Elaborate PEM. ( elaborate protein energy malnutrition
Answers
Answer:Protein-energy malnutrition
Definition
Protein-energy malnutrition (PEM) is a potentially fatal body-depletion disorder. It is the leading cause of death in children in developing countries.
Description
PEM is also referred to as protein-calorie malnutrition. It develops in children whose consumption of protein and energy (measured by calories) is insufficient to satisfy their nutritional needs. While pure protein deficiency can occur when a person's diet provides enough energy but lacks an adequate amount of protein, in most cases deficiency will exist in both total calorie and protein intake. PEM may also occur in children with illnesses that leave them unable to absorb vital nutrients or convert them to the energy essential for healthy tissue formation and organ function.
When to call the doctor
The doctor should be consulted if a child has lost a significant amount of weight without trying, has persistent diarrhea, or has any other signs of PEM.
Diagnosis
When the physician suspects PEM, A thorough physical examination is performed, and these areas assessed:
eating habits and weight changes
body-fat composition and muscle strength
gastrointestinal symptoms
presence of underlying illness
developmental delays and loss of acquired milestones in children
nutritional status
Doctors further quantify a patient's nutritional status by:
comparing height and weight to standardized norms
calculating body mass index (BMI)
measuring skinfold thickness or the circumference of the upper arm
Treatment
Treatment is designed to provide adequate nutrition , restore normal body composition, and cure the condition that caused the deficiency. Tube feeding or intravenous feeding is used to supply nutrients to patients who cannot or will not eat protein-rich foods.
In patients with severe PEM, the first stage of treatment consists of correcting fluid and electrolyte imbalances, treating infection with antibiotics that do not affect protein synthesis, and addressing related medical problems. The second phase involves replenishing essential nutrients slowly to prevent taxing the patient's weakened system with more food than it can handle. Physical therapy may benefit patients whose muscles have deteriorated significantly.
Prognosis
Most children can lose some of their body weight without side effects, but losing more than 40 percent is usually fatal. Death usually results from heart failure, an electrolyte imbalance, or low body temperature. Patients with certain symptoms, including semiconsciousness, persistent diarrhea, jaundice , and low blood sodium levels, have a poorer prognosis than other patients. Recovery from marasmus usually takes longer than recovery from kwashiorkor. The long-term effects of childhood malnutrition are uncertain. Some children recover completely, while others may have a variety of lifelong impairments, including an inability to properly absorb nutrients in the intestines, as well as mental retardation. The outcome appears to be related to the length and severity of the malnutrition, as well as to the age of the child when the malnutrition occurred.