Malnutrition, microcephaly & macrocephly, respiratory system (pneumonia), pancreatitis, cardiovascular system (congenital heart defects)

List of lectures topic
1. Malnutrition
2. Microcephaly & Macrocephaly
3. Respiratory System (Pneumonia)
4. Pancreatitis
5. Cardiovascular System (Congenital Heart Defects)

1.Malnutrition
Malnutrition is a condition that results from
eating a diet in which nutrients are either
not enough or are too much such that the
diet causes health problems.
It may involve :-
 Calories
 Protein
 Carbohydrates
 Vitamins
 Minerals
Undernutrition:- Not enough nutrients and
need able element deficiency.
Overnutritions:- so much nutrients in intake
food.
Types of Malnutrition
 Undermutrition

 Overnuteition
 Imbalance of Nutritions
 Specific Deficiency
There are two major types of malnutrition:
 Protein-energy malnutrition - resulting
from deficiencies in any or all nutrients.
 Micronutrient deficiency diseases -
resulting from a deficiency of specific
micronutrients.
Undernutrition:- (1). Marasmus
(2). Kwashiorkor
(1). Marasmus
 Somatic protein compartment more
severely impacted.
o Spindly arms and lungs
 Serum albumin normal or slightly reduced

(2). Kwashiorkor
 Visceral protein compartment more
severely impacted
 Apathy, listlessness, loss of appetite
 Enlarged fatty liver
 Hypoalbuminemia
 Anasarca
 Other characteristics
 Skin:- alternating zone of
hyperpigmentation, desquamation
 Hair:- loss of color or alternating bands or
pale and darker hair.
Overnutrition:- Obesity
Obesity is divided into two types:-
Exogenous:- Over feeding or over eating with
less physical activity.
Endogenous:- There may be one or more
endogenous factors e.g.:- Endocrine,
Metabolic, Hypothalamic.

Symptoms
 Lack of appetite or interest in food or drink
 Tiredness and irritability
 Always feeling cold
 Loss of fat, muscle mass, and body tissue
 Longer healing time for wounds
 Higher risk of complications after surgery
 Depression
 Reduced sex drive and problems with fertility
In more severe cases:-
 Breathing becomes difficult
 Skin may become thin, dry, inelastic, pale, and cold
 Hair becomes dry and sparse, falling out easily
Causes
Malnutrition can result from various environmental and
medical conditions.
1) Low intake of food
This may be caused by symptoms of an illness, for
example, dysphagia.
2) Mental health problems
 Depression

 Dementia
 Schizophrenia
 Anorexia Nervosa
 Bulimia
3) Social and mobility problems
Some people cannot leave the house to buy food or find
it physically difficult to prepare meals. Those who live
alone and are isolated are more at risk. Some people do
not have enough money to spend on food, and others
have limited cooking skills.
4) Digestive disorders and stomach conditions
If the body does not absorb nutrients efficiently, even a
healthful diet may not prevent malnutrition. People
with Crohn's disease or ulcerative colitis may need to
have part of the small intestine removed to enable them
to absorb nutrients.
Persistent diarrhea, vomiting, or both can lead to a loss
of vital nutrients.
5) Alcoholism
Addiction to alcohol can lead to gastritis or damage to
the pancreas. These can make it hard to digest food,
absorb certain vitamins, and produce hormones that
regulate metabolism.
6) Lack of breastfeeding

Not breastfeeding, especially in the developing world,
can lead to malnutrition in infants and children.
Diagnosis
These are the 5 steps of Diagnosis:-
 Step 1:- Measure height and weight, calculate
body mass index and provide a score.
 Step 2:- Note the percentage of unplanned weight
loss and provide a score. For example, an
unplanned loss of 5 to 10 percent of weight would
give a score of 1, but a 10-percent loss would
score 2.
 Step 3:- Identify any mental or physical health
condition and score. For example, if a person has
been acutely ill and taken no food for over 5 days,
the score will be 3.
 Step 4:- Add scores from steps 1, 2 and 3 to obtain
an overall risk score.
 Step 5:- Use local guidelines to develop a care
plan.
Treatment
Low risk:- Recommendations include ongoing
screening at the hospital and at home.

Medium risk:- The person may undergo observation,
their dietary intake will be documented for 3 days, and
they will receive ongoing screening.
High risk:- The person will need treatment from a
nutritionist and possibly other specialists, and they will
undergo ongoing care.
For all risk categories, help and advice on food choices
and dietary habits should be offered.
Prevention
 To prevent malnutrition, people need to consume a
range of nutrients from a variety of food types.
 There should be a balanced intake
of carbohydrates, fats, protein, vitamins, and
minerals, as well as plenty of fluids, and especially
water.
Management of Malnutrition
Among those patients who are hospitalized, nutritional
support improves protein, calorie intake and weight.
Food

 The evidence for benefit of supplementary feeding
is poor. This is due to the small amount of research
done on this treatment.
 Specially formulated foods do however appear
useful in those from the developing world with
moderate acute malnutrition.
 In young children with severe acute malnutrition it is
unclear if ready-to-use therapeutic food differs from
a normal diet.
 They may have some benefits in humanitarian
emergencies as they can be eaten directly from the
packet, do not require refrigeration or mixing with
clean water, and can be stored for years.
 In those who are severely malnourished, feeding
too much too quickly can result in refeeding
syndrome.
 This can result regardless of route of feeding and
can present itself a couple of days after eating
with heart failure, dysrhythmias and confusion that
can result in death.
Micronutrients
Treating malnutrition, mostly through fortifying foods with
micronutrients (vitamins and minerals).
In those with diarrhea, once an initial four-hour
rehydration period is completed, zinc supplementation is
recommended. Daily zinc increases the chances of
reducing the severity and duration of the diarrhea, and

continuing with daily zinc for ten to fourteen days makes
diarrhea less likely recur in the next two to three months.
In addition, malnourished children need both potassium
and magnesium.
For a malnourished child with diarrhea from any cause,
this should include foods rich in potassium such as
bananas, green coconut water, and unsweetened fresh
fruit juice.
Diarrhea
The World Health Organization recommends rehydrating
a severely undernourished child who has diarrhea
relatively slowly. The preferred method is with fluids by
mouth using a drink called oral rehydration solution.
These complications include congestive heart
failure. Over time, ORS developed into ORT, or oral
rehydration therapy, which focused on increasing fluids
by supplying salts, carbohydrates, and water.
Breast feeding and eating should resume as soon as
possible. Drinks such as soft drinks, fruit juices, or
sweetened teas are not recommended as they contain
too much sugar and may worsen diarrhea.
Low blood sugar
 Hypoglycemia can be treated with a mixture of
sugar and water.
 If the child is conscious, the initial dose of sugar and
water can be given by mouth.

 If the child is unconscious, give glucose
by intravenous or nasogastric tube.
 If seizures occur after despite glucose,
rectal diazepam is recommended.
 Blood sugar levels should be re-checked on two
hour intervals.
Hypothermia
Hypothermia can occur. To prevent or treat this, the
child can be kept warm with covering including of the
head or by direct skin-to-skin contact with the mother or
father and then covering both parent and child.
Economics
There is a growing realization among aid groups that
giving cash or cash vouchers instead of food is a
cheaper, faster, and more efficient way to deliver help to
the hungry, particularly in areas where food is available
but unaffordable.
Reference:-
 Kapitan Pediatrics Book
 GHAI Essential Pediatrics (Eighth Edition)
 Health line ( https://www.healthline.com )
 WebMd ( https://www.webmd.com )
 Mayo Clinic ( https://www.mayclinic.org )
 My Self

2.Microcephaly & Macrocephaly
Microcephaly
Head circumference more than 3 standard deviations
below the mean for age and sex
Classification
(1) Primary/ genetic
(2) Secondary/ non genetic
(1). Primary microcephaly
 Genetic
 Defective cellular migration
 Defective neurulation
 Defective presencephalisation
 Syndromes
(2). Secondary microcephaly
(a) Prenatal
(b) Postnatal
(a) Prenatal
 Maternal intake of drug

 Maternal illnesses toxemia, diabetes, CRF, phenyl
keto urea
 Intrauterine infections- CMV, rubella, toxoplasma
 Radiation
 Migration defects
(b) Postnatal
 Perinatal insults e.g.:- birth asphyxia
 Inborn errors of metabolism phenyl keto urea
 CNS insults- encephalitis, meningitis, HSV
 HIV infections, malnutrition
 Rett syndrome
 Trauma
 Endocrine- hypothyroid and hypopituitarism
 Metabolic- hypoglycemia, PKU
Deference between primary and secondary
microcephaly
Primary
 Low crown, receding forehead. Occipital flattening,
wrinkling of skin
 Present since birth
Secondary
 Small head

 Maybe present at birth/ evident later
Causes
 Exposure to toxic chemicals
 Methylmercury poisoning
 Not enough vitamins and nutrients
 Infection with cytomegalovirus, rubella, varicella
virus, Zika virus, or toxoplasma
 Prescription medicine use
 Illegal drug use
 Drinking alcohol
 Untreated phenylketonuria
 Stroke
Causes of congenital microcephaly include:-
Microcephaly is often congenital, meaning a baby is
born with the condition. In other cases, a baby can
develop microcephaly after birth.
 Prenatal infections:-
 Zika virus, especially in the first trimester of
pregnancy, can damage nerve cells in the brain.
 Rubella, chickenpox, toxoplasma and
cytomegalovirus.
 Genetic mutations:
 Several hundred genes have been linked with
microcephaly, and more are still being discovered.

 Defects in these genes can interfere with the brain’s
growth. In some cases, microcephaly may be
related to Down syndrome.
 Other causes during pregnancy:
 There is evidence that alcohol and substance
abuse, inadequate nutrition, untreated
phenylketonuria (PKU) or exposure to toxic
chemicals and certain prescription drugs during
pregnancy can cause microcephaly in a baby.
Causes of microcephaly during infancy include:
 Genetic mutations
 Traumatic brain injury
 Lack of oxygen to the brain
 An infection in the brain
Symptoms
 Very small head
 High-pitched cry
 Trouble feeding
 Seizures
 Shaky movement of the arms and legs (spasticity)
 Developmental delays
 Intellectual disability

Diagnosis
After birth, the healthcare provider will ask about your
child’s health history. He or she may ask about your
pregnancy and health history, and your family’s health
history. The provider will give your child a physical
exam.
Your child may have tests, such as:-
 Head circumference measurement:- The
measurement is compared with a scale for normal
growth and size.
 CT scan:- This test uses a series of X-rays and a
computer to create images of the inside of the body.
A CT scan shows more detail than a regular X-ray.
 MRI:- This test uses large magnets, radio waves,
and a computer to make images of the inside of the
body.
 Blood tests:- These include genetic tests. Genetic
tests check for conditions that tend to run in
families.
 Urine test:- This is done to look for a substance
that may show a certain type of microcephaly.
Treatment
 There is no treatment for microcephaly that will
return the baby's head to a normal size or shape.
 Microcephaly is a lifelong condition that has no
cure.
 Treatment focuses on preventing or reducing
problems and maximizing a child's abilities.

 The healthcare team will give support and teach
you how best to manage your child’s health.
Child may see healthcare providers such as:-
 Pediatrician or family doctor:- This is a child’s
primary healthcare provider.
 Neurologist:- This is a doctor who treats conditions of
the brain, spinal cord, and nerves.
 Rehabilitation team:- These include physical,
occupational, speech, and audiology therapists.
Preventions
 Your healthcare provider may advise genetic
counseling. You can learn more about the risk of
microcephaly in a future pregnancy.
 Parents who have 1 child with autosomal recessive
microcephaly have a 1 in 4 (25%) chance for
another child with microcephaly with each
pregnancy. For X-linked microcephaly, mothers who
are carriers have a 50% chance that a son will have
the disorder.
 Daughters have a 50% chance of inheriting the
gene and the same risk of passing it along to their
children.
Macrocephaly
Macrocephaly refers to an overly large head in infants.

However, it is often a sign of other complications or
conditions in the brain.
Causes
Sometimes there is a problem with the brain, such as
hydrocephalus or excess fluid. These underlying
conditions will require treatment.
Benign extra-axial collection is a condition where there is
a small amount of fluid in the brain. The amount of fluid
is so minor that it does not require treatment.
Other conditions that can cause macrocephaly
include:-
 Brain tumors
 Intracranial bleeding
 Chronic hematomas and other lesions
 Morquio syndrome
 Hurler syndrome
Symptoms
Some children will have benign macrocephaly. Many of
these children will experience no other symptoms aside
from a larger head circumference.

In other cases, children may experience developmental
delays. These include delays in reaching learning
milestones.
Other symptoms include:-
 mental disabilities or delays
 rapid head growth
 slowed growth of the rest of the body
 comorbidity with other conditions, including
autism or epilepsy
Macrocephaly risk factors
There are certain factors that increase the likelihood of
macrocephaly. Genetics is one factor thought to play a
part. Familial macrocephaly is an inherited condition. It’s
also thought that infants with autism have a higher
likelihood of macrocephaly. One study estimates that
macrocephaly will be evident in 15 to 35% of children
with autism.
Other risk factors include:-
 Hydrocephalus
 Alexander disease
 Canavan disease
 Neurofibromatosis

 A mother being infected with Zika virus while
pregnant
There is no evidence that macrocephaly affects children
of any particular gender, nationality, or race more often.
DIAGNOSIS
 A pediatrician can diagnose macrocephaly with an
examination of the infant’s head measurements
from birth to present.
 They may also perform neurological tests.
 These can include a CT scan, ultrasound, or MRI to
get a better look at the head and brain.
 Signs of increased pressure include vomiting,
irritability, and headaches.
 The doctor will also look for bulging veins and eye
problems.
 These symptoms will warrant further neurological
evaluation to determine the underlying problem
and its severity.

TREATMENT
Treatment for macrocephaly will depend on the
diagnosis.
If tests indicate no problems and brain scans come back
normal, the infant’s head will continue to be monitored.
During the monitoring phase, parents are advised to
watch for:-
 A bulging soft spot
 Vomiting
 Lack of interest in food
 Abnormal movements in the eyes
 Excessive sleeping
 Irritability
Reference:-
 My Self

3.Respiratory System (Pneumonia)
Pneumonia is an inflammation of the lungs caused by
bacteria, viruses, or chemical irritants.
It is a serious infection or inflammation in which the air sacs
fill with pus and other liquid.
 Lobar pneumonia:- This affects one or more sections
(lobes) of the lungs.
 Bronchial pneumonia (or bronchopneumonia):- This
affects patches throughout both lungs.
Types of pneumonia
The main types of pneumonia are:-
 Bacterial pneumonia:- This is caused by various
bacteria. The streptococcus pneumoniae is the most
common bacterium that causes bacterial pneumonia.
Many other bacteria may cause bacterial pneumonia
including:-
 Group B streptococcus
 Staphylococcus aureus
 Group A streptococcus
Bacterial pneumonia may have a quick onset and the
following symptoms may occur:-

 Productive cough
 Pain in the chest
 Vomiting or diarrhea
 Decrease in appetite
 Fatigue
 Viral pneumonia:- This is caused by various
viruses, including the following:
 Respiratory syncytial virus, or RSV (most
commonly seen in children under age 5)
 Parainfluenza virus
 Influenza virus
 Adenovirus
Early symptoms of viral pneumonia are the same as those of
bacterial pneumonia.
However, with viral pneumonia, the respiratory involvement
happens slowly. Wheezing may occur and the cough may
worsen.
Viral pneumonias may make a child susceptible to bacterial
pneumonia.
 Mycoplasma pneumonia:-
 This presents somewhat different symptoms and
physical signs than other types of pneumonia.
 They generally cause a mild, widespread pneumonia
that affects all age groups.

Symptoms usually do not start with a cold, and may include
the following:-
 Fever and cough are the first to develop
 Cough that is persistent and may last three to four
weeks
 A severe cough that may produce some mucus
Other less common pneumonias may be caused by the
inhaling of food, liquid, gases or dust, or by fungi.
Causes of Pneumonia
Germs:-
Viruses, bacteria, fungi, and parasites.
Viruses:-
Adenoviruses, rhinovirus, influenza virus
(flu), respiratory syncytial virus (RSV), and
parainfluenza virus.
Often, pneumonia begins after an upper
respiratory tract infection (an infection of the
nose and throat), with symptoms starting after 2
or 3 days of a cold or sore throat. It then moves
to the lungs. Fluid, white blood cells, and debris
start to gather in the air spaces of the lungs and
block the smooth passage of air, making it
harder for the lungs to work well.

 Kids with pneumonia caused by
bacteria usually become sick fairly quickly,
starting with a sudden high fever and
unusually fast breathing.
 Kids with pneumonia caused by
viruses probably will have symptoms that
appear more gradually and are less severe,
though wheezing can be more common.
 Some symptoms give important clues about
which germ is causing the pneumonia. For
example, in older kids and teens, pneumonia
due to Mycoplasma is very common and
causes a sore throat, headache, and rash in
addition to the usual symptoms of
pneumonia.
 In babies, pneumonia due to chlamydia may
cause conjunctivitis (pinkeye) with only mild
illness and no fever. When pneumonia is due
to whooping cough (pertussis), a child may
have long coughing spells, turn blue from
lack of air, or make the classic "whoop"
sound when trying to take a breath.
Fortunately, the pertussis vaccine can help
protect kids against whooping cough.
 The length of time between exposure to the
germ and when someone starts feeling sick
varies, depending on which virus or bacteria
is causing the pneumonia.

Symptoms of pneumonia
In addition to the symptoms listed above, all pneumonias
share the following symptoms. However, each child may
experience symptoms differently.
Symptoms may include:-
 Fever
 Chest or stomach pain
 Decrease in appetite
 Chills
 Breathing fast or hard
 Vomiting
 Headache
 Not feeling well
 Fussiness
Pneumonia symptoms in children may be different than the
signs of infection among adults.
 According to the World Health Organization
(WHO), Pneumonia claims the life of a child
every 20 seconds.
 While 99 percent of pneumonia-related
deaths occur in low- and middle-income
countries, it's still important to recognize how
the symptoms show up in children.
 Unlike adults, children who have pneumonia
may not experience a nagging cough or

fever, and may have signs of infection that
are much more subtle.
Overall, pneumonia symptoms vary according to
age, but there are a number of clues that can
help you recognize when your child has more
than a bad cold.
Mild Pneumonia in Children
 Pneumonia that is caused by certain bacteria,
including:-
Mycoplasma pneumoniae and Chlamydophila
pneumoniae.
 This type of pneumonia, known as atypical or
walking pneumonia, is prevalent among
school-age children.
 Children with walking pneumonia may not
feel sick enough to stay home, but they could
have the following symptoms:-
 Dry cough
 Low-grade fever
 Headache
 Tiredness
 Mycoplasma pneumoniae is responsible for
about 2 to 20 percent of all adult cases of
pneumonia, but the rate is even higher
among school-age children.

Moderate Pneumonia in Children
 Viruses cause most cases of pneumonia in
preschool children between ages 4 and 5.
 Affected children will usually have symptoms
that are also associated with other viruses,
such as:-
 Sore throat
 Cough
 Low-grade fever
 Nasal congestion
 Diarrhea
 Loss of appetite
 Tiredness or lack of energy
Severe Pneumonia in Children
 Bacterial pneumonia is more common among
school-age children and teens.
 These types of pneumonia often develop
more abruptly than a cold or virus and result
in more dramatic symptoms, such as:
 High fever
 Sweating or chills
 Flushed skin
 A bluish tint to the lips or nail beds

 Wheezing
 Difficulty breathing
Pneumonia in Newborns and Infants
 Newborns and infants may not show typical
signs of pneumonia infection.
 It may also be difficult to determine if
toddlers have the illness because they may
not be able to communicate how they feel as
well as an older child can.
 Still, the following symptoms can indicate
that a baby or young child may have
pneumonia:-
 Looking pale
 Being limp or lethargic
 Crying more than usual
 Feeding poorly
 Being irritable or restless
 Vomiting
Diagnosis
Diagnosis is usually made based on the season and the extent
of the illness.

May include the following tests to confirm the diagnosis:-
 Chest X-ray:-
A diagnostic test which uses invisible
electromagnetic energy beams to produce images of
internal tissues, bones, and organs onto film.
 Blood tests:-
Blood count for evidence of infection;
arterial blood gas to analyze the amount of carbon
dioxide and oxygen in the blood.
 Sputum culture:-
A diagnostic test performed on the
material that is coughed up from the lungs and into the
mouth. A sputum culture is often performed to
determine if an infection is present.
 Pulse oximetry:-
An oximeter is a small machine that
measures the amount of oxygen in the blood. To obtain
this measurement, a small sensor (like a Band-Aid) is
taped onto a finger or toe. When the machine is on, a
small red light can be seen in the sensor. The sensor is
painless and the red light does not get hot.
 Chest CT scan:-
A test that takes images of the
structures in the chest
 Bronchoscopy:-
A procedure used to look inside the
airways of the lungs

 Pleural fluid culture:-
A culture of fluid sample taken
from the pleural space (space between the lungs and
chest wall) to identify the bacteria that cause
pneumonia
Treatment for pneumonia
Specific treatment for pneumonia will be determined by your
child's doctor based on:-
 Your child's age, overall health, and medical history
 Extent of the condition
 Cause of the condition
 Your child's tolerance for specific medications,
procedures, or therapies
 Expectations for the course of the condition
 Your opinion or preference
Treatment may include antibiotics for bacterial and
mycoplasma pneumonia. There is no clearly effective
treatment for viral pneumonia, which usually resolves on its
own.
Other treatment may include:-
 Appropriate diet
 Increased fluid intake
 Cool mist humidifier in the child's room
 Acetaminophen (for fever and discomfort)
 Medication for cough

Some children may be treated in the hospital if they are
having severe breathing problems. While in the hospital,
treatment may include:-
 Intravenous (IV) or oral antibiotics
 Intravenous (IV) fluids, if your child is unable to drink
well
 Oxygen therapy
 Frequent suctioning of your child's nose and mouth (to
help get rid of thick secretions)
 Breathing treatments, as ordered by your child's doctor
Antibiotics Treatment
There are some antybiotics:-
Beta-lactam antibiotics
 Amoxicillin
 Cefuroxime
 Cefdinir
Macrolide antibiotics
 Azithromycin
 Clarithromycin
Reference:-
 My Self

4.Pancreatitis
Pancreatitis simply means inflammation of the pancreas.
Pancreatitis is a disease in which the pancreas
becomes inflamed. Pancreatic damage happens
when the digestive enzymes are activated before
they are released into the small intestine and
begin attacking the pancreas.
Types
Acute pancreatitis:-
 Acute pancreatitis is a
sudden inflammation that lasts for a short
time. It may range from mild discomfort to a
severe, life-threatening illness.
 Most people with acute pancreatitis recover
completely after getting the right treatment.
In severe cases, acute pancreatitis can result
in bleeding into the gland, serious tissue
damage, infection, and cystformation.
 Severe pancreatitis can also harm other vital
organs such as the heart, lungs, and kidneys.
Chronic pancreatitis:-
 Chronic pancreatitis is long-
lasting inflammation of the pancreas. It most
often happens after an episode of acute
pancreatitis.

 Heavy alcohol drinking is another big cause.
Damage to the pancreas from heavy alcohol
use may not cause symptoms for many years,
but then the person may suddenly develop
severe pancreatitis symptoms.
Symptoms of Pancreatitis
Signs and symptoms of pancreatitis may vary,
depending on which type you experience.
Acute pancreatitis signs and symptoms include:-
 Upper abdominal pain
 Abdominal pain that radiates to your back
 Abdominal pain that feels worse after eating
 Fever
 Rapid pulse
 Nausea
 Vomiting
 Tenderness when touching the abdomen
Chronic pancreatitis signs and symptoms include:-
 Upper abdominal pain
 Losing weight without trying
 Oily, smelly stools (steatorrhea)

Symptoms of acute pancreatitis:-
 Upper abdominal pain that radiates into the
back; it may be aggravated by eating,
especially foods high in fat.
 Swollen and tender abdomen
 Nausea and vomiting
 Fever
 Increased heart rate
Symptoms of chronic pancreatitis:
 Symptoms of chronic pancreatitis may or may not
include abdominal pain that may include
o Bleeding due to anemia,
o Liver problems (jaundice),
o Weight loss,
o Nutritional deficiencies, and
o Inability to produce insulin resulting
in diabetes.
 Diagnosis of pancreatitis (both acute and chronic)
is done similarly. Patient history will be taken,
physical exam will be performed, and various tests
may be ordered.
 Although acute pancreatitis should not be treated at
home initially, there are steps that can help prevent
or reduce symptoms.

 The major risk factors for pancreatitis are
heavy alcohol consumption and a history of
gallstones; they cause about 80%-90% of
pancreatitis; other factors such as genetics and
medications may increase an individual's risk.
Treatment
 Treatment of acute pancreatitis is done according
to the underlying cause. Most acute cases of
pancreatitis are treated in the hospital or the goal is
to relieve symptoms in support body functions so
that the pancreas can recover from the
inflammation.
 Treatment of chronic pancreatitis is often treated
with pain relieving medications, diet changes.
Some patients may require oral pancreatic
enzymes in pill form to help digest food and others
may require insulin. All patients with pancreatitis
are strongly advised to stop drinking alcohol.
 Surgical treatment of pancreatitis may be used to
remove gallstones and the gallbladder or
abnormalities in the pancreas.
 A pancreatic diet is a low-fat diet; no more than
20g/day and no alcohol but plenty of fluid and with
chronic pancreatitis flares, only clear liquids with no
foods may be recommended for 24-48 hours.
 Pancreatitis can be reduced or prevented by
stopping alcohol consumption; early intervention to

prevent complications of gallstones also may
reduce the chance of developing pancreatitis.
 About 90%-95% of patients treated for acute
pancreatitis may completely recover if the
underlying cause such as alcohol or infection is
appropriately treated.
 Some people may develop chronic pancreatitis or
die from complications such as kidney
failure, diabetes, breathing problems and/or brain
damage. The prognosis for someone with chronic
pancreatitis is less optimistic than for acute
pancreatitis.
 In most cases, the pain and nausea associated
with pancreatitis are severe enough that a person
seeks medical attention from a health-care
professional.
Any of the following symptoms warrant immediate
medical attention:-
 Inability to take medication or to drink and eat
because of nausea or vomiting
 Severe pain not relieved by nonprescription
medications
 Unexplained pain
 Difficulty breathing
 Pain accompanied by fever or chills, persistent
vomiting, feeling faint, weakness, or fatigue

 Pain accompanied by presence of other medical
conditions, including pregnancy
Causes
 Alcohol abuse and gallstones are the two main
causes of pancreatitis, accounting for 80% to 90%
of all individuals diagnosed with pancreatitis.
 Pancreatitis from alcohol use usually occurs in
individuals who have been long-term alcohol
drinkers for at least five to seven years. Most cases
of chronic pancreatitis are due to alcohol abuse.
Pancreatitis is often already chronic by the first time
the person seeks medical attention (usually for
severe pain).
The remaining 10% to 20% of cases of pancreatitis
have various causes, including the following:-
 Medications
 Exposure to certain chemicals
 Injury (trauma), as might happen in a car accident
or bad fall leading to abdominal trauma
 Hereditary disease
 Surgery and certain medical procedures
 Infections such as mumps (not common)
 Abnormalities of the pancreas or intestine
 High fat levels in the blood.
In about 15% of cases of acute pancreatitis and 40% of
cases of chronic pancreatitis, the cause is never known.

Pancreatitis caused by gallstones
 Pancreatitis is inflammation in the pancreas. The
pancreas is a long, flat gland that sits tucked behind
the stomach in the upper abdomen. The pancreas
produces enzymes that help digestion and
hormones that help regulate the way your body
processes sugar (glucose).
 Pancreatitis can occur as acute pancreatitis —
meaning it appears suddenly and lasts for days. Or
pancreatitis can occur as chronic pancreatitis, which
is pancreatitis that occurs over many years.
 Mild cases of pancreatitis may go away without
treatment, but severe cases can cause life-
threatening complications
 Pancreatitis occurs when digestive enzymes
become activated while still in the pancreas,
irritating the cells of your pancreas and causing
inflammation.
 With repeated bouts of acute pancreatitis, damage
to the pancreas can occur and lead to chronic
pancreatitis. Scar tissue may form in the pancreas,
causing loss of function. A poorly functioning
pancreas can cause digestion problems and
diabetes.
Conditions that can lead to pancreatitis include:-
 Alcoholism

 Gallstones
 Abdominal surgery
 Certain medications
 Cigarette smoking
 Cystic fibrosis
 Family history of pancreatitis
 High calcium levels in the blood (hypercalcemia),
which may be caused by an overactive parathyroid
gland (hyperparathyroidism)
 High triglyceride levels in the blood
(hypertriglyceridemia)
 Infection
 Injury to the abdomen
 Pancreatic cancer
Complications
Pancreatitis can cause serious complications,
including:-
 Pseudocyst:- Acute pancreatitis can cause fluid
and debris to collect in cyst like pockets in your
pancreas. A large pseudocyst that ruptures can
cause complications such as internal bleeding and
infection.
 Infection:- Acute pancreatitis can make your
pancreas vulnerable to bacteria and infection.
Pancreatic infections are serious and require
intensive treatment, such as surgery to remove the
infected tissue.

 Kidney failure:- Acute pancreatitis may cause
kidney failure, which can be treated with dialysis if
the kidney failure is severe and persistent.
 Breathing problems:- Acute pancreatitis can
cause chemical changes in your body that affect
your lung function, causing the level of oxygen in
your blood to fall to dangerously low levels.
 Diabetes:- Damage to insulin-producing cells in
your pancreas from chronic pancreatitis can lead to
diabetes, a disease that affects the way your body
uses blood sugar.
 Malnutrition:- Both acute and chronic pancreatitis
can cause your pancreas to produce fewer of the
enzymes that are needed to break down and
process nutrients from the food you eat. This can
lead to malnutrition, diarrhea and weight loss, even
though you may be eating the same foods or the
same amount of food.
 Pancreatic cancer:- Long-standing inflammation in
your pancreas caused by chronic pancreatitis is a
risk factor for developing pancreatic cancer.
Outlook
 Most people with acute pancreatitis recover
completely from their illness unless they develop
necrotizing pancreatitis.

 The pancreas returns to normal with no long-term
effects. Pancreatitis may return, however, if the
underlying cause is not eliminated.
 Some 5%-10% of people develop life-threatening
pancreatitis and may be left with any of these
chronic illnesses, or even die due to complications
of pancreatitis:-
 Kidney failure
 Breathing difficulties
 Diabetes
 Brain damage
 Chronic pancreatitis does not resolve completely
between attacks. Although the symptoms may be
similar to those of acute pancreatitis, chronic
pancreatitis is a much more serious condition
because damage to the pancreas is an ongoing
process. This ongoing damage can have any of the
following complications:
Reference:-
 My Self

5.Cardiovascular System
(Congenital Heart Defects)
 Congenital heart defects are problems with the
heart's structure that are present at birth.
These defects can involve:-
The interior walls of the heart
The valves inside the heart
The arteries and veins that carry blood to the heart
or the body
 Congenital heart defects change the normal flow of
blood through the heart.
 There are many types of congenital heart defects.
They range from simple defects with no symptoms to
complex defects with severe, life-threatening
symptoms.
 Congenital heart defects are the most common type
of birth defect. They affect 8 out of every 1,000
newborns. Each year, more than 35,000 babies in the
United States are born with congenital heart defects.
 Many of these defects are simple conditions. They
need no treatment or are easily fixed. Some babies
are born with complex congenital heart defects.

These defects require special medical care soon after
birth.
Types
Congenital heart disease refers to a range of possible heart
defects.
Aortic valve stenosis:-
Aortic valve stenosis is an uncommon and serious type of
congenital heart defect. It accounts for around 5% of cases of
congenital heart disease.
Coarctation of the aorta:-
Coarctation of the aorta (CoA) is where the main artery (the
aorta) has a narrowing, which means that less blood can flow
through it.
Ebstein's anomaly:-
Ebstein's anomaly is where the valve on the right side of the
heart (the tricuspid valve), which separates the right atrium
and right ventricle, doesn't develop properly. This

means blood can flow the wrong way within the heart, and the
right ventricle may be smaller and less effective than normal.
Patent ductus arteriosus:-
Patent ductus arteriosus (PDA) is a rare type of congenital
heart disease, affecting around 5 in every 100,000 babies.
Pulmonary valve stenosis:-
Pulmonary valve stenosis accounts for around 10% of cases of
Septal defects:-
A septal defect is where there's an abnormality in the wall
(septum) between the main chambers of the heart. The two
main types of septal defect are outlined below.
Atrial septal defects:-
An atrial septal defect (ASD) is where there's a hole between
the two collecting chambers of the heart (the left and right
atria). It's a common type of congenital heart defect that
affects about 2 in every 1,000 babies.
Ventricular septal defects:-

A ventricular septal defect (VSD) is also a common form of
congenital heart disease, affecting around 2 in every 1,000
babies. It occurs when there's a hole between the 2 pumping
chambers of the heart (the left and right ventricles).
Single ventricle defects:-
A single ventricle defect is where only one of the pumping
chambers (ventricles) develops properly. Without treatment,
these defects can be fatal within a few weeks of birth.
Hypoplastic left heart syndrome:-
Hypoplastic left heart syndrome (HLHS) is a rare type of
Tricuspid atresia:-
It's estimated that 10 babies in every 100,000 are affected by
tricuspid atresia.
Tetralogy of Fallot:-
Tetralogy of Fallot is a combination of several defects,
affecting about 3 in every 10,000 babies.

Truncus arteriosus:-
Truncus arteriosus is an uncommon type of congenital heart
disease, affecting around 5 in every 100,000 babies. Truncus
arteriosus is usually fatal within a year of birth, if it isn't
treated.
Causes
 Congenital heart disease is caused when something
disrupts the normal development of the heart.
 It's thought that most cases occur when
something affects the heart's development during
about week five of pregnancy. This is when the heart is
developing from a simple tube-like structure into a shape
more like a fully-formed heart.
 While some things are known to increase the risk of
congenital heart disease, no obvious cause is identified in
most cases.
 There are a number of things that can increase the
chances of a child having congenital heart disease. Some
of these are described below.

Genetic conditions:-
Several genetic health conditions that a baby inherits from one
or both parents can cause congenital heart disease. It's also
recognised that certain types of congenital heart disease run in
families.
Down's syndrome is the most widely-known genetic
condition that can cause congenital heart disease.
Children with Down's syndrome are born with a range of
disabilities as the result of a genetic abnormality.
Turner syndrome a genetic disorder that only affects
females; it's estimated that 25% of children with Turner
syndrome will be born with congenital heart disease,
which is usually a type of valve or artery narrowing
problem.
Noonan syndrome a genetic disorder that can cause a
wide range of potential symptoms; around 80% of
children with Noonan syndrome will be born with
congenital heart disease, and in about half of all cases,
this will be pulmonary stenosis.
Maternal diabetes:-
Women with diabetes are five times more likely to give birth
to a baby with congenital heart disease than women who don't
have diabetes. It's estimated that 3-6% of women with

diabetes who become pregnant will give birth to a baby with a
heart defect – most commonly, transposition of the great
arteries.
Alcohol:-
If a pregnant woman drinks too much alcohol during
pregnancy, it can have a poisonous effect on the tissue of the
fetus. This is known as fetal alcohol syndrome.
Rubella:-
Rubella (German measles) is an infectious condition caused
by a virus. It isn't usually a serious infection for adults or
children, but it can have a devastating effect on an unborn
baby if a mother develops a rubella infection during the first 8
to 10 weeks of pregnancy.
Flu:-
Women who get flu during the first trimester (three months)
of pregnancy are twice as likely to give birth to a baby with
congenital heart disease than the general population. The
reasons for this are unclear. The flu vaccine is recommended
for all pregnant women.
Medications:-
These include:-

 Certain anti-seizure medications
 Certain acne medications
 Ibuprofen
 Paracetamol
Symptoms
 Serious congenital heart defects usually become
evident soon after birth or during the first few
months of life.
Signs and symptoms could include:
 Pale gray or blue skin color (cyanosis)
 Rapid breathing
 Swelling in the legs, abdomen or areas around the
eyes
 Shortness of breath during feedings, leading to poor
weight gain
 Less serious congenital heart defects may not be
diagnosed until later in childhood, because your
child may not have any noticeable signs of a
problem. If signs and symptoms are evident in older
children.
they may include:-
 Easily becoming short of breath during exercise or
activity
 Easily tiring during exercise or activity

 Fainting during exercise or activity
 Swelling in the hands, ankles or feet
Complications
Some potential complications that can occur with a
congenital heart defect include:-
 Congestive heart failure:-
This serious complication
may develop in babies who have a significant heart
defect. Signs of congestive heart failure include rapid
breathing, often with gasping breaths, and poor
weight gain.
 Slower growth and development:-
Children with more-
serious congenital heart defects often develop and
grow more slowly than do children who don't have
heart defects. They may be smaller than other
children of the same age and, if the nervous system
has been affected, may learn to walk and talk later
than other children.
 Heart rhythm problems:-
Heart rhythm problems
(arrhythmias) can be caused by a congenital heart
defect or from scarring that forms after surgery to
correct a congenital heart defect.
 Cyanosis:-

If your child's heart
defect causes oxygen-poor blood to mix with oxygen-
rich blood in his or her heart, your child may develop
a grayish-blue skin color, a condition called cyanosis.
 Stroke:-
Although uncommon,
some children with congenital heart defects are at
increased risk of stroke due to blood clots traveling
through a hole in the heart and on to the brain.
 Emotional issues:-
Some children with
congenital heart defects may feel insecure or
develop emotional problems because of their size,
activity restrictions or learning difficulties. Talk to
your child's doctor if you're concerned about your
child's moods.
 A need for lifelong follow-up:-
Children who have
heart defects should be mindful of their heart
problems their entire lives, as their defect could lead
to an increased risk of heart tissue infection
(endocarditis), heart failure or heart valve problems.
Most children with congenital heart defects will need
to be seen regularly by a cardiologist throughout life.

Treatment
Treatment for congenital heart disease depends on the specific
defect you or your child has.
 Mild heart defects don't usually need to be treated,
although it's likely that you'll have regular check-ups to
monitor your health.
 More severe heart defects usually require surgery and
long-term monitoring of the heart throughout adult life
by a congenital heart disease specialist.
 In some cases, medications may be used to relieve
symptoms or stabilise the condition before and/or after
surgery.
 These may include diuretics to remove fluid from the
body and make breathing easier, and digoxin to slow
down the heartbeat and increase the strength at which the
heart pumps.
Prevention
As so little is known about the causes of congenital heart
disease, there's no guaranteed way of avoiding having a baby
with the condition.

However, if you're pregnant, the following advice can help
reduce the risk:-
 Ensure you are vaccinated against rubella and flu.
 Avoid drinking alcohol or taking drugs.
 Take 400 micrograms of folic acid supplement a day
during the first trimester (first 12 weeks) of your
pregnancy – this lowers your risk of giving birth to a
child with congenital heart disease, as well as several
other types of birth defect.
 Check with your GP or pharmacist before you take any
medication during pregnancy, including herbal remedies
and medication that's available over the counter.
 Avoid contact with people who are known to have an
infection.
 If you have diabetes, make sure it's controlled.
 Avoid exposure to organic solvents, such as those used in
dry cleaning, paint thinners and nail polish remover.
 If you have congenital heart disease and become
pregnant, your congenital heart specialist will usually
arrange an echocardiogram (heart scan) for your baby
approximately 20 weeks into your pregnancy. This is to
check whether your baby has any evidence of congenital
heart disease. This scan will be in addition to your
usual antenatal ultrasound scans.

Reference:-
 My Self

Malnutrition, microcephaly & macrocephly, respiratory system (pneumonia), pancreatitis, cardiovascular system (congenital heart defects)

Recommandé

Recommandé

Contenu connexe

Tendances

Tendances (20)

Similaire à Malnutrition, microcephaly & macrocephly, respiratory system (pneumonia), pancreatitis, cardiovascular system (congenital heart defects)

Similaire à Malnutrition, microcephaly & macrocephly, respiratory system (pneumonia), pancreatitis, cardiovascular system (congenital heart defects) (20)

Plus de VIKRAM SINGH PANIHARIYA

Plus de VIKRAM SINGH PANIHARIYA (20)

Dernier

Dernier (20)