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By O. Lester. Sul Ross State University. 2018.

Percentage of responses from all respondents to Do you think antibiotics are widely used in agriculture in your country? These findings can both help shape future public awareness efforts and aid evaluation of the impact of these efforts buy 25mg hydroxyzine free shipping. Although antibiotic resistance occurs naturally order hydroxyzine 10mg with amex, overuse and misuse of antibiotics in humans and animals is accelerating the process safe hydroxyzine 10mg. For this reason, it is critical that people understand the problem, and the way in which they can change their behaviour. They show that although people recognize the problem, they do not fully understand what causes it, or what they can do about it. Antibiotic use The results of the survey questions on antibiotic use demonstrate how frequently antibiotics are taken, with a considerable majority of respondents (65%) across the 12 countries reporting having taken them within the past six months. This rises to 76% in Egypt, the country with the highest number of respondents reporting having taken antibiotics in the past six months, including 54% having taken them within the past month. Even in Barbados the country in which respondents reported the lowest use in the past six months the number stands at 35%. This prevalence is highly relevant to public campaigns on antibiotic resistance both because high levels of use contribute to the problem, and because it demonstrates just how many people it could impact in a short time frame if the antibiotics they are taking become increasingly ineffective. The results of the survey questions on how people obtained antibiotics and whether they got advice on how to take them show that a sizeable majority of respondents across the countries surveyed state that they got their last course of antibiotics, or a prescription for them, from a doctor or nurse (81%), and that they received advice from a medical professional on how to take them (86%). These factors indicate that the antibiotics are more likely to be taken to treat an appropriate condition and in the appropriate fashion, both of which are important in the context of tackling antibiotic resistance. Respondents were asked to indicate whether they thought the statement It s okay to use antibiotics that were given to a friend or family member, as long as they were used to treat the same illness was true or false. Although it is in fact a false statement, one quarter (25%) of respondents across the 12 countries included in the survey believe that this statement is true, though there is considerable variation in the findings between countries. While only 10% of respondents in Barbados think the statement is true, this rises to 37% in Nigeria. Across the 12 countries surveyed, respondents in rural areas, those with lower levels of education and those in lower income countries are more likely to think that this statement is true. Further investigations are needed in order to check if there is a link between broader issues around access to health care and medicine, and the affordability of antibiotics and other drugs for these groups. There is even more evidence of misunderstanding around the second statement shown to respondents: It s okay to buy the same antibiotics, or request these from a doctor, if you re sick and they helped you get better when you had the same symptoms before. Across the 12 countries included in the survey, 43% think this false statement is in fact true. However, close to one third (32%) of respondents surveyed across the 12 countries believe that they should stop taking the antibiotics when they feel better, and this rises to 62% in Sudan. Younger respondents and those in rural areas across the 12 countries, as well as those in lower income countries, are more likely to think they should stop taking antibiotics when they feel better. Understanding which conditions can be treated with antibiotics is also important, as the use of antibiotics for conditions which are not in fact treatable with these medicines is another contributor to misuse, and therefore to the development of resistance. Respondents were asked to indicate which of a list of medical conditions could be treated with antibiotics the list included both conditions that can and cannot be treated with antibiotics. Antibiotics are used to treat bacterial infections, whereas colds and flu are caused by viruses and therefore are not treatable with antibiotics. Further to this, we see that in Sudan, Egypt and India, three quarters or more of respondents think colds and flu can be treated with antibiotics. Younger respondents and those with lower levels of education are also more likely to think antibiotics should be taken for colds and flu. In combination, these survey findings related to the appropriate use of antibiotics suggest that action which effectively builds understanding of how and when to take antibiotics and what they should be used for particularly targeting groups among whom misunderstandings seem to be most prevalent is critical. The survey explored levels of awareness and understanding by asking respondents whether they had heard of a series of commonly used terms relating to the issue. The results show high levels of familiarity (more than two thirds of respondents) with three of the terms: antibiotic resistance, drug resistance and antibiotic-resistant bacteria. Levels of awareness of the terms is not uniform across the countries surveyed however for example, while 89% of respondents in Mexico are aware of the term antibiotic resistance, only 21% of those in Egypt are. Those who were aware of any or all of the terms were asked where they had heard the term. It is, of course, important that the public is not only aware of the issue, but also understands it. The survey sought to establish levels of understanding by asking respondents to indicate whether a series of statements around antibiotic use were true or false. Similarly to the survey findings related to appropriate antibiotic use, the results suggest that there are high levels of misunderstanding in this area. While large proportions of respondents correctly identify some statements, even larger numbers incorrectly identify others. For example, more than three quarters (76%) of respondents believe that antibiotic resistance occurs when their body becomes resistant to antibiotics. Encouragingly, the majority of respondents in all cases agreed that the actions could help, with numbers rising to 91% across the 12 countries in relation to People should wash their hands regularly.

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Vernal Conjunctivitis Clinical Presentation Vernal conjunctivitis is a chronic cheap hydroxyzine 25 mg online, bilateral discount 10 mg hydroxyzine visa, catarrhal inflammation of the conjunctiva most commonly arising in children during the spring and summer order hydroxyzine 10mg on line. The illness is usually seen during the preadolescent years and often resolves at puberty. Male patients are affected about three times more often than female patients when the onset precedes adolescence, but when there is a later onset, female patients predominate. In the palpebral variety, which is more common, the tarsal conjunctiva of the upper lid is deformed by thickened, gelatinous vegetations produced by marked papillary hypertrophy. This hypertrophy imparts a cobblestone appearance to the conjunctiva, which results from intense proliferation of collagen and ground substance along with a cellular infiltrate ( 45). In the limbal form, a similar gelatinous cobblestone appearance occurs at the corneal scleral junction. This thick, ropey, white or yellow mucous discharge has highly elastic properties and produces a foreign-body sensation. It is usually easily distinguished from the globular mucus seen in seasonal allergic conjunctivitis or the crusting of infectious conjunctivitis. The patient may be particularly troubled by this discharge, which can string out for more than 2. Pathophysiology and Cause The cause and pathophysiologic mechanisms of vernal conjunctivitis remain obscure. Several features of the disease, however, suggest that the atopic state is related to its pathogenesis. The seasonal occurrence, the presence of eosinophils, and the fact that most of the patients have other atopic disease ( 46) are circumstantial evidence supporting this hypothesis. In addition, several different immunologic and histologic findings are consistent with an allergic etiology. Patients with vernal conjunctivitis have elevated levels of total immunoglobulin E (IgE) ( 47), allergen-specific IgE (48), histamine (47), and tryptase (49) in the tear film. Patients with vernal conjunctivitis have markedly increased numbers of eosinophils, basophils, mast cells, and plasma cells in biopsy specimens taken from the conjunctiva (50). Elevated levels of major basic protein are found in biopsy specimens of the conjunctiva (51). Also, in keeping with the postulated role of IgE-mediated hypersensitivity is the pattern of cytokine secretion and T cells found in tears and on biopsy specimens. Also in keeping with this hypothesis is the improvement demonstrated during therapy with topical cyclosporine. This over-expression of mediators both locally and systemically probably accounts for the upregulation of adhesion molecules ( 57) on corneal epithelium noted in this disorder. Also of interest is the hypothesis that complement, perhaps activated by IgG allergen immune complexes, plays a role in producing vernal conjunctivitis. Pollen-specific IgG antibodies ( 58) and complement activation products (C3 des-Arg) occur in tears of patients with vernal conjunctivitis ( 59). The specific IgG antipollen found in the tear film may not be acting through the complement system, however, because much of it appears to be IgG4 ( 58), a non complement-fixing subclass with putative reaginic activity. Also, patients with vernal conjunctivitis have decreased tear lactoferrin, an inhibitor of the complement system ( 60). Diagnosis and Treatment Vernal conjunctivitis must be distinguished from other conjunctival diseases that present with pruritus or follicular hypertrophy. In most instances, the distinction between acute allergic conjunctivitis and vernal conjunctivitis is not difficult. However, in the early phases of vernal conjunctivitis or in mild vernal conjunctivitis, giant papillae may be absent. In such instances, the distinction may be more difficult because both conditions occur in atopic individuals, and pruritus is a hallmark of each. The conjunctivitis and keratoconjunctivitis associated with atopic dermatitis can be similar to vernal conjunctivitis. In atopic dermatitis, the conjunctivitis can produce hypertrophy and opacity of the tarsal conjunctiva ( 61,62). A form of keratoconjunctivitis with papillary hypertrophy and punctate keratitis can occur ( 63). Many of these patients have signs and symptoms typical of vernal conjunctivitis, including giant follicles and pruritus. In addition, vernal conjunctivitis and atopic dermatitis can occur together in the same patient. The giant papillary conjunctivitis caused by wearing of soft contact lenses is similar to that of vernal conjunctivitis. Patients complain of itching, mucous discharge, and a decreasing tolerance to the lens.

Glove and stocking sensory loss in all modalities (pain discount 10 mg hydroxyzine fast delivery, temperature generic 25 mg hydroxyzine fast delivery, vibration and joint position sense) occurs in peripheral neuropathies 10 mg hydroxyzine. They may have peripheral muscle weakness, which is also bilateral, symmetrical and distal. Bilateral symmetrical loss of all modalities of sensation occurs with a transverse section of the cord. These lesions are characteristically associated with lower motor neurone signs at the level of transection and upper motor neurone signs below the level. There are also ipsilateral upper motor neurone signs below the level of the lesion and lower motor neurone signs at the level of the lesion. Common causes are st- will cause weakness and wasting of the small muscles rokes(vascularocclusionorhaemorrhage)andtumours. Ask the patient to say r Decreased power in the distribution of the affected British Constitution or West Register Street. Usually due to a cervical spinal cord lesion, occasionally bilateral cerebral lesions. Hemiplegia Weakness of one half of the body (sometimes including the face) caused be a contralateral cerebral hemisphere lesion, a brainstem lesion or ipsilateral spinal cord lesion (unusual). Paraplegia Affecting both lower limbs, and usually caused by a thoracic or lumbar spinal cord lesion e. Bilateral hemisphere (anterior cerebral artery) lesions can cause this but are rare. Monoplegia Contralateral hemisphere lesion in the motor cortex causing weakness of one limb, usually the arm. Test the abil- r Bradykinesia (slowness in movements) is noticeable ity of the patient to sit on the edge of the bed with their when doing alternate hand tapping movements, or arms crossed. Micro- r Gait:Wide-basedgait,withatendencytodrifttowards graphia (small, spidery handwriting). Even a mild cerebellar problem makes tiation of movement is impaired (hesitancy) with the this very difcult. A festinating gait is Causes include the following: r when the patient looks as though they are shufing in Multiple sclerosis r order to keep up with their centre of gravity, and then Trauma r has difculty in stopping and turning round. The three groups of tremor are distinguished by obser- r Metabolic: Alcohol (acute, reversible or chronic de- vation (see Table 7. If unilateral, the leg is swung out to the side to move it forwards (circumduction). If bilateral, the Extrapyramidal signs (Parkinsonism) pelvis has to alternately tilt and the gait often becomes r Appearance: Expressionless face. Thepatientcanstandontip-toe,butoften Resting tremor which is slow and classically pill- not on their heels. Even if mildly affected the patient is unable to strating whether seizure activity is suppressed by walk heel-toe in a straight line. In or encephalitis, as well as occurring in focal status Parkinson s disease, this pattern tends to be asym- epilepticus. They are useful in the di- agnosis of muscle disease, diseases of the neuromuscular Electroencephalography junction, peripheral neuropathies and anterior horn cell disease. It is obtained by placing electrodes on the scalp, using a jelly to reduce electrical Electromyography resistance. A recording of at least half an hour is usually Aneedleelectrodeisplacedintomusclesandinsertional, needed, to maximise the chances of picking up tran- resting and voluntary electrical activity is studied, using sient abnormalities. Its main use is for the classication of epilepsy, but is r Peripheral neuropathies and anterior horn cell disease it may also be useful in the diagnosis of other brain dis- lead to a reduced number of motor units, which re orders such as encephalitis. Surface electrodes or occasionally needles are used both r Suspected spinal cord compression. The knees are drawn up as far as possible and uation of brachial and lumbosacral plexus and nerve the neck exed, to open up the spinous processes of the roots. The lumbar puncture needle is inserted in the midline Lumbar puncture with its stylet in place aiming slightly towards the um- bilicus. If the needle encounters rm resistance, it Indications should be withdrawn and another approach tried. When any of the following are suspected: Sometimes the patient will feel a pain radiating into r Infection (meningitis, encephalitis, fungal infections the leg or back this is due to the needle touching a or neurosyphilis). A simultaneous blood diagnosis of idiopathic (benign) intracranial hyperten- sample for glucose should be sent. Thereisadiffer- in the case of sick patients, is relatively unaccessible ence in healthy tissue and infarcted, infected or oedema- although some units have facilities for ventilation in the tous tissue.

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Two principal concepts exist to disperse the range purchase 10mg hydroxyzine mastercard, while the latter covers the entire mass range ions: spatial separation and separation in time buy hydroxyzine 25mg mastercard. Te at once) determine the potential for certain applica- main elements proven 25mg hydroxyzine, common to all mass spectrometers, tions. Such devices all yield mass component pieces detected; by assembling the spectra, which represent the intensity distribution masses of each fragment, one can deduce the com- of the constituents of the sample, sorted according position and obtain structural information; this to an increasing mass-to-charge ratio. Today there works reliably for previously unknown analytes, are many types of ion-source and mass analyser, especially when they are large and/or complex. Te and a large variety of combinations of these exist, structure of complex biomolecules can be derived all specialised for certain applications. Here, important ones being mass range (the range from an almost infnite variety of concepts and tech- the lightest to the heaviest mass that may be ana- niques exist, tailored for the specifc physical and lysed, typically this ranges from one mass unit chemical properties of the sample and the purpose [hydrogen is the lightest chemical element] to a of the analysis. Te goal of all these techniques is few 10,000 [which is typical for fragments of com- to dissolve the sample by the impact of photons plex biomolecules like proteins]), mass resolving (e. Biological substances while research laboratories have reported sub-cel- are ofen processed at ambient air pressure, while lular resolutions down to ~1 micrometre. In both cases, the desorbed and charged infnitely wide range of applications emerges due sample debris are accelerated by an electric feld to the fact that basically every organic or inorganic towards the mass spectrometer and collected by its material can be dissolved to microscopic frag- atmospheric pressure inlet system. Te method is label-free and can be applied to basically any human or animal provides unique features for the analysis of tissues, tissue. Common to all is the generation of charged matrices, they require sensitive, high resolving mass sample fragments that can be analysed by the mass spectrometers with high dynamic range able to han- analyser. Top left: principle of an electro-scalpel in combination with an Venturi-pump inlet system for mass spectrometric analysis of vaporised tissue (reprinted with permission from Anal. Bottom left: the device in operation during surgery (fgure credit: Imperial College London). Right: mass spectra of a cancerous (top) and a healthy (bottom) human bladder tissue show different characteristic patterns (reproduced from Faraday Discuss. Left: single-pixel mass spectrum of the outer stripe outer medulla; each pixel has an area of about 1/1000 square-millimetre. The green label indicates the mass peak that is characteristic for imatinib (m/z=494. Right: imaging mass spectrometry yields the distribution of different substances in the mouse kidney. The green arrow points to the imatinib distribution, which is concentrated in the outer stripe outer medulla (fgures reprinted from ref. It also Very appealing is the potential of mass spectrom- allows identifcation of metastases of various cancer etry for histology. Typical histological analyses take types and to distinguish the original cancer from several hours. Te knife collects some smoke, sucks However, such samples are invariably complex and it into the mass spectrometer and performs an a single tissue section contains a large variety of instant mass spectrometric analysis. Te obtained chemical species ranging from salts, amino acids mass spectra exhibit diferent lipid profles, which and lipids, to peptides and proteins. Terefore, the are analysed by multi-dimensional principal com- use of several diferent methods, each optimised for ponent analysis. A good example is tissue with pharmaceuticals and personal care products samples of the brain, which are ideally suited for are of increasing concern and represent a threat to mass spectrometry analyses, since many of the rele- wildlife and humans, vant neuro-transmitters are either peptides or small detection and identifcation of food contaminants: molecules. Each method tions or food-packaging migrants, that need to be was carried out on the same tissue slice of a mouse identifed and quantifed, and brain. Te combination of information from each security: the possibility of deployment of biologi- method provides a unique, complementary perspec- cal weapons by terrorists is an existing threat and tive by allowing analysis with each technique. Tese developments are a living example of feld deployment and use in many daily circum- how mass spectrometry methods and instruments, stances. In the past, this evolution has largely ben- and in general experts in technology for nuclear efted from technologies developed and tested in the detection. Tere are many examples of research- experimental nuclear physics battleground, and it ers trained in nuclear physics groups doing basic seems that this trend will only increase in the future. In the nuclear imaging the active groups are typically in academia where arena, though, trends and technologies are being they can fnd the resources and knowledge to imple- introduced, tested and dismissed at high speed. One ment and develop the most highly sophisticated can assess this by attending every year the leading molecular imaging technologies available today. We have also noticed that advances in instrumen- References tation for medical imaging should be accompanied by corresponding advances in image reconstruction [1] Bauer, J. Wermes, Pixel detectors for tracking and their spin-of in imaging applications, Nucl. Te application of closed radioactive sources (brachytherapy) is formally part of the feld radi- ology but has much in common with nuclear medicine and will therefore also be covered.

There are IgA antibodies found against reticulin and smooth muscle endomysium (124) cheap 25mg hydroxyzine. Recently generic hydroxyzine 25mg with visa, this antibody has been identified as an antibody to tissue transglutaminase generic 25 mg hydroxyzine mastercard. Circulating IgG and IgA antibodies to gliadin are also found in most patients with celiac disease ( 127). Antigliadin antibodies are shown to be synthesized in vitro in cultured biopsy samples taken from the mucosa of patients with untreated celiac disease ( 128). Total IgA levels are frequently elevated, and total IgM levels decreased in many untreated patients. The clinical and pathophysiologic findings are consistent with an immunologic process in response to gluten ingestion: increased plasma cells and lymphocytes in the small intestine, destruction of the normal structure of the intestinal mucosa, specific antibodies to gliadin in the mucosa and the serum, and the reversal of mucosal lesions and serologic markers with the elimination of gluten with recurrence upon rechallenge. First thought to be immune complex mediated with the finding of specific antibodies, there is now evidence for T-cell mediated mechanisms as well ( 132,133 and 134). Further support for T-cell involvement is the increased number of gd-positive T cells noted in the peripheral blood of children with celiac disease, correlating with the density of gd-positive T cells in the lamina propria ( 135). Dermatitis Herpetiformis Dermatitis herpetiformis is a food hypersensitivity manifested by a pruritic rash in association with gluten-sensitive enteropathy ( 136). The remainder of patients usually have subclinical symptoms of celiac disease that are unmasked with aggressive gluten challenge. In addition to its association with gluten sensitivity, there is other evidence for an immune-mediated process. IgA deposition in either a granular (85% 90%) or linear (10% 15%) pattern as well as C3 are found on immunofluorescent staining of dermal papillary tips both in normal and affected skin (136). Immune complexes are frequently found in the sera, although what role they play is uncertain ( 137). IgA antibodies against smooth muscle endomysium are found in approximately 70% of patients, and titers correlate with the severity of the intestinal disease. However, cutaneous lesions may respond more slowly to treatment and also may appear more slowly with rechallenge. Sulfones are the mainstay of therapy for the cutaneous lesions and may relieve pruritic symptoms within 24 hours ( 137). Consistent with hemosiderosis, hemosiderin-laden macrophages may be seen in biopsy samples of the lung or in stomach aspirates ( 139). The titers, however, do not correlate with disease severity, and their significance is as yet unknown ( 140). Symptoms improve when milk is eliminated from the diet and recur with rechallenge. Some patients with positive precipitins do not respond to milk elimination, whereas some with no titers do ( 142). The resultant symptoms are the same as respiratory symptoms seen with aeroallergens, rhinoconjunctivitis, and asthma. This is the most common food-related lung disease, and affects workers who are regularly exposed to flour. Bronchial provocation has shown sensitivity to flour as well as to contaminants such as insects or molds ( 147,148 and 149). A study of crab processors reported that the IgE sensitization occurs through exposure to aerosolized proteins, in this case in the steam of cooking water, thus explaining the resultant respiratory symptoms (150). This also may explain some adverse reactions that food-sensitive individuals have experienced with smelling the food, or being in close vicinity while it is cooked. In a study of salmon processing workers, 24 of 291 employees developed occupational asthma. They worked in close proximity to machines that generated aerosolized salmon serum protein; IgE antibodies to salmon serum protein was demonstrated ( 151). Of interest, 12 of 54 snow crab workers who were sensitized by inhalation and developed asthma, experienced the same reaction with ingestion of the snow crab ( 150). Of note, there have been isolated reports of anaphylaxis from ingestion of food contaminated with an aeroallergen ( 153,154). A subset of patients have these symptoms only if exercise is performed within 2 to 6 hours of food ingestion ( 156). For some patients, this postprandial exercise-induced anaphylaxis may occur with any food ingestion followed by exercise ( 156,157). Others have exercise-induced anaphylaxis only associated with the ingestion of specific foods, such as celery ( 156) or shellfish (158). These patients are skin test positive to the foods, yet they have no allergic reactions unless ingestion is followed by or preceded by rigorous exercise ( 156,158). For all food-related exercise-induced anaphylaxis, episodes are prevented with avoidance of food ingestion 4 to 6 hours prior to or following exercise ( 157).

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Both are consistently sensitive to gentamycin buy generic hydroxyzine 25mg, furoxone and norfloxacin but resistance to ampicillin discount hydroxyzine 10 mg on line, chloramphenicol and tetracycline cheap hydroxyzine 25mg on line. Gentamicin and furoxone were employed in 40 cases and average time for a clinical response was 4 days whereas with norfloxacin the symptoms stopped 2 days after employing the drug. Norfloxacin, a new quinolone antibiotic, is effective in drug resistant shigellosis and it also cuts down the duration of symptoms. Frequency distribution of cases, radiological findings and radiological diagnosis are discussed. Usefulness specificity and sensitivity of some importance radiological signs and radiological diagnosis seen on 2 films study are presented. The duration of illness before attending the hospital was found to be one to seven days. The frequency of motion among dysentery cases were found to be from 16 to 20 times per day. The initial safety record of this procedure has continued unblemished and it remains the safest operation in treating duodenal ulcer disease. Position of appendix was also studied on 21 barium Enema x-ray films and records of 32 cases of acute appendicitis from surgical unit of North Okkalapa General Hospital. Rectocaecal appendix were also observed and more than 90% of retrocaecal appendix were associated with ileal attachments. Half of the total numbers of appendicdes studied were provided with triangular mesoappendix which extended to the tip and one third of the cases lacked mesentry. The arterial supply to the appendix was studied on 78 cases by (a) plain gross dissection and after injection the ileocolicartery with plastic latex; (b) histological study after injecting the ileocolic artery with 1% trypan blue solution and (c) radiological examination after aqueous dionosil injection. Six trypan blue injected specimens were studied with Van Gieson s stain to study the intramutal arterial pttern. It was observed that the appendicular artery arose from six sources and most coomonly from ileocolic artery- 44. Anastomotic connection between the primary branches and between the appendicular artery and posterior caecal artery was lso identified. Two arterial plexus were found within the subserosa and submucosa layer of appendix. Correlation betweenthe presence of mesoappendix and position and position, arterial anastomosis and incidence of acute appendicitis were also discussed. Rectal swabs were also taken and investigated for culture and sensitivity at the Microbiology Department, Institute of Medicine I, Yangon. Among the study subjects, 60% were male and 40% were female for both diseased and control groups. Regarding the age distribution 7-9 month group was the commonest (38%) age group in which acute gastroenteritis occurred followed by 10-12 (24%), 4-6 (20%) and 0-3 (18%) month age groups. Diarrhoea was common among bottle fed infants while breast feeding was the usual feeding pattern in controls for the 0-6 month infants. Regarding the clinical presentation of patients in the study group, dehydration was the commonest (66%) feature followed by vomiting (64%) refusal to feed (60%) and fever (58%). Bacterial pathogens were isolated in 18% of the cases comprising enteropathogenic Escherichia coli 12%, Klebsiella species 4% and Pseudomonas species 2%. Sensitivity to chloramphenicol was seen in 25% of cases whereas Augmentin, Carbenicillin, Sulfizoxazole and Sulfamethcxazole/ trimethoprim all had a 12% sensitivity only. Serctypes O126, O1, O142 and O125 showed multiple drug resistance but serotype O26 did not show any resistance to all the antibiotics tested. Children were stratified according to grade of dehydration (mild, moderate or severe) and the initial purging rates during the first 6h (low (<2ml/kg/h), moderate (2-5ml/kg/h) and high (>5ml/kg/h) purgers). The clinical characteristics of the children in the two treatment groups were comparable. The net intestinal fluid balance and total body fluid balance were similar in the two groups. Amylase (25mg) thinned the gluey rice water when 100g of rice was cooked in 500ml of water for 10 minutes. In study 1, 12 children with diarrhea and mild dehydration were studied to determine the safety of Amylyte. The osmolality of 7,994 packages used to make the Amylyte solution ranged between 277-340mOsm/kg. The mean electrolyte composition was Na+=68mEq/L, 110 Bibliography of Research Findings on Gastrointestinal Diseases in Myanmar K+=20mEq/L, Cl=73mEq/L, the caloric density 425kcal/L and rice proteins 0. It can safely and effectively rehydrate children with acute diarrhea and dehydration.