Protein-Energy Malnutrition (PEM)

​She was brought by her mother because she had a protruded abdomen, thin but swollen legs. Her hair was fluffy and mother wondered why she wasn't thriving at 2years.

She was febrile too and appeared very ill. We made a diagnoses of PEM, a group of protein and energy deficiency based states including kwashiokor, Marasmus, marasmic kwashirkor, undernutrition, Obesity.

After few days of management that included stabilizing temperature, electrolytes, she is recuperating on nutritional rehabilitation.
This cases are rampant in Northern Nigeria and it is unfortunately so. Where many can have alot and even spare, while some can't have a single meal.

​First picture is a 10month old infant, whereas the one on the left is a 2 year old child.
One was exclusively breastfed for 6months, the other wasn't.
One gets lots of protein in their diet, the other doesn't.
Can you spot the difference?

The rural doctor initiative will attempt to narrow the gap between resource poor settings and professional care givers.
The rural doctor initiative... Everyone deserves good health.