- An essential feature of all nutritional surveys
- Simple & most practical method of ascertaining the nutritional status of a group of individuals
- It utilizes a number of physical signs, (specific & non specific), that are known to be associated with malnutrition and deficiency of vitamins & micronutrients.
- Good nutritional history can be obtained
- General clinical examination, with special attention to organs like hair, angles of the mouth, gums, nails, skin, eyes, tongue, muscles, bones, & thyroid gland.
- Detection of relevant signs helps in establishing the nutritional diagnosis.
Advantages
- Fast & easy to perform
- Inexpensive
- Non-invasive
Clinical examination is the most important part of nutritional assessment. It provides direct information of the signs and symptoms of dietary deficiencies prevalent among the people. The Indian Council of Medical Research (ICMR) has evolved a score card for assessing the various clinical signs and symptoms. This score card has been widely used in India in all nutrition surveys and has proved useful in assessing the improvement in nutritional status brought about by food supplements.
Table: Clinical signs of nutritional deficiency
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Symptoms
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Deficiency due to
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Hair
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Sparse & thin
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Protein, Zinc, Biotin
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Easy to pull out
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Protein
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Corkscrew coiled hair
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Vit C & A
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Mouth
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Glossitis
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B- Complex
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Bleeding & spongy gums
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Vit C,K & A folic acid & niacin
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Angular stomatitis, Cheilosis & Fissured tongue
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B2,B6 & niacin
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Sour mouth & tongue
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Vit B12,B6,C, niacin ,folic acid & iron
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Eyes
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Night blindness, xerophthalmia
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Vitamin A
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Photophobia-blurring, conjunctival inflammation
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Vit B2 & vit A
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Nails
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Spooning (koilonychia)
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Iron
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Transverse lines
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Protein
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Skin
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Pallor
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Folic acid, iron, B12
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Follicular hyperkeratosis
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Vitamin B & Vitamin C
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Flaking dermatitis
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PEM, Vit B2, Vitamin A, Zinc & Niacin
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Pigmentation, desquamation
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Niacin & PEM
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Participants