Is knowledge and practice of oral rehydration therapy suboptimal? Assessment at Federal Medical Center, Asaba, South-South Nigeria

Background: Oral rehydration therapy (ORT) is a core component of the childhood survival strategies to reduce child mortality and morbidity due to diarrhoeal disease with its fatal dehydrating complication of acute kidney injury. This strategy is indispensable to the attainment of the International Society of Nephrology’s (ISN) aim to eliminate preventable deaths from acute kidney injury (AKI) by year 2025. Diarrheal disease is the second most common cause of morbidity and mortality in children at our centre. This interventional study assessed the knowledge and the practice of ORT among caregivers, educated and trained them on the management of diarrhoeal diseases and practice of ORT. Oral rehydration salt (ORS) and zinc tablets were also distributed. Methods: An interviewer-administered questionnaire was used following informed consent. Consented care givers of wards attendees of FMC Asaba were assessed on their knowledge and their practice of ORT, educated on childhood diarrheal diseases, trained on practice of ORT and had ORS and zinc tablets distributed to them. These assessments were done on the spot and 6 weeks after the health talk, from July 2015 to December 2015. Results: There were 266 respondents and 231 were mothers. The immediate impact of the health talk on the knowledge and the practice of ORT was laudable, p≤0.0001 and educational attainment of the respondent influenced the immediate post health talk knowledge of ORT, p=0.009. The age of the respondent predicted the long term impact of health talk on practice of ORT, p=0.020. Conclusions: Knowledge and practice of ORT are not optimal but can be improved by regular education.

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Knowledge, attitude and practice of acute diarrheal disease and use of oral rehydration therapy among mothers of under five children

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193708 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1976

Author(s):

Achinta K. R. Mallick ◽

Janki Bangari ◽

Shalu S. Kumar ◽

Himani Suyal

Keyword(s):

Acute Diarrhea ◽

Diarrheal Disease ◽

Oral Rehydration Therapy ◽

Bottle Feeding ◽

Cross Sectional Survey ◽

Oral Rehydration ◽

Attitude And Practice ◽

Correct Definition ◽

Knowledge And Practice ◽

Knowledge Attitude And Practice

Background: Acute diarrhea in children is among the commonest causes of outpatient and inpatient attendance in medical setup. Though enough has been done in imparting knowledge about diarrhea and its management, there is a gap between knowledge and practice in the population. Aim of the study is to assess the mother’s knowledge, attitude and practice about diarrhea in children.Methods: Cross-sectional survey, conducted in the pediatric department of a peripheral hospital in Pune, Maharashtra.Results: Of the 305 mothers surveyed, their knowledge about diarrhea was good with 77.1% knowing correct definition, and most mothers knowing correctly about its mode of transmission, the positive role of good hygiene & sanitation, breast feeding and oral rehydration therapy (ORT) in prevention and management of acute diarrhea. However, their attitude and practice were found lacking, with higher rate of bottle feeding (59.3%) and lesser use of standard (46.3%) as well as home based (69.9%) ORT measures.Conclusions: There is discrepancy between the knowledge and practice. Hence, there is the need of sustained efforts in imparting both knowledge and practice among the population.

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To Improve the Household Management of Diarrhea

Practicing Anthropology ◽

10.17730/praa.18.3.q560w848241856hx ◽

1996 ◽

Vol 18 (3) ◽

pp. 15-19

Author(s):

Margaret Bentley ◽

Elizabeth Herman

Keyword(s):

Diarrheal Disease ◽

Public Awareness ◽

Oral Rehydration Therapy ◽

Oral Rehydration Salt ◽

Simple Solution ◽

Intravenous Therapy ◽

Oral Rehydration ◽

Child Morbidity ◽

Sustained Use ◽

The 1960S

Diarrheal disease is one of the leading causes of infant and child morbidity and mortality worldwide. Developed in the 1960s, oral rehydration salt solutions (ORS) were a major technological advance, offering a practical alternative to intravenous therapy for treatment of dehydration. Subsequently, ORS in prepacked sachets (or various home prepared solutions, such as sugar-salt solution or cereal-based solutions) have been promoted worldwide for home and clinic treatment of diarrhea. Yet early efforts to promote ORS, often through sophisticated social marketing and mass media programs, showed that increasing public awareness of diarrheal disease and the benefits of ORS did not necessarily lead to the desired behavior change—the effective and sustained use of ORS. (See, for example, M. K. Nations and L. A. Rebhun, "Mystification of a Simple Solution: Oral Rehydration Therapy in Northeast Brazil," Social Science and Medicine 27[1988]:25-38.) Apparently, the "simple solution" is not quite so simple.

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Fifteen-minute consultation: how to identify and treat children with acute kidney injury

Archives of Disease in Childhood - Education and Practice ◽

10.1136/archdischild-2020-319928 ◽

2021 ◽

pp. edpract-2020-319928

Author(s):

Maura Scott ◽

Grace McCall

Keyword(s):

Acute Kidney Injury ◽

Fluid Management ◽

Kidney Injury ◽

Case Presentation ◽

Mortality And Morbidity ◽

Fluid Status ◽

Close Observation ◽

Long Term Follow Up

Acute kidney injury (AKI) is under-recognised in children and neonates. It is associated with increased mortality and morbidity along with an increased incidence of chronic kidney disease in adulthood. It is important that paediatricians are able to recognise AKI quickly, enabling prompt treatment of reversible causes. In this article, we demonstrate an approach to recognising paediatric AKI, cessation of nephrotoxic medication, appropriate investigations and the importance of accurately assessing fluid status. The mainstay of treatment is attempting to mimic the kidneys ability to provide electrolyte and fluid homeostasis; this requires close observation and careful fluid management. We discuss referral to paediatric nephrology and the importance of long-term follow-up. We present an approach to AKI through case-presentation.

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Nutritional Support in Acute Kidney Injury

10.2310/tywc.12040 ◽

2018 ◽

Author(s):

Alice Sabatino ◽

Giuseppe Regolisti ◽

Filippo Fani ◽

Enrico Fiaccadori

Keyword(s):

Acute Kidney Injury ◽

Oxidation Rate ◽

Nutritional Support ◽

Rapid Change ◽

Kidney Injury ◽

Resting Energy Expenditure ◽

Protein Energy Wasting ◽

Mortality And Morbidity ◽

Protein Energy ◽

Increased Risk

Protein-energy wasting (PEW) is particularly common in patients with acute kidney injury (AKI). It is correlated, at least in part, with specific factors of the reduction of renal function and is associated with significant increase in mortality and morbidity. In this clinical condition, the optimal nutritional support remains an open question due to its qualitative composition in terms of macro- and micronutrients. In fact, data on critically ill patients have confirmed that nutritional support targeting the real protein and energy needs is associated with improvement of clinical outcome. However, data available in AKI patients are still scarce. AKI is characterized by increased risk of both under- and overfeeding because of the coexistence of many factors that can influence the evaluation of nutrient needs, such as a rapid change in body weight due to alterations in fluid balance, loss of nutrients during renal replacement therapy (RRT), and the presence of hidden calories in the RRT (ie, calories derived from anticoagulants and/or from solutions used in the different dialysis methods). As AKI comprises a highly heterogeneous group of patients, with oscillatory nutrient needs during patients’ clinical course, nutritional requirements should be frequently reassessed, individualized, and carefully integrated with RRT. Nutrient needs in patients with AKI can be difficult to estimate and should be directly measured, especially in the intensive care unit setting. This review contains 4 figures, 3 tables and 104 references Keywords: Malnutrition In ICU Patients, Acute Kidney Injury, Nutritional Support, Indirect Calorimetry, Resting Energy Expenditure, Lipid Oxidation Rate, Glucose Oxidation Rate, Micronutrients

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A study on oral rehydration therapy of diarrheal disease in Western Sicily

European Journal of Epidemiology ◽

10.1007/bf00239752 ◽

1987 ◽

Vol 3 (2) ◽

Author(s):

A. Nastasi ◽

M.F. Massenti ◽

G. Scarlata ◽

C. Mammina ◽

V. Alestra ◽

...

Keyword(s):

Diarrheal Disease ◽

Oral Rehydration Therapy ◽

Oral Rehydration ◽

Western Sicily

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Influence of β-Lactam Infusion Strategy on Acute Kidney Injury

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00871-17 ◽

2017 ◽

Vol 61 (10) ◽

Cited By ~ 10

Author(s):

Sarah E. Cotner ◽

W. Cliff Rutter ◽

Donna R. Burgess ◽

Katie L. Wallace ◽

Craig A. Martin ◽

...

Keyword(s):

Acute Kidney Injury ◽

Medical Center ◽

Academic Medical Center ◽

Kidney Injury ◽

Intermittent Infusion ◽

Prolonged Infusion ◽

Infusion Group ◽

Academic Medical ◽

Baseline Creatinine ◽

End Stage

ABSTRACT Limited literature is available assessing nephrotoxicity with prolonged β-lactam infusions. This study compared the incidence of acute kidney injury (AKI) associated with a prolonged β-lactam infusion or an intermittent infusion. This was a retrospective, matched-cohort study at an academic medical center from July 2006 to September 2015. Adult patients who received piperacillin-tazobactam (TZP), cefepime (FEP), or meropenem (MEM) for at least 48 h were evaluated. Patients were excluded for preexisting renal dysfunction or pregnancy. The primary outcome was difference in incidence of AKI evaluated using the RIFLE (risk, injury, failure, loss, and end-stage) criteria. Patients in the intermittent group were matched 3:1 to patients in the prolonged-infusion group based on the following: β-lactam agent, age, gender, Charlson comorbidity index, baseline creatinine clearance, hypotension, receipt of vancomycin, and treatment in an intensive care unit. A total of 2,390 patients were included in the matched analysis, with 1,700 receiving intermittent infusions and 690 receiving prolonged infusion. The incidence of AKI was similar in the prolonged-infusion group to that in the intermittent-infusion group (21.6% versus 18.6%; P = 0.1). After multivariate regression, prolonged infusion was not associated with increased odds of AKI (odds ratio [OR], 1.07; 95% confidence interval [95% CI], 0.83 to 1.39). Independent predictors of AKI included TZP therapy, concomitant nephrotoxins, hypotension, and heart failure. Although AKIs were numerically more common in patients receiving prolonged β-lactam infusions than those receiving intermittent infusions, prolonged infusion was not an independent risk factor for AKI.

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Educational Needs of Mothers about using Oral Rehydration Salt (ORS) at Home During Acute Diarrhea in Children under 5 at Urmia Population Research Center

Journal of Public Health International ◽

10.14302/issn.2641-4538.jphi-20-3296 ◽

2020 ◽

Vol 2 (3) ◽

pp. 1-6

Author(s):

Baratali Rezapour

Keyword(s):

Acute Diarrhea ◽

Hospital Admissions ◽

Health Workers ◽

Oral Rehydration Therapy ◽

Educational Needs ◽

Oral Rehydration Salt ◽

Low Literacy ◽

Oral Rehydration ◽

Children Under 5 ◽

At Home

Preventable factors such as infectious diseases (pneumonia, diarrhea, and malaria), malnutrition and neonatal complications are still the leading cause of child mortality worldwide 1 In 2013, it is estimated that 6.3 million babies born worldwide died before the age of 5, and approximately 9.2% of these deaths were due to diarrheal diseases 2, 3 in simple, accessible ways, and effective treatment can reduce diarrhea-related mortality and make hospital admissions unnecessary, and the role of mothers is the most important 4. Since the presentation of Oral Rehydration Therapy (ORT) in 1979, mortality has reduced. Diarrhea has had a steady downward trend 5. If mothers who have children under 5 years of age, used correctly ORS, they could easily resolve the problem of dehydration in acute diarrhea 6. Mothers didn’t use correctly ORS because of their Low literacy and lack of knowledge and wrong attitude about ORT7. Some health care workers provide mothers’ required equipments, regardless of their educational needs, and mothers may not use ORS. In this study, health workers identified mothers' educational needs and subsequently they trained them about using ORS at home in acute diarrhea in children under 5 years of age

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Mechanisms of LPS-Induced Acute Kidney Injury in Neonatal and Adult Rats

Antioxidants ◽

10.3390/antiox7080105 ◽

2018 ◽

Vol 7 (8) ◽

pp. 105 ◽

Cited By ~ 8

Author(s):

Egor Plotnikov ◽

Anna Brezgunova ◽

Irina Pevzner ◽

Ljubava Zorova ◽

Vasily Manskikh ◽

...

Keyword(s):

Oxidative Stress ◽

Acute Kidney Injury ◽

Smooth Muscle Actin ◽

Accelerated Aging ◽

Kidney Injury ◽

Nuclear Antigen ◽

Kidney Cells ◽

Adult Rats ◽

Mortality And Morbidity ◽

Causes Of Mortality

Neonatal sepsis is one of the major causes of mortality and morbidity in newborns, greatly associated with severe acute kidney injury (AKI) and failure. Handling of newborns with kidney damage can be significantly different compared to adults, and it is necessary to consider the individuality of an organism’s response to systemic inflammation. In this study, we used lipopolysaccharide (LPS)-mediated acute kidney injury model to study mechanisms of kidney cells damage in neonatal and adult rats. We found LPS-associated oxidative stress was more severe in adults compared to neonates, as judged by levels of carbonylated proteins and products of lipids peroxidation. In both models, LPS-mediated septic simulation caused apoptosis of kidney cells, albeit to a different degree. Elevated levels of proliferating cell nuclear antigen (PCNA) in the kidney dropped after LPS administration in neonates but increased in adults. Renal fibrosis, as estimated by smooth muscle actin levels, was significantly higher in adult kidneys, whereas these changes were less profound in LPS-treated neonatal kidneys. We concluded that in LPS-mediated AKI model, renal cells of neonatal rats were more tolerant to oxidative stress and suffered less from long-term pathological consequences, such as fibrosis. In addition, we assume that by some features LPS administration simulates the conditions of accelerated aging.

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Use of Oral Fluids in Treatment of Diarrhea

Pediatrics in Review ◽

10.1542/pir.7.1.27 ◽

1985 ◽

Vol 7 (1) ◽

pp. 27-30

Author(s):

William J. Klish

Keyword(s):

Fluid Intake ◽

Diarrheal Disease ◽

Medical Profession ◽

Folk Medicine ◽

Oral Rehydration Therapy ◽

Early 19Th Century ◽

Oral Rehydration ◽

Oral Fluids ◽

Folk Remedy ◽

History Of

The practicing physician cannot help but be somewhat surprised by the current interest and publicity given to oral rehydration therapy for diarrheal disease. Indeed, oral rehydration therapy has been used to some extent by all physicians who deal with diarrhea, and the history of its use as a folk remedy is probably as long as the history of diarrheal illness. Why, then, has interest in this rather mundane therapy reemerged? Only recently have we begun to understand how oral fluids are absorbed, and this has resulted in changes in the composition and indications for use of these fluids. Even though the need for fluid intake during an episode of diarrhea has appeared always to have been a part of folk medicine, the medical profession did not consider this practice until the early 19th century. In 1832, after William O'Shoughnessy, an Irish physician, described the chemical composition of the stools in cholera, Thomas Latta of Scotland attempted to treat cholera by the intravenous infusion of water and salts. Of the 15 cases he reported in The Lancet, five patients survived. Latta was criticized severely for this therapy, but it was pointed out (in discussion in The Lancet) that these five patients were saved from almost certain death.

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The impact of minimal invasive extracorporeal circulation on postoperative kidney function

Perfusion ◽

10.1177/0267659120954601 ◽

2020 ◽

pp. 026765912095460

Author(s):

Ara Shwan Media ◽

Peter Juhl-Olsen ◽

Nils Erik Magnusson ◽

Ivy Susanne Modrau

Keyword(s):

Acute Kidney Injury ◽

Renal Function ◽

Kidney Function ◽

Extracorporeal Circulation ◽

Artery Bypass ◽

Bypass Graft ◽

Kidney Injury ◽

Minimal Invasive ◽

Mortality And Morbidity ◽

The Impact

Introduction: Acute kidney injury following cardiac surgery is a frequent complication associated with increased mortality and morbidity. Minimal invasive extracorporeal circulation is suggested to preserve postoperative renal function. The aim of this study was to assess the impact of minimal invasive versus conventional extracorporeal circulation on early postoperative kidney function. Methods: Randomized controlled trail including 60 patients undergoing elective stand-alone coronary artery bypass graft surgery and allocated in a 1:1 ratio to either minimal invasive (n = 30) or conventional extracorporeal circulation (n = 30). Postoperative kidney injury was assessed by elevation of plasma neutrophil gelatinase-associated lipocalin (NGAL), a sensitive tubular injury biomarker. In addition, we assessed changes in estimated glomerular filtration rate (eGFR), and the incidence of acute kidney injury according to the Acute Kidney Injury Network (AKIN) classification. Results: We observed no differences between groups regarding increase of plasma NGAL (p = 0.31) or decline of eGFR (p = 0.82). In both groups, 6/30 patients developed acute kidney injury according to the AKIN classification, all regaining preoperative renal function within 30 days. Conclusion: Our findings challenge the superiority of minimal invasive compared to conventional extracorporeal circulation in terms of preservation of renal function following low-risk coronary surgery.

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