Marasmus biochemistry PowerPoint presentation.pptx

Marasmus

1. Marasmus Submitted by: Bhisma Rai Kushma Gautam Roll no: 21-22

2. Contents Introduction Causes Clinical features Symptoms Complications Treatments Feeding pattern Adult marasmus Preventive measures Recommendations

3. Introduction Marasmus is derived from the G reek word Marasmos, which means withering or wasting. It is a severe form of PEM that consists of the chronic wasting away of fat, muscle and other tissues in the body. Marasmus represents the end result of starvation where both protein and calories are deficient due to inadequate intake. It occurs in individuals at any time but is more common at the age before 1 year.

4. Contd… Marasmus is commonly seen in children of developing nation like latin America, Africa and South Asia, where insufficient food supplies and contaminated water are hugely prevalent. Grading of marasmus Grade I: Wasting starting in axilla and groin. Grade II: I + wasting in thigh and buttocks region. Grade III: II + chest and abdomen Grade IV: Buccal pad of fat.

5. Causes Poverty that lead to the low food availability and poor child care. Inappropriate breast feeding and weaning practices. Prolonged breastfeeding without introduction of other foods. Cultural and social practices such as food taboos and fads. Environmental factors like drought, flood, earthquakes, famine etc. Poor farming practices often due to lack of knowledge, money, time or equipment. Overcrowded and unsanitary living conditions. Maternal morbidity.

6. Contd… Infectious diseases like diarrhea , measles and other respiratory infections. Poor infant and child rearing due to ignorance. Defective hygiene. Deficiency of certain nutrients like vitamin A, and K Inadequate diets for women during and after pregnancy. low quality, expensive, non-existent or unfriendly Health services. Premature birth, mental deficiency and digestive upsets (malabsorption, vomiting, etc.) Mother’s desire to feed her baby from the bottle rather than the breast .

7. Clinical features Severe wasting of weight by less than 60% Growth retardation Loss of subcutaneous fat Loose skin and thin arm Patient is extremely emaciated Muscle atrophy Patient looks older than the age or senile face Decreased in blood protein Vitamin A deficiency

8. Symptoms Frequent diarrhea Abdominal distention Persistent dizziness Alert but miserable hungry Failure to thrive

9. Contd … Severe lethargy Delayed wound healing Problems with bladder and bowel control Persistent vomiting

10. Complications Hypoglycemia Hypothermia Severe anemia Complete and partial paralysis Joint deformities Severe weakness Permanent vision loss Abnormality of tongue Organ failure Coma

11. Treatments Provide the affected individual healthy and nutritious diet which is rich in proteins and calories. Provision for adequate breastfeeding. When available, care must be taken to feed with small amounts at first In artificial feeding one should encounter the danger of prolonged starvation and over-feeding. Medical management of complications, infectious illness and deficiency states. In the absence of life threatening complications individual should be kept in Nutrition Rehabilitation Centre.

12. Contd… The methods such as use of IV fluids, rehydration solutions administered orally , and feeding through NG tubes should be used for refeeding and rehydrating. While choosing the food for treatment following principles should be followed: Fat is poorly digested and therefore best kept low if prescribed in ordinary mixtures. It is desirable to feed with as much carbohydrate as possible. P rotein is better digested than the other food elements, and it has therefore been customary to rely on a high protein diet in these cases.

13. Feeding Pattern The initial food given should be of low volume containing adequate energy. The initial diet should provide no more than the requirements of energy and protein. Once the patient is free from complications, energy content of the diet should be increased. Along with feeding, emotional stimulation, play and tender loving care is important. A mixture of multiple micronutrients should be fed. Though anaemia is present, iron supplementation is not given in the initial stages.

14. Adult Marasmus Marasmus generally occurs in children below one year of age. However, it is also seen in adult.

15. Contd…. The causes of adult marasmus are: Insufficient food due to famine, severe war, civil disturbances, natural disasters etc. Infections especially chronic, untreated or untreatable . The most common is HIV/AIDS which cause marked wt. loss and severe wasting. Malabsorption due to inability of the body to digest or absorb certain foods and nutrients. Malignancies. Eating disorder such as anorexia nervosa, which occurs more commonly in adolescent females than males and in affluent society than poor.

16. Preventive measures S tart weaning a child at 4 to 6 month of age. Development of low cost weaning. Food fortification . Breastfeeding should be encouraged. Proper guidance to mother. Pregnancies in quick succession should be avoided and mother’s health should be looked after. Increase the intake of carbohydrate and protein rich foods.

17. Contd… Prompt treatment of childhood inter-current infections and diseases. Do not substitute infant formula in place of mother’s milk. Improvement in the economic status of families . Promote good personal and community hygiene practices. Improve household level feeding practices and health care . Promote adequate and hygienic food preparation and consumption.

18. Contd … Immunization.

19. Recommendations Provide nutrition education including demonstration. Market-based interventions to ensure food remains affordable. Cash transfers by government to ensure families have sufficient money to purchase food. General food distribution where food is unavailable or un-affordable. Raise crop production, local market prices, and health service statistics. Regular home visits to educate the mother on feeding oneself and the child and also hygiene measures. Educate mother on danger signs specifically so that she can take the child early to a health center in case of infection.