1. Co-authors: Drs. K.A. Parvathy, C.V.Harinarayan, B. Vengamma, Bindu Menon, U.V. Prasad,G. Hima Bindu NUTRITIONAL STATUS IN ADOLESCENTS WITH EPILEPSY Presented by V.SWAPNA

2. AIM To evaluate To evaluate  The anthropometric measurements  Dietary parameters and  Biochemical markers of Bone Mineral Metabolism

3. NEED FOR THE STUDY  Adolescence, a period of transition, occupies a crucial position in the life of human beings.  Under-nutrition reduces growth rate, learning and working capacity amongst adolescents.  Epilepsy is the most serious common neurological disorder.  Epilepsy treatment leads to nutritional deficiencies, especially vitamin D 3 Metabolism.

4.  AED INTERFER WITH 25 OHase AT THE LIVER AND LOWERS THE FORAMTION OF1,25(OH) 2 D 3.  Low 25(OH)D levels leads to low 1,25(OHD)D levels.  Hence the absorption of calcium from the gut is retarded.

5.  n= 64  Anthropometry - Ht, Wt, BMI, Arm span, U.S, L.S Ht, Wt, BMI, Arm span, U.S, L.S  Skin fold thickness – Triceps, Biceps, S.Scapular, Suprailliac. Triceps, Biceps, S.Scapular, Suprailliac.  Dietary Intake – Calories, protein, fat, Ca, Phos, Phy/Ca ratio Calories, protein, fat, Ca, Phos, Phy/Ca ratio  Biochemical parameters – Serum Albumin, Ca, Phos, SAP, Creatinine, 25(OH)D, ntact PTH. Serum Albumin, Ca, Phos, SAP, Creatinine, 25(OH)D, ntact PTH. MATERIALS AND METHODS

6. STATISTICAL ANALYSIS  The results presented as Mean ± SD  Correlation co-efficient (Pearson's) - Value P<0.05 taken as significant.  Statistical package used SPSS software (version 10.0).

7. NUTRIENTS MEAN ± SD Energy(K.cal)2059±150 D.Calcium(mg)297±33 D.Phosphorous(mg)574±84 D.Protein(gm)36±7 D.Fat(gm)18±2 Phy/Cal0.6±0.08 DIETARY INTAKE PER DAY

8. PARAMETERS MEAN ± SD S.Albumin (3.0-5.5gm/dl) 4±0.34 S.Calcium (8-10.5mg/dl) 10±0. S.Phoshorous(2.7-4.5 mg/dl) 4±0.8 SAP (140 IU/l) 95±59 S.Creatinine (<1.6 mg/dl) 0.79±0.19 25(OH)D (>20 ng/ml) 16.59±10.4 PTH (13-54pg/ml) 21.57±11.3 BIOCHEMICAL VALUES

11. *SINCE TREATMENT INCLUDES MORE THAN ONE DRUG, THE PERCENTAGE WILL EXCEED HUNDRED.

12. DISCUSSION  AED’s can lower the uptake of calcium, worsening the bone health.  Inadequate intake of calcium can lead to a decreased amount of bone calcium reserves.  Adolescent epileptic girls in the rural areas could be greater risk of nutritional stress.

13.  The socio-economic aspects have not been dealt Micro study  The data was collected from only SVIMS, Tirupati.  Data from other hospitals and clinics were not collected.  The epilepsy patients approaching SVIMS for treatment mostly belong to lower socio- economic strata. LIMITATIONS OF THE STUDY

14. Strategies  Awareness  Dietary Intake  Supplements  Life Skills Education  Primary Care  Social Stigma

15. CONCLUSION  Hypo Vitaminosis-D and low dietary calcium intake adversely affect the bone mineral homeostasis in adolescents with epilepsy.  There is a need to treat epilepsy through proper diet & nutrition and reducing the intake of medicines over a period of time

16. CONCLUSION  Epileptic adolescents to be supplemented with dietary calcium and vitamin-D  Health educators have to be trained to deal with adolescent girls with epilepsy as they are vulnerable for social evils like early marriage

17. Than Q