MALNUTRITION - HOMOEOPATHY

INFANT CAREMALNUTRITION - MANAGEMENT : 

INFANT CAREMALNUTRITION - MANAGEMENT Dr.S.K.M.SASTRY M.D(Hom.) Asst.Chief Medical Officer(H) NTPC HOSPITAL- RAMAGUNDAM PHYSICIAN’S SOCIAL RESPONSIBILITY

MILE STONES OF HEALTH : 

MILE STONES OF HEALTH

TWO SIDES OF THE COIN : 

TWO SIDES OF THE COIN

TWO SIDES OF THE COIN : 

TWO SIDES OF THE COIN 1 2

What is Malnutrition : 

What is Malnutrition Malnutrition is defined as a pathological state resulting from relative or absolute deficiency of one or more essential nutrients. It is primary when there is deficiency of food available or secondary when food is available but the body cannot assimilate it for one or another reason. Malnutrition is common in children between age of 3 months and 3 years

Anthropometric Indices in Malnutrition (Protein Energy Malnutrition (PEM) : 

Anthropometric Indices in Malnutrition (Protein Energy Malnutrition (PEM) Weight for age is the best screening tool. Weight for age below 2 Standard Deviation from median is taken as Malnutrition. It is used for mass screening of children to detect under nutrition. Weight for Height below the 5th Centile classifies the child as Wasted ( Acute Malnutrition). Height for age below the 5th centile classifies the child as Stunted (Chronic Malnutrition)

Malnutrition in India : 

Malnutrition in India 38% of Children are Low Weight for Age. (14% of Children are Wasted) 36% or Urban and 44% of rural Children are Stunted. Bottle-feeding puts infants at a higher risk of illness, especially diarrhoeal disease, Malnutrition is responsible as underlying factor for 55% of Deaths in Children under 5 years of age.

Coloured MUAC tape : 

Coloured MUAC tape No numbers Suitable for use by uneducated people Facilitates work of community-based case-finders

Etiology of Primary Malnutrition : 

Etiology of Primary Malnutrition Failure of Lactation. Improper Weaning Practices Poverty Food Taboos Reduced space between child berths Death of Mother Incompetent/ Ignorant Mother. Lack of Family Planning

Etiology of Secondary Malnutrition : 

Etiology of Secondary Malnutrition Lack of Immunization Congenital Diseases: ASD, VSD, cleft palate etc. Malabsorption: Celiac Disease, Lactose intolerane, Giardiasis, Cystic Fibrosis Metabolic: Inborn errors of Metabolism, CRF, Renal tubular Acidosis etc. Infections: Tuberculosis ( very common in India)

Maintaining Causes of Malnutrition : 

Maintaining Causes of Malnutrition Outcomes Immediate causes Basic Causes Underlying Causes

Prevention of Malnutrition - 1 : 

Prevention of Malnutrition - 1 Treat/prevent hypo-glycaemia Treat/prevent hypothermia Treat/prevent dehydration Correct electrolyte imbalance Treat/prevent infection

Prevention of Malnutrition- 2 : 

Prevention of Malnutrition- 2 6. Correct micronutrient deficiencies 7. Initiate refeeding 8. Facilitate catch-up growth 9. Provide sensory stimulation and emotional support 10. Prepare for follow-up after recovery

Prevention of Malnutrition- 2 Poor man's Rich Food : 

Prevention of Malnutrition- 2 Poor man's Rich Food Groundnut and Jaggery Cakes Milk Green Vegetables Cereals powder with Jaggery (Rich in Calcium, Iron, Carbohydrates, Fats, Proteins) Feeding even in diarrhoea

Iron Deficiency : 

Iron Deficiency Most common form of malnutrition Most common cause of anemia Low dietary iron intake Low iron bioavailability Non-heme iron Inhibitors Other causes of anemia: Parasitic infection Malaria

Clinical features in Marasmus : 

Clinical features in Marasmus Marked muscle wasting and loss of subcutaneous fat. Monkey Facies Skin becomes loose and hangs in folds Abdomen protuberant due to hypotonic muscles Temperature is usually sub-normal Child is alert

Clinical features of Kwashiorkor : 

Clinical features of Kwashiorkor Generalized Edema more marked in Lower Extremities. Apathy and Irritability Fine, sparse and discoloured hair Anemia Usually Flaky Paint Dermatitis Enlarged Liver due to Fatty Changes

KWASHIORKAR : 

KWASHIORKAR Calc.carb Baryta.carb Iodium Calc.phos Abrotanum

Lab Investigations in Malnutrition : 

Lab Investigations in Malnutrition Check Hemoglobin in all cases. If there is no BCG Scar, do Diagnostic BCG and read after 72 hours. If more than 10 mm of indurations, treat as Tuberculosis. Do Stool R/E and Urine R/E. Do Chest X-ray in all cases of Malnutrition. Serum Pre-Albumin level. This is the most sensitive prognostic indicator in Kwashiorkor. Do on Day1, Day 5 and before discharge of the patient. Plasma Proteins and Serum Albumin level. These are usually very low in Kwashiorkor.

Complications of Malnutrition : 

Complications of Malnutrition Hypothermia Hypoglycemia Cardiac Failure Infections Vitamin A Deficiency Severe Anemia Dermatosis

Objectives : 

Reduction in Grade 3 & 4 malnutrition in 0-6 age group Special focus on health, nutrition and immunisation aspects in 0-3 age group Reduction in Grade 1 & 2 malnutrition in 0-6 age group Newborn care initiatives Antenatal, prenatal and postnatal care for mothers Focus on pre-teen/adolescent girls: nutrition and health education Transfer of the management function to the community Objectives

Therapeutic Nutrition in Malnutrition : 

Therapeutic Nutrition in Malnutrition Start slowly with F-75. If that is not available, give traditional easy to make, calorie rich foods. For those having severe anorexia, feed overnight with Milk given through NG tube, till appetite returns. Give Vitamin A, Vitamin D, Zinc, Magnesium, and folate to all children Treat Oral thrush, if present.

Prevention of Malnutrition : 

Prevention of Malnutrition Primary Prevention Health Education to mothers about good nutrition and food hygiene through Lady Health Workers Immunization of children. Growth monitoring on Growth Charts specially of all children under 3 years of age Secondary Prevention Mass Screening of high risk populations, using simple tools like Weight for age or MUAC. Tertiary Prevention Good Nutritional Care, supplementary feedings and rehabilitation, counseling of mothers

Andhra Pradesh Initiatives : 

Andhra Pradesh Initiatives Woman Health Volunteers in each of the rural and tribal habitations. Setting up an additional 100 round-the-clock women health centres. A subsidized Emergency Health Transportation Scheme. Incentives to women health volunteers, village Panchayats that promote Immunization & Hospital delivery etc

Homoeopathic Point of View : 

Homoeopathic Point of View

HOMOEOPATHIC CONSIDERATIONSAPART FROM ROUTINE : 

HOMOEOPATHIC CONSIDERATIONSAPART FROM ROUTINE MIASM Psora & Others Syphillis & Others Sycosis & Others CONSTITUTIONS Oxygenoid & Others Hydrogenoid & Others Carbo – Nitrogenoid & Others IATROGENIC DRUGS ECONOMIC POOR, LOW DIET OR DEFECTIVE ASSIMILATION

Homoeopathic Remedies : 

Homoeopathic Remedies Abrotanum, Argentum Nit. Baryta Carb, Calcarea Phosphorica. Calcarea Carbonica, Cina, Chamomilla, Hepar Sulphur, Iodine. Kali.Iod, Magnesia Carbonica, Natrum Muriaticum, Silica, Sulphur, Tuberculinum etc. are some of the medicines to be thought of.

Iodium & Tuberculinum : 

Iodium & Tuberculinum IODIUM Dark complexion Hot baby Ravenous hunger Anxiety Better in open air Glandular enlargement TUBERCULINUM. Light complexion, blue eyes, mental activity Ravenous hunger with rapid emaciation Anxiety

Magnesia Carbonica. : 

Magnesia Carbonica. Puny children Marasmus Milk < undigested vomiting; griping and colicky pains; sour green grassy stools, improperly nourished; ulcers in the mouth, swollen glands bloated abdomen. Jaundice offensive Sweat

Tuberculinum : 

Tuberculinum Light complexion, blue eyes, mental activity Ravenous hunger with rapid emaciation Anxiety

Natrum Mur. : 

Natrum Mur. Marasmus from defective nourishment Thin neck, Ravenous appetite , The child grows thin. Excess thirst and craves water all the time Gets intermittent fever frequently. Dry mouth and throat constipated bowels. Skin is scurfy with oozing eruptions. Craving for salt

CALC-CARB : 

CALC-CARB Marasmus Defective nutrition, Sour stools and vomiting of milk, Sweat on scalp, head and face, the feet are damp and cold, Enlargement of the glands Voracious appetite. Dwindled body, Prominent abdomen. morbid appetite, craving indigestible articles. Engorgement of mesenteric glands Scrofulous infants. Diarrhoea on beginning to eat or drink; Rapid emaciation with a harsh and dry skin. The debility, weariness and irritable restlessness

ABROTANUM : 

ABROTANUM Marasmus. Impaired Nutrition Defective digestion and assimilation Marked emaciation of lower limbs, ascending type Great weakness Ravenous appetite with rapid emaciation. Chilly Constipation and diarrhoea alternate

CALC .PHOS : 

CALC .PHOS Emaciation Predisposition to glandular and osseous disease Large heads, defective bony development, open fontanelles and tardy development of the teeth, weak spine, curved, thin neck Sallow complexion Persistent vomitings and diarrhoea of green, slimy and undigested stools, accompanied with much offensive flatus. Engorgement of glands, enlarged tonsils Scrofulous tendency.

HELP THE CHILD TO SMILE – HEALTH FOLLOWS : 

HELP THE CHILD TO SMILE – HEALTH FOLLOWS A SMILE IN COMFORT A SMILE IN HAPPYNESS A SMILE IN BLISS A SMILE IN LOVE

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TATSAT