Aubrey Unique Maranan Evangelista

1st year JMCM

Comparative Evaluation on the Effect of

Zinc-Probiotic and Zinc Therapy in Pediatric
Acute Gastroenteritis

CLINICAL SCENARIO OR mother with complain of having

QUESTION
Patient. E.M, 8 years old, Female,
came in to the clinic together with her
generalized abdominal pain, loose
bowel movement and is febrile with a
body temperature of 37.9 degrees
Celcius. No laboratory tests were being
done, but due to history, signs and
symptoms, and results of the physical
examination, it was revealed that the
patient has a manifestation of Acute
Gastroenteritis. The patient’s mother
then inquire if her daughter should take
a zinc-probiotic or zinc alone for her
Acute gastroenteritis.

SEARCH

Comparative Evaluation on the Effect

of Zinc-Probiotic and Zinc Therapy in
Pediatric Acute Gastroenteriti

CRITICAL APPRAISAL

PRIMARY VALIDTY A. Was the assignment of patients to treatment

RANDOMIZED?
GUIDES -Yes, randomized controlled trial

B. Were all patients who entered the trial property

accounted for and attributed at its conclusion?
-Yes
 . C. Was follow-up complete?
-No follow up

D. Were patients analyzed in the groups to which

they were randomized?
-Yes

SECONDARY VALIDITY E. Were patients, their clinicians, and study

personnel “blind” to treatment
GUIDES
-Yes

F. Were the groups similar at the start of the trial?

-Yes

G. Aside from the experimental intervention, were

the groups treated equally?
-Yes

OVERALL, IS THE STUDY

VALID?
-Yes
WHAT ARE THE
RESULTS?
Among the study population 63.5%
male & 32.7% female in group A and
56.4% male & 34.5% female in group
B. Duration of acute watery diarrhea
was significantly reduced in group A
than group B (56.4 hours versus 70.80
hours respectively). It is also observed
significant difference in length of
hospital stay in Group A and Group B
(68.16 hours vs 83.04 hours)
respectively.
CAN THE RESULTS HELP
ME IN CARING FOR MY
PATIENTS?
-Yes
H. How large was the treatment effect?
A total of 100 numbers of children
ages 3 months to 5 years with acute
watery diarrhea were enrolled those
who were fulfilled the selection
criteria. They were divided into two
groups. Group A (n=50) received zinc-
probiotics combination therapy and
group B (n=50) received zinc only.
Measurement of disease severity was
based on the frequency of diarrhea
(Times/day) and duration of diarrhea
(Hours) after initial drug consumption.
I. How precise was the estimate of
treatment effect?
In this study, the zinc-probiotics group
complete remission was achieved
within 56.4±21.36 hours which was
faster (p-0.002) than that of zinc alone
group (70.8±22.8 hours). This study
also showed a significant improvement
in duration of hospital stay
(68.16±23.76 hours VS 83.04±26.16
hours) in patients who were given in
combination therapy
J, Can the results be applied to my patient care
-Yes
 K. Were all clinically important outcomes
considered?

-Yes

L. Are the likely treatments benefits worth the

potential harm and costs?

-Yes

RESOLUTION OF THE
PROBLEM IN THE This study emphasized on compared
SCENARIO effect of using a combination zinc –
probiotic and zinc in pediatric acute
gastroenteritis. It also supports the
potential role of zinc and zinc-
probiotics in the treatment of Acute
Diarrhea in children However, the
World Health Organization (WHO)
does not recommended the use of
probiotic in diarrhea, but in our
country the use of probiotic is
increasing day by day in acute watery
diarrhoeas. By yhe result of this study,
it can be can concluded that the
combination of probiotics & zinc
therapy is more effective in reducing
the severity of acute diarrhea than zinc
therapy alone