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Scholars Journal of Applied Medical Sciences | Volume-8 | Issue-03
Role of Selected Clinical Signs in Predicting Fatal Outcome in Severely Malnourished Children Admitted in Hospital
Dr. Farhana Akhter Faruque, Dr. Md. Ataur Rahman Dr. Md. Nurul Absar, Dr. Joyashree Chakraborty
Published: March 21, 2020 | 108 91
DOI: 10.36347/sjams.2020.v08i03.036
Pages: 989-995
Introduction: Nutritional deficiency constitutes a major public health problem worldwide and often associated with fatal outcome [1]. The malnutrition scenario presented by UNICEF in 2011 showed that 52 million children under 5 years of age were moderately or severely wasted, More than 29 million under 5, an estimated 5 percent suffered from severe wasting, Bangladesh has a very high prevalence of malnutrition-above 15 per cent[2]. However, a recent hospital-based systematic surveillance study in a diarrhoea treatment centre in Dhaka, Bangladesh revealed that severe wasting, severe stunting and severe under-nutrition in under 5 children were 3%, 11% and 16% respectively[3]. Every year over 4 million children are born in Bangladesh and nearly 289,000 of them die before reaching their fifth birthday. Aim of the study: To determine the role of four clinical signs (bradycardia, low volume pulse, impaired consciousness and delayed capillary refilling time) in predicting the death of severely malnourished children admitted in the hospital. Materials & Method: All the cases of severe acute malnutrition in age group of 3 months to 59 months were included during the study period of March 2016 to September 2016. History, physical findings and particularly four clinical signs- bradycardia, low volume pulse, impaired consciousness and capillary refill time > 3 sec were recorded for all the children. They were treated as per WHO guideline with prevention and treatment of hypoglycemia, hypothermia, dehydration, electrolyte imbalance, treatment of infections and other problems including shock and severe anaemia. Feeding was started with F-75 formula for one week, then replaced by F-100.They were also given multivitamin, folic acid and zinc. Outcome particularly death of the patients were recorded, co-morbidities, duration of their hospital stay were also recorded. Children who had any one or more of the four clinical signs were then considered as case and rest as control .........