scholarly journals Ovarian Vein Embolization With N-butyl-2 Cyanoacrylate Glubran-2® for the Treatment of Pelvic Venous Disorder

2021 ◽  
Vol 8 ◽  
Author(s):  
Maofeng Gong ◽  
Xu He ◽  
Boxiang Zhao ◽  
Jie Kong ◽  
Jianping Gu ◽  
...  
Keyword(s):  
Symptom Relief ◽  
Duplex Ultrasound ◽  
Attractive Alternative ◽  
Ovarian Vein ◽  
Post Intervention ◽  
Embolic Material ◽  
Multislice Computer Tomography ◽  
Glubran 2 ◽  
The Mean

Background: There are few reports in the literature on the use of Glubran-2 for the embolization of ovarian veins in patients with pelvic venous disorder (PeVD). In addition, a consensus on the efficacy and safety of Glubran-2 has not been reached.Purpose: To investigate the safety and efficacy of ovarian vein embolization (OVE) with N-butyl-2 cyanoacrylate (NBCA) Glubran-2 for the treatment of PeVD.Material and Methods: Between January 2013 and January 2020, 21 women (mean age, 43.9 ± 13.3 years) with PeVD who underwent OVE with Glubran-2 were evaluated. Of those patients, ovarian vein or pelvic venous plexus insufficiency was verified by duplex ultrasound and/or multislice computer tomography (MSCT). The symptoms and signs of PeVD included chronic pelvic pain (CPP) (21/21; 100%), dyspareunia (12/21; 57.1%), dysmenorrhea (10/21; 47.6%), and vulvar varices (3/21; 14.3%). The medical data were retrospectively reviewed.Results: Glubran-2 was employed as the sole embolic material in 18 cases (85.7%) and used to perform rescue embolization in 3 cases (14.3%) due to CPP recurrence 1 month after initial embolization using microcoils. Technically successful embolization was achieved using Glubran-2 in all patients. No Glubran-2 related complications were noted. Neither persistent nor recurrent CPP was observed during follow-up, for which the mean was 62 ± 38 months (range, 12–102 months). Clinical efficacy was evaluated, and all patients exhibited complete or slight improvement of CPP after embolization. The visual analog scale (VAS) score significantly decreased from pre-intervention to post-intervention (p < 0.001). Six patients (28.6%) gave birth to healthy babies during follow-up after embolization with Glubran-2.Conclusions: Ovarian vein embolization with Glubran-2 is a feasible and safe treatment for CPP secondary to PeVD. This treatment may represent a potential and attractive alternative when patients desire symptom relief and want to continue reproducing. Larger studies are warranted to confirm the findings of this study.

scholarly journals Ovarian Vein Embolization with N-butyl-2 Cyanoacrylate Glubran-2® for the Treatment of Chronic Pelvic Pain Secondary to Pelvic Congestion Syndrome

2020 ◽  
Author(s):  
Maofeng Gong ◽  
Xu He ◽  
Boxiang Zhao ◽  
Jie Kong ◽  
Haobo Su
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Symptom Relief ◽  
Attractive Alternative ◽  
Ovarian Vein ◽  
Medical Database ◽  
Pelvic Congestion Syndrome ◽  
Glubran 2 ◽  
Pelvic Congestion

Abstract Objective: To evaluate the safety and efficacy of ovarian vein embolization using N- butyl-2 cyanoacrylate (NBCA) Glubran-2® in the treatment of chronic pelvic pain (CPP) secondary to pelvic congestion syndrome (PCS).Materials and Methods: Between January 2013 and June 2019, seven wo-men (mean age, 45.6±15.9 y) presenting with CPP secondary to PCS were evaluated for ovarian vein embolization with Glubran-2®. PCS was initially diagnosed by transva-ginal Doppler Ultrasound or CT and further confirmed by pelvic venography. Medical database was retrospectively reviewed.Results: Glubran-2 was employed as a sole embolic material in two cases, four cases subsequently underwent added microcoils in the opening of varicose ovarian vein trunk during the same procedure. Secondary embolization was achieved in one case due to CPP recurrence one month after initial embolization with microcoils. Technical success of ovarian vein embolization with Glubran-2 was achieved in all patients. There were no Glubran-2 related complications mid procedure and postintervention. With mean 62±40 months (range, 12-102 months) follow-up, neither persistent nor recurrent CPP was observed. Clinical efficacy was evaluated on the 1st, 3rd, 6th, 12th months, complete or slight improvement of CPP after embolization were achieved in all patients. VAS score used to identify preintervention and postintervention significantly decreased (p<0.001). Two patients after Glubran-2 embolization gave birth to a healthy baby during follow-up.Conclusions: Ovarian vein embolization with Glubran-2 is a feasible and safe treatment of CPP secondary to PCS. In particularly, it appears to be a potential and attractive alternative when patients with the desires of symptom relief and reproduction.

Partial Splenic Embolization UsingBletilla striataParticles for Hypersplenism in Cirrhosis: A Prospective Study

2011 ◽  
Vol 39 (02) ◽  
pp. 261-269 ◽  
Author(s):  
Rong Liu ◽  
Xiao-Jun Teng ◽  
Jiang-Fu He ◽  
Shao-Shu Xiao ◽  
Zhi-Bing Yuan ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Esophageal Varices ◽  
Embolic Material ◽  
Cell Counts ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Bleeding Episodes ◽  
The Mean

The article evaluates the long-term follow-up results of PSE using Bletilla striata (BS) particles for hypersplenism in cirrhosis, as compared to PSE using gelfoam particles. Fifty-nine patients with cirrhosis-induced hypersplenism were treated with PSE. The patients were randomly assigned into two groups: gelfoam group, which includes 32 patients using gelfoam particles as the embolic material, and BS group, which includes 27 patients using BS particles. The peripheral blood cell counts and parameters for complications associated with PSE were measured during the follow-up. The mean values of leukocyte and thrombocyte, but not hemoglobin, were significantly increased after PSE (p < 0.01) in both groups. The values of leukocyte and thrombocyte during the long-term follow-up were significantly improved in BS group than that in gelfoam group (both p < 0.01). The frequency of bleeding episodes from esophageal varices in both groups was significantly reduced after PSE (both p < 0.01), but the post-PSE bleeding episodes showed no remarkable differences between the two groups (p = 0.084). Post-embolization syndrome consisted mainly of fever, nausea and vomiting, and abdominal pain in the two groups. The incidence of grade II to III abdominal pain in BS group (82.8%, 27/33) was significantly higher than in gelfoam group (57.9%, 33/57) (p = 0.020). The mean survival time was 61.5 ± 9.1 (median 60, 1–157) months in gelfoam group and 63.4 ± 9.9 (median 52, 0–161) months in BS group, which showed no significant difference (p = 0.930).In conclusion, BS particles could be used as the embolic material in PSE. Compared to gelfoam used in PSE, BS can achieve even better efficacy in alleviating hypersplenism. It provides a long-term effect on the hematological parameters, bleeding from esophageal varices and good palliation, and improved clinical status contributing to symptomatic control.

STEREOTACTIC RADIOSURGICAL TREATMENT OF CRANIAL AND SPINAL HEMANGIOBLASTOMAS

Neurosurgery ◽  
2009 ◽  
Vol 65 (1) ◽  
pp. 79-85 ◽  
Author(s):  
Jason M. Moss ◽  
Clara Y.H. Choi ◽  
John R. Adler ◽  
Scott G. Soltys ◽  
Iris C. Gibbs ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Treatment Effectiveness ◽  
Attractive Alternative ◽  
Von Hippel Lindau ◽  
Spinal Lesions ◽  
Large Patient ◽  
Von Hippel Lindau Disease ◽  
The Mean

ABSTRACT OBJECTIVE Stereotactic radiosurgery has been used for nearly 2 decades to treat hemangioblastomas, particularly those that are in surgically inaccessible locations or that are multiple, as is common in von Hippel-Lindau disease. There is a paucity of long-term published radiosurgical treatment outcomes, particularly for spinal lesions, in a large patient population. The purpose of this study was to provide a long-term retrospective evaluation of radiosurgical hemangioblastoma treatment effectiveness, with a special emphasis on the relatively recent use of frameless, image-guided radiosurgery in the treatment of spinal lesions. METHODS From 1991 to 2007, 92 hemangioblastomas in 31 patients, 26 with von Hippel-Lindau disease, were treated with radiosurgery (27 tumors treated with frame-based linear accelerator radiosurgery, and 67 tumors were treated with CyberKnife radiosurgery). The mean patient age was 41 years (range, 18–81 years). The radiation dose to the tumor periphery averaged 23.4 Gy (range, 12–40 Gy). The mean tumor volume was 1.8 cm3 (range, 0.058–65.4 cm3). Tumor response was evaluated in serial, contrast-enhanced, computed tomographic, and magnetic resonance imaging scans. RESULTS Clinical and radiographic follow-up data were available for 82 hemangioblastoma tumors. Only 13 (16%) of the treated hemangioblastomas progressed, whereas 18 tumors (22%) showed radiographic regression, and 51 tumors (62%) remained unchanged in size. With median follow-up of 69 months (range, 5–164 months), the actuarial local control rates at 36 and 60 months were 85% and 82%, respectively. Radiosurgery improved lesion-associated symptoms in 36 of 41 tumors. During the follow-up period, 9 patients died of causes unrelated to the progression of their treated hemangioblastomas, and 5 patients developed radiation necrosis. CONCLUSION Stereotactic radiosurgery is safe and effective in the treatment of hemangioblastomas and is an attractive alternative to surgery for patients, including those with von Hippel-Lindau disease.

scholarly journals Effect of health education on knowledge and attitude of menopause among middle-age teachers

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Helen Gebretatyos ◽  
Lidia Ghirmai ◽  
Soliana Amanuel ◽  
Ghidey Gebreyohannes ◽  
Zemenfes Tsighe ◽  
...  
Keyword(s):  
Health Education ◽  
Educational Intervention ◽  
Statistical Significance ◽  
Post Intervention ◽  
Post Hoc Analysis ◽  
Time Points ◽  
The Mean ◽  
Knowledge And Attitude ◽  
Post Hoc

Abstract Background Adequate knowledge and positive attitude toward menopause are important for women to tackle changes related to menopause. Even though all women experience menopause at some stage in their life, teachers face more difficulties more than other female employees due to the nature of their roles do. In Eritrea, menopause has been given little attention hence gaps exist concerning women’s knowledge, attitude, and the effects of health education on the same subject. This study aimed at assessing the effect of health education on knowledge and attitude of menopause among middle-aged teachers in elementary, junior, and secondary schools of Asmara, Eritrea. Method A semi-experimental design with pre-intervention, immediate post-intervention, and three-month follow up test was used in this study. The data was collected from 99 middle age teachers using stratified random sampling. The intervention was done using lectures, group discussions, brochures, and handouts. Data on socio-demographics, knowledge, and attitude was collected using a pre-designed questionnaire. The effect of educational training at the three-time points was evaluated by repeated measure ANOVA using SPSS version 22. Results The mean scores of correct knowledge at pre-intervention, immediate post-intervention, and 3-months follow-up were 12.3/22 (SD = 3.06), 17.3/22 (SD = 3.21), and 16.5/22 (SD = 2.52) respectively. A significant difference in scores of knowledge at the three-time points was observed due to the educational intervention with a statistical significance of (p <  0.0001). Post-hoc analysis revealed that knowledge score immediately after intervention was significantly greater than that of pre-intervention (p <  0.0001), and 3-months follow-up (p = 0.004). The mean scores of attitude at the three-time points were 27.9/45 (SD = 5.14), 28.3/45(SD = 5.25), 28.32/45(SD = 5.12). The educational intervention had brought a change in the mean scores of attitude at the three-time point with a statistical significance of (p < 0.0001). Post-hoc analysis revealed that attitude scores at immediate post-intervention were also significant (p = 0.001) with the 3-months follow up at (p < 0.0001) were higher than that of pre-intervention. Conclusion The structured educational intervention was beneficial to the studied women in intensifying their knowledge and tuning them toward a positive attitude. Hence, proper health education programs regarding menopause are strongly recommended.

Simultaneous Septal Perforation Repair with Septorhinoplasty: A 31-Year Experience

2018 ◽  
Vol 34 (03) ◽  
pp. 298-311 ◽  
Author(s):  
Sean Delaney ◽  
Russell Kridel
Keyword(s):  
Symptom Relief ◽  
Advancement Flap ◽  
Open Approach ◽  
Septal Perforation ◽  
Cosmetic Results ◽  
Presenting Symptoms ◽  
The Mean ◽  
Four Quadrant ◽  
Anterior Posterior

AbstractSeptal perforation repair and septorhinoplasty (SRP) each present unique surgical challenges. However, in many instances, these procedures may be performed together successfully. In this study, the authors aim to determine the safety and effectiveness of combining primary or revision SRP and septal perforation repair via an open approach. A retrospective review was carried out of all consecutive patients who had SRP and septal perforation repair via an open approach between 1986 and 2017 in the senior author's practice. Perforation closure in surgery and at the patient's last follow-up, resolution of presenting symptoms, cosmetic results, and complications were analyzed. Records for 141 patients who had simultaneous septal perforation repair and SRP via an open approach, with a mean follow-up of 3.24 years, were reviewed. The mean anterior–posterior perforation dimension was 1.41 ± 0.89 cm, and the mean vertical perforation dimension was 1.16 ± 0.59 cm. The most common etiologies for septal perforation were previous SRP (35.4%) and septoplasty (24.1%). An overall 93.6%, perforation closure, 91.1% symptom relief, and 91.2% patient satisfaction with cosmetic results were achieved. Septal perforations under 1.5 cm in height were closed in 96.7% of patients as opposed to 71.4% of patients with perforations 1.5 cm or taller. Minor revision rhinoplasties were performed in 7.0% of patients. Postoperative infections were rare and noted in only two (1.4%) patients. In the largest study of its kind to date, the authors have shown that in experienced hands septal perforation repair may be performed simultaneously with primary or revision SRP via an open approach without compromising the perforation repair outcome. The vertical dimension of a septal perforation and presence of mucosa above and below a perforation are important considerations for the difficulty of a perforation closure, as septal mucosa is recruited from these locations in our technique of four-quadrant intranasal bipedicled mucosal advancement flap closure.

scholarly journals Image-guided stereotactic radiosurgery for treatment of spinal hemangioblastoma

2017 ◽  
Vol 42 (1) ◽  
pp. E12 ◽  
Author(s):  
James Pan ◽  
Allen L. Ho ◽  
Myreille D'Astous ◽  
Eric S. Sussman ◽  
Patricia A. Thompson ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Symptomatic Relief ◽  
Symptomatic Improvement ◽  
Attractive Alternative ◽  
Imaging Evaluation ◽  
Image Guided ◽  
Contrast Enhanced Ct ◽  
The Mean ◽  
Vhl Disease

OBJECTIVE Stereotactic radiosurgery (SRS) has been an attractive treatment option for hemangioblastomas, especially for lesions that are surgically inaccessible and in patients with von Hippel-Lindau (VHL) disease and multiple lesions. Although there has been a multitude of studies examining the utility of SRS in intracranial hemangioblastomas, SRS has only recently been used for spinal hemangioblastomas due to technical limitations. The purpose of this study is to provide a long-term evaluation of the effectiveness of image-guided radiosurgery in halting tumor progression and providing symptomatic relief for spinal hemangioblastomas. METHODS Between 2001 and 2011, 46 spinal hemangioblastomas in 28 patients were treated using the CyberKnife image-guided radiosurgery system at the authors' institution. Fourteen of these patients also had VHL disease. The median age at treatment was 43.5 years (range 19–85 years). The mean prescription radiation dose to the tumor periphery was 21.6 Gy (range 15–35 Gy). The median tumor volume was 0.264 cm3 (range 0.025–70.9 cm3). Tumor response was evaluated on serial, contrast-enhanced CT and MR images. Clinical response was evaluated by clinical and imaging evaluation. RESULTS The mean follow-up for the cohort was 54.3 months. Radiographic follow-up was available for 19 patients with 34 tumors; 32 (94.1%) tumors were radiographically stable or displayed signs of regression. Actuarial control rates at 1, 3, and 5 years were 96.1%, 92.3%, and 92.3%, respectively. Clinical evaluation on follow-up was available for 13 patients with 16 tumors; 13 (81.2%) tumors in 10 patients had symptomatic improvement. No patient developed any complications related to radiosurgery. CONCLUSIONS Image-guided SRS is safe and effective for the primary treatment of spinal hemangioblastomas and is an attractive alternative to resection, especially for those with VHL disease.

Longitudinal analysis of hearing before and after radiosurgery for vestibular schwannoma

2012 ◽  
Vol 117 (5) ◽  
pp. 877-885 ◽  
Author(s):  
Shoji Yomo ◽  
Romain Carron ◽  
Jean-Marc Thomassin ◽  
Pierre-Hugues Roche ◽  
Jean Régis
Keyword(s):  
Vestibular Schwannoma ◽  
Hearing Preservation ◽  
Tumor Control ◽  
Post Intervention ◽  
Accurate Analysis ◽  
Tumor Margins ◽  
Before And After ◽  
The Mean ◽  
The Impact

Object The aim of this study was to perform an accurate analysis of changes in hearing in patients with vestibular schwannoma (VS) who have undergone Gamma Knife surgery (GKS) and distinguish the impact of radiosurgery from the natural course of hearing deterioration due to the tumor itself. Methods This study was a retrospective review of prospectively collected patient data. A group of 154 patients with unilateral nonsurgically treated VS was conservatively monitored for more than 6 months and then treated with GKS between July 1997 and September 2005. They were followed up with serial clinical examination, MRI, and audiometry. The annual hearing decrease rate (AHDR) was measured before and after radiosurgery, and the possible prognostic factors for hearing preservation were investigated. Results The mean dose prescribed to the tumor margins was 12.1 Gy. The mean radiological follow-up period after GKS was 60 months (range 7–123 months). The tumor control rate was 94.8%, and 8 patients underwent subsequent intervention due to tumor progression. The mean audiological follow-up times before and after GKS were 22 and 52 months, respectively. The mean AHDRs before and after GKS were 5.39 dB/year (95% CI 3.31–7.47 dB/year) and 3.77 dB/year (95% CI 3.13–4.40 dB/year), respectively (p > 0.05). The mean pre- and post-GKS AHDRs in patients who initially had Gardner-Robertson (GR) Class I hearing were −0.57 dB/year (95% CI −2.95 to 1.81 dB/year) and 3.59 dB/year (95% CI 2.52–4.65 dB/year), respectively (p = 0.007). The mean pre- and post-GKS AHDRs in patients who initially had GR Class II hearing were 5.09 dB/year (95% CI 1.36–8.82 dB/year) and 4.98 dB/year (95% CI 3.86–6.10 dB/year), respectively (p > 0.05). A subgroup of 80 patients had both early and late post-intervention AHDR assessment (with early referring to the period from GKS to the assessment closest to the 2-year follow-up point and late referring to the period from that assessment to the most recent one); in these patients, the mean early post-GKS AHDR was 5.86 dB/year (95% CI 4.25–7.50 dB/year) and the mean late post-GKS AHDR was 1.86 dB/year (95% CI 0.77–2.96 dB/year) (p < 0.001). A maximum cochlear dose of less than 4 Gy was found to be the sole prognostic factor for hearing preservation. Conclusions The present study demonstrated the absence of an increase in AHDR after radiosurgery as compared with the preoperative AHDR. There was even a trend indicating a reduction in the annual hearing loss after radiosurgery over the long term. To fully elucidate a possible protective effect of radiosurgery, longer-term follow-up with a larger group of patients will be required.

scholarly journals Shape memory polymer ovarian vein embolisation in a patient with nickel allergy

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Davide Castellano ◽  
Andrea Boghi ◽  
Luca Di Maggio ◽  
Alessandro Rapellino ◽  
Daniele Savio
Keyword(s):  
Shape Memory ◽  
Shape Memory Polymer ◽  
Ovarian Vein ◽  
Resonance Imaging ◽  
Nickel Allergy ◽  
Embolic Material ◽  
Case Presentation ◽  
Metallic Implants ◽  
Pelvic Congestion

Abstract Background Ovarian vein embolization in pelvic varicocele is usually obtained using nitinol coils. These devices can not be used in patients with proven nickel allergy. Case presentation Shape memory polymer is a new embolic material available to interventionalists. A patient presented with pelvic congestion syndrome requiring embolisation of the left ovarian vein. The target vessel consisted of two twisted branches, each 5–6 mm in diameter. The patient also had a known allergy to nickel. Considering the anatomy and allergy status, embolisation with polyurethane shape memory polymer vascular plugs was considered a good case strategy. The embolisation procedure was technically successful with the deployment of two shape memory polymer plugs into each of the two left ovarian vein branches. Follow-up magnetic resonance imaging at 4 months showed sustained occlusion of the treated vessels and the patient showed no signs of allergy to the implanted material. Conclusions In conclusion, our case presented an opportunity to utilise a new embolic material and achieve a good outcome in a patient with an allergy that may have resulted in complications when using metallic implants.

scholarly journals The effects of a non-operative multimodal programme on osteoarthritis of the knee

2010 ◽  
Vol 92 (6) ◽  
pp. 467-471 ◽  
Author(s):  
Shelain Patel ◽  
Fahad S Hossain ◽  
Bruce Paton ◽  
Fares S Haddad
Keyword(s):  
Effect Size ◽  
Scoring System ◽  
Oxford Knee Score ◽  
Womac Score ◽  
Osteoarthritis Of The Knee ◽  
Knee Score ◽  
Post Intervention ◽  
Patient Reported ◽  
The Mean

INTRODUCTION The purpose of this study was to determine if a multimodal programme including physiotherapy and education could improve the symptoms of osteoarthritis of the knee across various severities of disease. PATIENTS AND METHODS Seventy-two patients with osteoarthritis of the knee confirmed on radiographic evidence were referred over a 13-month period for a lower limb programme which consisted of 12 classes over 6 weeks of group physiotherapy and included education on osteoarthritis, diet and exercise. Six patients went on to have joint arthroplasty at a mean time of 6.5 months with three placed on the waiting list during follow-up. RESULTS Pre-intervention, the mean WOMAC score was 42.0 and the mean Oxford Knee Score was 32.8. Post-intervention at a mean follow-up of 12 months, the mean WOMAC score was 31.6 and the mean Oxford Knee Score 24.3. The change in scores following intervention was statistically significant (P < 0.01). Using the WOMAC scoring system, the greatest effect size was seen in patients with Kellgren–Lawrence grade IV whilst using the Oxford knee scoring system, the greatest effect size was seen in patients with Kellgren–Lawrence grade II. CONCLUSIONS At 12 months, a multimodal programme of non-operative interventions has an excellent impact upon the symptoms of osteoarthritis of the knee with improved patient-reported scores. The level of improvement cannot be inferred from the radiographic grade of osteoarthritis. This modality could be considered for all patients with mild-to-moderate osteoarthritis of the knee.

scholarly journals Sustainability of the Effectiveness of Complementary Feeding and Learning Session in Improving Nutrition Status and Feeding Practices of Children in Malawi-RCT

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 234-234
Author(s):  
Elisabeth Mamani
Keyword(s):  
Dietary Diversity ◽  
Feeding Practices ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Post Intervention ◽  
Anthropometric Indices ◽  
The Mean ◽  
Minimum Dietary Diversity

Abstract Objectives To estimate the proportion of children aged 6 to 9 months who met the minimum dietary diversity and minimum meal frequency between children in CCFLS group versus children in GMP and compare their anthropometric indices 6 months post-intervention in Thyolo district. Methods Children age 6 to 9 months from Thyolo district, Nchiramwera area were individually randomised into intervention or control arm of the study. Caregivers of children in the intervention arm received CCFLS sessions while those in control arm attended standard growth monitoring promotion sessions (GMP) at their nearest facility. Data on feeding practices were collected at baseline and after six months. Furthermore, data on anthropometric indices were collected monthly for six months. CCFLS vs control group comparisons of baseline-end-line change in proportions of achieving minimum dietary diversity (MDD) and frequency (MDF) were done. Additionally, both bivariate and multivariate logistic regression analyses were done to determine the effect of CCFLS on improving MDD and MDF at six months follow up. Student's t-test was used to compare the mean six months change in anthropometric indices in the CCFLS group to the control group. Results A cohort of 168 children were randomised; 84 in the CCFLS arm and 84 in the GMP arm. There was strong evidence of an association between receiving the CCFLS intervention and achieving MDD. Adjusting for the baseline MMD proportion the children that had CCFLS had a nearly 12 times higher odds of achieving MDD compared to controls, AOR (95% C.I.) 12.43 (5.39 –28.67 p value &lt; 0.001). After 6 months follow up, the mean (95% C.I.) change in weight in the CCFLS group was + 1.45 kg (1.30–1.59) and + 1.22 kg (1.02 –1.42) in the GMP group and this was statistically significantly different (p-value 0.04 t-test). Analysis showed there was no association between receiving CCFLS intervention and achieving a change in MMF and MUAC. Conclusions Impact of CCFLS in improving MDD and weight gain is sustained post intervention, at least in the short term of 6 months follow up. Funding Sources Malawi Government; Ministry of Education Science and Technology.

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