scholarly journals Implications of updated protocol for classification of childhood malnutrition and service delivery in world’s largest refugee camp amid this COVID-19 pandemic

2022 ◽  
pp. 1-12
Author(s):  
Afsana Anwar ◽  
Probal Kumar Mondal ◽  
Uday Narayan Yadav ◽  
Abu Ahmed Shamim ◽  
Abu Ansar Md. Rizwan ◽  
...  
Keyword(s):  
Service Delivery ◽  
Relevant Literature ◽  
Refugee Camp ◽  
Severe Malnutrition ◽  
Refugee Camps ◽  
Extra Effort ◽  
Malnourished Children ◽  
Ration Size

Abstract Objectives: During the COVID-19 pandemic, the authorities made a change in the classification of malnutrition and concomitant service delivery protocol among the Rohingya children, residing in world’s largest refugee camp, located in Bangladesh. In this paper, we discussed the potential implications of this updated protocol on the malnutrition status among children from the Rohingya camp. Design: This paper reviewed relevant literature and authors’ own experience to provide a perspective of the updated protocol for the classification of malnutrition among the children in the Rohingya camps and its implication from a broader perspective. Setting: Rohingya refugee camps, Bangladesh Participants: Children aged less than five years residing in the Rohingya camps. Results: Major adaptation during this COVID-19 was discontinuation of using weight-for-height z-score (WHZ) and use of only MUAC and presence of edema for admission, follow up and discharge of malnourished children in camps. However, evidence suggest that use of MUAC only can underestimate the prevalence of malnutrition among the children in Rohingya camps. These apparently non-malnourished children are devoid of the rations that they would otherwise receive if classified as malnourished, making them susceptible to more severe malnutrition. Conclusions: Our analysis suggests that policymakers should consider using the original protocol of using both MUAC and WHZ to classify malnutrition and retain the guided ration size. We also believe that it would not take an extra effort to adopt the original guideline as even with MUAC only guideline, certain health measures needed to adopt during this pandemic.

Development of Severely Malnourished Children Who Received Psychosocial Stimulation: Six-Year Follow-up

PEDIATRICS ◽  
1987 ◽  
Vol 79 (2) ◽  
pp. 247-254 ◽  
Author(s):  
Sally Grantham-McGregor ◽  
William Schofield ◽  
Christine Powell
Keyword(s):  
Home Visiting ◽  
Intervention Group ◽  
Severe Malnutrition ◽  
The Third ◽  
Malnourished Children ◽  
Catching Up ◽  
Psychosocial Stimulation ◽  
Catch Up ◽  
Home Visiting Program

The development of 16 children who were hospitalized for severe malnutrition and participated in a home-visiting program of psychosocial stimulation was compared with that of two other groups who were also hospitalized but received standard medical care only: severely malnourished group (n = 18) and an adequately nourished one (n = 20). All groups were assessed regularly on the Griffiths Mental Development Scales and the Stanford-Binet test. Both groups of malnourished children were markedly behind the adequately nourished group on admission to the hospital and the group that received no intervention showed little sign of catching up. The intervention group caught up to the adequately nourished group in 2 years. This report covers the third year of home-visiting and the 3 years following its cessation. The intervention group showed a decline in three of the five Griffiths subscales. However, they retained a marked advantage over the nonintervention group of malnourished children on the Stanford-Binet test until the end of follow-up, showing no further decline in the last year. For height, both malnourished groups failed to catch up to the adequately nourished group. It was concluded that a relatively simple intervention can benefit the development of severely malnourished children.

How healthy are children one year after discharge from nutritional rehabilitation centres?

2018 ◽  
Vol 48 (4) ◽  
pp. 277-282 ◽  
Author(s):  
Pavan Pandey ◽  
Sneha Jain ◽  
Arushi Sharma
Keyword(s):  
Nutritional Status ◽  
Severe Malnutrition ◽  
Nutritional Rehabilitation ◽  
Malnourished Children ◽  
Nutritional Recovery ◽  
The Mean ◽  
One Year ◽  
Moderate Malnutrition

Nutritional rehabilitation centres (NRCs) have been established to ensure the nutritional recovery of severely malnourished children. The long-term nutritional outcomes in children discharged from NRCs have not been described. In this retrospective cohort study, the nutritional status of 514 children was assessed one year after discharge. Household and maternal data, as well as data regarding variables related to the children’s stay at the NRC, were collected. A total of 33.4% had moderate malnutrition and 11.7% had severe malnutrition. The mean weight for height Z-score at admission, discharge and one year after discharge were −3.61, −1.90 and −2.34, respectively. Thus, long-term monitoring and follow-up of children discharged from NRCs till they achieve normal nutritional status is mandatory.

scholarly journals Screening for fecal occult blood loss in severely malnourished children

2020 ◽  
Vol 7 (8) ◽  
pp. 420-424
Author(s):  
Dr. Triya Malde ◽  
◽  
Dr. Gaurang Pabani ◽  
Dr. Mohmmad Shahid M Mirza ◽  
Dr. Om Prakash Shukla ◽  
...  
Keyword(s):  
Blood Loss ◽  
Clinical Signs ◽  
Occult Blood ◽  
Severe Malnutrition ◽  
Fecal Occult Blood ◽  
Fecal Occult ◽  
Malnourished Children ◽  
Grade Ii ◽  
Very High

Introduction: PEM is the most important and basic hurdle in the triple-M complex of malnutrition,morbidity, and mortality. Very high mortality has been reported in severe PEM. PEM is found toaccount for about 4 million deaths in children. The study aimed to perform a fecal occult blood testin patients in the age group of six months to five years and also to identify the conditions associatedwith fecal occult blood loss in pem patients. Materials and Methods: A total of 100 indoor patientsof PEM admitted in our pediatric ward were taken as subjects in this study. According to WHO andIAP classification of PEM, severe malnutrition (marasmus, kwashiorkor, and marasmic kwashiorkor)were taken as study group; and mild grades of PEM (grade I and grade II) were taken as a controlgroup. Results: In severe PEM, marasmus (83%) was more common followed by kwashiorkor(14%) and marasmic kwashiorkor (3%); however in mild grades of PEM, grade I PEM was found in58% and grade II PEM was found in 42%. In severe PEM, pallor (64%), hair changes (38%), andtachypnoea(31%) were major clinical signs; while tachypnoea(36%), dehydration (26%), and pallor(20%} were major clinical signs in patients with mild grades of PEM. Conclusion: A positive fecaloccult blood test (FOBT) is strongly associated with moderate to severe anemia in severe PEMpatients. So all patients having a positive FOBT should have a hemogram profile done and thenappropriately treated for anemia.

Die Wirksamkeit eines Frühinterventionsprogramms für Jugendliche mit Computerspiel- und Internetabhängigkeit: Mittelfristige Effekte der PROTECT+ Studie

2020 ◽  
Vol 48 (1) ◽  
pp. 3-14 ◽  
Author(s):  
Carolin Szász-Janocha ◽  
Eva Vonderlin ◽  
Katajun Lindenberg
Keyword(s):  
Internet Use ◽  
Health Problems ◽  
Reliable Change Index ◽  
Gaming Disorder ◽  
Statistical Classification ◽  
Reliable Change ◽  
Classification Of Diseases ◽  
International Statistical Classification

Zusammenfassung. Fragestellung: Das junge Störungsbild der Computerspiel- und Internetabhängigkeit hat in den vergangenen Jahren in der Forschung zunehmend an Aufmerksamkeit gewonnen. Durch die Aufnahme der „Gaming Disorder“ in die ICD-11 (International Statistical Classification of Diseases and Related Health Problems) wurde die Notwendigkeit von evidenzbasierten und wirksamen Interventionen avanciert. PROTECT+ ist ein kognitiv-verhaltenstherapeutisches Gruppentherapieprogramm für Jugendliche mit Symptomen der Computerspiel- und Internetabhängigkeit. Die vorliegende Studie zielt auf die Evaluation der mittelfristigen Effekte nach 4 Monaten ab. Methodik: N = 54 Patientinnen und Patienten im Alter von 9 bis 19 Jahren (M = 13.48; SD = 1.72) nahmen an der Frühinterventionsstudie zwischen April 2016 und Dezember 2017 in Heidelberg teil. Die Symptomschwere wurde zu Beginn, zum Abschluss der Gruppentherapie sowie nach 4 Monaten anhand von standardisierten Diagnostikinstrumenten erfasst. Ergebnisse: Mehrebenenanalysen zeigten eine signifikante Reduktion der Symptomschwere anhand der Computerspielabhängigkeitsskala (CSAS) nach 4 Monaten. Im Selbstbeurteilungsbogen zeigte sich ein kleiner Effekt (d = 0.35), im Elternurteil ein mittlerer Effekt (d = 0.77). Der Reliable Change Index, der anhand der Compulsive Internet Use Scale (CIUS) berechnet wurde, deutete auf eine starke Heterogenität im individuellen Symptomverlauf hin. Die Patientinnen und Patienten bewerteten das Programm zu beiden Follow-Up-Messzeitpunkten mit einer hohen Zufriedenheit. Schlussfolgerungen: Die vorliegende Arbeit stellt international eine der wenigen Studien dar, die eine Reduktion der Symptome von Computerspiel- und Internetabhängigkeit im Jugendalter über 4 Monate belegen konnte.

scholarly journals POS1456-HPR THE SERUM IRON LEVEL MIGHT BE USEFUL IN DETERMINING THE SEVERITY OF MALNUTRITION IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1012.2-1012
Author(s):  
Y. Matsumoto ◽  
Y. Sugioka ◽  
M. Tada ◽  
T. Okano ◽  
K. Mamoto ◽  
...  
Keyword(s):  
Grip Strength ◽  
Serum Iron ◽  
Roc Analysis ◽  
Severe Malnutrition ◽  
Inflammatory Condition ◽  
Research Support ◽  
Chugai Pharmaceutical ◽  
The Relationship ◽  
Nutritional Indicator

Background:The Global Leadership Initiative on Malnutrition (GLIM) criteria, the first international criteria for diagnosis of malnutrition, was released in 2018 [1]. Patients with rheumatoid arthritis (RA) are thought to be prone to malnutrition due to decreased food intake and increased muscle catabolism caused by chronic inflammation or pain. However, there has been no report to assess the nutritional status of RA patients in accordance with the GLIM criteria. In addition, commonly used blood nutrient indicators such as albumin might not be appropriate as nutritional indicators for RA because these values are affected by inflammation.Objectives:This study aims to examine the rates of malnutrition in RA patients according to GLIM criteria, and the relationship between blood nutrient indicators and the severity of malnutrition.Methods:In this study, we conducted a cross-sectional survey of 135 female RA patients in 2020. According to the GLIM criteria, patients were considered to be malnourished if patients had one of the following phenotypic: (1) low body mass index, (2) non-volitional weight loss, (3) reduced muscle mass, and one of the following etiologic: (1) reduced food intake or assimilation, (2) disease burden/inflammatory condition. Reduced muscle mass was evaluated by measuring calf circumference, and inflammatory condition was evaluated by Disease Activity Score (DAS) 28. In accordance with the GLIM criteria, the severity of malnutrition was judged as three levels: no problem, moderate, and severe malnutrition. Albumin, transthyretin, transferrin, retinol binding protein, zinc, iron, ceruloplasmin, and total cholesterol were assessed as blood nutrition indicators. Also grip strength was assessed. We compared each nutritional indicator among the three groups according to the severity of malnutrition using age-adjusted analysis of covariance, and examined the relationship between each nutritional indicator and the severity of malnutrition using receiver operating characteristic (ROC) analysis.Results:In RA patients, 20% were classified as severe malnutrition, and 40% were moderate or more. Serum iron levels were significantly lower in the severe malnutrition group compared to the no problem group (p = 0.001). In ROC analysis, serum iron, zinc, albumin, and grip strength (area under curve; AUC; 0.680, 0.696, 0.636, 0.790, respectively) were significant parameters for classification of moderate and severe malnutrition. Serum iron and grip strength (AUC for respective parameters were 0.741, 0.747) were significant parameters for classification of severe malnutrition.Conclusion:Evaluation based on the GLIM criteria showed that about 40% of RA patients were under moderate or severe malnutrition. It was suggested that serum iron and grip strength might be useful to predict the severity of malnutrition.References:[1]Cederholm T, Jensen GL, Correia MITD, Gonzalez MC, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community. Clinical Nutrition 2019; 38: 1-9.Acknowledgements:We thank to Tomoko Nakatsuka, and the Center for Drug & Food Clinical Evaluation, Osaka City University Hospital, for management and collection of the study data. We also thank to study participants.Disclosure of Interests:Yoshinari Matsumoto Grant/research support from: Yamada Research Grant, Yuko Sugioka: None declared, Masahiro Tada: None declared, Tadasi Okano Speakers bureau: AbbVie, Asahikasei, Astellas Pharma Inc, Ayumi Pharmaceutical, Bristol-Myers Squibb, Chugai Pharmaceutical, Daiich Sankyo, Eisai, Janssen, Lilly, Mitsubishi Tanabe Pharma Corporation, Novartis Pharma, Ono Pharmaceutical, Pfizer, Sanofi, Takeda Pharmaceutical, Teijin Pharma and UCB, Grant/research support from: AbbVie, Eisai, Mitsubishi Tanabe Pharma Corporation and Nipponkayaku, Kenji Mamoto: None declared, Kentaro Inui Speakers bureau: Daiichi Sankyo Co. Ltd., Mitsubishi Tanabe Pharma, Janssen Pharmaceutical K.K., Astellas Pharma Inc., Takeda Pharmaceutical Co. Ltd., Ono Pharmaceutical Co. Ltd., Abbvie GK, Pfizer Inc., Eisai Co., Ltd., Chugai Pharmaceutical Co., Ltd, Grant/research support from: anssen Pharmaceutical K.K., Astellas Pharma Inc., Sanofi K.K., Abbvie GK, Takeda Pharmaceutical Co. Ltd., QOL RD Co. Ltd., Mitsubishi Tanabe Pharma, Ono Pharmaceutical Co. Ltd., Eisai Co., Ltd., Daiki Habu: None declared, Tatsuya Koike Speakers bureau: AbbVie, Astellas Pharma Inc, Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai, Janssen, Lilly, Mitsubishi Tanabe Pharma Corporation, MSD, Ono Pharmaceutical, Pfizer, Roche, Takeda Pharmaceutical, Teijin Pharma, and UCB, Grant/research support from: AbbVie, Astellas Pharma Inc, Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai, Janssen, Lilly, Mitsubishi Tanabe Pharma Corporation, MSD, Ono Pharmaceutical, Pfizer, Roche, Takeda Pharmaceutical, Teijin Pharma, and UCB

scholarly journals NIMG-53. GLUTAMATE/GABA RATIO ON MRS IS ELEVATED IN PATIENTS WITH LOWER GRADE GLIOMAS AND SEIZURES

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii159-ii160
Author(s):  
Roberta Rudà ◽  
Riccardo Pascuzzo ◽  
Francesca Mo ◽  
Alessia Pellerino ◽  
Peter B Barker ◽  
...  
Keyword(s):  
Tumor Location ◽  
Resonance Spectroscopy ◽  
Lower Grade ◽  
Lack Of Information ◽  
Baseline Evaluation ◽  
Grade Ii ◽  
Grade Iii

Abstract BACKGROUND There is lack of information on the role of excitatory and inhibitory neurotransmitters in the development of seizures in patients with lower grade gliomas. Increase of glutamate and downregulation of GABA have been suggested in preclinical models and human surgical samples to be associated with brain tumor-related epilepsy. MATERIAL AND METHODS We prospectively investigated with the use of magnetic resonance spectroscopy (MRS) the differences in the ratio of metabolites (glutamate/GABA, glutamate/creatine and GABA/creatine) in the peritumoral areas between patients with or without seizures in a series of lower grade gliomas. Tumors were classified according to WHO Classification of 2016 as follows:11 grade II IDH mutated and 1p/19q codeleted; 3 grade III IDH mutated and 1p/19q codeleted; 6 grade II IDH mutated and 1p/19q intact; 1 grade III IDH mutated and 1p/19q intact; 1 grade II IDH wild-type. Patients received surgery alone or followed by temozolomide chemotherapy according to the presence of risk factors. RESULTS At baseline evaluation, maximum glutamate/GABA values were significantly higher (p=0.023) in the peritumoral area of patients with seizures (1.008 ± 0.368) with respect to those without seizures (0.691 ± 0.170). No other metabolites ratio showed significant differences between the two groups. Similar results were obtained when analyzing the metabolites ratio in the examinations during the follow-up. In the cohort of patients with seizures (n.14) variations of metabolite ratios were not associated with tumor location, 1p/19q codeletion, use of AEDs, concomitant chemotherapy or seizure characteristics (type, duration, frequency). CONCLUSIONS The study is ongoing with the aim of analyzing further the correlations between ratio of metabolites and status of the tumor (stable vs progressive).

The Refugee Camp as Site of Multiple Encounters and Realizations

2020 ◽  
Vol 54 (2) ◽  
pp. 215-233
Author(s):  
Ayham Dalal
Keyword(s):  
Everyday Life ◽  
Refugee Camp ◽  
Human Geography ◽  
Entry Point ◽  
Material Composition ◽  
Refugee Camps

AbstractLiterature in Human Geography has given much attention to “encounters” and their impact on negotiating difference in everyday life. These studies, however, have focused solely on cities, while “other” spaces like refugee camps have received little attention to date. In this paper, I highlight the significance of “encounters” in camps by exposing three main types: the “refugee-refugee,” the “refugee-humanitarian,” and the “refugee-more-than-human” encounters. Using empirical examples from Zaatari camp in Jordan, I show that the “refugee-refugee” encounters cannot be fully understood without taking refugees’ culture, background, and urban identities into consideration. I also explain how the “refugee-humanitarian” encounters result in new types of behaviors and might harden the boundaries between both groups. And lastly, I demonstrate how the “refugee-more-than-human” encounters can inform us about refugees’ unique experiences with shelters, space, and materiality. Building on the examples given for each type, this article suggests that “encounters” have the ability to generate knowledge and learnings, which contributes to shaping the space of the camp by either enforcing boundaries between different groups and/or by allowing new and hybrid spatialities to emerge. This not only confirms that “encounters” are an important entry point in understanding the socio-spatial and material composition of refugee camps, but also that further studies in this regard are direly needed. It also suggests that architects and planners need to allow for the “new” to emerge as a result of these encounters and, therefore, to enable flexibility and adaptability within camps’ design and planning.

MRI analysis and surgical treatment of Wassel Type IV duplicated thumbs

2021 ◽  
pp. 175319342098321
Author(s):  
Anyuan Wang ◽  
Jian Ding ◽  
Long Wang ◽  
Tinggang Chu ◽  
Zhipeng Wu ◽  
...  
Keyword(s):  
Type A ◽  
Surgical Reconstruction ◽  
Mri Findings ◽  
Level Of Evidence ◽  
Type D ◽  
Type Iv ◽  
Secondary Operations ◽  
Type C

We present the MRI findings for 39 Wassel Type IV duplicated thumbs in 38 patients. We found that MRI revealed the morphology of the cartilaginous connection between the thumb anlages and the location of the deviation corresponding to the classification of Horii, which allowed precise preoperative planning of corrective osteotomies. All 39 thumbs were available for follow-up after surgical reconstruction at a mean of 29 months (range 25 to 39). Four out of nine Horii Type A cases and all 12 Type B, as well as the six Type C and the six Type D cases, achieved good results according to the Tada scoring system. Five Type A cases achieved fair results with residual stiffness of the interphalangeal joint. No secondary operations were needed. We conclude that MRI proved useful in subclassifying Wassel Type IV duplicated thumbs and may aid in planning the osteotomies needed for their reconstruction. Level of evidence: IV

scholarly journals Is podocytopathy another image of renal affection in p-SLE?

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Hend H. Abdelnabi
Keyword(s):  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Histopathological Analysis ◽  
Immune Deposits ◽  
Foot Process ◽  
Lupus Podocytopathy ◽  
Focal Segmental Sclerosis ◽  
Nephrotic Range Proteinuria

Abstract Background Lupus podocytopathy (LP) is a renal affection described in systemic lupus erythematosus (SLE) patients with nephrotic range proteinuria, characterized by diffuse foot process effacement without immune deposits and glomerular proliferation. This study describes LP, its pathological features and outcomes of pediatric (p-SLE) patients in comparison to the usual lupus nephritis (LN) cases. Methodology A retrospective cohort study conducted on a 10-year registration (2010–2019) of 140 p-SLE patients at the Pediatric Department, Tanta University. Histopathological analysis with light microscopy (LM) and immunofluorescence (IF) of all renal biopsies were evaluated according to the International Society of Nephrology Renal Pathology Society (ISN/RPS) grading system. In addition, some biopsies were examined with electron microscopy (EM). Results Eighty-six p-SLE cases (61.4%) had renal involvement; seventy-nine biopsies (91.86%) of them met the classification criteria of LN as defined by ISN/RPS system. Five biopsies were normal (MCD) and two showed focal segmental sclerosis (FSGN) that did not meet any known classification of LN. Hence, they were reevaluated using EM that revealed diffuse effaced podocytes without glomerular sub-epithelial, endocapillary or basement membrane immune deposits, and were classified as having lupus podocytopathy, representing (8.14%) of all LN biopsies. Those seven cases showed good response to steroids with a complete remission duration of 3.40 ± 1.95 weeks. However, some case had 1–3 relapses during the duration of follow up. Conclusions LP is a spectrum of p-SLE, not an association as it is related to disease activity and its initial presentation.

scholarly journals Use of Feldspathic Porcelain Veneers to Improve Smile Harmony: A 3-Year Follow-up Report

2016 ◽  
Vol 27 (6) ◽  
pp. 767-774 ◽  
Author(s):  
Leonardo Federizzi ◽  
Érica Alves Gomes ◽  
Samantha Schaffer Pugilato Báratro ◽  
Flares Baratto-Filho ◽  
Ataís Bacchi ◽  
...  
Keyword(s):  
Clinical Success ◽  
Relevant Literature ◽  
Clinical Results ◽  
Anterior Teeth ◽  
Correct Execution ◽  
Bond Interface ◽  
Laboratory Procedures ◽  
Feldspathic Porcelain ◽  
Strength And Durability

Abstract This case report describes an esthetic treatment to improve the shape and alignment of the anterior teeth, reestablishing smile harmony, using feldspathic porcelain veneers. Results of clinical follow up after 36 months are also presented. The advantages, disadvantages and limitations of the technique are detailed with reference to the relevant literature. This suggests that the success of treatment depends on adequate conditions of bonding between the veneers and the tooth complex, which involves parameters such as the strength and durability of the bond interface. Therefore, the clinical success of feldspathic porcelain veneers depends on the accurate selection of cases and correct execution of clinical and laboratory procedures. The rehabilitation involved from first right premolar to the left with feldspathic porcelain veneers made on refractory dies. After the 3-year follow up, excellent clinical results and patient satisfaction were achieved.

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