Efficacy Comparison of Oral Rehydration Solutions Containing Either 90 or 75 Millimoles of Sodium per Liter

PEDIATRICS ◽  
1987 ◽  
Vol 79 (2) ◽  
pp. 190-195
Author(s):  
Daniel Pizarro ◽  
Bernardita Castillo ◽  
Gloria Posada ◽  
Cecilia Lizano ◽  
Leonardo Mata

In a randomized trial, 62 infants 2 to 35 months of age with dehydration due to acute watery diarrhea were allocated to one of two groups: group A received solution A (World Health Organization-recommended oral rehydration solution), which contained (mmol/L): Na+ 90, K+ 20, Cl- 80, citrate3- 10, and glucose 110; group B received solution B (Pedialyte RS; Abbott Laboratories, North Chicago), which contained (in mmol/L): Na+ 75, K+ 20, Cl- 65, citrate3- 10, and glucose 139. Oral therapy was given until clinical signs of hydration status were normal. During the 48-hour trial, the following laboratory data were collected: blood gases, serum electrolytes, glucose, urea, and creatinine values and sodium and potassium concentrations in stool and urine; serial weights and clinical signs were also reported. Six of the 62 infants, three in each group, required intravenous fluids because of high stool output. Results of clinical outcome and normalization of altered serum electrolyte values were similar in both groups. During the 48-hour trial, eight patients in group A and four in group B had mild, asymptomatic hypernatremia. Pedialyte RS was found to be a safe glucose/electrolyte solution for oral rehydration therapy.

2018 ◽  
Vol 30 (2) ◽  
pp. 32-38
Author(s):  
Mst Musarrat Sultana ◽  
Md Shafiqul Islam ◽  
Shahana Akhter ◽  
Md Belal Hossain ◽  
Md Sanaul Haque Mia

Objective: Diarrhea is a common problem in our country especially children. There were many treatment options for acute watery diarrhea in addition to oral rehydration saline for reducing the severity of acute watery diarrhea. The aim of this study was to compare the efficacy of zinc & probiotics combination therapy to zinc alone therapy in reducing the severity of acute diarrhea.Method: This was a randomized controlled trial type study, conducted at department of pediatrics Rajshahi Medical College Hospital from July 2014 to June 2016. A total of 110 numbers of children ages 6 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=55) received zinc-probiotics combination therapy and group B (n=55) 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.Result: Among the study population 56% male &44% female in group A and 58% male & 42% female in group B. Duration of acute watery diarrhea was significantly reduced in group A than group B(56.22 versus 70.69 hours respectively), (P-0.002)and frequency of stool also reduced in group A than group B(3.92 versus 7.15 times/day) on day 2 (P-0.002). Consistency of stool also improved in group A than group B[liquid stool12(21.8%) versus 25(45.5%), (P-0.015) on day 1, semi-liquid stool 4 (8.2%) versus 16 (30.8%), (P-0.004) on day 2, formed stool 29 (52.73%) versus 16(29.09%), P-0.004 on day 2 respectively].Conclusion: Combination therapy was more effective in reducing the severity of acute watery diarrhea than zinc alone therapy in children.TAJ 2017; 30(2): 32-38


PEDIATRICS ◽  
1995 ◽  
Vol 95 (2) ◽  
pp. 191-197
Author(s):  
Susana Molina ◽  
Carolina Vettorazzi ◽  
Janet M. Peerson ◽  
Noel W. Solomons ◽  
Kenneth H. Brown

Objective. To assess the effects of glucose (G)-oral rehydration solution (ORS), rice dextrin (RD)-ORS, and rice flour (RF)-ORS on fluid intake, rapidity of rehydration, and stool output of children with acute diarrhea and mild or moderate dehydration. Methods. The study was a randomized, double-masked clinical trial. One hundred forty-six male infants, ages 3 to 36 months, were randomly assigned to one of three treatment groups. Clinical evaluations and fluid balances were conducted every 2 to 4 hours for 48 hours. Principal outcome variables were ORS consumption, recovery of hydration status, and fecal output. Results. The groups were similar at admission with regard to age, nutritional status, history of the current episode, and clinical status. There were no differences in ORS consumption by treatment group during any period of study. During the first 6-hour period, patients in group RF had less stool output (16 ± 14 g/kg/body weight) than those in group G (22 ± 20 g/kg) or RD (21 ± 19 g/kg; P < .05). After 12 hours of hospitalization, there were no differences by treatment group. Recovery of hydration status, changes in serum sodium and potassium, and duration of diarrhea in the hospital were similar in all three groups. Conclusion. There was a 24% to 27% reduction in stool output during the first 6 hours of treatment among children who received RF-ORS compared with those who received G-ORS or RD-ORS, but this effect did not persist after the first 12 hours of therapy. Because this difference was of small magnitude and limited duration, it has minor clinical importance. Thus, we conclude that the three solutions had similar efficacy for children with acute, watery diarrhea and mild or moderate dehydration.


2017 ◽  
Vol 4 (3) ◽  
pp. 691 ◽  
Author(s):  
Ekong E. Udoh ◽  
Martin M. Meremikwu

Background: Diarrhea disease is a leading cause of under-five mortality globally. The World Health Organization recommends low osmolality oral rehydration solution, zinc supplementation and adequate nutrition in the management. Antibiotic is indicated only in specific circumstances. This study was aimed at determining the antibiotic prescription in the management of under-fives with acute watery diarrhea.Methods: An audit of under-fives managed for acute watery diarrhea was conducted between January and February 2012. A multi-stage stratified random sampling technique was used to select 32 health facilities (21 primary and 11 secondary) from two local government areas of Cross River State. Case records of children managed for the condition six months prior to the audit were retrieved and evaluated. The appropriateness, types and frequency of antibiotic prescriptions were assessed.Results: A total of 370 case records were evaluated. Antibiotic was not indicated in any of the children but was prescribed for 291 (78.6%). Of this number, 169 (45.7%) received one antibiotic while 122 (33.0%) received two or more antibiotics. The difference in the prescription of multiple antibiotics between health workers in the primary and secondary facilities was statistically significant (p value = 0.00001). Metronidazole was the most prescribed antibiotic 228 (50.9%), followed by co-trimoxazole 88 (19.6%) and gentamicin 55 (11.8%).Conclusions: There is a high level of irrational antibiotic prescriptions in the State with oral metronidazole being the most prescribed. Periodic training of health workers on indications for antibiotic prescriptions in the management of diarrhea in under-fives is necessary.


2021 ◽  
Vol 9 (4) ◽  
pp. 263-268
Author(s):  
Dr. Mamta Nikhurpa ◽  
◽  
Dr. Renu Agnihotri ◽  

Background: Diarrhea is the major cause of morbidity and mortality among children worldwide.Various studies were done on the role of zinc therapy and probiotic therapy in reducing the durationand severity of acute watery diarrhea. This study aimed to compare the effect of Zinc –probioticcombination versus Zinc only therapy in acute watery diarrhea in pediatric patients. Material andMethods: This was an open, randomized control trial in the pediatric outpatient department of Sub-District Female Hospital, Haldwani (Uttarakhand), from June 2020 till August 2020 for three months.Total 104 children aged six months to 5 years with acute diarrhea who met the inclusion criteriawere enrolled and divided into 52 patients each. 1stGroup A (n=52) received Zinc-Probioticscombination therapy, and 2ndGroup B (n=52) received Zinc only. Measurement of disease severitywas based on the frequency of diarrhea (times/day) and duration of diarrhea (hours) after initialdrug consumption. The resolution was assessed in mean remission time (time required to form solidstool from watery stool).Result: Among the study population in group A, 62% were male, 38%were female, and in group B, 65% were male & 35% were female. Male predominance was observedin both groups. The mean frequency of diarrhea before treatment in Group A was 7.46 ± 4.1times/day as compared to 6.69 ± 3.6 times/day in Group B. Mean duration of diarrhea in Group Awas 53.5 ± 30.5 hours as compared to 57.6 ± 34.3 hours in Group B. Conclusion: Combinationtherapy was more effective than Zinc only therapy in early remission and resolution of acute waterydiarrhea in children.


2020 ◽  
Vol 19 (1) ◽  
pp. 74-77
Author(s):  
Md Anwarul Azim ◽  
Badrud Doza ◽  
Shahed Iqbal ◽  
Farah Chowdhury ◽  
Sanjoy Kanti Biswas

Background: Acute watery diarrhea in under 5 children is still a major healthburden worldwide despite all available efforts that have been made to reduce itsincidence and prevalence. Mortality rate is still high among under 5 children.Therefore, appropriate and comprehensive management of diarrhea is essential.There are lot of studies on the role of zinc and probiotic in reducing the duration andseverity of acute watery diarrhea. This study emphasized on compared effect ofusing a combination zinc –probiotic and zinc in pediatric acute gastroenteritis. Materials and methods: This was a randomized controlled trial type study,conducted at Department of Pediatric Gastroenterology at Chattogram Maa-OShishuHospital Medical College from November 2018 to March 2019. A total of 100numbers of children ages 3 months to 5 years with acute watery diarrhea wereenrolled those who were fulfilled the selection criteria. They were divided into twogroups. Group A (n=50) received zinc-probiotics combination therapy and group B(n=50) received zinc only. Measurement of disease severity was based on thefrequency of diarrhea (Times/day) and duration of diarrhea (Hours) after initial drugconsumption. Results: Among the study population 63.5% male & 32.7% female in group A and56.4% male & 34.5% female in group B. Duration of acute watery diarrhea wassignificantly reduced in group A than group B (56.4 hours versus 70.80 hoursrespectively). We also observed significant difference in length of hospital stay inGroup A and Group B (68.16 hours vs 83.04 hours) respectively. Conclusion: Combination therapy was more effective in reducing the severity ofacute watery diarrhea than zinc alone therapy in under 5 children. Chatt Maa Shi Hosp Med Coll J; Vol.19 (1); January 2020; Page 74-77


2021 ◽  
pp. 188-200
Author(s):  
I. N. Zakharova ◽  
I. V. Berezhnaya ◽  
A. T. Kamilova ◽  
D. K. Dmitrieva ◽  
D. I. Akhmedova

Today, as in ancient times, diarrhea (loss of water and electrolytes along with stool) accompanies many pathological conditions in humans. The pathophysiology of various types of diarrhea has been studied, which made it possible to optimize therapeutic approaches and save the lives of many people. The most dangerous conditions occur in young patients with osmotic and exudative types of diarrhea, as they result in exicosis within a short time. In arriving at a diagnosis, rehydration therapy should be started as soon as possible. The article presents the historical aspects associated with the global pandemics of cholera. The history of the creation of solutions for intravenous and oral rehydration is covered. The authors presented tables for calculating fluid losses and the required volume of solutions for oral or parenteral administration. The modern requirements for rehydration solutions and the principles of rehydration in children are presented. Oral rehydration is particularly problematic for young children due to the limited range of drugs and requirements for the composition of solutions used in pediatrics. According to the recommendations of the World Health Organization and ESPGHAN, clinical recommendations of the Russian Federation, low-osmolar solutions should be used. When complex solutions containing probiotic and zinc are used, the therapy compliance increases. A rehydration solution, which contains a weighted amount of salt for the preparation of a low-osmolar solution, as well as the probiotic L. reuteri DSM 17938 at least 1 billion of viable bacteria and zinc sulphate 0.004 g is one of the latest solutions. The results of studies of this solution are provided.


2019 ◽  
Vol 10 (3) ◽  
pp. 536-551
Author(s):  
Heidi Amezcua Hempel ◽  
María Salud Rubio Lozano ◽  
Eliseo Manuel Hernández Baumgarten ◽  
Pablo Correa Girón † ◽  
Oscar Torres Ángeles ◽  
...  

The study was to determine the presence of Classical Swine Fever virus (CSFv), in the meat of vaccinated pigs with the PAV-250 strain and then challenged using the same strain. Five treatment groups were established (each with four pigs). Group A: Pigs thatwere fed with processed hams from negative animals; Group B: Pigs that were fed with processed hams from commercial pigs inoculated with the ALD (reference strain) (titre of 104.0/ml); Group C: Pigs fed with processed hams from pigs infected with the virulent ALD strain (titre of 102.5/ml); Group D: Pigs fed with processed hams from pigs vaccinated with the PAV-250 strain and challenged with the ALD strain (titre of 101.1/ml); and Group E: Pigs fed with processed hams from pigs vaccinated with two doses of the PAV-250 strain and challenged with the ALD strain (negative). Blood samples were taken at d 1, 5, 10, 15 and 20 for biometric analysis. Groups B, C and D manifested clinical signs of CSFv: 40 °C temperature, anorexia, paralysis, vomiting, diarrhea, tremor, hirsute hair and cyanosis. Pigs were slaughtered and necropsies performed to identify lesions in tissues. Results of direct immunofluorescence testing of tissues were positive and the virus was recovered. Under these study conditions, it was found that CSFv resisted the cooking method at 68 °C for 40 min in hams from unvaccinated pigs, and that the virus was able to transmit the disease to healthy unvaccinated pigs, whereas the hams from the vaccinated animals did not transmit the virus.


2009 ◽  
Vol 21 (3) ◽  
pp. 344-345 ◽  
Author(s):  
Silke Schmitz ◽  
Christina Coenen ◽  
König Matthias ◽  
Thiel Heinz-Jürgen ◽  
Reto Neiger

Different antibody-based tests for rapid detection of Canine parvovirus antigens in feces are commercially available, allowing quick diagnosis in a clinical setting. However, the diagnostic accuracy of these tests compared with standard methods has not been evaluated so far. In the current study, 3 commercial tests were compared with immune-electron microscopy (IEM) and polymerase chain reaction (PCR). Dogs were divided into 3 groups: group A, samples from dogs with acute hemorrhagic diarrhea ( n = 50); group B, dogs with chronic diarrhea ( n = 10); and group C, dogs with no evidence of gastrointestinal disease ( n = 40). Specificity of all 3 commercial tests versus PCR and IEM was good to excellent (92.2–100%). Sensitivity, in contrast, was poor: 15.8–26.3% versus PCR and 50–60% versus IEM. In group A, 10 dogs were positive by IEM and 24 dogs were positive by PCR. Positive PCR results were also obtained from animals in control groups (group B, 1 dog; group C, 5 dogs). No dog in group B or C was positive by IEM. In conclusion, the rapid tests are useful to diagnose canine parvoviral enteritis, but they do not rule out parvovirus infection in an animal with typical clinical signs. In addition, a small percentage of healthy dogs and dogs with chronic diarrhea showed positive PCR results; this may be due to asymptomatic/persistent infection or intestinal passage of virus. The significance of this finding remains unclear.


2015 ◽  
Vol 43 (02) ◽  
pp. 91-96 ◽  
Author(s):  
R.-L. Austin-Busse ◽  
A. Ladinig ◽  
G. Balka ◽  
S. Zoels ◽  
M. Ritzmann ◽  
...  

Summary Objective: In the present study various tissues of pigs were investigated for the presence of histopathologic lesions after an experimental infection with Haemophilus (H.) parasuis serovar 5. Material and methods: Conventional pigs (n = 36) were divided into a control group B (n = 9) and a challenge group A (n = 27), which was infected intratracheally. Pigs that did not die prior to study termination were euthanized on day 14 post inoculation. Postmortem samples of the lung, heart, liver, kidney, spleen, left tarsal joint capsule and brain were collected. Results: All but one pig with detectable histopathologic lesions (n = 11) showed typical macroscopic changes. Histopatho logic examination of all tissue samples identified pyelitis (n = 10), synovitis (n = 7) and meningitis (n = 7) and all those animals were euthanized prior to study termination. No histopathologic lesions were found in pigs of the control group. The correlations between pyelitis and meningitis, pyelitis and synovitis and synovitis and meningitis were significant (p < 0.001). No significant correlation could be observed between the histopathologic and the clinical examination of the joints. The investigation of samples from the joints by PCR was not significantly correlated with the observed synovitis. The clinical observation of neurologic signs was significantly correlated with meningitis (p = 0.03). A significant correlation (p < 0.001) could be detected between meningitis and the detection of H. parasuis by PCR in brain samples. Conclusions: H. parasuis constantly causes clinical signs and pathologic lesions as soon as it infects the brain while it can infect the joints without causing histopathologic lesions. Pigs with histopathologic lesions do not always show typical clinical signs. Only few studies described the finding of kidney lesions in pigs with Glässer’s disease and this is the first study to describe a pyelitis in pigs experimentally infected with H. parasuis. The observed pyelitis mainly occurred in acute cases.


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