Pem
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Nutritional disease can result from protein energy malnutrition (PEM), which is caused by inadequate intake of proteins and calories. PEM leads to deficiencies in digestion/absorption and loss of fat, muscle tissue, and weight. It has multiple etiologies including poverty, infections, illness, alcoholism, and ignorance. PEM is a serious, often lethal condition especially in children under 5 years old. It is diagnosed by body mass index, skin fold thickness, mid-arm circumference, and serum proteins. The two main types are marasmus, characterized by weight loss and depletion of muscle, and kwashiorkor, which occurs when protein deprivation exceeds calorie deficit and results in edema, skin lesions, and fatty liver.
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Marasmus kwashiorkor
This document discusses protein-energy malnutrition (PEM) in infants and children. It defines malnutrition and the specific forms of PEM, including marasmus and kwashiorkor. For kwashiorkor, it covers the pathophysiology, etiology, clinical signs and symptoms, laboratory findings, and complications. For marasmus it discusses the definition, etiology, clinical assessment, and differences from kwashiorkor. The document also outlines the WHO's 10 steps for recovery from malnutrition and provides a nursing care plan to address malnutrition through dietary interventions and maintaining appropriate body temperature.
1.malnutrition
Malnutrition is a condition that develops from an imbalance of nutrient intake and the body's needs. It can manifest as protein-energy malnutrition (PEM) in various forms including kwashiorkor, marasmus, and marasmic-kwashiorkor. Kwashiorkor is characterized by edema and results from insufficient protein intake while marasmus is caused by lack of energy intake leading to wasting. PEM is assessed clinically through measurements, lab tests, and evaluating functional criteria to determine severity and appropriate treatment.
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The document discusses malnutrition, defining it as deficiencies, excesses, or imbalances in energy and nutrient intake. It describes two types - undernutrition, which includes stunting, wasting, and micronutrient deficiencies, and overnutrition, which includes overweight, obesity, and diet-related diseases. The document outlines the causes, signs, and effects of malnutrition as well as strategies for prevention.
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malnutrition, undernutrition, micronutrient deficiencies, overweight, obesity, non communicable disease, protein energy malnutrition, growth, development, illness, stunting, wasting, underweight, height for age, weight for age, weight for height, acute malnutrition, chronic malnutrition, indicator, classification of pem, marasmus, kwasiorker, severely malnourished, vitamin A, Mineral, multivitamins, supplementation, calorie, zinc, iron, copper, vitamin k, begin feeding, NG feed, mil based formula, starter formula, F-75, severe edema, breastfeeding, refeeding syndrome, signs of heart failure, respirations, pulse, catch up growth, rehabilitation, vigorous phase, F100, catch up formula, sensory stimulation, emotional support, mental, behavioural, tender love, care, physical activity, whole blood, severe dehydration, intraosseus, septic shock, RL, ORS, severe anemia, blood transfusion, frusemide, eye sign, zinc deficiency, diarrhea, lactose, intolerance, lactose intolerance, tuberculosis, failure to respond, primary failure to respond, secondary failure to respond, appetite, consecutive, discharge , infection, hypoglycemia, immunization, adequate, eating, caretakers, local health worker, monitoring, feeding, high energy, snacks, meal, thank you
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Kwashiorkor and marasmus are protein deficiency diseases that primarily affect children. Kwashiorkor occurs when children switch from breastfeeding to a low protein diet, causing symptoms like pigmentation, vomiting, and edema. Marasmus occurs due to a very low protein and calorie diet, leading to weight loss, diarrhea, and respiratory infections. Both diseases are diagnosed through physical exams and tests. Treatment focuses on increasing protein intake through foods like milk, eggs, and soy for kwashiorkor, and increasing overall protein, calories, and nutrients for marasmus.
Protein Energy Malnutrition (PEM)
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This document discusses protein-energy malnutrition (PEM) in infants and children. It defines malnutrition and the specific forms of PEM, including marasmus and kwashiorkor. For kwashiorkor, it covers the pathophysiology, etiology, clinical signs and symptoms, laboratory findings, and complications. For marasmus it discusses the definition, etiology, clinical assessment, and differences from kwashiorkor. The document also outlines the WHO's 10 steps for recovery from malnutrition and provides a nursing care plan to address malnutrition through dietary interventions and maintaining appropriate body temperature.
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Kwashiorkor and marasmus are protein deficiency diseases that primarily affect children. Kwashiorkor occurs when children switch from breastfeeding to a low protein diet, causing symptoms like pigmentation, vomiting, and edema. Marasmus occurs due to a very low protein and calorie diet, leading to weight loss, diarrhea, and respiratory infections. Both diseases are diagnosed through physical exams and tests. Treatment focuses on increasing protein intake through foods like milk, eggs, and soy for kwashiorkor, and increasing overall protein, calories, and nutrients for marasmus.
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Protein energy malnutrition (PEM) refers to a group of conditions caused by inadequate protein and calorie intake. The main types are marasmus, kwashiorkor, and a combined form. PEM is diagnosed using measurements of weight for height and age along with lab tests. Treatment involves correcting nutritional deficiencies, managing complications, and gradual refeeding to support recovery. Prevention strategies target national, community, and family levels through measures like supplementation, education, growth monitoring, and breastfeeding promotion.
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- In India, prevalence is highest among young children (6-59 months), with Bihar having the highest rate at 78%.
- Causes include inadequate intake of iron-rich foods, poor absorption from diets high in phytates, blood loss from hookworm infection, and increased demands from pregnancy and growth.
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protein energy malnutrition
The document discusses protein-energy malnutrition (PEM) in children. It defines PEM as a group of pathological conditions arising from a lack of proteins and calories, most commonly seen in infants and young children. The three main forms of PEM are marasmus (predominant energy deficiency), kwashiorkor (predominant protein deficiency with some energy deficiency), and intermediate states. The document then discusses indicators used to assess malnutrition, the global and regional burden of PEM, clinical manifestations, classifications, management, preventive measures, and Indian government programs addressing PEM like ICDS and mid-day meals.
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undernutrition
This document discusses different types of malnutrition including primary and secondary malnutrition. It describes the clinical syndromes of marasmus and kwashiorkor that represent the two extremes of protein-energy malnutrition (PEM). Marasmus is characterized by loss of muscle and fat mass while kwashiorkor presents with edema and skin changes. Anorexia nervosa, bulimia, cachexia and starvation are also summarized as forms of self-induced malnutrition.
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PEM final.pptx
Undernutrition in Children was presented. The key points are:
1. Protein Energy Malnutrition (PEM) affects children worldwide and manifests as kwashiorkor (protein deficiency), marasmus (calorie deficiency), or marasmic kwashiorkor (severe protein and calorie deficiencies).
2. Clinical features of kwashiorkor include edema, poor growth, and mental changes while marasmus presents with extreme muscle wasting.
3. Management involves nutritional rehabilitation with diets providing adequate calories and protein, micronutrient supplementation, oral rehydration, infection control, and supplementary feeding programs.
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PROTEIN ENERGY MALNUTRITION
Protein energy malnutrition (PEM) refers to a group of conditions caused by inadequate protein and calorie intake. The main types are marasmus, kwashiorkor, and a combined form. PEM is diagnosed using measurements of weight for height and age along with lab tests. Treatment involves correcting nutritional deficiencies, managing complications, and gradual refeeding to support recovery. Prevention strategies target national, community, and family levels through measures like supplementation, education, growth monitoring, and breastfeeding promotion.
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The document discusses nutrition and HIV/AIDS. It notes that adequate nutrition is important for health for all individuals, including those with HIV/AIDS, but that HIV and malnutrition are interconnected - HIV can cause malnutrition and malnutrition can worsen HIV. Good nutrition can help manage HIV symptoms and reduce susceptibility to opportunistic infections. The document outlines recommendations for nutritional assessments and counseling for people living with HIV/AIDS.
Protein calorie malnutrition
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There are two forms of protein-energy malnutrition: Kwashiorkor, associated with oedema and hepatomegaly from fair-to-normal energy but inadequate protein intake, and Marasmus, from inadequate energy and protein intake leading to severe wasting. Risk factors include young age, chronic illness, neglect, poverty, seasonal food insecurity, and conditions affecting appetite, eating, or nutrient absorption in elderly or disabled people. Symptoms include weight loss, fatigue, wounds, and decreased muscle mass in Marasmus or moon facies, oedema, and skin changes in Kwashiorkor.
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Nutritional deficiency disorders are a major public health problem in developing countries like India. They affect vast numbers of people and cause approximately 55% of childhood deaths. Malnutrition results from relative or absolute deficiencies of essential nutrients. It is caused by factors like infections, poor socioeconomic status, cultural influences, and inadequate health services. Proper assessment, treatment, and rehabilitation are needed to address malnutrition.
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Public health significance
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Dietary guidelines
Vitamin C
the B Vitamins
Thiamin (Vitamin B1)
Riboflavin (Vitamin B2)
Niacin (Vitamin B3)
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Marasmus is a form of severe protein-energy malnutrition resulting from inadequate calorie intake. It is characterized by muscle wasting and loss of subcutaneous fat. Complications include infection, hypothermia, and organ failure. Treatment involves dietary management with balanced, energy-dense feedings through nasogastric tubes if needed. Nursing care focuses on providing nutrition, maintaining temperature, preventing infection, and educating families on proper nutrition.
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The document discusses protein-energy malnutrition (PEM) in children. It defines PEM as a group of pathological conditions arising from a lack of proteins and calories, most commonly seen in infants and young children. The three main forms of PEM are marasmus (predominant energy deficiency), kwashiorkor (predominant protein deficiency with some energy deficiency), and intermediate states. The document then discusses indicators used to assess malnutrition, the global and regional burden of PEM, clinical manifestations, classifications, management, preventive measures, and Indian government programs addressing PEM like ICDS and mid-day meals.
Protein energy malnutrition
Protein-energy malnutrition (PEM) is a pathological condition arising from a lack of proteins and calories, most common in infants and young children. It manifests as marasmus, due to calorie deficiency, or kwashiorkor, due to protein deficiency. PEM is a global problem causing childhood mortality and morbidity. Causes include inadequate food intake, infections, and poor hygiene. Treatment involves stabilizing the patient, rebuilding tissues, and preparing for follow-up rehabilitation. Preventive measures encompass promoting breastfeeding, improving family diets, and early diagnosis and treatment of infections.
undernutrition
This document discusses different types of malnutrition including primary and secondary malnutrition. It describes the clinical syndromes of marasmus and kwashiorkor that represent the two extremes of protein-energy malnutrition (PEM). Marasmus is characterized by loss of muscle and fat mass while kwashiorkor presents with edema and skin changes. Anorexia nervosa, bulimia, cachexia and starvation are also summarized as forms of self-induced malnutrition.
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This document discusses hypervitaminosis, or vitamin toxicity, for several vitamins:
- Vitamin A toxicity can cause headaches, abdominal pain, and impaired consciousness from acute high doses, or bone pain and loss of appetite from chronic excessive intake.
- High vitamin D levels from supplements or medications can lead to polyuria, polydipsia, hypercalcemia, and in severe cases, death.
- Excessive vitamin E intake above 1 g/kg can cause bruising and bleeding due to reduced platelet function and impaired immunity.
- High vitamin B6 doses over 200 micrograms daily taken long-term may damage nerves and cause numbness, poor coordination, and tiredness.
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Vitamin D deficiency can cause rickets in children and osteomalacia in adults. It is caused by lack of vitamin D from diet and sun exposure. The body synthesizes the inactive form cholecalciferol from cholesterol in skin upon sun exposure and the active form calcitriol is produced in the kidneys. Vitamin D plays a key role in calcium absorption and bone mineralization. Deficiency is highly prevalent in India due to low dietary intake and sun exposure. It is associated with many systemic disorders including musculoskeletal, autoimmune, cardiovascular and infectious diseases.
Malnutrition
Malnutrition is defined as a deficiency or excess of essential nutrients. India has a major malnutrition problem, with over 200 million undernourished people. Malnutrition has many dimensions and can be measured through anthropometry, clinical signs, biochemical tests and secondary data. The major forms of malnutrition in India are undernutrition like stunting, wasting, and micronutrient deficiencies. Prevention and control requires efforts across many sectors like agriculture, public health, and socioeconomic development. Key programs in India aim to address issues like vitamin A deficiency, anemia, and iodine deficiency through supplementation and nutrition education.
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Kwashiorkor disease is from problem that often in relationship with children, and it's because defeciency of protein and normal or high calories .
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Vitamin E deficiency can result from insufficient dietary intake or impaired absorption of the vitamin. Selenium and polyunsaturated fatty acids (PUFAs) affect vitamin E needs, with selenium sparing vitamin E needs and higher PUFA intake increasing vitamin E needs. Other nutrient deficiencies, malabsorption conditions, and genetic mutations can also lead to vitamin E deficiency. Symptoms of vitamin E deficiency impact the neuromuscular, vascular and reproductive systems and result from oxidative damage to cell membranes.
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The document discusses the relationship between nutrition and infection. It notes that historically, the interaction between the two was not well recognized. However, studies demonstrated that infection can lead to malnutrition, and malnutrition increases susceptibility to infection, creating a vicious cycle. The effects of malnutrition on resistance to infection include reduced immune function and antibody production. Infection also affects nutritional status through increased nutrient needs, reduced intake and absorption, and increased losses. The interactions between the two are complex and bidirectional.
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5) Nutrition guidelines provide recommendations on cal
2009 外文讲义2
Protein-calorie malnutrition (PCM), also known as protein energy malnutrition, is a form of malnutrition resulting from a lack of protein or calories in the diet. PCM affects one quarter of the world's children and is responsible for over 5 million child deaths per year. The two main types of PCM are marasmus, characterized by a lack of calories and wasting, and kwashiorkor, characterized by edema and a lack of protein despite adequate calorie intake. Treatment of PCM focuses on improving nutrition through breastfeeding, dietary supplementation, and management of complications through infection control and supportive therapies.
CELLULAR ACCUMULATIONS
MEDICAL COUNCIL OF INDIA CURRICULUM BASED UNDERGRADUATE CURRICULUMFOR THE INDIAN MEDICAL GRADUATE, 2018
Nutrititional Disorders.pptx
Nutritional disorders can result from deficiencies or excesses of certain nutrients. The document discusses several main nutritional disorders including obesity, kwashiorkor, marasmus, eating disorders, and vitamin deficiencies. Kwashiorkor occurs in children between 6 months to 3 years of age and is characterized by growth failure, wasting of muscles but preserved fat tissue, edema, enlarged fatty liver, and low serum proteins. In contrast, marasmus is common in infants under 1 year old and involves wasting of all tissues including muscles and fat without edema. Vitamin deficiencies can result in conditions like scurvy from vitamin C deficiency, beriberi from vitamin B1 deficiency, and night blindness from vitamin A deficiency.
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This document discusses various metabolic diseases and their management. It covers defects in amino acid, carbohydrate, fatty acid, and other metabolisms. For treatment, it recommends reducing precursor substrates, providing alternative substrates, supplementing cofactors, and removing toxic metabolites. Specific diets are described for phenylketonuria (PKU), maple syrup urine disease (MSUD), and other conditions. Both acute and long-term management strategies are outlined.
Nutrition for the immune compromised patient
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Option D
The document discusses various topics related to human nutrition:
- It describes the essential nutrients that must be consumed as part of our diet, including water, lipids, some amino acids, and vitamins and minerals.
- It then covers digestion, including the roles of the stomach, small intestine, liver, and heart. The stomach aids in protein digestion through gastric juices. The small intestine completes digestion with enzymes from the pancreas and bile from the liver. The liver performs many functions including detoxification and production of proteins and bile. The heart pumps blood throughout the body.
approach to inborn error of metabolism dr.mounika
This document provides an overview of inborn errors of metabolism (IEM). It discusses that IEM have an overall incidence of 1 in 1000 to 1 in 2000 births. The most common presentation is sepsis in 30% of cases. IEM are classified based on the defective metabolic pathway, such as amino acid metabolism defects, carbohydrate metabolism defects, and organic acidemias. Clinical pointers for suspected IEM include deterioration after apparent normalcy, hypoglycemia, metabolic acidosis, abnormal urine odor, and dysmorphic features. Evaluation of neonates involves blood tests, blood gases, glucose and ammonia levels, urine analysis, and plasma amino acid analysis to identify specific disorders. Management involves identifying and limiting the offending substance
OBESITY in children
This document discusses obesity in children and provides information on risk factors, evaluation, treatment, and prevention. Some key points include:
- Risk factors for childhood obesity include parental obesity, high birth weight, lack of breastfeeding, sedentary lifestyle, and genetic factors.
- Evaluation of an obese child includes examining growth charts, medical history, physical exam, and lab tests if indicated.
- Treatment focuses on behavior changes like increasing physical activity, improving diet, and reducing screen time. Medications are rarely used.
- Prevention strategies target various levels like families, schools, healthcare, and policy/environmental changes to promote healthy lifestyles.
OBESITY in children
This document discusses obesity in children and provides information on risk factors, evaluation, treatment, and prevention. Some key points include:
- Risk factors for childhood obesity include parental obesity, high birth weight, lack of breastfeeding, sedentary lifestyle, and genetic factors.
- Evaluation of an obese child includes examining growth charts, medical history, physical exam, and lab tests if indicated.
- Treatment focuses on behavior changes like increasing physical activity, improving diet, and reducing screen time. Medications are rarely used.
- Prevention strategies target various levels like families, schools, healthcare, and policy/environmental changes to promote healthy lifestyles.
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Pem
- 3. • Malnutrition also referred as PEM • Inadequate intake of proteins & calories • Deficiencies in the digestion & absorption • Resulting loss of fat, muscle tissue, weight loss,lethargy,generalized weakness
- 4. Appropriate diet •Should provide sufficient energy •Amino acids & fatty acids used for synthesis of proteins •Vitamins & minerals function as co enzyme
- 5. •One or all of the these components are missing Primary •Malabsorption, •Impaired utilization secondary
- 6. Etiology • Poverty • Infections • Acute & chronic illness • Chronic alcoholism – Thiamine deficiency • Ignorance & failure of diet supplementation • Self imposed dietary restriction
- 7. PEM •Serious , often lethal disease •Children's •High death rate children's <5years of age
- 8. Malnutrition determined by • Body mass index • Weight in kilograms / Height in meters squared • Normal 18.5 to 25kg/m² • BMI < 16kg/m² - malnourished
- 9. Other parameters….. •Evaluation of fat stores - Thickness of skin fold •Muscle mass – Mid arm circumference •Serum proteins
- 10. Types • Marasmus • Kwashiorkor Functional aspect: • Somatic compartment - Proteins in the skeletal muscle • Visceral compartment – Proteins in the visceral organs
- 11. Marasmus • Weight falls to 60% of normal for sex,height,age • Growth retardation • Loss of muscle • Depletion of somatic compartment • Visceral compartment normal • So serum albumin levels normal or slightly reduced • Extremities are emaciated • Anemia
- 15. Reduced leptin level Stimulate the HPA Produce high level of cortisol lipolysis
- 16. kwashiorkor • Occurs when protein deprivation is more then deficit of total calories • Severe depletion of visceral compartment • Resultant hypoalbuminemia • Generalized or dependent edema • Weight loss is masked by edema • Skin lesion – hyperpigmentation, desquamation, hypopigmentation • Flaky paint appearance • Hair changes – loss of hair or alternating pale or dark colour hair • Fatty liver • Defects in immunity – secondary infections
- 18. Morphology • Main anatomic changes • Growth failure • Peripheral edema – kwashiorkor • Liver enlarged – kwashiorkor • Loss of fat , muscle – Marasmus • Small bowel – Mucosal atrophy, loss of villi & microvilli • Bone marrow – Hypoplastic nature • Brain – Reduced number of neuron • Thymic or lymphoid atrophy
- 19. Cachexia • PEM is common complication in AIDS & advanced cancer • Cachexia occurs in GIT , pancreatic, lung cancer patient • Exact pathogenesis not known • Mediators released from the tumor cells contributes its development • Proteolysis inducing factor • Lipid mobilizing factor
- 20. TNF & CYTOKINES PIF TUMOUR NF - ҡB NUCLEUS – TRANSCRPITION FACTOR MUSCLE SPECIFIC UBIQUITIN LIGASES MYOSIN HEAVY CHAIN PROTEASOME LOSS OF MYOFIBRILS & MUSCLE MASS