Search

Sixty children < 2 years of age suffering from mild acute gastroenteritis with < 5 dehydration were randomly assigned to two different isocaloric feeding regimens, viz., a locally prepared milk-free formulation (group A) of rice, lentil, sugar, and coconut oil and a spray dried commercial cow's milk formula (group B). There were two treatment failures in group A and one in group B. The postintervention duration of diarrhea (days) in group A (11.0 ± 10.0) was higher than in group B (7.6 ± 10.8), but these differences were not significant (p > 0.05). The energy intake (kcal/kg/24 h) on postintervention day 4 was 78.7 ± 31.7 in group A and 101.3 ± 41.1 in group B (p > 0.05). The corresponding values for day 7 were 74.2 ± 29.1 and 110.0 ± 41.1, respectively (p < 0.05). The mean weight gain (g/kg/24 h) between admission and the day of recovery in group A (2.0 ± 4.2) was significantly lower (p < 0.05) than in group B (5.8 ± 7.8). Similar trends in weight gain were observed at days 4 and 7. These findings suggest that a cow's milk-based formula is well tolerated by majority of the infants with mild acute gastroenteritis after initial rehydration with ORS. The infants who were fed the milk-free cereal-based diet showed significantly less energy intake and gained weight less rapidly than those who were fed the cow's milk-based formula.

This randomized, double-blind trial determined whether adding 90 mmol/L of alanine with a reduction in glucose to 90 mmol/L (alanine ORS) improves the efficacy of the standard oral rehydration solution (WHO-ORS). One hundred twenty-nine males aged 3–48 months with weight for length ≥70 of NCHS, diarrheal duration ≤96 h, and clinical signs of mild to moderate dehydration were randomly allocated to either treatment group. During 0–6 h of treatment, ORS was offered at 120 ml/kg for rehydration without food or water. Beyond 6 h, ORS was offered as a volume-to-volume replacement for stool losses and a mixed diet of uniform composition was offered in amounts standardized for body weight. The most frequently isolated pathogens in alanine ORS and WHO-ORS groups were rotavirus (42 and 48, respectively) and enterotoxigenic Escherichia coli(15 and 12, respectively). In the 0–6 h period when food was withheld, median urine output in ml/kg (8;5, p< 0.05) and percentage decrease in total serum solids (9:7, p= 0.06) was significantly greater in alanine ORS than in WHO-ORS; median ORS intake and stool output were marginally lower in the alanine group but the differences were statistically not significant. Between 0 h and recovery, although the median values for duration of diarrhea (56.5 and 65.0 h), ORS consumption (260 and 323 ml/kg), and stool output (188.4 and 216.3 g/kg) were lower in the alanine ORS group, these differences with the WHO-ORS group were not statistically significant. Our findings are consistent with improved efficacy of WHO-ORS following alanine fortification but the clinical benefits achieved in these mildly dehydrated cases fall short of what may be clinically meaningful and of relevance to public health

R-1 anti-reticulin antibodies (ARA) were present in sera of 10 of the 12 children who subsequently fulfilled the ESPGAN diagnostic criteria for celiac disease (CD), hut was not found in any children in the age-matched control groups, viz., severely malnourished (n = 20). acute gastroenteritis (n = 23), normally nourished asymptomatic (n = 38), and 42 children with protracted diarrhoea and failure to thrive due to nonceliac causes. ARA was a highly specific (100) and sensitive (83) assay for the early diagnosis of CD. A positive ARA assay with an initial subtotal villous atrophy was seen to always suggest CD, and these together would provide a useful basis for instituting gluten-free diets in suspected cases of CD rather than histological findings alone, which may be often present in children in the third world with protracted diarrhoea and associated severe malnutrition.