Childhood malnutrition: Nutritional and social background analysis.

The analysis was done in 52 infants and Preschool children under 6 years of age who were referred to Pediatric nutrition clinic, Siriraj Hospital during September 1987 to August 1988 because of growth delay. AII of the patients, 18 boys and 34 girls were under 3rd percentile of body weight. 52% of the cases were 12.23 months old, while average age was 30 months. The onset of growth delay was noticed at the average age of 8.8 months. In 62% of the cases the onset was associated with breast milk weaning, while in 16% and 22% they were associated with additional food and illness (diarrhea, vomiting and measles) respectively. Eighty three percent of the cases was classified by modified Gomez’s criteria as having first degree malnutrition. While 17% was second degree. 29% was classified to be acute malnutrition. While another 29% was nutritional dwarfism and 40% was acute on chronic malnutrition by Waterloo’s classification. 71% and 96% of the cases were less than 10 percentiles of arm muscle area and arm fat area respectively. The three-day caloric count was completely performed in 20 patients. The caloric intake was found to be significantly lower than expected calories per both ideal body weight and recent weight. The average percentage of protein: fat: carbohydrate was 15: 30: 55.The amount of food and the way of feeding seemed to be more important to childhood malnutrition than the familial income.

Knowledge, attitude and practice in food values, exercise and daily behaviour in obese children at out-patient clinic of Siriraj Hospital.

An analysis of questionaires taken from 20 cases of childhood obesity in the out-patient clinic of Siriraj Hospital showed these patients lacked in knowledge about food value, exercise, daily behaviour which are contributing factors. Their attitudes towards dietary control, exercise and active asctivity were also negative. In term of practice. these patients were fond of various kinds of foods, inactive in physical exercise and household routine work. We can use this preliminary report as a guideline for treating these patients, by changing or improving their knowledge, attitude and practices in food values. Exercise and daily behaviour.

Urticaria in Thai children.

In this study, 142 patients under 12 years of age with the diagnosis of urticaria accompanied or not by angioedema were examined. In all 72.6% of the patients were under 6 years of age. Boys and girls were equally affected, 13.4% of the cases had chronic urticaria, 56.3% had a previous history of urticaria, 88.0% had generalized urticaria, and about half of the cases had associated angioedema. The causes of the urticaria were identified or suspected in 32.4% of the cases. Drugs, foods, insect bites and stings, infections and cold were the most common or associated precipitating agents in that order. Histories revealed 27.5% of the cases had records of other allergic diseases, and 76.1% had allergic diseases in the family. Dermographisms were found in 16.2% of the cases, and 22.5% of cases had eosinophilia. The means of IgE levels in both acute and chronic urticaria were within normal limits, and there was no statistically significant difference between the two groups. Skin testing was of little practical value in evaluating the etiology of the urticaria. Clinical trials of drugs for symptomatic treatment revealed that clemastine, ketotifen and hydroxyzine gave approximately equally high response rates. All these three medications gave significantly greater response rates than chlorpheniramine.

Lymphangioma cutis. A report of a childhood case.

A case of lymphangioma in a 6-year-old Thai girl was reported. She had verrucous plaque and cystic appearing vesicles on her right lateral chest. A reddish patch on this area had been noticed since was born. At the age of 8 months, vesicles occurred on top of the patch, which enlarged without any further symptoms. She was referred to Siriraj Hospital because of fever following infection of ruptured vesicles. On admission, the verrucous plaque was found from the right axilla to the right subcostal region with vesicular lesions 2-15 millimeters in diameter. After the infection subsided and the diagnosis of lymphangioma cutis was verified by histo pathological section, radiotherapy was started. After 4 consecutive days of 200 rads deep radiation, the lesion remained the same but her father refused further treatment and hospitalization.