Physical growth in thalassemic children of 2-12 years with multiple transfusions

The hemoglobinopathies are the most common single-gene defect in man. The thalassemia syndromes are a heterogeneous group of hereditary disorder due to decreased synthesis of either α or β globin chain of Hb A. There are 3 phases of growth disturbances and have three different etiologies. First phase: growth disturbances is mainly due to hypoxia, anaemia, ineffective erythropoiesis and nutritional factors; the Second phase: During late childhood, growth retardation is mainly due to iron overload affecting the GH-IGF-1 axis and other endocrinal complications. Third phase: after the age of 10-11 years, delayed or arrested puberty is an important contributory factor to growth failure in adolescents thalassemic who does not show any growth spurt. Cross-sectional, observational, single-centre, tertiary hospital-based study. Children of thalassemia major of 2-12 years with multiple transfusions was taken over 1 year. Study population was divided into 2 groups: Group1-irregularly transfused; Group 2-regularly transfused. Clinical settings, anthropometry, laboratory tests like serum ferritin, pre-transfusion haemoglobin, total leucocyte count etc. were taken into consideration. Thalassemia children with other comorbidities like tuberculosis, chronic kidney disease, chronic heart diseases etc. were excluded from the study.Among the 200 children, 143 (71.5%) were taking regular (2-4 weekly) transfusion therapy and 57 (28.5%) were taking irregular transfusion (>4weekly). Mean age of diagnosis was 18.66 ± 7.443months in Group 1 (Irregularly transfused) and 18.93 ± 7.218 months in Group 2 (Regularly transfused). Among the regularly transfused thalassemic 17.7% children had W/A < 3 percentile and among the irregularly transfused children it was 15%. Among the irregularly transfused children, 27. 1% and among the regularly transfused children 21.6% had H/A <3rd percentile. In the present study children 61% had normal BMI and only 5.4 % had BMI less than 3rd percentile overall. Among irregularly transfused thalassemic children >10years of age, 86.7% have not attained puberty yet. Among the regularly transfused thalassemic children 96.7% have not attained puberty yet. US and LS individually affected resulting in stunting but it was proportionate innature so US: LS ratio was according to age. A positive correlation between pre-transfusion haemoglobin and W/A and H/A suggested that with decreasing pre-transfusion haemoglobin concentration more child had growth retardation. Mean value of serum Ferritin was 941 ± 608.490 ng/ml in Group 1(Irregularly transfused) and Mean value of serum Ferritin was 1403 ± 685.584ng/ml in Group 2(Regularly transfused). MUAC in the present study was 12.44cm suggesting mild-moderate malnutrition. Extremely variable clinical and haematological findings were observed in these patients. Growth retardation has found in both regularly and irregularly transfused patients. These findings are almost comparable to other Indian studies. Appropriate knowledge regarding prenatal counselling, early diagnosis, regular transfusions and overall treatment can help better management of this group of patients.

Physical and mental relationships : an historical survey of the attempts to find a relationship between physical growth and intelligence, and physique and temperament

The relationship of mind and body has long claimed man's attention. Early enquiries into the relationship of these two aspects of development have presumed that physical and mental growth were related functionally, that their growth proceeded together at a similar rate, and that any defect of one would immediately show itself in the other. The relationship occupied the minds of such men as Hippocrates, Plato and Aristotle, and many since have seen the relationship and guessed its nature.

Physical and mental relationships : an historical survey of the attempts to find a relationship between physical growth and intelligence, and physique and temperament

The relationship of mind and body has long claimed man's attention. Early enquiries into the relationship of these two aspects of development have presumed that physical and mental growth were related functionally, that their growth proceeded together at a similar rate, and that any defect of one would immediately show itself in the other. The relationship occupied the minds of such men as Hippocrates, Plato and Aristotle, and many since have seen the relationship and guessed its nature.

A predictive model for the aggregation of polycyclic aromatic compounds

The physical aggregation of polycyclic aromatic compounds (PACs) is a key step in soot inception. In this work, we set out to elucidate which molecular properties influence the physical growth process and use machine learning to quantitatively relate these features to the propensity of these molecules to physically dimerize with other PACs. To this end, we first develop a dataset of PAC monomers along with their calculated free energies of dimerization emphasizing a set of PACs with a diverse range of properties. First, we augment existing calculations of dimerization energies with our own molecular dynamics simulations enhanced by well-tempered Metadyanmics. We then demonstrate that a machine learning model based on the least absolute shrinkage and selection operator (Lasso) is able to quantitatively learn how molecular features contribute to physical aggregation and predict the free energy of dimerization for new pairs of molecules. The model is able to accurately determine the stability for both homodimerization and heterodimerization cases. Our approach also provides a data driven method to determine the molecular features most important to predicting the dimer stability. From this, we determine that the PAC properties most influential to physical dimerization are size, shape, oxygenation, and presence of rotatable bonds. This work highlights the molecular complexity of the PAC monomers that must be accounted for in order to accurately represent physical aggregation. We anticipate that this approach will allow for more effective modeling of the PAC dimerization process as it facilitates the efficient prediction of dimerization propensity from easily calculable molecular features.

Assessment of Stunting Status and Stunting Prevention Efforts in Toddlers in Penajam District, North Penajam Paser Regency

North Penajam Paser Regency (PPU) is one of the 100 priority districts/cities for stunting intervention in Indonesia. The prevalence of stunting in PPU Regency is 27%, while the prevalence in East Kalimantan is 28.3%, and nationally, 36.4%. Stunting has an impact on impaired brain growth, physical growth, and development. The purpose of community service is to analyze the characteristics of stunting toddlers and stunting prevention through posyandu activities. The method of implementing descriptive-analytic through secondary data collection activities for stunted toddlers is described. Posyandu activities for toddlers through health checks, providing nutrition education to toddlers in the villages of Penajam, Gunung Steleng, Nipah Nipah, and Nenang. Literature study on the prevention of stunting under five by the local government of PPU Regency. The results showed that there were 92 stunting toddlers, 53 boys, and 39 girls, with 68 short toddlers and 24 very short toddlers, most of whom were >24 -60 months old, i.e. 59 toddlers. Stunting prevention includes health checks for children under five, education on stunting prevention at posyandu and strengthening of stunting prevention/control policies with Regent Regulations. More optimal efforts are needed in implementing the Regent's regulation for the prevention of stunting under five.

Low length/weight growth trajectories of early-term infants during the first year: evidence from a longitudinal study in China

ObjectiveTo identify common length, weight and body mass index (BMI) growth trajectories of term infants during infancy, and to determine their association with early-term infants.DesignProspective longitudinal study.SettingWuhan, China.PatientsA total of 4308 term infants (born at 37–41 weeks of gestation) were included. All term infants were single live birth with no defects and birth weight ≥2500 g, and their mothers were permanent residents of Wuhan for more than 2 years. After excluding 887 infants, a total of 3421 term infants (1028 early-term infants born at 37–38 weeks of gestation and 2393 full-term infants born at 39–41 weeks of gestation) entered the statistical analysis stage.Main outcome measuresPatterns of length, weight and BMI growth trajectories by using group-based trajectory modelling.ResultsThree distinct physical growth trajectories were identified as follows: length: low stable (1056, 30.9%), moderate stable (1887, 55.2%) and high increasing (477, 13.9%); weight: low stable (1031, 30.1%), moderate stable (1884, 55.1%) and high increasing (505, 14.8%); BMI: low stable (689, 20.1%), moderate stable (2167, 63.4%) and high increasing (564, 16.5%). Compared with the full-term infants, early-term infants were more likely to remain at low-stable trajectory in length (OR: 1.40; 95% CI: 1.19 to 1.66) and weight (OR:1.29; 95% CI: 1.09 to 1.53). These associations were still statistically significant after adjusting potential confounders and were more evident among girls in the stratified analysis. There was no statistical association between BMI trajectory patterns and gestational age categories.ConclusionOur results suggested the heterogeneity of term infants existed in length, weight and BMI growth trajectories of early childhood. Compared with full-term birth, early-term birth was related to low length and weight trajectories rather than BMI trajectory. Further research is needed to evaluate the duration of these low trajectories and their possible long-term health effects.

Association of Pregestational BMI and Gestational Weight Gain with Maternal and Neonatal Outcomes in Adolescents and Adults from Mexico City

During pregnancy, adolescents experience physiological changes different from adults because they have not concluded their physical growth. Therefore, maternal and neonatal outcomes may not be the same. This paper aimed to analyze the association between pregestational BMI (pBMI) and gestational weight gain (GWG) with maternal and neonatal outcomes in adolescent and adult pregnant women. The authors performed an observational study that included 1112 women, where 52.6% (n = 585) were adolescents. Sociodemographic information, pBMI, GWG, neonatal anthropometric measures, and maternal and neonatal outcomes were obtained. Adolescent women had a mean lower (21.4 vs. 26.2, p ≤ 0.001) pBMI than adults and a higher gestational weight gain (12.3 vs. 10.7 kg, p ≤ 0.001). According to Poisson regression models, gestational diabetes is positively associated with insufficient GWG and with pregestational obesity. Furthermore, the probability of developing pregnancy-induced hypertension increased with pBMI of obesity compared to normal weight. Preeclampsia, anemia, and preterm birth were not associated with GWG. Insufficient GWG was a risk factor, and being overweight was a protective factor for low birth weight and small for gestational age. We conclude that pBMI, GWG, and age group were associated only with gestational diabetes and low birth weight.

AN ECONOMIC ANALYSIS OF AWARENESS ON RURAL HEALTH PROGARMMES IN MUDIKANDANALLUR VILLAGE, SRIMUSHNAM TALUK,CUDDALORE DISTRICT,TAMILNADU

World Health Organization (WHO) defines adolescence as the period of life between 10and 19 year of age. The adolescent experiences not only physical growth and change but also emotional, psychological, social, and mental change and growth. Physiological changes change lead to sexual maturity and usually occur during the first several year of this period. Adolescence represents a window of opportunity to prepare for a healthy adult life. The world’s adolescent population-1200 million persons, 10-19 year of age or about 19% of the total population-faces series of serious challenges not affecting their growth and development but also their livelihood as adults. Yet adolescents remain a largely neglected, difficult-to-measure, and hard-to-reach population, in which the needs of adolescent girls in particular are often ignored. Adolescence is period of increased risk taking and therefore susceptibility to behavioural problems at the time of puberty and new concerns about reproductive health. Majority of adolescents still do not have access to information and education on sexuality, reproduction, and sexual and reproductive health and rights, nor do they have access to preventive and preventive curative service. Commercial innovation to address health needs at the bottom of the pyramid for more than 800 million men, women and children across India living on USD 1-3 ADAY, the idea if accessible and affordable medicine is often as remote as their rural homes. Arogya Parivar (“health family’’ in Hindi) is a for-profit social initiative developed by Novartis to reach the undeserved million living at the bottom of the pyramid in rural India. After just years, Arogya Parivar is proving to be both a force for improving rural health programme in rural community and a sustainable business.

Overview of Macro Nutrient Intake and Nutritional Status of Students at the Putri Hidayatullah Islamic Boarding School, Ternate City

Adolescents are one of the nutritionally vulnerable groups. At this time, adolescents enter the second phase of rapid growth and then physical growth declines as young adults enter. Problems that arise in adolescents are undernutrition and overnutrition. One that is related to nutritional status is nutrient intake which is very influential on a person's nutritional status. Nutrient intake is influenced by eating habits and eating patterns of adolescents themselves. The purpose of this study was to determine the description of macronutrient intake and nutritional status at the Putri Hidayatullah Islamic Boarding School, Ternate City. The type of research used is descriptive research. The sampling technique used total sampling with a total sample of 29 people. The tools used were Microtoise, Bathroom Scale and form food recall 24. The results showed that the intake of macronutrients, as many as 28 people (96.6%) with less energy intake, 29 people (100.0%) with less protein intake, 16 people (55.2%) with more fat intake and 26 people (89.7%) with less carbohydrate intake. There were 25 people (86.2%) with normal nutritional status. It was concluded that from the results of the respondents had less protein intake and most had less energy and carbohydrate intake. On the other hand, most of these teenagers have good fat intake with normal nutritional status.