EFFECTIVENESS OF FOLIC ACID IN ACUTE WATERY DIARRHEA AMONG CHILDREN
EFFECTIVENESS OF FOLIC ACID IN ACUTE WATERY DIARRHEA AMONG CHILDREN
Folic acid is a palatable and easily available drug with no serious adverse effects.
 L-methylfolate is its biologically activated form and is preferred because of its direct
 availability for certain metabolic processes. As there is no specific and safe drug available
 that may help in decreasing the duration of diarrhea, purging rate or consistency of stools;
 and having known the theoretical benefits of folic acid in this regard, it would be
 appropriate to assess the effectiveness of L-methylfolate among children with diarrhea.
After approval from the Institutional Review Board of King Edward Medical University, Mayo
 Hospital, Lahore, all children diagnosed with acute watery diarrhea as per operational
 definition fulfilling the inclusion criteria, presenting to the Department of Pediatrics,
 Mayo Hospital, will be enrolled in this study.

 Informed written consent will be taken from the parents/guardians of all participants. A
 detailed history and examination of each subject would be done by an investigator at
 presentation.

 Patients will be randomized in two groups - A and B by lottery method. There will be 162
 patients in each group. The treatment regimen that includes breast feeding, nutritional
 advice, rehydration plan; ORT by low osmolar ORS or intravenous rehydration (if required) and
 zinc sulphate will be given according to the WHO guidelines to all patients of both groups.
 Children under 1 year of age in group A will receive 3 drops (90mcg) of L-methylfolate
 calcium) while those older than 1 year of age will be given 5 drops (150mcg). Subjects in
 Group B will receive equal amount of distilled water as placebo (i.e. 3 drops to <1yr age and
 5 drops to >1 yr. Frequency and grades of loose stools in both groups will be assessed daily
 and written down on a predesigned proforma.
Inclusion Criteria:

 -  Children aged 2months- 5 years

 -  Both genders

 -  Acute watery diarrhea as per operational definition

 -  Diarrhea of less than 7-day duration

 Exclusion Criteria:

 -  Severely malnourished children <3 SD

 -  Bloody diarrhea

 -  Prolonged (7-14 days duration), persistent (>14 days duration) or chronic diarrhea
 (>4weeks duration)

 -  Those who received folic acid within the last 14 days

 -  Hospital-acquired diarrhea (diarrhea occurring after 48hrs of stay in hospital)

 -  Antibiotic-associated diarrhea.

 -  Presence of other co morbid conditions like pneumonia, sepsis, meningitis, etc.