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Indian Pediatr 2013;50: 710 |
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Synthetic Apple Juice Masquerading as Low-osmolar
ORS
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Newton Luiz
Consultant Pediatrician, Dhanya Mission Hospital, Potta
PO, Thrissur Dt.,
Kerala 680 722, India.
Email: [email protected] m
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A 3-year-old child was admitted with profuse watery diarrhea.
A pediatrician elsewhere had advised low-osmolar ORS and
even prescribed five packs (200 mL each) of "ORS-L" by
Jagdale Industries Limited, Bangalore (Fig. 1).
While the tetrapac is named ‘ORS-L’ in large letters, below
that in smaller letters is inscribed ‘Apple Drink’ and
‘enriched with electrolytes and Vitamin C’. Table
I offers a comparison of the contents of the tetrapac
with low-osmolar ORS. The total osmolarity of ORS-L is 585
mmol/L and is guaranteed to cause a severe osmotic diarrhea
if ingested in adequate quantity.
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Fig. 1 Apple drink mislabelled as ‘ORS-L’.
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TABLE I Comparison of the Apple Drink with ORS-L
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Contents (L) |
Apple drink |
Low-osmolar
ORS |
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NaCl |
1.25 g |
2.6 g |
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KCl |
1.5 g |
1.5 g |
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Sod Citrate |
2.9 g |
2.9 g |
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Vitamin C |
500 mg |
– |
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Glucose |
27 g |
13.5 mg |
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Sugar |
80 g |
– |
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Carbohydrate |
40 g |
– |
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Osmolarity |
585 |
245 |
It is unfortunate that in our country
apple juice can be openly mislabelled and sold as ORS. All
pediatricians should be alert to this fraud, which requires
knowledge of the formula of ORS-L. Perhaps the IAP through
its Medico-legal Group should lodge an official complaint
with the Ministry of Food Processing Industries and the
Central Drugs Standard Control Organization.
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