الفهرس 
Protein energy malnutrition
Management of severe PEMOnly 14 pages are availabe for public view
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Abstract
Protein energy malnutrition (PEM) is a pathological state resulting from insufficient intake of energy and other nutrients. Malnutrition remains one of the most common causes of morbidity and mortality among infants and children throughout out world. (UNICEF, 1999) estimated that 31% of children under 5 years in developing countries are underweight, 38% are stunted and 11% wasted. In least developed countries, 40% of children are underweight and 47% are stunted. Ghrelin, a recently discovered peptide hormone that is structurally related to motilin, is produced mainly by the stomach. Circulating ghrelin concentrations increase during fasting, are reduced by the presence of nutrients in the stomach, and are lower in obese versus lean human subjects. In contrast to the anorexigenic effects of other GI peptide hormones, peripheral or central administration of ghrelin increases food intake in rodents, whereas administration of antibodies against ghrelin inhibits feeding. In humans, circulating ghrelin levels are decreased in chronic (obesity) and acute (caloric intake) states of positive energy balance, whereas plasma levels of ghrelin are increased by fasting and in cachectic patients with anorexia nervosa.
The present study was conducted on 30 infants suffering from PEM. They were 19 males and 11 females with ages ranged between 5-20 months with a mean age of 13.17 + 2.21. They were recruited from the inpatient department and the nutrition clinic of Pediatric Hospital, Ain Shams University.The patients were classified into three groups according to the classification suggested by (Gernaat and Voorhoeve, 2000), marasus, KWO, and marasmic.KWO.
All studied infants were subjected to full history talking, clinical examination and laboratory investigations including measuring plasma ghrelin concentration by using radio immuno assay technique.
This study aimed at measuring serum ghrelin levels in patients with PEM and correlate these levels to different dietetic and feeding patterns of these patients, to identify whether there is a relation between this and PEM.