Growth Disorders Research Articles

First results of the growth disorders related twinning programme Partners4Growth implemented at the tertiary university pediatric endocrinology clinics in Bulgaria.

Early diagnosis of childhood growth disorders, their timely and proper treatment are important for better outcomes.The aim of the present study was to assess the results of the first 18months of the growth disorders related twinning programme "Partners4Growth" implemented at all tertiary university pediatric endocrinology clinics in Bulgaria. In 2019, Partners4Growth started operation at 7 centres (4 experienced and 3 twin centres) with the main aim of aligning their practices in the shortest possible time. Education of twin centres' personnel was organized, equipment and methods for growth evaluation and follow-up were standardized. The approach was tested initially at one centre. At baseline and at the 18th month a questionnaire concerning diagnosis and management of recombinant human growth hormone (rhGH) requiring disorders was applied. A total of 104 new patients were diagnosed compared to 30 in the previous year. Of those, 91 started rhGH treatment- 65 (64 %) GH deficient, 12 (12 %) Turner syndrome, 7 (7 %) Prader-Willi syndrome patients, and 7 (7 %) born small for gestational age without postnatal catch-up, representing 35.8 % of all currently rhGH treated Bulgarian children. A better geographical coverage and more advanced diagnostic and management practices were achieved. Partners4Growth facilitated the alignment of the tertiary pediatric endocrinology centres competences thus leading to an improved diagnosis and treatment of growth disorders as well as better patients' access. For its short existence, the Programme increased significantly the number of new patients in the difficult times of COVID-19 pandemic thus justifying its continuation.

A Century of Vitamin E: Early Milestones and Future Directions in Animal Nutrition

Vitamin E, consisting of four tocopherols and four tocotrienols, with α-tocopherol as the most biologically active form, has a significant history in scientific research. It was first identified in the 1920s for its role in preventing neonatal mortality in rats. Over time, its chemical structure was elucidated, and its importance in the immune system, skin health, anti-inflammatory properties, and hormonal balance was revealed. Vitamin E production has evolved from natural sourcing to efficient synthesis with standardized potency units. Initially, animal studies focused on reproductive health and growth disorders, but later research highlighted vitamin E’s role in preventing encephalomalacia in domestic fowl and muscular dystrophy in various animals. Today, vitamin E is commonly used as a feed additive to enhance animal health and immune function. Despite substantial knowledge about its role in animal nutrition, several questions remain unanswered. Current research seeks to determine optimal supplementation levels, interactions with other nutrients, impacts on gene expression, cell signaling, and communication, as well as the effects of high dosages in livestock. Vitamin E continues to be a crucial component in improving animal health, and ongoing research aims to uncover its benefits and mechanisms of action further.

Nutritional Balance Education for Parents, Supported Innovation of Corn Briquette Products for Family Economic Added Value

Abstract. Stunting can occur as early as 1000 days after conception and is related to many factors, including socio-economic, nutritional intake of pregnant women and infants, infection, nutritional status of the mother, infectious diseases, micronutrient deficiencies and the environment. Stunting is a nutritional problem in children globally. Data from Dadapayu District shows that the stunting rate is quite high, due to limited housewives causing children's health conditions to experience growth and development disorders. With technological devices to determine stunting in children, attention towards children’s nutrition’s needs to be socialized to the community through the understanding of PKK mothers and other residents. With the fulfillment of children's nutritional needs, it is necessary to increase the family economy. Every year, the village of Dadapayu experiences an abundant corn harvest, so corn cobs are only used as fuel for residents who have livestock, which is to repel livestock mosquitoes. With this information, a product innovation from corn cobs needs to be created. The need for energy is increasing and so is the level of demand for fuel oil, which triggers a scarcity of energy sources. It is necessary to look for alternative energy sources to replace the dwindling amount of fuel oil. This effort has been able to develop innovation and provide insight and training to the community to utilize abundant natural resources, namely corn cobs into charcoal briquettes.

THE CORRELATION OF MOTHER'S KNOWLEDGE AND MOTHER'S BEHAVIOR IN STUNTING PREVENTION EFFORTS IN TUNTUNGAN VILLAGE 2 DELI SERDANG REGENCY

Stunting is a situation of unbalanced nutrition which is a physical growth disorder and a decrease in the speed of growth in children. Nutritional problems related to stunting is still a problem that occurred in Indonesia. The long-term impact that occurs due to stunting is still physical, mental, intellectual and cognitive development disorders. The incidence of stunting in children with high resulted in the long-term problems and difficult to control so that it will cause a risk to off spring who will be vulnerable to a low birth weight. Nutrition survey data over the past year shows that nutritional problems are still high, one of which is stunting, which is the main problem. The role of the mother in the family greatly affects food preparation so that the mother's knowledge is needed to improve the nutrition of their family members. The purpose of this study was to determine the relationship between mother's knowledge and mother's behavior in preventing stunting in Tuntungan Village 2, Pancur Batu District, Deli Serdang Regency. This study was conducted on mothers who have toddlers aged 6-59 months and this research is a qualitative research with an phenomenological approach. Mother's knowledge is very important in preventing stunting. Mothers who have good knowledge will be very influential in preventing stunting in the family. The importance of collaboration with all layers in order to support increasing maternal knowledge in preventing stunting.

PENINGKATAN KETERAMPILAN KELUARGA DALAM PENCEGAHAN GANGGUAN PERTUMBUHAN BATITA

Indicators of community nutrition development through nutrition management in toddlers need to be supported by the family's ability to recognize children's growth. Having a healthy child is the hope of all families. To achieve this, of course, the family must be able to carry out family care functions which include, getting to know, making the right decisions, caring for, providing a supportive environment and utilizing existing health facilities. The purpose of this community service is to improve the ability about the function of family care in the prevention of toddler growth disorders. The outputs resulting from this community service are educational videos on preventing toddler growth disorders and the toddler growth module.

HUBUNGAN PENDAPATAN KELUARGA TERHADAP KEJADIAN BAWAH GARIS MERAH (BGM) PADA BALITA USIA 0-5 TAHUN

Introduction: The incidence of Below the Red Line (BGM) is a growth disorder that occurs in toddlers where the results of weight measurements are below of red line on the KMS. Risk factors that cause of below the red line are family income, maternal knowledge, birth interval Objective: to determine the relationship between family income and the incidence of Under the Red Line (BGM) for toddlers aged 0-5 years. Methods: This study was conducted in April 2023 in Public Health of Karangkembang Babat with a cross sectional design. The independent variables were family income variable and the incidence of Below the Red Line (BGM) as the dependent variable. The number of research samples was 50 toddlers aged 0-59 months with sampling using total sampling. Statistical analysis using rank spearman correlation. Results: There is a relationship between family income and the incidence of Below the Red Line (BGM) in toddlers 0-5 years (p value = 0.000). Conclusion: Family income will affect the incidence of Below the Red Line (BGM). Higher income will increase the family's food. Suggestion: families of toddlers to be able to increase the amount of food provision, especially for toddlers to improve nutritional status.

The Association Between Helicobacter pylori Infection With Different Types of Colon Cancer and Children’s Diseases: An Overview of Meta-analyses

Objectives: Helicobacter pylori is a gram-negative curved bacillus that assumes a significant role in colon cancer and children´s diseases. This study aimed to examine the association between H. pylori infection with colon cancer and children´s diseases in order to achieve a comprehensive understanding of these associations and for future works. Methods: Three main databases (i.e., Cochrane Central Register of Controlled Trials [CENTRAL], Scopus, and MEDLINE) were systematically searched by two reviewers from their inception date to 2022 in order to determine the association between the H. pylori infection with the colon cancer and children’s diseases. Results: The findings of two meta-analyses were similar regarding the positive association between the risks of colorectal neoplasm (pooled OR=0.18; 95% CI of 0.99–1.40; P>0.05) and colon neoplasia (pooled OR=0.41; 95% confidence interval 1.24–1.60; P=0.000). H. pylori was associated with an increased risk of colorectal adenoma, adenocarcinoma, and advanced adenoma. Also H. pylori infection was correlated with a high risk of iron deficiency anemia (IDA), otitis media with effusion (OME), Henoch-Schonlein purpura, and growth disorders in children. Conclusions: In sum, the H. pylori infection may have been associated with an increased risk of colorectal cancer and children’s diseases.

PENGARUH BABY MASSAGE TERHADAP PERKEMBANGAN BAYI

Infancy is also called the golden age or golden age as well as a critical period for the development of a baby at the age of 0-12 months. According to national data, according to the Indonesian Ministry of Health, in 2014, 13% - 18% of children under five in Indonesia experienced growth and development disorders. Developmental problems in babies can be done with stimulation, one form of stimulation that is commonly done by parents for babies is tactile stimulation in the form of baby massage. This study aims to determine the effect of baby massage on infant development. This study used a pre-experimental research design with a one group pretest and posttest research approach. The sampling technique used was purposive sampling. The sample in this study were 23 infants aged 0-12 months. The data analysis used was univariate and bivariate using the Wilcoxon pretest-posttest. The results of data analysis obtained a p-value of 0.014 (p <0.05) which indicates that Ha is accepted and Ho is rejected. Thus it can be concluded that there is an influence between baby massage on baby development in the Simpang Baru Health Center work area. It is recommended for mothers who have babies to be able to massage the baby as often as possible because the mother's touch can improve the baby's development.

Bacteriology and trends of antimicrobial resistance of Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus in otitis media: A retrospective data analysis.

Otitis media (OM) has a high prevalence worldwide and the treatment is crucial because hearing loss in children can lead to growth disorders such as language development disorders. The aim of this study is to analyse the changes in bacterial strains and the trends of antibiotic susceptibility in otitis media with effusion (OME), chronic otitis media (COM) and cholesteatomatous otitis media (Chole OM). This retrospective study involved 2926 patients diagnosed with OME, COM, or Chole OM between January 2000 and December 2020. The clinical data were collected and analysed through chart review from May 2021 to July 2021. Two tertiary medical centres. The 2926 OM patients. An otorrhea sample was collected on the first day of their hospital visit. Middle ear fluid samples for bacterial culture and antibiotics susceptibility test were collected from patients during middle ear surgery, including ventilation tube insertion. In each type of OM, the distribution of bacterial strains in the 2000s and the 2010s was compared. In addition, changes in the detection rate of methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PA) and trends in their antibiotic susceptibility over the last 10 years were analysed. The most frequently detected bacterial strains in OME, COM and Chole OM over the study period were coagulase-negative Staphylococcus (CNS) (29.6%), MRSA (24.1%), and PA (20.1%). Compared to the 2000s, the proportion of non-typable Haemophilus influenzae in OME and MRSA in COM increased in the 2010s (27.4%-31.6% and 1.5%-29.5%, respectively). In total three types of OM, although there was no significant trend of change in detection rates of MRSA, PA, and multidrug resistant-P. aeruginosa (MDR-PA) during the last 10 years, resistance to the Quinolone class of MRSA and PA tended to increase (P < .05). The composition of bacterial strains in each types of OM has changed over the past 20 years. Additionally, the antibiotic resistance of MRSA and PA has increased in the last decade. Therefore, when using empirical antibiotics in necessary situations, it is necessary to change to an appropriate antibiotic through a bacterial culture test and antimicrobial susceptibility test.

Rancang Bangun Sistem Informasi Geografis Pemetaan Wilayah Penderita Penyakit Stunting

Stunting is a growth disorder in children and toddlers caused by lack of nutritional intake, so that children's height is stunted compared to children their age. Currently, stunting sufferers in West Sakra District can be said to be quite vulnerable. So it requires intensive treatment and attention quickly and precisely. In mapping the area of stunting sufferers in West Sakra District it is still manual so that in the process of searching for areas with stunting in West Sakra it takes a long time and tends to cause problems. Therefore, a study was conducted to create a geographic information system for mapping the areas of stunting sufferers in West Sakra District. The purpose of this system is to provide convenience and help the West Sakra District, especially the Rensing Health Center, which manages the data. The steps taken in making this system are system requirements analysis, system design, system creation, and system testing. And in making this system, using the PHP programming language and using MySQL as the database

Adaptive Critical Region Extraction Net via relationship modeling for bone age assessment

Bone age assessment is an efficient clinical practice to diagnose children’s endocrine, genetic, and growth disorders. Guided by clinical diagnostic methods, local critical regions cropped from original hand radiography images have significant biological identification meaning in skeletal maturity analysis. However, existing methods crop local regions without maintaining the relationship between cropped regions and the global image, which results in discarding essential information. To address this problem, we propose an Adaptive Critical Region Extraction Net (ACRE-Net) for bone age assessment, which can automatically locate local critical regions from global images and calibrate features by relationship modeling. Unlike existing two-stage methods, which crop global images in the first stage and analyze cropped parts in the second stage separately, our ACRE-Net maintains the relationships between global images and cropped regions and further integrates such relationship information into relationship-guided features. With the relationship-guided features, we propose a novel cross-graph feature calibration module which is consisted of a bigraph structure to supplementary and calibrate features extracted from cropped parts by also modeling the relationship between cropped parts. Meanwhile, we offer a novel localization strategy in the patch-based region localization module, which aggregates and leverages multi-scale attention maps to locate patches of interest as critical regions to be cropped. In practical application, our ACRE-Net can free clinicians from time-consuming manual annotations on local critical regions and automatically assess bone age through radiography images. Extensive experiments illustrate that our ACRE-Net achieves state-of-the-art performance with Mean Absolute Error (MAE) 3.78 months on the public RSNA2017 dataset.

Sex-Linked Growth Disorder and Aberrant Pituitary Gene Expression in Nestin-Cre-Mediated Egr1 Conditional Knockout Mice.

Genes that regulate hormone release are essential for maintaining metabolism and energy balance. Egr1 encodes a transcription factor that regulates hormone production and release, and a decreased in growth hormones has been reported in Egr1 knockout mice. A reduction in growth hormones has also been observed in Nestin-Cre mice, a model frequently used to study the nervous system. Currently, it is unknown how Egr1 loss or the Nestin-Cre driver disrupt pituitary gene expression. Here, we compared the growth curves and pituitary gene expression profiles of Nestin-Cre-mediated Egr1 conditional knockout (Egr1cKO) mice with those of their controls. Reduced body weight was observed in both the Nestin-Cre and Egr1cKO mice, and the loss of Egr1 had a slightly more severe impact on female mice than on male mice. RNA-seq data analyses revealed that the sex-related differences were amplified in the Nestin-Cre-mediated Egr1 conditional knockout mice. Additionally, in the male mice, the influence of Egr1cKO on pituitary gene expression may be overridden by the Nestin-Cre driver. Differentially expressed genes associated with the Nestin-Cre driver were significantly enriched for genes related to growth factor activity and binding. Altogether, our results demonstrate that Nestin-Cre and the loss of Egr1 in the neuronal cell lineage have distinct impacts on pituitary gene expression in a sex-specific manner.

Intrauterine Growth Restriction Among Pregnant Hypertensive Women of Urban and Rural Areas

Background: Intrauterine growth restriction (IUGR) seems to have long-term health consequences in a newborn’s life. Hypertensive disorders of pregnancy are associated with placental blood flow and may lead to IUGR. This study aimed to determine the frequency and outcome of IUGR in hypertensive pregnant females of urban and rural areas. Method: This cross-sectional observational study was conducted from July 2021 to June 2022 in the Department of Gynecology &amp; Obstetrics, CMH Kohat. All pregnant patients(n=170) of age between 18 to 45 years, either nulliparous or multiparous diagnosed with hypertensive disorders were observed for IUGR and its outcomes including appearance, pulse, grimace, activity, and respiration (APGAR) score, and stillbirth in urban and rural females. The collected data was analyzed using SPSS version 23. The stratification was performed for different variables and the Chi-square test was applied post-stratification with a confidence interval of 95% and a p-value of ≤0.05 was considered significant. Results: Mean maternal and gestational age (mean ± SD) was 28.05±7.07 years and 36.16±3.64 weeks respectively. IUGR was detected in 110 (64.7%) babies. The outcomes observed were a low APGAR score of 42 (24.7%) and stillbirth was seen in 28 (16.46%) females. While IUGR in the urban population was 63.1% and higher in rural females at 65.71% (p = 0.80), the results were not statistically significant. Conclusion: It was found that rural females had a high percentage of IUGR in babies which is associated with low APGAR scores and stillbirth. Therefore, timely intervention can prevent hostile consequences and growth disorders.

Analisis Faktor Risiko TB paru Anak yang Tinggal Serumah dengan Penderita TB paru Dewasa

Pulmonary tuberculosis (TB) is still a major public health problem in Indonesia. Based on the Household Health Survey (SKRT) results tuberculosis is the number one respiratory disease and infectious disease. Tuberculosis in children causes growth disorders and even death. If pulmonary tuberculosis in a child is not treated immediately, it can quickly develop into parenchymal or tubercular pneumonia, milliary tuberculosis, bone tuberculosis (scrofuloderma), joint tuberculosis, abdominal tuberculosis, and even meningitis. This study used a case-control design with analytical observation. Children who were exposed to and lived in the same household with adult pulmonary tuberculosis patients as many as 90 adults participated in the study. The case sample consisted of children aged 0-15 years who were diagnosed with Pulmonary TB by doctors at the Wania Health Center, Mimika Regency. The case sample size was 30 respondents and the control sample was 30 respondents. The free variables in this study were parental knowledge, BCG vaccination history, child nutritional status, occupancy density, the behavior of TB sufferers at home, and length of contact. Data were analyzed using univariate analysis, bivariate analysis, and multivariate analysis (multiple logistic regression). The results of the study analysis showed that the factors that influence the incidence of tuberculosis in children are parental knowledge (p = 0.001), BCG vaccination history (p = 0.001), and the behavior of adult tuberculosis sufferers in the household (p = 0.000) The conclusion of the study was that the behavior of adult pulmonary tuberculosis patients who lived in the same house with children was most influential in the transmission of pulmonary tuberculosis in children who lived in the same household as adult pulmonary tuberculosis patients at the Health Centre of Wania, Mimika District.

Activity and Safety of Cinchonine Nanostructured Lipid Carriers as a Hair Growth Stimulant in Mice Model of Androgenetic Alopecia

Androgenetic alopecia (AA) is a hair growth disorder characterized by hair loss and miniaturization of the size of follicles and dermal papillae. Cinchonine is a quinoline alkaloid that can increase VEGF production and potential as a hair growth stimulant. This study aimed to determine the morphology, penetration (in vitro), as well as safety and activity of cinchonine nanostructured lipid carriers (CN-NLC) serum as a hair growth stimulant. Preparation of CN-NLC serum using a combination of micro-emulsification and ultra-sonification methods, characterization of CN-NLC serum included morphology and closed hair follicle diffusion methods. Dermal and eye irritation test using New Zealand rabbit strain with primary irritation index parameters. Hair growth stimulant activity test using Swiss Webster mice strain, induced with the hormone testosterone. Observations were performed at 7, 14, and 21 days with hair length and histology parameters. CN-NLC serum morphology is a spherical shape with size ±500 nm, diffusion of serum CN-NLC (open hair follicles) of 23.92±0.84%; (close hair follicles) of 11.37±2.29%; and CN solution of 6.00±0.72%. CN-NLC serum are non-irritant with a primary irritation index of 0.0. Activity tests showed hair length on days 7; 14 and 21 were increased by 20.24-23.74%; 33.47-36.43%, and 39.30-39.97% (P≤0.05). Histological data showed an increase in the number and size of both dermal papillae and hair follicles compared to the control group. CN-NLC serum can improve the penetration of CN into hair follicles. CN-NLC serum is safe and effective as a hair growth stimulant in the treatment of AA.

Effect of Nursing Interventions on Feeding Difficulties of Children with Cerebral Palsy

Context: Cerebral Palsy (CP) is a static non-progressive brain disorder defined as a group of motor disorders resulting from brain damage before, during, or after birth. Children with CP frequently have feeding problems, growth disorders, feeding complications, communication disorders, mental obstruction, seizure disorders, auditory problems, and visual deficiency, which may significantly impact their health.&#x0D; Aim: The study aimed to evaluate the effect of nursing interventions on feeding difficulties of children with cerebral palsy.&#x0D; Methods: A quasi-experimental (pre/post-test) research design was utilized in this study that was conducted at the Neurologic Specialized Clinic at Children's Hospital affiliated to Ain Shams University Hospitals. A convenient sample of forty-five children with CP having feeding difficulties and their mothers was selected from the previously mentioned setting. Data were collected by using three tools, a structured interview questionnaire and a Children Observation Assessment Record to assess the child's ability and feeding difficulties of the studied children before and after the intervention.&#x0D; Results: The study reveals a mother's mean age of 31.33±4.46 and a child's mean age of 6.28±2.91. The children's assessment reveals that 84.4% of cerebral palsy children were hypotonic. Pre and post-test comparisons of children's BMI revealed a statistically significant difference at p=0.018, and feeding difficulties revealed a statistically significant difference in spoon feeding p= 0.007, biting p=0.002, chewing p=0.003, cup drinking p= 0.005, swallowing p=0.001, and drooling during eating p=0.009.&#x0D; Conclusion: The study concluded that the supportive nursing intervention program was successful in improving the feeding difficulties as regards spoon feeding, biting, chewing, cup drinking, swallowing, and drooling during eating after the intervention compared to the children's pre-intervention level. The study recommended applying supportive nursing interventions for children with CP having feeding difficulties as a main supportive nursing intervention to overcome feeding difficulties.

Is It Truly Household Income Affect Underweightin Children Under Five Years Old ? Evidence From Indonesia

Background: Underweight is a nutritional problem that still often occurs in children under five in Indonesia and abroad. Indonesia is a maritime country, where most of the territory is water so that the population living in coastal areas is not small. Many factors influence the occurrence of under-nutrition under five in coastal areas. Toddlers who experience underweight will experience physical growth disorders, morbidity and even risk of death. The purpose of this study was to determine the dominant factor in the incidence of underweight in children under five in the coastal area. Methods: This type of research is analytic observational with a cross sectional study design. The population in this study were mothers who had toddlers aged 12 – 59 months with a total sample of 68 toddlers who were selected using simple random sampling technique. Data was collected by interview method using a questionnaire and then analyzed using chi-square test and logistic regression. Results: This study found that household income was the main factor for underweight in children under five years of age, although there were many other contributing factors such as mother's knowledge, parenting style, history of infectious diseases. Conclusions: Low income causes the purchasing power of food to be low, causing family food consumption to decrease which ultimately affects the weight of children under five. For this reason, the role of mothers, families and the government is needed in reducing the prevalence of underweight in toddlers in the coastal area, Indonesia.

News from the European Journal of Therapeutics: A new issue and a new editorial board

News from the European Journal of Therapeutics: A new issue and a new editorial board

The Relationship between Exclusive Breastfeeding and Stunting Incidents in Candipuro Village

Stunting is a problem of chronic malnutrition caused by a lack of nutrition for a long time, resulting in growth disorders. The condition of inadequate nutritional intake in children is important for stunting. The best nutritional intake for babies is breast milk. Breastfeeding is thought to affect the incidence of stunting. This study aimed to determine the relationship between exclusive breastfeeding and the incidence of stunting in Candipuro Village. The research design uses qualitative research, namely retrospective or case-control. The sampling technique used in this study is purposive sampling. Analysis of the data used in this study is to use descriptive and bivariate data analysis. The Chi-square data analysis results show a relationship between exclusive breastfeeding and the incidence of stunting in Candipuro Village (p=0.00). Thus, it can be concluded that there is a relationship between exclusive breastfeeding and the incidence of stunting in Candipuro Village. The results of this study provide input for mothers to provide exclusive breastfeeding to infants to avoid stunting.

The Effect of Baby Spa on Body Weight Changes in Babies Aged 3-6 Months

Infants aged 0-6 months are the most vulnerable to growth disorders. One way to increase a baby's weight is through baby SPA. This study aimed to determine the effect of infant SPA on weight changes in infants aged 3-6 months. This study used a quasi-experimental design with a control group pre-post test design approach. The population in this study were all infants aged 3-6 months at Ain Hartoko SPA, Tempeh District, Lumajang Regency, in July 2022. As many as 42 infants were divided into two groups, the experimental and the control groups, using the accidental sampling technique. The results showed that the baby's weight gain in the experimental group was mostly classified as overweight (56.3%), while in the control group, most were normal (62.5%). The Wilcoxon test results for the p-value for the experimental and control groups were both 0.000, so they experienced an increase in body weight after two weeks. The Mann-Whitney test results obtained p-value=0.045 &lt;0.05, so infant SPA affects weight changes in infants aged 3-6 months. Health workers are expected to conduct counseling about infant SPA in collaboration with Toddler Posyandu cadres in the village to overcome failure to thrive in toddlers.