Different Degrees Of Malnutrition Research Articles

Association of systemic immune-inflammation index with malnutrition among Chinese hospitalized patients: a nationwide, multicenter, cross-sectional study.

Systemic immune-inflammation index (SII) is associated with increased risk in a wide range of illnesses. However, few studies have explored the associations between SII and the risk of malnutrition. Therefore, this study aimed to investigate the association between SII and malnutrition in a nationwide, multicenter, cross-sectional study involving Chinese hospitalized patients. From August 2020 to August 2021, a total of 40,379 hospitalized patients met the inclusion and exclusion criteria. Detailed demographic data, diagnoses, as well as physical and laboratory examination results were recorded. The diagnosis of malnutrition was used with two distinct methods: the Malnutrition Screening Tool 2002 (NRS 2002) + Global Leaders Initiative on Malnutrition (GLIM) criteria and the controlling nutritional status (CONUT) score. The risk factors for malnutrition were analyzed using binary logistic regression and multiple logistic regression to obtain odds ratios (OR) and 95% confidence intervals (CI). Restricted cubic spline (RCS), linear spline, and receiver operating characteristic (ROC) analysis were also used. The prevalence of malnutrition diagnosed by the two methods was 13.4% and 14.9%, respectively. In the NRS 2002 + GLIM diagnostic model, lnSII showed statistical significance between the malnutrition and non-malnutrition group (6.28 ± 0.78 vs. 6.63 ± 0.97, p < 0.001). A positive association was observed between higher SII and the risk of malnutrition in both before and after adjustment models compared to the first quartile (Q3 vs. Q1, OR = 1.27, 95%CI: 1.15-1.40; Q4 vs. Q1, OR = 1.83, 95%CI: 1.67-2.00). However, a significant reduction in prevalence was observed when SII was in the second quartile (Q2 vs. Q1, OR < 1), as indicated by a restricted cubic spline with a U trend (p for nonlinear <0.001). According to the CONUT score, the prevalence of individuals with normal nutritional status decreased with increasing SII, while the occurrence of three different degrees of malnutrition generally increased. The Kappa value between the two diagnostic methods was 0.23, and the merged data observed an area under the ROC curve of 0.73 (95%CI: 0.714-0.742). The U-shaped association between SII and the prevalence of malnutrition was observed. Both lower and higher SII levels (either continuous or categorical variable) were significantly associated with an increased risk of malnutrition.

Are the GLIM Criteria Guiding in the Course of Hematological Malignancies?

Different degrees of malnutrition are seen in patients with hematological malignancies. None of the approaches used to determine malnutrition risk have general acceptance. The use of the GLIM criteria developed by the Global Leadership Initiative on Malnutrition has promising results. A total of 67 patients with leukemia, lymphoma, and multiple myeloma were included in the study. NRS-2002 (Nutritional Risk Screening-2002) was used to screen the nutritional status of the patients, and malnutrition was diagnosed and graded using the GLIM criteria in patients who were found to be at risk of malnutrition in this test. The parameters followed in the groups with and without malnutrition were compared. The Kolmogorov-Smirnov, Mann-Whitney U, and Chi-square test were used for statistical analysis. Patients were analyzed by dividing them into two groups as those with and without malnutrition. The presence of infection, duration of fever, antibiotic, and antifungal use were significantly higher in malnourished than in nonmalnourished patients. Platelet counts and sodium levels were significantly lower in the malnourished arm. Early nutritional support can increase the immunological status of patients with malignant disorders as well as their tolerability to treatment. Minimizing the risk of malnutrition and providing timely calorie and vitamin support are factors that may directly affect febrile neutropenia, duration of fever, and antifungal use, which will consequently lead to a decrease in the length of hospitalization.

Trajectories of resting energy expenditure and performance of predictive equations in children hospitalized with an acute illness and malnutrition: a longitudinal study

There is scarce data on energy expenditure in ill children with different degrees of malnutrition. This study aimed to determine resting energy expenditure (REE) trajectories in hospitalized malnourished children during and after hospitalization. We followed a cohort of children in Bangladesh and Malawi (2–23 months) with: no wasting (NW); moderate wasting (MW), severe wasting (SW), or edematous malnutrition (EM). REE was measured by indirect calorimetry at admission, discharge, 14-and-45-days post-discharge. 125 children (NW, n = 23; MW, n = 29; SW, n = 51; EM, n = 22), median age 9 (IQR 6, 14) months, provided 401 REE measurements. At admission, the REE of children with NW and MW was 67 (95% CI [58, 75]) and 70 (95% CI [63, 76]) kcal/kg/day, respectively, while REE in children with SW was higher, 79 kcal/kg/day (95% CI [74, 84], p = 0.018), than NW. REE in these groups was stable over time. In children with EM, REE increased from admission to discharge (65 kcal/kg/day, 95% CI [56, 73]) to 79 (95% CI [72, 86], p = 0.0014) and was stable hereafter. Predictive equations underestimated REE in 92% of participants at all time points. Recommended feeding targets during the acute phase of illness in severely malnourished children exceeded REE. Acutely ill malnourished children are at risk of being overfed when implementing current international guidelines.

Nutritional status efficacy of early nutritional support in gastrointestinal care: A systematic review and meta-analysis

Gastrointestinal surgery is a complicated process used to treat many gastrointestinal diseases, and it is associated with a large trauma: Most patients often have different degrees of malnutrition and immune dysfunction before surgery and are prone to various infectious complications during postoperative recovery, thus affecting the efficacy of surgical treatment. Therefore, early postoperative nutritional support can provide essential nutritional supply, restore the intestinal barrier and reduce complication occurrence. However, different studies have shown different conclusions.To assess whether early postoperative nutritional support can improve the nutritional status of patients based on literature search and meta-analysis.Articles comparing the effect of early nutritional support and delayed nutritional support were retrieved from PubMed, EMBASE, Springer Link, Ovid, China National Knowledge Infrastructure, China Biology Medicine databases. Notably, only randomized controlled trial articles were retrieved from the databases (from establishment date to October 2022). The risk of bias of the included articles was determined using Cochrane Risk of Bias V2.0. The outcome indicators, such as albumin, prealbumin, and total protein, after statistical intervention were combined.Fourteen literatures with 2145 adult patients undergoing gastrointestinal surgery (1138 patients (53.1%) receiving early postoperative nutritional support and 1007 patients (46.9%) receiving traditional nutritional support or delayed nutritional support) were included in this study. Seven of the 14 studies assessed early enteral nutrition while the other seven studies assessed early oral feeding. Furthermore, six literatures had "some risk of bias," and eight literatures had "low risk". The overall quality of the included studies was good. Meta-analysis showed that patients receiving early nutritional support had slightly higher serum albumin levels, than patients receiving delayed nutritional support [MD (mean difference) = 3.51, 95%CI: -0.05 to 7.07, Z = 1.93, P = 0.05]. Also, patients receiving early nutritional support had shorter hospital stay (MD = -2.29, 95%CI: -2.89 to -1.69), Z = -7.46, P < 0.0001) shorter first defecation time (MD = -1.00, 95%CI: -1.37 to -0.64), Z = -5.42, P < 0.0001), and fewer complications (Odd ratio = 0.61, 95%CI: 0.50 to 0.76, Z = -4.52, P < 0.0001) than patients receiving delayed nutritional support.Early enteral nutritional support can slightly shorten the defecation time and overall hospital stay, reduce complication incidence, and accelerate the rehabilitation process of patients undergoing gastrointestinal surgery.

Nutritional Assessment of Adult Patients Undergoing Maintenance Hemodialysis in the Gaza Strip

Malnutrition is a common condition in patients undergoing hemodialysis (HD), and it is associated with increased morbidity and mortality. The main objective of the study was to evaluate the nutritional status of patients on maintenance HD. After applying eligibility criteria, 141 HD patients attending major governmental dialysis centers were randomly recruited in this cross-sectional study and assessed for nutritional status using the Patient-Generated Subjective Global Assessment (PG-SGA) tool. The PG-SGA categorizes patients as well-nourished, moderately malnourished, and severely malnourished. Different anthropometric measurements, laboratory investigations, blood pressure measurements, and 24-h dietary recall were collected from each patient. According to PG- SGA results, 78% of patients were moderately malnourished and 22% of patients were severely malnourished. The mean body mass index was 27.8 kg/m2, and 5.7% of patients were underweight. There were significant differences in the mid-upper arm muscle circumference (P = 0.020) between the PG-SGA groups. The total energy and protein intake were significantly (P &lt;0.001) less than the recommended dietary intake by 1268.9 kcal and 41.4 g, respectively. The albumin level in 37.6% of patients was less than the normal level, and the results indicated that there were significant differences in serum iron (P = 0.022) between the moderately and severely malnourished patients. The results of this study indicated that all HD patients were suffering from different degrees of malnutrition and, unfortunately, most of their energy and nutrient intake was far less than the requirements, which might be the reason why they face nutritional and health risks.

Agreement Between Different Nutritional Assessments Tools Used for Elderly Hospitalized Patients

Nutrition assessment enables early diagnosis of patients at risk of malnutrition and those who are already malnourished. The main objective of the study was to evaluate the agreement between Mini Nutrition Assessment (MNA) and Geriatric Nutritional Risk Index (GNRI) as tools for nutritional assessment against the Subjective Global Assessment (SGA) among elderly hospitalized patients. One hundred and fifty hospitalized elderly patients were enrolled in this cross-sectional study. All elderly hospitalized patients aged 65 years who were admitted into medical and surgical departments and signed the consent form were recruited for the study. Socio-demographic and socioeconomic data, medical and nutritional characteristics, anthropometric measurements, biochemical measurements, SGA, MNA, and GNRI were collected from all respondents. The study was approved by the local Helsinki Committee (PHRC/HC/721/20). According to SGA, MNA, and GNRI results, 52.7%, 20.7%, and 4% of hospitalized elderly patients were suffering from malnutrition, respectively. More than half of the respondents were obese. All measured anthropometric parameters in the malnutrition group in all nutritional assessment tools were significantly lower than the non-malnutrition group. With reference to the SGA; the sensitivity, specificity, PPV, and NPV for the GNRI were 0.075, 1, 1, and 0.493, respectively, while those for the MNA were 0.354, 0.957, 0.903, and 0.571, respectively. The AUC of the GNRI was comparable to that of the MNA (0.711 and 0.860, respectively). Moreover, the optimal malnutrition cutoff value for the GNRI and MNA was 108.919 and 21.75, respectively. Results of this study indicated that elderly patients were suffering from different degrees of malnutrition and unfortunately they are undetected. GNRI and MNA show low sensitivity and NPV. Both the GNRI and MNA have a high Area Under the Curve (AUC), thus enabling the discovery of malnutrition in patients. The newly emerging cutoff points of GNRI and MNA for the Palestinian elderly indicated the highest sensitivity and specificity values than the original cutoff points.

EFFECTIVENESS OF STRUCTURED NURSING INTERVENTION ON NUTRITIONAL STATUS OF UNDERFIVE CHILDREN, KNOWLEDGE AND PRACTICE OF MOTHERS REGARDING THE PREVENTION AND MANAGEMENT OF PROTEIN ENERGY MALNUTRITION IN SELECTED COASTAL VILLAGES OF KERALA.

Malnutrition is not only an important cause of childhood morbidity and mortality, but leads also to permanent impairment of physical and possibly, of mental growth of those who survive. The study was carried out to nd out the effectiveness of structured nursing intervention on nutritional status of underve children, knowledge and practice of mothers regarding prevention and management of malnutrition in selected coastal villages of Kerala. Samples consisted of 122 underve children who were identied with different degrees of malnutrition and their mothers. Pre experimental study design was used. Anthropometric parameters (Weight, Height, MUAC) were checked. Structured knowledge questionnaire and practice check list were used to measure the knowledge and practice of mothers related to the prevention and management of malnutrition. All the measurements were carried out once before the Structured Nursing Intervention and three times after the intervention. Structured Nursing Intervention was found to be effective in improving the knowledge and practice of mothers related to prevention and management of malnutrition among underve children (p &lt; 0.001). Percentage of grade I malnutrition reduced from 83.6% in pre test to 63.69% in post test III. Z test was carried out and it was concluded that Structured Nursing Intervention had signicant inuence on the nutritional status of underve children (Z = 3.33**, p value &lt;0.01).

Direct health care costs associated to neurological diseases and different degrees of malnutrition.

Home-based care and oral supplemental nutrition may be an efficient way of managing health resources, freeing up hospital resources and improving patient care and quality of life. For some conditions, such as neurodegenerative diseases and acute neurological conditions, adequate nutritional control of patients at the time of discharge, with home monitoring by a home hospitalization unit (HHU), coupled with the introduction of necessary and appropriate oral nutritional supplements for each patient, is a good strategy for ensuring the efficiency of health resources. The aim of this paper is to analyse the direct health costs, considering home care and oral nutritional supplement, of patients with newly diagnosed neurological diseases and at risk of nutritional problems. A study was designed to measure direct health care costs of patients with neurological related diseases according to their different nutritional needs. The sample for this study consisted of all patients (n=100) of the Elda University Hospital in Elda, Spain, with newly diagnosed neurological pathology and suspected malnutrition at hospital discharge during a six months period. These patients were included in a home base care program and given oral nutritional supplements afterwards. The nutritional intervention consisted in giving nutritional supplements according to nutritional patients' needs through a home-based care unit. Nutritional needs could comprise from protein-calorie malnutrition to at risk of malnutrition. Descriptive health care costs analysis was carried out accounting for the nutritional status. Costs are expressed in 2018 euros and for a total time horizon of one year, six months of classical inpatient care and six months of home care monitoring with a nutritional intervention. Mean direct health care cost for neurological patients in the six months of classical inpatient care was €8309.30 and, the direct healthcare cost of treating these patients according to their nutritional needs from a home care unit was €2970.18. The subgroup of patients that most benefited from the nutritional intervention and monitoring from the home care unit were those who were in a state of protein-calorie malnutrition or at risk of malnutrition. Under the log transformation of the variables, the Shapiro-Wilk test showed significant differences in mean costs at the 5% level for the two time periods for those suffering from protein-calorie malnutrition or at risk of malnutrition. It is important to measure and economically quantify the direct health care costs of patients with neurological diseases in order to be able to evaluate different hospital and home-care interventions according to different nutritional needs. Oral nutritional supplements and monitoring by the hospital home care unit could be associated with saving money when patients have protein-calorie malnutrition or at risk of malnutrition. Therefore, direct health costs information is needed to future evaluate these different management interventions.

Nutritional status in post SARS-Cov2 rehabilitation patients

Background & aimsAfter prolonged hospitalization, the assessment of nutritional status and the identification of adequate nutritional support is of paramount importance. In this observational study, we aimed at assessing the presence of a malnutrition condition in SARS-Cov2 patients after the acute phase and the effects of a multidisciplinary rehabilitation program on nutritional and functional status.MethodsWe recruited 48 patients (26 males/22 females) admitted to our Rehabilitation Unit after discharge from acute Covid Hospitals in northern Italy with negative swab for SARS-Cov2. We used the Global Leadership Initiative on Malnutrition (GLIM) criteria to identify patients with different degrees of malnutrition. Patients underwent a 3 to 4-week individual multidisciplinary rehabilitation program consisting of nutritional intervention (energy intake 27to30 kcal/die/kg and protein intake 1–1.3 g/die/kg), exercise for total body conditioning and progressive aerobic exercise with cycle- and arm-ergometer (45 min, 5 days/week). At admission and discharge from our Rehabilitation Unit, body composition and phase angle (PhA) (BIA101 Akern), muscle strength (handgrip, HG) and physical performance (Timed-Up-and-Go, TUG) were assessed.ResultsAt admission in all patients the mean weight loss, as compared to the habitual weight, was −12.1 (7.6)%, mean BMI was 25.9 (7.9) kg/m2, mean Appendicular Skeletal Muscle Index (ASMI) was 6.6 (1.7) kg/m2 for males and 5.4 (1.4) kg/m2 for females, mean phase angle was 2.9 (0.9)°, mean muscle strength (HG) was 21.1 (7.8) kg for males and 16.4 (5.9) kg for females, mean TUG value was 23.7 (19.2) s. Based on GLIM criteria 29 patients (60% of the total) showed a malnutrition condition. 7 out of those 29 patients (24%) presented a mild/moderate grade and 22 patients (76%) a severe grade. After a rehabilitation program of an average duration of 25 days (range 13–46) ASMI increased, with statistically significant differences only in females (p = 0.001) and HG improved only in males (p = 0.0014). In all of the patients, body weight did not change, CRP/albumin (p < 0.05) and TUG (p < 0.001) were reduced and PhA increased (p < 0.01).ConclusionsWe diagnosed a malnutrition condition in 60% of our post SARS-Cov2 patients. An individualized nutritional intervention with adequate energy and protein intake combined with tailored aerobic and strengthening exercise improved nutritional and functional status.

The Relationship Between Malnutrition and Liver Enzymes in Hospitalized Children in Zahedan: A Case-control Study

Background: Malnutrition causes nutritional, metabolism, and biochemical disorders and finally leads to mortality. Several studies have highlighted that serum liver enzymes are increased in patients with malnutrition. Objectives: This study aimed to evaluate the relationship between malnutrition and liver enzymes in hospitalized children in Zahedan. Methods: This case-control study was conducted among 145 hospitalized children under six years old, including 74 cases and 71 controls. The case group was diagnosed with malnutrition according to weight for age indices (Z-Score &lt; -2SD), and controls were determined based on the following indices (Z-Score &gt; -2SD) of classification of WHO 2006 growth standards. Serum was isolated after taking blood from the samples. Then liver enzymes, including AST, ALP, and ALT, were measured by spectrophotometric method. Results: A total of 145 subjects were enrolled that consisted of 74 cases and 71 controls. No significant difference was observed in serum liver markers, including AST, ALT, and ALP between the two groups, However, the level of AST, ALT, and ALP was higher than the standard level. There was a significant correlation between AST with ALT (r = 0.74, P &lt; 0.001), and ALP (r = 0.27, P = 0.03). Conclusions: The findings indicated that there was no significant alteration in enzyme markers in the two groups. However, AST and ALT levels increased, and ALP levels decreased compared with the control. Different degrees of malnutrition, including mild, moderate, and severe, can probably change the levels of hepatic enzymes in under-nourished children. Alteration of these liver enzymes could be due to the metabolic modification, which can be the result of protein deficiency.

Narrative review of nutritional characteristics and supportive treatment of hepatitis B virus-related liver diseases

: The liver is an important metabolic and synthetic organ of the human body. When liver injury and function decline, abnormal metabolism of various nutrients and different degrees of malnutrition may occur, and many studies have confirmed that malnutrition can affect the therapeutic effect and prognosis of patients with chronic liver disease. We searched PubMed, the CNKI, and relevant meeting abstracts (2008 to April 2020) for randomized trials and some relevant reviews that assessed nutritional status and supportive treatment in patients with hepatitis B virus-related liver diseases. Searches were limited to human studies and English-language publications. The main keywords used for the search were nutrition, liver disease and hepatitis B. Citation lists of retrieved articles were manually screened to ensure sensitivity of the search strategy. The study suggests that malnutrition is common in patients with liver disease, since metabolism is diverse in different stages of HBV related liver disease, details of nutritional support are different. The occurrence of malnutrition is closely related to the occurrence, development and prognosis of liver disease. Malnutrition plays an important role in the development of liver disease. Appropriate nutritional intervention can improve the prognosis of HBV related liver disease.

Nutritional Status in Intensive Care Unit: A Meta-Analysis and Systematic Review

It is important to consider the nutritional status of patients in the intensive care unit (ICU) since it is a key element in the ability to overcome and survive critical illnesses and clinical outcomes. The aim of the present study was to provide a meta-analysis and systematic overview in determining the nutritional status of patients in ICU by examining other studies. All studies published during 2015-2019 on nutritional status in ICU were retrieved from Medline (via PubMed), Embase, Scopus, and Web of Science databases. Finally, 23 articles were included in the meta-analysis. Results obtained from these studies showed that the nutritional status of patients in ICU was inappropriate (the pooled proportion of malnutrition was 0.51 in the type of study stratified), in which many patients in this unit had different degrees of malnutrition (moderate-mild malnourished and severe malnutrition is 0.46 and 20%, respectively). According to the results of this study, the nutritional status of patients in ICU was unsatisfactory; hence, it is necessary to consider the nutritional status along with other therapeutic measures at the beginning of the patient’s admission.[GMJ.2020;9:e1678]

Nutritional Status in Intensive Care Unit: A Meta-Analysis and Systematic Review.

It is important to consider the nutritional status of patients in the intensive care unit (ICU) since it is a key element in the ability to overcome and survive critical illnesses and clinical outcomes. The aim of the present study was to provide a meta-analysis and systematic overview in determining the nutritional status of patients in ICU by examining other studies. All studies published during 2015-2019 on nutritional status in ICU were retrieved from Medline (via PubMed), Embase, Scopus, and Web of Science databases. Finally, 23 articles were included in the meta-analysis. Results obtained from these studies showed that the nutritional status of patients in ICU was inappropriate (the pooled proportion of malnutrition was 0.51 in the type of study stratified), in which many patients in this unit had different degrees of malnutrition (moderate-mild malnourished and severe malnutrition is 0.46 and 20%, respectively). According to the results of this study, the nutritional status of patients in ICU was unsatisfactory; hence, it is necessary to consider the nutritional status along with other therapeutic measures at the beginning of the patient’s admission.

Key points of perioperative whole-process management for patients with advanced gastric cancer

Perioperative whole-process management (WPM) for patients with advanced gastric cancer (AGC) mainly focuses on some clinical issues which are easily neglected or underappreciated. WPM is helpful in making a scientific and rational therapeutic plan, and avoiding inadequate communication in multi-disciplinary participation, so that the diagnosis, treatment and rehabilitation for AGC patients can be integrated organically. Based on the current clinical practice for AGC patients, eight key issues in WPM should be emphasized.(1) Preoperative clinical staging. An accurate preoperative staging by endoscopy and imaging technique is helpful in setting up a rational therapeutic plan, and is also a prerequisite to start WPM. (2) Indications and value of diagnostic laparoscopy. Laparoscopic exploration is beneficial to find intraperitoneal micro-metastases so as to avoid unnecessary laparotomy. For cases of AGC infiltrating serosal layer or suspected of peritoneal metastasis, preoperative laparoscopic exploration should be routinely performed. (3) Neoadjuvant therapy. Multiple RCT studies have shown that neoadjuvant chemotherapy can benefit a majority of patients with AGC, improving prognosis and prolonging their overall survival. Therefore, neoadjuvant therapy should be considered first for stage III and IVA AGC patients. (4) Prediction of efficacy in neoadjuvant chemotherapy. Endoscopy, MDCT scan, PET-CT and liquid biopsy have certain predictive value individually, which can be used together or separately to improve the accuracy of prediction. (5) Effective prevention of postoperative peritoneal metastasis. Extensive intraoperative peritoneal lavage (EIPL), neoadjuvant intraperitoneal and systemic chemotherapy (NIPS), hyperthermic intraperitoneal chemotherapy (HIPEC), early postoperative intraperitoneal chemotherapy (EPIC), and normothermic intraperitoneal chemotherapy (NIPEC) have been shown to be of various efficacy in preventing peritoneal metastases. (6) Prediction of postoperative prognosis of AGC patients. The key pathological indicators are tumor regression grade (TRG) and ypTNM staging, especially if there is lymph node metastasis. Usually for AGC patients who received neoajuvant chemotherapy with TRG 0 or ypN0, their prognosis was comparable to that of patients with cTNM stage I.(7) Postoperative adjuvant chemotherapy. Postoperative adjuvant therapy is always an important part of the WPM management of AGC patients. Several recent RCT studies have shown that duplet chemotherapy can significantly reduce the risk of death after D2 radical gastrectomy compared to singlet chemotherapy, especially for stage III patients. (8) Perioperative nutritional support. Due to different degrees of malnutrition in AGC patients, enhanced nutritional treatment in the perioperative period can not only reduce surgical complications, but also enable patients to complete necessary course of chemotherapy, and ultimately further improve their survival rate.

Influence of Environmental Factors on Rhinosinusal Tumours

Cancer of the nasal cavity and paranasal sinuses is a rare malignancy. The tumours of the nasal cavity are thus associated with the maxillary and ethmoidal sinuses. Those that start from the nasal vestibule and nasal septum raise particular problems and, although rare, form a particular group of cases among the rhinosinusal tumours. Radiation exposure, viral infections and constitutional factors were associated with the occurrence of rhinosinusal neoplasia also, but the evidence is inconclusive and indicates that only a small proportion of all squamous carcinomas can be attributed. The purpose of this study is the complex retrospective analysis of the cases of rhinosinusal malignancies diagnosed and treated in the Otolaryngology Clinic of the St. Spiridon Emergency Clinical Hospital in Iasi. We evaluated the characteristics of the patient group using a statistically significant analysis of the age, gender, background, and factors of affiliation. Specific tests and indicators have been used. It is not to be neglected the effects of the poor economic conditions andthe lack of education of the population, by postponing the moment of presentation tophysician, influencing the therapeutic decision, postoperative evolution. Thesepatients often present different degrees of malnutrition,immunodepression, etc. Statistical processing showed that thesepatients have a twofold risk of developing rhinosinusal tumours.

Stunting, Wasting, and Mid Upper Arm Circumpherence Status among Children Admitted to Nemazee Teaching Hospital

The aim of this study was to evaluate nutritional status in children without prior hospital admission or evidence of chronic disease. The current study is a cross-sectional and observational study which was conducted for assessing the nutritional status of children. In this study, consecutive sampling was used, with a sample size about 400 children aged 6 months to 18 years at first hospital admission. All subjects were hospitalized consecutively in the Pediatric Emergency Department of the Nemazee Teaching Hospital of Shiraz University of Medical Sciences (Shiraz, Islamic Republic of Iran). All children with evidence or history of chronic diseases such as liver cirrhosis, microcephaly, macrocephaly due to congenital infection or abnormal skull shape, patients with muscular or neurological problem, with prolonged steroid usage, nephrotic syndrome, cardiac problem, and protein loosing enteropathy were excluded from the study. The duration of the study was six months, starting from January 2016. In the current study, 430 (225 boys and 175 girls) cases were included. Mean age was 5.39 (SEM 0.23) for boys and 5.78 (SEM 0.38) for girls. According to H/A criteria (current height/ideal height), 194 (48.5%) patients were stunted, 75 (18.8%) were mild, 49 (12.3%) were moderate and 70 (17.5%) were severe. According to W/A data (current weight/ideal weight), 188 (47%) of the patients studied were malnourished. Of these cases, 118 (29.5%) had mild malnutrition; 54 (13.5%), moderate; and 16 (4%), severe. According to body mass index (BMI), 40 (10%) patients were overweight, four (16%) were obese, and four (1%) were severe obese. In relation to middle upper arm circumference (MUAC), 56 (14%) patients were malnourished, 33 (8.3%) were at risk, 14 (3.5%) presented moderate malnutrition, and 9 (2.3%), severe malnutrition. Prevalence of malnutrition among children without prior admission was 48.5% (according to H/A). According to W/A, 47% of children had different degrees of malnutrition.

Predicting resting energy expenditure in underweight, normal weight, overweight, and obese adult hospital patients.

BackgroundWhen indirect calorimetry is not available, predictive equations are used to estimate resing energy expenditure (REE). There is no consensus about which equation to use in hospitalized patients. The objective of this study is to examine the validity of REE predictive equations for underweight, normal weight, overweight, and obese inpatients and outpatients by comparison with indirect calorimetry.MethodsEquations were included when based on weight, height, age, and/or gender. REE was measured with indirect calorimetry. A prediction between 90 and 110% of the measured REE was considered accurate. The bias and root-mean-square error (RMSE) were used to evaluate how well the equations fitted the REE measurement. Subgroup analysis was performed for BMI. A new equation was developed based on regression analysis and tested.Results513 general hospital patients were included, (253 F, 260 M), 237 inpatients and 276 outpatients. Fifteen predictive equations were used. The most used fixed factors (25 kcal/kg/day, 30 kcal/kg/day and 2000 kcal for female and 2500 kcal for male) were added. The percentage of accurate predicted REE was low in all equations, ranging from 8 to 49%. Overall the new equation performed equal to the best performing Korth equation and slightly better than the well-known WHO equation based on weight and height (49% vs 45% accurate). Categorized by BMI subgroups, the new equation, Korth and the WHO equation based on weight and height performed best in all categories except from the obese subgroup. The original Harris and Benedict (HB) equation was best for obese patients.ConclusionsREE predictive equations are only accurate in about half the patients. The WHO equation is advised up to BMI 30, and HB equation is advised for obese (over BMI 30). Measuring REE with indirect calorimetry is preferred, and should be used when available and feasible in order to optimize nutritional support in hospital inpatients and outpatients with different degrees of malnutrition.

Dietary assessment of tribal children (3-5 years) suffering from different degrees of malnutrition in Odisha

The objectives of the study was to compare food and nutrient intake of the children suffering from different degrees of malnutrition and to asses the causes of food insecurity among the respondents. One hundred and fifty tribal children belonged to 3 to 5 years to age group were selected by random purposive sampling method from eleven anganwadis of udala ICDS project of Odisha for the present study and the data was collected with the help of required tools. The results of the study indicated that 32 per cent children were normal, 34 per cent children were wasted, 22 per cent were stunted and 12 per cent children were wasted and stunted. Joint family system (68%) was found to be prevalent in that area. Most of the parents were agricultural labourers having low education and low income. Prevalence of malnutrition was more among girls in comparison to boys. The mean food and nutrients intake of the respondents was found to be deficient in comparison to RDA except normal children. Parboiled rice was found to be their staple food. Fruit and milk consumption was found to be nil in the diet of all children except normal children. The food and nutrient intake of the respondents was found to be decreased with the severity of malnutrition. The most important causes for food insecurity was found to be poverty, wrong perception about Anganwadi food, working mother (88%), ignorance of mother (70%), dislike of food by the child and insanitary conditions of the households. Thus it can be concluded that strategies for reducing malnutrition should be focused on education of parents, health care facilities and improving the food security of the households.

Living Environs and Nutritional Status of Children from an Urban Indian Slum: An Analysis of Associative Factors

Growing urbanization gives rise to slums, which are densely populated peri-urban areas housing underprivileged populations. The nutritional status of children in slum areas can be compromised due to poor living environs despite availability of many urban health care facilities. The present cross- sectional study was undertaken to determine the nutritional status of children residing in slum and analyze the various associative factors. The study area was Ghousianagar, a slum in city of Mysore from South India. A sample of 676 children (2-11 years of age, males, 310 and females, 366) from two schools was chosen for detailed anthropometry. Data were also collected on living conditions, economic and literacy levels of parents and nutritional status of mothers (n=200) through standard techniques. The results revealed that the living conditions of children were highly unhygienic. Only in 36% of families both parents were literate. Children from all age groups exhibited different degrees of malnutrition which worsened with increasing age. Only 8% of children were normal and the rest suffered with different degrees of undernutrition. Stunting and wasting were significantly influenced by age and gender of children. Under associative factors studied, weight for age of children was significantly associated with economic status of family and maternal BMI. Weight for height was associated with economic status, family size and maternal BMI. Height for age exhibited marginal association with family size. It can be said that adverse living environment and limited resources influenced the nutritional status of children adversely.

Gastrointestinal symptoms and weight loss in cancer patients receiving chemotherapy

Cancer patients receiving chemotherapy have a high risk of malnutrition secondary to the disease and treatment, and 40-80 % of cancer patients suffer from different degrees of malnutrition, depending on tumour subtype, location, staging and treatment strategy. Malnutrition in cancer patients affects the patient's overall condition, and it increases the number of complications, the adverse effects of chemotherapy and reduces the quality of life. The aim of the present study was to evaluate weight-loss prevalence depending on the tumour site and the gastrointestinal (GI) symptoms of oncology patients receiving chemotherapy. We included 191 cancer patients receiving chemotherapy. Files of all patients were reviewed to identify symptoms that might potentially influence weight loss. The nutritional status of all patients was also determined. The cancer sites in the patients were as follows: breast (31·9 %); non-colorectal GI (18·3 %); colorectal (10·4 %); lung (5·8 %); haematological (13·1 %); others (20·5 %). Of these patients, 58 % experienced some degree of weight loss, and its prevalence was higher among the non-colorectal GI and lung cancer patients. Common symptoms included nausea (59·6 %), anorexia (46 %) and constipation (31·9 %). A higher proportion of patients with ≥ 5 % weight loss experienced anorexia, nausea and vomiting (OR 9·5, 2·15 and 6·1, respectively). In conclusion, these results indicate that GI symptoms can influence weight loss in cancer patients, and they should be included in early nutritional evaluations.