B-type Natriuretic peptide Levels and Outcome in Children With Severe Acute Malnutrition With Co-morbidity

2020 ◽  
Vol 57 (4) ◽  
pp. 362-364 ◽  
Author(s):  
Dhilip Kumar ◽  
Sunil Kumar Rao
Keyword(s):  
Natriuretic Peptide ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Co Morbidity

scholarly journals Study of Anaemia in Children with Severe Acute Malnutrition

2018 ◽  
Vol 37 (3) ◽  
pp. 250-253 ◽  
Author(s):  
Deepak Dwivedi ◽  
Veerendra Singh ◽  
Jyoti Singh ◽  
Sangita Sharma
Keyword(s):  
Severe Acute Malnutrition ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Acute Malnutrition ◽  
Folic Acid Deficiency ◽  
Care Hospital ◽  
Macrocytic Anaemia ◽  
Normal Children ◽  
Co Morbidity ◽  
Morphologic Type

Introduction: Severe anaemia is a leading cause of paediatric morbidity, hospitalization, and mortality and it is very important co morbidity in children with severe acute malnutrition. Severe Acute Malnutrition (SAM) with anaemia has been shown to have 2.62 times higher mortality as compared to SAM with no anaemia. So this study was done to evaluate this co-morbidity further. The aim of present study was to determine the prevalence and type of anaemia and to evaluate the possible aetiologies of anaemia in severe acute malnourished (SAM) children.Material and Methods: In tertiary care hospital a cross sectional study was conducted over a period of 8 month with 100 cases of SAM children and 101 cases of normal children. In both cases disorders of primary haematological problem were excluded. Auto analysers were used to measure blood counts. Blood smear was analysed by pathology consultant of institute and recorded for all patients with anaemia. Grade of anaemia and morphologic type of anaemia was analysed. Data were entered in Excel spreadsheets and analysed using SPSS 20.0.Results: Patient with SAM 42% had moderate anaemia and 19% had severe anaemia in contrast 41.6% and 16.8% in NON SAM child respectively. Predominant morphologic type in SAM patient was macrocytic anaemia (33%), while in controls microcytic anaemia (40.6%) was more prevalent.Conclusion: There was a high prevalence of anaemia in SAM children. Major morphologic type in SAM children was macrocytic anaemia which may indirectly show vitamin B12 or folic acid deficiency in these children.  

scholarly journals Invasive Fungal Infections in Under-Five Diarrheal Children: Experience from an Urban Diarrheal Disease Hospital

Life ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 94
Author(s):  
Nusrat Jahan Shaly ◽  
Mohammed Moshtaq Pervez ◽  
Sayeeda Huq ◽  
Dilruba Ahmed ◽  
Chowdhury Rafiqul Ahsan ◽  
...  
Keyword(s):  
Septic Shock ◽  
Early Diagnosis ◽  
Late Onset ◽  
Fungal Infections ◽  
Severe Acute Malnutrition ◽  
Fatal Outcome ◽  
Invasive Fungal Infections ◽  
Acute Malnutrition ◽  
Study Group ◽  
Co Morbidity

Invasive fungal infections (IFIs) are opportunistic, especially in immunocompromised and hospitalized patients. Children with IFIs are more vulnerable to a fatal outcome. For early diagnosis and treatment, knowledge of the spectrum and frequency of IFIs among children is prerequisite. In this prospective observational study, we enrolled 168 children of 2–59 months old of either sex from March 2018 to December 2019 admitted to the Dhaka hospital, icddr,b. Study participants with suspected IFIs were with or without severe acute malnutrition (SAM) along with sepsis/pneumonia and fulfilled any of the following criteria: (i) failure to respond to injectable antibiotics, (ii) development of a late-onset hospital-acquired infection, (iii) needed ICU care for >7 days, (iv) took steroids/antibiotics for >2 weeks before hospitalization, and (v) developed thrush after taking injectable antibiotics. The comparison group included non-SAM (weight-for-length Z score ≥ −2) children with diarrhea and fever <3 days in the absence of co-morbidity. We performed real-time PCR, ELISA, and blood culture for the detection of fungal pathogen. Study group children with SAM, positive ELISA and PCR considered to have a IFIs. In the study group, 15/138 (10.87%) children had IFIs. Among IFIs, invasive candidiasis, aspergillosis, histoplasmosis detected in 6 (4.53%), 11 (7.97%), and 1 (0.72%) children, respectively, and (3/15 [2.17%]) children had both candidiasis and aspergillosis. Children with IFIs more often encountered septic shock (26.7% vs. 4.9%; p = 0.013) and had a higher death rate (46.7% vs. 8.9%; p < 0.001) than those without IFIs. IFIs were independently associated with female sex (OR = 3.48; 95% CI = 1.05, 11.55; p = 0.042) after adjusting for potential confounders. Our findings thus implicate that, malnourished children with septic shock require targeted screening for the early diagnosis and prompt management of IFIs that may help to reduce IFIs related deaths.

scholarly journals Clinical Spectrum and Comorbidity Pattern of Severe Acute Malnutrition in Hospitalised Children Age between 6 Months to 59 Months

2021 ◽  
Author(s):  
Ashutosh Kumar Sharma ◽  
Ghanshyam Das ◽  
Durgesh Shukla
Keyword(s):  
Nutrition Education ◽  
Work Performance ◽  
Severe Acute Malnutrition ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
Acute Malnutrition ◽  
Categorical Variables ◽  
Comprehensive Treatment ◽  
Treatment Unit ◽  
Co Morbidity

Abstract BACKGROUND The prevalence of underweight children in India is the highest in the world, and is nearly double that of Sub-Saharan Africa. Poor nutrition in the first 1000 days of a child’s life leads to stunted growth, impaired cognitive ability, reduced school and work performance. The mortality rate and duration of stay in hospital with oedematous SAM has remained unacceptably high. Such high mortality in inpatients has been attributed to co-morbidities.METHOD Descriptive hospital based study was done in the Department of Paediatrics, Kamla Raja Hospital, Gwalior from October 2018 to October 2020. Children 6-59 months of age with severe acute malnutrition admitted in severe acute malnutrition treatment unit were enrolled. WHO criteria were used to define severe acute malnutrition. The quantitative variables were described as mean ± standard deviation and categorical variables were in terms of proportion.RESULT Out of 29036 children, 1020 have severe acute malnutrition, constitute prevalence of 3.51%. A total of 400 cases met eligibility criteria and exploited. Sex ratio male and female 52.5%:47.5%. The peak prevalence was found in age group between 6-12 months (55%). Anaemia (68.25%) was found to be the commonest co morbidity, and then pneumonia (17.75%) dehydration (16.5%) followed by sepsis (13.5%). Most common chief complaint was fever (69%), followed by cough (38%) and watery loose motion (38%).CONCLUSION Severe acute malnutrition remains severe public health problem and mainly affects children under 24 months. Commonest causes are poor feeding practices, improper care of sick child at home, low maternal BMI. Maternal nutrition, education, media awareness, domestic decision, adequate nutrition of the girl child, early identification of anaemia, diarrhoea, pneumonia, sepsis and comprehensive treatment can reduces the morbidity and mortality.

scholarly journals STUDY TO EVALUATE THE SPECTRUM OF DIFFERENT CO-MORBIDITIES IN CHILDREN SUFFERING FROM SEVERE ACUTE MALNUTRITION WITH UNEXPECTED DYSELECTROLYTEMIA IN DIARRHEA

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Arunabh Kumar ◽  
Ashok Kumar ◽  
Manish Ranjan
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
P Value ◽  
Medical College ◽  
Institutional Ethics ◽  
Co Morbidity ◽  
Significant Difference ◽  
Study Population ◽  
Hiv 1 ◽  
Morbid Conditions

Aim: to evaluate the spectrum of co-morbidities in severe acute malnutrition with unexpected dyselectrolytemia in diarrhea. Material and methods: The study was an observational study which was carried in the Department of pediatrics, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga Bihar, India for 2 years.  after taking the approval of the protocol review committee and institutional ethics committee. Total 200 Children below 5 year age were included in this study. Various co morbid conditions in study population were identified. All the laboratory examination was done with standard method. Results: Total 200 cases were included in study of which 96% were associated co-morbid conditions in SAM. Majority of children with SAM were having co-morbidity in the form of Anaemia (88%), Diarrhoea (60%) followed by pneumonia (32%), Rickets (31%), Tuberculosis (14%), Otitis    media    (12%),    UTI    (11%),    Celiac   (4%), Hypothyroidism (2%), & HIV (1%). Mean age (SD) of the diarrheal cases was 25(6) months (95% C.I. 24.1- 25.8) of which 70 were male (58.33%). Mean age (SD) of non-diarrheal cases was 19(6). (95% C.I. 16.6 – 19.4) of which 45 were male(75%). 120 (60%) SAM children presented with diarrhea of which 117 had dysnatremia in the form of Hyponatremia in 117 cases (58.5%) & Hypernatremia in 3 cases (1.5%) No statistically significant difference was found with hyponatremia in diarrheal or non-diarrheal cases of SAM (P value of 0.07). It was found that 20% SAM children were having hypokalemia. Hypokalemia was found in 15% of diarrheal cases & 5% in non- diarrheal cases. A statistically significant difference was found with hypokalemia in SAM (P value of 0.019) between Diarrheal & Non diarrheal cases. Conclusion: Dyselectrolytemia is high in complicated SAM and mainly sodium disturbances in form of hyponatremia are common in different co-morbid conditions. Keywords: Co-morbidities, Dyselectrolytemia, Potassium, Severe acute malnutrition, Sodium

scholarly journals Study of malaria and associated co-morbidity in children admitted with fever manifestation in a tertiary care centre

2020 ◽  
Vol 7 (8) ◽  
pp. 1705
Author(s):  
Pawan Ghanghoriya ◽  
Rahul Borkar ◽  
Monica Lazarus ◽  
Manish Ajmariya
Keyword(s):  
Severe Malaria ◽  
Severe Acute Malnutrition ◽  
Care Center ◽  
Tertiary Care ◽  
Febrile Illness ◽  
Acute Malnutrition ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Co Morbidity

Background: Children under five year of age are highly vulnerable to malaria infection and often face dire consequences such as severe malaria if they are not promptly and adequately treated with anti-malarial medications. Authors set out to evaluate malaria and associated co-morbidity among children admitted with febrile illness in tertiary care center NSCB Medical college Jabalpur, India.Methods: This prospective and analytic study focused on children admitted with fever in pediatric unit of N.S.C.B. Medical College, Jabalpur, Madhya Pradesh, India. If any co-morbidity present with malaria their manifestation was noted. Association of co-morbidity with malaria was done, and effect of co-morbidity on severity of malaria and outcome of patients was noted.Results: A total number of 1950 of children suspected to have malaria who were tested by RDT and microscopy (PSMP), out of them 100 children were positive. Mean age calculated was 7.3±4.3 years. Maximum number of severe malaria cases (40.6%) were found in 6 months to <5 years age group. Most common co-morbidity associated with malaria was anemia (53%) followed by pneumonia (36%) hepatitis (26%), diarrhea (24%), enteric fever (15%), septicemia and meningoencephalitis (10%) each, UTI (4%), and AKI (6%), while dengue (3%) and severe acute malnutrition (2%). Out of 69 cases of severe malaria 46.3% cases had two and 34.7% cases had more than two co-morbidities while in 31 cases of uncomplicated malaria 38.7% cases had two co-morbidity and only 3% had more than two co-morbidity.Conclusions: All RDT positive cases have associated co-morbidity with malaria in our study, more is the co-morbidity is longer were the duration of stay and higher the complications and even mortality. 

scholarly journals PATTERN OF CO-MORBIDITIES IN CHILDREN WITH SEVERE ACUTE MALNUTRITION ADMITTED IN MTC AT M.G. HOSPITAL BHILWARA, RAJASTHAN

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Sunil Kumar Dadhich ◽  
Kuldeep Singh Rajpoot
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Severe Malnutrition ◽  
Age Group ◽  
Morbid Condition ◽  
Who Criteria ◽  
Co Morbidity ◽  
Treatment Centre ◽  
High Index Of Suspicion ◽  
Acute Severe Malnutrition

Background: A round the globe nearly 20 million children below the age of five, having Severe Acute Malnutrition (SAM) and contributing to one million deaths every year in this age group. To study the pattern of co-morbidities in children having Severe Acute Malnutrition in MTC attached to a teaching hospital. Methods: This prospective study was carried out in the MTC attached to Department of Pediatrics, M.G. Hospital Bhilwara, Rajasthan. All children between One to sixty months of age with severe acute malnutrition (SAM) admitted in the Malnutrition Treatment Centre were included. WHO criteria were followed for diagnosis and need for admissions in children suffering from severe acute malnutrition. Results: Out of 200 children having SAM 55.00% children were having one co-morbidity, 27.00% were having two co-morbidity and 10.00% were having more than two co-morbidty. Conclusions: It is imperative to suspect and anticipate co-morbid condition in these children. High index of suspicion for these co-morbidities is the key to reduce mortality and better outcome in children having acute severe malnutrition. Keywords: sever acute malnutrition (SAM), malnutrition treatment corner (MTC), co-morbidity

scholarly journals Time to Cure and Predictors of Recovery among Children Aged 6-59 Months with Severe Acute Malnutrition Admitted in Jimma University Medical Center, Southwest Ethiopia

2020 ◽  
Author(s):  
Robel Kabthymer ◽  
Getu Gizaw ◽  
Tefera Belachew
Keyword(s):  
Median Time ◽  
Severe Acute Malnutrition ◽  
Average Length ◽  
Medical Center ◽  
Survival Curve ◽  
Acute Malnutrition ◽  
Rank Test ◽  
Co Morbidity ◽  
Wide Range ◽  
Jimma University

Background: Treatment at stabilization center is an important intervention to avert the huge burden of mortality for children with complicated severe acute malnutrition (SAM). Recent reviews indicated a wide range in recovery rate (34-88%) due to several context-specific factors. This study aimed to estimate time to recovery and to determine predictors of time to recovery among children aged 6-59 month with severe acute malnutrition. Method: Retrospective cohort study was used among 375 children aged 6-59 months admitted in Jimma university medical center, from September 2015 to September 2017. Kaplan Meir estimate and survival curve was used to compare the time to recovery using log-rank test among different characteristics. Cox Proportional Hazard Model was used to identify significant predictors of time to recovery. Results: Median time of recovery for cohort of SAM children&rsquo;s was 19 days (95%CI: 17.95-20.05). Independent predictors of time to recovery were: Play stimulation, vaccination status, Tuberculosis, malaria, use of amoxicillin, deworming and shock. Conclusion: The findings of this study showed that the average length of stay on treatment and median time for recovery are within the sphere standard. Psychosocial stimulation, appropriate provision of routine medication and management of medical co-morbidity are needed to promote fast recovery.

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