Calcium/calcimimetic via calcium-sensing receptor ameliorates cholera toxin-induced secretory diarrhea in mice

BACKGROUND Enterotoxins produce diarrhea through direct epithelial action and indirectly by activating the enteric nervous system.Calcium-sensing receptor(CaSR)inhibits both actions.The latter has been well documented in vitro but not in vivo.The hypothesis to be tested was that activating CaSR inhibits diarrhea in vivo.AIM To determine whether CaSR agonists ameliorate secretory diarrhea evoked by cholera toxin(CTX)in mice.METHODS CTX was given orally to C57BL/6 mice to induce diarrhea.Calcium and calci-mimetic R568 were used to activate CaSR.To maximize their local intestinal actions,calcium was administered luminally via oral rehydration solution(ORS),whereas R568 was applied serosally using an intraperitoneal route.To verify that their actions resulted from the intestine,effects were also examined on Cre-lox intestine-specific CaSR knockouts.Diarrhea outcome was measured biochemically by monitoring changes in fecal Cl-or clinically by assessing stool consistency and weight loss.RESULTS CTX induced secretory diarrhea,as evidenced by increases in fecal Cl-,stool consistency,and weight loss following CTX exposure,but did not alter CaSR,neither in content nor in function.Accordingly,calcium and R568 were each able to ameliorate diarrhea when applied to diseased intestines.Intestinal CaSR involvement is suggested by gene knockout experiments where the anti-diarrheal actions of R568 were lost in intestinal epithelial CaSR knockouts(villinCre/Casrflox/flox)and neuronal CaSR knockouts(nestinCre/Casrflox/flox).CONCLUSION Treatment of acute secretory diarrheas remains a global challenge.Despite advances in diarrhea research,few have been made in the realm of diarrhea therapeutics.ORS therapy has remained the standard of care,although it does not halt the losses of intestinal fluid and ions caused by pathogens.There is no cost-effective therapeutic for diarrhea.This and other studies suggest that adding calcium to ORS or using calcimimetics to activate intestinal CaSR might represent a novel approach for treating secretory diarrheal diseases.

Hydroelectrolytic and Energetic Replenisher in Horses Undergoing Marcha Training

The study aimed to assess the clinical, laboratory, and blood gas analysis of horses undergoing Marcha training and the effects of voluntary ingestion of hydroelectrolytic and energy replenishers after exercise. Eight horses of both genders aged between 5 and 10 years, were included in the study. The exercise consisted of a 10-min warm-up followed by 45 min uninterrupted Marcha on a flat dirt track in the morning. After exercise, the horses received one of the following treatments: Drinking water (control group);Hydroelectrolytic and energy replenisher containing sodium chloride, potassium chloride, calcium acetate, magnesium chloride, sodium citrate, dextrose, maltodextrin, and sucrose in three different concentrations (Replenishers A, B, and C). The horses were distributed across the four treatments in a 4 × 4 Latin Squares design using a Split-plot system with 48-hr intervals. Clinical and laboratory evaluations were conducted at four time points: T0 - 5 min before exercise;T1 - up to 5 min after exercise;T2 - 2 hr after starting treatment;and T4 - 4 hr after beginning treatment. Concentrations of urea, creatinine, lactate, phosphorus, and ionized calcium significantly changed after exercise. An increase in blood pH and a decrease in chloride concentrations were observed when replenishers B and C were offered after exercise. The replacements were ingested spontaneously by the animals in a volume greater than that of the control group (water). Replacement B was the most ingested by the animals, demonstrating its greatest potential.

The interplay between leaf water potential and osmotic adjustment on photosynthetic and growth parameters of tropical dry forest trees

Mimosa tenuiflora and Piptadenia stipulacea are commonly accepted as drought-tolerant species but little is known about their response to drought followed by rehydration.Therefore,the interplay between leaf water potential and osmotic adjustment on photo synthetic and growth parameters of these species was examined.A greenhouse study was conducted in a split-plot design with two water conditions in the main plots(control;drought followed by rehydration),and eight sampling times in the subplots(1,4and 7 days of drought,and 1,3,6,12,and 17 days of rehydration).Plant water status and biochemical changes were assessed as well as leaf gas exchange and subsequent growth.Under drought stress,both species maintained a low leaf water potential throughout the day by accumulating compatible solutes,thus allowing a rapid and full recovery of water status when rehydrated.Although these plants minimized water loss by closing their stomata,neither showed stomatal limitations to photosynthesis.The inhibition of this process during drought was possibly related to mesophyll limitations as well as to a reversible downregulation of photo systems,along with adjustments of their stoichiometry.Water deficits also triggered morphological adaptations at the whole plant level,leading to reduced growth,mainly of the shoots in M.tenuiflora and the roots in P.stipulacea.

Rare cause of cerebral venous sinus thrombosis:Spontaneous intracranial hypotension syndrome:A case report

BACKGROUND Spontaneous intracranial hypotension syndrome is a relatively uncommon neurological disorder of unknown etiology with a good prognosis.Cerebral venous sinus thrombosis is a specific type of cerebrovascular disease caused by multiple etiologies of cerebral venous sinus or vein thrombosis that obstructs cerebral venous return and is associated with impaired cerebrospinal fluid absorption;this entity is rarely seen clinically.Spontaneous intracranial hypotension syndrome is one of the causes of cerebral venous sinus thrombosis,and the probability of their combined occurrence is only 1%-2%.As such,it is easily overlooked clinically,thus increasing the difficulty of diagnosis and treatment.CASE SUMMARY A 29-year-old young woman presented with postural headache.Lumbar puncture suggested a pressure of 50 mmH2O(normal 80 mmH2O-180 mmH2O),and magnetic resonance imaging cerebral venography suggested thrombosis of the supratentorial sinus.These findings were considered indicative of cerebral venous sinus thrombosis due to spontaneous intracranial hypotension syndrome after ruling out immunological causes,tumor,infection,abnormal coagulation mechanism,and hypercoagulable state,etc.She was treated with rehydration and low-molecular heparin anticoagulation for 15 d,and follow-up magnetic resonance imaging cerebral venography suggested resolution of the thrombus.The patient had complete improvement of her headache symptoms.CONCLUSION Spontaneous intracranial hypotension syndrome is one of the rare causes of cerebral venous sinus thrombosis,which is frequently misdiagnosed or missed and deserves consideration by clinicians during differential diagnosis.Dehydration should be avoided in such patients,and early rehydration and anticoagulation therapy are effective treatment options.

Three-stage Transformation of Chlorophyll Transient Fluorescence Pattern Under Sustained Dehydration and the Discovery of Critical Water Content in Seaweeds

The chlorophyll fluorescence kinetics of marine red alga Grateloupia turutunt Yamada, green alga Ulva pertusa Kjellm and brown alga Laminaria japonica Aresch during natural sustained dehydration were monitored and investigated. The pulse amplified modulation (PAM) system was used to analyze the distinct fluorescence parameters during thallus dehydration. Results proved that the fluorescence kinetics of different seaweed all showed three patterns of transformation with sustained water loss. These were: 1) peak kinetic pattern (at the early stage of dehydration fluorescence enhanced and quenched subsequently, representing a normal physiological state). 2) plateau kinetic pattern (with sustained water loss fluorescence enhanced continuously but quenching became slower, finally reaching its maximum). 3) Platform kinetic pattern (fluorescence fell and the shape of kinetic curve was similar to plateau kinetic pattern). A critical water content (CWC) could be found and defined as the percentage of water content just prior to the fluorescence drop and to be a significant physiological index for evaluation of plant drought tolerance. Once thallus water content became lower than this value the normal peak pattern can not be recovered even through rehydration, indicating an irreversible damage to the thylakoid membrane. The CWC value corresponding to different marine species were varied and negatively correlated with their desiccation tolerance, for example. Laminaria japonica had the highest CWC value (around 90%) and the lowest dehydration tolerance of the three. In addition, a fluorescence 'burst' was found only in red algae during rehydration. The different fluorescence parameters F-o, F-v and F-v, F-m were measured and compared during water loss. Both F-o and F-v increased in the first stage of dehydration but F-v/F-m. kept almost constant. So the immediate response of in vivo chlorophyll fluorescence to dehydration was an enhancement. Later with sustained dehydration F-o increased continuously while F-v decreased and tended to become smaller and smaller. The major changes in fluorescence (including fluorescence drop during dehydration and the burst during rehydration) were all attributed to the change in F-o instead of F-v This significance of F-o indicates that it is necessary to do more research on F-o as well as on its relationship with the state of thylakoid membrane.

Experimental study on shrinkage and rehydration of seed during drying process

Biomaterial will shrink during the drying process. The characteristics of shrinkage and rehydration of fresh peas were studied. Drying curves, shrinkage and rehydration curves of peas without seed coats and whole peas were compared. In addition, different volumetric shrinkage coefficients were obtained and discussed. The results show that seed coats resist moisture movement not only from inside to outside but also from outside to inside during different drying conditions. During a seed’s drying process, the drying curve is similar to the shrinkage curve. The higher the heat flux is, the less drying time is needed, and in the meantime, volume would shrink more and more intensively. Dried media will break easily at high heat flux. When we create a drying regime, both drying speed and the quality of dried media should be considered.

Carbachol promotes gastrointestinal function during oral resuscitation of burn shock

AIM: To investigate the effect of carbachol on gastrointestinal function in a dog model of oral resuscitation for burn shock. METHODS: Twenty Beagle dogs with intubation of the carotid artery, jugular vein and jejunum for 24 h were subjected to 35% total body surface area fullthickness burns, and were divided into three groups: no fluid resuscitation (NR, n = 10), in which animals did not receive fluid by any means in the first 24 h postburn; oral fluid resuscitation (OR, n = 8), in which dogs were gavaged with glucose-electrolyte solution (GES) with volume and rate consistent with the Parkland formula; and oral fluid with carbachol group (OR/CAR, n = 8), in which dogs were gavaged with GES containing carbachol (20 μg/kg), with the same volume and rate as the OR group. Twenty-four hours after burns, all animals were given intravenous fluid replacement, and 72 h after injury, they received nutritional support. Hemodynamicand gastrointestinal parameters were measured serially with animals in conscious and cooperative state. RESULTS: The mean arterial pressure, cardiac output and plasma volume dropped markedly, and gastrointestinal tissue perfusion was reduced obviously after the burn injury in all the three groups. Hemodynamic parameters and gastrointestinal tissue perfusion in the OR and OR/CAR groups were promoted to pre-injury level at 48 and 72 h, respectively, while hemodynamic parameters in the NR group did not return to pre-injury level till 72 h, and gastrointestinal tissue perfusion remained lower than pre-injury level until 120 h post-burn. CO 2 of the gastric mucosa and intestinal mucosa blood flow of OR/CAR groups were 56.4 ± 4.7 mmHg and 157.7 ± 17.7 blood perfusion units (BPU) at 24 h postburn, respectively, which were significantly superior to those in the OR group (65.8 ± 5.8 mmHg and 127.7 ± 11.9 BPU, respectively, all P < 0.05). Gastric emptying and intestinal absorption rates of GES were significantly reduced to the lowest level (52.8% and 23.7% of pre-injury levels) in the OR group at about 2 and 4 h post-burn, and did not return to 80% of pre-injury level until 24 h. In the first 24 h postburn, the rate of gastric emptying and intestinal water absorption were elevated by a mean 15.7% and 11.5%, respectively, in the OR/CAR group compared with the OR group. At 5 days, the mortality in the NR group was 30% (3/10), 12.5% in the OR group (1/8), and none in the OR/CAR group. CONCLUSION: Carbachol had a beneficial effect on oral resuscitation of burn shock by promoting gastric emptying and intestinal absorption in our canine model.

Tuning the base properties of Mg–Al hydrotalcite catalysts using their memory effect

Herein,the relationship between the structure and base properties of Mg–Al hydrotalcite catalysts was comprehensively investigated in relation to heat treatment and rehydration processes,which are well known as memory effects of hydrotalcite.The structure of Mg–Al hydrotalcites changed from layered double hydroxide(LDH)to mixed metal oxide and subsequently to a spinel structure during heat treatment,and it was returned from mixed metal oxide to a LDH structure by rehydration.Based on various characterizations,we successfully proposed a detailed mechanism of memory effect.We also confirmed that the Mg–Al hydrotalcites had weak or strong base sites and that their base properties could be systematically tuned by heat treatment and rehydration.The prepared Mg–Al hydrotalcites were applied to a model reaction,isomerization of glucose to fructose,as base catalysts.Among the catalysts tested,the rehydrated Mg–Al hydrotalcite efficiently produced fructose due to its appropriate base and structure properties.We finally concluded that the base sites of Mg–Al hydrotalcites can be designed as desired by heat treatment and rehydration.Moreover,through systematic design of the base sites of Mg–Al hydrotalcites,these can be promising catalysts for various heterogeneous reactions over base catalysts,giving excellent catalytic performances.

Maintenance of mesophyll potassium and regulation of plasma membrane H^+-ATPase are associated with physiological responses of tea plants to drought and subsequent rehydration

Drought stress is one of the main factors limiting yield in tea plants. The plant cell's ability to preserve K^+homeostasis is an important strategy for coping with drought stress. Plasma membrane H^+-ATPase in the mesophyll cell is important for maintaining membrane potential to regulate K^+transmembrane transport. However, no research to date has investigated the possible relationship between plasma membrane H^+-ATPase and mesophyll K^+retention in tea plants under drought and subsequent rehydration conditions. In our experiment, drought stress inhibited plasma membrane H^+-ATPase activities and induced net H^+influx, leading to membrane potential depolarization and inducing a massive K^+efflux in tea plant mesophyll cells. Subsequent rehydration increased plasma membrane H^+-ATPase activity and induced net H^+efflux, leading to membrane potential hyperpolarization and thus lowering K^+loss. A first downregulated and then upregulated plasma membrane H^+-ATPase protein expression level was also observed under drought and subsequent rehydration treatment, a finding in agreement with the change of measured plasma membrane H^+-ATPase activities. Taken together, our results suggest that maintenance of mesophyll K^+in tea plants under drought and rehydration is associated with regulation of plasma membrane H^+-ATPase activity.

Overcompensation or limitation to photosynthesis and root hydraulic conductance altered by rehydration in seedlings of sorghum and maize

In view of the prospect of irregular extremes of high and low rainfall due to climate change, the mechanisms underlying plant responses to periods of drought and re-watering need to be understood. Sorghum (Sorghum bicolor L.) and maize (Zea mays L.) were grown in pots of loess soil at three soil moisture levels to examine the effects of different levels of drought over 10 days and plant responses to re-watering (5 days of rehydration). Photosynthesis-related traits recovered rapidly both in sorghum and maize on re-watering, suggesting that photosynthetic function was not severely damaged after a short drought period, although the values of these traits were dramatically reduced during drought per se. However, the two species differed in the extent to which they recovered from severe stress. In sorghum, net photosynthetic rate (P_n), stomatal conductance (G_s), and maximum photochemical efficiency of PSII (F_v/F_m) returned to control levels after re-watering. However, in maize, these parameters exceeded control levels after re-watering. Both overcompensation and pre-drought limitation were observed. Over a range of growth conditions, close relationships between G_s and root hydraulic conductance (K_r) were observed in pooled data sets. P_n, K_r, and their related characteristics were compared among species and treatments. Our results showed that the recovery of K_r is similar between sorghum and maize, at least after a short time of re-watering, although the two species differ in drought-tolerance capacity. Our results also suggest that sorghum can endure moderate drought by adjusting certain traits, but is still as vulnerable as maize under severe drought stress.

Desiccation tolerance in bryophytes： the rehydration proteomes of Bryum argenteum provide insights into the resuscitation mechanism

Bryum argenteum Hedw. is a desiccation tolerant bryophyte and belongs to one of the most important components of the biological soil crusts （BSCs） found in the deserts of Central Asia. Limited information is available on rehydration-responsive proteins in desiccation tolerant plants. As a complement to our previous research analyzing the rehydration transcriptome, we present a parallel quantitative proteomic effort to study rehydration-responsive proteins. Bryophyte gametophores were desiccated （Dry） and rehydrated for 2 h （R2） and 24 h （R24）. Proteins from Dry, R2 and R24 gametophores were labeled by isobaric tags for relative and absolute quantitation （iTRAQ） to determine the relative abundance of rehydration-responsive proteins. A total of 5503 non-redundant protein sequences were identified and 4772 （86.7%） protein sequences were annotated using Gene Ontology （GO） terms and Pfam classifications. Upon rehydration 239 proteins were elevated and 461 proteins were reduced as compared to the desiccated protein sample. Differentially up-regulated proteins were classified into a number of categories including reactive oxygen species scavenging enzymes, detoxifying enzymes, Late Embryogenesis Abundant （LEA） proteins, heat shock proteins, proteasome components and proteases, and photosynthesis and translation related proteins. Furthermore, the results of the correlation between transcriptome and proteome revealed the discordant changes in the expression between protein and mRNA.

Diarrhea in neonatal intensive care unit

AIM:To investigate the frequency,etiology,and current management strategies for diarrhea in newborn.METHODS:Retrospective,nationwide study involving 5801 subjects observed in neonatal intensive care units during 3 years.The main anamnesis and demographic characteristics,etiology and characteristics of diarrhea,nutritional and therapeutic management,clinical outcomes were evaluated.RESULTS:Thirty-nine cases of diarrhea(36 acute,3 chronic) were identified.The occurrence rate of diarrhea was 6.72 per 1000 hospitalized newborn.Etiology was defined in 29 of 39 newborn(74.3%):food allergy(20.5%),gastrointestinal infections(17.9%),antibiotic-associated diarrhea(12.8%),congenital defects of ion transport(5.1%),withdrawal syndrome(5.1%),Hirschsprung's disease(2.5%),parenteral diarrhea(2.5%),cystic fibrosis(2.5%),and metabolic disorders(2.5%).Three patients died due to complications related to diarrhea(7.7%).In 19 of 39 patients(48.7%),rehydration was performed exclusively by the enteral route.CONCLUSION:Diarrhea in neonates is a challenging clinical condition due to the possible heterogeneous etiologies and severe outcomes.Specific guidelines are advocated in order to optimize management of diarrhea in this particular setting.

Calcium-sensing receptor: A new target for therapy of diarrhea

Management of acute diarrhea remains a global challenge, particularly in resource-limiting countries. Oral rehydration solution (ORS), a passive rehydrating therapy developed approximately 40 years ago, remains the mainstay treatment. Although ORS is effective for hydration, since it does not inhibit enterotoxin-mediated excessive secretion, reduced absorption and compromised barrier function - the primary mechanisms of diarrhea, ORS does not offer a rapid relief of diarrhea symptom. There are a few alternative therapies available, yet the use of these drugs is limited by their expense, lack of availability and/or safety concerns. Novel anti-diarrheal therapeutic approaches, particularly those simple affordable therapies, are needed. This article explores intestinal calcium-sensing receptor (CaSR), a newly uncovered target for therapy of diarrhea. Unlike others, targeting this host antidiarrheal receptor system appears &#x0201c;all-inclusive&#x0201d;: it is anti-secretory, pro-absorptive, anti-motility, and anti-inflammatory. Thus, activating CaSR reverses changes of both secretory and inflammatory diarrheas. Considering its unique property of using simple nutrients such as calcium, polyamines, and certain amino acids/oligopeptides as activators, it is possible that through targeting of CaSR with a combination of specific nutrients, novel oral rehydrating solutions that are inexpensive and practical to use in all countries may be developed.

Differential Responses of Electrolyte Leakage and Pigment Compositions in Maize and Sorghum After Exposure to and Recovery from Pre- and Post-Flowering Dehydration

Drought stress is often the most limiting factor to maize and sorghum production in the semi-arid areas.This study evaluates the response of electrolyte leakage,chlorophyll,carotenoid and anthocyanin contents in maize （cv.Melkassa-2 and sorghum cv.Macia） after exposure to and recovery from pre- and post-flowering dehydration in plants grown in a controlled environment growth chamber under constant environmental conditions （12/12 h day/night,28-32/17°C day/night temperature,60-80% RH and PPFD of 1 200-1 400 μmol m-2 s-1）,at the Department of Botany,University of Cape Town,South Africa.It was revealed that dehydration induced increases in electrolyte leakage was observed in both species during both pre- and post-flowering stages.Electrolyte leakage was however,higher during post- than pre-flowering dehydration in both species.Dehydration during both pre- and post-flowering stages caused a decrease in chlorophyll and carotenoid contents in both maize and sorghum.Chlorophyll and carotenoid contents of both pre- and post-flowering dehydrated sorghum was markedly higher than that of maize throughout the duration of the dehydration period.As opposed to chlorophyll and carotenoid contents,anthocyanin contents increased during pre- and post-flowering dehydration in both species.Differences were however,observed between both species in the response of anthocyanin content to pre- and post-flowering dehydration.Full recovery of chlorophyll,carotenoid and anthocyanin contents were observed in those plants rehydrated during pre-flowering stages.There was however,no recovery in both species during post-flowering rehydration.This study should help understand some adaptive mechanisms developed by maize and sorghum during the dehydration and rehydration periods and contribute to identify useful traits for breeding programs.

The Influence of Abrasive Pretreatment on Hot Air Drying of Grape

The drying of grapes is a more complex process compared to the dehydration of other agricultural materials due to the necessity of a pretreatment operation prior to drying. Grape drying to produce raisins is a very slow process, due to the peculiar structure of grape peel, that is covered by a waxy layer. Its removal has been so far carried out by using several chemical pre-treatments. However, they cause heterogeneity in the waxes removal and create microscopic cracks. In this paper an abrasive pretreatment for enhancing the drying rate and preserving the grape samples is proposed. Two cultivars of grape were investigated: Regina white grape and Red Globe red grape. The drying kinetics of untreated and treated samples were studied using a convective oven at 50°C. Fruit quality parameters such as sugar and organic acid contents, shrinkage, texture, peel damage (i.e. by SEM analysis) and rehydration capacity were studied to evaluate the effectiveness of abrasive pretreatment on raisins. Abrasive pretreatment contributed to reduce drying time and rehydration time. The treated and untreated dried grapes were significantly different (p < 0.05) in sugar and in tartaric acid content. On the contrary, no significant differences (p < 0.05) in malic and citric acids and in texture properties between untreated and treated samples were observed.

Effects of Food Additives on Rehydration Properties of Frozen Dumpling Wrappers

With the vacuum freeze-drying technology, frozen dumpling wrappers were prepared, to investigate the effects of six kinds of food additives, including modified starch, compound phosphate, maltodextrin, guar gum, distilled monoglycerides and transglutaminase （TG enzyme）, on the drying rate, rehydration ratio and sense value of the frozen dumpling wrappers. The results showed that, with respective addition of 6% modified starch, O. 1% compound phosphate, 10% maltodextrin, 0.4% guar gum, 0.4% distilled monoglyceride and 0.3% transglutaminase, the drying rate, rehydration ratio and sense value of the frozen dumpling wrappers were the highest.

Ultrastructural analysis of the loss of desiccation tolerance in germinating Eremanthus erythropappus seeds

Eremanthus erythropappus(DC.)MacLeish is an important forest species native to the Brazilian savanna biome,an environment with well-defined rainy and dry seasons.Its seeds are desiccation tolerant,non-dormant and dispersed at the end of dry season.This exposes them to the first sporadic rains that can trigger germination but the subsequent dry days can compromise survival of the newly germinated seed.This study evaluates if the damages caused by drying of germinating E.erythropappus seeds,at the stage when they have lost desiccation tolerance,are lethal.The percentage of normal seedlings was evaluated when seeds with different imbibition times were dried to their initial water content and then pre-humidified and rehydrated.Desiccation tolerance was fully lost after 0.5 mm of hypocotyl-radicle protrusion(approximately 72 h)when the radicle had root hairs,a possible indicator of sensitivity to desiccation.Disintegration of cell contents and ultrastructural damage to the seeds subjected to drying were observed by electron scanning microscope.Root hairs disappeared after drying,reappearing after pre-humidification,possibly an attempt to increase the surface area of the radicle for water uptake.However,the hypocotylradicle axis became darkened,probably by antioxidant system failure,causing seed death.

Rehydration and Phase Transformation of Aluminas

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Zinc:Role in the management of diarrhea and cholera

Diarrhea and cholera are major health problems.Vibrio cholera,the causative agent of cholera,infects the small intestine,resulting in vomiting,massive watery diarrhea and dehydration.Reduced water and electrolyte absorption is also due to zinc deficiency.Zinc has an important role in recovery from the disease.The combination of zinc with cholera vaccine and oral rehydration solutions has a positive impact on cholera and diarrhea.It has led to a decrease in the mortality and morbidity associated with diarrhea.

Correspondence: Newer oral rehydration solution OS-1 for emesis gravidarum

Though nausea and vomiting are quite common in pregnancy, hyperemesis is found in only 1 - 2 patients per 100. Appropriate oral fluid and electrolyte replacement is the initial treatment regimen for patients with mild to moderate emesis to avoid hyperemesis gravidarum defined as dehydration, electrolyte unbalance and ketosis. A newer oral rehydration solution OS-1 therapy may be safe and feasible in the mild to moderate emesis gravidarum population. Physicians are encouraged to use this practice to maintain the amount of water in the body and electrolytes and to improve the patient’s comfort.