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NUTRITIONAL STATUS IN
ADOLESCENTS WITH EPILEPSY
Presented
by
V.SWAPNA
Co-authors:
Drs. K.A. Parvathy, C.V.Harinarayan, B. Vengamma, Bindu Menon,
U.V. Prasad,G. Hima Bindu
AIM
To evaluate
The anthropometric measurements
Dietary
parameters and
Biochemical
Metabolism
markers of Bone Mineral
NEED FOR THE STUDY
Adolescence, a period of transition, occupies
a crucial position in the life of human beings.
Under-nutrition reduces growth rate, learning
and working capacity amongst adolescents.
Epilepsy is the most serious common
neurological disorder.
Epilepsy treatment leads to nutritional
deficiencies, especially vitamin D3
Metabolism.
AED INTERFER WITH 25 OHase
AT THE LIVER AND LOWERS THE
FORAMTION OF1,25(OH)2 D3.
Low 25(OH)D levels leads to low
1,25(OHD)D levels.
Hence the absorption of calcium
from the gut is retarded.
MATERIALS AND METHODS
n= 64
Anthropometry Ht, Wt, BMI, Arm span, U.S, L.S
Skin fold thickness –
Triceps, Biceps, S.Scapular, Suprailliac.
Dietary Intake –
Calories, protein, fat, Ca, Phos, Phy/Ca ratio
Biochemical parameters –
Serum Albumin, Ca, Phos, SAP, Creatinine,
25(OH)D, ntact PTH.
STATISTICAL ANALYSIS
The results presented as Mean ± SD
Correlation co-efficient (Pearson's) - Value
P<0.05 taken as significant.
Statistical package used SPSS software
(version 10.0).
DIETARY INTAKE PER DAY
NUTRIENTS
MEAN ± SD
Energy(K.cal)
2059±150
D.Calcium(mg)
297±33
D.Phosphorous(mg)
574±84
D.Protein(gm)
36±7
D.Fat(gm)
18±2
Phy/Cal
0.6±0.08
BIOCHEMICAL VALUES
PARAMETERS
MEAN ± SD
S.Albumin (3.0-5.5gm/dl)
4±0.34
S.Calcium (8-10.5mg/dl)
10±0.
S.Phoshorous(2.7-4.5 mg/dl) 4±0.8
SAP (140 IU/l)
95±59
S.Creatinine (<1.6 mg/dl)
0.79±0.19
25(OH)D (>20 ng/ml)
16.59±10.4
PTH (13-54pg/ml)
21.57±11.3
Distribution of Vit D levels in the Study
Sample
20%
35%
<10ng/ml
10-20ng/ml
>20ng/ml
45%
Duration of Drugs used by study
samples
7%
<5y
36%
5-10y
57%
>10y
Percent of sample using each Drug
70%
60%
64%
50%
50%
43%
40%
30%
20%
10%
0%
% of Pop
Phy
CBZ
PB
*SINCE TREATMENT INCLUDES MORE THAN ONE DRUG, THE
PERCENTAGE WILL EXCEED HUNDRED.
DISCUSSION
AED’s
can lower the uptake of calcium,
worsening the bone health.
Inadequate
intake of calcium can lead to a
decreased amount of bone calcium
reserves.
Adolescent
epileptic girls in the rural areas
could be greater risk of nutritional stress.
LIMITATIONS OF THE STUDY
The
socio-economic aspects have not
been dealt
Micro study
The data was collected from only SVIMS,
Tirupati.
Data from other hospitals and clinics were
not collected.
The epilepsy patients approaching SVIMS
for treatment mostly belong to lower socioeconomic strata.
Strategies
Awareness
Dietary
Intake
Supplements
Life Skills Education
Primary Care
Social Stigma
CONCLUSION
Hypo
Vitaminosis-D and low dietary calcium
intake adversely affect the bone mineral
homeostasis in adolescents with epilepsy.
There
is a need to treat epilepsy through
proper diet & nutrition and reducing the
intake of medicines over a period of time
CONCLUSION
Epileptic
adolescents to be supplemented
with dietary calcium and vitamin-D
Health
educators have to be trained to deal
with adolescent girls with epilepsy as they
are vulnerable for social evils like early
marriage
Than Q