scholarly journals Skeletal Manifestations of Scurvy: A Case Report from Dubai

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Shahryar Noordin ◽  
Naveed Baloch ◽  
Muhammad Sohail Salat ◽  
Abdul Rashid Memon ◽  
Tashfeen Ahmad
Keyword(s):  
Dietary Habits ◽  
Bone Age ◽  
Developed Countries ◽  
Nutritional Deficiencies ◽  
X Rays ◽  
Dietary History ◽  
Ankle Joints ◽  
Pakistani Origin ◽  
Zone Of Provisional Calcification ◽  
High Index Of Suspicion

Introduction. Nutritional deficiencies are rarely reported in developed countries. We report a child of Pakistani origin brought up in Dubai who developed skeletal manifestations of scurvy due to peculiar dietary habits.Case Presentation. A 4.5 year old boy presented with pain and swelling of multiple joints for three months and inability to walk for two months. Dietary history was significant for exclusive meat intake for the preceding two years. On examination the child’s height and weight were below the 5th percentile for his age. He was pale and tachycardic. There was significant swelling and tenderness over the wrist, knee and ankle joints, along with painful restriction of motion. Basic blood workup was unremarkable except for anemia. However, X-rays showed delayed bone age, severe osteopenia of the long bones, epiphyseal separation, cortical thinning and dense zone of provisional calcification, suggesting a radiological diagnosis of scurvy. The child was started on vitamin C replacement therapy. Over the following two months, the pain and swelling substantially reduced and the child became able to walk. Repeat X-rays showed improvement in the bony abnormalities.Conclusion. Although scurvy is not a very commonly encountered entity in the modern era, inappropriate dietary intake can lead to skeletal abnormalities which may be confused with rickets. A high index of suspicion is thus required for prompt diagnosis of scurvy in patients with bone and joint symptoms.

HIGH LEVELS OF UNEMPLOYMENT IN THE MERCANTILIST ERA

2014 ◽  
Vol 36 (2) ◽  
pp. 237-251 ◽  
Author(s):  
John M. Letiche
Keyword(s):  
Twentieth Century ◽  
General Theory ◽  
Developed Countries ◽  
Nutritional Deficiencies ◽  
Less Developed Countries ◽  
Political Unrest ◽  
Keynes General Theory

This article draws attention to the high levels of unemployment in the mercantilist era, a parallel to conditions in the less developed countries at the present time. Understandably, distinguished economists of the twentieth century, writing before the publication of Keynes’ General Theory, tended to underestimate this problem. Actual causes of the high levels of unemployment are examined, including the fluctuating impacts of merchant entrepreneurs, agricultural revolutions, political unrest, and warfare, as well as nutritional deficiencies, which contributed directly to unemployment.

scholarly journals The Paradox of Happy Hypoxia in COVID 19

2021 ◽  
pp. 119-124
Author(s):  
Madhu Bansode ◽  
Pankaj Bansode
Keyword(s):  
Young Patients ◽  
The Elderly ◽  
Clinical Implications ◽  
X Rays ◽  
The Novel ◽  
Human Race ◽  
Self Monitoring ◽  
Diagnostic Modalities ◽  
High Index Of Suspicion ◽  
Rule Out

Ever since the human race has been exposed to the novel COVID 19 illness, newer and newer intriguing features of the COVID viral plethora are seen with each passing day. Many manifestations of the COVID 19 illness have been baffling and unexplainable to researchers currently. One such unusual presentation seen is ‘happy hypoxia’ or silent hypoxemia in a third of patients' total number. This review article is intending to put some light on the puzzling condition of happy hypoxia. We authors refer you through various theories postulated for happy hypoxia. It has definite clinical implications in the sense that it can be lifesaving if detected early and promptly in a COVID patient. We conclude that happy hypoxia or silent hypoxemia is a new entity and should be diagnosed with a high index of suspicion in COVID suspect patients in both young patients with no co morbidities and the elderly and diabetics. Diagnostic modalities like pulse oximeter should be widely used at hospitals and clinics and for self-monitoring by the patients at homes. Also, chest X-rays or HRCT imaging of the lungs is essential in the early stages to identify the early infective changes with compromised lung function and rule out this happy hypoxia. Also, further research is essential to find the exact ethologic of this subclinical though ominous prognostic entity.

scholarly journals Parathyroid hormone is elevated but bone markers and density are normal in young female subjects who consume inadequate dietary calcium

2000 ◽  
Vol 84 (1) ◽  
pp. 111-116 ◽  
Author(s):  
D. Bonofiglio ◽  
M. Maggiolini ◽  
S. Catalano ◽  
S. Marsico ◽  
S. Aquila ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Bone Mass ◽  
Population Sample ◽  
Negative Relationship ◽  
Bone Age ◽  
Sex Hormone Binding Globulin ◽  
X Rays ◽  
Mineral Density ◽  
Early Puberty ◽  
Igf I

Dietary Ca and osteocalcin (OC), parathyroid hormone (PTH), 25-hydroxyvitamin D (25-OH-D), insulin-like growth factor (IGF)-I and sex hormone binding globulin (SHBG) were assessed simultaneously to bone mineral density (BMD) in 200 adolescent girls (aged 11–15 years) and 100 young women (aged 20–23 years), selected from the lowest and highest end of the Ca intake distribution of a larger population sample. Ca intake was evaluated by food frequency questionnaires, BMD was measured by dual energy x-ray absorptiometry at ultradistal and proximal radius of non-dominant arm, bone age was estimated from x-rays of left hand and wrist according to. Surprisingly, mean Ca intakes were below the dietary reference intakes in the subgroups of girls and women with the highest measured Ca consumption. Postmenarcheal, but not premenarcheal girls showed radial densities as high as the women and in no group was BMD associated with Ca intake. In all adolescents serum PTH was negatively related to dietary Ca. In girls before menarche IGF-I was positively associated with bone age, while in the same subjects the negative relationship between SHBG and BMD pointed to the crucial role of bioavailable sex steroids on bone mass apposition in early puberty. OC levels decreased progressively with age, while serum 25-OH-D significantly increased after menarche. In conclusion, although in adolescents low Ca intake has not been shown to induce any immediate deleterious effect on radial density, the compensatory hypersecretion of PTH supports the need for an adequate Ca intake to achieve peak bone mass.

Health, Developmental, and Nutritional Status of Adolescent Alcohol and Marijuana Abusers

PEDIATRICS ◽  
1987 ◽  
Vol 79 (2) ◽  
pp. 218-223
Author(s):  
James A. Farrow ◽  
Jane M. Rees ◽  
Bonnie S. Worthington-Roberts
Keyword(s):  
Liver Function ◽  
Nutritional Status ◽  
General Health ◽  
Dietary Habits ◽  
Pediatric Population ◽  
Pubertal Development ◽  
Self Report ◽  
Dietary History ◽  
Chemical Abuse ◽  
The Impact

The impact of alcohol and marijuana abuse on the physical health and nutritional status of adolescents has not been well documented. The health consequences of alcoholism and chemical abuse in adults may not relate to the pediatric population. Forty-nine adolescent boys (mean age 15.8 years) with varying degrees of alcohol and marijuana use by self-report were evaluated as to their general health, pubertal development and nutritional status using health and dietary history, physical examination, anthropometrics, and biochemical assays of liver function and tissue nutrients. Thirteen (27%) were alcohol and marijuana abusers, 20 (41%) marijuana abusers, and 16 (32%) nonusers. There were significant differences between alcohol and marijuana abusers and marijuana abusers compared to nonusers with respect to endorsing symptoms of nutritional deficiency (muscle weakness, bleeding gums, tiredness, etc) (P < .001). There were no significant differences between subgroups in other nutritional measures except plasma zinc concentration which was low in marijuana abusers (mean 85µg/dL). All adolescents reported consuming adequate nutrients, although alcohol and marijuana abusers reported eating more snack foods and less fruit, vegetables, and milk than other groups. There were no significant differences in hemotologic status (complete blood cell count, transferrin, folate), liver function (γ-glutamyltranspeptidase), or anthropometric and sexual maturational indices of growth. There were no chronic signs of chemical abuse by physical examinations. It appears that health and nutritional disability from chemical abuse in adolescents relates more to poor dietary habits and symptomatic deterioration in general health than to specific effects on growth or nutritional status. Studies with larger numbers of subjects need to document these findings.

Knee joint dislocation: overview and current concepts

2021 ◽  
pp. 1-10
Author(s):  
Fitzgerald C Anazor ◽  
Kwaku Baryeh ◽  
Neville C Davies
Keyword(s):  
Knee Joint ◽  
Functional Limitation ◽  
Knee Injuries ◽  
X Rays ◽  
Specialist Care ◽  
Ligament Repair ◽  
Joint Dislocation ◽  
High Index Of Suspicion ◽  
Knee Dislocations

Knee joint dislocation is a relatively uncommon injury but its management is important because of the associated high risk of vascular, neurological and multi-ligamentous knee injuries. Clinicians must be aware that not all knee dislocations are diagnosed on plain X-rays; a high index of suspicion is required based on clinical evaluation. Multidisciplinary specialist care is required in all cases to achieve best outcomes. Early one-stage or multiple staged ligament repair and reconstruction offer better outcomes, but most patients have some long-term functional limitation. This article provides insights into the epidemiology and management of this injury and its devastating effects.

Non-alcoholic fatty liver disease – discussed under the light of Unani medicine

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Mohd Riyazuddin ◽  
Arisha Shahid
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Dietary Habits ◽  
Primary Source ◽  
Developed Countries ◽  
The Body ◽  
Excessive Alcohol Consumption ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Abstract Non-alcoholic Fatty Liver Disease (NAFLD) is one of the diseases that have evolved lately into a major challenge for gastroenterologists. Although, the term NAFLD has not been familiar to the medical world since long, other conditions resembling the presentation of NAFLD have been there since primitive times. It is a reversible condition of the liver, wherein large vacuoles of triglyceride fat accumulates in liver cells via the process of steatosis, despite any evidence of excessive alcohol consumption. In the developed countries NAFLD is reported to be the most common liver disorder, with a worldwide prevalence of 6–35%, in India its prevalence has been increasing gradually. Unani physicians have described liver as one of the principal organs of the body. It is the primary source of natural faculties, where the functions of digestion, concoction, absorption and excretion are performed, normally temperament of liver is hot and moist which can get converted to cold due to mutable dietary habits, consumption of fatty and cold food in abundance etc. In Unani System of Medicine, NAFLD has not been described as such, but it can be studied under Su’-i-Mizāj Kabid Bārid due to correlation of most of the symptoms. Its management mainly consists of elimination of morbid matter which is accumulated in the liver and correction of Su’-i-Mizāj Kabid Bārid by using drugs having opposite temperament (Ilaj bil zid).

scholarly journals P649 Dietary habits in patients with inactive Crohn’s disease: Results of a controlled study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S535-S535
Author(s):  
N Ben Mustapha ◽  
H Ben Youssef ◽  
A Labidi ◽  
M Hafi ◽  
M Fekih ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Dietary Habits ◽  
Controlled Study ◽  
Control Group ◽  
Cross Sectional ◽  
Dietary History ◽  
Dietary Restrictions ◽  
Digestive Disorders ◽  
Vegetables And Fruits

Abstract Background The purpose of this study was to compare the dietary habits of patients with Crohn’s disease in remission with a control group. Methods This is a comparative cross-sectional descriptive study that took place over a period of one month including 45 patients already managed for Crohn’s disease (CD), who had been in stable clinical remission for at least 6 months at the time of the survey and had the same treatment for at least 6 months compared with a group of 40 healthy volunteers adjusted for age, sex and body mass index (BMI) recruited among health personnel. Questionnaires about dietary habits, patients’ attitudes and beliefs about diet and its impact on their illness, and a dietary history-type food survey were asked and completed for all subjects. Results Total energy and macronutrient intakes were comparable in both groups and adapted to the guidelines. Fibre and micronutrient intakes were significantly lower in CD group, as was the consumption of dairy products, legumes, vegetables and fruits, oleaginous fruit. There were multiple dietary restrictions among CD patients including milk and its derivatives, fruits, vegetables, and legumes. In fact, 11% of them continued to strictly follow the same residue-free diet prescribed at the time of flares and others had barely expanded their diet. The reasons were mainly represented by the fear of triggering digestive disorders in 77% of cases. Fifty-six per cent of patients believed that fibre and milk negatively affect their disease and could trigger digestive disorders. Forty-four per cent said that the avoided foods gave them digestive disorders. By stratifying patients by age, sex or disease characteristics (location, treatment, history of surgery), we found no predictive factor for these dietary restrictions. Moreover, in 23% of patients, the diet was totally obscured by the doctor during consultations. In addition, and despite the discussion with the doctor about food, 46% turned to other sources such as the entourage, other patients, media and internet to find information on their diet. Conclusion Our study shows that patients with Crohn’s disease in remission suffer from several deficiencies due to multiple dietary exclusions. The results suggest that an unbalanced diet should be identified to avoid the micronutrient deficiency observed and highlights the importance of communication about diet between Doctors and patients.

scholarly journals Automated Determination of Bone Age in a Modern Chinese Population

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Shao-Yan Zhang ◽  
Gang Liu ◽  
Chen-Guo Ma ◽  
Yi-San Han ◽  
Xun-Zhang Shen ◽  
...  
Keyword(s):  
Los Angeles ◽  
Chinese Population ◽  
Age Determination ◽  
Bone Age ◽  
Chinese Children ◽  
X Rays ◽  
Automated Method ◽  
Rating Method ◽  
Set Up

Rationale and Objective. Large studies have previously been performed to set up a Chinese bone age reference, but it has been difficult to compare the maturation of Chinese children with populations elsewhere due to the potential variability between raters in different parts of the world. We re-analysed the radiographs from a large study of normal Chinese children using an automated bone age rating method to establish a Chinese bone age reference, and to compare the tempo of maturation in the Chinese with other populations. Materials and Methods. X-rays from 2883 boys and 3143 girls aged 2–20 years from five Chinese cities, taken in 2005, were evaluated using the BoneXpert automated method. Results. Chinese children reached full maturity at the same age as previously studied Asian children from Los Angeles, but 0.6 years earlier than Caucasian children in Los Angeles. The Greulich-Pyle bone age method was adapted to the Chinese population creating a new bone age scale BX-China05. The standard deviation between BX-China05 and chronologic age was 1.01 years in boys aged 8–14, and 1.08 years in girls aged 7–12. Conclusion. By eliminating rater variability, the automated method provides a reliable and efficient standard for bone age determination in China.

Nutritional assessment

2018 ◽  
Author(s):  
John Puntis
Keyword(s):  
Nutritional Assessment ◽  
Protein Energy Malnutrition ◽  
Growth Failure ◽  
Developed Countries ◽  
Nutritional Deficiencies ◽  
Negative Effects ◽  
Healthy Life ◽  
Protein Energy ◽  
Nutritional Needs ◽  
Routine Assessment

Routine assessment of nutritional status should be part of normal practice when seeing any patient. The purpose is to document objective nutritional parameters (e.g. anthropometry), identify nutritional deficiencies, and establish nutritional needs. Protein–energy malnutrition has many adverse consequences including growth failure (identified by reference to standard growth charts). Worldwide, malnutrition contributes to a third of deaths in children under 5 years of age, and one in nine people don’t have enough food to lead an active and healthy life. In developed countries, malnutrition complicates both acute and chronic illness with negative effects on outcomes. In clinical practice, a useful approach to nutritional assessment is to consider three elements: ‘what you are’ (i.e. body habitus—underweight for height; short for age; etc.), ‘what you can do’ (functional activity), and ‘what you eat’ (current nutritional intake).

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