A study to assess the impact of medical nutrition therapy compared to standard nutrition therapy in children with severe thinness in the age group of 5 to 10 years.

Aim: The aim of our study was to study and compare the impact and efficacy of medical nutrition therapy (MNT) with that of the standard nutrition therapy(SNT) in children diagnosed with Severe thiness in the age group of 5-10 years and diagnosed as severely thin. Study Design: It was a prospective comparative study, conducted over a period of 18 months at the Nutrition Rehabilitation, Research and Training Centre (NRRTC) associated with a tertiary care hospital in India. Methods and Materials: A total of 113 children in the age group of 5 to 10 years with severe thinness were enrolled and divided into 2 groups-58 were placed in the MNT group and 55 in the SNT group for a period of 8 weeks. The children in both groups received MNT and SNT diet over the said period of 8 weeks. Primary outcome variables were weight gain and body mass index (BMI) (i.e., change in nutritional status). Results: At the end of 8 weeks, the rate of weight gain (gm/kg/day) was significantly greater in the MNT group, that is, 2.35 gm/kg/day as compared with the SNT group, that is, 0.73 gm/kg/day, and the change in nutritional status was significantly better in the MNT group (p < 0.001) with 62.1% achieving normal nutritional status, 32.8% remaining thin, and 5.2% remaining severely thin as compared to the SNT group in which 9.1% achieved normal nutritional status, 65.5% remained thin, and 25.5% remained severely thin. Conclusion: To conclude, MNT is superior to SNT for the treatment of severe thinness (ST).

Indigenously Prepared Ready-to-use Therapeutic Food (RUTF) in Children with Severe Acute Malnutrition.

OBJECTIVE: To compare efficacy of indigenous Ready-to-use Therapeutic Food (Medical Nutrition Therapy) with Standard Nutrition Therapy in children with Severe acute malnutrition. DESIGN: Two facility-based and two community-based models: (i) Open prospective randomized controlled trial comparing Indigenous Ready-to-use Therapeutic Food (Medical Nutrition Therapy) with Standard Nutrition Therapy; (ii) Only Indigenous Ready-to-use Therapeutic Food (Medical Nutrition Therapy); (iii) Doorstep Child Care Centre; and (iv) Community-based Management of Acute Malnutrition. SETTING: (i) Urban Health Center, Dharavi, Mumbai; (ii) Two day care centers of Non-governmental Organization SNEHA - Mumbai; (iii) Urban slums, M East and L Ward, Mumbai. PARTICIPANTS: 1105 children aged 6-60 months in community or hospital inpatient/ outpatient department diagnosed as Severe Acute Malnutrition by WHO definition. INTERVENTION: All subjects received either Indigenous Ready-to-use Therapeutic Food (Medical Nutrition Therapy) or Standard Nutrition Therapy (protein calorie rich diet) for eight weeks and followed up for next four months. MAIN OUTCOME MEASURES: Mean rate of weight gain (g/kg/day), target weight, change in nutritional status. RESULTS: Rate of weight gain was higher (P<0.05) at 2 weeks on indigenous Ready-to-use Therapeutic Food (Medical Nutrition Therapy) (5.63 g/kg/day) as compared to Standard Nutrition Therapy (3.43 g/kg/day). 61.2% subjects achieved target weight compared to 47.7% controls. At 8 weeks, 82.8% subjects recovered from Severe Acute Malnutrition compared to 19.3% controls (P<0.005). The results obtained in community were comparable to facility-based indigenous Ready-to-use Therapeutic Food (Medical Nutrition Therapy). The morbidity was less in study group at follow-up. CONCLUSIONS: Indigenous Ready-to-use Therapeutic Food (Medical Nutrition Therapy) appeared to be superior to Standard Nutrition Therapy in promoting weight gain in children with Severe Acute Malnutrition.

Neurocysticercosis-induced hemiballismus in a child.

Neurocysticercosis lesions can occur in the basal ganglia, but most of these are clinically silent. Neurocysticercosis manifesting as movement disorders is extremely uncommon. The authors report a case of neurocysticercosis in an 11-year-old girl presenting with right hemiballismus (a clinical manifestation not yet reported). Magnetic resonance imaging of the brain confirmed the solitary neurocysticercosis lesion in the left thalamus. The child was symptomatic for 5 years and improved dramatically within 2 days of starting definitive therapy for neurocysticercosis (albendazole and prednisolone).