COMPARISON OF ELECTROLYTE AND ELECTROCARDIOGRAPHIC CHANGES IN PATIENTS WITH PROTEIN
Vijay Gupta, Bharati P Choubey, Arvind G Shingwekar
2018
Indian Journal of Child Health
P rotein-energy malnutrition (PEM) is still a major challenge in low-and middle-income countries like India. It mainly involves population ranging from 6 months to <5 years of age. This includes stunting, wasting, and kwashiorkor, of which kwashiorkor and severe wasting are referred as severe acute malnutrition (SAM) [1] . As per the National Family Health Survey-4, it was found that the proportion of under-five children suffering from SAM weight for height Z (WHZ) score <−3 as per the WHO
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... ria has increased from 6.4% to 7.5% over the past 10 years [2] . Although the prevalence of SAM is lower in northern India (2.2%) as compared to the national average (around 7.5%), still it is a major cause of morbidity and mortality [3] . Younger age, small nuclear families, poor parental education, and occupation of family head were risk factors, which predispose the child to SAM [3] . PEM has the potential to involve multiple organ systems. Biochemical changes such as hyponatremia and hypokalemia are common and add to the severity of disease [4] . It was established that the mortality increases with increase in the severity of malnutrition, and it increases to 10 times-20 times for children with WHZ score <−3 and WHZ score <−4, respectively [5] . Similarly, these patients have myocardial involvement presenting ABSTRACT Introduction: Protein-energy malnutrition (PEM) in children is associated with several biochemical and electrocardiographic changes, which if left untreated may result in increased morbidity and mortality. Objective: This study compared the various biochemical and electrocardiographic changes present in patients with PEM on admission and after 2 weeks of nutritional rehabilitation therapy. Methods: This was prospective analytical study conducted at tertiary care pediatric hospital in North India. A total of 75 patients were enrolled with PEM. The electrolyte and electrocardiogram findings were recorded at the time of admission and after 2 weeks of nutritional rehabilitation therapy. Results: The mean age of patients was 2.2±1.2 years. The mean weight on admission was 7.2±2.1 kg. There were a total of 42 males and 33 females. There were significant improvements (p<0.05) in serum sodium, serum potassium, serum calcium levels, PR interval, and QTc interval after 2 weeks of therapy in most of the patients with PEM. The improvement may be less obvious in the PEM Category IV due to less number of patients. Conclusion: Among the several biochemical and electrocardiographic changes present in these patients with PEM, the majority showed significant improvement and reverts back to normal after nutritional therapy.
doi:10.32677/ijch.2018.v05.i05.006
fatcat:5jptgipwrjcevhxyzgdagwtbwq