ABSTRACT
Background: Patients with nephrotic syndrome (NS) lose 25-hydroxyvitamin D in the urine and can have low blood levels of this metabolite. Corticosteroid therapy on long term basis can cause osteoporosis and affects the bone mineral content (BMC) and bone mineral density (BMD) in children. Hence this study was undertaken to study the prevalence of Vitamin D deficiency in children with Nephrotic syndrome.Methods: It is a time bound prospective hospital based observational study done at Department of Paediatrics, KIMS Hospital, Hubli. A detailed history and clinical examination including anthropometry was taken for cases of Nephrotic syndrome admitted to the hospital. 5ml venous blood was collected and sent for estimation of calcium (Ca), phosphorus (P), Alkaline phosphatase (ALP) and 25(OH) Vitamin D levels.Results: Mean age of onset of nephrotic syndrome was 4.6 years and median age at study entry was 7 years. Male to female ratio was 1.4:1. Vitamin D deficiency was present in 16(47.05%) children and insufficiency was present in 11(32.35%) children with nephrotic syndrome. Wasting was present in 11.76% and stunting was present in 50% of the children with nephrotic syndrome. There was no statistically significant difference of vitamin D levels with respect to sex and age group. Frequent relapsers had low levels of vitamin D levels as compared to 1st episode and infrequent relapsers. There was moderately significant positive correlation between serum calcium and vitamin D levels and negative correlation between phosphate levels and vitamin D levels.Conclusions: Vitamin D deficiency is common in children with nephrotic syndrome even after the remission of proteinuria.
ABSTRACT
Background: Malnutrition is one of the leading causes of morbidity and mortality in children under the age of five years in developing countries. Despite economic growth of nearly 10% per annum, in India in 2006 the NFHS-3 indicated that 6.4% of children below 60 months of age were suffering from severe acute malnutrition. This study was undertaken to know the prevalence and the risk factors associated with SAM in ICDS block of rural Hubli.Methods: This was a cross sectional observational community based study conducted in the ICDS block of rural Hubli. All children in the age group of 0- 59 months were included in the study. The study is conducted by the department and it is self-funded by the authors, no monetary benefit either from the institute or from the government or its organization.Results: Among 1796 children who were examined in present study, the prevalence of SAM children was 5.79% (104 children). 48% were in the age group of 37 months to 59 months. Male: female ratio was 2:3. 51% of the mothers and 47.1% of fathers were illiterate. 82.7% of the parents had per capita income belonged to class 5 of the modified B.G. Prasad classification. 60% of the SAM children were seen in families who had 3 or 4 children. Maternal anemia, IUGR and PIH were seen in 53.6%, 21.6% and 18% respectively. Low birth weight (<2.5kg) and Birth asphyxia were seen in 80.6% and 11.1%.Conclusions: The risk factors for SAM were illiteracy, low per capita income, high order births, maternal anemia, IUGR, PIH, low birth weight and Birth asphyxia. Due emphasis should be given in improving the knowledge and practices of the parents on appropriate infant and young child feeding practices.