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The Simplest Solution To Life… ORS

Water is a major constituent of the earth and so as our bodies & vital organs. It provides five vital functions in our body: Cell life, Chemical and metabolic reactions, Transport of nutrients, Body temperature regulation, Elimination of waste. However water and salt regulate the water content of the body because of salt’s natural property of osmotic retention of water. Unrefined natural salt is a vital element for all living things & provides many health benefits. So it is obvious that survival of living beings depends on a balanced intake of water and salt.

We know that infant dehydration due to diarrhoea results in 600,000 deaths annually in the developing world due to inappropriate or no treatment. This is largely due to the lack of knowledge among mothers regarding cost-effective interventions tackling diarrheal diseases. Oral Rehydration Salts (ORS) combats this dehydration.

Hence depending on material availability WHO and UNICEF jointly maintain official guidelines for the manufacture of ORS and recommend various alternative preparations. Commercial preparations are available as either pre-prepared fluids or packets of oral rehydration salts (ORS) ready for mixing with the fluid. Improved medicine packaging designs increase caregivers' willingness to provide ORS to children. The sachet size is also reduced to make a smaller volume will reduce the potential for waste and reduce the cost per sachet. Additionally, flavors are added to make the ORS more acceptable to infants.


 

WHO / UNICEF ORS

ORS Osmolarities

Ingredients

g/L

Particle

mmol/L

Sodium Chloride

2.6

Sodium

75

Potassium Chloride

1.5

Potassium

20

Glucose anhydrous

13.5

Glucose

75

    Chloride 65

Trisodium citrate dehydrate

2.9

Citrate

10

Total

20.5

Total

245

In situations where an oral rehydration solution (ORS) is not available, homemade solutions are sometimes used. When ORS is to be prepared without the standard ingredients then simple solution is made as follows– 6 level teaspoons sugar : half teaspoon salt : 1 quart fluid (approx. 1 litre clean water). As part of oral rehydration therapy, WHO recommends supplemental zinc (10 to 20 mg daily) for ten to fourteen days, to reduce the severity and duration of the illness and make recurrent illness in the following two to three months less likely. Preparations are available as a zinc sulfate solution for adults, a modified solution for children and in syrup form.


The oral rehydration therapy is useful in -


  • Oral rehydration therapy as a treatment for the symptoms of dehydration and rehydration in burns in resource-limited settings.
  • ORT is less invasive than the other strategies for fluid replacement, specifically intravenous (IV) fluid replacement.
  • Mild to moderate dehydration in children seen in an emergency department is best treated with ORT.
  • Persons taking ORT should eat within 6 hours and return to their full diet within 24–48 hours.
  • ORT in combination with anti-nausea drugs is indicated for vomiting patients sooner.


Vomiting seldom prevents successful rehydration since much of the fluid is still absorbed. If the patient vomits, the World Health Organization (WHO) recommends taking a pause of five to ten minutes and then restarting the solution more slowly. For example, a child under two can be given a teaspoonful of fluid every two to three minutes. The Rehydration therapy is with the optimal fluid - plain, clean water. However, fluids such as rice water, coconut water, vegetable broth, yogurt, weak unsweetened tea, unsweetened fresh fruit juice or even non-potable water are recommended when plain, clean water is unavailable. Water can be boiled or treated with chlorine. However, ORS is not withheld on the basis of potentially unsafe water. Rehydration takes precedence. Hence the simplest solution to life is water & salt balance in the body which is well achieved by ORS.



Dr. Mrs Prajakta Kaduskar

Consultant in Adolescent Paediatrics

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