1/23. malnutrition and gender relations in Western kenya. Child malnutrition, which is an increasing problem in Western kenya, is addressed primarily through efforts to reach the individual mother with information about proper feeding of her children. A study carried out in Siaya, Kisumu and Busia Districts showed that mothers perceived nutrition problems differently, emphasizing their embeddedness in gender and family relations. In situations of marital conflict, male labour migration, and impoverishment, women must rely on support from others; thus health education should be addressed to husbands, grandmothers and mothers-in-law as well as mothers. ( info) |
2/23. Percentile charts to determine the duration of child abuse by chronic malnutrition. Longstanding quantitative or qualitative under-supply of nutrition leads to weight loss and, in children, to stagnation of growth and thus to stunted growth. A comparison of the expected growth, according to percentile growth curves, with the actual body size, gives an indication as to the period of time in which malnutrition took place. The moment in which the growth curve bends off and leaves the norm is to be interpreted as the earliest begin, the moment in which the attained growth would have been achieved as the latest begin of the nutritional impairment. ( info) |
3/23. Severe malnutrition due to subtle neurologic deficits and epilepsy: report of three cases. In southern and eastern africa, where approximately eight per cent of households lack access to adequate food, children suffering from chronic infections such as tuberculosis, gastrointestinal parasites and human immunodeficiency virus, often present with severe protein energy malnutrition. Three cases are described of children presenting to Chikankata Salvation Army Hospital who required hospitalization and urgent feeding due to PEM. No underlying aetiology for their life-threatening PEM could initially be identified and they were all observed to gain weight while in the intensive feeding unit. After discharge, each re-presented with recurrent failure-to-thrive and were found to have subtle neurologic deficits and underlying epilepsy. epilepsy and developmental disabilities should be considered in patients with PEM for whom other aetiologies cannot be identified. ( info) |
4/23. Fibrocalculous pancreatic diabetes in a child: case report. A case of fibrocalculous pancreatic diabetes in a 12-year old boy is described. A medline literature search back to 1966 revealed that no cases had been reported from East africa. We reviewed the literature and suggest that the condition is probably under-reported. ( info) |
5/23. acrodermatitis acidemica secondary to malnutrition in glutaric aciduria type I. We encountered a patient with glutaric aciduria type I (GA-I) associated with skin lesions resembling acrodermatitis enteropathica (AE). This child was being fed with a low-protein diet when the skin disorder developed. A deficiency in plasma levels of essential amino acids, particularly isoleucine, and zinc was confirmed. Supplementation of a high-caloric, protein-rich diet together with zinc, selenium and vitamins led to a prompt improvement of the skin lesions. We assume that in our patient the skin lesions were the result of malnutrition, rather than being primarily associated with the underlying metabolic disease. To our knowledge, no other report is so far available concerning GA-I complicated by skin eruptions. ( info) |
| SUMMARY: The evaluation of genu varum and intoeing in young toddlers is a frequent problem seen by the primary care physician and the orthopaedic surgeon. This report describes six nonwhite breast-fed toddlers with extreme genu varum. Clinical and radiographic findings were consistent with vitamin D-deficiency rickets. Within 3 to 6 months of the initiation of ergocalciferol treatment, reparative processes were evident on both radiographic and clinical examinations. Laboratory studies also showed underlying correction. With the current emphasis on the benefits of breast-feeding and the limitation of sunlight, this diagnosis must remain on the differential in the evaluation of genu varum. ( info) |
7/23. Cancrum oris in hiv infected children in lesotho: report of two cases. Cancrum Oris (noma) has been known to mankind since time immemorial. Its public health importance is lately being realised especially in africa, where majority of the cases occur. It affects those whose immune systems are compromised and thus, it is no wonder that it is being reported in hiv infected individuals. This development could have serious implications regarding the impact of the hiv pandemic globally and in particular the African region where poverty is rife. ( info) |
8/23. Shwachman syndrome: a case report. Cutaneous involvement is frequent in Shwachman syndrome, and includes various degrees of dry skin, and eczematous and ichthyosiform lesions. A 12-year-old boy with Shwachman syndrome had cutaneous involvement characterized by dry skin, perioral dermatitis, and follicular keratosis. Polymorphonuclear motility was decreased. A nutrition work-up showed a decrease in liposoluble vitamins, and suggested a causative link with the skin lesions. ( info) |
9/23. Hypokalaemic paralysis in malnourished children. Six malnourished children presenting with acute flaccid paralysis caused by hypokalaemia are described. Their ages ranged from 6 to 36 months. The extent of paralysis varied from neck flop to quadriparesis. Two cases had respiratory paralysis requiring ventilatory support for 48-72 hours. All were successfully treated with potassium supplementation. Hypokalaemia should be considered in the differential diagnosis of acute flaccid paralysis in malnourished children. ( info) |
| Two children, aged 11 years, who originally had jejunal atresia corrected in the neonatal period, developed massive dilatation of the proximal small intestine. This resulted in circular muscular hypertrophy with lipofuscin deposits giving the typical appearance of "brown bowel." The condition was associated with malnutrition and vitamin e deficiency. Because of relatively short bowel, the condition was treated by limited resection and extensive tapering of the dilated segment, end-to-end reanastomosis, vitamin E supplementation, and intensive nutritional support. ( info) |