Original Research Article DOI: 10.18231/2455-6793.2017.0003 International Journal of Medical Pediatrics and Oncology, January-March, 2017:3(1):6-9 6 Spectrum of co-morbidities in severe acute malnutrition with unexpected dyselectrolytemia in diarrhea Hari S. Meshram 1,* , S. Manazir Ali 2 , T. Shehab 3 1 Junior Resident, 2,3 Professor, Dept. of Pediatrics, JNMCH, AMU, Aligarh *Corresponding Author: Email: harishankarmediram11@gmail.com Abstract Background: Co-morbidities are the reason behind high morbidity and mortality in SAM children. There is lack of literature regarding co morbidity pattern in SAM children. Objective: To study the co morbidities in severe acute malnourishment children admitted in NRC. Methods: SAM was diagnosed as per WHO protocol. Total of 299 SAM children were included. Co-morbidities were identified and were investigated further and managed accordingly. Results: 90% SAM children had anaemia.61% had diarrhea and 30% had pneumonia, Vitamin D deficiency features were found in 30% cases. 10% had UTI & 10% Otitis Media. Tuberculosis was diagnosed in 13% of cases. Celiac disease, Hypothyroidism and HIV were not found to be major co morbid conditions. Conclusions: Co-morbidities identification and treatment in SAM children is key step in reducing morbidity and mortality associated with SAM. Keywords: Co-morbidities, NRC, Severe Acute Malnutrition, Hypothyroidism, Celiac disease, Diarrhea, HIV Introduction Severe Acute malnutrition is a major challenge to achieve the millennium development goals. (1) A recent assessment showed that efforts to prevent child deaths need to be stepped up in order to meet that target. (2) One of the most daunting task in the field of nutrition and child health is how to reduce morbidity and mortality associated with severe acute malnutrition. (3,4) According to National Family Health Survey-III in India 6.4% of children below 60 months of age were suffering from severe acute malnutrition. With the current estimated total population of India as 1100 million, it is expected that about 8.1 million are likely to be suffering from SAM. There is a lack of data on co-morbidities found to be associated with severe malnutrition. We are presenting a description of co-morbid findings in children admitted to a Nutritional Rehabilitation Centre in Northern India. Materials & Methods Study design: This was a hospital-based observational study. Setting: The study was conducted in Nutritional Rehabilitation Centre of Department of Pediatrics, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh Study subject: Children aged 1 to 60 months, admitted in Nutritional Rehabilitation Centre of Department of Paediatrics, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh Study Period: Study was conducted from January 2013 to October 2014. Ethical considerations: Study was approved by Ethical committee of JNMCH, AMU, Aligarh. Study Procedure: Complete history and systemic examination were. Various co morbid conditions in study population were identified and managed accordingly. Laboratory examination were done.  Hemoglobin by Lab Life 3D hematological autoanalyzer & anaemia was defined as per WHO guidelines.  Total leucocyte count by Lab Life 3D hematological autoanalyzer.  TLC < 4,000 cells as leucopenia & TLC > 16,000 was taken as leucocytosis.  Random Blood glucose by Accu-Check® Active (Roche Diagnostics GmbH 68298 Mannheim, Germany).  < 54 mg% was taken hypoglycemia  Hyperglycemia cut off of > 120 mg/dl was taken  Urea with values >40 mmol/l as deranged & creatinine with values >0.90 as deranged  Serum sodium of < 135mEq/l & >145 as hyponatremia, & hypernatremia respectively  Serum potassium <3.5 as hypokalemia & > 5.5 as hyperkalemia respectively was taken in our study.  HIV ELISA for  Mantoux test in which > 10mm was taken as positive  CX Ray was done.  Urine microscopy & culture done for diagnosing urinary tract infections  ttG & TSH done in suspected cases with clinical symptoms and history suggestive of Celiac Disease & hypothyroidism respectively  Ear swab culture was done in SAM children with ear discharge.