Oral food challenge test to confirm the diagnosis of cow's milk protein allergy

Prevalence of cow's milk protein allergy [CMPA] is between 2 and 8%[1,2]. Results are conflicting and difficult to compare because of the different diagnostic criteria and study designs used, with prevalence rates being higher when based solely on clinical manifestations [usually parents' perception] than when using more objective diagnostic tools, such as the OFC[3,4]. The diagnosis of cow's milk protein allergy [CMPA] can be achieved with certainty only after direct observation of clinical events after milk ingestion. In fact, the common tests to identify CM sensitization [at cutaneous level or using specific IgE determination] have no absolute accuracy[5]. They can return often falsely positive in children who tolerate milk, or conversely can be negative even in the presence of a delayed, non-IgE mediated CMPA, Oral food challenge [OFC] is considered today, according to the literature, the "gold standard" for diagnosing food allergies[6,7]. Such a specific diagnosis will prevent unnecessary and potentially deleterious dietary restrictions when a suspected CMPA is not present. Unfortunately, in the world not all children can avail themselves of the OFC in milk allergy evaluation[8,9]

Low sodium oral rehydration solution versus the W.H.O. Formula in the correction of dehydration in children

This work aimed at comparing the efficacy and safety of an ORS solution containing 60 mEq/ litre of sodium versus the standard WHO formula [ORS-90]. It included 50 wellnourished infants with mild to moderate dehydration classified into 2 groups of 25 each. Mothers were allowed to give either ORS solution to dehydrated infants ad-libitum and feeding was allowed only after correction of dehydration. The study proved that there was no significant differences between both groups as regards the speed of rehydration the amount of ORS needed for rehydration and the weight gain after rehydration as well as the mean serum sodium and potassium. After rehydration, all cases of hyponatremia were corrected in both groups. Asymptomatic hypernatremia was still present in 12% of cases in the ORS-90 group while the risk of hypernatremia was nil in the ORS-60 group. These results were discussed