Optimal Cutoff Values for Anthropometric Adiposity Measures of Sri Lankan Adult Women

Anthropometric adiposity measures (AAMs) such as body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) are used to evaluate obesity status. Country-specific cutoff values of AAMs would provide more accurate estimation of obesity prevalence. This cross-sectional study was designed to determine the optimal cutoff values for AAMs, BMI, WC, hip circumference (HC), and WHR, of Sri Lankan adult women. The study was conducted in Galle, Sri Lanka, with 350 healthy community-dwelling middle-aged women aged 30–60 years, divided into two groups (Group A, n = 175 and Group B, n = 175). Total body fat percentage (TBFP) (kg) was measured with DXA. Body weight (kg), height (m), and WC and HC (cm) were measured. BMI (kg/m2) and WHR were calculated. Optimal cutoff values were determined by area under curve (AUC) in Receiver-Operating Characteristic (ROC) curve analysis using TBFP as the criterion at the TBFP level of 33% and 35% using the women in Group A. Then, the prevalence of obesity was determined in Group B while comparing the prevalence based on the cutoff values recommended by the World Health Organization (WHO) for Asians and the newly developed cutoff values for Sri Lankan women. Optimal cutoff values of AAMs which correspond to TBFP 33% are BMI, 24.5 kg/m2; WC, 80 cm; HC, 95 cm; and WHR, 0.83. TBFP 35% corresponds to the optimal cutoff values of BMI, 25.0 kg/m2; WC, 85 cm; HC, 100 cm; and WHR, 0.83. Prevalence of obesity (number, %) according to the WHO and newly defined cutoff values that correspond to TBFP 33% and 35% were as follows: BMI = 83 (47.4%), 98 (56.0%), 83 (47.4%); WC = 106 (60.6%), 106 (60.6%), 72 (41.1%); and WHR = 140 (80.0%), 106 (60.6%), 106 (60.6%). The observed cutoff values of BMI and WC in this study were within the ranges of those described by the WHO for Asian populations which correspond to the 33% and 35% TBFP levels, respectively. However, the WHR cutoff value of WHO (Asians) is lower when compared to the newly determined value for Sri Lankan females while overestimating the prevalence. More studies are needed to confirm these values before clinical use.

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Changes in the palliative performance scale may be as important as the initial palliative performance scale for predicting survival in terminal cancer patients

Palliative & Supportive Care ◽

10.1017/s1478951520001248 ◽

2021 ◽

pp. 1-5

Author(s):

Guk Jin Lee ◽

Ji Hyun Gwak ◽

Myoung Sim Kim ◽

Mi Yeong Lee ◽

Seo Ree Kim ◽

...

Keyword(s):

Cancer Patients ◽

Gastrointestinal Cancer ◽

Poor Prognosis ◽

Accurate Estimation ◽

Terminal Cancer ◽

Hospice Patients ◽

Terminal Cancer Patients ◽

Group A ◽

Group B ◽

Performance Scale

Abstract Objective The accurate estimation of expected survival in terminal cancer patients is important. The palliative performance scale (PPS) is an important factor in predicting survival of hospice patients. The purpose of this study was to examine how initial status of PPS and changes in PPS affect the survival of hospice patients in Korea. Method We retrospectively examined 315 patients who were admitted to our hospice unit between January 2017 and December 2018. The patients were divided based on the PPS of ≥50% (group A) and ≤40% (group B). We performed survival analysis for factors associated with the length of survival (LOS) in group A. Based on the hospice team's weekly evaluation of PPS, we examined the effect of initial levels and changes in group A on the prognosis of patients who survived for 2 weeks or more. Results At the time of admission to hospice, 265 (84.1%) patients were PPS ≥50%, and 50 (15.9%) were PPS ≤40%. The median LOS of PPS ≥50% and PPS ≤40% were 15 (2–158 days) and 9 (2–43 days), respectively. Male, gastrointestinal cancer, and lower initial PPS all predicted poor prognosis in group A. Male, gastrointestinal cancer, and a PPS change of 10% or greater, compared with initial status 1 week and 2 weeks of hospitalization, were all predictors of poor prognosis in group A patients who survived for 2 weeks or longer. Significance of results Our research demonstrates the significance of PPS change at 1 week and 2 weeks, suggesting the importance of evaluating not only initial PPS but also change in PPS.

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A Simple Clinical Scale to Stratify Risk of Recurrent Falls in Community-Dwelling Adults Aged 65 Years and Older

Physical Therapy ◽

10.2522/ptj.20090158 ◽

2010 ◽

Vol 90 (4) ◽

pp. 550-560 ◽

Cited By ~ 80

Author(s):

Severine Buatois ◽

Christine Perret-Guillaume ◽

Rene Gueguen ◽

Patrick Miget ◽

Guy Vançon ◽

...

Keyword(s):

Community Dwelling ◽

Added Value ◽

Clinical Scale ◽

Moderate Risk ◽

Stand Test ◽

Sit To Stand ◽

Balance Tests ◽

Recurrent Falls ◽

Group A ◽

Group B

BackgroundCorrect identification of people at risk for recurrent falls facilitates the establishment of preventive and rehabilitative strategies in older adults.ObjectiveThe purposes of this study were: (1) to develop and validate a simple clinical scale to stratify risk for recurrent falls in community-dwelling elderly people based on easily obtained social and clinical items and (2) to evaluate the added value of 3 clinical balance tests in predicting this risk.DesignThis was a prospective measurement study.MethodsA population of 1,618 community-dwelling people over 65 years of age underwent a health checkup, including performance of 3 clinical balance tests: the One-Leg-Balance Test, the Timed “Up & Go” Test, and the Five-Times-Sit-to-Stand Test. Falls were recorded using a self-administered questionnaire that was completed a mean (SD) of 25±5 months after the visit. Participants were randomly divided into either group A (n=999), which was used to develop the scale, or group B (n=619), which was used to prospectively validate the scale.ResultsLogistic regression analysis identified 4 variables that independently predicted recurrent falls in group A: history of falls, living alone, taking ≥4 medications per day, and female sex. Thereafter, 3 risk categories of recurrent falls (low, moderate, and high) were determined. Predicted probability of recurrent falls increased from 4.1% to 30.1% between the first and third categories. This scale subsequently was validated with great accuracy in group B. Only the Five-Times-Sit-to-Stand Test provided added value in the estimation of risk for recurrent falls, especially for the participants who were at moderate risk, in whom failure on the test (duration of >15 seconds) doubled the risk.LimitationsFalls were assessed only once, and length of follow-up was heterogeneous (18–36 months).ConclusionsClinicians could easily classify older patients in low-, moderate-, or high-risk groups of recurrent falls by using 4 easy-to-obtain items. The Five-Times-Sit-to-Stand Test provides added value to stratify risk for falls in people at moderate risk.

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Whole Genome Classification and Phylogenetic Analyses of Rotavirus B strains from the United States

Pathogens ◽

10.3390/pathogens7020044 ◽

2018 ◽

Vol 7 (2) ◽

pp. 44 ◽

Cited By ~ 4

Author(s):

Frances Shepherd ◽

Diana Herrera-Ibata ◽

Elizabeth Porter ◽

Nitipong Homwong ◽

Richard Hesse ◽

...

Keyword(s):

Phylogenetic Trees ◽

Phylogenetic Analyses ◽

Gene Segment ◽

Middle Layer ◽

The United States ◽

Viral Gastroenteritis ◽

Pairwise Identity ◽

Cutoff Values ◽

Group A ◽

Group B

Rotaviruses (RVs) are a major etiological agent of acute viral gastroenteritis in humans and young animals, with rotavirus B (RVB) often detected in suckling and weaned pigs. Group A rotavirus classification is currently based on the two outer capsid proteins, VP7 and VP4, and the middle layer protein, VP6. Using RVB strains generated in this study and reference sequences from GenBank, pairwise identity frequency graphs and phylogenetic trees were constructed for the eleven gene segments of RVB to estimate the nucleotide identity cutoff values for different genotypes and determine the genotype diversity per gene segment. Phylogenetic analysis of VP7, VP4, VP6, VP1–VP3, and NSP1–NSP5 identified 26G, 5P, 13I, 5R, 5C, 5M, 8A, 10N, 6T, 4E, and 7H genotypes, respectively. The analysis supports the previously proposed cutoff values for the VP7, VP6, NSP1, and NSP3 gene segments (80%, 81%, 76% and 78%, respectively) and suggests new cutoff values for the VP4, VP1, VP2, VP3, NSP2, NSP4, and NSP5 (80%, 78%, 79%, 77% 83%, 76%, and 79%, respectively). Reassortment events were detected between the porcine RVB strains from our study. This research describes the genome constellations for the complete genome of Group B rotaviruses in different host species.

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Evaluation of the efficacy of Latakaranja as Antispasmodic Drug in Kastaartava - A Randomised Clinical Control Trial

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.5.5.15 ◽

2020 ◽

Vol 5 (05) ◽

pp. 116-122

Author(s):

Dhiraj Ojha ◽

P.K. Rawal ◽

Shrishail S. Pujeri ◽

Sunita Shirguppi

Keyword(s):

Back Pain ◽

Family Doctor ◽

Research Work ◽

Causative Factor ◽

Adult Women ◽

Duration Of Treatment ◽

Post Test ◽

Group A ◽

Clinical Control Trial ◽

Group B

Kastaartava (Dysmenorrohea) is a greek word, describes about painful menstruation which the Pratyatmaka Lakhshans of various Yonivyapad that are Vatala Yonivyapad, Udavartini Yonivyapad, Paripluta Yonivyapad, Mahayoni and Vataja Artava Dusti that affects 75% of adolscents, 25-50% of adult women and 5-20% having dysmenorrhea. It is a common reason for losing time at school or work or visiting family doctor. Morbid Vatadosha especially Apanavata is a causative factor of Kastaartava. Vatahara properties are beneficial considering the morbidity and complications that are caused by Kastaaratava, mentioned above herbal preparation has been tried here. This research work is randomized control clinical study with Pre-test and Post-test design. 40 patients suffering from Kastaaratava (Dysmenorrohoea) were selected randomly for study. The selected patients were divided into 2 groups, 20 patients each. The selected 20 patients in Group A (Trial group) were administered Latakaranja Beeja Churna orally. The selected 20 patients in Group B (Controlled group) were administered Rajapravartini Vati. The duration of treatment was for 03 days of menstruation for 2 menstrual cycles and followup for the next menstrual cycle. After the completion of the clinical trial, it was found that in Rajapravartini Vati, there was highly significant result in Cramping pain in abdomen, Irritability, Tenderness in Breast, Back pain and Headache, where as Latakaranja Beeja Choorna there is also significant result in Cramping pain in Abdomen, Irritability, Tenderness in Breast, Back Pain, Headache and Vomiting but statistically considering average mean Latakaranja Choorna shows comparatively lesser effective than Rajapravartini Vati. By the statistical results it can be concluded that Rajapravartini Vati has better result when compared to Latakaranja Choorna in the present study.

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Outcome of implementing Surgical Safety Checklist in Pediatric Surgery in Tertiary Level hospital

Nepal Medical College Journal ◽

10.3126/nmcj.v23i1.36230 ◽

2021 ◽

Vol 23 (1) ◽

pp. 60-65

Author(s):

Jasmine Bajracharya ◽

R Shrestha ◽

HR Joshi ◽

RP Adhikari

Keyword(s):

Intervention Group ◽

World Health ◽

Care Group ◽

Tertiary Level ◽

Surgical Safety Checklist ◽

Surgical Safety ◽

Operative Care ◽

Group A ◽

Group B ◽

Level Hospital

The World Health Organization (WHO) implemented the Surgical Safety Checklist (SSCL) as a part of Safe Surgery Saves Lives campaign. Even after 12 years of implementation of WHO SSCL, available literature is still lacking from developing countries, where the potentially greatest impact could have been observed. A prospective randomized controlled trial done in Tertiary level hospital from September 2018 – February 2020 enrolled pediatric patients aged 0 day to 15 years. The patients were randomly allocated into groups by lottery as Group A - control and Group B – Intervention group. Group A was given the basic pre-operative care. Group B were enrolled in the safety checklist. The data were collected in the printed forms and analyzed. The patients were followed for surgical site infections (SSI). Compliance of the safety checklist was assessed with completion of the checklist fully or partially. Total cases enrolled were 310 with 155 in each group. Age of patients ranged from 1 day to 15 years. SSI was present in 35 patients in group A and 29 patients in group B. The Outcome of implementation of SSC on appearance of SSI was not significant. SSI was decreased on checklist implementation with OR of 0.78 (95% CI 0.45 – 1.37). Outcome of SSC compliance shown by OR was 0.39 (95% CI 0.15 – 0.99). Use of SSCL decreases the postoperative complications and improves the outcome. Compliance is the key to success of the implementation of the checklist.

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Changing trends and determinants of caesarean section using robson criteria in a government tertiary level hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20210737 ◽

2021 ◽

Vol 10 (3) ◽

pp. 1066

Author(s):

Anjali Singh ◽

Renuka Malik

Keyword(s):

Caesarean Section ◽

Caesarean Section Rate ◽

Study Groups ◽

World Health ◽

Tertiary Level ◽

Study Group ◽

Group A ◽

Group 2 ◽

Group B ◽

Level Hospital

Background: Robson Ten group classification system (TGCS) was proposed by World Health Organisation in 2014 for assessing, monitoring and comparing caesarean section rate between and within healthcare facilities. This tool was used in this study to analyse the determinants of caesarean section and compare with data of past.Methods: This observational comparative study was conducted at tertiary level hospital and included in study group A, 300 women delivered by caesarean section from November 2018 to November 2019 and in study group B, 300 women delivered by caesarean section from November 2015 to December 2016. The caesarean sections were classified as per TGCS to determine relative and absolute contribution made by each group to the overall caesarean section rate. The results were analysed to for determinants and change in trend.Results: In this study, the caesarean section rate in group A was 29.32% and group B was 28.03%. Group 2, 5, 1, 10 made the maximum contributions to overall caesarean section rate in both study groups. Group 2 was the largest contributor (25.00%) in study group A and 27.33% in study group B to overall caesarean sections.Conclusions: Implementing Robsons TGCS can help in comparing caesarean in an institution over a period of time and also among different institution at national and international level as a method of internal auditing, paving a way to rationalise and decrease Caesarean rate.

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Development and Cross-Validation of Anthropometric Predictive Equations to Estimate Total Body Fat Percentage in Adult Women in Sri Lanka

Journal of Obesity ◽

10.1155/2020/2087346 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Nirmala Rathnayake ◽

Gayani Alwis ◽

Janaka Lenora ◽

Sarath Lekamwasam

Keyword(s):

Body Fat ◽

Cross Validation ◽

Body Fat Percentage ◽

Adult Women ◽

Fat Percentage ◽

Predictive Equations ◽

Total Body Fat ◽

Group A ◽

Total Body ◽

Group B

Attempts have been made to estimate body fat using anthropometry, and most of them are country-specific. This study was designed to develop and cross-validate anthropometric predictive equations to estimate the total body fat percentage (TBFP) of Sri Lankan adult women. A cross-sectional study was conducted in Galle, Sri Lanka, with two groups: Group A (group for equation development) and Group B (cross-validation group) (n = 175 each) of randomly selected healthy adult women aged 30–60 years. TBFP (%) was quantified with total body DXA (TBFPDXA). Height (m), weight (kg), and skinfold thickness (SFT, mm) at six sites and circumferences (cm) at five sites were measured. In the first step, four anthropometric equations were developed based on the data obtained from multiple regression analyses (TBFPDXA = dependent variable and anthropometric measurements and age = independent variables) with Group A. They were developed on the basis of circumferences (TBFP1), SFTs (TBFP2), circumferences and SFTs (TBFP3), and highly significant circumferences and SFTs (r ≥ 0.6) (TBFP4). In the second step, the newly developed equations were cross-validated using Group B. Three equations (TBFP1, TBFP2, and TBFP4) showed the agreement with cross-validation criteria. There were no differences between TBFPDXA and TBFP estimated by these equations (p>0.05). They showed higher measurement concordance with TBFPDXA; correlation between measured TBFP with DXA and estimated with TBFP1, TBFP2, and TBFP4, respectively, was 0.80 (R2 = 0.65, SEE = 3.10), 0.83 (R2 = 0.69, SEE = 2.93), and 0.84 (R2 = 0.72, SEE = 2.78). Three anthropometric measurements based on predictive equations were developed and cross-validated to satisfactorily estimate the TBFP in adult women.

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ADHERENCE TO ESSENTIAL HYPERTENSION TREATMENT GUIDELINES IN A TERTIARY HOSPITAL IN NIGERIA

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2020v12i8.36452 ◽

2020 ◽

pp. 106-110

Author(s):

ISAAC CHIJIOKE IBEZIM ◽

IAN NAYLOR ◽

ABDULMUMINU ISAH ◽

NNEKA UCHENNA IGBOELI

Keyword(s):

Blood Pressure ◽

Treatment Guidelines ◽

Beta Blockers ◽

Study Groups ◽

University Teaching ◽

World Health ◽

Channel Blockers ◽

Cross Sectional ◽

Group A ◽

Group B

Objective: This study determined the level of prescribers’ adherence to the World Health Organization/International Society of Hypertension (WHO/ISH) guidelines for the management of hypertension at the Lagos University Teaching Hospital (LUTH), Nigeria. Methods: This study employed a retrospective cross-sectional design. Two groups were used: Group A (300 patients) were treated before the guidelines review in 2003, while Group B (200 patients) were treated after. The two study groups were compared, and systolic blood pressure of 130 mm Hg or above was taken as the index of hypertension. Results: There were 198 (66%) male patients in Group A, while Group B had 136 (68%) males. The highest age for Group A was 50–59 y for 89 (30%) patients, unlike group B that had 58 (29%) patients in aged 40–49 y as the highest. The highest blood pressure range for patients in Group A was 150–159 mm Hg for 64 (21%) patients, unlike Group B that had 43 (22%) patients as the highest in the same range. Furosemide was present in 282 (24%) prescriptions for group A patients. However, atenolol was present in 61 (20%) prescriptions for the same group. In group B, Furosemide was prescribed in 197 (97%) encounters, while Nifedipine was found in 81(40%) prescriptions. Conclusion: Prescribers at LUTH complied substantially with WHO/ISH guidelines in the management of hypertension. Diuretics and beta-blockers were used before the guideline review. After the review, diuretics and calcium channel blockers were the most frequently prescribed antihypertensives.

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Weekly high-dose leucovorin versus low-dose leucovorin combined with fluorouracil in advanced colorectal cancer: results of a randomized multicenter trial. Study Group for Palliative Treatment of Metastatic Colorectal Cancer Study Protocol 1.

Journal of Clinical Oncology ◽

10.1200/jco.1996.14.8.2274 ◽

1996 ◽

Vol 14 (8) ◽

pp. 2274-2279 ◽

Cited By ~ 71

Author(s):

E Jäger ◽

M Heike ◽

H Bernhard ◽

O Klein ◽

G Bernhard ◽

...

Keyword(s):

Colorectal Cancer ◽

Side Effects ◽

Metastatic Colorectal Cancer ◽

Low Dose ◽

Multicenter Trial ◽

World Health ◽

High Dose ◽

Who Grade ◽

Group A ◽

Group B

PURPOSE To determine the most effective dose of leucovorin (folinic acid [FA]) within a weekly bolus fluorouracil (FU) schedule, we conducted a randomized multicenter trial to compare therapeutic effects and toxicity of high-dose FA versus low-dose FA combined with FU at equal doses in both treatment groups. PATIENTS AND METHODS Patients with measurable inoperable or metastatic colorectal cancer were randomized to receive weekly FU 500 mg/m2 by intravenous (IV) bolus combined with high-dose FA 500 mg/m2 (group A) or low-dose FA 20 mg/m2 (group B) by 2-hour infusion. RESULTS Of 291 assessable patients (group A, n = 148; group B, n = 143), we observed, in group A, complete response (CR)/partial response (PR) in 32 (21.6%), no change (NC) in 64 (43.2%), and progressive disease (PD) in 52 (35.1%); and in group B, CR/PR in 25 (17.5%), NC in 63 (44.1%), and PD in 55 (38.5%). The median response duration was 24.8 weeks in group A and 23.1 weeks in group B. Median progression-free intervals were 29.3 weeks (group A) and 30 weeks (group B). The median survival time was 55.1 weeks in group A and 54.1 weeks in group B. Overall toxicity was moderate. Mild nausea and vomiting, and stomatitis were common side effects in both groups. The incidence of World Health Organization (WHO) grade III/IV diarrhea was significantly higher in group A (40 v 23 patients). Severe side effects were observed only in a minority of patients in both arms. WHO grade IV diarrhea was observed in seven patients: four in group A and three in group B. The rate of toxicity-related adjustments of dose and schedule was comparable in both groups. CONCLUSION High-dose FA/FU is not superior to low-dose FA/FU within a weekly treatment schedule. Response rates and survival were comparable in both treatment arms. Treatment-related toxicity was higher in group A (high-dose FA). Therefore, low-dose FA combined with weekly FU may be considered the preferred treatment for metastatic colorectal cancer.

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Efficacy Comparison of Oral Rehydration Solutions Containing Either 90 or 75 Millimoles of Sodium per Liter

PEDIATRICS ◽

10.1542/peds.79.2.190 ◽

1987 ◽

Vol 79 (2) ◽

pp. 190-195

Author(s):

Daniel Pizarro ◽

Bernardita Castillo ◽

Gloria Posada ◽

Cecilia Lizano ◽

Leonardo Mata

Keyword(s):

Laboratory Data ◽

Clinical Signs ◽

World Health ◽

Watery Diarrhea ◽

Hydration Status ◽

Oral Rehydration ◽

Rehydration Solutions ◽

Acute Watery Diarrhea ◽

Group A ◽

Group B

In a randomized trial, 62 infants 2 to 35 months of age with dehydration due to acute watery diarrhea were allocated to one of two groups: group A received solution A (World Health Organization-recommended oral rehydration solution), which contained (mmol/L): Na+ 90, K+ 20, Cl- 80, citrate3- 10, and glucose 110; group B received solution B (Pedialyte RS; Abbott Laboratories, North Chicago), which contained (in mmol/L): Na+ 75, K+ 20, Cl- 65, citrate3- 10, and glucose 139. Oral therapy was given until clinical signs of hydration status were normal. During the 48-hour trial, the following laboratory data were collected: blood gases, serum electrolytes, glucose, urea, and creatinine values and sodium and potassium concentrations in stool and urine; serial weights and clinical signs were also reported. Six of the 62 infants, three in each group, required intravenous fluids because of high stool output. Results of clinical outcome and normalization of altered serum electrolyte values were similar in both groups. During the 48-hour trial, eight patients in group A and four in group B had mild, asymptomatic hypernatremia. Pedialyte RS was found to be a safe glucose/electrolyte solution for oral rehydration therapy.

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