ABSTRACT
This study aims to improve the nutritional quality of traditional porridge intended for young children with moderate malnutrition. The biochemical and nutritional characteristics of three supplement porridges enriched with dried leaves Corchorus olitorius and Anacardium occidental were determined according to standard methods. The results revealed that enrichment with these two ingredients significantly improved the proportion of dry matter of porridges enriched with high contents in those containing only Western Anacardium BC2 (17.33 ± 0.83%) and that enriched with both Corchorus olitorius and Anacardium occidental BC4 (18.0 ± 0.5%) compared to the traditional non-enriched porridge BC1 (13.23 ± 0.41%) and that enriched with Corchorus olitorius only BC3 (14.63±0.56%). With regard to fat, the three enriched porridges showed significantly high levels: 16.00±0.00% (BC2); 13.75±0.25% (BC3); 19.25±0.35% (BC4) compared to porridge BC1 (12.75±0.25%). As for carbohydrates, enrichment did not lead to a significant increase in levels. On the other hand, the levels of proteins experienced a significant increase between 2.66 ± 0.08% (BC3) and 3.08 ± 0.05% (BC4). All the porridges showed high energy densities with values ranging between 463.43±1 Kcal/100 g (BC1) and 488.21±1 Kcal/100 g (BC4). Regarding micronutrients, the results indicated a significant increase in trace elements with higher mineral values in the porridge BC4 (Zinc: 05.05±0.06) and BC3 (Calcium: 60.91±0.07 mg /100 g; Iron: 21.80±0.20 mg/100 g; Copper: 01.57±0.04 mg/100 g; Phosphorus: 280.41±0.48 mg/100 g). The contents of fat-soluble vitamins, in particular vitamin A (BC2: 25.10±0.14 µg/100 g; BC3: 41.00±0.45 µg/100 g; BC4: 33.59± 0.12 µg/100 g) and water-soluble vitamins B2 (BC2: 12.39±0.01 mg/ 100g; BC3: 10.81±0.01 mg/100 g; BC4: 15.01±0.01 mg/100 g) and B9 (BC2: 23.05±0.25 mg/100 g; BC3: 27.13±0.29 mg/100 g; BC4: 35.16±0.36 mg/100 g) experienced a significant increase in the enriched porridge compared to the control. There is also a significantly high content of essential amino acid (leucine) with values between (37.78±0.05 and 78.31±0.9 g/100 g) in the enriched porridge compared to the control (18.51±0. 05 g/100 g). All the porridges are very rich in essential fatty acids, linoleic acid (Ω6) with contents between 19.73±0.01 and 22.59±0.01 g/100 g and linolenic acid (Ω3) with contents between 01.20±0.00 and 07.95±0.00 g/100 g, and this in accordance with the recommended values for moderate acute malnutrition (MAM). This nutritional supplementation also significantly improved their antioxidant properties with DPPH values varying between 47.52±3 and 56.91±1.55% compared to the control (41.58±4.34%). Enriching these porridges with Corchorus olitorius and Anacardium occidental improved their nutritional quality in accordance with the recommended dietary intakes for my moderately malnourished for most essential nutrients. These enriched porridges could then be recommended not only for the nutritional rehabilitation of MAMs and also to prevent certain chronic diseases such as obesity and cardiovascular diseases.
ABSTRACT
Background: Moderate Acute Malnutrition (MAM) is defined as Weight for Height between -2SD to -3SD, and/or Mid Upper Arm Circumference (MUAC) 11.5 cm to 12.5 cm. Effect of not treating MAM has a significant impact on Severe Acute Malnutrition (SAM) burden. Management of MAM is possible through supplementary feeding or Community centre counselling.Methods: Present study was a prospective case control study done in 2013-14 in 200 children in adjacent communities. Community in which intervention (dietary counselling) was planned, it was labelled as case group. For dietary counselling 'structured group counselling' method was selected in which at a time parents of six MAM children were involved. Counselling was done by a trained counsellor using all techniques proposed by IYCF. Counselling sessions were scheduled at 0, 1, 3 and 6 months.Results: 60% children of case group moved to improved or well- nourished nutritional status (p-value 0.00001). Amongst improved group, weight for height improvement is statistically significant (p-value 0.001), average weight attained is 2-3 kg in 6 months with average weight gain of 1.5-3 grams/kg/day. MUAC improvement was also found to be statistically significant (p-value 0.003), there was 47% improvement in case group with average MUAC gain is 0.6 cm to 1 cm in 6 months (0.13 cm/month). Also, there is early rise in weight for height then MUAC. Average duration to achieve target weight for height is 4.3 months in case group as compare to 5.3 months in control group.Conclusions: Structured and integrated group counselling using all counselling skills by a trained counsellor should be an integral part of managing MAM in community. Weight for height should be primary indicator in early phase of response as compare to MUAC in measuring impact of counselling.
ABSTRACT
Background: Pneumonia affects 156 million children under five years every year and is the leading cause of mortality in this age group. It emphasizes the need to identify high risk factors for Treatment Failure so as to treat them aggressively. The objective of this study was to assess factors influencing treatment failure in severe pneumonia treated with Ampicillin.Methods: Prospective observational study, in which 235 children with severe pneumonia between 2 months to 60 months were enrolled and started with intravenous Ampicillin as per WHO protocol. If no clinical improvement was seen after 48 hours, it was taken as treatment failure and managed accordingly.Results: Among 235 children, 43(18.2%) did not respond to Ampicillin. Among treatment failure cases males were 20 (46.5%) and females were 23 (53.6%). All the following parameters were statistically significant(p<0.05). Majority of 23(53.4%) were between 2 to 12 months. 13(30.2%) were incompletely immunized. MAM were 23(53.4%) and 22(51.1%) cases had signs of Rickets. 34(79.1%) had Anemia out of which 22(64%) had moderate anemia. 39(90.6%) children had fever and hypoxia at admission.Conclusions: Infancy, malnutrition, severity of anemia, rickets, lack of immunization, hypoxia at baseline were significant predictors of treatment failure in severe pneumonia. Strengthening immunization and improving nutritional status may improve the outcome. Children with above risk factors require vigilant monitoring.
ABSTRACT
Background: Nearly half of all deaths in children under 5 are attributable to under nutrition. Under nutrition puts children at greater risk of dying from common infections, increases the frequency and severity of such infections, and contributes to delayed recovery. The WHO recommends the use of Z scores or standard deviation score (SDS) for evaluating anthropometry, so as to accurately classify individuals with indices below the extreme percentile. In India most paediatricians use IAP classification to classify malnutrition. The aim of the study is to assess the nutritional status of children between 6 months to 5 years of age attending tertiary rural hospital according to WHO criteria and to compare the result of this study with IAP classification for grading malnutrition. The objectives of the study is to assess the knowledge of mothers regarding feeding practices among these children particularly below 2 years of age and to observe associated clinical problems and state of other nutrient deficiencies. Materials and methods: A cross sectional and observational study of 200 children admitted in pediatric ward and NRC (nutritional rehabilitation centre) of Dhiraj Hospital were taken for the study, Piparia, Waghodia, Vadodara. Study was carried for a period of 18 months from April 2015 to September 2016 to assess the nutritional status of children according to WHO criteria and to compare it with IAP classification. Assessment of the nutritional status was done by clinical examination and anthropometry. Interrogation was done with children’s mothers in the language they understood regarding young children feeding practices and accordingly their knowledge was assessed. Data was compiled, categorized and analyzed by appropriate statistical method in consultation with a statistician. Pathak S, Yadav T, Joshi C, Sharma N, Gulabani S, Gandhi D. Study of nutritional assessment of children between 6 months to 5 years. IAIM, 2017; 4(2): 42-52. Page 43 Results: Total 200 patients were taken in the study. Result shows that out of 200 patients 108(54%) were males and 92(46%) were females. The distribution of patients was more in age group between 13 and 36 months with 86(43%), of which distribution of males more than females were. Distribution of patients according to SAM and MAM (WHO classification) shows 127(63.5 %) fall under SAM and73 (36.5%) fall under MAM. Distribution of patients according to SAM and MAM (WHO classification) was studied. Result shows that out of 200 children taken in the study 127(63.5 %) fall under SAM and73 (36.5%) fall under MAM according to WHO classification. Distribution of children according to IAP classification in the present study interprets that 103 (51.5%) of the total children came under grade II of IAP classification. WHO classification detected more children with malnutrition than IAP classification, which was true for both boys and girls. Comparison of MUAC (WHO) with WHO (SAM and MAM) of children taken in the present study interprets that 67 (33.5%) had SAM and 95 (47.5%) had MAM according to MUAC criteria, remaining 19% did not fall under SAM and MAM. Comparison of MUAC (SAM) with WHO (SAM) of children in present study interprets that only 67 (52.75%) children came under SAM according to MUAC criteria out of the 127 children of SAM according to WHO classification. Comparison of MUAC (WHO) and IAP classification of children in the present shows that 67 children had MUAC <11.5 cm, out of 67 children (with SAM according to MUAC criteria) 28 (41.79%) came under grade II and 21 (31.3 %) came under grade III of IAP classification. Out of 95 children (MUAC between 11.5 cm and 12.5 cm) 18 (18.94%) came under grade I and 58 (61.05%) came under grade II of IAP classification. Associated co morbidities among children in the present study shows that among 200 patient 152 (76%) had anaemia, 44 (22%) had diarrhoea, 14 (7%) had pedal oedema, 12 (6%) had vitamin A deficiency, 44 (22%) had URTI and 24 (12%) had LRTI. Knowledge Aptitude and Practice study was done among 50 mothers and the result shows that mothers had less knowledge regarding what to be given in complementary feed, importance of immunization, birth spacing interval, and danger signs indicating illness. Conclusion: The present study shows that WHO classification detected more children with malnutrition than IAP classification, which was true for both boys and girls. There was also disparity among results of WHO criteria IAP classification and MUAC classification. Single criteria can’t be justified in assessing malnutrition. KAP study reveals that mother’s knowledge is important in combating malnutrition