Comparison of immunogenicity of combined DPT--inactivated injectable polio vaccine (DPT - IPV) and association of DPT and attenuated oral polio vaccine (DPT + OPV) in Pakistani children.

Two hundred children aged 2-24 months attending EPI Centre Rawalpindi General Hospital, were randomly assigned to two basic immunization schedules i.e. 3 doses of oral polio vaccine alongwith two doses of DPT (Conventional Schedule) and 2 doses of combined DPT - enhanced injectable polio vaccine (new simplified schedule). Comparison of the seroconversion results showed the presence of protective antibodies against all the 3 types of polio in 100% of the children in both the groups, but there was no statistical difference in the geometric mean antibody titre in the two immunization schedules. After two doses of DPT-IPV or DPT vaccine alone the results demonstrated antibody levels above the protective threshold in both the groups against Diphtheria, Pertussis and Tetanus.

The benefits of the very early introduction of powdered rice and dried edible seeds (Dal moong) in the oral rehydration solution during the treatment of acute infectious diarrhoea of infancy.

We have examined whether the addition of powdered rice and pulses (Dal moong) to oral rehydration solution will decrease the purging rate and thereby increase the efficacy of the oral rehydration therapy. The study was carried out on 60 male infants, with acute watery diarrhoea, moderate dehydration but without fever, vomiting, or other conditions like septicaemia and meningitis. The infants were treated with either the standard WHO oral rehydration salt solution (ORS) or with a modified solution where glucose was removed and powdered rice and Dal moong were added. We found that the infants receiving ORS with powdered rice and Dal moong had significantly lower fluid losses in the stools, a significant and more rapid weight gain, and needed significantly less fluid than the infants receiving ORS only.

Regulation of serum sodium in dehydrated and orally rehydrated infants. Influence of age and of purging rates.

We have examined the control of serum sodium concentration (S-Na) in 60 male infants with acute diarrheal disease, moderate dehydration, but without the presence of fever, vomiting or other conditions. The infants were studied on admission and during oral rehydration therapy (ORT). We examined the effect of rapid reduction of the purging rate on the control of S-Na by adding pulverized rice and pulses (dal moong) to the rehydration solution. On admission S-Na was significantly inversely related to age. This correlation could not only be attributed to difference in stool sodium losses. Changes in S-Na and urinary K/Na ratio during oral rehydration therapy (ORT), were analyzed separately in infants below and above 4 month of age. During the first six hours of ORT, there was an increase in S-Na in all groups. During the following 18 hours, S-Na tended to normalize around 138 mmol/l. Normalization occurred faster if purging rate was reduced. In all groups urinary K/Na ratio (index of aldosterone production and, inversely, of sodium balance), was high at admission and fell during ORT. In the youngest infants (below 4 month of age) the fall was significantly more pronounced if the purging was reduced. We conclude that it is important to consider age when prescribing ORT. The capacity to correct disturbances in S-Na becomes more efficient during maintenance stage of ORT. Correction of S-Na and sodium balance is enhanced by rapid reduction of abnormal intestinal losses.