scholarly journals Co-morbidities and micronutrient deficiencies in children with severe acute malnutrition

2017 ◽  
Vol 4 (4) ◽  
pp. 1225
Author(s):  
Kumar Saurabh ◽  
Shilpi Ranjan ◽  
J P Narayan
Keyword(s):  
Severe Acute Malnutrition ◽  
Retrospective Chart Review ◽  
Acute Malnutrition ◽  
Nutritional Deficiencies ◽  
Micronutrient Deficiencies ◽  
Medical College ◽  
Paediatric Unit ◽  
High Prevalence ◽  
The Mean ◽  
One Year

Background: To study the co-morbidities and nutritional deficiencies in hospitalized children of severe acute malnutrition (SAM).Methods: One year retrospective chart review of 150 cases of SAM was done in Paediatric unit of a medical college of northern India.Results: The mean age of study group was 17.3 months (6 months to 60 months’ age group). Diarrhoea (34.7%) and respiratory tract infection (31.33%) were the most common co-morbid conditions associated with this study. Tuberculosis was seen in 20% of cases whereas Measles was associated in 6.7% cases. Anaemia and Vitamin A deficiencies were common micronutrient deficiencies. A very high prevalence of intestinal helminthic infestation was present in this study. Ascaris lumbricoides being the most common parasite involved. Polyparasitism was present in 20% of cases.Conclusions: Early identification and management of co-morbidities can improve overall outcome and survival.

Time To Relapse of Severe Acute Malnutrition And Its Determinants Among Children Treated In The Health Posts of Hadiya Zone, Southern Ethiopia.

2021 ◽  
Author(s):  
Abera Lambebo ◽  
Desselegn Temiru ◽  
Tefera Belachew
Keyword(s):  
Severe Acute Malnutrition ◽  
Statistical Significance ◽  
Acute Malnutrition ◽  
Southern Ethiopia ◽  
Under Five ◽  
Back Ground ◽  
Relapse Time ◽  
The Mean ◽  
Time To Relapse ◽  
Hadiya Zone

Abstract Back ground: In developing countries including Ethiopia, children under five years old are likely to suffer from repeated bouts of SAM. There is lack of study that documented time to relapse of SAM and its determinants. Objective: This study aimed to identify time of relapse and its determinants among children discharged after treatment for SAM in health facilities of Hadiya Zone, South, Ethiopia Methods: An institution based retrospective cohort study was carried out from data spanning from 2014/2015 to 2019/2020. After checking all the assumptions, multivariable CPH model was fitted to isolate independent determinants of time to relapse. All tests were two sided and statistical significance at P values <0.05. Result: The mean(±SD) time for relapse of SAM among under five children was 22(±9.9) weeks from discharge to relapse time. On multivariable CPH model, the hazard of relapse for SAM was significantly higher for children who had edema (AHR =2.02 ,95%, CI: 1.17-3.50), age of 6-11 months (AHR = 5.2, 95%, CI:1.95-13.87), had discharge low MUAC (AHR = 12,95%, CI: 7.90-19.52)Concussion: The finding showed that children discharged from SAM are likely to have relapse in 3 weeks.

scholarly journals Clinical features and neuropsychiatric comorbidities in pediatric patients with tic disorders: A retrospective chart review study from South Korea

2020 ◽  
Author(s):  
Eu Gene Park ◽  
Young-Hoon Kim
Keyword(s):  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
Tic Disorders ◽  
Functional Impairments ◽  
Diagnostic And Statistical Manual ◽  
High Prevalence ◽  
Tic Severity ◽  
Lip Movement ◽  
The Mean ◽  
Neuropsychiatric Comorbidities

Abstract Background: Tic disorders are childhood-onset neuropsychiatric disorders characterized by multiple motor or vocal tics with frequent comorbidities and a broad spectrum of phenotypic presentations. In this study, we aimed to investigate the clinical characteristics and comorbid neuropsychiatric conditions in pediatric patients with tic disorders. Methods: We retrospectively reviewed the medical records of 119 pediatric patients (89 males, 30 females) who were diagnosed with tic disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) at Uijeongbu St. Mary’s Hospital, Republic of Korea, between January 2012 and July 2019.Results: The mean age of tic onset was 6.9 years (range, 1–14) and the mean age at diagnosis was 8 years (range, 1–17). The mean lag between tic onset and diagnosis was 13.3 months (range, 0.25–132). The most common, first-presenting tics were eye blinking (50.4%), followed by jaw or lip movement (29.4%) and throat clearing (29.4%). Thirty-seven (31.1%) patients had at least one co-occurring neuropsychiatric disorder at the time of tic diagnosis. Subtypes of tic disorders, types of initial tics, and presence of neuropsychiatric comorbidities were not associated with tic severity. Tic severity was associated with greater functional impairment and tic noticeability (p <0.05). A relatively shorter time to diagnosis was associated with tic severity (Spearman’s ρ = –0.14, p = 0.11).Conclusions: The evolving nature of tic expression and severity, high prevalence of neuropsychiatric comorbidities, and associated functional impairments emphasize the importance of comprehensive assessment during the disease course for determining and prioritizing goals of treatment.

scholarly journals Human Milk output among mothers previously treated for severe acute malnutrition in childhood in Democratic Republic of Congo

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Christine Chimanuka Murhima’Alika ◽  
Ghislain Maheshe Balemba ◽  
Pacifique Mwene-Batu Lyabayungu ◽  
Guy Mulinganya Mulume’oderhwa ◽  
Grace Munthali ◽  
...  
Keyword(s):  
Body Composition ◽  
Human Milk ◽  
Democratic Republic Of Congo ◽  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Control Groups ◽  
Milk Output ◽  
History Of ◽  
The Mean ◽  
And Control

Abstract Background Malnutrition is a public health problem, as wasting affects 7.5% of children worldwide. The harmful effects of severe acute malnutrition (SAM) can last a lifetime, but how SAM in childhood affects later breastfeeding ability is not clear. In the present study, we assessed the human milk output and body composition among mothers with a history of childhood SAM. Methods This retrospective cohort study was carried out in Miti-Murhesa Health Zone (Democratic Republic of Congo) from January 15 to March 17, 2020. We selected lactating mothers with breastfed infants aged 2–12 months. Two categories of mothers were included: those who had been treated for SAM during their childhood (years 1988–2003; n = 39) and a community control with no history of SAM (n = 40). The weight, height, and mid-upper arm circumference were measured and body mass index (BMI) calculated as weight/height2. Body composition and human milk output were assessed using standard deuterium dilution methods. Student t and chi2 tests ware applied to compare two groups. Results The mean age ± standard deviation of the mothers was 24.4 ± 5.1 and 26.0 ± 6.1 years for the SAM and control groups, respectively (p = 0.186). The age of their infants was 5.4 ± 2.3 months in both groups (p = 0.962). In the SAM and control groups, the mean maternal BMI was 23.8 ± 2.3 and 23.6 ± 3.7 kg/m2 (p = 0.849), mean Fat Mass 27.1% ± 5.0 and 27.1% ± 5.8% (p = 0.708), and the mean Fat Free mass 72.9% ± 5.0 and 72.9% ± 5.8% (p = 0.998), respectively. Human milk output was 833.7 ± 152.1 g/d in SAM group and 827.4 ± 171.4 g/d in the control group (p = 0.864). Conclusions We found no significant difference in human milk output and body composition in mothers treated for SAM during childhood compared to community controls.

scholarly journals Development and Acceptability of Locally Made Fish-Based, Ready-to-Use Products for the Prevention and Treatment of Malnutrition in Cambodia

2018 ◽  
Vol 39 (3) ◽  
pp. 420-434 ◽  
Author(s):  
Sanne Sigh ◽  
Nanna Roos ◽  
Daream Sok ◽  
Bindi Borg ◽  
Chhoun Chamnan ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Acute Malnutrition ◽  
Treatment Intervention ◽  
Intervention Trial ◽  
Overall Acceptability ◽  
High Prevalence ◽  
Prevention And Treatment ◽  
Moderate Acute Malnutrition ◽  
Hedonic Scale ◽  
Supplementary Foods

Background: Cambodia has a high prevalence of moderate acute malnutrition and severe acute malnutrition (SAM). The SAM treatment requires ready-to-use therapeutic foods (RUTFs), whereas ready-to-use supplementary foods (RUSFs) are used for prevention of acute malnutrition. Three locally produced fish-based products were developed: an RUTF paste (NumTrey-Paste) for treatment and 2 wafer versions, one for prevention (NumTrey-RUSF) and one for treatment (NumTrey-RUTF). Objective: To assess the acceptability of NumTrey-Paste and NumTrey-RUSF in comparison to a standard biscuit product (BP-100) used for the treatment of SAM. Methods: Acceptability of NumTrey-RUSF and NumTrey-Paste was tested in a nonblinded crossover taste trial among children (n = 52), aged ≥ 6 months to 18 years, and their caregivers. Eight organoleptic qualities were assessed on a 5-point hedonic scale, as well as a ranking test. A score of 1 to 3 was categorized as acceptable. The acceptability of NumTrey-RUTF was assessed using the caregivers’ perception during an SAM treatment intervention. Results: Taste trial: The proportion of children categorizing products as overall acceptable was lowest for NumTrey-Paste compared to for BP-100 and NumTrey-RUSF (21% vs 43% [BP-100] and 36% [NumTrey-RUSF]). No difference was found in the proportion of children who ranked BP-100 or NumTrey-RUSF as “liked most” ( P > .05). Acceptability of NumTrey-RUSF ranked highest in appearance and taste (caregiver), whereas acceptability of NumTrey-Paste was ranked lowest in appearance and smell among the products. Intervention trial: The acceptability of NumTrey-RUTF increased from 72% to 86%. Conclusions: The overall acceptability was ranked lowest for a pure paste product. However, filling the paste into a wafer made the product more acceptable.

scholarly journals Predictors of undesirable treatment outcomes of severe acute malnutrition among inpatient children in Addis Ababa, Ethiopia: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Absalat Serawit Negussie ◽  
Amare Worku Tadesse
Keyword(s):  
Treatment Outcomes ◽  
Retrospective Cohort ◽  
Cox Regression ◽  
Severe Acute Malnutrition ◽  
Addis Ababa ◽  
Child Death ◽  
Acute Malnutrition ◽  
Medical College ◽  
Kaplan Meier ◽  
Socio Demographic Factors

Abstract Background In 2018, malnutrition contributed to 45% of all global cause of child death. These early child deaths were due to conditions that could either be prevented or treated with basic interventions. Hence, this study intended to provide a quantitative estimate of factors associated with undesirable treatment outcomes of severe acute malnutrition (SAM). Methods We studied a retrospective cohort of 304 children aged 6–59 months with complicated SAM admitted to Yekatit 12 Hospital Medical College from 2013 to 2016. We extracted data from hospital records on nutritional status, socio-demographic factors and medical conditions during admission. The analysis was carried out using SPSS version 20. The Kaplan-Meier estimator was employed to analyze the recovery rate of the children treated for SAM and multivariable Cox regression was used to determine factors that predict inpatient undesirable treatment outcomes. Result From a total of 304 children 6–59 months with SAM, 133 (51.4%) were boys. Marasmus was the most common type (132 (51%)) of severe acute malnutrition. The recovery, death and defaulter rate were 70.4, 12.2 and 8.2% respectively. The main predictors of undesirable treatment outcomes were found to be the presence of HIV antibody (AHR = 3.208; 95% CI: [1.045–9.846]) and sepsis (AHR = 7.677, 95% CI: [2.320–25.404]). Conclusion The study revealed that the overall treatment outcomes were below the SPHERE standard recommendation. The main predictors of undesirable treatment outcomes among inpatient children treated for SAM were HIV and sepsis. Intervention to reduce undesirable treatment outcomes should focus on comorbidities, especially HIV and sepsis.

scholarly journals Nutrition Assessment of Under-Five Children in Sudan: Tracking the Achievement of the Global Nutrition Targets

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 363
Author(s):  
Mohamed Abu-Manga ◽  
Ayoub Al-Jawaldeh ◽  
Abdul Baseer Qureshi ◽  
Amira M. Elmunier Ali ◽  
Damiano Pizzol ◽  
...  
Keyword(s):  
Severe Acute Malnutrition ◽  
Secondary Data ◽  
Well Being ◽  
Acute Malnutrition ◽  
Survey Method ◽  
Micronutrient Deficiencies ◽  
Severe Stunting ◽  
Under Five ◽  
The Government ◽  
Global Nutrition

Background: Malnutrition places a heavy burden on the health, well-being, and sustainable development of populations in Sudan, especially a country affected by conflict, which continues to experience high levels of food insecurity, undernutrition, and micronutrient deficiencies; 3.3 million are acutely malnourished, with 522,000 children suffering from severe acute malnutrition and approximately 2.2 million children requiring treatment for moderate acute malnutrition. This study aims to describe the nutritional status of children under five years old and identify the progress toward the achievement of the Global Nutrition Targets. Methods: This is a secondary data analysis of a quantitative survey, using the second-round of the Simple Spatial Survey Method (S3M II) in Sudan in the period 2018–2019. The analysis used an area-based sampling methodology in all 18 Sudanese states. Data from the WHO Tracking Tools of the Global Nutrition Targets was used to reflect the progress in achieving the targets in Sudan. Results: Global stunting prevalence was at 36.35 percent including moderate stunting prevalence and severe stunting prevalence (21.25 percent and 15.06 percent respectively). Global wasting prevalence was 13.6 percent including moderate wasting prevalence and severe wasting prevalence (10.8 percent and 2.7 percent respectively). Sudan has made great progress in achieving the target of increasing exclusive breastfeeding. However, despite the welcome commitments by the Government and all stakeholders, Sudan is still struggling to implement strategies, policies, and regulatory measures to address malnutrition and achieve the Global Nutrition Targets in 2025 and the Sustainable Developmental Goals in 2030. Therefore, more than ever, there is a need for comprehensive, multi-sectoral action to address malnutrition in all its forms.

scholarly journals Clinical features and neuropsychiatric comorbidities in pediatric patients with tic disorders: a retrospective chart review study from South Korea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eu Gene Park ◽  
Young-Hoon Kim
Keyword(s):  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
Tic Disorders ◽  
Functional Impairments ◽  
Diagnostic And Statistical Manual ◽  
High Prevalence ◽  
Tic Severity ◽  
Lip Movement ◽  
The Mean ◽  
Neuropsychiatric Comorbidities

Abstract Background Tic disorders are childhood-onset neuropsychiatric disorders characterized by multiple motor or vocal tics with frequent comorbidities and a broad spectrum of phenotypic presentations. In this study, we aimed to investigate the clinical characteristics and comorbid neuropsychiatric conditions in pediatric patients with tic disorders. Methods We retrospectively reviewed the medical records of 119 pediatric patients (89 males, 30 females) who were diagnosed with tic disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) at Uijeongbu St. Mary’s Hospital, Republic of Korea, between January 2012 and July 2019. Results The mean age of tic onset was 6.9 years (range, 1–14) and the mean age at diagnosis was 8 years (range, 1–17). The mean lag between tic onset and diagnosis was 13.3 months (range, 0.25–132). The most common, first-presenting tics were eye blinking (50.4%), followed by jaw or lip movement (29.4%) and throat clearing (29.4%). Thirty-seven (31.1%) patients had at least one co-occurring neuropsychiatric disorder at the time of tic diagnosis. Subtypes of tic disorders, types of initial tics, and presence of neuropsychiatric comorbidities were not associated with tic severity. Tic severity was associated with greater functional impairment and tic noticeability (p < 0.05). A relatively shorter time to diagnosis was associated with tic severity (Spearman’s ρ = − 0.14, p = 0.11). Conclusions The evolving nature of tic expression and severity, high prevalence of neuropsychiatric comorbidities, and associated functional impairments emphasize the importance of comprehensive assessment during the disease course for determining and prioritizing goals of treatment.

scholarly journals Assessment, outcomes and implications of multiple anthropometric deficits in children

2021 ◽  
pp. bmjnph-2021-000233
Author(s):  
Idzes Kundan ◽  
Rajalakshmi Nair ◽  
Shashwat Kulkarni ◽  
Aparna Deshpande ◽  
Raju Jotkar ◽  
...  
Keyword(s):  
Weight Gain ◽  
Severe Acute Malnutrition ◽  
Secondary Data ◽  
Nutrition Therapy ◽  
The Body ◽  
Acute Malnutrition ◽  
Severe Stunting ◽  
Malnourished Children ◽  
High Prevalence ◽  
Group Recovery

BackgroundMalnutrition in children is widely prevalent around the world. It has been observed that malnourished children with multiple anthropometric deficits have higher mortality. However, adequate studies are not available on the outcome and recovery of these children.Nandurbar, a tribal district from Maharashtra, India, shows high prevalence of all three forms of malnutrition, often occurring simultaneously. A project previously undertaken in Nandurbar from July 2014 to June 2016 studied the effect of various therapeutic feeds in treatment of children with uncomplicated severe acute malnutrition (SAM). In this study, we analyse secondary data from it to correlate effects of stunting, wasting and underweight on treatment recovery.MethodsAnalysis was done on 5979 children with SAM using linear and logistic regression on R software for recovery rates and weight gain in children with SAM with single versus multiple anthropometric deficits, their relation to age, sex, and recovery from severe stunting by gain in height.ResultsThe mean age of children was 35 months and 53.1% of the children were males. 2346 (39.2%) children recovered at the end of the 8-week treatment. 454 (7.6%) had single anthropometric deficit (SAM only), 3164 (52.9%) had two anthropometric deficits (SAM and severe underweight (SUW)) and 2355 (39.4%) children had three anthropometric deficits (SAM, SUW and severe stunting). Out of the 5979 children with SAM, only 52 (0.9%) of children were not underweight (severe or moderate).44.94% of children with SAM who were severely stunted recovered, compared with 35.52% of children who were not (p<0.001). After controlling for confounders, severe stunting was found to increase the odds of recovery by 1.49. Severely stunted children with SAM also showed faster recovery and weight gain by 1.93 days (p<0.012) and 0.29 g/kg/day (p<0.001), respectively. Recovery was higher in females and younger age group. Recovery was also found to depend on the therapeutic feed, with children receiving medical nutrition therapy showing better recovery for severely stunted children.ConclusionOur findings corroborate previous literature that stunting is a way for the body to deal with chronic stress of nutritional deprivation and provides a survival advantage to a child.

scholarly journals Significance of Reporting Cannon Balls in Diagnosing Bacterial Vaginosis Infection in PAP Smear

2021 ◽  
Vol 23 (2) ◽  
pp. 109-113
Author(s):  
Kricha Pande ◽  
Shraddha Koirala ◽  
Astha Shrestha
Keyword(s):  
Bacterial Vaginosis ◽  
Pap Smear ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Gardnerella Vaginalis ◽  
Pap Smears ◽  
Cross Sectional ◽  
Medical College ◽  
The Mean ◽  
One Year

Bacterial vaginosis is the most common cause of vaginitis. It is caused by depopulation of lactobacilli from the normal vaginal flora and overgrowth of Gardnerella vaginalis and other anaerobic species. Pap smear being a screening and diagnostic tool for malignancy, is equally important to diagnose infective pathology as well. This study tried to establish the significance of reporting the presence of cannon balls in Pap smears and whether their presence suggested bacterial vaginosis or not. This was a cross sectional study conducted at Nepal Medical College, Teaching Hospital (NMCTH), Kathmandu for duration of one year (January 2020 to December 2020). Pap smears were sent from gynaecology department and standard routine Pap stain was done in Pathology Department. Presence of bacterial vaginosis and cannon balls were noted. Total of 799 Pap smears were received. The mean age of bacterial vaginosis was 38.2 ± 9.6 years. The age group of 31-40 years (n=32, 39%) was most commonly affected. Bacterial vaginosis was seen in 81 pap smears out of 799 pap smears. The prevalence of bacterial vaginosis was 10.1%. Of the total of 799 cases of Pap smears, cannon balls were seen in 9.1% cases and among the bacterial vaginosis, cannon balls were seen in 48% cases. There was significant association between cannonballs and bacterial vaginosis (p < 0.0001). Thus, the present study re-enforces the fact that Pap smear is also very effective tool to diagnose bacterial vaginosis.

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