Comparative efficacy of racecadotril versus loperamide and probiotics in acute diarrheal illness of adults.

2021 ◽  
Vol 28 (04) ◽  
pp. 605-609
Author(s):  
Amar Nazir ◽  
Muhammad Mustafa Qamar ◽  
Fida Muhammad Sheikh ◽  
Nighat Faima ◽  
Shahzad Aslam ◽  
...  
Keyword(s):  
Oral Rehydration Therapy ◽  
Stool Frequency ◽  
Comparative Efficacy ◽  
Pygmalion Effect ◽  
Double Blind ◽  
Oral Rehydration ◽  
Diarrheal Illness ◽  
Severe Diarrhea ◽  
Illness Study ◽  
Inpatient Management

Objective: Main aim of this research is to evaluate and differentiate the safety, effectiveness and acceptability of racecadotril versus probiotics and loperamide in the out/ inpatient management of adults with acute diarrheal illness. Study Design: Mainly a multicentre, heterogenous, double‐blind, comparable‐ assemblage analysis. Setting: Department of Medicine District Head Quarter Hospital Sargodha. Period: May 2019 to October 2019. Material & Methods: Patients over eighteen years of age (Males/females) having acute diarrheal illness were entitled for this study. Patients who have symptoms of at the minimum three watery stools per 24 hours with less than two weeks duration were considered having acute diarrhea. Acetorphan (100 mg 3 times/ 24hrs), probiotics and loperamide (2 mg succeeding every loose motion) were given orally in 100 adults with moderate severe diarrhea in three different groups of patients. Treatment plus oral rehydration therapy was continued for five days or uptill recuperation, if this sprung up prior. The patients were briefed (at the day one visit) to report during the succeding visit about symptoms control. Patients were not clued-up that normal stool frequency was the main seek of the study, so there was no chance for Pygmalion effect. Results: Towards the end of study it was observed that the quantifiable accomplishment rates for loperamide, racecadotril and probiotics were 89.0%, 94.28% and 33.33% respectively. Denote diarrhea span was (16 +/-1.9h) with racecadotril, (15+/-1.1h) for loperamide and 26 +/- 4.5h) for patients using probiotics. Conclusion: In adult patients having acute diarrheal illness loperamide and racecadotril are expeditious, about equivalently effectual therapies. Probiotics are not as effective as other two drugs but have least side effects. Treatment relevant constipation was more in loperamide group as compare to two others.

scholarly journals PERANAN ZINC PADA PENANGANAN KASUS PENYAKIT DIARE YANG DIALAMI BAYI MAUPUN BALITA

2017 ◽  
Vol 1 (1) ◽  
pp. 22-29
Author(s):  
Riskiyah Riskiyah
Keyword(s):  
Zinc Supplementation ◽  
Severe Disease ◽  
Age Groups ◽  
Oral Rehydration Therapy ◽  
Stool Frequency ◽  
Oral Rehydration ◽  
Beneficial Effects ◽  
Nutritional Immunity ◽  
Cell Immunity ◽  
Speed Up

In Indonesia, diarrhea still is one of top problem public health for causing morbidity and  many deaths. All age groups can be attacked by diarrhea, but severe disease with high mortality especially in infants and toddlers. WHO and UNICEF recommend about management of diarrhea in children namely by adding a supplementation of zinc (Zn) on oral rehydration therapy. Zinc functions in the immune system as a second messenger in signal transduction, cell immunity and nutritional immunity. Zinc also plays an important role in reducing the risk and severity of diarrhea. From some research shows that the effects of therapeutic zinc supplementation can reduce the duration of diarrhea, stool output and stool frequency. The supplementation of 20 mg of zinc per day on the eradication of child diarrhea are less than 5 years and 10 mg per day for infants less than 6 months for 10-14 days. The beneficial effects of zinc supplementation in diarrhea that can speed up the regeneration of the epithelium lining the intestine, increasing the absorption of water and electrolytes in the intestine, increase enzyme levels enterocyte brush-border, and enhance the immune response that can speed up clearance of pathogens from the gut.

scholarly journals LO80: Ondansetron administration to non-dehydrated children with acute gastroenteritis-associated vomiting, in emergency departments in Pakistan: a randomized, blinded, phase 3, superiority trial

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S35-S35
Author(s):  
S. Freedman ◽  
S. Soofi ◽  
A. Willan ◽  
S. Williamson-Urquhart ◽  
N. Ali ◽  
...  
Keyword(s):  
Treatment Group ◽  
Acute Gastroenteritis ◽  
Oral Rehydration Therapy ◽  
Fluid Administration ◽  
Double Blind ◽  
Oral Rehydration ◽  
Intravenous Rehydration ◽  
Intravenous Fluid Administration ◽  
Superiority Trial ◽  
Randomization Scheme

Introduction: In high-income countries, vomiting often impedes oral rehydration therapy, leading to intravenous rehydration fluid administration to children with acute gastroenteritis. Ondansetron administration reduces vomiting and intravenous fluid administration in this population. We evaluated whether ondansetron is similarly effective when employed in Pakistan. Methods: In this 2-hospital, double-blind, placebo-controlled, emergency department-based, randomized trial, we recruited children aged 0·5 to 5·0 years, without dehydration, who had diarrhea and 1 episode of vomiting within 4 hours of arrival. Patients were randomly assigned (1:1), via an internet-based randomization service, using a stratified, variable block randomization scheme, to receive a single dose of oral ondansetron or placebo. The primary endpoint was intravenous rehydration (administration of 20 ml/kg over 4 hours of an isotonic fluid) within 72 hours of randomization. All randomized children were analysed. Results: From July 3, 2014, to January 12, 2017, 626 children were randomized. Intravenous rehydration was provided to 10.8% (34/314) and 10.3% (27/312) of children administered placebo and ondansetron, respectively (OR: 0.946; 95% CI: 0.564, 1.587; P=0.834). A regression model fitted with treatment group and adjusted for antiemetic administration and vomiting frequency in the preceding 24 hours, yielded similar results; OR=0.952; 95% CI: 0.570, 1.589; P=0.850. There was no evidence of interaction between treatment group and age (P=0.974), 3 diarrheal stools in the preceding 24 hours (P=0.983) or 3 vomits in the preceding 24 hours (P=0.554). During the 4-hour study observation period, 24.0% (75/314) and 19.6% (61/312) of children in the placebo and ondansetron groups vomited, respectively; OR: 0.774; 95%CI: 0.528, 1.133; P=0.187. Conclusion: Ondansetron administration did not significantly reduce intravenous rehydration use, suggesting that in children without dehydration, ondansetron administration does not significantly alter the disease course and should not be administered to this group of children.

scholarly journals Assessment of Saudi Mother’s Knowledge and Attitudes towards Childhood Diarrhea and Its Management

2021 ◽  
Vol 18 (8) ◽  
pp. 3982
Author(s):  
Sultan Alghadeer ◽  
Wajid Syed ◽  
Abdulaziz Alhossan ◽  
Ziyad Alrabiah ◽  
Salmeen D. Babelghaith ◽  
...  
Keyword(s):  
Oral Rehydration Therapy ◽  
Childhood Diarrhea ◽  
Cross Sectional ◽  
Oral Rehydration ◽  
Severe Diarrhea ◽  
Related Information ◽  
Adequate Knowledge ◽  
Health Related ◽  
Simple Language ◽  
Transmission Prevention

This study evaluates the knowledge, attitude of Saudi mothers towards diarrhea in their children and its management at home. Online cross-sectional validated online surveys, targeting Saudi mothers who are living in Saudi Arabia, are used to collect data from the beginning of March to the end of April 2019. Our results show that a total of 1140 mothers (52.1% of them were housewives) participated in the study. Approximately 40.3% of participating mothers believed that childhood diarrhea is a major problem in the Saudi community; however, almost 23% of the participants were unable to identify any critical sign of severe diarrhea, and around 66% falsely stated that diarrhea is caused by teething. Although 62% of our participating mothers knew about oral rehydration therapy (ORS), only 23.5% of them used it for their children. Adequate knowledge about the critical signs, causes, transmission, prevention, and management of childhood diarrhea should be applied in simple language to communicate the health-related information clearly.

Analysis of Homeopathic Treatment of Childhood Diarrhea

PEDIATRICS ◽  
1995 ◽  
Vol 96 (5) ◽  
pp. 961-964
Author(s):  
Wallace Sampson ◽  
William London
Keyword(s):  
Active Material ◽  
Oral Rehydration Therapy ◽  
Childhood Diarrhea ◽  
Public Health Importance ◽  
Oral Rehydration ◽  
Severe Diarrhea ◽  
Significant Difference ◽  
Type C ◽  
And Control ◽  
To Receive

The article entitled "Treatment of Acute Childhood Diarrhea With Homeopathic Medicine: A Randomized Clinical Dual in Nicaragua" by Jacobs et al (Pediatrics. 1994;93:719-725) reported a study of the efficacy of homeopathy in the treatment of acute childhood diarrhea. Children with diarrhea were entered into the study if the diarrhea was not severe (type C severe diarrhea patients were sent to a hospital). Oral rehydration therapy was begun, and subjects were randomly assigned to receive either homeopathic preparations or placebos. The preparations were determined by a computerized therapeutic scheme. This scheme depended on a family observer's answers to questions from an "experienced homeopathic practitioner." The article purports to show a statistically significant difference favoring the treatment group over the controls. The report has faults of 1) purpose, 2) method, 3) diagnosis and treatment selection, 4) results interpretation, and 5) authors' editorial comments. The reported difference between treatment and control groups are of dubious significance. This article argues that the study's conclusion that homeopathy is effective for childhood diarrhea is unwarranted. Homeopaths claim that homeopathy is an "alternative" medical system. The authors justify their research in the hope that homeopathy would have public health importance. If true, one would presume the system to be equal to or better than oral rehydration therapy. Therefore, even if it were positive, this study would not prove homeopathy to be an alternative to the standard treatment of childhood diarrhea. METHODS Government agencies do not routinely assay homeopathic products. Homeopathic products have been found to be adulterated with active material.1-3

Oral Rehydration Therapy for Acute Diarrhea in Ambulatory Children in the United States: A Double-Blind Comparison of Four Different Solutions

PEDIATRICS ◽  
1985 ◽  
Vol 76 (2) ◽  
pp. 159-166 ◽  
Author(s):  
Mathuram Santosham ◽  
Barbara Burns ◽  
Vinay Nadkarni ◽  
Stephan Foster ◽  
Steven Garrett ◽  
...  
Keyword(s):  
United States ◽  
Acute Diarrhea ◽  
Oral Rehydration Therapy ◽  
The United States ◽  
Double Blind Study ◽  
Double Blind ◽  
Oral Rehydration ◽  
Rehydration Solutions ◽  
Few Data ◽  
Us Children

Oral rehydration solutions containing 50 to 90 mmol/L of sodium have recently been recommended for the treatment of diarrhea in both hospitalized and ambulatory children in the United States. Few data are available, however, from ambulatory US children. Therefore, we conducted a randomized double-blind study comparing the use of four different oral rehydration solutions with differing concentrations of sodium, glucose, and base. Ambulatory children less than 2 years of age with acute diarrhea (N = 140) were randomly chosen to receive solutions containing sodium at 90 (solution A), 50 (solution B), and 30 mmol/L (solutions C and D). All oral rehydration solutions contained 20 g/L of glucose except solution D which contained 50 g/L of glucose. Solution A contained bicarbonate as its base source whereas the other three contained citrate. All but three (98%) children were treated uneventfully according to the study protocol, and there were no differences among groups in measurements of clinical outcome. It was concluded that in ambulatory US children, oral rehydration solutions containing 90, 50, or 30 mmol/L of sodium can be used safely for the treatment of mild acute diarrhea and that citrate is as efficacious as bicarbonate in the correction of acidosis.

Evaluation of mothers' knowledge about oral rehydration therapy and sodium concentration in homemade sugar salt solutions

2001 ◽  
Vol 77 (6) ◽  
pp. 481-6
Author(s):  
Lauro Virgílio de Sena ◽  
Helcio de S. Maranhão ◽  
Mauro B. Morais
Keyword(s):  
Oral Rehydration Therapy ◽  
Sodium Concentration ◽  
Salt Solutions ◽  
Oral Rehydration

scholarly journals Issues and Controversies in the Evolution of Oral Rehydration Therapy (ORT)

2021 ◽  
Vol 6 (1) ◽  
pp. 34
Author(s):  
David Nalin
Keyword(s):  
Pediatric Patients ◽  
Oral Rehydration Therapy ◽  
Sodium Balance ◽  
Plain Water ◽  
Oral Glucose ◽  
Oral Rehydration ◽  
Low Sodium ◽  
Current Review ◽  
The Subject ◽  
Rehydration Solution

The original studies demonstrating the efficacy of oral glucose-electrolytes solutions in reducing or eliminating the need for intravenous therapy to correct dehydration caused by acute watery diarrheas (AWD) were focused chiefly on cholera patients. Later research adapted the oral therapy (ORT) methodology for treatment of non-cholera AWDs including for pediatric patients. These adaptations included the 2:1 regimen using 2 parts of the original WHO oral rehydration solution (ORS) formulation followed by 1 part additional plain water, and a “low sodium” packet formulation with similar average electrolyte and glucose concentrations when dissolved in the recommended volume of water. The programmatic desire for a single ORS packet formulation has led to controversy over use of the “low sodium” formulations to treat cholera patients. This is the subject of the current review, with the conclusion that use of the low-sodium ORS to treat cholera patients leads to negative sodium balance, leading to hyponatremia and, in severe cases, particularly in pediatric cholera, to seizures and other complications of sodium depletion. Therefore it is recommended that two separate ORS packet formulations be used, one for cholera therapy and the other for non-cholera pediatric AWD.

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