![]() Because stool amount can be measured using the hand, it can be easily applied and used as a powerful differential factor. Furthermore, the score of stool amount is the most crucial factor in the objective definition of diarrhea in infancy. Hence, except for early infancy with breast feeding, nocturnal stool can be used as an important discriminator. Breastfed infants sometimes may experience nocturnal stool, more commonly in early infancy, but the amounts may be small or the frequencies low. ![]() In infants more than two months of age, nocturnal stool revealed as an important differential factor. The highest score during the period of CFLS among the sum of these points per day was chosen and each highest score was compared. The size of permeated diaper or of fecal material was estimated by the hand and scored from 0 to 2 points at each evacuation a few knuckles (small=0), half of the hand (medium=1), and the whole of hand or more (large=2) ( Fig. Stool amount was measured by the hand of a Korean woman who has an average height of 160 cm. Because it is inconvenient and even troublesome to measure stool amount by scales, an easier method available had to be investigated, and thus the mother's hand system was adopted. Nocturnal stools were defined as those passed between 10 p.m. Positive response to therapy was defined as an improvement in general conditions including recovery from dehydration and weight gain. Thus, we investigated the referred 46 cases, and in particular, NFLS to DIDN ratio, causal illnesses, frequencies of clinic or hospital visits and admissions, and history of nutritionally deficient diet management before enrolling in the study, and factors that differentiated NFLS and DIDN.Ī part of the results of a stool smear test in NFLS patients, which was performed in primary clinics or secondary hospitals, were used for a diagnosis and also the analysis of patients' data. Two patients with immune deficiency and failure to thrive and with experience of surgical disease were excluded. Cases were recruited from among in- and outpatients at the Dongsan Medical Center (a tertiary hospital), Keimyung University School of Medicine. Similarly, the ages and locations of their pediatricians showed no notable feature. ![]() The referred clinics or hospitals were distributed throughout the Daegu area, and thus, presumably well represented. Hence, a total of 48 cases were transferred. Transferences were made twice from 7 clinics and 3 hospitals. The transferred patients were from 32 primary clinics and 6 secondary hospitals without a pediatric gastroenterologist. The region is serviced by 239 pediatricians 153 working for 121 primary clinics, 44 for 14 secondary hospitals, and 42 for 5 tertiary teaching hospitals. Daegu is the third largest city in South Korea and has a population of 2.5 million.
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