The packing and composition of ORS has undergone a change since its introduction. In India, some companies are manufacturing smaller pouches (4.2 g) to be dissolved in 200 ml of water. Therefore, out of confusion some prescribers routinely advise the patients to dissolve the standard formulation ORS pouch (21 g) in a glass (200 ml) of water. Two cases are discussed. First patient developed salt poisoning due to improper dilution and recovered after rapid correction. In the second patient improper reconstitution led to hypernatremia and death.

A second dose of measles vaccine boosts the measles antibody status in the study population as compared to those who receive only a single dose.

Research Question: How important is acute respiratory tract infections in children less than 5 years of age and what are the main factors that need attention. Objective: To determine the magnitude of ARI under 5 years of age in rural areas of Kashmir valley. 2) To identify various risk factors responsible for ARI. Methodology: Community based Cross sectional study using multistage sampling procedure was used to study 1644 children. A house to house survey was carried out in the defined geographical region in order to determine the prevalence and risk factors of ARI less than 5 years of age. Results: Among 1644 children under 5 years of age studied, 886 (53.89%) were males and 758 (46.11%) female. An overall prevalence of 21.41% under 5 years of age was observed in a Kashmir valley. The prevalence of ARI varied according to the age of child being 19.3% in age group of 0-1 years, 23.0% in 1-3 years and 20.4% in age group of 3-5 years. Prevalence of ARI was more (22.5%) in male children as compared to female (20.05%) children [P>0.05]. The socio demographic variables that showed a significant relationship with ARI prevalence were parental literacy status (OR = 1.806; CI = 1.333-2.447; P < 0.05) and more so the Mother's literacy status (OR = 1.635; CI = 1.284-2.083; P < 0.05). ARI risk being high among Malnourished children (OR = 2.38; CI = 1.804-3.157; P<0.05), inappropriately immunized children (OR=2.41; CI = 1.853-3.154, P<0.05), children lacking exclusive Breast feeding (OR = 4.854; CI = 3.735-6.309; P< 0.05) or put on early or delayed weaning (OR = 1.66; CI = 1.302-2.140; P < 0.05). Environmental / housing variables also showed significant association with ARI with risk being high in children living in poor ventilation (OR = 4.865; CI = 3.78-6.259; P < 0.05), overcrowded houses (OR = 1.829; CI = 1.442-2.320; P < 0.05), houses with kitchen not separate (OR = 1.829, CI = 1.442-5.481, P < 0.05), and using cooking fuel other than LPG (OR = 2.063; CI = 1.615-2.634; P < 0.05) Conclusion: Besides sensitizing mothers on childhood nutritional (exclusive breast feeding and early / delayed weaning) and immunization the role of environmental /housing variables (Poor ventilation, over crowding, combined kitchen and use of cooking fuel other than LPG) need attention.

BACKGROUNDThis study was conducted with an aim of understanding the patient related factors that influence timely diagnosis and case detection rate in Jammu and Kashmir.