27/01/2015 Food and Nutrition (PEM) By Dr. Nurul Islam PEM - TopicsExpress

27/01/2015 Food and Nutrition (PEM) By Dr. Nurul Islam PEM : Protein energy malnutrition in early childhood is a spectrum of disease . Classification of PEM : Three type a. Marasmus b.Kwashiorkor c.Marasmic kwashiorkor Cause of PEM : a. Inadequate food b. Infectious and parasitic disease c. Poor environment condition d. Large family size e. Failure of lactation f. Poor maternal health Management of PEM : a. Resuscitation : Correction of dehydration , electrolyte imbalance , acidosis , hypoglycemia and treatment of infections . b. Start of cure : It include re feeding gradually working up the calories . c. Nutritional rehabilitation . Prevention of PEM : a. Educate mother b. Advice to farmer c. Provide food supplementation in hospital d. Family planning e. Immunization program f. Encourage breast feeding g. MCH clinic Differences between marasmas and kwashiorkor : Point marasmas Kwashiorkor Cause calories and nutrition only protein Odema Absent Present Muscle wasting Present Absent Growth retardation Sever Less than marasmas Mental Change Usually absent Usually present Appetite Usually good Usually poor Skin change Usually none Pigmentation present Hair change Slight change Straight silky ,raddish Moon face Absent Present Liver change None Frequent

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