The New Nation - Internet Edition

-Jamayet Ali

Lemon grass is a large, coarse, glaucous grass found wild in many places, including by the side of the rivers, ditches, canals etc. It also grows wild in forests and specially in Chitagong Hill Tracts. Eminent Scientist (late) Prof. Dr. Nurul Absar Khan, ex-Chainnan, Bangladesh Council of Scientific and Industrial Research (BCSIR), successfully developed high yielding varieties of Lemon grass L G I C L-77 while serving as the Director, Dhaka Laboraties and Chitagong Laboratories after total 16 years of hard experiments. This variety of Lemon grass is able to yield 0.69 to 0.85 % oil which is now being cultivated in many parts of the country. Lemon grass oil is largely used in cosmetic industries. Lemon grass is also cultivated in India, Srilanka, Singapore and other tropical countries. It rarely or never bears flowers. Its botanical name is Andropogon citratus.

Medicinal Properties: Lemon grass oil is an important ingredient in preparing medicine under Ayurvedic and Unani system. When pure it is of a pale sherry colour, transparent, with an extremely pungent taste, and a peculiar fragrant lemon like odour. The properties atributed to it are stimulant, carminative, antispasmodic, and diaphoretic; locally it is a rubefacient It is recommended to be administered in flatulent and spasmodic affections of the bowels and in gastric irritability. In cholera it has been

spoken highly of as a remedy of great value, allaying and arresting the vomiting, and aiding the process of reaction. Dr. Waring, in the appendix to the Indian Pharmacopoeia, records a high testimony in its favour both as an external application in rheumatism and in other painful affections, and as a stimulant and diaphoretic internally. He states that among the Indo-Britons of South India, it is one of their most highly esteemed remedies in cholera. Dr. Ross, in the same notice, reports very favourably of a warm infusion prepared by macerating about four ounces of the leaves in a pint of hot water. This he has used very successfully as a diaphoretic in febrile affections, especially in weakly subjects, or when the fever is of a typhoid type.

Special Opinions: "Infusion of the leaves (tea) is largely used as an agreeable sudorific in mild cases of fever, and as a medicinal vapour bath for the same purpose. It is often combined with Mentha arvensis, when used with the above object" (Assistant Surgeon Sakharam Arjun Ravat, Bombay.) "Taken internally, in some parts of India, in the fonn of an infusion like tea or with milk, it is said to be a stimulant and diaphoretic. The vapour of a hot infusion is inhaled by fever patients to produce diaphoresis" (Surgeon W. Barren, Bhuj, Cutch, Bombay). "An infusion of the leaves (known as "lemon tea") is very refreshing." (Honorary Surgeon P. Kinsley, Chicacole, Ganjam, Madras.) "The roots and tender leaves are sometimes given with black pepper in cases of disordered menstruation and in the congestive and neuralgic form of dysrnenonrrhola. The oil is useful in flatulent colic and other spasmodic affections of the bowels, and as an application in chronic rheumatism, &c." (Brigade Surgeon J.H. Thornton, B.A., M.B., Monghyr.) "Carminative and tonic to the intestinal mucus membrane, useful in vomiting and diarrhoea, externally it forms a useful liniment" (Surgeon-Major Henry David Cook, Malabar.) "Lemon grass oil, applied with prolonged friction, is a pleasant and useful application in lumbago." (H. De Tatham).

Kantanatey

Kantanatey is an erect, glabrous, herbaceous weed with a hard main stem having many grooved branches with sharp divaricate spines, ovate or lanceolate leaves, numerous sessile flowers interminal and axillary dense or interrupted spikes, grows wild in all parts of Bangladesh. It also grows in India, Srilanka and other many tropical countries. The leaves make a good spinach and pot-herb, through the sharp spines in their axles are troublesome to pick. The poor among the natives use the leaves as pot-herbs, especially in times of scarcity. Its botanical name is Amarantus spinosus.

Medicinal Properties: The plant is cooling; digestible, alecteric, laxative, diuretic, stomachic, antipyretic; improves the appetite; useful in "kapha" and biliousness, blood diseases, burning sensation, hallucination, leprosy, bronchitis, rat-bite, piles, leucorrhoea. The root is heating, expectorant; lessens the menstrual flow; useful in leucorrhoea and leprosy (Ayurveda). The root is considered a specific in gonorrhoea. It is used in menorrhagia and eczema; and as a poultice it is applied to buboes and abscesses for hastening suppuration. it is also considered a lactagogue and a specific for colic. The boiled leaves and roots are given to children as a laxative; they are applied as an emollient poultice to abscesses, boils, and burns. The whole plant is used in the treatment of snake-bite; but no part of it is an antidote to snake-venom. In Cambodia, the root is used internally as a diuretic, sudorific and febrifuge. In the Gold Coast, it is used as an enema for stomac trouble and the Krobos use it for curing piles. In Madagascar, the root is considered diuretic, laxative and galactagogue. The root ground in water is applied to eczematous skin. The ash of the plant is applied topically to fungating chancre. In La Reunion, the herb is usud as a refiigerant and diuretic. For blennorrhagia the root is chewed and its decoction is drunk. (Indian Medicinal Plants, K.R. Kirtikar & B.D. Basu, Vol.-Ill, 2557, 2558) .

Medicine: The whole plant is used as an antidote for snake-poison, and the root as a specific for colic. The root has been found useful in the treatment of gonorrhoea: it is said to arrest the discharge.

Special Opinions: "Hindu physicians prescribe the root in combination with other drugs in menorrhagia. A poultice of the leaves was officinal in the Bengal Pharmacopoeia." (Dymock's Mat Med., W. Ind.) It is also considered a lactagogue, and, boiled with pulse, is given to cows. "The root has lately been introduced into European practice as a remedy for gonorrhoea, and is advertised by some of the London druggists." (Surgeon-Major Dymock.) "Roots made into poultice are applied to buboes and abscesses for hastening suppuration. (Surgeon Anund Chunder Muketri, Noakhally). "Supposed to be an excellent remedy for gonorrhoea. Dose of the decoction of the root one to two oz." (Surgeon W. Barren, Bhuj, Cutch.) "Kanta nutia is a cooling diuretic. An infusion in hot water I have used in some cases of gonorrhoea. It lessens burning and relieves pain." (Surgeon R.L. Dut, M.D., Pabna.) "Used frequently for colic pain and for scorpion-bite." Surgeon C.J.W. Meadows, Barisal.) "Emollient and used in the form of poultice." (Deputy Surgeon-General G. Bidie, Madras.) "Given to cows as a lactagogue." (Asst Surgeon Shib Chunder Bhutacharji, Chanda, Central Provinces.) (Dictionary of the Economic Products of India, Wat, Vol.!)

Properties and uses: Plant is febrifuge, antipyretic, laxative, stomachic, appetiser and diuretic. It is used in treating blood diseases, hallucination, bronchitis, leprosy, leucorrhoea and piles. Decoction of leaves and roots are used as laxative and as emollient poultice to abscesses, boils and burns. They are also used in constipation, flatulence, jaundice and gonorrhoea and in treating rat-bites. Root is heating and expectorant It reduces menstrual flow and is specific for gonorrhoea. Root is also used in leucorrhoea, menorrhagia and eczema. Pollen extract is useful in allergic asthma or allergic rhinitis in human patients. (Medicinal Plants of Bangladesh, Abdul Ghani, Second Edition, 90).

Dr. Vernon Coleman

Doctors, medical researchers and drug companies like to persuade all present and potential consumers of health care that medicine is a science and has advanced far beyond the mystical incantations and witch doctor remedies of the past But modern medicine is not a science and modern clinicians and medical researchers are not scientists. Modern clinicians may use scientific techniques but in the way that they treat their patients they are still quacks.

The foundation of modern, 20th century medical thinking is the Cartesian principle that although the mind and the body are linked they are essentially separate entities. Accordingly, doctors treat the lesion or the organ that they believe to be failing to function properly rather than the patient, his or her fears, and symptoms. They organise laboratory tests and then believe that by treating abnormalities they are acting scientifically.

But since doctors have very litle idea of what 'normal' blood levels are (since they ever measure the blood levels of people who are ill) the success of treatment is usually measured by how successful the doctor is at changing the laboratory results rather than at making the patient beter. When a patient complains of pain the doctor does tests to find out why, but doesn't treat the pain because that would interfere with the results of the tests. Meanwhile, the patient suffers so much from the pain that s/he becomes even more severely ill. With that sort of background it is hardly surprising that the reputation of allopathic medicine as a healing branch of science is crumbling rapidly. Too many modern doctors neither cure nor care.

The modern clinician and the medical researcher base their opinions and conclusions almost exclusively on subjective observations and wishful expectations, which are likely to be based on inaccurate historical perspectives and experimental experiences with members of another species.

Superstition and suspicion are the principal foundations of 20th century medical science. Error is built upon error and unproven theories are used as building blocks for new ideas. Assumptions, prejudices and hearsay compete with subjective observations and personal interpretations of symptoms and signs for the doctor's atention and allegiance. To be truly scientific, doctors would have to subordinate their personal opinions to impartial knowledge gained by analysis and experimentation; but if they did this doctors would lose the mystique and authority, which has traditionally been a part of the medicine man's armoury. By becoming scientists, doctors would become technicians and lose their god-like powers.

In true science an idea is born and then tested before conclusions are drawn. Without testing there can be no science and an idea can never be more than an opinion or a hypothesis. True scientists will do everything they can to disprove their hypotheses, excluding probability, chance, coincidence and the placebo effect, and ignoring pride, vanity and all commercial pressures in their search for the truth. Sadly such devotion is rare indeed within the world of medicine. All too frequently doctors use case reports as testimonials. They will admit that all patients are different and then they will draw conclusions about the treatment of thousands of patients from single case reports published in a medical journal. Statistics are essential for determining probabilities, for making predictions and for choosing the best possible remedy, but doctors frequently use their own interpretations of statistics. A doctor will say: "I have seen 300 patients with this disease over the last 5 years and this treatment or that remedy is best" He will forget that (???)ably never considered and he will ignore the fact that some of his patients may have died and many of them may have got no beter. When case histories are viewed subjectively the mind of the viewer can and often will lie and distort in order to protect the viewer's pride and vanity. Most patients probably assume that when a doctor proposes to use an established treatment to conquer a disease he will be using a treatment which has been tested, examined and proven. But this is not the case. The savage truth is that most medical research is organised, paid for, commissioned or subsidised by the drug industry (and the food, tobacco and alcohol industries). This type of research is designed, quite simply, to find evidence showing a new product is of commercial value. The companies which commission such research are not terribly bothered about evidence; what they are looking for are conclusions which will enable them to sell their product Drug company sponsored research is done more to get good reviews than to find out the truth.

Today's medical training is based upon pronouncement and opinion rather than on investigation and scientific experience. In medical schools students are bombarded with information but denied the time or the opportunity to question the ex-cathedra statements which are made from an archaic medical culture. Time and again new treatments and new techniques are introduced on a massive scale without there being any scientific support for them and without doctors knowing what the long term consequences are likely to be. Instead of experimenting and then practising tried and trusted techniques, modern medical practitioners use all their patients as guinea pigs and practice their black art as a massive international experiment

High dose contraceptive pills were prescribed for years for millions of patients without anyone knowing exactly what was likely to happen. When it became clear that such pills were killing hundreds of women lower dose contraceptive pills were introduced. As I pointed out in the 1960s, we still don't know what effect the contraceptive pill is likely to have on the children of women who took it Medicine doesn't anticipate disasters - it simple reacts to them. This sort of approach can hardly be described as 'scientific'.

Three specific examples illustrate how medical techniques are adopted on a mass scale without doctors having any idea what is likely to happen to the patients who are involved. The use of drugs to lower blood cholesterol levels, for example. If you have a high level of cholesterol in your blood should you try to do something about it - such as taking a drug? Or van lowering your blood cholesterol level prove more dangerous than leaving it alone?

For years now many doctors and patients have believed that a patient who has a high blood cholesterol level will probably be more likely to suffer from heart trouble, high blood pressure or a stroke. Millions of pounds have been spent on screening patients for blood cholesterol levels. And many patients have been frightened half to death by finding out that their blood cholesterol levels were too high. As a result of this belief the drug-industry has for some years planned to introduce cholesterol lowering drugs on a large scale. The cholesterol lowering drugs are everybody's dream. The drug companies love them because they know that there is a massive, long term international market, and they love massive long term international markets. And patients love the idea of taking a pill to lower blood cholesterol because although they believe that a high cholesterol level means a high heart atack risk they don't want to stop eating the faty food that cause a high blood cholesterol.

So I believe that the biggest growth area in the 90s for the drugs industry is likely to be in the sale of drugs which lower blood cholesterol levels and there is already some evidence that the explosion has already started. Between 1986 and 1990 the number of prescriptions for cholesterol lowering drugs trebled in the U.K. alone. For the health service and for governments all around the world the prescribing of cholesterol lowering drugs will be an expensive business. A huge proportion of apparently healthy population will be turned into regular pill takers. The profits for the international drug companies will run into billions.

Some trials seem to suggest that simply lowering the blood cholesterol level may not always be wise. For example, a low cholesterol level may be linked to death from injury or suicide. Some doctors have even argued that a cholesterol level that is too low may lead to a high cancer risk. But doctors, encouraged by drug companies, are nevertheless busy writing out prescriptions for drugs to lower blood cholesterol levels.

Let us now look at 'surgical experiment' which involves male patients vasectomy - and one which involves female patients - breast enlargement - as two examples of widely used medical techniques of doubtful safety. Both experiments are surgical procedures which are performed on healthy, young adults. Vasectomies have been popular for several decades and around the world many millions of men have already had the operation. It is a fairly quick and simple surgical procedure and the number of men having the operation is steadily increasing. The tubes which lead from the testes (where the sperm are produced) to the penis are simply cut or sealed and so sperm cannot get through. By the end of 1991 approximately 50 million young and healthy men around the world were believed to have had the operation. In recent years, however, some doctors have started to have fears about the safety of the operation, as independent studies have indicated that the operation may be linked to cancer of the testes or prostate, to heart disease, to immunological disorders, to a lack of interest in sex or to premature ageing. The possible links to cancer are particularly worrying. For example, a study of 3,000 men in Scotland who had undergone vasectomy showed that 8 developed testicular cancer within four years of the operation.

Likewise the fact that there might be real dangers associated with breast enlargement operations using silicone gel implants exploded into public view in early 1992 although the operation to increase breast size had, like vasectomy for men, been popular for several decades - and worries about the operation had been voice many years before.

Right from the start surgeons had realised that the widespread fashion for large breasts could become big business and they struggled hard to justify what come cynics saw as litle more than an opportunity to make money.

In the early 1980's, the American Society of Plastic and Reconstructive Surgeons argued that there is a substantial and enlarging body of medical information and opinion to the effect that these deformities (small breast) are really a disease. Plastic surgeons gave the disease a name - micromastia - and did their best to stamp it out It is estimated that in the last 30 years over 2 million victims of micromastia have been identified and 'cured' by plastic surgeons in America alone. To start with, surgeons injected silicone directly into the breast but when it became clear that this might cause problems as the silicone wandered around the recipient's body and started to trigger all sorts of reactions and possible problems (not least the fact that the enhanced breast quickly started to shrink as its silicone boost disappeared), surgeons started to install their silicone breast enlargers in small plastic bags which were thought to be safer.

At the end of 1991, however, a huge controversy blew up over the safety of these implants. On January 6, 1992, the FDA asked doctors to stop using silicone gel implants while they reviewed new evidence suggesting that the gel might cause autoimmune reactions or connective tissue disorders leading to weakness, immune system damage, poor memory, fatigue, chronic flu-like illness and so on.

The absence of scientific evidence supporting medical practices is apparent in all areas of medicine. With a very few exceptions there are no certainties in medicine. What the patient gets will depend more on chance and the doctor's personal prejudices than on science. This problem isn't a new one, of course. In the preface to this play The doctor's dilemma George Bernard Shaw points out that during the first great epidemic of influenza which developed towards the end of the 19th century, a London evening paper sent a journalist posing as a patient to all the great consultants of the day. The newspaper then published details of the advice and prescriptions offered by the consultants. Despite the fact that the journalist had complained of exactly the same symptoms to the many different physicians, the advice and the prescriptions that were offered were all different Nothing has changed. Even in these days of apparently high technology medicine there are many - almost endless - variations in the treatments preferred by differing doctors. Doctors offer different prescriptions for exactly the same symptoms; they keep patients in hospital for vastly different lengths of time, with apparently identical problems.

In America, each year, 61 in every 100,000 people have a coronary bypass operation. In Britain only 6 in every 100,000 have the same operation. In Japan 1 in 100,000 patients will have a coronary bypass operation. In America and Denmark 7 out of 10 women will have a hysterectomy at some stage in their lives, but in Britain only 2 women in 10 will have the same operation. Why? Are women in America having too many hysterectomies or are women in Britain having too few? In America one in five babies are born by Caesarean delivery. In England and Wales the figure is 9%. In Japan it is 8%. Even within individual hospitals one sees enormous variations between the beliefs of different consultants. Some ear, nose and throat consultants still believe that tonsils and adenoids should be removed at the earliest possible opportunity while others believe that the operations is useless or harmful and should hardly ever be done. Some surgeons remove gall bladders through tiny incisions, others prefer massive incisions. Some doctors still recommend that ulcer patients follow a milky diet while others claim that such dietary advice should have been abandoned as a piece of pre-history. Despite all these variations in the type of treatment offered, most doctors in practice seem to be convinced that their treatment methods are beyond question.

But, you may say, even if treatments are not selected with scientific precision, surely diagnoses are made in a scientific fashion? Again, the evidence does not support that contention. After one recent survey two pathologists reported that after carrying out 400 post-mortem examinations they had found that in more than half the patients the wrong diagnosis had been made. This presumably also means that in more than half the patients the wrong treatment had been given. And since so many modern treatments are undeniably powerful it also presumably means that a large proportion of those patients died because of their treatment The two pathologists reported that potentially treatable disease was missed in one in seven patients. They found that 65 out of 134 cases of pneumonia had gone unrecognised while out of 51 patients who had suffered heart atacks doctors had failed to diagnose the problem in 18 cases. Ignorance has become commonplace in medical practice. Doctors go to great lengths to disguise the fact that they are practising a black art rather than a science. The medical profession has created a 'pseudoscience' of mammoth proportions and today's doctors rely on a vast variety of instruments and tests and pieces of equipment with which to explain and dignify their interventions. This, of course, is nothing new. Now, if doctors were aware that medicine was not a science and that they were pulling what is undoubtedly the largest and most successful confidence trick ever tried the damage would be fairly minimal. But the problem is compounded by the fact that the vast majority of doctors believe the lie that they are taught; they believe that they are scientists, practising an applied science.

One result of this false faith is that doctors use the technology that is available to them with litle or no thought for their patients: they have been taught to ally medieval authority and a godlike sense of superiority with 20th century gadgetry. The result is therapeutic chaos. Patients are wildly and dangerously over-investigated and treatment programmes, which vary from one doctor to another, are planned and defined by guesswork rather than a scientific analysis of possibilities and consequences. In order to protect themselves from the anxieties which would otherwise accompany their ignorance and their lack of knowledge, doctors seek assurance and comfort by immersing themselves in technology. Doctors are taught that investigation is an end in itself rather than merely a signpost towards a therapeutic end. The needs of the patient are forgoten as doctors glory in their knowledge. Too many doctors obtain satisfaction not by making patients beter or relieving their discomfort but by playing a series of intellectual games in which the collecting and analysis of test results is regarded as far more important than the support and comfort of a patient Too often patients are over-investigated, over diagnosed , over treated and under cared for. 'Curing' not 'caring' has become the sole criterion and success is too often measured in the laboratory rather than the sickroom. What has happened? Why has medicine failed to become an authentic science? The answer is a simple one. In the last century the practice of medicine has become no more than an adjunct to the pharmaceutical industry and the other aspects of the huge, powerful and immensely profitable health care industry. Medicine is no longer an independent profession. Doctors have become nothing more than a link connecting the pharmaceutical industry to the consumer.

Doctors and Drug industry have jointly killed thousand times more persons in peace than all the war-time casualties put together in the last 500 years. There is a graphic book titled Doctors, Drugs and Devils, which traces the grotesque history of modern medicine. There is another equally damning evidence titled America the Poisoned, which records the evil effects of deadly chemicals destroying our environment, our wildlife and ourselves. And then there is that all-time famous treatise by Dr. Ivan Illich called The Medical Nemesis (or Limits to Medicine), which the drug companies bulk-purchased and burnt The intelligent readers of Amrit Manthan may read these scholarly books to advantage and unite to protect their own health which is in great danger.

(Dr. Vernon Coleman, M.D., D. Sc., has writen 75 books which are sold in more than 50 countries and translated into 22 languages. I met him at a conference at the Royal London Hospital in June 1992, at which both of us were main speakers. By Dr. Vernon Coleman - Lynmouth, Devon EX35 6EE, England - Source: Amrit-Manthan - International Journal devoted to Holistic Healing Arts by Leo Rebello.)

Dr. Md. Anisur Rahaman

Diarrhoea is a very common health problem in Bangladesh. It is defined as the passage of stool more than three times a day or when the stool is liquid or semisolid, passage of stool irrespective of frequency is defined as diarrhoea Urgency of defecation and faecal incontinence is a common feature of any variety of diarrhoea In thp developing country diarrhoea is one of the major killer of children. Atack of diarrhoea is found more in children than other human groups. Geographically Southern part of Bangladesh is more prone to diarrhoea. Sometimes diarrhoea become an epidemic form after flood. Diarrhoea mainly two types e.g acute and chronic diarrhoea Acute type is more life threating than chronic. Mainly acute diarrhoea causes death to human being. It plays a bigger role in child mortality rate. Diarrhoea causes dehydration in human body. Dehydration is the primary and important management of diarrhoea.

Factors causing Diarrhoea

1. Agent factors:

a. Biological agents:

Viruses e.g rota virus (Infant specially). Norwalk virus, Entero virus

Bacteria e.g salmonella. shigella. E. coil. V cholera staphylococcus, Campylobacter

Parasites e.g E. histolytica, Giardia.

Others e.g Fungi. Candida. albicans.

b. Nutrient agents: Proteins, fats. vitamins. minerals and water.

c. Social agents: Poverty. unhealthy life styles

2. Host factors:

a. Demographic:

· Age-Children under 5 years

· Sex - All groups

b. Social and economic: Housing, Education., Occupation, stress (acute psychological)

Factors causing Diarrhoea

C. life style factors: living habit nutrition.

3. Environmental factors:

a. Physical environmental-Applied to non-living things physical factors e.g Water. climate, geography.

b. Biological Environment: Microbial agent, animal and plants.

c. Psychosocial Environment-Customs, habit, beliefs.

4. Other factors:

Drugs, e.g Magnesium containing antacids, Antibiotics, (Ampicillin,

Amoxycillin), Purgatives.

Organic disease e.g I. B.S Ulcerative colitis

Food allergy, diabetes, Postvagotomy, Measles, Pnuemonia, Meningitis, Otitis media. Tongilitis. malabsorption syndrome.

Some statistical information

In the developing countries every year about 2 million children aged under 5 years die of Diarrhoea.

Children are affected by diarrhoea 3-4 times per year.

In our country about 17-20%children die of diarrhoea per year. (According to another statistics the rate is 25%)

Three children of every four who become night blindness have a history of diarrhoea atack before 4 weeks.

20%-30% children suffer from chronic diarrhoea who have already atacked by Diarrhoea.

2 month to 3 years aged group of children are more prone to diarrhoea.

6 month to 3 year aged group of children are usually affected by Rota virus.

About 4 million children die of diarrhoea in the world. Among them 80% aged under 2 years.

Breast feeding reduces 25% child mortality rate.

During diarrhoeal atack food consumption of Children reduce to 30%

Determining Factors of Diarrhoea

Key Signs for sever dehydration:

1. Radial pulse-Rapid, Feeble, sometimes, impalpable.

2. Skin elasticity- Pinch reacts very slow ( >2 second)

3. Eye-Deep sunken.

4. Tears-Absent

5. Urine flow-None passed for several hours.

Assessment of dehydration by % of body weight loss

1. Mild dehydration-4-5% body weight loss

2. Moderate dehydration-6-9% body weight loss.

3. Severe dehydration-1 0% or more body weigl1t loss.

Hospitalisation of Patient

If dehydration does not remove within 24 hours although taking oral rehydration saline (ORS)

If loose motion does not reduce within 48 hours.

If there is no micturation within 12 hours.

If there is an abnormal abdominal distension.

If there is a severe vomiting.

If there is an asthmatic condition

If there is a convulsive condition.

If there is high temperature/fever.

If there is an unconsciousness condition

Some complications:

Vitamin-A deficiency leading to night blindness.

Reduced kidney function leading to kidney failure.

Shock (Volumic)

Lathery

Convulsion.

Management of Diarrhoea.

B. Table-3 Antimicrobials commonly used in the treatment specific causes of acute diarrhoea.

Cause Drug (S) of choice Alternative

Cholera Tetracycline 50 mg/kg/ day in divided doses x 3 days Furazolidone 5 mg/kg/day in 4 divided doses x 3 days.Erythromycin 30 mg/kg/day in 4 divided x 3 days.

Shigellosis Nalidixic Acid 55 mg/kg/day in 4 divided doses x 5-7 days (all ages) Co-trimoxazole TMP 10mg/kg/day and SMX 50 mg/kg/day twice daily x 7 days. Ampicilling 100 mg/kg/day in 4 divided doses x 5 days.Pivmecillin Selxid) 40- 50mg/kg/day in 4 divided doses x 7 days.

Acute intestinal amoebiasis Metronidazole 30 mg/kg day x 5-10 days Tinidazole 60 mg/kg/day x 3 days.

Acute giardiasis Metronidazole 20 mg/kg/day x 5 days Quinacrine 5-7 mg/kg/day in divided dosesx 5 days.

Management of Diarrhoea.

C. Dietetory therapy:

Liquid food

Marh of rice

Water of Chira

Lemon syrup

Water of Green coconut

Syrup of gurh/ugar

Soft jaou of Price flower

D. Psychotherapy:

Diarrhoea of psychogenic origin are usually chronic in nature which require anti

depressant drugs along with proper survey for anxiety producing mechanism.

Differential Diagnosis (D/D

1. Dysentery (Shigellosis)

2. Campylobacter enteritis.

3. Diverticular diseases

4. Ulcerative colitis.

5. Ischemic colitis.

Preventive measures

Defaecation should be in a certain place or in a sanitary latrine Outside of dwelling place should be cleaned,

Preparing the meal for children juts before feeding,

Use hand or spoon to feed children

Vaccination of measles as well as other infections diseases Ensure only breast feeding for 6 month (for infant)

Ensure the use of pure drinking water,

Hand washing before and after taking foods,

Ensure hand washing after defaecation with soap or ashes, Avoid the use of artificial milk for infant

Being free from superstitions and wrong thought

Avoiding of over crowded living style,

Foods should be covered to resist flies.

Diarrhoea is a bigger health hazard in Bangladesh as well as in the developing country It is a killer of our future generation, The mortality rate due to diarrhoea IS not less than any other diseases, Specially children aged under 5 years are the victims. It affects our health indicator. Diarrhoea is a preventable disease, For prevention it consciousness relating to diarrhoea is the beter system, Here health education can playa vital role to grow consciousness e,g Education about washing the hand can reduce the secondary atack rate of diarrhoea within family by 85%, Improved hygiene including proper disposition of excreta also has the added benefits of reducing diarrhoea caused by gut parasites, If we fail to make the nation aware as well as its consequences. we might face its epidemic form, So all sort of possibility causing diarrhoea should be cut off initially to prevent the final break out