A 5-month old formula fed infant has been brought with complaints of watery diarrhoea of 2 days duration and irritability of one day duration.He had been receiving WHO ORS at home. Physical examination reveals a markedly irritable child with a rather doughy skin and rapid pulse.The most likely diagnosis is-

Ans. is 'd' i.e., Hypernatremic dehydration o This child has i) Irritability ii) Doughy skin iii) History of ORS taken at home o Irritability and doughy skin is seen in hypernatremic dehydration. o Hypernatremic dehydration occurs when fluid is given with more salts. o This child must have taken more ORS than fluid i.e., concentrated ORS. o About hyponatremic dehydration There is drowsiness (not irritability) Skin is dry inelastic (not doughy).