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

Authors

  • Protiksha Ukil Department of Pediatrics, Gandhi Medical College, Secunderabad, Telangana, India http://orcid.org/0000-0003-3979-0591
  • Srikanth S. Department of Pediatrics, Osmania Medical College, Hyderabad, Telangana, India
  • Usha Rani T. Department of Pediatrics, Osmania Medical College, Hyderabad, Telangana, India
  • Siva Ram Prasad K. Department of Pediatrics, Gandhi Medical College, Secunderabad, Telangana, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20222420

Keywords:

Malnutrition, Ankle reflex, Serum sodium, Serum potassium

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.

Author Biographies

Protiksha Ukil, Department of Pediatrics, Gandhi Medical College, Secunderabad, Telangana, India

Medical Intern,

Gandhi Medical College,

Secunderabad

Srikanth S., Department of Pediatrics, Osmania Medical College, Hyderabad, Telangana, India

MBBS, MD (Paediatrics)

Associate Professor of Pediatrics,

Niloufer Hospital,

Osmania Medical College,

Hyderabad

Usha Rani T., Department of Pediatrics, Osmania Medical College, Hyderabad, Telangana, India

MBBS, MD (Paediatrics)

Professor and HOD

Department of Paediatrics

Osmania Medical College,

Hyderabad

Siva Ram Prasad K., Department of Pediatrics, Gandhi Medical College, Secunderabad, Telangana, India

MBBS, MD (Paediatrics)

Professor

Department of Paediatrics

Gandhi Medical College,

Secunderabad

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.

Downloads

Published

2022-09-26

Issue

Section

Original Research Articles