iso-acetovanillon are two phenolic components isolated from a number of plants including Pycnocycla spinosa. P. spinosa extract has antispasmodic and antidiarrheal activities. However, no comparative study has been done on antidiarrheal action of isovanillin and iso- acetovanillon, so far. The aim of this study was to investigate antidiarrheal action of isovanillin and iso-acetovanillon and their effects on small intestinal transit, for comparison with propantheline. Male mice (25-30 g), fasted over night with free access to water, were treated with test compounds or control (p.o.). Thirty min later castor oil (0.5 ml) was given orally to the animals. In another groups of animals MgSO4 (0.5 ml of 10% solution) was given first and half an hour later the test drugs were administered. Onset and number of wet defecations were recorded for each animal over 3.5 h after treatment with diarrhoea inducing agents. In another groups, intestinal transit of charcoal meal was determined following administration of the compounds. Isovanillin (2 mg/kg & 5 mg/kg), iso-acetovanillon (2 mg/kg & 5 mg/kg) and P. spinosa extract (5 mg/kg) delayed onset of diarrhoea and significantly reduced wet defecation induced by castor oil and MgSO4. They all had antidiarrheal effect similar to propantheline (5 mg/kg). Isovanillin, iso-acetovanillon and P. spinosa extract compared to control groups, significantly reduced small intestinal transit of charcoal meal. This study shows that antidiarrheal effect of P. spinosa extract is at least partially due to presence of two active compounds isovanillin and iso-acetovanillon. PMID:25657776

  19. Improvement Effect of Dewaxed Brown Rice on Constipation in Antibiotic-treated Mice

    Science.gov (United States)

    INAGAWA, HIROYUKI; SAIKA, TOSHIYUKI; NISHIYAMA, NAOKI; NISIZAWA, TAKASHI; KOHCHI, CHIE; UENOBE, MAYA; SOMA, GEN-ICHIRO

    2017-01-01

    Background/Aim: A decrease in gastrointestinal motility causing weakened lipopolysaccharide (LPS) – toll-like receptor (TLR)4 signaling along with a decline in the number of enteric bacteria is known to be a cause of constipation due to the administration of antibiotics. A new type of brown rice with its wax layer removed, resulting in quick-cooking and tasty product, contains 100-times more LPS than polished white rice. In this study, the improvement effect on constipation due to intake of dewaxed brown rice was examined. Materials and Methods: Dewaxed brown rice was prepared at Toyo Rice from brown rice. Mice were given powdered feed to which powdered rice containing 0-50% of dewaxed brown rice was added. Antibiotics were administered for 10 or 27 days in drinking water containing vancomycin, metronidazole and neomycin. LPS, used as a control, was freely provided in drinking water. The defecation frequency, stool weight per hour and body weight were determined on the last day. Results: Although the 10-day administration of antibiotics reduced the stool weight per hour to half, the dewaxed brown rice and LPS groups showed a trend towards improvement at a level comparable to the group receiving no antibiotics. The body weight significantly decreased after the 27-day administration of antibiotics but was improved in the 50% dewaxed brown rice group at a level comparable to the group receiving no antibiotics. Though the defecation frequency and wet and dry stool weights per hour were reduced by as much as 50% in the group receiving antibiotics, a significant improvement in constipation was observed in the 50% dewaxed brown rice group. Conclusion: As the improvement effect of dewaxed brown rice on body weight loss and constipation caused by the long-term administration of antibiotics has been confirmed in animal experimentation, the introduction of dewaxed brown rice as a staple food to patients under long-term antibiotic treatment may improve constipation. PMID

  20. Risk Analysis of Typhoid Fever Based on Personal Hygiene and Street Food Consumption Habit at Home

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    Hilda Nuruzzaman

    2016-11-01

    Full Text Available Typhoid fever is disease caused by Salmonella typhi bacteria transmission trought contaminated food and drink. Data from RSUD dr. Abdoer Rahem showing that from 2011–2013 typhoid fever case always increase and often happened to children age 5–14 years old. The objective research to analysis risk factor of typhoid fever according to snacking habit at school and at house of children age 7–12 years old. This research was observasional case control study. Data for case in this research are taken from medical record of ‘Unit Teratai’ for the past 1 year in RSUD dr. Abdoer Rahem Situbondo, whereas for control are case group. There are eighty person taken for this research as sample. This result was the risk of typhoid fever children which has habit of hand washing had after defecation at home OR 3.67 (1.29 < OR < 10.64, children which has habit of hand washing before eating had OR 4.33 (1.54 < OR < 12.44, children with short dirty fingernails had OR 7.79 (1.46 < OR < 46.18 frequent street food consumption OR 3.89 (1.39 < OR < 11.06, buy snack at food street OR 3.95 (1.40 < OR < 11.30, buy some snack with packing had OR 3.5 (1.26 < OR < 9.38. The conclusion is that habit hand washing after defecation, habit hand washing before eating, short dirty fingernail, frequent food street consumption, buy food street and buy some food with sealed packing can secrease the risk of typhoid fever for children age 7–12 years Keywords: typhoid fever, risk factor of typhoid fever, personal hygiene, street food consumption habit

  1. A conceptual model of people's approach to sanitation

    Energy Technology Data Exchange (ETDEWEB)

    Avvannavar, Santosh M. [Center for Sustainable Technologies, Indian Institute of Science, Bangalore-560012, Karnataka (India)], E-mail: santosh@astra.iisc.ernet; Mani, Monto [Center for Sustainable Technologies, Indian Institute of Science, Bangalore-560012, Karnataka (India)

    2008-02-01

    Sanitation is a term primarily used to characterize the safe and sound handling (and disposal) of human excreta - or simply, people's approach to take-care of their (unavoidable) primal urge. According to the recent Human Development Report 2006 Global access to proper sanitation stands at approximately 58% with 37% being a conservative estimate both for South Asia and Sub-Saharan Africa. Various multi-million dollar sanitation programmes the world over have had little success, often due to inadequate understanding of people's sanitation approach. Sanitation approach includes the perception, feel and practices involved in satisficing the primal need to defecate and urinate (and their disposal). This paper presents a structure to understand the nature of psycho-socio-economic influences that determine societal approach to sanitation. Societies across the globe have evolved imbibing diverse influences attributed to the local environment, religion, cultural practices, war, etc. While a civilization's living environment reflects these influences in their built-environment characteristics, the influences are often deep-rooted and can be traced to the way the community members satisfice their need to defecate and urinate (sanitation approach). The objective of this paper is to trace the various approaches that diverse societies/civilizations, over time, across the world have had towards sanitation, and present a structure to articulate and understand determining factors. Sanitation also involves other domestic (solid and liquid) waste disposal but in the context of this paper the scope of sanitation has been restricted to human excreta alone. The structure presented and discussed in this paper would be useful in understanding a community better in terms of providing appropriate sanitation. It is hoped that this structure be considered as a basis for further refinement and detailed research into each of the factors determining people's sanitation

  2. Defecography

    International Nuclear Information System (INIS)

    Moon, Min Joo; Oh, Jae Whan; Kim, Hyun Shig; Lee, Jong Kyun

    1993-01-01

    To evaluate the results and clinical impact of defecography in patients with anorectal diseases, 304 defecographic examinations from 304 patients were reviewed. The defecographic results were screened for the anorectal angle and perineal descent at rest, squeezing and during straining. Changes of rectal configuration and canal width during straining were reviewed. 304 patients had defecation problems such as terminal constipation, defecation difficulty, blood or mucus discharge, tenesmus, obstruction sensation etc.. They were performed anorectal physical examination and anal manometry etc., and were later treated by operation and conservative management. Normal anorectal angle were measured to be 101 .deg., 91 .deg., 131 .deg. at rest, during squeezing and straining respectively. In the spastic pelvic floor syndrome, increase of anorectal angle less than 10 degrees from rest to straining was observed. Incontinent patients had a larger anorectal angle (mean: 128 .deg.) at rest. 7.8cm of perineal descent was found in descending perineal syndrome in comparison to 4.0cm in normal. Normal anal canal width was measured 1.4cm only during straining, but identified in incontinent patients at rest (mean: 1.2cm). Abnormal rectal configuration was found in 254 defecographic examinations: rectoceles were observed in 235 cases and were associated with rectal prolapse in 115 cases, and rectal prolapses were found in 134 cases. In conclusion, the anorectal angle was valuable in evaluation of spastic pelvic floor syndrome and fecal incontinence. Degree of perineal descent was abnormally increased in descending perineal syndrome. In the cases of the rectoceles and rectal prolapses, defecography is helpful in preoperative evaluation of rectal wall change and postoperative follow up

  3. Real world use of an Internet intervention for pediatric encopresis.

    Science.gov (United States)

    Ritterband, Lee M; Ardalan, Kaveh; Thorndike, Frances P; Magee, Joshua C; Saylor, Drew K; Cox, Daniel J; Sutphen, James L; Borowitz, Stephen M

    2008-06-30

    The Internet is a significant source of medical information and is now being shown to be an important conduit for delivering various health-related interventions. This paper aimed to examine the utility and impact of an Internet intervention for childhood encopresis as part of standard medical care in a "real world" setting. Patients diagnosed with encopresis were given a Web-based information prescription to use an Internet intervention for pediatric encopresis. A total of 22 families utilized the intervention between July 2004 and June 2006. A chart review and phone interview were undertaken to collect user characteristics; defecation-related information, including frequency of soiling, bowel movements (BMs) in the toilet, and amount of pain associated with defecation; and information on computer/Internet usage. Three questionnaires were used to examine the utility of, impact of, and adherence to the Internet intervention. Program utilization was obtained from a data tracking system that monitored usage in real time. Overall, parents rated the Internet intervention as enjoyable, understandable, and easy to use. They indicated that the Internet intervention positively affected their children, decreasing overall accidents and increasing child comfort on the toilet at home. Of the 20 children who initially reported fecal accidents, 19 (95%) experienced at least a 50% improvement, with a reduction of accident frequency from one fecal accident per day to one accident per week. Although it is not clear whether this improvement is directly related to the use of the Internet intervention, patient feedback suggests that the program was an important element, further establishing Internet interventions as a viable and desirable addition to standard medical care for pediatric encopresis. To our knowledge, this is the first time a pediatric Internet intervention has been examined as part of a "real world" setting. This is an important step toward establishing Internet

  4. Comparative efficacy of combination of 1 L polyethylene glycol, castor oil and ascorbic acid versus 2 L polyethylene glycol plus castor oil versus 3 L polyethylene glycol for colon cleansing before colonoscopy: Study protocol of a randomized, double-blind, single-center study.

    Science.gov (United States)

    Tian, Xu; Chen, Wei-Qing; Liu, Xiao-Ling; Chen, Hui; Liu, Bang-Lun; Pi, Yuan-Ping

    2018-04-01

    Colonoscopy has been regarded as an important method of early diagnosing and treating gastrointestinal lesions; however adequate bowel preparation is critical one of many factors needed for successful colonoscopy. Although several modified or novel regimes have been developed, desired quality of bowel preparation has not yet been generated. Scattered evidences revealed that castor oil may have potential of effectively cleansing colon. It is noted that, however, prospective trial of exploring the value of castor oil in preparing bowel before colonoscopy is lacking. The aims of this study are to test the hypotheses that low dose castor oil (30 mL) may enhance potential of polyethylene glycol (PEG) and combination of low castor oil and ascorbic acid may halve the volume of PEG.This is a randomized, double-blind (endoscopist and assessor), single center trial with three-arm design. We will randomly assign 282 adult patients (≥18 years but castor oil or combination of 1 L PEG, 30 mL castor oil and 5 g ascorbic acid. The bowel preparation quality based on Boston Bowel Preparation Scale (BBPS) is the primary outcome. The secondary outcomes include the first defecation time, total number of defecation, time of cecal intubation, detection rate of polyp and adenoma, willing to repeat the same regime, tolerance to regime, and adverse events.The study protocol has been approved by the Clinical Research Ethics Committees of Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital & Chongqing Cancer Center (2017[107]). The results from this trial will be submitted for publication in peer-reviewed journals, and will be presented at national and international conferences.

  5. EFFECT OF OXYTOCIN MASSAGE USING LAVENDER ESSENTIAL OIL ON PROLACTIN LEVEL AND BREAST MILK PRODUCTION IN PRIMIPAROUS MOTHERS AFTER CAESAREAN DELIVERY

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    Panglukies Ratna Agustie

    2017-08-01

    Full Text Available Background: Low milk production is one of the barries to exclusive breastfeeding. Oxytocin massage is considered as an alternative treatment, which combined with lavender essential oil as an aromatherapy. Objective: This study aims to examine the effect of oxytocin massage using lavender essential oil on the increase of levels of prolactin and milk production in primiparaous mothers after caesarean section. Methods: This was a quasi-experimental study with non-equivalent control group design conducted in October-December 2016 at the General Hospital of Dr.H. Soewondo Kendal. There were 32 recruited by consecutive sampling, divided to be intervention (16 participants and control group (16 participants. Prolactin hormone levels were measured using Enzyme-linked immunosorbent assay (ELIZA, breast milk production was measured based on the indicators of milk volume, urination and defecation frequency and sleep duration of babies; and infant’s weight was also measured by digital scale. Data were analyzed using Mann Whitney and Wilcoxon test. Results: The mean difference of prolactin hormone level in control group was 17.82 ng / ml while mean of difference of hormone prolactin level in intervention group was 132.13 ng / ml. There were statistically significant differences between intervention and control group in prolactin levels (p-value 0.000, milk volume (p-value 0.000, infant weight (p-value 0.000, urination frequency (p-value 0.017, defecation frequency (p-value 0.002, and infant sleep duration (p-value 0.000. Conclusion: There was a significant effect of the oxytocin massage using lavender essential oil on the increase of breast milk production and prolactin levels. Therefore, oxytocin massage using lavender essential oil can be used as an alternative treatment for midwives and other health professionals in an effort to increase milk production in postpartum.

  6. The increase of the fertility of soils using the liquid organic fertilizers and fertilizers based on sugar-beet wastes.

    Science.gov (United States)

    Vyborova, Oxana

    2010-05-01

    physical, physicochemical properties of soils, its air, water and thermal rate. Humic acids with mineral and organomineral particles of soil form the soil absorbent complex. The inclusion of humic fertilizers promotes the process when humic substances form a very valuable water-stable clumpy-granular structure, which improves water-carrying and water-holding capacity, its air permeability by agglutination of mineral particles with each other. The soils, where humic fertilizers are carried in soils regularly, are more stable for influence of chemical polluting substances (for example, radioactive nuclides, heavy metals, pesticides) than poor soils. The inclusion of humic fertilizers is very important in period of urbanization and cropping on the plough-lands not far from a big industrial area. The lignitic materials tie together the detrimental compounds formed the insoluble complex in soil solution. The detrimental compounds don't go into plants, subsoil waters and atmosphere. The lignitic watering of soils (in concentration from 0.1 to 0.01%) increases biological activity of soil in a man-caused zones and it promotes to stability of plants to detrimental emission of enterprises. Today the problem of processing of sugar-beet industry is very important. In the result of storing sugar-beet wastes the pollution of environment is occurred, examples of this pollution are gassing, salinization of soils and ground waters by filtrational sediments. One of these wastes is defecation sludge. The defecation sludge consists of CaCO3, organic matter, nitrogen, phosphorus, potassium and microelements. The technology of receiving N-Ca fertilizer based on defecate was developed because of impossibility of using this waste in pure form. For available data, using of these fertilizers improves the soil fertility and degree of pollution by heavy metals don't exceed an acceptance limits.

  7. Consequences of low or moderate prenatal ethanol exposures during gastrulation or neurulation for open field activity and emotionality in mice.

    Science.gov (United States)

    Schambra, Uta B; Nunley, Kevin; Harrison, Theresa A; Lewis, C Nicole

    In a previous study we used a mouse model for ethanol exposure during gastrulation or neurulation to investigate the effects of modest and occasional human drinking during the 3rd or 4th week of pregnancy (Schambra et al., 2015). Pregnant C57Bl/6J mice were treated by gavage during gastrulation on gestational day (GD) 7 or neurulation on GD8 with 2 doses 4h apart of either 2.4 or 2.9g ethanol/kg body weight, resulting in peak blood ethanol concentrations (BECs) of 104 and 177mg/dl, respectively. We found that mice exposed to the low dose on either day were significantly delayed in their neonatal sensorimotor development. In the present study, we tested the same cohort of mice in an open field as juveniles on postnatal day (PD) 23-25 and as young adults on PD65-67 for prenatal ethanol effects on exploration and emotionality with measures of activity, rearing, grooming and defecation. We evaluated the effects of dose, sex, day of treatment and day of birth by multiple regression analyses. We found that, compared to the respective gavage controls, juvenile mice that had been prenatally exposed to the low BEC on either GD7 or GD8 were significantly hypoactive on the first 2 test days, reared significantly more on the last 2 test days, and groomed and defecated significantly more on all 3 test days. Only mice that had been treated on GD7 remained hypoactive as adults. Juvenile mice prenatally exposed to the moderate BEC on GD7 groomed significantly more, while those exposed on GD8 reared and defecated significantly more. Sex differences were highly significant in adult control mice, with control males less active and more emotional than females. Similar, but smaller, sex differences were also evident in adults exposed to ethanol prenatally. Persistence into later life of a deleterious effect of premature birth (i.e., birth on GD19 rather than GD20) on weight and behavior was not consistently supported by these data. Importantly, mice shown previously to be delayed in

  8. Effect of Daikenchuto (TJ-100) on gastrointestinal symptoms following laparoscopic colectomy in patients with colon cancer: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Hoshino, Nobuaki; Kawada, Kenji; Hida, Koya; Wada, Toshiaki; Takahashi, Ryo; Yoshitomi, Mami; Sakai, Yoshiharu

    2017-11-21

    Postoperative paralytic ileus can be a difficult complication for both surgeons and patients. Causes and treatments have been discussed for more than two centuries, but have not yet been fully resolved. Daikenchuto (TJ-100, DKT) is a traditional Japanese herbal medicine. Recently, some beneficial mechanisms of DKT to relieve paralytic ileus have been reported. DKT can suppress inflammation, increase intestinal blood flow, and accelerate bowel movements. Therefore, we have designed a randomized controlled trial to investigate the effects of DKT on postoperative gastrointestinal symptoms following laparoscopic colectomy in patients with left-sided colon cancer at a single institution. As primary endpoints, the following outcomes will be evaluated: (i) grade of abdominal pain determined using the numeric rating scale (NRS), (ii) grade of abdominal distention determined using the NRS, and (iii) quality of life determined using the Gastrointestinal Quality Life Index (GIQLI). As secondary endpoints, the following will be evaluated: (i) postoperative nutritional status (Onodera's Prognostic Nutritional Index (PNI) and the Controlling Nutritional Status score (CONUT score)), (ii) duration to initial flatus, (iii) duration to initial defecation, (iv) bowel gas volume, (v) character of stool (Bristol Stool Form Scale), (vi) defecation frequency per day, (vii) postoperative complications (Clavien-Dindo classification), (viii) length of postoperative hospital stay, and (ix) metabolites in the stool and blood. This trial is an open-label study, and needs to include 40 patients (20 patients per group) and is expected to span 2 years. To our knowledge, this is the first randomized controlled trial to investigate the effects of DKT on postoperative subjective outcomes (i.e., postoperative quality of life) following laparoscopic colectomy as primary endpoints. Exploratory metabolomics analysis of metabolites in stool and blood will be conducted in this trial, which previously has

  9. (SWASH-D for Worms: A pilot study investigating the differential impact of school- versus community-based integrated control programs for soil-transmitted helminths.

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    Naomi E Clarke

    2018-05-01

    Full Text Available Soil-transmitted helminths (STH infect nearly 1.5 billion individuals globally, and contribute to poor physical and cognitive development in children. STH control programs typically consist of regular delivery of anthelminthic drugs, targeting school-aged children. Expanding STH control programs community-wide may improve STH control among school-aged children, and combining deworming with improvements to water, sanitation and hygiene (WASH may further reduce transmission. The (SWASH-D for Worms pilot study aims to compare the differential impact of integrated WASH and deworming programs when implemented at primary schools only versus when additionally implemented community-wide.A two-arm, non-randomized cluster intervention study was conducted. Six communities were identified by partner WASH agencies and enrolled in the study. All communities received a school-based WASH and deworming program, while three additionally received a community-based WASH and deworming program. STH infections were measured in school-aged children at baseline and six months after deworming. Over 90% of eligible children were recruited for the study, of whom 92.3% provided stool samples at baseline and 88.9% at follow-up. The school WASH intervention improved school sanitation, while the community WASH intervention reduced open defecation from 50.4% (95% CI 41.8-59.0 to 23.5% (95% CI 16.7-32.0. There was a trend towards reduced odds of N. americanus infection among children who received the community-wide intervention (OR 0.42, 95% CI 0.07-2.36, p = 0.32.This pilot study provides proof of principle for testing the hypothesis that community-wide STH control programs have a greater impact on STH infections among children than school-based programs, and supports the rationale for conducting a full-scale cluster randomized controlled trial. High recruitment and participation rates and successful implementation of school WASH programs demonstrate study feasibility and

  10. Polyethylene Glycol 3350 With Electrolytes Versus Polyethylene Glycol 4000 for Constipation: A Randomized, Controlled Trial.

    Science.gov (United States)

    Bekkali, Noor L H; Hoekman, Daniël R; Liem, Olivia; Bongers, Marloes E J; van Wijk, Michiel P; Zegers, Bas; Pelleboer, Rolf A; Verwijs, Wim; Koot, Bart G P; Voropaiev, Maksym; Benninga, Marc A

    2018-01-01

    The long-term efficacy and safety of polyethylene glycol (PEG) in constipated children are unknown, and a head-to-head comparison of the different PEG formulations is lacking. We aimed to investigate noninferiority of PEG3350 with electrolytes (PEG3350 + E) compared to PEG4000 without electrolytes (PEG4000). In this double-blind trial, children aged 0.5 to 16 years with constipation, defined as a defecation frequency of PEG3350 + E or PEG4000. Primary outcomes were change in total sum score (TSS) at week 52 compared to baseline, and dose range determination. TSS was the sum of the severity of 5 constipation symptoms rated on a 4-point scale (0-3). Noninferiority margin was a difference in TSS of ≤1.5 based on a 95%-confidence interval [CI]. Treatment success was defined as a defecation frequency of ≥3 per week with PEG3350 + E and PEG4000, respectively. Noninferiority criteria were not met (maximum difference between groups: -1.81 to 1.68). Daily sachet use was: 0 to 2 years: 0.4 to 2.3 and 0.9 to 2.1; 2 to 4 years: 0.1 to 3.5 and 1.2 to 3.2; 4 to 8 years: 1.1 to 2.8 and 0.7 to 3.8; 8 to 16 years 0.6 to 3.7 and 1.0 to 3.7, in PEG3350 + E and PEG4000, respectively. Treatment success after 52 weeks was achieved in 50% and 45% of children, respectively (P = 0.69). Rates of adverse events were similar between groups, and no drug-related serious adverse events occurred. Noninferiority regarding long-term constipation-related symptoms of PEG3350 + E compared to PEG4000 was not demonstrated. However, analysis of secondary outcomes suggests similar efficacy and safety of these agents.

  11. Developing robust arsenic awareness prediction models using machine learning algorithms.

    Science.gov (United States)

    Singh, Sushant K; Taylor, Robert W; Rahman, Mohammad Mahmudur; Pradhan, Biswajeet

    2018-04-01

    Arsenic awareness plays a vital role in ensuring the sustainability of arsenic mitigation technologies. Thus far, however, few studies have dealt with the sustainability of such technologies and its associated socioeconomic dimensions. As a result, arsenic awareness prediction has not yet been fully conceptualized. Accordingly, this study evaluated arsenic awareness among arsenic-affected communities in rural India, using a structured questionnaire to record socioeconomic, demographic, and other sociobehavioral factors with an eye to assessing their association with and influence on arsenic awareness. First a logistic regression model was applied and its results compared with those produced by six state-of-the-art machine-learning algorithms (Support Vector Machine [SVM], Kernel-SVM, Decision Tree [DT], k-Nearest Neighbor [k-NN], Naïve Bayes [NB], and Random Forests [RF]) as measured by their accuracy at predicting arsenic awareness. Most (63%) of the surveyed population was found to be arsenic-aware. Significant arsenic awareness predictors were divided into three types: (1) socioeconomic factors: caste, education level, and occupation; (2) water and sanitation behavior factors: number of family members involved in water collection, distance traveled and time spent for water collection, places for defecation, and materials used for handwashing after defecation; and (3) social capital and trust factors: presence of anganwadi and people's trust in other community members, NGOs, and private agencies. Moreover, individuals' having higher social network positively contributed to arsenic awareness in the communities. Results indicated that both the SVM and the RF algorithms outperformed at overall prediction of arsenic awareness-a nonlinear classification problem. Lower-caste, less educated, and unemployed members of the population were found to be the most vulnerable, requiring immediate arsenic mitigation. To this end, local social institutions and NGOs could play a

  12. Transrectal Drainage of Deep Pelvic Abscesses Using a Combined Transrectal Sonographic and Fluoroscopic Guidance

    International Nuclear Information System (INIS)

    Jeong, Kyung Soon; Lee, Eun Jung; Ko, Ji Ho; Joh, Young Duk; Jung, Gyoo Sik

    2005-01-01

    To evaluate the feasibility and clinical efficacy of transrectal drainage of a deep pelvic abscess using combined transrectal sonographic and fluoroscopic guidance. From March 1995 and August 2004, 17 patients (9 men; 8 women; mean age, 39 years) suffering from pelvic pain, fever and leukocytosis were enrolled in this retrospective study. Ultrasound (US) or computed tomography (CT), which was obtained prior to the procedure, showed pelvic fluid collections that were deemed unapproachable by the percutaneous trans abdominal routes. Transrectal drainage of the pelvic abscess was performed under combined transrectal sonographic and fluoroscopic guidance. The causes of the deep pelvic abscess were postoperative complications (n=7), complications associated with radiation (n=3) and chemotherapy (n=1) as well as unknown causes (n=6). A 7.5-MHz end-firing transrectal US probe with a needle biopsy guide attachment was advanced into the rectum. Once the abscess was identified, a needle was advanced via the biopsy guide and the abscess was punctured. Under US guidance, either a 0.018'or 0.035' guide wire was passed through the needle in the abscess. Under fluoroscopic guidance, the tract was dilated to the appropriate diameter with sequential fascial dilators, and a catheter was placed over the guide wire within the abscess. Clinical success of drainage was determined by a combination closure of the cavity on the follow up images and diminished leukocytosis. The technical and clinical success rate, complications, and patient's discomfort were analyzed. Drainage was technically successful in all patients and there were no serious complications. Surgery was eventually performed in two cases due to fistular formation with the rectum and leakage of the anastomosis site. The procedure was well tolerated in all but one patient who complained of discomfort while the catheter was inserted . The catheter did not interfere with defecation and there was no incidence of catheter

  13. TRREMS procedure (transanal repair of rectocele and rectal mucosectomy with one circular stapler: a prospective multicenter trial

    Directory of Open Access Journals (Sweden)

    José Vinicius Cruz

    2011-03-01

    Full Text Available CONTEXT: Since anorectocele is usually associated with mucosa prolapse and/or rectal intussusceptions, it was developed a stapled surgical technique using one circular stapler. OBJECTIVE: To report the results of Transanal Repair of Rectocele and Rectal Mucosectomy with one Circular Stapler (TRREMS procedure in the treatment of anorectocele with mucosa prolapse in a prospective multicenter trial. METHODS: It was conducted by 14 surgeons and included 75 female patients, mean aged 49.6 years, with symptoms of obstructed defecation due to grade 2 (26.7% and grade 3 (73.3% anorectocele associated with mucosa prolapse and/or rectal intussusception (52.0% and an average validated Wexner constipation score of 16. All patients were evaluated by a proctological examination, cinedefecography, anal manometry and colonic transit time. The TRREMS procedure consists of the manual removal of the rectocele wall with circumferential rectal mucosectomy performed with a circular stapler. The mean follow-up time was 21 months. RESULTS: All patients presented obstructed defecation and they persisted with symptoms despite conservative treatment. The mean operative time was 42 minutes. In 13 (17.3% patients, bleeding from the stapled line required hemostatic suture. Stapling was incomplete in 2 (2.6%. Forty-nine patients (65.3% required 1 hospitalization day, the remainder (34.7% 2 days. Postoperatively, 3 (4.0% patients complained of persistent rectal pain and 7 (9.3% developed stricture on the stapled suture subsequently treated by stricturectomy under anesthesia (n = 1, endoscopic stricturectomy with hot biopsy forceps (n = 3 and digital dilatation (n = 3. Postoperative cinedefecography showed residual grade I anorectoceles in 8 (10.6%. The mean Wexner constipation score decreased significantly from 16 to 4 (0-4: n = 68 (6: n = 6 (7: n = 1 (P<0.0001. CONCLUSION: Current trial results suggest that TRREMS procedure is a safe and effective technique for the treatment

  14. ARSH 1: Reproductive and sexual health problems of adolescents and young adults: a cross sectional community survey on knowledge, attitude and practice.

    Science.gov (United States)

    Nair, M K C; Leena, M L; Thankachi, Yamini; George, Babu; Russell, Paul Swamidhas Sudhakar

    2013-11-01

    To understand the problems faced and the difference in knowledge, attitude and practice of young people across the age group of 10-24 y on reproductive and sexual health issues and to get their suggestions regarding adolescent care services. This cross sectional community survey involving three districts in Kerala was conducted among adolescents and young adults of 10-24 y using a population proportion to sample size technique. The main problems faced by the young people between 10 and 24 y of age were financial, substance abuse in family, poor academic performance, difference of opinion, disease in self/family, mental problems, lack of talent, strict parents, difficulty in mingling, love failure, broken family, loneliness and problems at school/office in the descending order. As the age advances higher percentage of both boys (43.4%) and girls (61.7%) discuss reproductive sexual health issues among themselves. There was a statistically significant difference in personal hygiene practices like changing napkins/cloths more than once a day (94.3%), cleaning genital organs with soap every day (71.7%), washing after urination (69.2%), washing from front to back after defecation (62.2%) and washing hands with soap after defecation (73.2%) between 10-14, 15-19, and 20-24 y age group with higher percentages in the older groups. In order to make the service more useful, more of the older group participants suggested giving information on adolescent services to parents, adolescents and society as a whole by creating better societal acceptance and keeping confidentiality in service delivery. This study has shown an overall inadequacy in reproductive health knowledge in all age groups, but increasing knowledge gain and better attitude and practices on reproductive and sexual health as the age increases. The suggestions made by the group regarding need for adolescent reproductive sexual health (ARSH) and counseling services with privacy and confidentiality ensured, is useful

  15. Daily rhythms of food intake and feces reingestion in the degu, an herbivorous Chilean rodent: optimizing digestion through coprophagy.

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    Kenagy, G J; Veloso, C; Bozinovic, F

    1999-01-01

    Animals must match their foraging and digestion to seasonal changes in availability and quality of food. When these parameters decline, the animal's performance limits for extracting energy and nutrients may be challenged. In the laboratory, we investigated daily patterns of food processing on a low-quality (high-fiber) diet of alfalfa in an herbivorous, day-active rodent, the degu (Octodon degus), which inhabits semiarid central Chile. We manipulated timing of food availability, from continuous availability down to as little as 5 h/d. Degus maintained weight while digesting only 53% of dry-matter consumption. With food continuously available in a metabolic cage, the animals ate more food and deposited about twice as much feces in the day as at night. Continuous 24-h behavioral observation revealed that degus were actually defecating at the same rate both night and day but then ingesting most of the feces they produced at night. Further experimental treatments challenged animals with limited periods of food availability that matched natural foraging patterns. With either 11 h of daytime food availability or only 5 h (in morning and afternoon periods of 2.5 h each), degus consumed as much food as those with 24-h food availability. Continuous 24-h behavioral observations revealed in the 11-h group that nearly all feces produced at night were reingested and nearly none were reingested in the day, whereas the 5-h group resorted to further coprophagy during the 6-h midday interval with no food. Despite these differences in timing of food intake and coprophagy in response to the three experimental treatments, the degus were defecating at the same rate both night and day, which indicated a constant rate of output from the colon. This suggests a range of adjustments of digestive physiology to the timing of gut function by balancing coprophagy with ingestion of food. Overall, 38% of 24-h feces production was reingested, and 87% of this coprophagy occurred at night. The

  16. Patterns and determinants of communal latrine usage in urban poverty pockets in Bhopal, India.

    Science.gov (United States)

    Biran, A; Jenkins, M W; Dabrase, P; Bhagwat, I

    2011-07-01

    To explore and explain patterns of use of communal latrine facilities in urban poverty pockets. Six poverty pockets with communal latrine facilities representing two management models (Sulabh and municipal) were selected. Sampling was random and stratified by poverty pocket population size. A seventh, community-managed facility was also included. Data were collected by exit interviews with facility users and by interviews with residents from a randomly selected representative sample of poverty pocket households, on social, economic and demographic characteristics of households, latrine ownership, defecation practices, costs of using the facility and distance from the house to the facility. A tally of facility users was kept for 1 day at each facility. Data were analysed using logistic regression modelling to identify determinants of communal latrine usage. Communal latrines differed in their facilities, conditions, management and operating characteristics, and rates of usage. Reported usage rates among non-latrine-owning households ranged from 15% to 100%. There was significant variation in wealth, occupation and household structure across the poverty pockets as well as in household latrine ownership. Households in pockets with municipal communal latrine facilities appeared poorer. Households in pockets with Sulabh-managed communal facilities were significantly more likely to own a household latrine. Determinants of communal facility usage among households without a latrine were access and convenience (distance and opening hours), facility age, cleanliness/upkeep and cost. The ratio of male to female users was 2:1 across all facilities for both adults and children. Provision of communal facilities reduces but does not end the problem of open defecation in poverty pockets. Women appear to be relatively poorly served by communal facilities and, cost is a barrier to use by poorer households. Results suggest improving facility convenience and access and modifying fee

  17. Household sanitation and personal hygiene practices are associated with child stunting in rural India: a cross-sectional analysis of surveys

    Science.gov (United States)

    Rah, Jee Hyun; Cronin, Aidan A; Badgaiyan, Bhupendra; Aguayo, Victor M; Coates, Suzanne; Ahmed, Sarah

    2015-01-01

    Objectives Increasing evidence suggests that water, sanitation and hygiene (WASH) practices affect linear growth in early childhood. We determined the association between household access to water, sanitation and personal hygiene practices with stunting among children aged 0–23 months in rural India. Setting India. Participants A total of 10 364, 34 639 and 1282 under-2s who participated in the 2005–2006 National Family Health Survey (NFHS-3), the 2011 Hunger and Malnutrition Survey (HUNGaMA) and the 2012 Comprehensive Nutrition Survey in Maharashtra (CNSM), respectively, were included in the analysis. Primary outcome measures The association between WASH indicators and child stunting was assessed using logistic regression models. Results The prevalence of stunting ranged from 25% to 50% across the three studies. Compared with open defecation, household access to toilet facility was associated with a 16–39% reduced odds of stunting among children aged 0–23 months, after adjusting for all potential confounders (NHFS-3 (OR=0.84, 95% CI 0.71 to 0.99); HUNGaMA (OR=0.84, 95% CI 0.78 to 0.91); CNSM (OR=0.61, 95% CI 0.44 to 0.85)). Household access to improved water supply or piped water was not in itself associated with stunting. The caregiver's self-reported practices of washing hands with soap before meals (OR=0.85, 95% CI 0.76 to 0.94) or after defecation (OR=0.86, 95% CI 0.80 to 0.93) were inversely associated with child stunting. However, the inverse association between reported personal hygiene practices and stunting was stronger among households with access to toilet facility or piped water (all interaction terms, phygiene practices are associated with reduced prevalence of stunting in rural India. Policies and programming aiming to address child stunting should encompass WASH interventions, thus shifting the emphasis from nutrition-specific to nutrition-sensitive programming. Future randomised trials are warranted to validate the causal

  18. Household sanitation and personal hygiene practices are associated with child stunting in rural India: a cross-sectional analysis of surveys.

    Science.gov (United States)

    Rah, Jee Hyun; Cronin, Aidan A; Badgaiyan, Bhupendra; Aguayo, Victor M; Coates, Suzanne; Ahmed, Sarah

    2015-02-12

    Increasing evidence suggests that water, sanitation and hygiene (WASH) practices affect linear growth in early childhood. We determined the association between household access to water, sanitation and personal hygiene practices with stunting among children aged 0-23 months in rural India. India. A total of 10 364, 34 639 and 1282 under-2s who participated in the 2005-2006 National Family Health Survey (NFHS-3), the 2011 Hunger and Malnutrition Survey (HUNGaMA) and the 2012 Comprehensive Nutrition Survey in Maharashtra (CNSM), respectively, were included in the analysis. The association between WASH indicators and child stunting was assessed using logistic regression models. The prevalence of stunting ranged from 25% to 50% across the three studies. Compared with open defecation, household access to toilet facility was associated with a 16-39% reduced odds of stunting among children aged 0-23 months, after adjusting for all potential confounders (NHFS-3 (OR=0.84, 95% CI 0.71 to 0.99); HUNGaMA (OR=0.84, 95% CI 0.78 to 0.91); CNSM (OR=0.61, 95% CI 0.44 to 0.85)). Household access to improved water supply or piped water was not in itself associated with stunting. The caregiver's self-reported practices of washing hands with soap before meals (OR=0.85, 95% CI 0.76 to 0.94) or after defecation (OR=0.86, 95% CI 0.80 to 0.93) were inversely associated with child stunting. However, the inverse association between reported personal hygiene practices and stunting was stronger among households with access to toilet facility or piped water (all interaction terms, phygiene practices are associated with reduced prevalence of stunting in rural India. Policies and programming aiming to address child stunting should encompass WASH interventions, thus shifting the emphasis from nutrition-specific to nutrition-sensitive programming. Future randomised trials are warranted to validate the causal association. Published by the BMJ Publishing Group Limited. For permission to use

  19. In vivo translocation and toxicity of multi-walled carbon nanotubes are regulated by microRNAs

    Science.gov (United States)

    Zhao, Yunli; Wu, Qiuli; Li, Yiping; Nouara, Abdelli; Jia, Ruhan; Wang, Dayong

    2014-03-01

    We employed an in vivo Caenorhabditis elegans assay system to perform SOLiD sequencing analysis to identify the possible microRNA (miRNA) targets of multi-walled carbon nanotubes (MWCNTs). Bioinformatics analysis on targeted genes for the identified dysregulated miRNAs in MWCNT exposed nematodes demonstrates their involvement in many aspects of biological processes. We used loss-of-function mutants for the identified dysregulated miRNAs to perform toxicity assessment by evaluating functions of primary and secondary targeted organs, and found the miRNA mutants with susceptible or resistant property towards MWCNT toxicity. Both the physiological state of the intestine and defecation behavior were involved in the control of the susceptible or resistant property occurrence for specific miRNA mutants towards MWCNT toxicity. This work provides the molecular basis at the miRNA level for future chemical design to reduce the nanotoxicity of MWCNTs and further elucidation of the related toxicological mechanism.We employed an in vivo Caenorhabditis elegans assay system to perform SOLiD sequencing analysis to identify the possible microRNA (miRNA) targets of multi-walled carbon nanotubes (MWCNTs). Bioinformatics analysis on targeted genes for the identified dysregulated miRNAs in MWCNT exposed nematodes demonstrates their involvement in many aspects of biological processes. We used loss-of-function mutants for the identified dysregulated miRNAs to perform toxicity assessment by evaluating functions of primary and secondary targeted organs, and found the miRNA mutants with susceptible or resistant property towards MWCNT toxicity. Both the physiological state of the intestine and defecation behavior were involved in the control of the susceptible or resistant property occurrence for specific miRNA mutants towards MWCNT toxicity. This work provides the molecular basis at the miRNA level for future chemical design to reduce the nanotoxicity of MWCNTs and further elucidation of the

  20. Role of the employment status and education of mothers in the prevalence of intestinal parasitic infections in Mexican rural schoolchildren

    Directory of Open Access Journals (Sweden)

    Hagan Paul

    2006-09-01

    Full Text Available Abstract Background Intestinal parasitic infections are a public health problem in developing countries such as Mexico. As a result, two governmental programmes have been implemented: a "National Deworming Campaign" and b "Opportunities" aimed at maternal care. However, both programmes are developed separately and their impact is still unknown. We independently investigated whether a variety of socio-economic factors, including maternal education and employment levels, were associated with intestinal parasite infection in rural school children. Methods This cross-sectional study was conducted in 12 rural communities in two Mexican states. The study sites and populations were selected on the basis of the following traits: a presence of activities by the national administration of albendazole, b high rates of intestinal parasitism, c little access to medical examination, and d a population having less than 2,500 inhabitants. A total of 507 schoolchildren (mean age 8.2 years were recruited and 1,521 stool samples collected (3 per child. Socio-economic information was obtained by an oral questionnaire. Regression modelling was used to determine the association of socio-economic indicators and intestinal parasitism. Results More than half of the schoolchildren showed poliparasitism (52% and protozoan infections (65%. The prevalence of helminth infections was higher in children from Oaxaca (53% than in those from Sinaloa (33% (p Giardia duodenalis and Hymenolepis nana showed a high prevalence in both states. Ascaris lumbricoides, Trichuris trichiura and Entamoeba hystolitica/dispar showed low prevalence. Children from lower-income families and with unemployed and less educated mothers showed higher risk of intestinal parasitism (odds ratio (OR 6.0, 95% confidence interval (CI 1.6–22.6; OR 4.5, 95% CI 2.5–8.2; OR 3.3, 95% CI 1.5–7.4 respectively. Defecation in open areas was also a high risk factor for infection (OR 2.4, 95% CI 2.0–3

  1. Functional Disoders of Gastreointestinal System

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    H Shafagh

    2014-04-01

    Full Text Available Based on Rome III criteria, functional disorders of GI are listed below:   Infant regurgitation: -regurgitation two or more times per day for 3 or more weeks -no retching, hematemesis, aspiration, apnea, FTT, abnormal posturing Infant rumination syndrome: -repetitive contraction of abdominal muscle -regurgitation of gastric content in to the mouth and reswallowed Cyclic vomiting syndrome: -Two or more periods of intense nausea and vomiting lasting hours to days  and return    to usual state of health lasting weeks to months Infant colic: -paroxysms of irritability, or crying that start and stop without obvious cause - episodes lasting 3 or more hours pre day and occurring at least 3 days per week for at least 1 week Infant Dyschesia: In a child less than 6 months old, must include: - At least 10 minutes of straing and crying before successful passage of soft stools Functional dyspepsia: - Persistent or recurrent discomfort centered in the upper abdomen - Not  relieved by defecation -No evidence of an inflammatory or other causes that explains the symptoms -Criteria fulfilled at least once per week for at least 2 months Irritable bowel syndrome: -Abdominal discomfort associated with two or more of the following -Improvement with defecation -Change in frequency of stool -Change in form of stool -No evidence of an inflammatory or other causes that explain the symptoms -Criteria fulfilled at least once per week for at least 2 month Functional diarrhea, functional constipation, aerophagia,  abdominal migraine, functional abdominal pain,   are other  functional  GI disorders.                                                                                 

  2. Comparison between dynamic cystocolpoproctography and dynamic pelvic floor MRI: pros and cons: which is the "functional" examination for anorectal and pelvic floor dysfunction?

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    Maglinte, Dean D T; Hale, Douglass S; Sandrasegaran, Kumar

    2013-10-01

    "Functional" imaging of anorectal and pelvic floor dysfunction has assumed an important role in the diagnosis and management of these disorders. Although defecography has been widely practiced for decades to evaluate the dynamics of rectal emptying, debate concerning its clinical relevance, how it should be done and interpreted continues. Due to the recognition of the association of defecatory disorders with pelvic organ prolapse in women, the need to evaluate the pelvic floor as a unit has arisen. To meet this need, defecography has been extended to include not only evaluation of defecation disorders but also the rest of the pelvic floor by opacifying the small bowel, vagina, and the urinary bladder. The term "dynamic cystocolpoproctography" (DCP) has been appropriately applied to this examination. Rectal emptying performed with DCP provides the maximum stress to the pelvic floor resulting in complete levator ani relaxation. In addition to diagnosing defecatory disorders, this method of examination demonstrates maximum pelvic organ descent and provides organ-specific quantification of organ prolapse, information that is only inferred by means of physical examination. It has been found to be of clinical value in patients with defecation disorders and the diagnosis of associated prolapse in other compartments that are frequently unrecognized by history taking and the limitations of physical examination. Pelvic floor anatomy is complex and DCP does not show the anatomical details pelvic magnetic resonance imaging (MRI) provides. Technical advances allowing acquisition of dynamic rapid MRI sequences has been applied to pelvic floor imaging. Early reports have shown that pelvic MRI may be a useful tool in pre-operative planning of these disorders and may lead to a change in surgical therapy. Predictions of hypothetical increase cancer incidence and deaths in patients exposed to radiation, the emergence of pelvic floor MRI in addition to questions relating to the

  3. Gastrointestinal symptoms of infantile colic and their change after light needling of acupuncture: a case series study of 913 infants

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    Ullman Dacil

    2011-08-01

    Full Text Available Abstract Background Infantile colic is a common painful clinical condition associated with signs of distended intestines and an increase in colon peristalsis. However, clinical documentation of observed gastrointestinal functions in the condition is still lacking. Even though the ailment is common, no clear treatment guidelines exist. While acupuncture with minimal stimulation has been shown to be effective in reducing crying behaviour of infants suffering from colic, the documented effect of acupuncture on gastrointestinal function in children with infantile colic is scarce. This case series study aims to document the symptoms of routinely rated gastrointestinal function and the changes in these symptoms after minimal acupuncture in a larger group of children with infantile colic. Methods This study included 913 infants with normal weights, and lengths at birth. The infants' mean age was 5.4 weeks when the observations started, and had colic symptoms since two weeks after birth. Light needling stimulation of the acupuncture point LI4 was performed for 10-20 seconds bilaterally on a daily basis for a mean of 6.2 consecutive days. A questionnaire with verbal rating scales for the parents' evaluation was used before and after the treatment period. Results Before treatment the infants were assessed by the parents in terms of 'often have inflated stomachs' (99% and 'seldom drool' (76%, 'regurgitate' (53% and 'belch' (62%. Moreover, the reported frequency of defecation was 5-8 times per day (64%, with a yellowish-green colour (61% and with a water-thin consistency (74%. After treatment, the variables of inflated stomachs, drooling and regurgitating were systematically changed, and rated by the parents as occurring 'sometimes' while belching was rated as occurring 'often' and the frequency of defecation was reduced to 1-4 times/day with a mustard yellow colour and a gruel-like consistency. The parents also rated their impression of the infants

  4. Ingestive behavior of crossbred Santa Inês sheep fed water with different salinity levels

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    José Helder Andrade de Moura

    2016-04-01

    Full Text Available The objective of the present study was to evaluate the effect of four water salinity levels on the ingestive behavior of non-castrated crossbred Santa Inês sheep. Thirty-two non-castrated crossbred Santa Inês sheep in feedlot, at seven months of age and initial average weight of 21.76±1.25 kg, were used in the experiment. The experimental design was completely randomized, with four treatments and eight replicates. Four concentrations of salts in the water fed to the animals were evaluated: low (640 mg/l; medium (3,188 mg/l; high (5,740 mg/l and very high (8,326 mg/l levels of total dissolved solids (TDS. For the ingestive behaviors, the animals were observed every ten minutes, for 24 hours, to determine the time spent feeding, ruminating and idle. Also, cud chewing and the average number of defecations and urinations and the frequency of water ingestion were determined. The time spent feeding, ruminating and idle were not changed by the salinity levels in the water. Dry matter intake, neutral detergent fiber intake, total chewing time, total cud chews per day, number of daily meals, average duration of each meal and number of defecations per day did not change either. However, feeding and rumination efficiency in grams of DM/h, water intake and number of urinations were linearly affected, whereas the variables rumination efficiency in grams of NDF/h, grams of dry matter per cud, grams of neutral detergent fiber per cud, number of cuds, number of chews per cud and chewing time per cud presented quadratic effect. The different levels of total dissolved solids (640; 3,188; 5,740; and 8.326 mg/l in the water fed to the sheep did not cause alterations in their ingestive behavior. In conclusion, water with up to 8,326 mg TDS/l can be an alternative strategic and seasonal method to water crossbred Santa Ines sheep.

  5. Geographical inequalities in use of improved drinking water supply and sanitation across Sub-Saharan Africa: mapping and spatial analysis of cross-sectional survey data.

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    Rachel L Pullan

    2014-04-01

    Full Text Available Understanding geographic inequalities in coverage of drinking-water supply and sanitation (WSS will help track progress towards universal coverage of water and sanitation by identifying marginalized populations, thus helping to control a large number of infectious diseases. This paper uses household survey data to develop comprehensive maps of WSS coverage at high spatial resolution for sub-Saharan Africa (SSA. Analysis is extended to investigate geographic heterogeneity and relative geographic inequality within countries.Cluster-level data on household reported use of improved drinking-water supply, sanitation, and open defecation were abstracted from 138 national surveys undertaken from 1991-2012 in 41 countries. Spatially explicit logistic regression models were developed and fitted within a Bayesian framework, and used to predict coverage at the second administrative level (admin2, e.g., district across SSA for 2012. Results reveal substantial geographical inequalities in predicted use of water and sanitation that exceed urban-rural disparities. The average range in coverage seen between admin2 within countries was 55% for improved drinking water, 54% for use of improved sanitation, and 59% for dependence upon open defecation. There was also some evidence that countries with higher levels of inequality relative to coverage in use of an improved drinking-water source also experienced higher levels of inequality in use of improved sanitation (rural populations r = 0.47, p = 0.002; urban populations r = 0.39, p = 0.01. Results are limited by the quantity of WSS data available, which varies considerably by country, and by the reliability and utility of available indicators.This study identifies important geographic inequalities in use of WSS previously hidden within national statistics, confirming the necessity for targeted policies and metrics that reach the most marginalized populations. The presented maps and analysis approach

  6. Study of Relationship between Hypernatremia in Neonates and Way of Maternal Breast Feeding

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    H Boskabadi

    2014-04-01

    Full Text Available Introduction: The extreme reduction in breast milk intake during the first days of life leads to weight loss, kidney failure and hypernatremia. The aim of this study was to examine the relationship between hypernatremia in neonates and way of maternal breastfeeding in hospitalized infants in Ghaem Hospital of Mashhad.   Materials and Methods: After obtaining parental consent, 687 infants referred to the neonatal ward and clinic of Ghaem hospital of Mashhad participated in this cross-sectional study. First, complete history of the mother and baby regarding pregnancy and delivery problems, way of breastfeeding, and the first time of lactation beginning were obtained. Then neonates were divided into two groups of normal and hypernatremia (sodium≥150 mg/dl according to the amount of blood sodium level. Data was analyzed using correlation tests, chi-square, t test and Mann-Whitney tests with SPSS software (version 11.5.   Results: According to the findings of this study, the average age (P=0.911, Apgar scores (P=0.192, time of the first lactation (P=0.081 and breast feeding duration (P=o.108 showed no statistically significant difference between normal and hypernatremia groups. But the admission weight (P=0.011, times of lactation (P=0.108, breast-feeding status (P=0.001, let down reflex in mother’s breast (0.001, kind of nutrition (P=o.oo1, breast filling after childbirth and lactation (P=0.000, and breast softening after breast-feeding (P=0.000, urination frequency (P=0.000, defecation frequency (P=0.000 and duration of maternal hospitalization (P=0.007 showed statistically significant difference between the groups.   Conclusion: Neonatal weight control, times of lactation, lactation status, breast changes during breast feeding and frequency of urination and defecation may be effective in the early detection of the reduced breast milk intake and the control of the related complications.   Key Words: Breast Feedinf, Breast Milk

  7. Xiaozhi decoction reduced posthemorrhoidectomy pain and analgesic medication consumption: a prospective study

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    Shen JB

    2017-01-01

    Full Text Available Jianbin Shen,1,* Xiagang Luo,2,* Xiao Zhou,3 Chengwu Tang,1 Huanyu Ju,2 Yongqiang Xu,1 Lianjin Qin1 1Department of General Surgery, First People’s Hospital Affiliated to Huzhou Normal College, Huzhou, Zhejiang, 2Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 3Department of Orthopedics, People’s Hospital of Zhangqiu, Jinan, Shandong, People’s Republic of China *These authors contributed equally to this work Objective: The aim of this study was to investigate the effect of Xiaozhi decoction (XZD on posthemorrhoidectomy pain and analgesic medication consumption.Methods: From May 2013 to March 2015, 315 patients who underwent open hemorrhoidectomy in our hospital were enrolled in this study, of whom, 160 patients were randomly assigned to accept sitz bath with warm water after hemorrhoidectomy (control group and 155 patients were randomly assigned to accept sitz bath with XZD (XZD group after hemorrhoidectomy. Postoperative pain at 12 hours after surgery and on postoperative days (PODs 1, 2, 7, 14 and 28 was evaluated by Visual Analog Scale (VAS. Pain on defecation on PODs 1, 2, 7, 14 and 28 was also recorded using the VAS. The consumption of analgesics was also analyzed.Results: No significant difference was found in baseline characteristics between the two groups. Postoperative pain score of the XZD group was significantly lower on POD 2 (6.04±1.11 vs 6.33±1.14, P=0.0229, POD 7 (3.35±0.75 vs 4.22±0.87, P=0.0000 and POD 14 (2.87±0.64 vs 3.64±0.77, P=0.0000 than that of the control group. Similarly, patients in the XZD group experienced significantly less pain on defecation on POD 2 (5.02±1.34 vs 5.43±1.56, P=0.0130, POD 7 (3.08±1.17 vs 3.52±1.29, P=0.0017 and POD 14 (2.31±0.85 vs 2.68±0.99, P=0.0004. Patients in the XZD group consumed significantly less analgesic medication on POD 2 (P=0.0136, POD 7 (P=0.0074 and POD 14 (P=0.0046 than the control group. Conclusion

  8. Self-reported postoperative recovery in children after tonsillectomy compared to tonsillotomy.

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    Eriksson, Mats; Nilsson, Ulrica; Bramhagen, Ann-Cathrine; Idvall, Ewa; Ericsson, Elisabeth

    2017-05-01

    Tonsil surgery is associated with significant morbidity during recovery. Patient-reported outcome measures (PROM) are the golden standard for the planning and follow-up of delivered care, which should also be an axiom for children. The current aims were to describe self-reported postoperative recovery in children after tonsil surgery, and to compare tonsillotomy and tonsillectomy in this respect. In total, 238 children (4-12 years old) with a history of obstructive problems and/or recurrent tonsillitis, and undergoing tonsil surgery were included. Forty-eight per cent were operated with partial tonsil resection/tonsillotomy (TT) and 52% with total tonsillectomy (TE), all in day surgery. Postoperative recovery was assessed on days 1, 4 and 10 using the validated self-rating instrument PRiC, Postoperative Recovery in Children. This includes 23 items covering different aspects of recovery after tonsil surgery. A higher score indicates worse status in the respective items. Daily life activities (sleeping, eating and playing), physical symptoms (e.g., headache, stomach ache, sore throat, otalgia, dizziness, nausea, defecation, urination), and emotional aspects (sadness, frightening dreams) were affected during the recovery period. The TE-girls showed higher scores than the boys regarding stomach ache, defecation and dizziness. Children above 6 years of age reported higher values for the physical comfort variables, while the younger group showed worse emotional states. Postoperative recovery improved from day 1-10 in all surgical groups. The TE-group showed lower recovery compared to the TT-group (p < 0.01-0.001) in most items. The goal of postoperative management is to minimize or eliminate discomfort, facilitating the recovery process and avoiding complications. Children are able to describe their recovery, and thus, PRiC seems to be able to serve as a PROM to obtain patient-centered data after tonsil surgery. The recovery process after TT causes less postoperative

  9. Randomised controlled trial of biofeedback training in persistent encopresis with anismus.

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    Nolan, T; Catto-Smith, T; Coffey, C; Wells, J

    1998-08-01

    Paradoxical external anal sphincter contraction during attempted defecation (anismus) is thought to be an important contributor to chronic faecal retention and encopresis in children. Biofeedback training can be used to teach children to abolish this abnormal contraction. A randomised controlled trial in medical treatment resistant and/or treatment dependent children with anismus using surface electromyographic (EMG) biofeedback training to determine whether such training produces sustained faecal continence. Up to four sessions of biofeedback training were conducted at weekly intervals for each patient. Anorectal manometry was performed before randomisation and six months later. Parents of patients completed the "child behaviour checklist" (CBCL) before randomisation and at follow up. Sixty eight children underwent anorectal manometry and EMG. Of these, 29 had anismus (ages 4-14 years) and were randomised to either EMG biofeedback training and conventional medical treatment (BFT) (n = 14) or to conventional medical treatment alone (n = 15). All but one child were able to learn relaxation of the external anal sphincter on attempted defecation. At six months' follow up, laxative free remission had been sustained in two of 14 patients in the BFT group and in two of 15 controls (95% confidence interval (CI) on difference, -24% to 26%). Remission or improvement occurred in four of 14 patients in the BFT group and six of 15 controls (95% CI on difference, -46% to 23%). Of subjects available for repeat anorectal manometry and EMG at six months, six of 13 in the BFT group still demonstrated anismus v 11 of 13 controls (95% CI on difference, -75% to -1%). Of the four patients in full remission at six months, only one (in the BFT group) did not exhibit anismus. Rectal hyposensitivity was not associated with remission or improvement in either of the groups. Mean CBCL total behaviour problem scores were not significantly different between the BFT and control groups, but there

  10. Antidiarrhoeal and antimicrobial activity of Calpurnia aurea leaf extract

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    Umer Shemsu

    2013-01-01

    Full Text Available Abstract Background In Ethiopia, Calpurnia aurea is used for the treatment of syphilis, malaria, rabies, diabetes, hypertension, diarrhoea, leishmaniasis, trachoma, elephantiasis, fungal diseases and different swellings. However, despite its traditional usage as an antidiarrhoeal and antimicrobial agent, there is limited or no information regarding its effectiveness and mode of action in diarrhoea which may be caused by Shigella flexneri, Staphylococcus aureus, Escherichia coli and Salmonella typhi. Hence, we evaluated the 80% methanol (MeOH extract of dried and powdered leaves of C. aurea for its antidiarrhoeal and antimicrobial activities. Methods Swiss albino mice of either sex were divided into five groups (five/group: Group I served as control and received vehicle (1% Tween 80 at a dose of 10 ml/kg orally; Group II served as standard and received loperamide at the dose of 3 mg/kg orally; Groups III, IV and V served as test groups and received the 80% MeOH leaf extract of C. aurea at doses of 100, 200 and 400 mg/kg orally, respectively. Diarrhoea was induced by oral administration of 0.5 ml castor oil to each mouse, 1 h after the above treatments. During an observation period of 4 h, time of onset of diarrhea, total number of faecal output (frequency of defecation and weight of faeces excreted by the animals were recorded. Data were analyzed using one way analysis of variance followed by Tukey post test. Antimicrobial activity test was conducted using agar well diffusion assay. Clinical isolates tested were Salmonella typhi, Salmonella paratyphi, Salmonella typhimurium, Shigella species, Pseudomonas aeruginosa, Staphylococcus aureus and Escherichia coli. Results In castor oil induced diarrhea model, the 80% methanol leaf extract of C. aurea at 100, 200 and 400 mg/kg and the standard drug loperamide (3 mg/kg significantly reduced the time of onset of diarrhea, the frequency of defecation (total number of faecal output and weight of faeces. C

  11. Geographical Inequalities in Use of Improved Drinking Water Supply and Sanitation across Sub-Saharan Africa: Mapping and Spatial Analysis of Cross-sectional Survey Data

    Science.gov (United States)

    Pullan, Rachel L.; Freeman, Matthew C.; Gething, Peter W.; Brooker, Simon J.

    2014-01-01

    Background Understanding geographic inequalities in coverage of drinking-water supply and sanitation (WSS) will help track progress towards universal coverage of water and sanitation by identifying marginalized populations, thus helping to control a large number of infectious diseases. This paper uses household survey data to develop comprehensive maps of WSS coverage at high spatial resolution for sub-Saharan Africa (SSA). Analysis is extended to investigate geographic heterogeneity and relative geographic inequality within countries. Methods and Findings Cluster-level data on household reported use of improved drinking-water supply, sanitation, and open defecation were abstracted from 138 national surveys undertaken from 1991–2012 in 41 countries. Spatially explicit logistic regression models were developed and fitted within a Bayesian framework, and used to predict coverage at the second administrative level (admin2, e.g., district) across SSA for 2012. Results reveal substantial geographical inequalities in predicted use of water and sanitation that exceed urban-rural disparities. The average range in coverage seen between admin2 within countries was 55% for improved drinking water, 54% for use of improved sanitation, and 59% for dependence upon open defecation. There was also some evidence that countries with higher levels of inequality relative to coverage in use of an improved drinking-water source also experienced higher levels of inequality in use of improved sanitation (rural populations r = 0.47, p = 0.002; urban populations r = 0.39, p = 0.01). Results are limited by the quantity of WSS data available, which varies considerably by country, and by the reliability and utility of available indicators. Conclusions This study identifies important geographic inequalities in use of WSS previously hidden within national statistics, confirming the necessity for targeted policies and metrics that reach the most marginalized populations. The

  12. [Open-field behavioral study in rat hyperlipidemia combined with chronic unpredictable mild stress model].

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    Hu, Hua; Zhang, Yingchun; Xu, Yeqing; Liu, Chunfeng; Wang, Liwei

    2015-06-16

    To investigate behavioral changes in a rat hyperlipidemia model induced by high lipid feed combined with depression by Chronic Unpredictable Mild Stress (CUMS). A total of 40 rats were randomly divided into control (CON), control feed for 9 weeks followed by CUMS for 4 weeks (CON + CUMS), high fat diet (HFD) and high lipid feed for 9 weeks followed by CUMS for 4 weeks (HFD + CUMS) (n = 10 each). Open-field test was individually measured at baseline, week 9 and week 13. (1) Serum lipids: total cholesterol [(2.67 ± 0.04) mmol/L, (2.68 ± 0.02) mmol/L] and low density lipoprotein [(1.08 ± 0.03) mmol/L, (1.06 ± 0.01) mmol/L] of HFD and HFD + CUMS were both significantly higher than those of CON and CON + CUMS [(1.78 ± 0.12) mmol/L, (0.79 ± 0.04) mmol/L; (1.76 ± 0.09) mmol/L, (0.76 ± 0.06) mmol/L, all P Open-field test: at week 13, compared to CON rats, CON + CUMS rats exhibited enhanced locomotor activity during the first minute, reduced activity in the center squares and rearing, and increased the number of grooming and defecation (all P < 0.05). In comparison to the CON rats, a decrease in total squares in 5 min, central squares and peripheral squares was observed in HFD rats at week 13 (all P < 0.05). However, compared with HFD, CON, CON + CUMS rats, when high lipid feed for 9 weeks combined with depression, significant decrease activities in total squares in 5 min, central squares and peripheral squares were observed in HFD + CUMS rats at week 13. Besides these, the number of rearing was reduced, however, locomotor activity during the first minute and the number of grooming and defecation was significantly increased (all P < 0.001). Under uncontrolled hyperlipidemia, severe depressive symptoms will present more early once exposure to a series of chronic stressors followed by significant autonomic nervous dysfunctional symptoms.

  13. Geographical inequalities in use of improved drinking water supply and sanitation across Sub-Saharan Africa: mapping and spatial analysis of cross-sectional survey data.

    Science.gov (United States)

    Pullan, Rachel L; Freeman, Matthew C; Gething, Peter W; Brooker, Simon J

    2014-04-01

    Understanding geographic inequalities in coverage of drinking-water supply and sanitation (WSS) will help track progress towards universal coverage of water and sanitation by identifying marginalized populations, thus helping to control a large number of infectious diseases. This paper uses household survey data to develop comprehensive maps of WSS coverage at high spatial resolution for sub-Saharan Africa (SSA). Analysis is extended to investigate geographic heterogeneity and relative geographic inequality within countries. Cluster-level data on household reported use of improved drinking-water supply, sanitation, and open defecation were abstracted from 138 national surveys undertaken from 1991-2012 in 41 countries. Spatially explicit logistic regression models were developed and fitted within a Bayesian framework, and used to predict coverage at the second administrative level (admin2, e.g., district) across SSA for 2012. Results reveal substantial geographical inequalities in predicted use of water and sanitation that exceed urban-rural disparities. The average range in coverage seen between admin2 within countries was 55% for improved drinking water, 54% for use of improved sanitation, and 59% for dependence upon open defecation. There was also some evidence that countries with higher levels of inequality relative to coverage in use of an improved drinking-water source also experienced higher levels of inequality in use of improved sanitation (rural populations r = 0.47, p = 0.002; urban populations r = 0.39, p = 0.01). Results are limited by the quantity of WSS data available, which varies considerably by country, and by the reliability and utility of available indicators. This study identifies important geographic inequalities in use of WSS previously hidden within national statistics, confirming the necessity for targeted policies and metrics that reach the most marginalized populations. The presented maps and analysis approach can provide a

  14. Behavioral pattern of Rohilkhandi kids under different feeding systems

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    Anjali Kumari

    2016-07-01

    Full Text Available Aim: The present study designed to evaluate the effect of different feeding systems on the behavior of local Rohilkhandi kids. Materials and Methods: A total of 21 growing goats (local goat of Rohilkhand region, weighing around 7-11 kg and aging 4-5 months, were used. These animals were kept in three groups. Group I was fed un-chopped green fodder in circular feeder (newly designed. Group II was fed un-chopped green fodder in linear feeder that was similar to the existing farm practice. Group III was fed chopped green fodder in linear feeder (modified version. Amount of concentrate and dry fodder fed was kept constant for all the three groups subject to equal increment in accordance with their increasing age. Adlibitum green fodder was made available to the animals. The experiment was conducted for 3 months. On-going behavior was recorded each day 4 h (2 h in the morning from 9:00 am to 11:00 am, after offering the feed, and same was repeated for 2 h in the afternoon, i.e., from 2:00 pm to 4:00 pm was made between 9 am and 5 pm. The individual behaviors, viz., feeding, drinking, lying down, ruminating, idling, butting, pressing, pushing, frontal clashing, and physical displacement at feed barrier (active and passive: Without physical contact of the goat were recorded using time-sampling method. Further, incidental activities such as defecation and urination were also recorded. Results: Among all the groups, butting, head to head, and pushing were the common agonistic behavior found but values did not differ significantly. The pushing while feeding was relatively less in Group II (0.22±0.04 min which differed significantly (p<0.05 from the other two groups. The idling time was found significantly (p<0.05 lower in Group II (1.68±0.21 as compared to Group I (4.67±0.52 and Group III (4.27±0.56. Time spent in rumination near the feeding trough as well as away from the feeding trough was also significantly higher in Group I (p<0.05 than the other

  15. Differential Gene Expression Profile in the Rat Caudal Vestibular Nucleus is Associated with Individual Differences in Motion Sickness Susceptibility.

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    Jun-Qin Wang

    Full Text Available To identify differentially expressed genes associated with motion sickness (MS susceptibility in the rat caudal vestibular nucleus.We identified MS susceptible (MSS and insusceptible (inMSS rats by quantifying rotation-induced MS symptoms: defecation and spontaneous locomotion activity. Microarray analysis was used to screen differentially expressed genes in the caudal vestibular nucleus (CVN after rotation. Plasma stress hormones were identified by radioimmunoassay. Candidate genes were selected by bioinformatics analysis and the microarray results were verified by real-time quantitative-PCR (RT-qPCR methods. By using Elvax implantation, receptor antagonists or recombinant adenovirus targeting the candidate genes were applied to the CVN to evaluate their contribution to MS susceptibility variability. Validity of gene expression manipulation was verified by RT-qPCR and western blot analysis.A total of 304 transcripts were differentially expressed in the MSS group compared with the inMSS group. RT-qPCR analysis verified the expression pattern of candidate genes, including nicotinic cholinergic receptor (nAchR α3 subunit, 5-hydroxytryptamine receptor 4 (5-HT4R, tachykinin neurokinin-1 (NK1R, γ-aminobutyric acid A receptor (GABAAR α6 subunit, olfactory receptor 81 (Olr81 and homology 2 domain-containing transforming protein 1 (Shc1. In MSS animals, the nAchR antagonist mecamylamine significantly alleviated rotation-induced MS symptoms and the plasma β-endorphin response. The NK1R antagonist CP99994 and Olr81 knock-down were effective for the defecation response, while the 5-HT4R antagonist RS39604 and Shc1 over-expression showed no therapeutic effect. In inMSS animals, rotation-induced changes in spontaneous locomotion activity and the plasma β-endorphin level occurred in the presence of the GABAAR antagonist gabazine.Our findings suggested that the variability of the CVN gene expression profile after motion stimulation might be a putative

  16. Immune response is required for the control of in vivo translocation and chronic toxicity of graphene oxide

    Science.gov (United States)

    Wu, Qiuli; Zhao, Yunli; Fang, Jianpeng; Wang, Dayong

    2014-05-01

    Graphene oxide (GO) shows great promise as a nanomaterial for medical applications; however, the mechanism for its long-term adverse effects is still largely unclear. Here, we show that chronic GO exposure not only caused damage on the function of both primary and secondary targeted organs but also induced severe accumulation of pathogenic microbial food (OP50) in the intestine of Caenorhabditis elegans, a non-mammalian alternative toxicity assay system. GO accumulated in the intestine could be largely co-localized with OP50 and induced decreased immune response of animals. In contrast, feeding with UV-treated OP50 suppressed GO toxicity and accumulation in the intestine and maintained the relatively normal immune response of animals. The severe accumulation of OP50 in the intestine might be partially due to the damage by GO on the development and function of AVL and DVB neurons controlling defecation behavior. Reduction of chronic GO toxicity by PEG surface modification largely resulted from the inhibition of OP50 accumulation in the intestine and the maintenance of normal immune response. Our results highlight the key role of innate immunity in regulating in vivo chronic GO toxicity, which will be helpful for our understanding of the interactions between nanomaterials and biological systems during the long-term development of animals.Graphene oxide (GO) shows great promise as a nanomaterial for medical applications; however, the mechanism for its long-term adverse effects is still largely unclear. Here, we show that chronic GO exposure not only caused damage on the function of both primary and secondary targeted organs but also induced severe accumulation of pathogenic microbial food (OP50) in the intestine of Caenorhabditis elegans, a non-mammalian alternative toxicity assay system. GO accumulated in the intestine could be largely co-localized with OP50 and induced decreased immune response of animals. In contrast, feeding with UV-treated OP50 suppressed GO

  17. Determinants of child anthropometric indicators in Ethiopia.

    Science.gov (United States)

    Ahmadi, Davod; Amarnani, Ekta; Sen, Akankasha; Ebadi, Narges; Cortbaoui, Patrick; Melgar-Quiñonez, Hugo

    2018-05-15

    Malnutrition is one of the major contributors to child mortality in Ethiopia. Currently established, child nutrition status is assessed by four anthropometric indicators. However, there are other factors affecting children's anthropometric statuses. Thus, the main objective of this paper is to explore some of the determinants of child anthropometric indicators in Ethiopia. Data from GROW (the Growing Nutrition for Mothers and Children), a survey including 1261 mothers and 1261 children was carried out in Ethiopia in 2016. Based on the data gathered, the goal of GROW is to improve the nutritional status of women of reproductive age (15-49), as well as boys and girls under 5 years of age in Ethiopia. In order to investigate the association between different factors and child anthropometric indicators, this study employs various statistical methods, such as ANOVA, T-test, and linear regressions. Child's sex (confidence intervals for (wasting = - 0.782, - 0.151; stunting = - 0.936,-0.243) (underweight = - 0.530, - 0.008), child's age (confidence intervals for (wasting = - 0.020, 0.007; stunting = - 0.042,-0.011) (underweight = - 0.025, - 0.002), maternal MUAC (confidence intervals for (wasting = 0.189, 0.985; BMI-for-age = 0.077, 0.895), maternal education (stunting = 0.095, 0.897; underweight = 0.120, 0.729), and open defecation (stunting = 0.055, 0.332; underweight = 0.042, 0.257) were found to be significantly associated with anthropometric indicators. Contrary to some findings, maternal dietary diversity does not present significance in aforementioned child anthropometric indicators. Depending on the choice of children anthropometric indicator, different conclusions were drawn demonstrating the association between each factor to child nutritional status. Results showed child's sex, age, region, open defecation, and maternal MUAC significantly increases the risk of child anthropometric indicators

  18. Randomised controlled trial of biofeedback training in persistent encopresis with anismus

    Science.gov (United States)

    Nolan, T.; Catto-Smith, T.; Coffey, C.; Wells, J.

    1998-01-01

    BACKGROUND—Paradoxical external anal sphincter contraction during attempted defecation (anismus) is thought to be an important contributor to chronic faecal retention and encopresis in children. Biofeedback training can be used to teach children to abolish this abnormal contraction.
METHODS—A randomised controlled trial in medical treatment resistant and/or treatment dependent children with anismus using surface electromyographic (EMG) biofeedback training to determine whether such training produces sustained faecal continence. Up to four sessions of biofeedback training were conducted at weekly intervals for each patient. Anorectal manometry was performed before randomisation and six months later. Parents of patients completed the "child behaviour checklist" (CBCL) before randomisation and at follow up.
RESULTS—Sixty eight children underwent anorectal manometry and EMG. Of these, 29 had anismus (ages 4-14 years) and were randomised to either EMG biofeedback training and conventional medical treatment (BFT) (n = 14) or to conventional medical treatment alone (n = 15). All but one child were able to learn relaxation of the external anal sphincter on attempted defecation. At six months' follow up, laxative free remission had been sustained in two of 14 patients in the BFT group and in two of 15 controls (95% confidence interval (CI) on difference, −24% to 26%). Remission or improvement occurred in four of 14 patients in the BFT group and six of 15 controls (95% CI on difference, −46% to 23%). Of subjects available for repeat anorectal manometry and EMG at six months, six of 13 in the BFT group still demonstrated anismus v 11 of 13 controls (95% CI on difference, −75% to −1%). Of the four patients in full remission at six months, only one (in the BFT group) did not exhibit anismus. Rectal hyposensitivity was not associated with remission or improvement in either of the groups. Mean CBCL total behaviour problem scores were not significantly different

  19. Protective effects of novel organic selenium compounds against oxidative stress in the nematode Caenorhabditis elegans

    Directory of Open Access Journals (Sweden)

    Sílvio Terra Stefanello

    2015-01-01

    Full Text Available Organic selenium compounds possess numerous biological properties, including antioxidant activity. Yet, the high toxicity of some of them, such as diphenyl diselenide (DPDS, is a limiting factor in their current usage. Accordingly, we tested four novel organic selenium compounds in the non-parasite nematode Caenorhabditis elegans and compared their efficacy to DPDS. The novel organic selenium compounds are β-selenoamines 1-phenyl-3-(p-tolylselanylpropan-2-amine (C1 and 1-(2-methoxyphenylselanyl-3-phenylpropan-2-amine (C2 and analogs of DPDS 1,2-bis(2-methoxyphenyldiselenide (C3 and 1,2-bisp-tolyldiselenide (C4. Synchronized worms at the L4 larval stage were exposed for one hour in M9 buffer to these compounds. Oxidative stress conditions were induced by juglone (200 μM and heat shock (35 °C. Moreover, we evaluated C. elegans behavior, GST-4::GFP (glutathione S-transferase expression and the activity of acetylcholinesterase (AChE. All tested compounds efficiently restored viability in juglone stressed worms. However, DPDS, C2, C3 and C4 significantly decreased the defecation cycle time. Juglone-induced GST-4::GFP expression was not attenuated in worms pretreated with the novel compounds, except with C2. Finally, AChE activity was reduced by DPDS, C2, C3 and C4. To our knowledge, this is study firstly showed the effects of C1, C2, C3 and C4 selenium-derived compounds in C. elegans. Low toxic effects were noted, except for reduction in the defecation cycle, which is likely associated with AChE inhibition. The juglone-induced stress (reduced viability was fully reversed by compounds to control animal levels. C2 was also efficient in reducing the juglone-induced GST-4::GFP expression, suggesting the latter may mediate the stress induced by this compound. Future studies could be profitably directed at addressing additional molecular mechanisms that mediate the protective effects of these novel organic selenium compounds.

  20. Micronutrientes: una opción en el tratamiento de las enfermedades diarreicas agudas

    Directory of Open Access Journals (Sweden)

    Carlos Coronel Carbajal

    2000-12-01

    Full Text Available Se realizó un estudio longitudinal y prospectivo a 126 pacientes que ingresaron al Servicio de Diarreas Agudas del Hospital General Docente "Armando Enrique Cardoso", en el período comprendido entre junio de 1998 y enero de 1999. A 71 pacientes se les ofrecieron microelementos (vitamina A, sulfato de zinc y fumarato ferroso con el objetivo de conocer los beneficios de los microelementos en la enfermedad diarreica aguda. Al concluir el estudio se pudo comprobar que el grupo de pacientes suplementados tuvo una estadía más corta y la duración del episodio fue menor. Además se halló que en estos pacientes el número de deposiciones es menor, así como la afectación nutricional. También se comprobó cómo la recuperación nutricional es mucho más rápida, así como la recuperación del apetito. Se pudo mostrar cómo la consistencia de las deposiciones al tercer día de tratamiento, en el grupo que recibió micronutrientes, mejoró.A longitudinal and prospective study was conducted among 126 patients that were admitted in the Service of Acute Diarrheas of "Armando Enrique Cardoso" General Teaching Hospital between June, 1998, and January, 1999. 71 patients were administered microelements (vitamin A, zinc sulfate and ferrous fumarate in order to know their benefits in the acute diarrheal disease. On concluding the study, it was proved that the length of stay and the episode were shorter in the group of supplemented patients. It was also observed that the number of defecations as well as the nutritional affectation were lower in these patients and that the nutritional recovery and the recuperation of appetite were faster. The consistency of the defecations improved on the third day of treatment in the group that received micronutrients.