COMPARATIVE STUDY OF NUTRITIONAL STATUS OF RHEUMATIC HEART DISEASES PATIENTS BEFORE AND AFTER THE SURGERY IN DHARAN AND NEARBY VDC’S.

Abstract

Rheumatic heart disease (RHD) remains a significant health problem in the developing world, affecting 15.6 million people worldwide, with a prevalence of 1.2/1000 in 5-15 year old school children in Nepal. RHD is largely a disease of poverty, of which overcrowding, poor nutrition, poor health-care access and limited health resources are major contributing factors. Considering the nutritional status of RHD, the survey was done in Dharan and nearby VDC‟s. Thirty post operative patients ranging from the age 9 to 37 were included in the survey. Ten of the patients were Dalit and 13 patients were NYHA III categorized. Nine of the patients were residing in Dharan. The daily calorific value was calculated on the basis of the response from the questionnaire. On the survey it was found that there was a significant increase in calorific value but only six of them were meeting up the recommended calorific intake value. Besides it was found that there is a significant increase in carbohydrate, protein, vitamin A and riboflavin intake but not fat before and after the surgery. Loss of appetite was one major symptom of the diseases before the surgery and more over lack of knowledge about this disease had leaded the patients to the valve operation otherwise it can be cured in primary phase. On the basis of the BMI sixty percentages of total patients were categorized as normal after the surgery and the percentage of underweight was reduced from 36.67% to 30%. Poverty was major reasons for malnutrition in the patients in the pre-surgery conditions