Role of Anthropometric Nutritional Assessment in Severe Head Injury

2019 ◽  
Vol 16 (01) ◽  
pp. 21-26
Author(s):  
Manju Dhandapani ◽  
Sivashanmugam Dhandapani ◽  
Meena Agarwal ◽  
Alka Chutani ◽  
Bhawani S. Sharma ◽  
...  
Keyword(s):  
Head Injury ◽  
Severe Head Injury ◽  
Nutritional Assessment ◽  
Unfavorable Outcome ◽  
Skin Fold Thickness ◽  
Skin Fold ◽  
Arm Circumference ◽  
Triceps Skin Fold ◽  
Systemic Disorder ◽  
Independent Association

Abstract Aim Nutritional demand after traumatic brain injury is increased due to hypermetabolic response. The present study was undertaken to assess nutritional status with anthropometric indices, factors associated, and their prognostic role following severe head injury (SHI). Method A total of 114 patients in age group 20 to 60 years, admitted within 24 hours of SHI, with Glasgow Coma Scale of 4 to 8, and with no serious systemic disorder were enrolled for the study. Of these, 67 were prospectively assessed weekly till 21 days for changes in mid arm circumference (MAC), mid arm muscle circumference (MAMC), and triceps skin fold thickness (TSF). They were studied in relation to other factors and outcome was assessed at 3 months. Results The percentage fall at 3 weeks for MAC, MAMC, and TSF were 14, 10, and 37%, respectively. The percentage of fall in MAMC was the earliest, and was significantly greater in patients with surgical intervention, tracheostomy, prolonged fever, delayed enteral feeding, and greater caloric deficit. Admission MAMC < 90% of standard was significantly associated with unfavorable outcome (odds ratio 5.9 [95% confidence interval 1.3–27.8], p = 0.01). Unfavorable outcome was significantly more frequent in patients who had at least 15% fall in MAC (85.7 vs. 41.9%, p = 0.03), or 10% fall in MAMC (68.8 vs. 38.2%, p = 0.04) at 2 weeks, compared with others. Fall in TSF had no significant association with outcome at 3 months. In multivariate analysis, MAMC fall had significant independent association with unfavorable outcome. Conclusion Bedside anthropometry (especially MAMC) is efficient in identifying patients with nutrition depletion with significant influence on outcome at 3 months.

scholarly journals Correlation of body mass index with biceps and triceps skin fold thickness

2020 ◽  
Vol 7 (4) ◽  
pp. 1475
Author(s):  
Snehal P. Chavhan ◽  
Mandar V. Chandrachood
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Nutritional Assessment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Skin Fold Thickness ◽  
Institutional Ethics ◽  
Skin Fold ◽  
Triceps Skin Fold ◽  
Triceps Skin Fold Thickness

Background: Body mass index (BMI) and skin fold thickness are independently established methods of nutritional assessment. Present study tries to find out correlation between them.Methods: A cross sectional study was conducted in private medical college among 2nd year MBBS students. Total 24 students were sampled by purposive sampling method. After obtaining permission from Institutional Ethics committee and written informed consent from participants, study information was gathered using semi structured proforma. Anthropometric measurements were taken using standard techniques and equipments. Data was analysed using Microsoft Excel and Prism version 5.0 and appropriate tests were used considering normality of data.Results: Out of 24 study participants 14 were males and 10 were females. Mean weight was 59.29±12.59 kg, mean height was 164.77±10.28 cm, mean BMI was 21.68±3.18 kg/m2. Mean biceps skin fold thickness was 7.20±2.68 mm and mean triceps skin fold thickness was 10.75±3.33mm. Of all the participants 4 (16.67%) were having underweight BMI, 15 (62.50%) were having normal BMI, 5 (20.83%) were pre-obese. BMI correlated significantly with triceps skin fold thickness Spearman’s r=0.53, p=0.006 as compared to biceps skin fold thickness Spearman’s r=0.36, p=0.07 in complete sample. Among males BMI correlated significantly with triceps skin fold thickness Spearman’s r=0.64, p=0.01 as compared to biceps skin fold thickness.Conclusions: BMI correlates significantly with triceps skin fold thickness as compared to biceps skin fold thickness in general. Significant correlation between BMI and triceps skin fold thickness was found with males as compared to females.

Nutritional assessment and requirements

2011 ◽  
Author(s):  
R. Mark Beattie ◽  
Anil Dhawan ◽  
John W.L. Puntis
Keyword(s):  
Nutritional Status ◽  
Nutritional Assessment ◽  
Supply And Demand ◽  
Simple Method ◽  
Feeding Difficulties ◽  
Dietary History ◽  
Skin Fold Thickness ◽  
Skin Fold ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

Nutritional assessment 2Risk factors for undernutrition 3Nutritional intake 4Taking a feeding history 5Basic anthropometry: the assessment of body form 6Growth 7Patterns of growth 15Malnutrition 17Nutritional requirements 19Nutritional status reflects the balance between supply and demand and the consequences of any imbalance. Nutritional assessment is therefore the foundation of nutritional care for children. When judging the need for nutritional support an assessment must be made both of the underlying reasons for any feeding difficulties, and of current nutritional status. This process includes a detailed dietary history, physical examination, anthropometry (weight, length; head circumference in younger children) with reference to standard growth charts, and basic laboratory indices when possible. In addition, skin fold thickness and mid-upper arm circumference measurements provide a simple method for estimating body composition....

scholarly journals ANTHROPOMETRIC PROFILE OF CHILDREN WITH CYANOTIC AND NONCYANOTIC CONGENITAL HEART DISEASE

2020 ◽  
Vol 15 (1) ◽  
pp. 1
Author(s):  
Mahrus Rahman ◽  
I Ketut Alit Utamayasa ◽  
Taufiq Hidayat ◽  
Roedi Irawan ◽  
Rina Elizabeth
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Nutritional Status ◽  
Congenital Heart ◽  
Cyanotic Congenital Heart Disease ◽  
Upper Arm ◽  
Skin Fold Thickness ◽  
Skin Fold ◽  
Arm Circumference ◽  
Mid Upper Arm Circumference

Impaired nutritional status is a frequent complication of congenital heart disease (CHD). Non cyanotic congenital heart disease (NC-CHD) have problem with lung overfl ow and heart failure. Consequences of Cyanotic congenital heart disease (C-CHD) are decrease pulmonary blood fl ow and prolong hypoxia. These conditions can have eff ect on nutritional status and outcome of surgery. This study aimed to compare anthropometric profi les of children with C-CHD and NC-CHD. Cross-sectional study conducted in 66 children, age 3 months until 5 years old who met inclusion criteria in Pediatric Cardiology Outpatient Unit Dr. Soetomo Hospital Surabaya in November 2012. A total of 66 children, consisted of 26 children with C-CHD and 40 children NC-CHD included in study. We measure weight, length/height, head circumference, upper arm circumference, and skin fold thickness. We used Chi Square test for statistical analysis with Confi dence Interval 95%. Mean age of both groups was 27.82 ± 16.63 months. Majority of NC-CHD was Ventricular Septal Defect (28.6%) and C-CHD was Tetralogy of Fallot (21.4%). There were no signifi cant diff erence from weight for age, length for age weight for length, head circumference for age, mid upper arm circumference for age, mid upper arm circumference for age, and skin fold thickness for age between children with C-CHD and NC-CHD (p= 0.80; 0.98;0.54 0.29; 0.80; 0.53 respectively). There were no diff erence in anthropometric profi les among children with cyanotic congenital heart disease and non-cyanotic congenital heart disease in this study.

Abdomen System

2010 ◽  
Author(s):  
Gautam Mehta ◽  
Bilal Iqbal
Keyword(s):  
Liver Disease ◽  
Vascular Lesions ◽  
Skin Fold Thickness ◽  
System P ◽  
Skin Fold ◽  
Normal Individuals ◽  
Palmar Erythema ◽  
Triceps Skin Fold ◽  
Specific Finding ◽  
Fat Stores

1. Jaundice is a marker of severity of liver disease, as well as a consequence of decompensation. Yellow discolouration is not usually seen until the serum bilirubin is >40μmol/L (twice the upper limit of normal), although the earliest signs of jaundice can be detected in the periphery of the conjunctivae, or in the buccal mucosa. Remember, there are other causes of jaundice in liver disease, such as Zieve’s syndrome (haemolysis and hyperlipidaemia in alcohol misuse), or biliary obstruction. 2. Cachexia can be established by demonstrating muscle and fat loss. Wasting of the temporalis muscle is an early sign of generalized muscle atrophy. A reduced triceps skin-fold thickness is a marker of loss of fat stores. This can be demonstrated by palpating for redundant skin over the triceps area between your thumb and forefingers. 3. Anaemia is most reliably demonstrated by looking for conjunctival pallor. This is thought to be more sensitive than looking for pallor of skin creases, nails, or other mucosal membranes. If there is no evidence of anaemia, it is an important negative to mention to the examiner. The principal causes of anaemia in chronic liver disease are blood loss from portal hypertensive gastropathy, alcohol excess causing bone marrow suppression and poor nutrition. 4. Other gastrointestinal (GI) causes of clubbing include inflammatory bowel disease (IBD), coeliac disease, GI lymphoma and rare causes of malabsorption such as tropical sprue and Whipple’s disease. 5. Leuconychia is a non-specific finding which is associated with hypoalbuminaemia as well as other conditions such as heart failure, renal disease, Hodgkin’s lymphoma (HL) and diabetes mellitus (see Case 8—Nephrotic Syndrome). 6. Palmar erythema reflects the vasodilated state of cirrhosis. Other causes of palmar erythema include hypercapnoea, rheumatoid arthritis, thyrotoxicosis, pregnancy, fever, and exercise. 7. Spider naevi are vascular lesions, with a central arteriole that supplies smaller surrounding vessels. Generally, the number and size correlate with the severity of liver disease, although they may occur in normal individuals and pregnancy. Spider naevi, palmar erythema, gynaecomastia, and loss of body hair are thought to be the consequence of altered sex hormone metabolism, and an increase in the oestradiol:free testosterone ratio.

Assessment of Nutrition Status in Children with Leukemia: A Study from a Developing Country

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1317-1317
Author(s):  
Soma Mukhopadhyay ◽  
Tusi Dutta ◽  
Sonali Dey ◽  
Somnath Datta ◽  
Ashis Mukhopadhyay
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Disease Free Survival ◽  
Skin Fold Thickness ◽  
Skin Fold ◽  
Low Weight ◽  
Arm Circumference ◽  
Height For Age ◽  
Weight For Age ◽  
Low Serum

Abstract Background: In developing countries 40 % children suffer from mal-nutrition. It has been shown that a good nutritional status can reduce complications of treatment, strengthen the immune system and contribute to the patient’s general well being throughout treatment. A good nutritional status is therefore essential for optimal treatment of a leukemic child. The aim of our study was to see the nutritional status of leukemic children on diagnosis and effect of nutrition on outcome of therapy. Material & Methods: During period from January 2004 to December 2007 we prospectively analyzed the nutritional status of 400 paediatric patients in Netaji Subhash Chandra Bose Cancer Research Institute, a tertiary cancer center of Eastern India. The age of the patients were 1 to 18 years (median age 12.5 years). The parameter analyzed were weight for age, height for age, total protein, serum albumin and skin fold thickness. The weight for age, height for age and skin fold thickness were taken as normal if they were between 3rd and 97th percentile curve of the growth chart recommended by the Indian Council of Medical Research. The albumin level and the total protein was considered normal if the value is equal to or more than 3gm% and 5.8gm% respectively. Result: It was seen that total 56 patients (14% children) were low weight for age, 40 patients (10% children) were low height and 67 patients (16.75% children) had low mid arm circumference. Total 44 patients (11% children) had low serum albumin while 80 patients (20% children) had low serum protein. It was found that low weight for age, low serum albumin and low mid arm circumference were significance factors in remission induction, disease free survival and toxicity of chemotherapy (p &lt; 0.005). Conclusion: We conclude that mal-nutrition is a major finding in cancer patients with leukemia in developing country like ours. The patient with mal-nutrition had less remission in induction, disease free survival and more toxicities during therapy as compared to well-nourished children.

Extracranial complications of severe head injury

1992 ◽  
Vol 77 (6) ◽  
pp. 901-907 ◽  
Author(s):  
Jürgen Piek ◽  
Randall M. Chesnut ◽  
Lawrence F. Marshall ◽  
Marjan van Berkum-Clark ◽  
Melville R. Klauber ◽  
...  
Keyword(s):  
Head Injury ◽  
Severe Head Injury ◽  
Time Course ◽  
Data Bank ◽  
Systemic Blood Pressure ◽  
Unfavorable Outcome ◽  
Stepwise Logistic Regression ◽  
Electrolyte Disorders ◽  
Content Type ◽  
Extracranial Complications

✓ In order to define the role of intracranial and extracranial complications in determining outcome from severe head injury, 734 patients from the Traumatic Coma Data Bank were analyzed. Nine classes of intracranial and 13 classes of extracranial complications occurring within the first 14 days after admission were analyzed, while controlling for age, admission Glasgow Coma Scale motor score, early hypoxia or hypotension, and severe extracranial trauma. Outcome for survivors was based on the last recorded Glasgow Outcome Scale score, obtained a median of 521 days after injury. Intracranial complications did not significantly alter outcome for the study group. Of the extracranial complications, pulmonary, cardiovascular, coagulation, and electrolyte disorders occurred most frequently at 2 to 4 days. Infections developed later, peaking at 5 to 11 days. Gastrointestinal, renal, and hepatic complications followed no specific time course. Electrolyte abnormalities were the most frequent occurrence (59% of patients) but did not alter outcome. Pulmonary infections (41%), shock (29%, systemic blood pressure ≤ 90 mm Hg for 30 minutes or more), coagulopathy (19%), and septicemia (10%) were significant independent predictors of an unfavorable outcome. Backward-elimination, stepwise logistic regression modeling indicated that the estimated reduction of unfavorable outcome was 2.9% for the elimination of pneumonia, 3.1% for coagulation disturbances, 1.5% for septicemia, and 9.3% for shock. These data suggest that extracranial complications are highly influential in determining the outcome from severe head injury and that significant improvements in outcome in a sizeable proportion of patients could be accomplished by improving the ability to prevent or reverse pneumonia, hypotension, coagulopathy, and sepsis.

scholarly journals Nutritional Profile of Patients with Acquired Immunodefience Syndrome

2021 ◽  
pp. 42
Author(s):  
Keyword(s):  
Body Mass Index ◽  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Waist Circumference ◽  
Nutritional Status ◽  
Body Mass ◽  
Skin Fold ◽  
Arm Circumference ◽  
Immunodeficiency Virus ◽  
Triceps Skin Fold

Objective: To evaluate the nutritional status of patients living with the human immunodeficiency virus and making use of antiretroviral medication. Methods: This is an observational cross-sectional analytical study that was conducted from May to July 2018. The nutritional status was determined through the evaluation of anthropometric data. The anthropometric measurements collected were: body mass index, brachial circumference, triceps skin fold and waist circumference. Results: We evaluated 120 patients in regular use of antiretroviral therapy. According to the body mass index, most individuals (41.2%) presented eutrophy, followed by overweight (35.7%). Regarding waist circumference, about 30% of patients presented a much increased risk for cardiovascular diseases. It was also observed that 47.5% of the patients presented eutrophy through the arm circumference parameter. Regarding the anthropometric parameter, triceps skin fold, it was observed that 29.9% of the patients presented severe malnutrition, followed by obesity (24.2%). Conclusion: It is known that even individuals undergoing antiretroviral therapy, aiming at slowing the progression of the disease, may present a possible involuntary weight loss during treatment. When related, the parameters of arm circumference, triceps skin fold, and waist circumference characterize the clinical signs of lipodystrophic syndrome, defined as abnormal redistribution of body fat. It is concluded that constant nutritional monitoring of patients in regular use of antiretroviral therapy drugs is necessary in order to prevent possible complications in the nutritional status of patients living with the human immunodeficiency virus.

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