Protein energy malnutrition (PEM) and Pediatric Rehabilitation


It is a type of pathological conditions arising from coincident lack of dietary protein or energy in varying proportions.  The condition may be mild, moderate or severe depending on the stage of nutrition provided to the child.  It commonly includes deficiencies of many micronutrients. PEU can be sudden and total (starvation) or gradual. Severity ranges from subclinical deficiencies to obvious wasting to starvation. It affects the child at the most crucial period of time of development, which can lead to permanent impairment in later life.  It is a major public health problem in India. It affects particularly the preschool children with its direct consequences ranging from physical to cognitive growth and susceptibility to infection.  Diagnosis usually involves laboratory testing, including serum albumin. Treatment consists of correcting fluid and then gradually replenishing nutrients.



Marasmus is characterised by wasting of body tissues, particularly muscles and subcutaneous fat, and is usually a result of severe restrictions in energy intake.



Kwashiokor affects mainly children, is characterised by oedema (particularly ascites), and is usually the result of severe restrictions in protein intake. However, both types can be present simultaneously and mask malnutrition due to the presence of oedema.



 



 


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