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Hypocalcemia in children: Though the term ‘hypocalcemia’ is generally used to denote S. Calcium <9 mg/dl, clinical manifestations depend on ionic Ca levels (<3.0 mgldl). If facility to measure ionic Ca’ is not available, it is worthwhile to measure S. albumin levels simultaneously. In normal buminic, low S. Calcium reflects ionic hypocalcemia in children. However, […]

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Hypokalemia in children is the commonest electrolyte abnormality in sick children, defined as S. Potassium levels <3 mg. Causes Severe diarrhea/vomiting is the commonest cause of acute hypokalemia in children, while persistent hypokalemia usually indicates underlying renal disease. Pathophysiology Low extracellular potassium levels slow down the post-depolarization return of potassium into the cells, delaying process […]

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Hypernatremia in children is relatively less common than hyponatremia, defined as serum sodium levels> 150 meqlL. Causes Hypernatremia in children is usually iatrogenic in origin, due to use of concentrated ORS/parenteral fluids. Concentration hypematremia is seen in disorders with excessive water loss e.g. diabetes insipidus. Pathophysiology Hypernatremia leads to increased ECF osmolarity > osmotic movement […]

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Edema in children is a clinical term to denote – excess accumulation of fluids in interstitial fluid compartment, which normally contributes to —45% of TBW. Etiology Edema is caused by any factor that a) reduces plasma oncotic pressure, b) increases hydrostatic pressure, c) increases capillary permeability, and d) prevents lymphatic return. Diagnostic approach: Although the […]

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Although many Nutrition program in India are operational in India for high-risk children, many of them are being integrated with wider-spectrum programs i.e. ICDS. Salient features of some general nutritional programs are discussed here, while those against specific nutritional deficiencies have been discussed in relevant chapters. Applied nutrition program in India (ANP) was also started […]

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Early (Presenting) Complications of PEM: a) Infections include Common like ARI, Diarrhea, TB, helminthiasis. Severe Gram —ye sepsis, septic shock, DIC and Opportunistic Candidiasis b) Hypothermia c) Metabolic Hypoglycemia Hypocalcaemia Hypomagnesemia d) Fluid & electrolyte imbalance Dehydration Hypokalemia Hypernatremia e) Lactose intolerance f) Severe anemia & other nutrient deficiencies g) Congestive cardiac failure Late (Recovery) […]

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Protein energy malnutrition (PEM) is the commonest health problem in preschool children of developing countries, associated with significant morbidity and mortality. Children are more vulnerable to Protein energy malnutrition due to relatively higher caloric and protein requirements for growth and physical activity. Even subclinical under nutrition in this age group may lead to long-term growth […]

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PEM Management

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PEM Management: Depending on the severity, PEM may be managed at home, nutritional rehabilitation centers, or hospital. Hospitalization is indicated in cases with severe PEM, life-threatening complications, severe anorexia and refusal to accept oral feeds, emotionally deprived or neglected child, and failure of domiciliary treatment. PEM Management aims towards diagnosis & treatment of complications, dietary […]

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Balanced diet for children is the ‘diet containing variety of foods in such quantities and proportions, which fulfills the needs for all essential nutrients, necessary to maintain optimal health and growth. Principles: General characteristics of a balanced diet for children, based on dietary goals from various sources (Prudent diet; WHO) are as follows — a) […]

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Weaning

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Weaning (Complementary feeding) may be defined as “gradual introduction of semi-solids and solids in baby’s diet apart from breast milk, to meet their growing demands, usually at 4-6 months.” Note that weaning is a complementary process and not the discontinuation of Breast feeding, which should continue as long as possible. Aims: BM is all that […]

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