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Hey fellas,before we talk or discuss
About how to diagnosis the diseases
How to
Treatment this diseases
and talk about pathophysiology of diseases
the first of all and the most important thing
we must know about definition of marasmus and kwashiorkor
what is marasmus?
marasmus is one of acute disorder that include
protein energy malnutrition. Marasmus
is derived from "Greek Word"
Marasmos which means
wasting
it's severe malnutrition diseases
one of marasmus significant defect is
functional decrease
of fat, muscles and tissues in body
The malnutrition diseases
if remained untreated could lead to dead
in short time, after i have explained about
what is marasmus. I want to make you
know what is kwashiorkor.Kwashiorkor
is a part of new spectrum of the diseases
collectively refer to protein energy
malnutrition just like marasmus
Kwashiorkor is derived from "Ghananian word"
which means the diseases of
older child develops when
a new child is born. This condition is very common in
poor country or natural disaster condition. this condition
are responsible for a lack
of food or good nutrition which lead to
malnutrition. Epidemilogy of diseases
marasmus and kwashiorkor have same epidemiology
this diseases is more common happen in
developing countries. in 2000, the WHO
estimated that malnourished children numbered
181 million (32 %) in developing countries
in addition, an estimated
149 million children younger than 5 years
are malnourised when measured in terms of weight
for age. after we have knowed about
definition and epidemiology of diseases. I want to explain about
pathophysiology of diseases
First, Marasmus is
characterized by gross wasting of the
muscles and subcutaneous tissues
and marked stunting with absence of oedema
there are so many changes
Growth Failure
marked weight deficient al well as
a deficit in height are apparent. They are grossly emiciated
and look like they have had
a great many worries
Psychological changes make them irritable
and fretful. Their appetite
increases markedly
Skin
and hair changes. Then the face
features like a thin "old man face" and their body become
weak and frail.
Next, I want to explain about kwashiorkor
the condition of kwashiorkor is
lack of blood plasma protein. This condition
makes tissues fluid retention. it
affects swelling of abdomen
(OEDEMA).Weight deficit
almost always present
thinning hair, dermatitis, stunted growth, impaired mental
and physical development. Marasmus and Kwashiorkor
can be diagnosed with the same way, because
both of that are include in
malnutrition disease. Clinical history
and symptoms of malnutrition are often
the major determinats of malnutrition
Outline of diagnosis of malnutriton includes BMI
and routine blood test.In children weight and height is measured
and compared with the charts showing
expected average height and weight for child
of the age. The routine blood test
is done to assess anemia
other vitamins and mineral deficiencies
We need to plan treatment for this diseases. Malnutrition causes
more problems in children than any other age group
that may lead to growth retardation
(physical dan mental) and suspectibilty
to repeated infections.
children with long-term diseases need therapy for malnutrition
as prophylactic measure.
these includes additional
nutrients, vitamins and mineral supplements
etc.The underlying diseases
also need to be treated adequately
to prevent malnutrition. Children with
severe malnutrition need therapy in the hospital.
complication of the disease
there are some complication in Marasmus and Kwashiorkor
because of children with Malnutrition have
a very bad and weak condition, and their immune system is poor
when immune system is poor
there are some bacteria, virus, etc which can develop into
a diseases will attack their body. The complications that usually attack
child with malnutrition are serious infections
especially septicemia,pneumonia
gastroenteritis, tuberculosis,measles
and AIDS often precipitate kwashiorkor
hypoglycemia due to loss of energy stores
her failure to due to small, week heart
bleeding, usually purpura
anemia due to protein and iron deficiency
electrolyte imbalances, especially potassium
deficiency, malabsorption
tremors.
in this phase,i'm talking about the prognosis of the diseases
the outlook depends on the cause of
malnutrition.
most nutritional deficiencies can be treated.
However, if malnutrition is caused by
a medical condition, that illness has to be treated
in order to reverse the nutritional deficiency.
there is
rehabilitation phase starts once
complications have been addressed adequately
with gradual return of apetite,
resolution of diarrhea and sepsis
and correction of
electrolyte imbalances.
The main goals of this phase are to increase
dietary caloric intake,
treat occult infections,
complete vaccination, improve
family involvement
and the last the
stimulate psychomotor activity. Prevention of the diseases
Generally, malnutrition is caused by lack of nutritional components
it can be prevented by providing special diet such as
fruit, vegetable, milk product, oils, meat and beans
etc with sufficient amount in timely.
there are primary prevention,secondary prevention and tertiary prevention
for malnutrition.
the primary prevention are health promotion and the contain
are health education to mothers about good nutrition and
food hygiene health workers, distribution supplements like distribution of iron, folic acid and
vitamin E
promotion of breastfeeding, development of
low-cost weaning foods, measures to improve family diet,
nutritional education, home economics,
family planning and birth spacing, family environment.
Then the spesific protection are spesific protein diet,
eggs, milk, fresh fruit, immunization, fortification of food
Now, I will talk about the correlation between
marasmus and kwashiorkor. There are two types of
protein energy malnutrition, there are marasmus and kwashiorkor.
there is a correlation between both of them
the correlation occur when
marasmus and kwashiorkor overlap,
it is referred to as Marasmic-Kwashiorkor.
This disease is mixed form of
pem or protein energy malnutrition,
these children have concurrent gross wasting and oedema
and frequently are
stunted. They usually
have mild skin
and hair changes and
enlarged palpable fatty liver.
the child with this condition
have symptoms from both of it.
finally, we have the conclusion of this case
Malnutrition is very common
in the critically ill child and has negative effect
on the prognosis, increasing
the incidence of complications
and morbidity and mortality
The objectives in the future should be to
administer individualized
nutrition in accordance with the spesific charateristics
on of each critically ill child
and to be able to adjust integration
continuously according to the metabolic changes
and nutritional status.
For this, this is important to conduct studies
to identify sensitive methods
for the evaluation of nutrition
that can be a applied in the majority
of critically ill children.