DOI: https://dx.doi.org/10.18203/2349-3291.ijcp20222420
Published: 2022-09-26

Relationship between serum sodium, serum potassium levels and ankle reflex grades in malnourished children

Protiksha Ukil, Srikanth S., Usha Rani T., Siva Ram Prasad K.

Abstract


Background: Malnutrition among children is a major health issue in South East Asia presenting with stunting and wasting. Many research studies have been conducted to establish the signs, symptoms, corresponding effects of malnutrition on child health, growth and development and the current study focusses more specifically on the effects of electrolyte levels on ankle reflex grades in malnourished children.

Methods: This is an observational case-control type of study conducted in two teaching hospitals in India. Cases of protein-energy malnutrition (PEM) (n=30), children with mid upper arm circumference (MUAC) lesser than 12.5 along with control group of normal healthy children (n=30), all aged between 1 and 5 years were selected. Ankle reflexes were noted using a knee hammer on three consecutive days and graded based on the NINDS reflex grading scale for cases and controls and noted against the corresponding serum sodium and serum potassium values obtained from the children.

Results: A Chi square test performed and p=0.379 obtained for serum sodium and 0.026 for serum potassium for cases.

Conclusions: A conclusion could be drawn that serum sodium levels and ankle reflex grades have no statistically significant relationship in cases of controls, while serum potassium levels and ankle reflex grades have statistically significant relationship in cases but not in control group indicating a plausible cause for hyporeflexia in the patients.


Keywords


Malnutrition, Ankle reflex, Serum sodium, Serum potassium

Full Text:

PDF

References


Bhutia DT. Protein Energy Malnutrition in India: The Plight of Our Under Five Children. JFPMC. 2014;3(1):63-7.

Hoffer LJ. Clinical Nutrion: 1. Protein-Energy Malnutrition in the inpatient. CMAJ. 2001;165(10):1345-49.

Sharma M, Chowdhury SN, Singh AP. Changes in serum protein and electrolytes in acute protein energy malnutrition. J Sci. 2018;8(2):105-9.

Ukil PK. Study of ankle reflex grades in protein energy malnourished children aged between 1 and 5 years. Ind J Child Health. 2022;9(6):102-7.

Hallett M. NINDS Myotatic Reflex Scale. 1993;43(12).

Fiorentino M, Sophonneary P, Laillou A. Current MUAC Cut-Offs to Screen for Acute Malnutrition Need to Be Adapted to Gender and Age: The Example of Cambodia. PLoS One. 2016;11(2):e0146442.

Tsegaye B, Mekasha A, Genet S. Serum Transthyretin Level as a Plausible Marker for Diagnosis of Child Acute Malnutrition. Biochem Res Int. 2017;9196538.

Litvan I, Mangone CA, Werden W, Bueri JA, Estol CJ, Garcea DO et al. Reliability of the NINDS Myotatic Reflex Scale. Neurology. 1996;47(4):969-72.

Manschot L, Van Passel E, Buskens A, Algra J, Van G. Mayo and NINDS scales for assessment of tendon reflexes: between observer agreement and implications for communication. J Neurol Neurosur Psychiat. 1998;64:253-5.

Malik MM, Jindal S, Bansal S, Saxena V, Shukla US. Relevance of ankle reflex as a screening test for diabetic peripheral neuropathy. Indian J Endocrinol Metab. 2013;17(1):S340-41.

Kardalas E, Paschou SA, Anagnostis P, Muscogiuri G, Siasos G, Vryonidou A. Hypokalemia: a clinical update. Endocr Connect. 2018;7(4):R135-46.

Greenberg A. Diuretic complications. Am J Med Sci. 2000;319(1):10-24.