Naupang chu nitin a hring chhuak tih hriat theihin a lo thang chho zel em? Chu chu Marasmus tia koh dinhmun hlauhawm tak a ni thei!

A châng chuan naupang tê tê emaw, puitling emaw chu ni tin, a danglam bîk takin an lo hring a, an ruhte a lang chhuak thei khawpa chak lo an lo awm ṭhin tih i hre ngai em? "Aw, an ei tha lo a ni ngei ang," tiin kan ngaihtuah mai thei. Mahse, hei hi a pawi zawk thei hle. Chu chu tunlaia kan sawi tur ei leh in lama harsatna nasa tak chi khat, Marasmus tia koh chu a ni. Fuel engmah tel lova motor tlan chawlhsan ang mai a ni.

Marasmus chu eng nge ni?

A awlsam zawngin, Marasmus hi ei leh in lama harsatna nasa tak a ni . A bik takin, protein-energy undernutrition a ni . Chu chu, he dinhmun hi kan taksain nitin a hnathawh leh thanlenna atana a mamawh nutrient lian pathum – carbohydrates, fats, leh proteins te chu a tlakchham nghal a nih chuan a lo awm thin tihna a ni. Ngaihtuah teh, kan taksain gasoline emaw diesel emaw ang chi a hmuh loh chuan eng nge thleng? Chutiang chu a ni. Chuvang chuan taksain thil tih dan pangngai vawng reng tura a mamawh chakna a hloh ta a ni. Marasmus vei i hmuh chuan a chak lo, a chak lo va, an taksaa sa chu a lo hmin vek tawh mai mai tih i hmu thei. Naupang tê tê tan chuan an ṭhanlenna chu a tlahniam vek thei a ni . Hetiang dinhmun hi a awm chhunzawm zel chuan riltam atanga thihna thlengin a kal thei .

Marasmus leh Kwashiorkor te hi eng nge an danglamna?

Malnutrition chungchang sawi hian Kwashiorkor tih hming pawh i hre tawh mai thei. An pahnih hian protein-energy malnutrition na tak an ni. Mahse, an pahnih inkarah hian danglamna tlem a awm.

• Marasmus: Kan sawi tawh ang khan hei hi ei tur lian ber ber (carbohydrates, thau, leh protein) zawng zawng tihtlem nana dinhmun a ni. Chumi awmzia chu calorie intake zawng zawng a tlahniam tihna a ni. Marasmus vei chu a hring, a hring, leh a vawt angin a lang fo .
• Kwashiorkor: Hei hi protein tlakchham vang a ni ber . Carbohydrates (chhang, buhfai, buhfai) an ei thei a, mahse protein tamna ei tur (sangha, sa, artui, lentils) an ei thei lo. Kwashiorkor ziarang pakhat chu edema a ni a, chu chu tui awm vanga taksa a hring chhuak a ni. A bik takin pum leh hmai hi a na hle.

Chuvangin, marasmus-ah chuan taksa a thim a, kwashiorkor-ah erawh chuan taksa chu a hring niin a lang thei thung. An pahnih hian hlauhawm tak an ni a, mahse an lo awm dan leh a lan chhuah dan erawh a inang lo deuh.

Marasmus hian tute nge a nghawng ber?

Hetianga marasmus natna hian tu pawh a nghawng thei a, chu chu a tlangpuiin ei leh in lama harsatna nei apiang a nghawng thei a ni. Amaherawhchu, naupang tê tê, a bikin nausen-ah a tam hle a, a chhan chu an taksa a thang chak em em a, calorie tam zawk an mamawh a ni.

Hetiang dinhmun hi hmuh tur a tam berRam changkang zawkah te, retheihna leh ei tur tlakchhamna hluarna hmunah te. Tin, parasite leh natna hrik kai chi hrang hrangte hian taksa chakna a tihchhiat avangin he dinhmun hi a thlen thei bawk. Sri Lanka ram hmun thenkhatah chuan sum leh pai lama harsatna avanga ei leh in inthlau thei lo chhungkua an awm a. Chutiang mite chu an hlauhawm zawk a ni.

Ram changkang zawkah pawh, he hlauhawmna hi nursing home emaw, damdawi in emawa awm tarte tan emaw, mahni chauha awm leh ṭanpuina tlemte nei tarte tan emaw a awm a ni .

Marasmus dinhmunah hian taksa chu eng nge thleng?

Taksain chaw atanga chakna a riltam chuan taksain thil mak tak (mahse hlauhawm tak) a ti thin. Energy a hmuh theih nan a tissue ngei pawh a ti chhe tan thin. A chhe hmasa ber chu thau tissue (oil kan ti) a ni. Tichuan taksa ruhte chu a chhe tan ta a ni.

Chu mai ni lovin, taksain chakna humhalh nan a thiltih thenkhat chu zawi zawiin a tihtlem phah a ni.

• Cardiac activity a tlahniam. Chumi awmzia chu heart rate a tlahniam a, thisen sang a tlahniam a, taksa lumna a tlahniam tihna a ni. A then phei chuan hei hian thinlung lam a tichhe thei hial a ni.
• Immune system a chak lo hle. Chuvang chuan ei leh in lama harsatna nei te chu awlsam takin natna chi hrang hrang an kai thei a, an damloh chuan an dam leh theih nan hun rei zawk a ngai a ni.
• Naupang tê tête ṭhanlenna leh ṭhanlenna chu a tlahniam vek a ni. An stuntted a, intellectual disabilities an nei thei bawk. Enkawlna hmang pawhin heng nghawngte hi a chang chuan dam chhung zawng a daih thei.
• Digestive system hmun thenkhat chu hman dik loh vangin a tlahniam tan thin. Hei hi a hlauhawmna chu ei thei mah la, chu chaw atanga nutrients te chu i la tha thei lo mai thei. Mak tak maiin, marasmus hian a châng chuan ei duhna a tichhe thei a ni .

Marasmus natna thlentu berte chu engte nge ni?

Hei hi chhan hrang hrang a awm a. Age group hrang hrangin i then darh ang u.

Mi zawng zawng nghawng thei chhan tlangpui:

• Retheihna leh ei tur tlakchhamna: Hei hi a chhan ber a ni. Chaw tha tak tak hmuh theihna tur economic power tlakchhamna.
• Taksa tichhe thei natna: Entirnan, `(AIDS)` ang chi natna.
• Hun rei tak chhunga ril\am thlentu natna hrik: Hei hian taksain ei tur tha a lakluh a ti harsa hle.
• Ei leh in lama harsatna, anorexia: Chaw ei duh lohna emaw, ei leh in lama thunun theih lohna emaw avanga lo awm.

Naupangte nghawng bik chhan:

• Nausen piang tharte hnute tui ei tlem emaw, nau hnute pek an chawlhsan hma lutuk emaw: Nausen thla hmasa lamah chuan nutrition tha ber a ni.
• Naupang ngaihsak loh emaw, tihduhdah emaw: Naupangte pawh chutiang chhan lungchhiatthlak tak avangin ei leh in lama harsatna an tawk thei bawk.

Puitlingte nghawng thei thil: 1.1.

• Dementia ang chi theihnghilh natna: 1.1.Heng natna vei te hian an ei leh in pawh an hre lo mai thei.
• Tarte ngaihsak loh emaw, tihduhdah emaw: Kum upa lam, mahni inenkawl thei lote chu an hlauhawm hle.

Marasmus pawn lam chhinchhiahnate chu engte nge ni?

Hetiang natna vei kan hmuh hian kan hriat theih tur chhinchhiahna engemaw zat a awm a:

• A taksaa thau leh sa chu a lo hmin vek tawh mai a, a hmel a tha hle bawk.
• Ruhte chu chiang takin a lang.
• Taksa nena khaikhin chuan lu hi a lianin a lang thei.
• Hmai chu kum upa tawh leh hrual ang maiin a lang thei.
• Vun a vawt thei a, a sag thei bawk. Hei hi skin atrophy an ti a.
• Sam chu a vawt a, a hring a, a tla pawh a chhuak thei bawk.
• Naute lu chunglam (fontanelles) hmun nem tak takte chu a pil lut tawh mai thei.
• Chauhna, ngaihven lohna leh chak lohna te.
• Taksa rihna 40% aia tam hloh.
• Having a Body Mass Index (BMI) of less than 16. (BMI hi i san zawng nena inmil tura i taksa rihna hrisel tak i neih leh neih loh tehna a ni a, mahse chu chu a bulpui ber a ni lo.)

Marasmus vang hian eng symptom leh complication dang nge lo awm thei?

Pawn lam atanga a lan chhuah bakah hian chhungril lamah pawh harsatna tam tak a awm thei bawk:

• Dehydration: Taksa chhunga tui tlakchhamna.
• Electrolyte imbalances: Electrolyte hi kan taksaa tui balance leh nerve function ang chi thil atana pawimawh, salt ang chi thil a ni. Chûngte chu a tam lutuk emaw, a tlem lutuk emaw chuan a hlauhawm thei a ni.
• Thisen sang hniam.
• Heart rate a tlahniam.
• Taksa lumna tlahniam.
• Gastrointestinal-a ei leh in lama harsatna (malabsorption) a awm.
• Growth tihkhawtlai a ni.
• Hmasawnna lama tlai lutuk.
• Anemia: Taksaah thisen tlakchhamna.
• Ruh chak lohna natna (Puitlingah Osteomalacia, Naupangah Rickets).

Marasmus hi engtin nge kan hriat theih ang?

Doctor ten an tih hmasak ber chu damlo uluk taka enfiah hi a ni. Marasmus natna lan chhuah dan thenkhat a awm a, a bulpui ber chu taksaa thau leh sa te chu mit hmuh theih chinah a lo hmin tawh a ni. Heng mite hi an chak lo hle a, ruhro ang maiin an lang. Vun hnuaia thau leh thau awmte a bo avangin vun chu a hring leh a hring (wrinkled and saggy) angin a lang thei.

A lan dan bakah hian doctor-te chuan damlo san zawng, a rih zawng, leh a kut chunglam vel te pawh an en ang.A tehna a ni. Mi pakhatin a kum leh a san zawng nena inmil rit a neih leh neih loh hriat nan standardized table hrang hrang hman a ni. Marasmus hi heng table-a normal range aia hniam zawka tla a ni. Entirnan, mi tam zawkin an hriat body mass index (BMI) chu 16 aia tlem a ni a, heng tehnate hi a natna hriat chian nan leh natna nasat dan tehna atan hman a ni.

Marasmus hmuhchhuah nan hian eng test nge hman thin?

Diagnosis hi taksa tehna atanga chhut a ni ber. Malnutrition nasat dan hi upper arm circumference leh weight for height ang chi thil hmanga teh a ni. Naupangteah chuan an kum a zirin an san zawng enin an than chakna a tlai tih hriat theih a ni. Doctor-te chuan taksa pianphung chauh a\angin marasmus hi an hre chhuak tlangpui.

A dawt leh tur chu thisen test a ni. Hei hian marasmus-in secondary effects, vitamin, mineral, enzyme leh electrolyte tlakchhamna bikte hriat theihna kawngah a pui thei a ni. He information hian refeeding laiin eng nge pek tur tih hriat theih nan a pui thei a ni. Thisen chhiar kim chuan marasmus thlentu emaw, a thlentu emaw infection a awm leh awm loh a enfiah thei bawk. Stool sample pawh parasite awm leh awm loh test theih a ni bawk. Infection a awm chuan a hranin enkawl tur a ni.

Marasmus hi engtin nge kan enkawl ang? (Hei hi a pawimawh hle mai!)

Marasmus enkawlnaah hian fimkhur hle tur thil pakhat a awm. Chu chu nunna atana hlauhawm thei complication "refeeding syndrome" an tih a ni. Hei hi ei leh in lama harsatna nasa tak nei taksa chu vawi khata ei tur tam lutuk pek a nih chuan a lo awm thin a, a chhan chu taksain a thiam loh vang a ni. Hun rei tak chhunga hnathawk tawh machine pakhat chu phurrit rit tak pek nghal a nih chuan thil thleng ang hian han ngaihtuah teh.

Chuvangin, marasmus vei enkawl nan hian step engemaw zat a ngai a, fimkhur takin. Hetiang enkawlna hi damdawi inah tih a tha ber a, doctor leh nurse te uluk taka enkawl a ni. Refeeding syndrome lama training nei medical staff te chuan a lo awm loh nan an veng thei a, a lo awm a nih chuan electrolyte leh micronutrient tlakchham tawhte thlak danglamin rang takin an enkawl thei bawk.

Phase One: Taksa tihngheh leh Dehydration enkawl

Enkawlna hmasa ber hian tui tlakchhamna enkawl te, electrolyte imbalance siamthat te, micronutrient tlakchhamna te chinfel te a ni. Hei hi taksa re-nutrition atana buatsaih nan tih a ni. Vawi tam tak chu heng zawng zawngah hian solution inang chiah hman a ni a, chu chu ei leh in tha lo tan rehydration solution bik (REhydration SOlution for MALnutrition - ReSoMal) a ni. Hei hi hmui hmangin emaw, nasogastric tube hmangin emaw pek theih a ni.

Tin, damlo lum vawn reng hi a pawimawh hle bawk.A chhan chu taksa lumna a tlahniam thei a, hypothermia a thlen thei a ni. Infection eng pawh hi enkawl a ni bawk a, a chhan chu infection hian taksa immune system a tichak lo zual sauh a ni. Damlo dinhmun azirin, taksa chu chaw pek leh theih tura a dinhmun a nghet theih nan darkar engemaw zat, a nih loh leh ni tam tak pawh a la ngai thei.

Stage hnihna: ei leh in siam that leh

Refeeding hi zawi zawiin a intan a, liquid foods hmangin. Heng ei tur te hi uluk takin carbohydrate, protein leh thau lamah an inthlau hle. Doctor-te chuan damdawi ina awmte chu tube feeding pek an duh zawk. Hei hian zawi zawiin, mahse ei tur tha tak tak supply chhunzawm zel theihna a siam a ni.

A tirah chuan chutiang kum lama mi pakhat tan ni khata ei tur ruahman zinga 70% velin calorie pek thin a ni. Hetiang zat hi a pung zauh zauh a. Naupang than chak lo a nih chuan a thanlenna mamawh phuhruk nan nitin a pek tur ruahman atanga 140% thleng calorie tihpun theih a ni. He phase hi kar hnih atanga kar ruk chhung a ni thei. Hetih lai hian damlo chu zawi zawiin regular solid foods chu a hmui hmangin a inhmeh tir thin.

Phase thumna: Follow-up leh Relapse venna

Marasmus hi natna lo lang leh thei a nih avangin enkawlna ruahmanna kimchang takah chuan damlo leh/ emaw an enkawltu tan damlo chu damdawi ina a chhuah hmain zirtirna leh puihna kalpui zel a tel a ni

Sri Lanka ang ram changkang zawkah chuan hei hian nau hnute pek pawimawhzia hriattirna te, tui thianghlim in tur leh ei tur buatsaih dan dik chungchanga thurawn pek te, hri danna pek te, leh natna tlanglawn laka inven dan tur zirtirna te a huam thei a ni. Ram changkang takah chuan enkawltute chuan an enkawltute ei leh in lama harsatna nei chhinchhiahna an hriat theih dan tur kaihhruaina an mamawh mai thei. Malnutrition Universal Screening Tool (MUST) ang chi hmanrua te hian ei leh in lama harsatna tawk te hriatchhuahna kawngah a pui thei a ni.

Marasmus hi engtin nge kan ven theih ang?

Kan khawtlang tana thu sawiin marasmus venna kawngah kan pui thei a, a bik takin naupang leh kum upa lam (a bik takin damdawi in leh nursing home-a awmte) tan an mamawh thu sawi thei lote tan kan pui thei a ni.

Khawvel pumah marasmus hi hetiang hian a veng thei a ni:

• Retheihna kan do a ngai a ni.
• Chaw tha tak tak awlsam taka hmuh theih lohna "Food desert" te chu tihbo a ngai a ni.
• Nutrition education tihchangtlun a ngai a ni.
• Natna hrik kai darh zau tak takte hi kan thunun a ngai a ni.
• Ram changkang zawkah hian bawlhhlawh paihna hmun siam that a ngai a ni.
• Ram changkang zawkah chuan tar enkawlna hi tihchangtlun a ngai a ni.

Marasmus atanga dam leh kim theih a ni em?

Marasmus hi a dam theih nan ni 42 vel a ngai tlangpui. Enkawlna an neih zawh chuan hriselna tha neih theihna tura hmanraw leh enkawlna mamawh awmna hmuna insawn te chu an dam kim thei fo mai.Naupang tam tak chuan an thanlenna leh an thanlenna chu an phak lo niin a lang a, mahse heng hun rei tak chhunga nghawng a neih dan chungchangah hian zirchianna an la nei reng a ni. Vitamin leh mineral supplement ei chhunzawm hian a pui thei ang.

Marasmus hi total caloric deficit vang a ni. Chaw tlakchhamna hian a thlentu tur a tawk. Mahse a nghawng chu a buaithlak zawk hle. A chhan chu marasmus hi riltam mai a ni lo - taksain riltam a tuar theihna tura a siam danglam (adaptation) a ni. Chutiang insiamremnate chu tihdanglam a, hriselna zawng zawng siam\hat leh tur chuan hun leh fimkhur a ngai a ni. Mahse, chutiang thil neihte hmang chuan mite chu kawng mak tak takin an lo harh chhuak thei a ni.

Take-Home Thuchah a ni

• Marasmus hi ei leh in lama harsatna nasa tak a ni. Taksa mamawh ei tur zawng zawng a tlahniam nghal tihna a ni.
• Hei hian naupang tê leh tarte a nghawng nasa hle a ni .
• A lan chhuah dan ber chu taksa hring pangngai lo, than chak lohna, leh natna fo thin hi a ni .
• Hei hi enkawlna a awm a, mahse damdawi inah, damdawi lam enkawlna hnuaiah, stage engemaw zatah tih a ngai a ni .
• Refeeding syndrome chungchangah hian fimkhur a ngai a ni.
• Retheihna te, ei tur tlakchhamna te, ei leh in lama inhriatthiam lohna te hi a chhan ber a ni.
• He dinhmun hi ei leh in dik, faina, leh khawtlang level-a puihna hmangin ven theih a ni .

Nangmah emaw, i hriatte emaw hian heng symptoms hi an nei nia i rinhlelh chuan doctor rawn nghal rawh. Enkawl hmasak hian result tha zawk a thlen thei a ni.

` Ei leh in tha lo, marasmus, wasting, naupang chaw tha lo, ei leh in lama harsatna, chakna tlakchham, protein tlakchham