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52. Clinical trials of improved oral rehydration salt formulations: a review

Author

Bhan, M. K., Mahalanabis, D., Fontaine, O., and Pierce, N. F.

Subjects
Diarrhea, Clinical Trials as Topic, Double-Blind Method, Child, Preschool, Rehydration Solutions, food and beverages, Humans, Infant, Research Article, Randomized Controlled Trials as Topic
Abstract

Reviewed are all the published clinical trials of glycine-based oral rehydration salts (ORS), L-alanine-based ORS, L-glutamine-based ORS, maltodextrin-based ORS, and rice-based ORS, as well as the results of several recently completed, but unpublished, studies of these formulations that were supported by WHO. All experimental ORS formulations contained the same concentrations of salts as citrate-based WHO-ORS; all trials were randomized comparisons with WHO-ORS, and all except those with rice-based ORS were double-blind studies. The rate of stool loss and, less frequently, the duration of diarrhoea were used as indicators of clinical performance to compare ORS formulations. The following conclusions were reached concerning the efficacy and use of modified ORS formulations. Rice-based ORS (50 g/l) is superior to WHO-ORS for patients with cholera, and for such patients it can be recommended in any situation where its preparation and use are practical. Rice-based (50 g/l) and WHO-ORS solutions are equally effective for treating children with acute non-cholera diarrhoea, when feeding is resumed promptly following initial rehydration, as has been consistently recommended by WHO. Since rice-based ORS is not superior to WHO-ORS for such children, there is no apparent reason to advise a change from glucose to pre-cooked rice in the recommended formulation for WHO-ORS. Maltodextrin-based ORS formulations (50 g/l) and WHO-ORS appear to be equally effective for treating children with acute non-cholera diarrhoea; there is no reason to advise a change from glucose to maltodextrin in the recommended formulation for WHO-ORS. Amino-acid-containing ORS formulations are not recommended for either non-cholera or cholera diarrhoea, since they are more costly and have no clinical advantage over WHO-ORS for children with acute non-cholera diarrhoea or over rice-based ORS for persons with cholera.

Published
1994

61. Possible Role of Neonatal Infection with the Asymptomatic Reassortant Rotavirus (RV) Strain I321 in the Decrease in Hospital Admissions for RV Diarrhea, Bangalore, India, 1988–1999

Author

Vethanayagam, R. R., primary, Ananda Babu, M., additional, Nagalaxmi, K. S., additional, Maiya, P. P., additional, Venkatesh, H. A., additional, Purohit, S., additional, Behl, R., additional, Bhan, M. K., additional, Ward, R. L., additional, Greenberg, H. B., additional, and Durga Rao, C., additional

Published
2004
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65. Aggregative Escherichia coli, Salmonella, and Shigella are associated with increasing duration of diarrhea.

Author

Bhan, M., Sazawal, S., Raj, P., Bhandari, N., Kumar, R., Bhardwaj, Y., Shrivastava, R., Bhatnagar, S., and Bhan, M K

Abstract

In order to relate etiology of diarrhea to the duration of the episode, a cohort of 452 children up to 36 months of age was visited once weekly at their households for 18 consecutive months to record diarrheal morbidity. Fecal specimens were obtained in 453 diarrheal episodes occurring in 354 children during this period. The common putative agents as single isolations associated with diarrhea were EA-AggEC (17.2%), ETEC (14.1%), EPEC (6.0%) and rotavirus (4.0%). The pathogens with higher median duration of diarrhea were Shigella (13.5; mean +/- SD 13.7 +/- 2.7), Salmonella (8.8: 15.3 +/- 4.5) and EA = AggEC (12.0: 15.1 +/- 1.8). Of 55 episodes with duration of greater than 14 days, the main pathogens isolated were EA-AggEC (32.7%), ETEC (9.0), Salmonella, G. lamblia (5.5% each) and Shigella (3.5%). These data provide a preliminary evidence to suggest that EA = AggEC may well be the main long sought microbial agent responsible for diarrhea of long duration. [ABSTRACT FROM AUTHOR]

Published
1989
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67. Districtwise wheat and rice yield predictions using meteorological variables in eastern Madhya Pradesh.

Author

GIRI, A. K., BHAN, M., and AGRAWAL, K. K.

Subjects
WHEAT yields, RICE yields, AGRICULTURAL meteorology, AGRICULTURE, PREDICTION models
Abstract

District wise rice and wheat yield prediction equations were developed for seven districts of eastern Madhya Pradesh using weakly weather data from 1980-2009. The coefficient of determination (R2) varied between 0.4 - 0.78 for rice and 0.6 - 0.92 for wheat in different districts. Model performance was evaluated with independent reported data for year 2010 and 2011. As the deviations for both the years were less than ± 15 per cent, the models can be used for predicting the rice and wheat yields in Madhya Pradesh. [ABSTRACT FROM AUTHOR]

Published
2017
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71. Remote microwave plasma source for cleaning chemical vapor deposition chambers: Technology for reducing global warming gas emissions

Author

Raoux, S., primary, Tanaka, T., additional, Bhan, M., additional, Ponnekanti, H., additional, Seamons, M., additional, Deacon, T., additional, Xia, L.-Q., additional, Pham, F., additional, Silvetti, D., additional, Cheung, D., additional, Fairbairn, K., additional, Jonhson, A., additional, Pearce, R., additional, and Langan, J., additional

Published
1999
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80. Unusual diversity of human rotavirus G and P genotypes in India

Author

Ramachandran, M, primary, Das, B K, additional, Vij, A, additional, Kumar, R, additional, Bhambal, S S, additional, Kesari, N, additional, Rawat, H, additional, Bahl, L, additional, Thakur, S, additional, Woods, P A, additional, Glass, R I, additional, Bhan, M K, additional, and Gentsch, J R, additional

Published
1996
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