A randomized controlled trial on the efficacy and safety of a modified ready to use therapeutic food among malnourished children

RATIONALE: In the Philippines, 25% of children OBJECTIVE: To determine the efficacy, safety and acceptability of a modified RUTF (mRUTF) to supplement caloric intake. METHOD: One hundred (100) children 18 months to 10 years old with mild to moderate malnutrition were randomized to either mRUTF or control group. The treatment arm received mRUTF during weekdays for 5 weeks while controls had no supplementation. Anthropometric measurements were taken at baseline, weekly for 5 weeks and 2 weeks post-supplementation. RESULTS: The two groups were comparable at baseline. At five weekly intervals, there was no significant difference in weight, height and mid upper arm circumference between groups, although the mean percentage weight gain of the mRUTF group was higher compared with controls (8% vs 2.6%, p=0.15). Cessation of supplementation resulted in weight loss in the mRUTF group. [mRUTF: -0.40 (0.33) vs -0.03 (0.35), p=0.00]. The taste of mRUTF was acceptable. CONCLUSION: Ready-to-use-therapeutic food is an effective, safe and acceptable alternative supplement for children, 18 months to 10 years old, with mild to moderate malnutrition.

A five year review of pancreatitis among Filipino children

BACKGROUND: Pancreatitis is uncommon in childhood and there is presently no study among Filipino children. OBJECTIVE: To determine the clinical features and outcome of pancreatitis among Filipino children. METHOD: Review of medical records of all patients diagnosed to have pancreatitis based on standard criteria from 2005 to 2009. RESULTS: A total of 23 children (mean age: 12 years; 13 male, 10 female) were included, 21 with acute and two with chronic pancreatitis. Twenty one (91%) presented with abdominal pain and two with jaundice. Nine had idiopathic pancreatitis. In 14 patients, the etiology was identified: bile duct obstruction (7), trauma (2), drugs (2), infection (2) and hypertriglyceridemia (1). Only four of 20 patients with ultrasound examination showed an enlarged pancreas. Complications were pseudocyst formation (6), pancreatic abscess (4), diabetes mellitus (2) and hypocalcemia (1). Of the 23 patients, eight required surgery: pancreatic debridement (4), choledochal cyst excision (2), cholecystectomy (1) and Whipple's procedure (1). All pseudocyst resolved spontaneously. One patient with pancreatic tumor declined surgery and another with pancreatitis due to choledochal cyst died of sepsis. CONCLUSIONS: In our study, severe abdominal pain was the most frequent presenting symptom of childhood pancreatitis. Sixty percent had an identifiable cause for pancreatitis. A favorable outcome was observed.