Approach to Tall Stature.

As a presenting chief complaint, tall stature represents only ‘tip of iceberg’ of all the tall children. For a pediatrician, it is very important to distinguish familial or constitutional tall stature from other pathological forms of tall stature. For practicing pediatricians, availability of literature discussing clinical approach to a child presenting with tall stature is limited. This article presents clinically simple and rational approach to tall stature.

A study of weight gain pattern and associated factors in the children with severe acute malnutrition in a hospital based nutritional rehabilitation ward.

Introduction: Severe acute malnutrition is widely prevalent problem in developing countries and a major cause of morbidity and mortality in India. nutritional rehabilitation of such patients is very important aspects of management and often inadequate. This study was planned to understand catch up growth in severe acute malnourished patients admitted to rehabilitation ward for providing nutrition. Objectives: (1) To study the weight gain pattern of the patients with severe acute malnutrition admitted to hospital based nutritional rehabilitation center. (2) To study the factors associated with good or poor weight gain in the patients with severe acute malnutrition admitted to nutrition rehabilitation centre. Materials and methods: In this case record based retrospective study; records of severe acute malnourished patients admitted to nutritional. rehabilitation ward during the period of February 2012 to December 2012 were included. Results: A total of 98 patients were admitted during this period for nutrition rehabilitation. Mean baseline weight/ height z score (WHZ), Weight/age z score (HAZ) was - 1.67 (2.48), -4.19 (0.98) and -4.90 (2.50) respectively. 76 patients who stayed for more than 7 completed days were analysed for comparative statistics. Mean WHZ score of this 76 patients was-1.70 (2.25). Mean weight gain of these patients was 5.56 gm/kg/day. Patients age (p=0.03, OR=1.12, 95% CI: 1.040-1.211), educated mother (p=00.048, OR=1.29, 95% CI: 1.320-2.478) and recommended dietary intake of at least 80% (p=0.001, OR=7.94, 95%CI: 2.247-28.79) were the only statistically significant factors associated with good weight gain. Conclusion: Our study highlighted important role of nutritional rehabilitation of the severe acute malnourished children in hospital for early catct-up of the growth.