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In: Infant and child survival technologies, annual technical update No. 1 by Technologies for Primary Health Care Projects [PRITECH]. Arlington, Virginia, Management Sciences for Health, PRITECH Project, 1984 Sep. 15-8.WHO and UNICEF have recommended a universal oral rehydration solution (ORS) for the treatment of dehydration caused by diarrhea. Several features of this formula have been debated. Some pediatricians in developed countries have expressed concern about the sodium content of the solution, arguing that this can potentially cause an excess of sodium in the blood. However, when used properly, significant adverse consequences of the high sodium concentration (90 mmol/liter pf the solution) have not been demonstrated, and formulas employing lower sodium concentrations have not proven uniformly adequate in correcting dehydration. The replacement of glucose with sucrose in ORS has also been investigated. In the past few years, futher studies have been undertaken to investigate possible improvements in the ORS formula. For instance, a formula employing sodium citrate in the same molarity as the sodium bicarbonate has been proven effective in field studies sponsored worldwide by WHO. The citrate is now recommended for all packets as it extends shelf life. Other alternatives and supplements to the simple sugar in the formula are also under investigation. Solutions using rice-based starches have been demonstrated to be as effective in correcting dehydration as those using glucose or sucrose. In addition, the caloric intake is twice as high with rice-fortified ORS as with regular ORS. Research is under way to identify a super ORS in which the formula is modified to increase further the absorption of water and sodium from the intestinal lumen. Controversy over the potable quality of water for preparation of ORS continues. There is no evidence that bacterial contamination in any way changes the physiologic effectiveness of the resulting ORS solution. Recent studies show that boiling ORS does not change its compostion. Thus, to ensure the quality of water ORS can be boiled. More attractive ORS market presentations, e.g., ORS in tablet form, the provision of pre-mixed solutions in cheap containers such as those for juices, are being introduced in the commercial sectors of many countries. Uses of oral rehydration are reviewed for neonates, for hypernatremia and hyponatremia and other dehydrating conditions such as respiratory illness and dengue hemorrhagic fever and shock syndrome.