For general use, each packet should be mixed with a liter of water. However, for malnourished children, experts recommend adding a packet of ORS to two liters of water, along with an extra 50 grams of sucrose and some stock potassium solution.People who have no access to commercially available ORS can make a homemade version using water, sugar, and table salt. Experts agree that homemade ORS preparations should include one liter (34 oz.) of clean water and 6 teaspoons of sugar; however, they disagree about whether they should contain half a teaspoon of table salt or a full teaspoon. Most sources recommend using half a teaspoon of salt per liter of water. However, people with malnutrition have an excess of body sodium. To avoid worsening this symptom, ORS for people with severe undernutrition should contain half the usual amount of sodium and more potassium. Patients who do not drink may require fluids by nasogastric tube. Intravenous fluids are recommended only in those who have significant dehydration due to their potential complications, including congestive heart failure. Low blood sugar
Hypoglycemia, whether known or suspected, can be treated with a mixture of sugar and water. If the patient is conscious, the initial dose of sugar and water can be given by mouth. Otherwise, they should receive glucose by intravenous or nasogastric tube. If seizures occur (and continue after glucose is given), rectal diazepam may be helpful. Blood sugar levels should be re-checked on two hour intervals. Hypothermia
Hypothermia (dangerously low core body temperature) can occur in malnutrition, particularly in children.
Pantothenic acid, also called vitamin B5 is a water-soluble B vitamin and therefore an essential nutrient. All animals require pantothenic acid in order to synthesize coenzyme A (CoA) – essential for fatty acid metabolism – as well as to, in general, synthesize and metabolize proteins, carbohydrates, and fats.Pantothenic acid is the combination of pantoic acid and β-alanine. Its name derives from the Greek pantos, meaning "from everywhere", as minimally, at least small quantities of pantothenic acid are found in nearly every food. Human deficiency is very rare. As a dietary supplement or animal feed ingredient, the form commonly used is calcium pantothenate because of chemical stability, and hence long product shelf life, compared to sodium pantothenate or free pantothenic acid. Definition
Pantothenic acid is a water-soluble vitamin, one of the B vitamins. It is synthesized from the amino acid β-alanine and pantoic acid (see biosynthesis and structure of coenzyme A figures). Unlike vitamin E or vitamin K, which occurs in several chemically related forms known as vitamers, pantothenic acid is only one chemical compound. It is a starting compound in the synthesis of coenzyme A (CoA), a cofactor for many enzyme processes. Use in biosynthesis of coenzyme A
Pantothenic acid is a precursor to CoA via a five-step process. The biosynthesis requires pantothenic acid, cysteine, four equivalents of ATP (see figure). Pantothenic acid is phosphorylated to 4′-phosphopantothenate by the enzyme pantothenate kinase. This is the committed step in CoA biosynthesis and requires ATP.