Epidemic dropsy in Trans Yamuma areas of Delhi and U.P.

Thirty patients of epidemic dropsy from seven families scattered in different areas of East Delhi and UP were studied. The age group of the affected individuals varied from 2 years to 55 years. Argemone oil contamination was found in mustard oil used for cooking. Sanguinarine was detected in all suspected oil samples. Pitting edema of legs was the most consistent feature present in all cases. Other prominent features like local erythema and tenderness were present in 80% and 70% cases, respectively. In contrast to earlier epidemics, two striking features were presence of persistent tachycardia without any pyrexia in all the cases and absence of any ocular problems. There was one death due to congestive heart failure and partial recovery in all others in a 2 months follow up.

Oral therapy of neonates and young infants with World Health Organization rehydration packets: a controlled trial of two sets of instructions.

The World Health Organization (WHO) recommends an oral rehydration solution (ORS) that has been linked with a risk of hypernatremia in young infants when extra water or dilute milk is withheld. A controlled, randomized study was therefore undertaken in 50 male infants aged 0-3 months to evaluate the relative safety, efficacy, and practicability of two methods of obviating this risk without negating the concept of a universal rehydrating packet. Twenty-five infants in Group A were rehydrated with a 2:1 regimen (two parts, i.e., 60 ml, WHO-ORS followed by one part, i.e., 30 ml, plain water in an alternating manner) whereas 25 infants in Group B received diluted WHO-ORS (1.5 L water instead of 1 L). In two patients, one in each group, oral therapy failed and they were excluded from analysis. Sub-Group Ac was comprised of 15 cases in Group A in whom the rehydrating instructions were followed correctly. Diluted WHO-ORS provided as safe and effective rehydration as the 2:1 regimen administered properly (sub-Group Ac). Both methods adequately corrected and maintained the hydration status and serum sodium levels, but a few infants in each group had subnormal serum K+/HCO-3 levels during therapy. Rehydrating instructions in Group A were misinterpreted in nine (37.5%) cases. Excessive ORS intake in five infants resulted in hypernatremia (three cases, 12.5%), periorbital edema (three cases, 12.5%), excessive irritability (two cases, 8.3%), and mild pedal edema (one case, 4.2%). Excessive water intake in comparison to ORS in four infants was responsible for delayed rehydration (three cases, 12.5%) and asymptomatic hyponatremia and hypokalemia (two cases, 8.3%).(ABSTRACT TRUNCATED AT 250 WORDS)

Controlled trial of rice powder and glucose rehydration solutions as oral therapy for acute dehydrating diarrhea in infants.

A controlled, randomized trial was conducted in 50 infants (3 to 18 months old) hospitalized with acute noncholera dehydrating diarrhea to compare the safety, efficacy, and acceptability of the standard World Health Organization (WHO) recommended glucose oral rehydration solution (ORS) (Group A: 25 infants) with that of a rice powder ORS (Group B: 25 infants), containing 30 g/L of rice powder instead of glucose (20 g/L). The electrolyte composition of both solutions was identical. The proportion of successfully treated patients in each group was 92%, and the two rehydrating solutions proved comparable in correcting and maintaining the hydration status and the serum sodium and potassium levels. The mean rehydration time, stool output, stool frequency, ORS intake, weight gain, and urine output were comparable (p greater than 0.05) in both groups. It is concluded that rice powder ORS is safe, effective, and acceptable as the standard WHO glucose ORS for the treatment of acute noncholera dehydrating diarrhea in infants.

Oral rehydration of neonates and young infants with dehydrating diarrhea: comparison of low and standard sodium content in oral rehydration solutions.

Oral rehydration among infants aged 0-3 months has not been adequately investigated. A controlled, randomized study was thus conducted in 65 young infants hospitalized with acute noncholera dehydrating diarrhea. The study was designed to compare the efficacy and safety of the standard WHO oral glucose-electrolyte solution containing 90 mmol of sodium per liter (Group A: 22 infants) with that of an oral glucose-electrolyte solution containing 60 mmol of sodium per liter (Group B: 22 infants) and with standard intravenous therapy (Group C: 21 infants). Among the 44 infants in Groups A and B, none required intravenous therapy. Dehydration, acidosis, and initial hyponatremia or hypokalemia were corrected with equal efficacy in all the three groups. In the critical first 8 h, the mean sodium absorption was significantly higher (p less than 0.01) in Group A. This resulted in hypernatremia (50%), periorbital edema (50%), mild pedal edema (27%), excessive irritability, and convulsions (4.5%). The mean serum sodium levels at 8, 24, and even 48 h were significantly higher (p less than 0.05) than those in Groups B and C. It is concluded that glucose-electrolyte oral solution containing 60 mmol of sodium per liter is as safe and effective as intravenous rehydration for the treatment of noncholera neonatal and early infantile diarrhea, while the standard WHO solution carries a significant risk of hypernatremia under similar conditions.