Discriminative Ability of Electrophysiological Tests Such as Nerve Conduction Velocities for The Classification of Malnourished Children from Normal Children

Authors

  • Anju Agarwal G.R. Medical College Gwalior, M.P., India
  • Nikhil Agrawal AIIMS Jodhpur, Rajasthan, India
  • Neetu Sharma G.R. Medical College Gwalior, M.P., India
  • Durgesh Shukla G.R. Medical College Gwalior, M.P., India
  • Ajit Singh Rajput G.R. Medical College Gwalior, M.P., India

DOI:

https://doi.org/10.55489/njcm.140720233052

Keywords:

Discriminant, Median Sensory Nerve Velocity, Sural Sensory Nerve Velocity, Tibial Motor Nerve Velocity

Abstract

Background: Nerve Conduction Velocities (NCVs) measures electrical changes and speed in the nerve. Objectives of this study were: to compare mean velocities, to find rank of importance of different velocities and to frame equation to classify severely acute malnourished (SAM) children with normal children.

Material & Methods: Present case- control study was conducted on 50 SAM children and 50 normal children aged 6 months to 59 months. Independent t test and Discriminant analysis was performed. Standardized discriminant coefficient, canonical correlation and Wilks’ Lambda was calculated and p value was judges at 5% level of significance.

Results: NCVs were observed significantly lower among the cases as compared with the controls. Sural Sensory Nerve Velocity holds first position followed by Sensory Nerve Velocity. So, in final discriminant model 3 variables i.e., Sural Sensory Nerve Velocity; Median Sensory Nerve Velocity; Tibial Motor Nerve Velocity were used and 42.1 % of the total variance in the discriminant scores not explained by differences among the groups by the three-variable model. Model is able to classify 82.5% cases correctly.

Conclusion: Sural Sensory Nerve Velocity; Median Sensory Nerve Velocity; Tibial Motor Nerve Velocity were found as most important nerve conduction velocities with a good classification ability.

Author Biographies

Neetu Sharma, G.R. Medical College Gwalior, M.P., India

Associate Professor, Department of Paediatrics

Ajit Singh Rajput, G.R. Medical College Gwalior, M.P., India

Prof. and Head , Department of Physiology 

References

Sahu SK, Kumar SG, Bhat BV, Premarajan KC, Sarkar S, Roy G, Joseph N. Malnutrition among under-five children in India and strategies for control. J Nat Sci Biol Med. 2015 Jan-Jun;6(1):18-23. Doi: https://doi.org/10.4103/0976-9668.149072 PMid:25810629 PMCid:PMC4367032

International Institute for Population Sciences (IIPS) and ICF. (2021). National Family Health Survey (NFHS-5) 2019-2021. http://rchiips.org/nfhs/factsheet_NFHS-5.shtml

Kar, B. R., Rao, S. L., & Chandramouli, B. A. (2008). Cognitive development in children with chronic protein energy malnu-trition. Behavioral and Brain Functions, 4(1), 1-12. Doi: https://doi.org/10.1186/1744-9081-4-31 PMid:18652660 PMCid:PMC2519065

Raina SK, Sharma S, Bhardwaj A, Singh M, Chaudhary S, Kashyap V. Malnutrition as a cause of mental retardation: A population-based study from Sub-Himalayan India. J Neuro-sci Rural Pract. 2016 Jul-Sep;7(3):341-5.). Doi: https://doi.org/10.4103/0976-3147.182776 PMid:27365949 PMCid:PMC4898100

Bhutta ZA, Berkley JA, Bandsma RHJ, Kerac M, Trehan I, Briend A. Severe childhood malnutrition. Nat Rev Dis Pri-mers. 2017 Sep 21;3:17067. Doi: https://doi.org/10.1038/nrdp.2017.67 PMid:28933421 PMCid:PMC7004825

RUBHA S, VINODHA R. Effects of protein energy malnutrition on peripheral nerve conduction in children. International Journal of Medical Research & Health Sciences. 2015; 4.4: 768-770. Doi: https://doi.org/10.5958/2319-5886.2015.00150.2

Alvarez JL, Dent N, Browne L, Myatt M, Briend A. Mid-Upper Arm Circumference (MUAC) shows strong geographical vari-ations in children with edema: results from 2277 surveys in 55 countries. Arch Public Health. 2018 Aug 15;76:58 Doi: https://doi.org/10.1186/s13690-018-0290-4 PMid:30181875 PMCid:PMC6114774

Misra UK, Kalita J. Clinical Neurophysiology (2nd Edition). Elsevier India; 2010. p.482

Aminoff MJ. Electrodiagnosis in clinical neurology. Churchill Livingston; 1986. p.786

Binnie CD. Clinical neurophysiology. 2nd ed. Amsterdam ; London : Elsevier; 2003. (Cited 2023, February 21)

Mallik A, Weir A. Nerve conduction studies: essentials and pitfalls in practice. J Neurol Neurosurg Psychiatry. 2005;76 (Suppl 2):ii23-31. Doi: https://doi.org/10.1136/jnnp.2005.069138 PMid:15961865 PMCid:PMC1765692

Walson JL, Berkley JA. The impact of malnutrition on child-hood infections. Curr Opin Infect Dis. 2018 Jun;31(3):231-236. Doi: https://doi.org/10.1097/QCO.0000000000000448 PMid:29570495 PMCid:PMC6037284

Rodríguez L, Cervantes E, Ortiz R. Malnutrition and Gastroin-testinal and Respiratory Infections in Children: A Public Health Problem. International Journal of Environmental Re-search and Public Health. 2011; 8(4):1174-1205. Doi: https://doi.org/10.3390/ijerph8041174 PMid:21695035 PMCid:PMC3118884

National Research Council (US) and Institute of Medicine (US) Committee on Integrating the Science of Early Childhood De-velopment; Shonkoff JP, Phillips DA, editors. From Neurons to Neighborhoods: The Science of Early Childhood Develop-ment. Washington (DC): National Academies Press (US); 2000. 8, The Developing Brain. Available from: https://www.ncbi.nlm.nih. gov/books/NBK225562/

Cusick SE, Georgieff MK. The Role of Nutrition in Brain Devel-opment: The Golden Opportunity of the "First 1000 Days". J Pediatr. 2016 Aug;175:16-21. Doi: https://doi.org/10.1016/j.jpeds.2016.05.013 PMid:27266965 PMCid:PMC4981537

Stoch MB, Smythe PM. Does undernutrition during infancy inhibit growth and subsequent intellectual development? Archs Dis Children.1963;38:546-552) Doi: https://doi.org/10.1136/adc.38.202.546 PMid:21032415 PMCid:PMC2018962

Osuntokun BO (1971) Motor nerve conduction in kwashior-kor (Protein-calorie deficiency) before and after treatment. Afr J Med Sci 2:109-119

Sachdev KK, Taori GM, Pereira SM (1971) Neuromuscular status in protein-calorie malnutrition. Clinical, nerve conduc-tion, and electromyographic studies. Neurology (Minneap) 21:801-805 Doi: https://doi.org/10.1212/WNL.21.8.801 PMid:5106296

Singh N, Kumar A, Ghai OP (1976) Conduction velocity of mo-tor nerves in children suffering from protein-calorie malnu-trition and marasmus. Electromyogr Clin Neurophysiol 16:381-392

Ghosh S, Vaid, K., Mohan, M., & Maheshwari, M. C. Effect of de-gree and duration of protein energy malnutrition on periph-eral nerves in children. Journal of Neurology, Neurosurgery & Psychiatry.1979. 42(8), 760-763. Doi: https://doi.org/10.1136/jnnp.42.8.760 PMid:114607 PMCid:PMC490311

Kabakus N, Ayar A, Yoldas TK, Ulvi H, Dogan Y, Yilmaz B, Kilic N. Reversal of iron deficiency anemia-induced peripheral neuropathy by iron treatment in children with iron deficien-cy anemia. J Trop Pediatr. 2002 Doi: https://doi.org/10.1093/tropej/48.4.204 PMid:12200980

Zabihullah M, Agrawal D.K., Shahab T. Sensory Nerve Conduc-tion Velocity in Malnourished Children. Journal of Evolution of Medical and Dental Sciences. 2019; 8(7) 399. Doi: https://doi.org/10.14260/jemds/2019/88

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Published

2023-07-01

How to Cite

1.
Agarwal A, Agrawal N, Sharma N, Shukla D, Singh Rajput A. Discriminative Ability of Electrophysiological Tests Such as Nerve Conduction Velocities for The Classification of Malnourished Children from Normal Children. Natl J Community Med [Internet]. 2023 Jul. 1 [cited 2024 May 14];14(07):418-23. Available from: https://njcmindia.com/index.php/file/article/view/3052

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