Write a process-writing on "The preparation of O.R.S "
Answers
Answer:
1. Oral Rehydration Salts By Dr Utpal Sharma Assistant Professor Department of Community Medicine SMIMS, Gangtok, Sikkim
2. Introduction Worldwide, diarrhea claims several million lives annually, mostly those of infants. Poverty, crowding, and contaminated water supplies all contribute. Almost all of these deaths could have been prevented with adequate fluid replacement. Incidence is much lower in developed nations but remains one of the two most common reasons for visits to pediatric emergency departments
3. Cont… More than 5 million children under the age of 5 years die every year due to diarrhoea . In India, more than 1 million children get killed by this miserable disease known as diarrhoea . Before the advent of ORT, death from diarrhea was the leading cause of infant Between 1980 and 2006, With the introduction of ORT, infant deaths, worldwide have decreased the number of, from 5 to 3 million per year.
4. What is diarrhoea? Increases in volume or fluidity of stools, changes in consistency, and increased frequency of defecation. Blood in stool indicate an acute diarrhoeal illnesses or dysentery, irrespective of frequency. “Passage of loose or watery stools at least three times in a 24 h period” WHO
5. Cont…. Diarrhoeal disorders are divided into: Acute Diarrhoea The most usual form of diarrhoeal illness, have an abrupt onset, resolve within 14 days and are mostly caused by infections Persistent Diarrhoea Diarrhoea which persists for longer than 14 days Chronic Diarrhoea Duration of symptoms is longer than a month
6. Pathophysiology of diarrhea Fluid from the body enters the intestinal lumen (isosmotic i.e approx.142 mEq/L Na+) during digestion. A healthy individual secretes 2000–3000mg of sodium per day into the intestinal lumen. Nearly all of this is reabsorbed so that sodium levels in the body remain constant. In a diarrheal illness, sodium rich intestinal secretions are lost before they can be reabsorbed. This can lead to a life-threatening hyponatraemia within hours. This is the motivation for sodium and water replenishment in ORT.
7. Ion exchange in intestine
8. Physiological basis of using ORT in Diarrhoea Sodium passes into epithelial cells by co-transport via the SGLT1 protein. From the intestinal, sodium is pumped by active transport by the Na+ K + pump through to extracellular space. The Na+ K + ATPase pump moves 3 Na+ in exchange for 2 K + This creates a “downhill” sodium gradient within the cell. SGLT proteins use energy from sodium gradient to transport glucose into the cell against the glucose gradient..
9. Cont…. The GLUT uniporters then transport glucose across membrane. SGLT1 protein requires 2 Na+ to co-transport one molecule of glucose (as galactose). Without sodium, intestinal glucose is not absorbed. This is why oral rehydration salts (ORS) include both sodium and glucose. For each cycle, hundreds of water molecules move into the epithelial cell, slowly rehydrating the patient.
10. Oral rehydration therapy Most diarrhea-related deaths in children are due to dehydration…… ….loss of large quantities of water and electrolytes from the body in the liquid stool. Many of these deaths can be prevented with the use of oral rehydration therapy (ORT). Oral rehydration therapy (ORT) is a type of fluid replacement used as a treatment for dehydration. It involves drinking water mixed with sugar and salt and other home available fluids, while continuing to eat.
11. History of ORT Over 2,500 years ago, Sushruta described the treatment of acute diarrhea with rice water, coconut juice and carrot soup. In 1831, William Brooke treated cholera patients with IV Fluids reducing mortality from 70 % to 40 %. IV fluid replacement became the standard of care for moderate/severe dehydration for over a hundred years. Late 1950’s: Dr Hemendranath Chatterjee 1971: Dr. Dilip Mahalanabis 350,000 treated with mortality of 0.36%
12. Oral rehydration solution So as soon as diarrhoea starts, it is essential to give the child extra drinks to replace the liquid being lost. Oral Rehydration solution (ORS) is the cheap, simple and effective way to treat dehydration caused by diarrhoea. ORS drink contains the main elements that are lost from the body during diarrhoea. effective in treating dehydration resulting from all types of acute diarrhoeal diseases. ORS drinks should be given to the child every time a watery stool is passed.
13. Oral rehydration salts
14. PRINCIPLE of ORS Glucose when given orally enhances the intestinal absorption of salt & water. Thus it can correct electrolyte & water deficit. WHOM CAN IT BE GIVEN? All age groups IN WHAT CONDITIONS CAN IT BE GIVEN? All aetiologies All countries
15. Types of ORS?? Sodium bicarbonate based Trisodium citrate based Reduced osmolarity ORS Super ORS