Complications of

P.E.M
Hypoglycemia
Hypothermia
Hypokalemia
Hyponatremia
Heart failure
Dehydration & shock
Infections (bacterial, viral & thrush)
Vitamin A deficiency:

( Hemeralopia / Nyctalopia)
Commonly called the Night blindness, Rabun senja. Beginning
of stem cell disorders of the retina, which is difficult to adapt
after the light, this is clearly seen when the late afternoon,
Xerosis conjunctivae
When night blindness keeps going and very low consumption
of vitamin A did not even exist in the daily diet, then the next
stage will be the white part of the eye will be dry, dull, no shine
Corneal opacities
Eye problems that can lead to scarring or clouding of the cornea
Birth Defects

Iodine Deficiency
Physical & Mental Retardation,
Stunted Growth
Deafness
Fatigue
Weight Gain
Enlarged Thyroid

Prognosis
Protein Enegry Malnutrition
Up to 10% of a person's body weight can be
lost without side effects, but if more than
40% is lost, the situation is almost always
fatal. Death usually results from heat
failure, electrolyte imbalance, or low body
temperature. Patients with
semiconsciousness, persistent
diarrhea, jaundice, or low blood sodium
levels have a poorer prognosis.

Some children with protein-energy malnutrition
recover completely. Others have many health problems
throughout life, including mental retardation and the
inability to absorb nutrients through the intestinal
tract. Prognosis for all patients with malnutrition
seems to be dependent on the age of the patient, and
the length and severity of the malnutrition, with young
children and the elderly having the highest rate of long-
term complications and death.
Kwash & Marasmus-Kwash have greater risk of
morbidity & mortality compared to Marasmus and
under weight
Early detection & adequate treatment are associated
with good outcome
Late ill-effects on IQ, behavior & cognitive functions
are doubtful and not proven
Deficiency Vitamin A
20-40% of the entire cause of blindness. The risk of
blindness increases when accompanied by severe PEM
or morbilli.
Deficiency Iodine
Poor prognosis in late-treated cases has long been
known, especially IQ deficits. Conversely patients treated
with thyroid hormone before the age of 3 months, can
achieve near-normal growth and IQ. Therefore, early
diagnosis is important, but difficult to enforce because it
is often clinically in infants appear normal at birth, even
if it shows symptoms are very vague and non-specific.
The typical symptoms of hypothyroidism usually obvious
when a baby a few months old, but at this time the
diagnosis too late


MEDICAL REFERRAL
P.E.M with complication (Heart failure
,Infections bacterial, viral & thrush)
Vitamin A deficiency is more often treated by
concomitant disease indications