SEROPREVALENCE OF CELIAC DISEASES IN CHILDREN SUFFERING FROM SEVERE ACUTE MALNUTRITION IN AGE GROUP OF 1–5 YEARS

Background: The objective is to study the various social and demographic determinants of severe acute malnutrition in children aged 6 months to 59 months in a tertiary care centre of Odisha, India.Methods: This is a hospital based prospective observational study done in a tertiary care centre of Odisha during the period of Nov 2015 to Oct 2017 in which all children with severe acute malnutrition as per WHO criteria in the age group 6 months to 59 months were enrolled and their socioeconomic and demographic details were evaluated.Results: Present study revealed a prevalence of severe acute malnutrition as 2.8%. Males (54.2%) were more affected than females (45.8%). Most common age group affected was 6-12 months (37.4%). Most of the children were from low socioeconomic status (96.4%) and from rural areas (84.8%).63.7% of the study population were unimmunised. Only 12.6% of the participants were exclusively breast fed.100% of the children in the study population received top feeding with cow’s milk.Conclusions: The prevalence of malnutrition is high in Odisha but most of the causative factors are preventable. Adequate education regarding exclusive breastfeeding, complementary feeding, immunisation, promotion of proper referral and health care services can help to improve nutritional status in the state of Odisha.

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Screening for Hypothyroidism in children with severe acute malnutrition at Nutrition Rehabilitation Center, Children’s Hospital and Institute of Child Health Multan.

The Professional Medical Journal ◽

10.29309/tpmj/2022.29.01.5722 ◽

2021 ◽

Vol 29 (01) ◽

pp. 116-120

Author(s):

Saadia Khan ◽

Waqas Imran Khan ◽

Ayesha Fayyaz ◽

Ibad Ali ◽

Asad Abbas ◽

...

Keyword(s):

Child Health ◽

Severe Acute Malnutrition ◽

Acute Malnutrition ◽

Total Serum ◽

Age Group ◽

Rehabilitation Center ◽

Mean Values ◽

Children's Hospital ◽

Children’S Hospital ◽

Nutrition Rehabilitation

Objective: To determine the percentage of Hypothyroidism in children with severe acute malnutrition. Study Design: Cross Sectional study. Setting: Nutrition Rehabilitation Center, Children’s Hospital and Institute of Child Health Multan. Period: January 2019 to December 2019. Material & Methods: A total of 255 malnourished patients (as per inclusion criteria) were included in current study. A written Performa was designed to collect history, anthropometric measurements and systemic examination. Taking aseptic measures venous blood was sent for baseline tests as well as for T3, T4 and TSH, total serum protein albumin and total ferritin levels to hospital laboratory. Correlation between serum thyroid concentrations and total protein, albumin, hemoglobin and serum ferritin were estimated by using t-test and p-vlaue less than 0.05 was considered as significant. Total collected data was entered and analyzed in SPSS version 21.0. Results: A total of 255 malnourished children were included in this study. Majority of studied subjects were male (52.5%) with 83.92%, 3-5 years of age. Amongst the 255 children mean values of T3 in MAM and SAM patients were 105.4 ng/dl and 89.7 ng/dl respectively. There was a statistically significant (p <0.001) association between decreased T3 and type of malnutrition. Similarly, mean values of T4 in MAM and SAM patients were 6.3 ug/dl and 5.7 ug/dl respectively that was statistically significant (p <0.05). Lower values of T4 were higher among SAM children in 1 to 3 years age group compared to respective MAM children with p value .0.05 and high T4 value in 3-5 years age group of MAM children were both statistically insignificant. Higher mean Values of TSH was found in SAM compared to MAM children both age groups. Conclusion: Severe acute malnutrition (SAM) is associated with reduction in T3 and T4 levels and higher levels of TSH in SAM children as compared to MAM. The altered thyroid hormone status in children with PEM is perhaps a protective phenomenon to limit protein catabolism and lower energy requirements.

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Serum vitamin B12 levels in severe acute malnutrition hospitalized children between age group 6 months to 59 months in Kangra, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20183546 ◽

2018 ◽

Vol 5 (5) ◽

pp. 1997

Author(s):

Ajay Vaid ◽

Milap Sharma ◽

Jamunashree B. ◽

Piyush Gautam

Keyword(s):

Vitamin B12 ◽

Severe Acute Malnutrition ◽

Megaloblastic Anemia ◽

Serum Vitamin ◽

Vitamin B12 Deficiency ◽

Work Capacity ◽

Acute Malnutrition ◽

Age Group ◽

Female Ratio ◽

Increased Risk

Background: Child malnutrition is a major global health problem contributing to childhood morbidity, mortality, impaired intellectual development, suboptimal adult work capacity and increased risk of diseases in adulthood. Severe acute malnutrition, among children below five years of age remains a major embarrassment, and impediment to optimal human capital development in India.Methods: The study was an observational study conducted in the Department of Pediatrics and Biochemistry at Dr. RPGMC Kangra at Tanda, Himachal Pradesh. All children aged between 6 to 59 months presenting in the Department of Pediatrics with SAM (Severe Acute Malnutrition) and fulfilling the inclusion and exclusion criteria were included in the study after taking the informed consent from the guardian in local language.Results: Out of 48 children included in the study, 28 (58%) children were Males and 20 (42%) children were females with male to female Ratio 1.3:1. Out of 48 children 28 (58%) were vitamin B12 deficient and 20 (42%) were non-deficient. In the present study 53.5% (15) of males were vitamin B12 deficient. Out of 20 females 65% (13) of females were vitamin B12 deficient, showed slight preponderance of females over males. It has been observed that younger age group children mostly <2-year-old were, the most vulnerable group as far as vitamin B12 deficiency is considered (16%)Conclusions: Micronutrients play a central part in metabolism and in maintenance of tissue functions. All severely malnourished children have vitamin and mineral deficiencies. The most common type of anemia was microcytic followed by megaloblastic anemia.

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Clinical profile of patients with infantile tremor syndrome in a tertiary care center

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20204539 ◽

2020 ◽

Vol 7 (11) ◽

pp. 2172

Author(s):

Gargi H. Pathak ◽

Anuya V. Chauhan ◽

Dhruti Pandya

Keyword(s):

Vitamin B12 ◽

Complementary Feeding ◽

Severe Acute Malnutrition ◽

Vitamin B12 Deficiency ◽

Clinical Profile ◽

Acute Malnutrition ◽

Severe Anemia ◽

Age Group ◽

Nutritional Rehabilitation ◽

B12 Deficiency

Background: Infantile tremor syndrome (ITS) is a condition reported from many areas of Indian subcontinent due to lack of proper nutrition, improper weaning or delayed introduction of complementary feeding. There is no proven macro or micro nutrient deficiency responsible for it but relation with vitamin B12 deficiency has been identified in some studies. The aim of this study was to study the clinical profile of patients with ITS.Methods: It is a prospective observational study including total 30 patients, from 6 months to 3-year age group, admitted to pediatric wards and nutritional rehabilitation centre, civil hospital, Ahmedabad, from June 2018 to December 2019.Results: Out of 30 patients studied, 69% had pre-ITS and rest had ITS, 61.5% were males and 38.4% were females, 69.2% had severe acute malnutrition, 84.6% had severe anemia and 23% of them presented with CCF, 15.4% patients had microcephaly and 23% had hypotonia. 23% had motor and speech delay. 61.5% belonged to lower socio-economic group. There was delayed introduction of complementary feeding in 63% of patients. 69% patients had severe vitamin B12 deficiency and 21% had moderate vitamin B12 deficiency.Conclusion: ITS, is commonly seen among male children belonging to lower socio-economic group among age group of 6 months to 24 months, presents with coarse tremors with moderate to severe anemia with moderate to severe acute malnutrition and is associated with deficiency of vitamin B12. Early diagnosis and treatment including nutritional rehabilitation grossly improved the outcome.

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Clinical profile and major co-morbidities among hospitalized children with severe acute malnutrition: experience from a tertiary care teaching hospital of North India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20205431 ◽

2020 ◽

Vol 8 (1) ◽

pp. 30

Author(s):

Ashish Marwah ◽

Poonam Mehta Nee Marwah

Keyword(s):

Respiratory Tract ◽

Teaching Hospital ◽

Lower Respiratory Tract ◽

Severe Acute Malnutrition ◽

Tertiary Care ◽

Acute Malnutrition ◽

Hospitalized Children ◽

Severe Anemia ◽

Age Group ◽

Delayed Initiation

Background: Malnutrition is still a leading cause of morbidity and mortality in children aged less than 5 years and responsible for 60% of the 10 million deaths. The study was designed to evaluate the clinical profile and major clinical co-morbidities among hospitalized children with severe acute malnutrition (SAM).Methods: A prospective study was conducted in a pediatric department of a tertiary care teaching hospital of Haryana. All children aged 6 months to 5 years with SAM admitted between 1st April 2018 to 31st March 2019 were included in the study. The socio-demographic details, anthropometry, clinical details and outcome were recorded in a pre-designed structured performa. Statistical analysis was done using SPSS software version 16. P value<0.05 was considered significant.Results: After screening a total of 131 children, 102 children met the inclusion criteria and were enrolled in the study. Out of these, 50 were males and 52 were females. Majority of children (i.e., 59.8%) belonged to 6-12 months age group. Majority (92.16%) belonged to lower socio-economic status. Exclusive breastfeeding during first 6 months was documented in 74.51% of the children. Delayed initiation of complementary feeds was observed in 78.43% of children and had a significant association with poor future outcome (p<0.05). Major clinical co-morbidities were severe anemia (56.86%), diarrhea (27.45%) and lower respiratory tract infection (19.6%).Conclusions: In our study, most vulnerable age group for severe malnutrition was 6-12 months infants. Low socioeconomic status of family and delayed initiation of complementary feeding were the major risk factors. Most common co-morbidities were severe anemia, diarrhea, lower respiratory tract infections and sepsis emphasizing the need to target these factors.

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Estimation of serum folate and vitamin B12 levels in children with severe acute malnutrition

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20201512 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1013

Author(s):

Anjana Murthy K. ◽

Ashwini Malladad ◽

Mallesh Kariyappa

Keyword(s):

Folic Acid ◽

Vitamin B12 ◽

Severe Acute Malnutrition ◽

Folate Deficiency ◽

Acute Malnutrition ◽

Serum Folate ◽

Folic Acid Deficiency ◽

Plasma Vitamin ◽

Age Group ◽

Folate And Vitamin B12

Background: Severe acute malnutrition is the important health issue children affected in India. It is often associated with Iron, Vitamin B12 and Folic acid and other micronutrient deficiencies. These reports of declining trend of Iron and folic acid deficiency with implementation of national anemia control programme. Estimation of Serum Folate and Vitamin B12 levels in SAM children aged 6-60 months with anemia was the objective of the study.Methods: A hospital based observational study on 80 children admitted to nutritional rehabilitation center were suffering from severe acute malnutrition (SAM) in the age group of 6-60 months enrolled in the study during the period November 2018 to May 2019 .Data was collected using a predesigned and pretested Proforma, containing details of feeding, socio-economic and development history. Blood samples were sent for measurement of plasma vitamin B12 and serum folate levels. Statistical analysis was done using SPSS version 20.0.Results: Out of 80 children, majority were between the age group of 24-60 months and majority were boys (53.8%). Mean Vitamin B12 and folic acid levels being 384.61 and 8.95 respectively. 45% and 3.8% had vitamin B12 and folic acid deficiencies respectively. Majority of neurological changes and developmental delays were noted in B12 deficient group. Of the 36, B12 deficient children, majority had moderate anaemia (40.2%), normal total count (41.7%), 60% had neutropenia, 44.4% had lymphocytosis, majority had normocytic (30.9%) anemia.Conclusions: There was a moderate to high prevalence of vitamin B12 deficiency among malnourished children. Folate deficiency was found only in few. Efforts should be directed to prevent its deficiency in pregnant and breastfeeding women and their infants with special attention on malnourished children.B12 and folate deficiency shall be considered in all cases with SAM irrespective of blood indices. Treatment will have impact on prognosis of child.

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Complimentary feeding practices in severe acute malnutrition children admitted in malnutrition treatment centre of RNT medical college

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20171709 ◽

2017 ◽

Vol 4 (3) ◽

pp. 972

Author(s):

Rupali Jain ◽

Vivek Arora ◽

Sandip Gediya

Keyword(s):

Breast Feeding ◽

Severe Acute Malnutrition ◽

Goat Milk ◽

Acute Malnutrition ◽

Cow Milk ◽

Feeding Practice ◽

Nutritional Requirement ◽

Age Group ◽

Treatment Centre ◽

Anthropometric Assessment

Background: To assess the complimentary feeding practice in Severe Acute Malnutrition (SAM) children aged between 6months to 5years.Methods: 110 SAM children admitted in Malnutrition Treatment Centre (MTC) of MBGH Hospital, Udaipur over a period of 3 months were taken in the study. Structured questionnaire including child’s personal data, socioeconomic status of the family, breast feeding and complementary feeding status were used. Clinical and anthropometric assessment of children was done.Results: Out of the 110 children included in the study, 58 (52.7%) were males and 52 (47.2%) were females. Mean age of children included was 16.8 ± 10.73 months. Maximum children were in the age group of 6-12months 60 (54.5%), followed by 13-24 months of age 38 (34.5%), followed by >2-5years of age 12 (10.9%). Thirty-four (30.9%) children were on exclusive breast feeding, with 30 (27.3%) in age group of 6-12 months and 4 (3.6%) in 12- 24 months. Breast feeding with complimentary feeding was practiced in 30 (27.3%) children of 6-12 months of age and 22 (20%) children of 13-24 months. Out of the 76 children on additional feed with or without breast feeds, 70 (92.1%) consumed milk- either goat milk, cow milk or buffalo milk.Conclusions: Anthropometric assessment revealed that maximum number of SAM children also had chronic malnutrition. Diet of SAM children mainly included milk and cereals. They did not obtain a balanced diet to meet their nutritional requirement.

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

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20203161 ◽

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.

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An experience of facility based management at one of the malnutrition treatment centre in district Baran of Rajasthan, India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20172195 ◽

2017 ◽

Vol 4 (6) ◽

pp. 2162

Author(s):

Shakila Mulla ◽

Pankaj Kumar Gupta

Keyword(s):

Weight Gain ◽

Length Of Stay ◽

Performance Indicators ◽

Death Rate ◽

Severe Acute Malnutrition ◽

Acute Malnutrition ◽

Age Group ◽

Treatment Centre

Background: To assess performance of one of the Malnutrition Treatment Centre (MTC) in district Baran of Rajasthan. India. Methods: An observational prospective study was conducted at MTC where 132 Severe Acute Malnutrition (SAM) children were recruited. Their socio-demographic details and anthropometric measurements were recorded. These SAM children were followed till the period of 4 follow-up visits to measure their weight. MTC performance indicators were assessed. Results: Majority of SAM children belong to age group less than 2 years, gender female, caste OBC (Other Backward Class), SC (Scheduled Caste) and ST (Scheduled Tribe). ASHAs (Accredited Social Health Activists) are playing key role in referring them to MTC. Death rate was 0%, cure (recovery) rate 42.4%, defaulter rate 25.8%, mean length of stay (days) at MTC was 8.04 and mean weight gain was 5.926 g/kg/day. Performance indicators are significantly affected by length of stay at MTC. Follow-up rate was poor with no significant weight gain observed after discharge. Conclusions: MTCs are effective in saving lives of SAM children but not in maintaining long term control on malnutrition.

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Analysis of Co-morbidities in Children with Severe Acute Malnutrition in Eastern Nepal

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v35i2.13098 ◽

2016 ◽

Vol 35 (2) ◽

pp. 99-102 ◽

Cited By ~ 1

Author(s):

Anil Thapa ◽

Gauri Shankar Shah ◽

Om P Mishra

Keyword(s):

Socioeconomic Status ◽

Developing Countries ◽

Maternal Education ◽

Severe Acute Malnutrition ◽

Hospital Setting ◽

Acute Malnutrition ◽

Age Group ◽

Appropriate Treatment ◽

Middle Socioeconomic Status ◽

Biochemical Abnormalities

Introduction: Malnutrition is a common problem in developing countries and often associated with co-morbidities. The present study was undertaken with objectives of to find out the comorbidities in children with severe acute malnutrition (SAM).Materials and Methods: This was a hospital based study carried in 77 children with SAM, diagnosed on the basis of WHO criteria.Results: The age group of children was 1- 5 years (median age 23 months) with about 39% between 1- 2 years. There were 38 males (49.3%). Low maternal education (60%), overcrowding (60%), lower- middle socioeconomic status (87%) were some of the predisposing factors observed. Pneumonia (51%), acute gastroenteritis (21%) and bacterial meningitis (8%) were common co- morbidities found. Associated abnormal laboratory parameters found were anemia (60%), leucocytosis (38%), hyboalbuminemia (36%) hyponetremia (31%), and hypokalemia (17%).Conclusion: Presence of infections and biochemical abnormalities require urgent attention in SAM cases and appropriate treatment in a hospital setting to improve their survival.J Nepal Paediatr Soc 2015;35(2):99-102

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