Friday, January 22, 2010

MARASMUS [SEVERE ENERGY DEFICIENCY]




MARASMUS.

Marasmus is a form of severe malnutrition, dominated by energy deficiency of nutrients or foods intake. Probably combine with protein, vitamins and minerals deficiency. Marasmus occurrence increases prior to age one to under five year age.

The syndrome of marasmus:
1. Clinically, there is failure to gain weight, later followed by weight less and finally emaciation [to cause to lose flesh so as to become very thin] and dry skin.
2. There is loss of adipose tissue from normal areas for deposits like buttocks and tights.
3. There is extensive tissue and muscle wasting and weakness.
4. Other common symptoms include loose skin folds hanging over the axillary skin and gluteal skin.
5. The abdomen may be concave or flat; if there is distention of the abdomen, usually it is due to parasitic diseases such as ascariasis [roundworm], schistosoma, oxyuriasis [enterobius vermicularis or seatworm] combines with mild edema.
6. Vitamins deficiency vitamin B-complex and C are common often leading to anemia, pellagra, dry beriberi and scurvy.
7. The afflicted patients are often fretful and irritable.


Picture: Child suffering with marasmus in India.



It seems, the child is about under five years old.

Causes:
Marasmus is caused by a severe deficiency of nearly all nutrients or foods intake particularly energy or calories and protein.

Treatment:
It is necessary to treat the cause of marasmus with adequate nutrients feeding rich in energy or calories, protein, vitamins and minerals. Treatment in the uncomplicated case requires temporarily a high energy, high protein diet, with much of the nutrients derived from milk, eggs and meat.
The maintenance diet should be an average one according to age and weight of the patient.

Others treatment for anemia, pellagra, dry beriberi and scurvy can be administered with vitamin B-complex and vitamin C; and the treatment of any coexisting infections with antibiotics.
Parasitic diseases treatment with combantrin [pyrantel pamoate] syrup for children.
Treatment of dry skin and dehydration, administer the Ringer's lactate solution or Dextran 6 % in saline intravenous infusion.

Prevention:
Nutrients should be planned to avoid dietary deficiency by feeding rich in protein, adequate in energy, vitamins and minerals. Nutrients derived from milk, eggs, meat, whole grain, fruit, and vegetables.
Good hygienic habit and immunization to prevent infectious diseases.

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