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Background: Oral rehydration therapy reduces mortality and morbidity due to diarrheal diseases. However, Oral rehydration therapy remains to be underused worldwide and particularly in low-income countries. This study aims to assess the prevalence of oral rehydration therapy use during diarrheal episode and associated factors among mothers of under-five children visiting public health facilities in North Showa zone, Oromia region, Ethiopia. Methodology: Institutional based cross-sectional study design was employed for one month in June 2020. A structured interview administered questionnaire was used to collect data. Data were entered into EPI-info 3.5.2 then transported to SPSS 21 version. Descriptive statistical analysis was done, and an association between dependent variables and independent variables were examined in logistic regression models. Results: The overall prevalence of oral rehydration therapy use during diarrheal episode was 51.5%. Maternal literacy [AOR= 2.175, 95% CI: (1.178, 4.015)], mothers occupation being farmer [AOR= 0.394, 95% CI: (0.203, 0.762)], post natal care visit [AOR= 2.565, 95% CI: (1.468, 4.480)] and good knowledge of oral rehydration therapy [AOR= 1.919, 95% CI: (1.132, 3.253)] were significantly associated with oral rehydration therapy use. Conclusion: In this study oral rehydration therapy use was moderate. Maternal literacy, good knowledge of oral rehydration therapy, maternal occupation being a farmer, and postnatal care visit were the independent predictors of oral rehydration therapy use. Therefore, programmers and stakeholders who are working on child health programs should design interventions that focus on factors deterring child oral rehydration therapy use during diarrheal episode morbidity and mortality. [ABSTRACT FROM AUTHOR]

Une gastro-entérite correspond à une inflammation de la muqueuse gastrique et intestinale d'origine virale, bactérienne, parasitaire ou toxique. En période hivernale, les gastro-entérites virales sont fréquentes chez les enfants et constituent la première cause d'hospitalisation chez le nourrisson. Un épisode de diarrhée aiguë doit être rapidement pris en charge car ses conséquences sont potentiellement sévères. Gastroenteritis is an inflammation of the gastric and intestinal mucosa of viral, bacterial, parasitic or toxic origin. In winter, viral gastroenteritis is common in children and is the leading cause of hospitalisation in infants. An episode of acute diarrhoea must be managed quickly because its consequences are potentially severe. [ABSTRACT FROM AUTHOR]

Low-osmolality carbohydrate–electrolyte solution (LCS) ingestion can replace losses from exercise-induced dehydration, but the benefits of LCS ingestion strategy after exhaustive endurance exercise (EEE) remain unknown. The present study evaluated the effects of LCS ingestion on dehydration, oxidative stress, renal function, and aerobic capacity after EEE. In our study with its double-blind, crossover, counterbalanced design, 12 healthy male participants were asked to consume LCS (150 mL four times per hour) or placebo (water) 1 h before and 1 h after EEE. All participants completed a graded exercise test to exhaustion on a treadmill for the determination of maximal oxygen consumption ( V ˙ O 2 max ), applied to further intensity calibration, and then completed the EEE test. The average heart rate, maximal heart rate, running time to exhaustion, and peak oxygen uptake (VO2peak) were recorded during the exercise period. The participants’ body weight was recorded at different time points before and after the EEE to calculate the dehydration rate. Blood samples were drawn at baseline and before, immediately after, 1 h after, and 2 h after EEE to determine indicators of oxidative stress and renal function. The results indicated that the dehydration rates in participants with LCS ingestion at 15 min, 30 min, and 45 min after EEE were significantly lower than in participants with placebo ingestion (−1.86 ± 0.47% vs. −2.24 ± 0.72%; −1.78 ± 0.50% vs. −2.13 ± 0.74%; −1.54 ± 0.51% vs. −1.94 ± 0.72%, respectively; p < 0.05). In addition, the concentration of catalase in participants with LCS ingestion immediately after EEE was significantly higher than in participants with placebo ingestion (2046.21 ± 381.98 nmol/min/mL vs. 1820.37 ± 417.35 nmol/min/mL; p < 0.05). Moreover, the concentration of protein carbonyl in participants with LCS ingestion immediately after EEE was slightly lower than in participants with placebo ingestion (2.72 ± 0.31 nmol carbonyl/mg protein vs. 2.89 ± 0.43 nmol carbonyl/mg protein; p = 0.06). No differences were noted for other variables. Our findings conclude that LCS ingestion can effectively avoid fluid loss and oxidative stress after EEE. However, LCS ingestion had no benefits for renal function or aerobic capacity.

The aim of the research was to access clinical efficacy of oral rehydration therapy using III generation solutions in the treatment of secretory diarrhea in infants. To achieve this aim, on the basis of infectious box unit (enteric infections) of regional clinical hospital (Chernivtsi) we examined 116 infants, randomly selected, with acute gastroenteritis, who admitted to the hospital with signs of exycosis due to secretory diarrhea. Among examined patients, 73 (67.5 %) children with the purpose of oral rehydration therapy received rehydration solutions, and 35 (32.4 %) patients received other rehydration solutions. Monitoring of the dynamics of patients’ state enabled to state that, when we used III generation mixture as a main component of oral rehydration therapy, rate of positive dynamics in terms of clinical status of patients was significantly faster, in particular, body temperature, frequency and nature of bowel movements normalized significantly earlier, vomiting disappeared. In children treated with rehydration solutions, compared with patients receiving other rehydration solutions, odds ratio to confine only oral rehydration was 3.7 (95% CI 0.4–38.9) with an absolute risk to avoid the need for infusion therapy — 11 %.

Abstract: Background: Intestinal obstruction is an abdominal disease associated to mortality, especially if complicated with sepsis. Resuscitation increases survival, although controversies remain concerning to therapeutic strategy. Methods: To assess the effects of hypertonic saline and pentoxifylline on the inflammatory response and oxidative stress, Wistar rats underwent a laparotomy loop intestinal obstruction and ischemia. After 24 h, the intestinal segment was resected (IO) without any other treatment and resuscitation/pentoxifylline were administered according to the group: Ringer's lactate (RL); hypertonic saline (HS); pentoxifylline (PTX); Ringer's lactate with pentoxifylline (RL + PTX); hypertonic saline with pentoxifylline (HS + PTX) and the control group (CG) that was not submitted to ischemia and obstruction. Mean arterial pressure (MAP) was recorded 4 times, and euthanasia was done 3 h after the resuscitation to obtain lung tissue, for malondialdehyde (MDA) by thiobarbituric acid reactive substances (TBARS) method, inflammatory cytokines were assessed using ELISA and NF-κΒ by Western blotting. Results: The initial MAP levels were higher in the RL and HS groups than in the others; however, the last measurement was similar among all the groups. IL-1β, IL-6 and CINC-1 (Cytokine-Induced Neutrophil Chemoattractant-1) were lower in the HS, PTX and HS + PTX groups compared with the IO and RL groups. IL-10 was lower in the HS + PTX group than in the IO group. NF-κB in the HS, PTX and HS + PTX groups were lower than in the IO group; NF-κB in the HS + PTX group was lower than in the RL group. MDA in the lung was lower in the HS + PTX group compared with other groups. Conclusion: Hypertonic saline and pentoxifylline, both alone and in combination, attenuated oxidative stress and the activation of NF-κB, leading to a decrease in the inflammatory response. [Copyright &y& Elsevier]

Long-term preservation of human platelets will greatly reduce the risk of their shortage. Lyophilization has been proved feasible for this purpose. For the recovery of lyophilized platelets, rehydration is an important process. In this paper, the rehydration processes for 1 mL and 2 mL samples were studied. The effects of prehydration duration (15, 30, 60, 90, 120 and 150 min) in 37°C water vapor and the concentration of rehydration solution (25%, 50%, 75%, 100% platelet-poor plasma) on the recovery rate, MPV (mean platelet volume) and PDW (platelet distribution width) were investigated. The mass changes during the prehydration process were weighed. The optimized rehydration conditions are as follows: (1) for 1 mL sample, the prehydration duration was 15 min and for 2 mL sample the prehydration duration was 90 min; (2) the rehydration solution was 75% platelet-poor plasma. Under optimized conditions, the morphology of the rehydrated platelets kept normal and their ultrastructures kept intact, their aggregation capacity to thrombin (1 U/mL) was 82.8% of the fresh ones. These results will be helpful for designing the freeze-drying protocols for human platelets. [ABSTRACT FROM AUTHOR]

A rehydration process for freeze-dried human platelets was studied on 1 ml of samples. The effects of prehydration duration, prehydration temperature, and rehydration solution on the recovery rate, mean platelet volume (MPV), and platelet distribution width (PDW) were investigated. The mass changes during the prehydration process were also studied. Three prehydration durations: 0, 1.5, and 3.5 h, and two rehydration solutions: platelet-poor plasma and phosphate-buffered saline (PBS), were tested. It was found that: (1) the prehydration was of significance; (2) 1.5 h of prehydration had better effects than 3.5 h of prehydration; (3) as a rehydration solution, the platelet-poor plasma behaved better than the PBS. The impacts of prehydration duration and temperature on the results were studied. There was almost no difference between 35 and 37 °C. Among all the prehydration durations tested, 15, 30, 60, 90, and 120 min, the best result was achieved with the time duration of 15 min. The weights of prehydrated platelets at the end of each test were measured and the water contents were calculated. After 15 min of prehydration, the water contents in the samples were about (4.8±0.01)% and (5.27±0.29)% (w/w) corresponding to the conditions of 35 and 37 °C, respectively. These results will be helpful for further studies on the freeze-drying of mammalian cells. [ABSTRACT FROM AUTHOR]

Abstract: The lyophilization of human red blood cells has important implications for blood transfusion in clinical medicine. In this study, sugars, human serum albumin, polyvinylpyrrolidone, and dimethyl sulfoxide were used as protective reagents for the lyophilization of red blood cells. Freezing temperature, shelf temperature, and the rehydration conditions were optimized. The results showed that extracellular disaccharides, especially trehalose, did not increase the recovery of hemoglobin. However, when the concentration of human serum albumin was higher than 25%, it had a considerable protective effect on the recovery of lyophilized red blood cells; the cellular hemoglobin recovery was over 70%, which was significantly higher than that in the group without human serum albumin (P &#60;0.01). As the concentration of polyvinylpyrrolidone was increased, the extent of vitrification also increased. But when the concentration of polyvinylpyrrolidone was over 40%, the resulting concentration of free hemoglobin was over 1g/L, which was significantly higher than that with 40% (P &#60;0.01). When lyophilization was carried out after freezing at different temperatures, the recovery of cells and hemoglobin was 70–80% and there were no significant differences among the five groups. When the shelf temperature was higher than −30°C, the samples were partly collapsed, but when the shelf temperature was lower than −30°C, the recovery of cells in the −40 and −45°C groups was significantly higher than in the −30 and −35°C groups (P &#60;0.05). The recovery of cells and hemoglobin after lyophilization and rehydration in solutions containing low concentrations of polymers was over 80%, which is significantly higher than the other groups (P &#60;0.01). In addition, when the temperature was higher than 25°C, the concentration of free hemoglobin was significantly lower than it was at 4°C (P &#60;0.01). In conclusion, our study showed the lyophilization of red blood cells is feasible. Disaccharides have no protective effect on lyophilized cells when they are only extracellular and extensive vitrification may be not beneficial. Although the recovery of cells after lyophilization and rehydration by our method was over 70%, the ultrastructure of the cells may be compromised and some hemolysis does still exist. Further research is required. [Copyright &y& Elsevier]

Low-osmolality carbohydrate–electrolyte solution (LCS) ingestion can replace losses from exercise-induced dehydration, but the benefits of LCS ingestion strategy after exhaustive endurance exercise (EEE) remain unknown. The present study evaluated the effects of LCS ingestion on dehydration, oxidative stress, renal function, and aerobic capacity after EEE. In our study with its double-blind, crossover, counterbalanced design, 12 healthy male participants were asked to consume LCS (150 mL four times per hour) or placebo (water) 1 h before and 1 h after EEE. All participants completed a graded exercise test to exhaustion on a treadmill for the determination of maximal oxygen consumption ( V ˙ O 2 max ), applied to further intensity calibration, and then completed the EEE test. The average heart rate, maximal heart rate, running time to exhaustion, and peak oxygen uptake (VO2peak) were recorded during the exercise period. The participants' body weight was recorded at different time points before and after the EEE to calculate the dehydration rate. Blood samples were drawn at baseline and before, immediately after, 1 h after, and 2 h after EEE to determine indicators of oxidative stress and renal function. The results indicated that the dehydration rates in participants with LCS ingestion at 15 min, 30 min, and 45 min after EEE were significantly lower than in participants with placebo ingestion (−1.86 ± 0.47% vs. −2.24 ± 0.72%; −1.78 ± 0.50% vs. −2.13 ± 0.74%; −1.54 ± 0.51% vs. −1.94 ± 0.72%, respectively; p < 0.05). In addition, the concentration of catalase in participants with LCS ingestion immediately after EEE was significantly higher than in participants with placebo ingestion (2046.21 ± 381.98 nmol/min/mL vs. 1820.37 ± 417.35 nmol/min/mL; p < 0.05). Moreover, the concentration of protein carbonyl in participants with LCS ingestion immediately after EEE was slightly lower than in participants with placebo ingestion (2.72 ± 0.31 nmol carbonyl/mg protein vs. 2.89 ± 0.43 nmol carbonyl/mg protein; p = 0.06). No differences were noted for other variables. Our findings conclude that LCS ingestion can effectively avoid fluid loss and oxidative stress after EEE. However, LCS ingestion had no benefits for renal function or aerobic capacity. [ABSTRACT FROM AUTHOR]

Objective: To determine diarrhea management in rural practitioners.Methods: This study was conducted among the RMP's of 4 blocks of Aligarh. Pre-coded questionnaire was completed and educational programme followed. 91% were prescribing ORS in various combinations, but only 9.8% were advising ORS and feeding as standard management of diarrhea. Only 12.8% could name a WHO ORS brand and 50% were giving wrong instructions for preparation. 95% were advising inadequate amounts of ORS. Only 43.5% were advising feeding during diarrhea but 86.6% were advising to continue breastfeeding. On an average every 3rd to 4th patient was administered IVF's. 52% felt that drugs should be prescribed.Results: 90% and 55.3% of RMPs could identify diarrhea and key signs of dehydration.Conclusion: There is a need for hands on training for the practitioners and education of the masses regarding proper management of diarrhea. [ABSTRACT FROM AUTHOR]

Childhood diarrhea continues to be a major cause of under-five (U-5) mortality globally and in India. In this study, 1571 U-5 children residing in nine rural villages and four urban slums in Ujjain, India were included with the objective to use community participation and drug utilization research to improve diarrheal case management. The mean age was 2.08 years, with 297 (19%), children living in high diarrheal index households. Most mothers (70%) considered stale food, teething (62%), and hot weather (55%) as causes of diarrhea. Water, sanitation, and hygiene (WASH)-related characteristics revealed that most (93%) households had toilets, but only 23% of the children used them. The study identified ineffective household water treatment by filtration through cloth by most (93%) households and dumping of household waste on the streets (89%). The results revealed low community awareness of correct causes of diarrhea (poor hand hygiene, 21%; littering around the household, 15%) and of correct diarrhea treatment (oral rehydration solution (ORS) and zinc use, 29% and 11%, respectively) and a high antibiotic prescription rate by healthcare providers (83%). Based on the results of the present study, context-specific house-to-house interventions will be designed and implemented.

Hypokalaemia is associated with an increase in mortality in children with severe acute malnutrition (SAM) and diarrhoea. This is a descriptive cross-sectional retrospective study conducted in the Nutritional Ward at Mohamed Alamin Hamid Pediatrics Hospital in Omdurman, Sudan. It aimed to assess the frequency of hypokalaemia among children with SAM to understand the influence of hypokalaemia and potassium supplementations contributed on the children survival rates (January-December 2015). It included 215 patients with SAM and acute diarrhoea. The potassium levels of all the patients were assessed upon hospital admission and this correlated with the mortality according to the degree of hypokalaemia and treatment initiated. Hypokalaemia was evident in 70.2% of the patients. Mortality was 3.1% in normokalaemic and 13.9% in hypokalaemic patients. The patients' survival was significantly associated with their serum potassium levels and the treatment received. The survival rates have been assessed via the Multinomial Logistic Model, which reveals that normokalaemic children had a chance of 157.349 (95% confidence interval 18.479-1,339.811) times higher than that compared to the baseline children with advanced hypokalaemia with serum levels <2 mEq/l ( p -value < 0.001). Children with mild hypokalaemia within the serum levels of 3.0-3.4 mEq/ml showed an increased survival chance of 549.970 (95% CI 19.293-3,238.716) times compared to the baseline children (p-value = 0.000). In patients with SAM, who presented with acute diarrhoea, there was an increase in mortality in patients with hypokalaemia compared with patients who presented with normal potassium levels. Corresponding mortality rates increased significantly with the severity of hypokalaemia. In severe hypokalaemia, there is a significant difference in mortality between patients treated with oral rehydration solutions for malnutrition in relation to patients treated with oral potassium supplements or with intravenous potassium.