To Study Ph Disorders in Severe Acute Malnutrition

Abstract

OBJECTIVE:To study pH disorders in severe acute malnutrition. DESIGN: A prospective, cohort, observational study. SETTING: Severe malnutrition treatment unit in a tertiary level care hospital in central India. PARTICIPANTS: 202 children between 6 to 60 months of age. METHODOLOGY: Radial artery sample was taken at admission which was analyzed by automated blood gas analyzer; results were studied and correlated with nutritional status at discharge/outcome. STATISTICAL ANALYSIS: The data were analyzed using SPSS 20. Univariate and bivariate analysis of data was done using the Student t test and two-tailed Fisher exact or chi-square test. RESULTS: Out of 202 children studied 51.5% were males and 48.5% were females, 16.8% children had pH <7.35, 43.6% had pH between 7.35 to 7.45 and 39.6% had pH >7.45. The mean values of pH, HCO3 -, PCO2, PO2 and Cl -were 7.42, 17.1mmol/l, 25.22 mmHg, 93.71mmHg and 109.05mmol/l respectively. Most children (n = 173/202; 85.6%) were discharged, 11(5.4 %) expired and 18 patients left the treatment. In pH < 7.35 group, mortality rate was highest (P value < 0.00001). Rate of weight gain in all groups were comparable and duration of stay was 16½ days in normal pH group and was 19 days in pH < 7.35 and 17 ½ days in pH > 7.46 group. CONCLUSION: In this study, metabolic acidosis with hyperchloremia was associated with poor outcome. There is no significant change in the duration of hospital stay and rate of weight gain in any pH group. KEYWORDS: pH, severe acute malnutrition, metabolic acidosis INTRODUCTION:Severe acute malnutrition is a metabolic disorder, characterized by profound disturbance of water, electrolytes, minerals, protein, fat, carbohydrates and energy metabolism, along with disturbances in function and composition of almost all tissues of the body. Nutrition has long been known to strongly influence acid-base balance. Malnutrition is a state of catabolism and severe malnutrition is a state of severe catabolism. In a healthy body homeostasis is maintained mainly by kidney, lungs, minerals and body fluids, and it is altered in malnutrition.The present work is an attempt to study the prevalence of acid base disorder in severe acute malnutrition and its effect on outcome. Few studies have demonstrated the acid base disturbances in SAM children with associated diarrhea and pneumonia but their main focus was the underlying comorbidities rather than SAM. 1, 2, 3 The present study was conducted to evaluate prevalence of acid base disturbance in all SAM children irrespective of underlying etiology.

pH 7.35 to 7.45– Mathematical Reasoning of Treatment Principle Based on Yin Yang Wu Xing Theory in Traditional Chinese Medicine (II)

“…which is called Yin Yang Wu Xing model, denoted by 5 V . The Yin Yang Wu Xing model can be written as follows: Define…”

“…Because the real disease is according to the order of light to heavy, the real disease is the disease type which is heavier. It has three types, so start from (3), (4) to (5). The cases (1) and (2) are for the disease of the real-normal situation.…”

“…Almost always, when there is disease, the condition of the blood pH value is a Yin condition, little is a Yang condition. There are a lot of evidences (e.g., experimental identification for probability and real applications) to support this viewpoint, such as, Shirakabe et al [1], Kaur et al [2], Aly et al [3], Intven et al [4], Patel et al [5], Handman et al [6], Natalia et al [7], Barfod et al [8], Zhu et al [9], Zhu et al [10], Robert et al [11], Mona et al [12], Saritas et al [13], Stevens et al [14], and so on.…”

Acupuncture Treating Dystrophy Based on pH &lt;br/&gt;—Mathematical Reasoning of Treatment Principle Based on Yin Yang Wu Xing Theory in Traditional Chinese Medicine (III)

“…In the twelve earthly branches, other names of them are corresponding to the human body's organs respectively: Foot jueyin liver meridian (0,(23)), Foot shaoyang gallladder meridian (0,e), Hand jueyin pericardium meridian (1,(23)), Hand shaoyang triple energizer meridian (1,e), Foot taiyin spleen meridian (0,(132) ), Foot yangming stomach meridian (0,(12)), Hand taiyin lung meridian (1,(132)), Hand yangming large intestine meridian (1,(12)), Foot shaoyin kidney meridian (0,(123)), Foot taiyang bladder meridian (0,(13)), Hand shaoyin heart meridian (1,(123)), Hand taiyang small intestine meridian (1,(13) The laws of the Jingluo system or the twelve Earthly Branches model are summarized in Figure 3.# In TCM, the Zangxiang and Jingluo models are not the anatomy systems as the first physiological system corresponding to their steady multilateral systems, are only them the mathematical logic models. If there are the Yin Yang Wu Xing model 5 V , the Telluric effluvium model 6 V and the Tao model 2 V , then the V V × must be existed in logic. So they form a parasitic system of the Yin Yang Wu Xing system 5 V , namely the second physiological system of the steady multilateral systems…”

“…There are a lot of evidences (e.g., experimental identification for probability and real applications) to support this viewpoint, such as, Shirakabe et al [1], Kaur et al [2], Aly et al [3], Intven et al [4], Patel et al [5], Handman et al [6], Natalia et al [7], Barfod et al [8], Zhu et al [9], Zhu et al [10], Robert et al [11], Mona et al [12], Saritas et al [13], Stevens et al [14], and so on.…”