***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: This study investigated the therapeutic effectiveness of oral rehydration salt ( ORS ) solutions containing trisodium citrate ( ORS-citrate ) in place of sodium bicarbonate ( ORS-bicarbonate ) .  74 children with cholera and 34 infants and children under 2 years of age with infantile diarrhea , all of whom had moderate to severe dehydration , were r and omly assigned to 1 of the 2 treatment solution groups . Children with severe dehydration were 1st rehydrated with intravenous fluid followed by maintenance therapy with ORS solution ( bicarbonate or citrate ) , while those with moderate dehydration received either ORS-bicarbonate or ORS-citrate during both the initial and the maintenance phases of therapy . Treatment effectiveness was assessed by comparing the success rates , stool output , ORS intake , gain in body weight , changes in erythrocyte volume fraction and plasma specific gravity , correction of acidosis , and maintenance of electrolyte balance . Of the children with cholera , 92 % of those who received ORS-citrate and 86 % of those who received ORS-bicarbonate were successfully treated . Of the children under 2 years of age with infantile diarrhea , 100 % of those who received ORS-citrate and 94 % of those who received ORS-bicarbonate were treated successfully . The results indicated that treatment with ORS-citrate is as successful as that with ORS-bicarbonate in terms of its ability to rehydrate , correct the acidosis , and maintain electrolyte concentrations . Thus , trisodium citrate dihydrate , which has the a advantage of a longer shelf-life in hot and humid climates , can effectively replace sodium bicarbonate in the st and ard ORS solution if used as an adjunct to st and ard hydration and antibiotic therapy in children with severe cholera or as the only treatment in children with infantile diarrhea assocated with less severe dehydration The authors compared the safety and efficacy of a ready-to-use , premixed , rice-based oral rehydration solution ( R-ORS ) with a glucose-based oral rehydration solution ( G-ORS ) , each containing 75 mmol/L sodium , in Mexican children with acute diarrhea for less than 5 days . Methods One hundred eighty-nine boys 3 to 24 months old admitted to the hospital with acute diarrhea and signs of dehydration were r and omly assigned to receive either G-ORS or R-ORS . Intake and output were measured every 3 hours . Results In the group treated with R-ORS , significantly fewer patients required supplemental intravenous fluids during the rehydration phase compared to the G-ORS group ( 1%v 8.7 % ; P < 0.01 ) . Mean stool output , percent weight gain , ORS intake , urine output , and number of patients who vomited during rehydration were similar in the two groups . The mean total stool output after the first 24 hours of maintenance phase was significantly lower in the R-ORS group than in the G-ORS group . Conclusions The authors found rice-based ORS to be safe , and its use reduced the rate of intravenous fluid therapy in comparison with the use of a glucose-based ORS A controlled study was conducted comparing the st and ard method of treating hospitalized infants with acute diarrhea ( limited starvation ) with the initiation of " early feeding " using a soy-based , lactose-free formula in infants of an American Indian tribe 12 months of age or younger . Forty-three patients , r and omly assigned to group A , were given a soy-based , lactose-free formula four hours after hospitalization , and 44 patients , r and omly assigned to group B , received st and ard therapy ( food was withheld for the first 48 hours of hospitalization ) . After the first 48 hours , the same soy-based , lactose-free formula was given to the group B patients . Fluid intake and output of stool , urine , and vomitus were measured until the diarrhea resolved . Overall , group A patients showed less mean stool output ( 121 + /- 129 ( SD ) mL/kg ) than group B patients ( 299 + /- 319 mL/kg ) ( P less than .001 ) . Furthermore , the duration of illness was significantly shorter in group A patients ( 54 + /- 28 hours v 93 + /- 56 hours ) ( P less than .001 ) . It was concluded that soy-based , lactose-free formulas can be safely used during the acute phase of diarrheal illness in infants and that their use shortens the duration of illness and decreases stool output in comparison with st and ard therapy In a controlled trial of oral rehydration therapy , a rice-based electrolyte solution was evaluated in a group ( n=26 ) of infants and young children aged between 3 months and 5 years with moderate to severe dehydration owing to acute diarrhoea , and the results were compared with a matched control group ( n=26 ) receiving WHO recommended glucose electrolyte solution . The former was found to be more effective than the latter as shown by an appreciably lower rate of stool output , a shorter duration of diarrhoea , and a smaller intake of rehydration fluid Background : Oral rehydration solution ( ORS ) for treatment of diarrhea relies on enhancement of small intestinal sodium and fluid absorption to correct dehydration . Amylase-resistant starch added to ORS significantly reduced the duration and severity of diarrhea in adults with cholera , presumably by generation of short-chain fatty acids in the colon and enhancement of colonic sodium and fluid absorption . The present study was initiated to determine whether addition of amylase-resistant starch to st and ard World Health Organization glucose-ORS ( G-ORS ) would reduce the duration of diarrhea and fecal fluid losses in children with acute diarrhea . Methods : One hundred eighty-three children ( 6 months to 3 years ) with acute watery diarrhea were r and omized to receive either st and ard treatment with G-ORS or G-ORS with additional amylase-resistant starch , HAMS ( HAMS-ORS , 50g/L ) . Stool weight and consistency were monitored serially until development of formed stool or development of treatment failure defined as either the need for unscheduled intravenous fluid therapy or diarrhea longer than 72 hours . Results : Five of the subjects were lost to follow up . In 178 remaining children ( 87 HAMS-ORS and 91 G-ORS ) with evaluable data , time from enrolment to last unformed stool was significantly less in children receiving HAMS-ORS ( median , 6.75 hours ; 95 % confidence interval , 4.27 - 9.22 ) than in children treated with G-ORS ( 12.80 hours , 8.69 - 16.91 ) ( P = 0.0292 ) . Time to first formed stool was also significantly shorter in children receiving HAMS-ORS ( median , 18.25 hours ; 95 % confidence interval , 13.09 - 23.41 ) compared with children receiving G-ORS ( median , 21.50 hours ; 95 % confidence interval , 17.26 - 25.74 ) ( P = 0.0440 ) . The total amount of ORS  consumed was similar in both groups . There was a trend toward lower mean stool weight in first 24 hours ( P = 0.0752 ) as well as total diarrheal stool weight ( P = 0.0926 ) in patients in the HAMS group compared with the G-ORS group . Conclusion : In children with acute diarrhea , the addition of amylase-resistant starch to glucose ORS significantly shortened duration of diarrhea compared with st and ard treatment ABSTRACT . Two groups of infants aged 2 to 20 months with moderate to severe dehydration were r and omly assigned to either sucrose high sodium ( 90 mEq/l ) or sucrose low sodium ( 58 mEq/l ) solution in a double blind manner . Rehydration was assessed on clinical grounds and confirmed by serial determination of body weight , hematocrit , total serum protein and blood urea nitrogen . Twenty ( 80 % ) of 25 patients on sucrose high sodium solution and 20 ( 77 % ) of 26 patients on sucrose low sodium solution were successfully hydrated . Only the assigned sucrose‐electrolyte solution was given during the average rehydration period of about 7 hours when the serum electrolytes were remeasured . Three patients on high sodium solution  developed mild hypernatremia . Slight hyponatremia was encountered in 2 patients on low sodium  solution . Purging rate was significantly higher in patients who failed as compared to those who succeeded . The results of this study suggest that oral sugar electrolyte solution with sodium concentration of 90 mEq/l is safe and effective in the majority of infants with diarrhoeal dehydration of diverse causes . However , intravenous fluids must be available particularly for those with a high purging rate as a significant number of them may fail OBJECTIVE We evaluated and compared the efficacy of the World Health Organization ( WHO ) oral rehydration solution ( ORS ) and 2 different formulations of reduced osmolarity ORSs in infants with persistent diarrhea . STUDY DESIGN Infants with persistent diarrhea ( n = 95 ) were r and omized to 1 of the 3 ORSs : WHO-ORS ( control , n = 32 ) , a glucose-based reduced osmolarity ORS ( RORS-G , n = 30 ) , or a rice-based reduced osmolarity ORS ( RORS-R , n = 31 ) for replacement of ongoing stool losses for up to 7 days . Major outcome measures were stool volume and frequency , ORS intake , and resolution of diarrhea . RESULTS Although there were variations from one study day to another , the stool volume was approximately 40 % less in the reduced osmolarity ORS groups ; consequently , these children required less ORS ( 22 % for RORS-G and 27 % for RORS-R groups ) . A higher proportion of children in the RORS-R groups also had resolution of diarrhea during the study period . No children in any of the treatment groups had hyponatremia . CONCLUSION Reduced osmolarity ORS is clinical ly more effective than WHO-ORS and may thus be advantageous for use in the treatment of children with persistent diarrhea Summary : The World Health Organization ( WHO ) recommends an oral rehydration solution ( ORS ) that has been linked with a risk of hypernatremia in young infants when extra water or dilute milk is withheld . A controlled , r and omized study was therefore undertaken in 50 male infants aged 0–3 months to evaluate the relative safety , efficacy , and practicability of two methods of obviating this risk without negating the concept of a universal rehydrating packet . Twenty-five infants in Group A were re- hydrated with a 2:1 regimen ( two parts , i.e. , 60 ml , WHO-ORS followed by one part , i.e. , 30 ml , plain water in an alternating manner ) whereas 25 infants in Group B received diluted WHO-ORS ( 1.5 L water instead of 1 L ) . In two patients , one in each group , oral therapy failed and they were excluded from analysis . Sub-Group Ac was comprised of 15 cases in Group A in whom the rehydrating instructions were followed correctly . Diluted WHO-ORS provided as safe and effective rehydration as the 2:1 regimen administered properly ( sub-Group Ac ) . Both methods adequately corrected and maintained the hydration status and serum sodium levels , but a few infants in each group had subnormal serum K+/HCO3- levels during therapy . Rehydrating instructions in Group A were misinterpreted in nine ( 37.5 % ) cases .  Excessive ORS intake in five infants result ed in hypernatremia ( three cases , 12.5 % ) , periorbital edema ( three cases , 12.5 % ) , excessive irritability ( two cases , 8.3 % ) , and mild pedal edema ( one case , 4.2 % ) . Excessive water intake in comparison to ORS in four infants was responsible for delayed rehydration ( three cases , 12.5 % ) and asymptomatic hyponatremia and hypokalemia ( two cases , 8.3 % ) . It is concluded that diluted WHO-ORS is as efficient as the 2:1 regimen for correcting and maintaining the serum sodium and hydration status . However , complications can arise from improper administration of the latter by illiterate users ; and both methods are deficient with respect to K+ and HOC3- requirements ABSTRACT . We evaluated the efficacy and safety of an oral rehydration solution containing glycyl‐glycine , glycine , and maltodextrin ( GGG‐ORS ) , in comparison to the glucose based ORS ( st and ard ORS ) . The osmolality of the GGG‐ORS ( 305 mOsm/1 ) and st and ard ORS ( 311 mOsm/1 ) was similar . Ninety‐two children presenting with acute gastroenteritis and moderate dehydration , aged 3 months to 3 years , were r and omly assigned to receive st and ard ORS or GGG‐ORS . All the patients were successfully rehydrated orally . The two groups were comparable for baseline characteristics including the microbial etiology . Rotavirus ( 49 % , 36 % ) , ETEC ( 11 % , 18 % ) or a combination of 
    Output:
    
We estimated that ORS may prevent 93 % of diarrhoea deaths .
CONCLUSIONS ORS is effective against diarrhoea mortality in home , community and facility setting s ; however , there is insufficient evidence to estimate the effectiveness of RHFs against diarrhoea mortality