clove and Dehydration

Since its recommendation by WHO, Oral Rehydration Solutions (ORS) contributed in reducing the rate of mortality due to acute gastroenteritis. In Madagascar, the rate of lethality imputed to gastroenteritis is about 3%. Rehydration can be performed either by using spoons which reliability is unsure because of parents' potential inobservance and child's refusal, or by nasogastric tube. The nasogastric tube may resolve these obstacles at the hospital. We realized a preliminary study to evaluate the efficacy and the safety of nasogastric tube and spoon administration of the ORS in rehydration of child with moderate post-gastroenteritis dehydration. This is an open comparative study realized in the Pediatric Unit at the Joseph-Raseta-Befelatanana Hospital from the 21 January to 21 May 2008. Main outcomes was the proportion of rehydrated children at 4 hours, other were: failure at 8 hours, duration and volume of SRO, side effects. Fifty-three children from 4-month to 4-year old among 1306 patients were recruited and forty-seven patients were included. Nine patients failed (4 children received ORS by spoon and 5 children by nasogastric tube). The use of spoon was more effective: 62.5% of the patients were rehydrated at the fourth hour versus 39.3% in nasogastric tube group (P = 0.04). Making debit constant presents difficulties in rehydration with nasogastric tube (44.4 %). Tolerance of nasogastric tube is generally good but 16.7% children get out their tube during this study. No ORS' inhalation was observed with both routes. No false passage or tube or ORS rejection was recorded in both techniques. This study shows that using spoon to rehydrate is more effective for the rehydration of moderate dehydration. The use of nasogastric tube needs more surveillance.

Topics: Administration, Oral; Child, Preschool; Cooking and Eating Utensils; Dehydration; Device Removal; Diarrhea, Infantile; Female; Fluid Therapy; Gastroenteritis; Humans; Infant; Intubation, Gastrointestinal; Madagascar; Male; Patient Acceptance of Health Care; Vomiting

To examine mortality risk factors during rehydration among 6-35 month malnourished children with diarrhoea.. Data collected prospectively during a clinical trial comparing two oral rehydration solutions (ORS).. Paediatric ward.. Study children had either a weight-for-age Z-score below -2 or a weight-for-height below 70% of NCHS median. All had diarrhoea for < 5 days. 150 were enrolled and two were excluded for intercurrent infection.. Children were randomly allocated to receiving 100 ml/kg of standard or rice-based ORS during the 6h following admission. Then they received 420 kJ/kg/day of high energy milk, progressively increased to 840 kJ/kg/day.. Mortality rate was 16% and with no difference by ORS group. In univariate analysis, the risk of dying (mean odds ratio; 95% confidence interval) was significantly higher among girls (3.5; 1.4-8.9), in non-breast-fed children (3.7; 1.4-9.6) and in children with a low weight-for-height (5.1; 1.9-14.1). Low weight, moderate or severe dehydration, low plasma specific gravity or total plasma protein and longer duration of diarrhoea before inclusion also were significant risk factors. In multivariate logistic analysis, only absence of breast-feeding was associated with a higher risk of dying among girls with a low weight-for-height. Among them, eight out of nine died, compared to 15 out of 139 for other children.. Breast-feedings protected severely malnourished girls against death from diarrhoea even when dehydration was corrected. Mechanisms underlying this selective effect are poorly understood.

Topics: Breast Feeding; Cause of Death; Child Nutrition Disorders; Child, Preschool; Dehydration; Diarrhea; Female; Fluid Therapy; Hospitalization; Humans; Infant; Infant Nutrition Disorders; Madagascar; Male; Multivariate Analysis; Odds Ratio; Prospective Studies; Risk Factors; Sex Factors; Time Factors

Cell and sub-cellular anatomical adjustments are adaptations utilized by plants to tolerate abiotic stress. Both melatonin and Morinda lucida-silver nanoparticles (ML-AgNPs) are recognized as bio-stimulants. The study examined the morphological changes and adaptive characteristics of these bio-stimulants under water-stress Eugenia uniflora. Twenty-four hours was spent priming the seeds with melatonin (0.06 mg/L), ML-AgNPs (0.06 mg/L), and a mixture (1:1) of the two. The seeds were sown and subjected to water stress for 7 days. The leaves, stems, and roots of water-stressed E. uniflora were sectioned, dried, and examined using a microscope. Drought stress led to the production of non-glandular trichomes on the abaxial and the transformation of paracytic stomata into diacytic stomata. During water stress, melatonin enlarges intercellular gaps and stomata, increases sponge and palisade parenchyma, and thickens epidermis (stem and root) and fibers. The ML-AgNPs diminished the size of mesophyll, intercellular gaps, stomata, and stem fiber. The ML-AgNPs increased the size of bulliform cells and activated the mechanical resistance features of sclerophyllous leaves (thick-celled epidermis and sclerieds) and ray parenchyma (root and stem). Equally, Melatonin and ML-AgNPs increased stem and root anatomical characteristics (xylem, bark, pith, cortex, epidermis, and vascular bundles). Stomata of E. uniflora are susceptible to alterations and undergo cell division into two new stomata (stomatogensis) in response to varying conditions (melatonin and ML-AgNPs). Melatonin adopted a strategy for maintaining a high plant water status, possibly by osmoregulation, whereas E. uniflora primed with ML-AgNPs survived by minimizing transpirational water loss through morphological changes.

Topics: Dehydration; Eugenia; Melatonin; Metal Nanoparticles; Plant Leaves; Plants; Silver

Silicon (Si) is a beneficial element that can mitigate effects of water stress on photosynthetic metabolism and plant growth. Thus, the aimed was to evaluate the effect of Si in mitigating the stressful effect of water deficit and flooding in Eugenia myrcianthes Nied. seedlings. The seedlings received three silicon doses (0, 2, and 4 mmol) and were subjected to two water regimes (I - continuous irrigation and S - water fluctuation, characterized as water stress obtained by two cycles of water regimes: irrigation suspension and flooding). Each cycle was ended when the seedlings had a photosynthetic rate close to zero (P0) when the stressful irrigation condition was normalized until the photosynthetic rate reached the values of the control seedlings (REC). The evaluations were carried out in five periods: T0 - initial seedling condition; 1st and 2nd P0; and 1st and 2nd REC. The E. myrcianthes seedlings reached P0 at 22 and 50 days under water deficit and flooding, respectively. Water stress caused damage to photochemical activities in photosystem II. E. myrcianthes is a species sensitive to water stress, but capable of adjusting to water fluctuation, and the application of 2 mmol Si contributed to the regulation of gas exchange, photochemical yields, and growth of this species at the deficit and flooding phases. We emphasize that E. myrcianthes seedlings have potential for resilience due to physiological plasticity, regardless of the silicon application.

Topics: Dehydration; Eugenia; Photosynthesis; Plant Leaves; Seedlings; Silicon; Stress, Physiological

Morpho-anatomical traits of the rarely studied dicotyledonous desiccation-tolerant shrub Myrothamnus moschatus were examined and compared for the first time to Myrothamnus flabellifolius under the aspect of desiccation tolerance. Both species almost exclusively occur on rock outcrops and differ mainly in their geographic range and leaf morphology (fan-shaped in M. flabellifolius, lanceolate in M. moschatus) but have a very similar leaf and wood anatomy, except for the lack of hydathodes in M. moschatus. Both species adopt the parallel leaf venation of monocots, although this is more pronounced in M. moschatus. This provides a mechanical and protective advantage over the net venation pattern of most dicots and facilitates the reversible, drought-induced, accordion-like leaf contraction. The sclerenchyma, as a stabilising tissue, is mainly confined to vascular bundles in leaves of both species. Here, mechanical support seems to be less crucial for survival in long periods of drought than other morpho-anatomical traits (e.g. parallel leaf venation).

Topics: Adaptation, Physiological; Dehydration; Madagascar; Magnoliopsida; Plant Leaves; Plant Stems

The parents 'educational conditions are one of the factors of health inequalities among children. During May 2009, the parents' instruction level of children admitted at the triage unit of a Pediatric Service in Antananarivo, Madagascar was evaluated and related to the severity of their children' health status and to the mode of reference. All the surviving children (from 2 months to 15 years old) were included in this study. Patients were classified by the IMCI guideline and we analyzed the educational level of their mothers. Each patient was classified as severe illness or without severe illness, according to IMCI algorithm. The quality of referring physician was recorded: public physicians, liberal physicians, nurses, or without referral. Among 296 children, 9 (3%) died before admission, 217 (75.6%) were included. Among them, 123 (56.7%) had a severe illness and 38,2% general signs of danger. The severity (92.3 versus 54.4%; P = 0.003), the number of severe dehydration (15.4 versus 3.9%; P = 0,027) and malnutrition (15.4 versus 4.4%; P = 0.039) were related with a poor parents educational level. The referral agents were mostly liberal physicians (56.7%), public physicians (26.7%) or nurses (1.8%). Mothers with higher educational level preferred to attend liberal physicians (58 versus 41.9%; P = 0.1). The reference delay was shorter if there was a severe illness (6.41 versus 19.6 days; P < 0.000) or no medical referral (51.1 versus 24.4%; P > 0.000). Despite the fact that access to hospital care was respectful of a two-step process (85.3%), the number of patients with severe illness was high among families with low educational level. Theses results suggest to educate in priority the mother with low education, in order to recognize the general signs of danger and facilitate early first health care.

Topics: Adolescent; Algorithms; Anemia; Child; Child, Preschool; Dehydration; Diagnosis-Related Groups; Diarrhea; Educational Status; Emergencies; Emergency Service, Hospital; Female; Fever; Hospitals, Urban; Humans; Infant; Madagascar; Male; Malnutrition; Mothers; Pneumonia; Prospective Studies; Referral and Consultation; Severity of Illness Index; Socioeconomic Factors