Comparative efficacy of rice-ORS and glucose-ORS in moderately dehydrated Turkish children with diarrhea
Department of Social Pediatrics, Hacettepe University Institute of Child Health, Ankara, Turkey.The Turkish journal of pediatrics (Impact Factor: 0.43). 01/1995; 37(4):315-21.
The efficacy of precooked rice-based (50 g/L) oral rehydration solution (R-ORS) was compared with standard glucose-based ORS (G-ORS) in a randomized controlled trial in 79 children who were moderately dehydrated due to diarrhea. ORS intake rate and weight gain after rehydration were found to be similar in the two treatment groups (p > 0.05). The time necessary for rehydration was significantly lower in the R-ORS-treated group than in the G-ORS-treated group (5.2 +/- 2.2 and 7.5 +/- 3.4 hours, respectively, p < 0.05). Although the mean serum bicarbonate levels were significantly increased in both treatment groups at the end of the treatment, a significant increase in the mean pH value was observed in only the R-ORS treated group (p < 0.05).
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ABSTRACT: Following the successful rehydration of two moderately dehydrated patients with transient glucose intolerance (TGI) using rice-oral rehydration solution (R-ORS), R-ORS has been used in Hacettepe University Ihsan Dogramaci Children's Hospital Diarrhea Training and Treatment Unit (DTTU) to rehydrate moderately dehydrated children with TGI. The files of children with moderate dehydration and glucose intolerance admitted to the unit were reviewed retrospectively within two periods according to the availability of R-ORS. The clinical and laboratory findings were analysed where available. Before R-ORS became available (September 1993) 6 patients were admitted, all of whom deteriorated with glucose (G)-ORS treatment in 7.0 +/- 3.8 h and were hospitalized for i.v. fluid treatment. During the second period 22 moderately dehydrated children with TGI were admitted. The clinical and laboratory characteristics on admission of the children in the two periods were not statistically different (p > 0.05). Among the 22 patients admitted during the second period 10 were administered G-ORS in the unit and 12 had already received G-ORS at home. Clinical and laboratory deterioration was observed in these 10 patients while receiving G-ORS in the unit within 6.3 +/- 3.7 h and rehydration was continued with R-ORS. Clinical and laboratory improvement were demonstrated in 8 patients within 18.2 +/- 6.5 h. Overall, 17 patients were rehydrated successfully with R-ORS, with a mean time of 18.0 +/- 7.2 h. Five patients were hospitalized. The overall success rate of R-ORS was 77.3%. R-ORS may be considered as an alternative mode of therapy to i.v. treatment in the rehydration of moderately dehydrated children with TGI.Acta Paediatrica 02/1999; 88(1):34-7. DOI:10.1111/j.1651-2227.1999.tb01264.x · 1.67 Impact Factor
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ABSTRACT: Acute diarrhoea is a common cause of death and illness in developing countries. Oral rehydration solutions (ORS) have had a massive impact worldwide in reducing the number of deaths related to diarrhoea. Most ORS is in the form of a sugar–salt solution, but over the years people have tried adding a variety of compounds ('glucose polymers') such as whole rice, wheat, sorghum, and maize. The aim is to slowly release glucose into the gut and improve the absorption of the water and salt in the solution. This review updates and expands on a 1998 Cochrane Review of rice-based ORS, and assesses the available evidence on the use of polymer-based ORS (both rice and non-rice based) in comparison with the glucose-based ORS. The original ORS was based on glucose and had an osmolarity of ≥ 310 mOsm/L (ORS ≥ 310). Glucose-based ORS with a lower osmolarity was later introduced in attempts to improve efficacy, and is considered better at reducing the amount and duration of diarrhoea. Thirty-four trials involving 4214 participants met the inclusion criteria: 27 in children; five in adults; and two in both. Most trials compared polymer-based ORS with a sugar–salt ORS with a particular strength (ORS ≥ 310), which is slightly more salty than the currently agreed best formula (≤ 270 mOsm/L). The trials' methodological quality was variable. Fewer people in the polymer-based ORS group needed a drip to be rehydrated compared with those in the glucose-based ORS group. Adverse events were similar for polymer-based ORS and glucose-based ORS. The authors conclude that polymer-based ORS show some advantages compared to glucose-based ORS for treating diarrhoea of any cause and in diarrhoea caused by cholera. Limited evidence favoured the polymer-based ORS over ORS ≤ 270. Further trials should compare the efficiency of ORS ≤ 270 with a polymer-based ORS.Cochrane database of systematic reviews (Online) 04/2009; 2(2):CD006519. DOI:10.1002/14651858.CD006519.pub2 · 6.03 Impact Factor
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ABSTRACT: Most diarrhoeal deaths can be prevented through the prevention and treatment of dehydration. Oral rehydration solution (ORS) and recommended home fluids (RHFs) have been recommended since 1970s and 1980s to prevent and treat diarrhoeal dehydration. We sought to estimate the effects of these interventions on diarrhoea mortality in children aged <5 years. We conducted a systematic review to identify studies evaluating the efficacy and effectiveness of ORS and RHFs and abstracted study characteristics and outcome measures into standardized tables. We categorized the evidence by intervention and outcome, conducted meta-analyses for all outcomes with two or more data points and graded the quality of the evidence supporting each outcome. The CHERG Rules for Evidence Review were used to estimate the effectiveness of ORS and RHFs against diarrhoea mortality. We identified 205 papers for abstraction, of which 157 were included in the meta-analyses of ORS outcomes and 12 were included in the meta-analyses of RHF outcomes. We estimated that ORS may prevent 93% of diarrhoea deaths. ORS is effective against diarrhoea mortality in home, community and facility settings; however, there is insufficient evidence to estimate the effectiveness of RHFs against diarrhoea mortality.International Journal of Epidemiology 04/2010; 39 Suppl 1(Suppl 1):i75-87. DOI:10.1093/ije/dyq025 · 9.18 Impact Factor
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