***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 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A r and omised three cell study was carried out in 78 children with acute diarrhoea to evaluate the relative efficacy of oral rehydration solution ( ORS ) made from partially hydrolysed wheat grain , cooked rice powder , or glucose .  Twenty six patients with comparable age , body weight , duration of diarrhoea , and degree of dehydration were studied in each of the three groups . Initial rehydration was carried out by using intravenous Dhaka solution within one to two hours followed by administration of oral rehydration solution . The mean ORS intake during the first and second 24 hours of treatment in patients with cholera receiving wheat-ORS and rice-ORS was significantly less compared with those receiving glucose-ORS . The stool output during the same period in patients receiving wheat-ORS and rice-ORS was significantly less compared with those receiving glucose-ORS . Similar trends in both ORS intake and stool output were observed during the next 24 hours OBJECTIVE . The purpose of this work was to evaluate whether education about zinc supplements and provision of zinc supplements to caregivers is effective in the treatment of  acute diarrhea  and whether this strategy adversely affects the use of oral rehydration salts . PATIENTS AND METHODS . Six clusters of 30 000 people each in Haryana , India , were r and omly assigned to intervention and control sites . Government and private providers and village health workers were trained to prescribe zinc and oral rehydration salts for use in diarrheal episodes in 1-month-old to 5-year-old children in intervention communities ; in the control sites , oral rehydration salts alone was promoted . In 2 cross-sectional surveys commencing 3 months ( survey 2 ) and 6 months ( survey 3 ) after the start of the intervention , care-seeking behavior , drug therapy , and oral rehydration salts use during diarrhea , diarrheal and respiratory morbidity , and hospitalization rates were measured . RESULTS . In the 2 surveys , zinc was used in 36.5 % ( n = 1571 ) and 59.8 % ( n = 1649 ) and oral rehydration salts in 34.8 % ( n = 1571 ) and 59.2 % ( n = 1649 ) of diarrheal episodes occurring in the 4 weeks preceding interviews in the intervention areas . In control areas , oral rehydration salts were used in 7.8 % ( n = 2209 ) and 9.8 % ( n = 2609 ) of episodes . In the intervention communities , care seeking for diarrhea reduced by 34 % ( survey 3 ) , as did the prescription of drugs of unknown identity ( survey 3 ) and antibiotics ( survey 3 ) for diarrhea . The 24-hour prevalences of diarrhea and acute lower respiratory infections were lower in the intervention communities ( survey 3 ) . All-cause , diarrhea , and pneumonia hospitalizations in the preceding 3 months were reduced in the intervention compared with control areas ( survey 3 ) . CONCLUSIONS . Diarrhea is more effectively treated when caregivers receive education on zinc supplementation and have ready access to supplies of oral rehydration salts and zinc , and this approach does not adversely affect the use of oral rehydration salts ; in fact , it greatly increases use of the same 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 r and omized clinical trial was carried out to compare a packaged ready‐to‐mix rice oral rehydration solution ( ORS ) to the st and ard glucose ORS for the treatment of childhood diarrhoea . Children were of either gender , aged 3–35 months , presenting with a history of watery diarrhoea for 72 h or less . The main outcomes examined were stool output , ORS intake , duration of diarrhoea and nutritional recovery during follow‐up at 16 d of illness . Stool output in the first 24 h ( 106 vs 107 g kg‐1 ) ,  ORS intake in clinic ( 93 vs 102 ml per motion ) and duration of diarrhoea ( 88 h vs 81 h ) were similar in the two treatment groups . The few episodes that became persistent were similar ( 2 % ) in the two groups . The weight gain during follow‐up was similar in the two ORS groups 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 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 We sought to determine the efficacy of three different types of treatment in children with acute diarrhea who , during the oral rehydration period , had high stool output ( greater than 10 mL/kg per hour ) . Sixty-six children , aged 1 to 18 months , with an average stool output of 22.6 mL/kg per hour were r and omly distributed into three groups : group 1 received a rice flour solution , group 2 received the World Health Organization rehydration solution by gastric infusion , and group 3 continued to receive this solution orally . In all three groups , a decrease in stool output was observed , with the higher decrease observed in group 1 patients . Such a decrease facilitated rehydration of all 22 patients in group 1 ( 100 % ) in 3.3 + /- 1.5 hours , 16 ( 73 % ) in group 2 in 4.3 + /- 2.1 hours , and 15 ( 69 % ) in group 3 in 4.9 + /- 2.0 hours . No complications were observed . These data indicate that the rice flour solution is effective in children with high stool output diarrhea OBJECTIVE To compare the efficacy of two commonly used solutions in the rehydration of infants with mild to moderate dehydration caused by acute diarrhea in the United States . DESIGN AND SETTING Double-blind , parallel-group , r and omized study performed at Children 's Hospital Medical Center . PATIENTS Sixty infant boys ( < or = 2 years old ) , with mild ( < or = 5 % ) or moderate ( 6 to 9 % ) dehydration caused by acute diarrhea of less than 1 week 's duration were included in the study . INTERVENTIONS Infants were r and omly assigned to receive treatment with either a glucose-based oral rehydration solution ( ORS ) ( Pedialyte , Ross Laboratories , Columbus , OH ) or a rice syrup solids-based ORS ( Infalyte , Mead Johnson Nutritional Group , Evansville , IN ) . After rehydration was achieved , patients entered a maintenance phase during which , in addition to a maintenance ORS , breast milk or a soy-based formula was offered ; infants older than 1 year were also given a lactose-free diet . OUTCOME MEASURES Rehydration was judged clinical ly . Infants remained on a metabolic bed during the study in to separate and quantitate urine and stool output . Therefore , in addition to clinical outcome , we compared intake , output and apparent absorption and retention of fluid , sodium , and potassium between groups . RESULTS All patients were successfully rehydrated using an ORS without the use of intravenous fluids . No differences were detected between treatment groups in time to rehydration , percentage of weight gain after rehydration , consumption of ORS to achieve rehydration , or stool output . However , the apparent sodium absorption ( net intake less fecal output ) was greater in the Infalyte group than the Pedialyte group during the first 24 hours . CONCLUSION The two maintenance oral electrolyte solutions ( Pedialyte and Infalyte ) most commonly used in the United States are effective as rehydration solutions for infants with mild to moderate dehydration . We speculate that a strategy for oral rehydration therapy in the United States , based on the use of a single solution during the rehydration and maintenance phase , might gain additional acceptance by practicing pediatricians and family physicians Sixty four children between 2.5 months and 5 years of age were r and omly treated in a country hospital in Jos , Nigeria , with either the oral rehydration solution 
    Output:
    
Authors ' conclusions Polymer‐based ORS  shows advantages compared to glucose‐based ORS ( at ≥ 310 mOsm/L ) .