Reduction of stool bacterial counts and prevention of diarrhea using an oral homeopathic product in newborn lambs.

Lamb farming is generally a secondary activity for farmers, and many breeding systems suffer from management failures that impair production. One reason for decline in performance is enteritis, usually affecting newborn lambs. Enteritis can be fatal, especially in dairy herds. Generally, lambs are fed sucrose or unprocessed milk from sheep or cow that is heated and fed to animals two or three times a day in baby bottles. However, on most farms, milk temperature differs among feeds, as often the process of alteration among diet adaptations is deficient, contributing to enteritis and consequent diarrhea. Therefore, the objective of the present study was to verify the administration of the homeopathic product (Dia 100®) in newborn and bottle-fed lambs, in order to prevent or minimize the occurrence of diarrhea. We studied 60 lambs, divided into two groups with ten repetitions each (n = 30) and during the nursing period (1-45 days of life). Animals in the treated group received the homeopathic product (36 g) orally divided into three doses (1, 7 and 14 days of life). We measured weight gain, mortality, bacterial counts (Escherichia coli and total coliforms) in feces, hematological analysis (leukocytes, hematocrit, hemoglobin and erythrocytes) and biochemical analyses (glucose, triglycerides, cholesterol, albumin, globulin, urea and total protein) at four time-points. There were no differences in weight gain between groups (P > 0.05); however, there was a higher mortality rate in the control group (13%) than in the treated group (6%). E. coli counts were significantly higher in the stools of control group lambs on days 15 and 45 of the experiment (P < 0.05). Total leukocyte counts were greater in treated animals due to greater numbers of lymphocytes on day 15 of the experiment (P < 0.05). In the treated group, we found higher serum levels of total protein, urea (day 15), globulin and triglycerides (days 15 and 30). In the period of administration of the homeopathic product, there was substantial and significant reduction of cases of diarrhea (up to day 14); however, after this period, there were no difference between groups. Based on these results, we concluded that the homeopathic product had moderate efficacy in terms of control of diarrhea. The treated lambs made better use of nutrients, contributing to the development of their immune responses.

Homeopathic treatment as an alternative prophylactic to minimize bacterial infection and prevent neonatal diarrhea in calves.

Bovine neonatal diarrhea is common due low immunity in newborn calves, poor management (or absence) of sanitary barriers, and other factors. Newborn calves with diarrhea in the first days of life suffer failure to thrive and may die if left untreated. The aim of this study was to evaluate whether prophylactic administration of a homeopathic product (Dia 100®) can control bovine neonatal diarrhea in calves born on a farm with substantial sanitary challenges. We counted total bacteria and protozoan parasites in fecal samples. We measured serum glucose, total protein, globulin, albumin, cholesterol and triglycerides on days 1, 7 and 14 of life. Twenty newborn calves were maintained in individual stalls, and were divided in two groups: ten untreated animals (control) and ten animals treated with Dia 100®. Fecal consistency was evaluated daily. We diagnosed diarrhea in five animals in the treated group, and in all animals from the control group. Infections with Escherichia coli and Giardia duodenalis were identified as the responsible organisms. The E. coli count was low in the treatment group on day 7 of life compared with the control group. Antibiotics were given to eight animals in the control group, and to two animals in the treatment group. On day of life 7, serum levels of total protein and globulins were higher in the control group, but were lower on day 14. Serum levels of glucose and triglycerides were greater in treated animals on days 7 and 14, suggesting that the homeopathic product contributes to improvement of intestinal health and absorption and nutrients. We conclude that Dia 100® controls diarrhea with 50% of efficacy, and reduces antibiotic utilization.

[Management of Acute Gastroenteritis in Children: A Systematic Review of Anthroposophic Therapies].

BACKGROUND: Acute gastroenteritis in children accounts for about 10% of hospital admissions and is still one of the major causes of death worldwide. As many children are treated with complementary and alternative medicine (CAM) and anthroposophic medicine, respectively, especially in Europe, the aim of this review was to descriptively present published anthroposophic therapies applied for the treatment of acute gastroenteritis in childhood. METHODS: A complex search strategy recording a broad spectrum of CAM therapies was developed to identify anthroposophic therapy options for the treatment of gastroenteritis in children. The search was conducted in 4 general scientific as well as 3 CAM-specific databases. RESULTS: In total, 3,086 articles were identified and screened for anthroposophic related content. The majority of hits deal with nutritional/dietary therapies. Articles considering anthroposophic approaches constitute only 3.1% (7/227) of all CAM-related articles. Among these articles 2 observational studies, 3 experience reports and 2 reviews were identified. In the experience reports, a variety of anthroposophic remedies was recommended but mostly unsupported by scientific evidence. However, observational studies for the anthroposophic medications, Bolus alba comp. and Gentiana comp., were detected. Additionally, studies investigating the efficacy and safety of Chamomilla, Ipecacuanha, Podophyllum or Tormentilla preparations in homeopathy and phytomedicine, respectively, were presented. CONCLUSIONS: Most CAM-associated therapies for gastroenteritis in childhood comprise dietary recommendations. Studies concerning anthroposophic approaches and medications, respectively, are deficient. The results of this study underline that effort is needed to evaluate anthroposophic therapies in a clinical setting.

Uso de secnidazol y homeopatía para el control de giardiasis en perros / Use of secnidazole and homeopathy for giardiasis control in dogs

RESUMEN Los perros con infecciones por Giardia tienen diarrea que persiste durante días, incluso después del tratamiento. Manejamos la giardiasis canina usando dos enfoques distintos: tratamiento con el secnidazol antiprotozoario solo; y secnidazol más un producto homeopático indicado para el control de la diarrea en perros. Tratamiento I: Diez perros beagle mostraron signos clínicos de diarrea severa. Sus heces revelaron una gran cantidad de quistes compatibles con Giardia sp. Por lo tanto, tratamos a los perros con secnidazol (10 mg/kg, dosis única) por vía oral. Cinco días después del tratamiento, todos los perros fueron negativos para Giardia spp. Tratamiento II: Tres meses después, los mismos diez Beagles nuevamente presentaron diarrea. Se recogieron las heces, revelando Giardia sp. en todos los perros. Esta vez, los tratamos con un antiprotozoo (secnidazol, dosis de 10 mg/kg) combinado con un medicamento homeopático comercial para el control de la diarrea (dosis de 3 g/animal a intervalos de 12 h). Descubrimos que se necesitaban de tres a cinco dosis homeopáticas para lograr puntajes fecales normales en todos los perros. Después de 5 días de tratamiento, las muestras de heces tuvieron una consistencia normal y fueron negativas para Giardia. Este es el primer registro de uso de secnidazol para el control de la giardiasis canina asociado con homeopáticos para evitar la diarrea.

ABSTRACT Dogs with Giardia infections have diarrhea that persists for days, even after treatment. We managed canine giardiasis using two distinct approaches: treatment with the antiprotozoan secnidazole alone; and secnidazole plus a homeopathic product that is indicated for control of diarrhea in dogs. Treatment I: Ten beagle dogs showed clinical signs of severe diarrhea. Their feces revealed large numbers of cysts consistent with Giardia sp. Therefore, we treated the dogs with secnidazole (10 mg/kg, single dose) given orally. Five days after treatment, all dogs were negative for Giardia spp. Treatment II: Three months later, the same ten Beagles again presented with diarrhea. Feces were collected, revealing Giardia sp. in all dogs. This time, we treated them with an antiprotozoan (secnidazole, 10 mg/kg dose) combined with a commercial homeopathic drug for diarrhea control (3 g dose/animal at 12 h interval). We found that three to five homeopathic doses were needed to achieve normal fecal scores in all dogs. After 5 days of treatment, stool samples had normal consistency and were negative for Giardia. This is the first record of using secnidazole to control canine giardiasis associated with homeopathic drugs to prevent diarrhea.

The occurrence of diseases and their relationship with passive immune transfer in Holstein dairy calves submitted to individual management in southern Brazil / Ocorrência de doenças e sua relação com a transferência de imunidade passiva em bezerras Holandês criadas em sistema individual no sul do Brasil

Calves are extremely dependent on colostrum intake for the acquisition of passive immunity. This study aimed to determine the occurrence of diarrhea and respiratory diseases and the impact of Failure of Passive Immune Transfer (FPIT) on the health and zootechnical performance of Holstein dairy calves in individual management. This study has been carried out in five commercial farms in Rio Grande do Sul State, Brazil, from March 2017 to January 2018. In this study, 131 calves were followed from birth to 60 days of age. Total Plasmatic Protein (TPP) has been performed to determine passive immune transfer quality in 53 calves (53/131). A daily clinical follow-up has been accomplished aiming at diagnosing diseases and their incidences, and zootechnical measures such as withers height, width of the croup and weight have been evaluated. FPIT rate was 32.07%, diarrhea occurrence and respiratory diseases were 77.9% and 49.6%, respectively. FPIT increased the chances of calves presenting diarrhea and developing respiratory diseases, but no differences on zootechnical performance were found. The frequency of FPIT is still high and is a factor that corroborated the increased risk for diarrhea and respiratory disease but did not influence the performance of calves in the preweaning phase.(AU)

Bezerras são extremamente dependentes da ingestão de colostro para adquirir imunidade passiva. Este estudo teve o objetivo de determinar os índices de ocorrência de diarreia e de doença respiratória, assim como o impacto da falha na transferência de imunidade passiva (FTIP) no desenvolvimento de doenças e no desempenho zootécnico de bezerras Holandês criadas em sistema individual. O estudo foi desenvolvido em cinco propriedades comerciais no Rio Grande do Sul, Brasil, entre março de 2017 e janeiro de 2018. Assim, 131 bezerras foram acompanhadas, do nascimento aos 60 dias de idade. Em 53 animais, foi realizada avaliação de proteínas plasmáticas totais para determinar a qualidade na transferência de imunidade passiva. Acompanhamento clínico diário foi realizado, a fim de diagnosticar doenças e suas incidências, assim como avaliações zootécnicas, como altura de cernelha, largura de garupa, perímetro torácico e peso. O percentual de FTIP foi 32,07%, a ocorrência de diarreias e de doenças respiratórias foi, respectivamente, 77,9% e 49,6%. A FTIP aumentou as chances de as bezerras apresentarem diarreia e doenças respiratórias, mas não alterou o desempenho zootécnico. Conclui-se que a frequência na FTIP ainda é elevada, fator que corroborou o aumento do risco para as diarreias e doença respiratória. Apesar disso, a FTIP não influenciou no desenvolvimento das bezerras na fase de aleitamento.(AU)

Tratamento da diarreia crônica com o medicamento homeopatico phosphorus: relato de caso / Treatment of chronic diarrhea with the homeopathic medicine phosphorus: case report

Há poucos estudos sobre a eficácia do tratamento homeopático na diarréia crônica, por isso relatos de casos são os primeiros degraus da evidência clínica [1]. As pesquisas utilizando medicamentos altamente diluídos têm avançado significativamente e a Medicina sempre está em busca de novas abordagens terapêuticas. Sendo a Homeopatia uma possibilidade no tratamento devido à sua alta resolutividade e baixo custo, comentamos sobre este tema que vem assumindo a cada dia mais importância na sociedade, devido aos impactos que provoca. Este relato de caso tem como objetivo principal apresentar o tratamento Unicista orientado por Hahnemann. Apresentamos o caso de uma paciente adulta que procurou consulta homeopática por diarréia crônica, após longo período de tratamento alopático sem resolução. Relatamos o atendimento, a repertorização e o tratamento com o medicamento policresto Phosphorus (simillimum da paciente). Demonstramos o surpreendente resultado obtido com o tratamento, respeitando a individualidade da paciente e observando os fundamentos da Homeopatia. Concluímos que a atuação do médico tem importância relevante na condução do tratamento e na melhora de qualidade de vida do seu paciente, e que a Homeopatia é uma grande aliada ao minimizar os danos deste transtorno. A cura de uma doença pode ser feita com tratamento homeopático Unicista segundo os ensinamentos do Pai da Homeopatia.

There are few studies on the effectiveness of homeopathic treatment in Chronic Diarrhea, so case reports are the first steps of clinical evidence. Researchs using highly diluted drugs has advanced significantly. Considering a challenge, Medicine is looking for new therapeutic approaches and Homeopathy is a possibility in the treatment due to its high resolution and low cost. We briefly comment on this topic, which is becoming increasingly important in society, due to the impacts it causes. This case report has as main objective to present the homeopathic treatment in a Unicist way according to the guidelines of Hahnemann. In the patient's search for homeopathy, we studied the case, performed the repertorization and found Phosphorus as the patient's simillimum. We demonstrate the surprising result obtained with the homeopathic treatment, respecting the patient's individuality and observing the fundamentals of Homeopathy. We conclude that the doctor's performance has relevant importance in the conduct of the treatment and in the improvement of the patient's quality of life, and that homeopathy is a great ally in minimizing the damage of this disorder. The cure of a disease can be done with Unicist homeopathic treatment according to the teachings of the Father of Homeopathy.

Atividade antiviral e virucida de extratos hidroalcoólicos de própolis marrom, verde e de abelhas Jataí (Tetragonisca angustula) frente ao herpersvírus bovino tipo 1 (BoHV-1) e ao vírus da diarreia viral bovina (BVDV) / Antiviral and virucidal activity of hydroalcoholic extracts of propolis brown, green and jataí bees (Tetragonisca angustula) against Bovine Herpesvirus Type-1 (BoHV-1) and Bovine Viral Diarrhea Virus (BVDV)

Dentre as propriedades biológicas da própolis, a atividade antimicrobiana tem merecido destacada atenção. No presente trabalho, descreve-se a ação antiviral e virucida de três extratos hidroalcoólicos de própolis (marrom, verde e de abelhas jataí (Tetragonisca angustula), frente ao Herpesvírus Bovino tipo (BoHV-1) e ao Vírus da Diarreia Viral Bovina (BVDV). Os três extratos hidroalcoólicos foram obtidos de extração etanólica e são oriundos do sul do Brasil. A composição química dos extratos de própolis foi determinada pela cromatografia líquida de alta eficiência acoplada a espectrômetro de massas (UFLC-PDA-ESI-TOF/MS) que identificou e quantificou compostos como: ácido cafeico e ácido p-cumárico, ácido clorogênico, ácido ferúlico, além de flavonoides como a rutina. A toxicidade celular bem como a atividade antiviral dos extratos de própolis em monocamadas de células MDBK (Madin-Darby Bovine Kidney) foi avaliada através de observação microscópica e quantificada pelo teste de MTT (3-(4,5 dimetiltiazol-2yl)-2-5-difenil-2H tetrazolato de bromo). O extrato de própolis de abelhas jataí demonstrou ser menos citotóxico (1,57µg/mL), quando comparado aos extratos verde (0,78µg/mL) e marrom (0,39µg/mL). Quanto a atividade antiviral, a própolis verde demostrou maior eficácia em ambos os tratamentos celulares (pós e pré-exposição) frente ao BoHV-1 em relação aos outros extratos, ou seja, houve maior viabilidade celular quando comparada aos controles de células e vírus. Já a de jataí apresentou atividade frente aos dois vírus (BoHV-1 e BVDV) no método pré-infecção, enquanto a própolis marrom demonstrou ação apenas frente ao BoHV-1 também no método pré-infecção. Para determinação da atividade virucida foram utilizadas diferentes diluições dos vírus, bem como temperaturas e tempos distintos de incubação. A própolis verde a 37°C propiciou a maior redução no título viral (4,33log) em relação a marrom (log = 3,5log) e de jataí (log = 3,24log). No entanto, frente ao BVDV a própolis jataí apresentou os melhores resultados em ambas as temperaturas (22oC e 37oC). Portanto, os extratos avaliados apresentaram atividade antiviral e virucida frente ao BoHV-1 e BVDV, o que os torna alvo para o desenvolvimento de novos biofármacos como alternativa ao uso de antivirais comerciais em Medicina Veterinária.(AU)

Among the biological properties of propolis, the antimicrobial activity has received prominent attention. In this paper, we describe the antiviral and virucidal effect of three hydroalcoholic extracts of propolis (brown, green and jataí bees (Tetragonisca angustula), against bovine herpesvirus type-1 (BoHV-1) and bovine viral diarrhea Virus (BVDV). All hydroalcoholic extracts were obtained from ethanol extraction. The chemical composition of propolis extracts was determined by high-performance liquid chromatography coupled to mass spectrometer (UFLC-PDA-ESI-TOF/MS) to identify and quantify compounds such as caffeic acid and p-coumaric acid, chlorogenic acid, ferulic, and flavonoids such as rutin. Cell toxicity and antiviral activity of propolis extracts in monolayers of MDBK cells (Madin-Darby Bovine Kidney) were assessed by microscopic observation and quantified by the MTT assay (3- (4.5 dimethylthiazol-2yl) -2- 5-diphenyl-2H-tetrazolato bromine). Propolis extract from Jataí bees proved to be less cytotoxic (1.57mg / ml) when compared to green extracts (0.78mg / ml) and brown (0.39mg/mL). Regarding antiviral activity, propolis has shown greater efficacy in both cellular treatments (post and pre-exposure) against BoHV-1 when compared to other extracts, ie, there was increased cell viability compared to cell and virus controls. Extracts from Jataí showed activity against both viruses (BoHV-1 and BVDV) infection in the pre-test, whereas brown propolis demonstrated action only against the BoHV-1 in the pre-infection method. To determine the virucidal activity, it were used different dilutions of virus, as well as different temperatures and incubation times. The green propolis at 37°C led to a greater reduction in viral titer (4.33log) compared to brown (3.5log) and jataí (3.24log). Jataí propolis showed the best results in both temperatures (22oC and 37oC) when tested against BVDV. In summary, the evaluated extracts showed antiviral and virucidal activity against BoHV-1 and BVDV, and may be important targets for the development of new compounds as an alternative to commercial antivirals.(AU)

Homeopatia para o tratamento de transtornos gastrintestinais em crianças / Homeopathy for the treatment of gastrointestinal disorders in children

Background: Colic and diarrhea are among the most common gastrointestinal disorders in childhood, which manifest spontaneously and acute. The allopathic treatment consists, in most cases, in the administration of the association homatropine-dimethicone to relieve colic, and oral rehydration and loperamide in cases of diarrhea [1,2]. The ineffectiveness of the conventional treatment and the possible adverse effects they may cause have led to increase the demand from children? parents for complementary and alternative therapies, and homeopathy can be one of the first choices in this disorders [3]. Aims: make a literature review evaluating the effectiveness of homeopathic treatment for colic and diarrhea in children, observing the relation between the main medicines prescribed in these disorders and their pathogenesis described in materia medica. Methodology: a literature research was performed applying electronic database, including Medline, HomeoIndex, BIREME, LILACS, PubMed, SciELO, and ScienceDirect in the period from September to December 2010. Results: Data found indicate that few studies are available in the literature to prove the effectiveness of homeopathic medicines for colic and diarrhea in children, but the applicability of this therapeutic modality seems to be useful, safe and low cost, which are important factors for less favored communities. Besides, studies concerning diarrhea are more frequent, not only because of its gravity, but also for the duration, which makes more adequate the monitoring, on the contrary to acute colic. The most cited medicines were Chamomilla, Nux vomica, Arsenicum album and Mercurius solubilis. Conclusions: Homeopathy can be an important source of colic and diarrhea relief. However, more investigations should be performed in order to show parents how valuable this kind of therapy can be to children and the whole family.(AU)

Introdução: a cólica e a diarreia estão entre os transtornos gastrintestinais mais comuns da infância, os quais se manifestam de forma espontânea e aguda. O tratamento alopático consiste, na maioria dos casos, na administração da associação homatropina-dimeticona para o alívio da cólica, e, reidratação oral e loperamida nos casos de diarreia [1,2]. A falta de eficácia do tratamento convencional e os possíveis efeitos adversos que o mesmo pode causar têm levado ao aumento da demanda por parte dos pais por terapias alternativas e complementares e a homeopatia pode ser uma das primeiras escolhas nestas situações [3]. Objetivos: fazer uma revisão da literatura avaliando a efetividade do tratamento homeopático para cólica e diarreia em crianças, observando a relação entre os principais medicamentos prescritos nestes casos e suas patogenesias descritas na matéria médica. Metodologia: foi realizada uma pesquisa na literatura usando as bases de dados eletrônicas, incluindo Medline, Homeoindex, BIREME, Lilacs, Pubmed, Scielo e Sciencedirect, no período de setembro a dezembro de 2010. Resultados: os dados encontrados indicam que poucos estudos estão disponíveis na literatura para provar a efetividade dos medicamentos homeopáticos em cólica e diarreia em crianças, mas a aplicabilidade desta modalidade terapêutica parece ser útil, segura e de baixo custo, que são fatores importantes para comunidades de baixa renda. Além disso, os estudos em relação a diarreia são mais frequentes, não apenas por sua gravidade, mas também pela duração, que torna mais adequado o monitoramento, ao contrário da cólica que é aguda. Os medicamentos mais citados foram Chamomilla, Nux vomica, Arsenicum album e Mercurius solubilis. Conclusões: a homeopatia pode ser um importante recurso para o alívio da cólica e da diarreia. Entretanto, mais pesquisas devem ser realizadas a fim de mostrar aos pais quão valiosa este tipo de terapia pode ser para as crianças e toda a família.(AU)

Evaluation of preventive homeopathic treatment against Colibacillosis in swine production

Escherichia coli is the most important etiologic agent implied in neonatal diarrhea in swine; colibacillosis is the disease with highest impact in production of swine. The demands of consumers for meat without chemical residues and the ban on the use of antibiotics and chemotherapics in production of swine compelled to find alternative therapeutic and preventive treatments. Aims: to assess homeopathic treatment as preventive against colibacillosis in swine. Methods: the study was conducted in a farm in Mato Grosso, Brazil; stools of 4 piglets with diarrhea were collected to establish the presence of E. coli; concomitantly it was performed a clinical exam to identify the symptoms leading to the choice of a homeopathy remedy. Newborn piglets were divided into 4 groups (n= 11 or 12): 1) control, subjected to antibiotic treatment against diarrhea; 2) homeopathic treatment, performed with Phosphorus 30cH according to the symptoms collected; 3) biotherapic treatment, performed with Escherichia coli 30cH prepared from the locally obtained bacteria; 4) homeopathic + biotherapics treatment. Results: all 3 groups treated with homeopathy/isotherapy presented a significant reduction of diarrhea compared to the control group (p=0.02); the group treated with Phosphorus 30cH + Escherichia coli 30cH presented the highest weight gain which was significant by comparison to all other groups (p=0.001). Conclusion: homeopathic and biotherapics treatment were more effective than antibiotics in the control of diarrhea in newborn piglets; combination of homeopathic and isopathic treatment resulted in the highest weight gain. These results suggest that homeopathy and isopathy are effective alternatives for the treatment of diarrhea by E. coli in newborn swine.

Practice of oral therapy: role of village practitioners.

PIP: In September 1978, ICDDR,B started a community training project in Chandpur, Bangladesh. Because there are few doctors in Bangladesh, village practitioners perform many of the services of community health care. In March, 1979, a 7-day training session was conducted for village practitioners in diarrhea, and its management; nutrition; and, health education. Before the training, a KAP study was conducted with the following results: 12% had formal medical education; 60-75% have general education between grade 9 or 10 passed; and, about 90% practice allopathic medicine alone or in combination with homeopathic or indigenous methods. More than 60% have been practicing medicine for 6-10 years. About 70% attend patients from 5-10 villages, but receiving patients from more than 10 villages is not uncommon. Almost half of the practitioners have pharmaceutical shops of their own. Every month, on an average, 58% attend 3-10 cases.^ieng

Reducing infant mortality.

PIP: Public health and social policies at the population level (e.g., oral rehydration therapy and immunization) are responsible for the major reduction in infant mortality worldwide. The gap in infant mortality rates between developing and developed regions is much less than that in maternal mortality rates. This indicates that maternal and child health (MCH) programs and women's health care should be combined. Since 1950, 66% of infant deaths occur in the 1st 28 days, indicating adverse prenatal and intrapartum events (e.g., congenital malformation and birth injuries). Infection, especially pneumonia and diarrhea, and low birth weight are the major causes of infant mortality worldwide. An estimated US$25 billion are needed to secure the resources to control major childhood diseases, reduce malnutrition 50%, reduce child deaths by 4 million/year, provide potable water and sanitation to all communities, provide basic education, and make family planning available to all. This cost for saving children's lives is lower than current expenditures for cigarettes (US$50 billion in Europe/year). Vitamin A supplementation, breast feeding, and prenatal diagnosis of congenital malformations are low-cost strategies that can significantly affect infant well-being and reduce child mortality in many developing countries. The US has a higher infant mortality rate than have other developed countries. The American College of Obstetricians and Gynecologists and the US National Institutes of Health are focusing on prematurity, low birth weight, multiple pregnancy, violence, alcohol abuse, and poverty to reduce infant mortality. Obstetricians should be important members of MCH teams, which also include traditional birth attendants, community health workers, nurses, midwives, and medical officers. We have the financial resources to allocate resources to improve MCH care and to reduce infant mortality.^ieng

Mothers can prepare and use rice-salt oral rehydration solution in rural Bangladesh.

A feasibility study of rice-salt solution for oral rehydration (OR) was conducted in a village in the Chandpur area of rural Bangladesh in 1983. 305 mothers of children aged 0-4 years were interviewed with a pretraining questionnaire to find out about the availability of rice. The mothers were then trained and encouraged to use rice-salt OR solution to treat patients with diarrhoea. Evaluation of training was assessed by means of field diarrhoea surveillance, case follow-up, rice-salt OR solution sample analysis, and a post-training survey. The study showed that mothers in rural areas could prepare rice-salt OR solution quite easily and use it to treat diarrhoea patients. Mothers considered that this method would increase the utilisation of OR treatment in rural homes. After training rice-salt OR solution was the most common method of treatment for diarrhoea.

PIP: A feasibility study of rice-salt solution for oral rehydration (OR) was conducted in a village in the Chandpur area of rural Bangladesh in 1983. 305 mothers of children aged 0-4 years were interviewed with a pretraining questionnaire to learn about the availability of rice. The mothers were then trained and encouraged to use rice-salt OR solution to treat patients with diarrhea. Evaluation of training was assessed by means of field diarrhea surveillance, case follow-up, rice-salt OR solution sample analysis, and a post-training survey. The pretraining questionnaire survey showed that rice was always available in all households and ready-made rice powder was available in 30% of households. For patients with diarrhea rice was very acceptable. "Chira," flat beaten rice soaked in water, was the 1st choice for 82% of mothers. "Luta," a thick boiled rice-powder fluid was the 2nd choice (15%), and "jao," a thick fluid preparation of boiled whole rice, was the least preferred. 78% of mothers did not consider the method of preparation of rice-salt OR solution a problem, but the remainder thought that the effort and time involved in preparation was sometimes difficult. 53% of mothers felt more people would use oral rehydration to treat diarrhea if they were trained to prepare the solution. During the 4-month surveillance period 945 diarrhea episodes were detected in the study population. 50% occurred in 479 children aged 0-4 years. Diarrhea with simple loose or watery stools was more frequent (70%) than bloody or mucoid diarrhea (30%). Mothers and family members used rice-salt OR solution, sugar-salt OR solution, and drugs in various combinations. Rice-salt OR solution by itself was used more frequently (30%) than sugar-salt OR solution (6%), even though the sugar-salt method was introduced earlier. After rice-salt OR solution the most frequent diarrheal treatment was with drugs, which included modern medicine and homeopathic, herbal, and indigenous preparations. Rice-salt OR solution was the commonest initial treatment (37% for diarrheal episodes), and the commonest end treatment (47% of episodes). The sodium content of 150 samples of home-made rice-salt OR solution is shown in a table. The mean sodium concentration was 97 mmol/1. Though the range of values varied from 2-250 mmol/1, in 57% of the sample the range was 71-110 mmol/1, 15% had 70 mmol/1 or less, and 28% had more than 110 mmol/1. In the post-training survey, 82% of the mothers considered rice-salt OR solution superior to sugar-salt OR solution, despite their long experience with the sugar-salt mixture.