The World Health Organization (WHO) recommends an oral rehydration solution (ORS) that has been linked with a risk of hypernatremia in young infants when extra water or dilute milk is withheld. A controlled, randomized study was therefore undertaken in 50 male infants aged 0-3 months to evaluate the relative safety, efficacy, and practicability of two methods of obviating this risk without negating the concept of a universal rehydrating packet. Twenty-five infants in Group A were rehydrated with a 2:1 regimen (two parts, i.e., 60 ml, WHO-ORS followed by one part, i.e., 30 ml, plain water in an alternating manner) whereas 25 infants in Group B received diluted WHO-ORS (1.5 L water instead of 1 L). In two patients, one in each group, oral therapy failed and they were excluded from analysis. Sub-Group Ac was comprised of 15 cases in Group A in whom the rehydrating instructions were followed correctly. Diluted WHO-ORS provided as safe and effective rehydration as the 2:1 regimen administered properly (sub-Group Ac). Both methods adequately corrected and maintained the hydration status and serum sodium levels, but a few infants in each group had subnormal serum K+/HCO-3 levels during therapy. Rehydrating instructions in Group A were misinterpreted in nine (37.5%) cases. Excessive ORS intake in five infants resulted in hypernatremia (three cases, 12.5%), periorbital edema (three cases, 12.5%), excessive irritability (two cases, 8.3%), and mild pedal edema (one case, 4.2%). Excessive water intake in comparison to ORS in four infants was responsible for delayed rehydration (three cases, 12.5%) and asymptomatic hyponatremia and hypokalemia (two cases, 8.3%).(ABSTRACT TRUNCATED AT 250 WORDS)

Acidosis↗

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Controlled trial of rice powder and glucose rehydration solutions as oral therapy for acute dehydrating diarrhea in infants.

A controlled, randomized trial was conducted in 50 infants (3 to 18 months old) hospitalized with acute noncholera dehydrating diarrhea to compare the safety, efficacy, and acceptability of the standard World Health Organization (WHO) recommended glucose oral rehydration solution (ORS) (Group A: 25 infants) with that of a rice powder ORS (Group B: 25 infants), containing 30 g/L of rice powder instead of glucose (20 g/L). The electrolyte composition of both solutions was identical. The proportion of successfully treated patients in each group was 92%, and the two rehydrating solutions proved comparable in correcting and maintaining the hydration status and the serum sodium and potassium levels. The mean rehydration time, stool output, stool frequency, ORS intake, weight gain, and urine output were comparable (p greater than 0.05) in both groups. It is concluded that rice powder ORS is safe, effective, and acceptable as the standard WHO glucose ORS for the treatment of acute noncholera dehydrating diarrhea in infants.

Acidosis↗

PubMedDate not supplied

Hyperreflexia in leprosy.

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Humans↗

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Cardiac function during vagus escape.

It is generally believed that the stimulation of vagus nerve has no direct effect on ventricular myocardium. But recent work has demonstrated clear-cut negative inotropic effect of vagal stimulation on ventricles. In an attempt to study further the effect of vagal stimulation on heart, 15 dogs were studied hemodynamically under nembutal anaesthesia. Bilateral vagotomy caused 9% elevation of heart rate whereas arterial pressure and cardiac output increased by 5% and 3% respectively. Stroke volume output decreased by 8%. Stimulation of the cut peripheral end of vagus caused cardiac standstill followed by vagus escape. During the steady state of vagus escape there was marked reduction in arterial pressure, heart rate and cardiac output, but the stroke volume was significantly elevated above the mean control. These findings suggest that when heart rate decreases, the stroke volume increases in order to restore the decreased cardiac output and that this happens inspite of the negative inotropic effect of vagal stimulation. Thus the Frank-Starling mechanism has a very significant role in an intact organism with normal hemodynamics.

Animals↗