title: Efficacy of partially hydrolyzed guar gum (PHGG) supplemented modified oral rehydration solution in the treatment of severely malnourished children with watery diarrhoea: a randomised double-blind controlled trial.
abstract: OBJECTIVE
  To examine whether PHGG added ORS reduce duration of diarrhoea, stool output and enhance weight gain.
  
  
  METHODS
  In a double-blind controlled clinical trial, 126 malnourished children (weight for length/weight for age < -3 Z-score with or without pedal edema), aged 6 - 36 months with acute diarrhoea <7 days were studied in two treatment groups; 63 received modified WHO ORS (Na 75, K 40, Cl 87, citrate 7, glucose 90 mmol/L) with PHGG 15 g/L (study group); 63 received modified WHO ORS without PHGG (control). Other treatments were similar in both groups. The study protocol was approved by Ethics Committee of icddr,b; the study was carried out at the Dhaka Hospital.
  
  
  RESULTS
  The mean duration of diarrhoea (h) was significantly shorter in children of the study group (Study vs. control, mean ± SD, 57 ± 31 vs. 75 ± 39, p = 0.01). Although there was a trend in stool weight reduction in children receiving ORS with PHGG (study vs. control, stool weight (g), mean ± SD; 1(st) 24 hour, 854.03 ± 532.15 vs. 949.11 ± 544.33, p = 0.32; 2(nd) 24 hour, 579.84 ± 466.01 vs. 761.26 ± 631.64, p = 0.069; 3(rd) 24 hour, 385.87 ± 454.09 vs. 495.73 ± 487.61, p = 0.196), especially in 2(nd) 24 h period, the difference was not statistically significant. The mean time (day) to attain weight for length 80% of NCHS median without edema was significantly shorter in the study group (study vs. control, mean ± SD, 4.5 ± 2.6 vs. 5.7 ± 2.8, p = 0.027).
  
  
  CONCLUSIONS
  PHGG added to ORS substantially reduced duration of diarrhoea. It also enhanced weight gain. Further studies might substantiate to establish its beneficial effect.
  
  
  BACKGROUND
  NCT01821586.
authors.affiliation: International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh. nhalam@icddrb.org.
authors.forename: Nur Haque
authors.initials: NH
authors.lastname: Alam
authors.affiliation: International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh. nhalam@icddrb.org.
authors.forename: Hasan
authors.initials: H
authors.lastname: Ashraf
authors.affiliation: International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh. drkamrul07@gmail.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Kamruzzaman
authors.affiliation: International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh. tahmeed@icddrb.org.
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
authors.affiliation: Department of Pharmacy, East West University, Dhaka, Bangladesh. sufiaislam@gmail.com.
authors.forename: Sufia
authors.initials: S
authors.lastname: Islam
authors.affiliation: Nestle Health Care Nutrition, Gland, Switzerland. maryam.olesen@nestle.com.
authors.forename: Maryam Kadjar
authors.initials: MK
authors.lastname: Olesen
authors.affiliation: Department of Internal Medicine, University Hospital, Basel, Switzerland. niklaus.gyr@unibas.ch.
authors.forename: Niklaus
authors.initials: N
authors.lastname: Gyr
authors.affiliation: Department of Gastroenterology, Hepatology and Nutrition, Kantonsspital, Liestal, Switzerland. meier.remy@outlook.com.
authors.forename: Remy
authors.initials: R
authors.lastname: Meier
mesh_terms: D001459:Bangladesh; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003967:Diarrhea / Q000209:etiology / Q000517:prevention & control*; D003968:Diarrhea, Infantile / Q000209:etiology / Q000517:prevention & control; D004043:Dietary Fiber / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005440:Fluid Therapy; D005685:Galactans / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D006786:Hospitals, Urban; D006801:Humans; D006868:Hydrolysis; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D008351:Mannans / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D053149:Plant Gums / Q000008:administration & dosage / Q000378:metabolism / Q000627:therapeutic use*; D015532:Rehydration Solutions / Q000627:therapeutic use*; D000067011:Severe Acute Malnutrition / Q000503:physiopathology / Q000628:therapy*; D015430:Weight Gain; D014944:World Health Organization
chemical_list: D004043:Dietary Fiber; D005685:Galactans; D008351:Mannans; D053149:Plant Gums; D015532:Rehydration Solutions; C007894:guar gum
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