scholarly journals Recognising the return of nutritional deficiencies: a modern pellagra puzzle

2018 ◽  
Vol 11 (1) ◽  
pp. e227454 ◽  
Author(s):  
Elisabeth Ng ◽  
Madeleine Neff
Keyword(s):  
Protein Energy Malnutrition ◽  
Caloric Intake ◽  
Diet Analysis ◽  
Vegan Diet ◽  
Nutritional Deficiencies ◽  
Vitamin B ◽  
Protein Energy ◽  
History Of ◽  
Diffuse Erythema ◽  
Erythematous Skin

A 34-year-old previously well woman presented with a 4-week history of diffuse erythema and crusting of skin affecting all four limbs. Examination revealed erythematous skin plaques associated with ulceration and fissuring affecting sun-exposed areas of all four limbs primarily on the dorsal surfaces, and a body mass index of 17 kg/m2. She was admitted under the infectious diseases unit, and an autoimmune and infective screen was performed which returned unremarkable. Dietetic consultation led to the diagnosis of severe protein-energy malnutrition, consequent to a severely restricted, primarily vegan, diet. Analysis of the patient’s reported diet with nutritional software revealed grossly suboptimal caloric intake with risk of inadequacy for most micronutrients, vitamins and minerals, including niacin. Oral thiamine, multivitamin, iron supplementation and vitamin B complex were started, and a single intramuscular vitamin B12 dose was administered. Marked improvement was seen after 6 weeks, with near-complete resolution of skin changes. These findings supported a diagnosis of pellagra.

scholarly journals Angular Cheilitis pada Anak yang Mengalami Defisiensi Nutrisi

e-GIGI ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 196
Author(s):  
Verena M. Ekarisma ◽  
Christy N. Mintjelungan ◽  
Aurelia S. R. Supit ◽  
Johanna A. Khoman
Keyword(s):  
Literature Review ◽  
Nutritional Status ◽  
Protein Energy Malnutrition ◽  
Nutritional Deficiencies ◽  
Vitamin B ◽  
Cross Sectional ◽  
Oral Infections ◽  
Protein Energy ◽  
Complex Deficiency

Abstract: Nutritional problems in Indonesia and developing countries in general are still dominated by the protein energy malnutrition (PEM) and other micronutrient problems such as iron deficiency and vitamin B complex deficiency. Nutritional deficiency is always accompanied by malnutrition in childhood. Children face the greatest risk of developing malnutrition. This can lead the children to become susceptible to infectious diseases. One of the most common oral infections in children with nutritional deficiencies is angular cheilitis. This study was aimed to review nutritional deficiencies in children with angular cheilitis. This was a literature review study. This study reviewed topics related to nutritional deficiencies in children from previous studies. There were 12 literature reviewed in this study consisting of 11 cross-sectional studies and one simple experimental study. The results showed that angular cheilitis was more common in children with malnutrition based on BMI for age measurement and moderate nutritional status based on MUAC measurements. Angular cheilitis type 1 were most commonly found in children with mild nutritional status, while types 2, 3 and 4 were most commonly found in children with moderate nutritional status. None of types 2, 3, and 4 were seen in children with good nutritional status. In conclusion, children with angular cheilitis are mostly deficient in vitamin B complex.Keywords: angular cheilitis, children, nutritional deficiencies Abstrak: Masalah nutrisi di Indonesia dan di negara berkembang pada umumnya masih didominasi oleh masalah kurang energi dan protein (KEP) serta masalah nutrisi mikro lainnya seperti defisiensi zat besi dan defisiensi vitamin B kompleks. Defisiensi nutrisi selalu dihubungkan dengan kekurangan gizi pada masa anak-anak. Anak-anak menghadapi risiko paling besar untuk mengalami kurang gizi. Defisiensi nutrisi dapat menyebabkan anak rentan terhadap penyakit infeksi. Salah satu penyakit infeksi rongga mulut yang sering terjadi pada anak dengan defisiensi nutrisi ialah angular cheilitis. Penelitian ini bertujuan untuk mengetahui gambaran defisiensi nutrisi pada anak dengan angular cheilitis. Jenis penelitian ialah suatu literature review. Penelitian ini mempelajari topik terkait defisiensi nutrisi pada anak dengan angular cheilitis dari penelitian-penelitian sebelumnya. Pustaka yang diulas dan dipelajari dalam penelitian ini sebanyak 12 pustaka yang terdiri dari 11 studi potong lintang dan satu eksperimental sederhana. Hasil penelitian menunjukkan bahwa lesi angular cheilitis lebih sering ditemukan pada anak dengan status gizi kurang berdasarkan pengukuran IMT/U dan status kurang nutrisi sedang berdasarkan pengukuran LLA. Lesi angular cheilitis tipe 1 paling banyak ditemukan pada anak dengan status kurang nutrisi ringan, sedangkan tipe 2, 3 dan 4 paling banyak ditemukan pada anak dengan status kurang nutrisi sedang dan tidak satu pun lesi tipe 2, 3, 4 terlihat pada anak dengan status nutrisi baik. Simpulan penelitian ini ialah anak dengan angular cheilitis paling banyak mengalami defisiensi nutrisi mikro vitamin B kompleks.Kata kunci: angular cheilitis, anak, defisiensi nutrisi

scholarly journals Prevalence of nutritional deficiencies among school going adolescents of Vadodara, Gujarat, India: a cross sectional study

2019 ◽  
Vol 6 (6) ◽  
pp. 1767
Author(s):  
Ashish Shamjibhai Bhalsod ◽  
Nisarg N. Dave ◽  
Nilesh Thakor
Keyword(s):  
Vitamin A Deficiency ◽  
Protein Energy Malnutrition ◽  
Cross Sectional Study ◽  
Nutritional Deficiencies ◽  
Growth Spurt ◽  
Cross Sectional ◽  
Male Adolescents ◽  
Protein Energy ◽  
Complex Deficiency ◽  
Fatty Acid Deficiency

Background: Adolescent constitutes over 23% of the population in India. Critical development occurs during adolescence period. Growth spurt and increase in physical activity during adolescent period increases the nutrition and health needs of the adolescent. Objective was to study prevalence of nutritional deficiencies among school going adolescents of Vadodara city, Gujarat.Methods: The study was carried during period from September 2018 to August 2019. After taking the permission of principals of 3 schools and consent of the parents of adolescents, 511 adolescents from 3 schools of Vadodara city were examined for signs of various nutritional deficiencies. The data was collected by predesign, pretested proforma and analyzed using SPSS 17.0 (Trial Version).Results: Out of total 511 adolescents 253(49.5%) were female. Mean age of the study adolescents was 15.6±1.81 years. Maximum numbers of the adolescents were in the age group of 10-14 years (60.3%). Mean age of female and male adolescents was 15.2±1.71 years and 15.6±2.01 years respectively. The study revealed that vitamin A deficiency was present in 38(7.4%) adolescents. Vitamin B complex deficiency signs were seen in 112(21.9%) adolescents. Vitamin C deficiency signs were seen in 43(8.4%) adolescents. Protein Energy Malnutrition was observed in 52(10.1%) adolescents. Essential fatty acid deficiency was observed in 56(10.9%) adolescents.Conclusions: High prevalence of nutritional deficiencies among these adolescents needs great attention and health education.

scholarly journals Nutritional deficiencies and later behavioural development

2000 ◽  
Vol 59 (1) ◽  
pp. 47-54 ◽  
Author(s):  
S. M. Grantham-McGregor ◽  
S. P. Walker ◽  
S. Chang
Keyword(s):  
Cultural Context ◽  
School Achievement ◽  
Protein Energy Malnutrition ◽  
Term Effect ◽  
Nutritional Deficiencies ◽  
Long Term Effects ◽  
Protein Energy ◽  
Long Term Effect ◽  
Long Term Follow Up

The literature on the long-term effects of nutritional deficiencies in early life is reviewed. The severity and duration of the deficiency, the stage of the children’s development, the biological condition of the children and the socio-cultural context may all modify the effect. There is substantial evidence that reduced breast-feeding, small-for-gestational-age birth weight, Fe and I deficiency, and protein-energy malnutrition (PEM) are associated with long-term deficits in cognition and school achievement. However, all these conditions are associated with poverty and poor health, which may account for the association. It is difficult to establish that the long-term relationship is causal, as it requires a randomized treatment trial with long-term follow-up. Such studies are only available for I deficiency in utero and early childhood PEM. Results from these studies indicate that I deficiency has a long-term effect and PEM probably has a long-term effect.

Effects of massive bowel resection

2020 ◽  
pp. 2911-2916
Author(s):  
Stephen J. Middleton ◽  
Simon M. Gabe ◽  
Raymond J. Playford
Keyword(s):  
Small Bowel ◽  
Protein Energy Malnutrition ◽  
Intestinal Resection ◽  
Intestinal Transplantation ◽  
Renal Stones ◽  
Electrolyte Solutions ◽  
Venous Access ◽  
Vitamin B ◽  
Protein Energy

Major vascular events involving the superior mesenteric artery and small-bowel volvulus are the commonest reasons for adults to require massive intestinal resection. The ability of the residual bowel to adapt after resection varies greatly between patients, but common postoperative problems include sepsis, diarrhoea (or high-output stoma losses), fluid and electrolyte imbalance, malnourishment (protein–energy malnutrition, mineral and vitamin deficiencies), gallstones, renal stones, and psychological illness. Where appropriate, oral nutrition, initially consisting of low-volume polymeric feeds administered by nasogastric or enteral tube, should be started within the first few days of surgery. Small-volume, frequent, solid or semisolid meals with low long-chain triglycerides and (when colon is in continuity) oxalate content should be introduced subsequently, and isotonic electrolyte solutions given as required. Oral multivitamin and mineral supplements are usually needed, and vitamin B12 injections may be required. There should be regular long-term monitoring of fat-soluble vitamins (A and D), vitamin B12, folate, magnesium, zinc, and bone status. Long-term intravenous nutrition is sometimes needed. Growth factor administration, especially glucagon-like peptide-2 analogues, may stimulate bowel adaptation. Small-bowel lengthening may be considered for patients with dilated bowel close to the length required. Those who are dependent on peripheral nutrition and develop complications such as loss of venous access or liver disease should be considered for intestinal transplantation.

Nutritional assessment

2018 ◽  
Author(s):  
John Puntis
Keyword(s):  
Nutritional Assessment ◽  
Protein Energy Malnutrition ◽  
Growth Failure ◽  
Developed Countries ◽  
Nutritional Deficiencies ◽  
Negative Effects ◽  
Healthy Life ◽  
Protein Energy ◽  
Nutritional Needs ◽  
Routine Assessment

Routine assessment of nutritional status should be part of normal practice when seeing any patient. The purpose is to document objective nutritional parameters (e.g. anthropometry), identify nutritional deficiencies, and establish nutritional needs. Protein–energy malnutrition has many adverse consequences including growth failure (identified by reference to standard growth charts). Worldwide, malnutrition contributes to a third of deaths in children under 5 years of age, and one in nine people don’t have enough food to lead an active and healthy life. In developed countries, malnutrition complicates both acute and chronic illness with negative effects on outcomes. In clinical practice, a useful approach to nutritional assessment is to consider three elements: ‘what you are’ (i.e. body habitus—underweight for height; short for age; etc.), ‘what you can do’ (functional activity), and ‘what you eat’ (current nutritional intake).

scholarly journals A Case Report on Mucormycosis in Non-Diabetic, Non-Covid Recovered Patient with no History of Steroid use

2021 ◽  
pp. 14-19
Author(s):  
Gautam Panduranga ◽  
Bavu Akhil Kumar ◽  
Mandhala Sai Krishna ◽  
Akhil Aakunuri ◽  
Nikitha Godishala
Keyword(s):  
Standard Treatment ◽  
Protein Energy Malnutrition ◽  
Symptomatic Treatment ◽  
Severe Trauma ◽  
Intermittent Fever ◽  
Steroid Use ◽  
Azole Antifungals ◽  
Protein Energy ◽  
Uncontrolled Diabetes ◽  
History Of

Rhino cerebral orbital mucormycosis is an aggressively spreading fungal infection caused by filamentous fungi of the Mucoraceae family and is found to be more prone in patients with comorbidities that include: uncontrolled diabetes mellitus, immune-suppressed patients, iron and aluminum overload, chronic steroid therapy, severe trauma, and protein-energy malnutrition. A 51year old male patient was admitted to the hospital with a complaint of headache and intermittent fever. The patient had no history of diabetes or denovo hypertension. Based on the analysis of histopathological and radiological investigations, the patient was diagnosed with mucormycosis. The patient furthermore underwent an endoscopic surgical debridement followed by standard treatment including antifungal antibiotic(amphotericin-B) and azole antifungals (posaconazole) along with symptomatic treatment. Though the patient was given all possible therapy available, no improvement was seen in the patient's condition (poor prognosis).

scholarly journals TERAPI NUTRISI PADA NEFROPATI DIABETIK, GAGAL JANTUNG KRONIK NYHA III, KARSINOMA SERVIKS, POST OPERASI URS BILATERAL, REPLACE DJ STENT

2021 ◽  
Vol 4 (1) ◽  
pp. 1-11
Author(s):  
Andi Syurma Sari Ismail ◽  
Agussalim Bukhari
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Protein Energy Malnutrition ◽  
Vitamin B ◽  
Diabetic Kidney ◽  
Protein Energy ◽  
Dj Stent

Nefropati Diabetik or Diabetic Kidney Disease (DKD) adalah perubahan struktural dan fungsional patologis spesifik yang terlihat pada ginjal pasien Diabetes Mellitus (DM). Nefropati diabetik menyebabkan berbagai perubahan pada kapiler dan arteri, penebalan membran endotel, trombosis dan inflamasi. Kondisi ini terlihat setelah satu atau dua tahun menderita DM. Diabetes mellitus juga dapat berkontribusi pada gagal jantung kronik dengan mekanisme sistemik, miokard, dan seluler. Semua faktor inilah yang dapat menyebakan malnutrisi. Ini adalah laporan kasus dari seorang wanita berusia 50 tahun, dengan keluhan tidak ada asupan oral yang didiagnosis dengan moderate protein energy malnutrition, nefropati diabetik, gagal jantung kronik NYHA III dengan karsinoma serviks dan pasca operasi URS Bilateral, Replace DJ Stent. Terapi nutrisi diberikan 720 kkal, ditingkatkan bertahap menjadi 2000 kkal sesuai kemampuan dan kondisi pasien, dengan komposisi 0,8-1 g / kg BB ideal / hari protein dan ekstrak ikan gabus, 45-50% karbohidrat dan 41-47% lemak diikuti dengan suplementasi seng (20 mg / hari), vitamin B kompleks, dan kurkumin. Terjadi peningkatan asupan energi dari 245 kkal menjadi 2.142,6 kkal diikuti dengan peningkatan hasil laboratorium seperti penurunan ureum / kreatinin (114 / 3,2 menjadi 84 / 2,05 mg / dl, penurunan leukosit (14.000 menjadi 7200 / µl), penurunan asam urat (13,1 hingga 7,3) mg / dl, penurunan kadar gula darah (199 menjadi 162 g / dl), peningkatan hemoglobin (6,7 hingga 8,2 g / dl), peningkatan kadar natrium (128 hingga 131 mmol / l) Kesimpulan: Terapi gizi yang adekuat selama 16 hari dapat memperbaiki kondisi, status metabolisme dan kualitas hidup pasien.

scholarly journals Undernutrition, food insecurity, and leprosy in North Gondar Zone, Ethiopia: A case-control study to identify infection risk factors associated with poverty

2021 ◽  
Vol 15 (6) ◽  
pp. e0009456
Author(s):  
Puneet Anantharam ◽  
Lisa E. Emerson ◽  
Kassahun D. Bilcha ◽  
Jessica K. Fairley ◽  
Annisa B. Tesfaye
Keyword(s):  
Food Insecurity ◽  
Dietary Habits ◽  
Protein Energy Malnutrition ◽  
Strong Association ◽  
Nutritional Deficiencies ◽  
Cell Mediated Immunity ◽  
Biometric Data ◽  
Protein Energy ◽  
Individual Host ◽  
Infection Risk Factors

Background Ethiopia has over 3,200 new cases of leprosy diagnosed every year. Prevention remains a challenge as transmission pathways are poorly understood. Susceptibility and disease manifestations are highly dependent on individual host-immune response. Nutritional deficiencies, such as protein-energy malnutrition, have been linked to reduced cell-mediated immunity, which in the case of leprosy, could lead to a higher chance of active leprosy and thus an increased reservoir of transmissible infection. Methodology/Principal findings Between June and August 2018, recently diagnosed patients with leprosy and individuals without known contact with cases were enrolled as controls in North Gondar regional health centers. Participants answered survey questions on biometric data, demographics, socioeconomic situation, and dietary habits. Descriptive statistics, univariate, and multivariate logisitic regression examined associations between undernutrition, specifically body mass index (BMI), middle upper arm circumference (MUAC), and leprosy. Eighty-one participants (40 cases of leprosy, 41 controls) were enrolled (75% male) with an average age of 38.6 years (SD 18.3). The majority of cases were multibacillary (MB) (90%). There was a high prevalence of undernutrition with 24 (29.6%) participants underweight (BMI <18.5) and 17 (21%) having a low MUAC. On multivariate analysis, underweight was significantly associated with leprosy (aOR = 9.25, 95% CI 2.77, 30.81). Also found to be associated with leprosy was cutting the size of meals/skipping meals (OR = 2.9, 95% CI 1.0, 8.32) or not having enough money for food (OR = 10, 95% CI 3.44 29.06). Conclusions/Significance The results suggest a strong association between leprosy and undernutrition, while also supporting the framework that food insecurity may lead to undernutrition that then could increase susceptibility to leprosy. In conclusion, this study highlights the need to study the interplay of undernutrition, food insecurity, and the manifestations of leprosy.

Nutritional Deficiencies and Toxicities

2017 ◽  
Author(s):  
Karl E. Misulis ◽  
E. Lee Murray
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Copper Deficiency ◽  
Protein Energy Malnutrition ◽  
Nutritional Deficiencies ◽  
Wernicke Encephalopathy ◽  
Diagnosis And Management ◽  
Protein Energy ◽  
Korsakoff Syndrome ◽  
B12 Deficiency

Nutritional disorders are often encountered in hospital neurology practice, especially deficiencies of vitamins B1 and B12. Medical conditions can predispose to nutritional disorders. This chapter discusses the presentation, diagnosis, and management of B12 deficiency, B1 deficiency, protein-energy malnutrition, folate deficiency especially in the context of pregnancy, B6 deficiency, B6 toxicity, copper deficiency, and vitamin D deficiency. Wernicke encephalopathy and Korsakoff syndrome are also discussed.

Anaemia as a challenge to world health

2020 ◽  
pp. 5366-5371
Author(s):  
David J. Roberts ◽  
David J. Weatherall
Keyword(s):  
Chronic Infection ◽  
Protein Energy Malnutrition ◽  
Tropical Sprue ◽  
Reproductive Age ◽  
World Health ◽  
Nutritional Deficiencies ◽  
Middle Income ◽  
Middle Income Countries ◽  
Protein Energy ◽  
Glucose 6 Phosphate Dehydrogenase

Anaemia is a very common problem in low- and middle-income countries (LMICs): 27% of the world’s population or 1.93 billion people are affected by anaemia (2013) and more than 90% of people with anaemia live in the developing world. Preschool children and women of reproductive age are particularly affected by anaemia and more 60% of anaemia is caused by iron deficiency. Causes of anaemia in LMICs—this is often multifactorial, with causes including (1) nutritional deficiencies—iron, folate, vitamin B12; (2) chronic infection—including malaria, tuberculosis, AIDS; (3) blood loss—hookworm, schistosomiasis; (4) protein–energy malnutrition; (5) malabsorption—for example, tropical sprue; (6) hereditary—for example, thalassaemias, haemoglobin variants, glucose-6-phosphate dehydrogenase deficiency. A series of vicious cycles exist in LMICs—maternal anaemia due to iron or folate deficiency and chronic malaria is associated with the birth of underweight infants who frequently have low iron stores, may also be folate deplete, and are usually anaemic from about 6 months of age. Such infants are prone to infection, particularly gastrointestinal, and may be further depleted of iron or folate by inappropriately prolonged breastfeeding or weaning onto an inadequate diet. They are exposed to hookworm infection as soon as they start to crawl, malaria becomes an important problem after 6 months, and in many populations the increasingly common haemoglobinopathies are a further cause of anaemia after the first few months of life.

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