Growth Velocity Research Articles

Severe Bronchopulmonary Dysplasia Adversely Affects Brain Growth in Preterm Infants

Introduction: Bronchopulmonary dysplasia (BPD) is associated with neurodevelopmental outcomes of preterm infants, but its effect on brain growth in preterm infants after the neonatal period is unknown. This study aimed to evaluate the effect of severe BPD on brain growth of preterm infants from term to 18 months of corrected age (CA). Methods: Sixty-three preterm infants (42 with severe BPD and 21 without severe BPD) who underwent magnetic resonance imaging at term equivalent age (TEA) and 18 months of CA were studied by using the Infant Brain Extraction and Analysis Toolbox (iBEAT). We measured segmented brain volumes and compared brain volume and brain growth velocity between the severe BPD group and the non-severe BPD group. Results: There was no significant difference in brain volumes at TEA between the groups. However, the brain volumes of the total brain and cerebral white matter in the severe BPD group were significantly smaller than those in the non-severe BPD group at 18 months of CA. The brain growth velocities from TEA to 18 months of CA in the total brain, cerebral cortex, and cerebral white matter in the severe BPD group were lower than those in the non-severe BPD group. Conclusion: Brain growth in preterm infants with severe BPD from TEA age to 18 months of CA is less than that in preterm infants without severe BPD.

Rapid dendritic growth kinetics of primary phase within supercooled Zr-V alloy at electrostatic levitation state

The liquid Zr100−xVx (x = 8.6, 16.5, 30) alloys were undercooled to the maximum undercooling of 364 K (0.18 TL), 405 K (0.21 TL), and 375 K (0.21 TL), respectively, by using electrostatic levitation technique. The Zr91.4V8.6 and Zr83.5V16.5 alloys present only one recalescence during liquid/solid phase transition, while the Zr70V30 alloy presents a transformation from two recalescence to one recalescence phenomenon with a critical undercooling of approximately 300 K. According to the LKT/BCT model, the calculated results of the primary β-Zr dendrite growth velocity in undercooled liquid Zr91.4V8.6 and Zr83.5V16.5 alloys agree well with the experiments. The velocity inflection points at 119 K of Zr91.4V8.6 alloy and 201 K of Zr83.5V16.5 alloy could be explained by the competition between solutal undercooling control and thermal undercooling control modes. For Zr70V30 alloy solidified in the P1 with twice recalescence, a critical second undercooling of 253 K and corresponding undercooling of 65 and 244 K are obtained. When the undercooling is in the range of 65–244 K, the second undercooling would be greater than 253 K, and the residual liquid phase would solidify into anomalous eutectic microstructure for Zr70V30 alloy. The Vickers hardness of Zr100−xVx (x = 8.6, 16.5, 30) alloys all show a quadratic relationship with undercooling. Under electrostatic levitation condition, the mechanical property of Zr-V alloys could be significantly regulated through solidifying the alloys at different undercoolings.

Diagnosis and treatment of growth hormone deficiency in children on the ketogenic diet: A case series.

The ketogenic diet (KD) can have a negative impact on the linear growth and body composition of children. The aims of this study were to review two centers' experience with children who developed height deceleration on the KD and determine if the height deceleration was secondary to growth hormone deficiency (GHD), and if growth hormone therapy (GHT) would be effective and safe (not altering ketosis or seizure frequency). Retrospective chart reviews were performed on patients with KD referred to Endocrinology between 2013 and 2018. Seventeen children were identified. Data reviewed included: demographics, growth velocity, KD ratio, protein/calorie intake, lab results, GH dosage, Tanner stage, and seizure frequency, and endocrine recommendations. Descriptive statistics were performed. Of the 17 children referred to the Endocrine Division, seven children were growth hormone deficient and began GHT. Data were provided for six patients (2 males, 4 females; age 2-7 years at the start of KD) on the KD for >6 years and on GHT for >4 years. Growth for all patients stabilized or increased. IGF-1 z-scores normalized. GHT did not affect seizure frequency or ketosis. GHT in those with GHD can be an appropriate option allowing better growth while still maintaining ketogenic therapy and seizure control. PLAIN LANGUAGE SUMMARY: The KD can be an effective treatment for difficult-to-control epilepsy and some disorders of carbohydrate metabolism. The KD can adversely affect the linear growth (height) of children. This case series reviewed six patients who had slow linear growth. It was found that all six children had growth hormone deficiency, grew better with growth hormone treatments, and that their seizures and ketone levels were not affected.

Stability of neurodevelopmental trajectories in moderately late and early preterm children born 15 years apart.

Neurodevelopmental trajectories of preterm children may have changed due to changes in care and in society. We aimed to compare neurodevelopmental trajectories in early and moderately late preterm children, measured using the Developmental (D)-score, in two cohorts born 15 years apart. We included early preterm and moderately late preterm children from two Dutch cohorts (LOLLIPOP, 2002-2003 and ePREM, 2016-2017). ePREM counterparts were matched to LOLLIPOP participants by gestational age and sex. D-score trajectories were summarized by a multilevel model with random intercepts and random slopes, and multigroup analyses were used to test if the intercepts and slopes differed across cohorts. We included 1686 preterm children (1071 moderately late preterm, 615 early preterm) from LOLLIPOP, and matched these with 1686 ePREM counterparts. The neurodevelopmental trajectories of the two cohorts were mostly similar. For early preterm children, we found no statistically significant differences. For moderately late preterm children, both the intercept (43.0 vs. 42.3, p < 0.001) and slope (23.5 vs. 23.9, p = 0.002) showed some, but only clinically minor, differences. Developmental trajectories, measured using the D-score, in the first four years of life are comparable and stable across a period of 15 years for both early and moderately late preterm children. Neurodevelopmental trajectories are similar for early and moderately late preterm children born 15 years apart and thus seem quite stable in time. The validated Developmental score visualizes these trajectories based on developmental milestone attainment Because of its stability over time, the Developmental score trajectory may aid clinicians in neurodevelopmental assessment of preterm children as this simplifies monitoring and interpretation, similar to a growth chart.

Growth and Neurodevelopmental Outcomes of Preterm Infants Born < 26 Weeks Gestation before and after Implementation of a Nutrition-Care Bundle.

This study aimed to assess the impact of a nutrition-care bundle on growth and neurodevelopmental outcomes of micro-preterm infants born in a level III neonatal intensive care unit (NICU) by two years corrected age. A nutrition-care bundle emphasizing the prompt initiation of parenteral nutrition at birth, initiation of enteral feeds within 6 h after birth, and early addition of human milk fortifiers was implemented in 2015 for infants born < 26 weeks gestation. This before-and-after study evaluated growth and neurodevelopmental outcomes in infants born between 2012-2013 (before-nutrition-bundle, BNB) and 2016-2017 (after-nutrition-bundle, ANB). A total of 145 infants were included in the study. Infants in the ANB group (n = 73) were smaller (birthweight and gestational age), and there were more male infants and multiples included compared to the BNB group (n = 72). Enteral feeds and fortifiers started earlier in the ANB group. Growth velocity and weight z-score changes were similar in both groups during NICU stay and post-discharge. Systemic steroid use, but not cohort, was linked to lower Bayley scores across all domains. Implementing a nutrition-care bundle was not consistently associated with improved weight gain and neurodevelopmental outcomes in the micro-preterm infant population, possibly due to ongoing high-quality nutritional care by the clinical team.

Pinning/depinning dynamics of trijunction lines during faceted/nonfaceted eutectic growth

We present an in situ experimental study of decoupled- and coupled-growth patterns in a binary faceted/ nonfaceted (f/nf) eutectic alloy. Real-time optical observation is carried out at low growth velocity V (<0.3μms−1) during directional solidification of the transparent AminoMethylPropaneDiol-Succinonitrile (AMPD-SCN) eutectic in thin samples. On a large scale, the two-phase growth front mostly exhibits irregularly spaced decoupled-growth patterns involving faceted fiber-like AMPD crystals that protrude in the liquid ahead of, and in weak diffusive interaction with the nonfaceted SCN solid. The morphological stability of low-velocity, steady-state decoupled-growth patterns is evidenced. In addition, three types of (f/nf) coupled-growth patterns with fiber-like, tubular (or “hollow”) and C-shaped morphologies, respectively, are identified. New light is cast on the pinning/depinning dynamics of trijunctions at which the two solid phases and the liquid meet in equilibrium. A discussion is initiated on the interplay between the interfacial kinetics of the more or less mobile facets and the solute diffusion field, and on the stability of triple junctions with strongly anisotropic interfaces.

Faltering growth

The monitoring of growth is perhaps the longest-standing health surveillance practice in paediatrics, with routine assessments of height and weight occurring throughout childhood. Faltering from these predicted centiles will often result in a review in primary care accompanied by heightened parental anxiety. Although a drop in growth velocity may well be normal for an individual, it may also be the first warning sign of underlying pathology. The challenge for clinicians is to differentiate what is normal from faltering growth that occurs as the culmination of underlying medical, environmental, or psychosocial factors. This article gives an overview of growth and its assessment, alongside current UK criteria for faltering growth and an approach for its management in primary care.

Vosoritide treatment for children with hypochondroplasia: a phase 2 trial

Hypochondroplasia is a rare autosomal dominant skeletal dysplasia due to activating variants in FGFR3. It presents with disproportionate short stature with a wide range of clinical severity. There are currently no approved medications to treat short stature in children with hypochondroplasia. Vosoritide is a C-type natriuretic peptide analog that was recently approved for improving growth in children with achondroplasia. We aimed to evaluate the safety and efficacy of vosoritide in children with hypochondroplasia. We conducted a single-arm, phase 2, open-label trial at a single centre in the USA and enrolled 26 children with hypochondroplasia. The trial consists of a 6-month observation period to establish a baseline annualized growth velocity followed by a 12-month intervention period during which vosoritide is administered daily via subcutaneous injection at a dose of 15μg/kg/day. The trial's co-primary endpoints included the incidence of adverse events and the change from baseline in age-sex standardized annualized growth velocity and height standardized deviation score (SDS) after 12 months of treatment. This trial is registered with ClinicalTrials.gov (NCT04219007). Twenty-four participants with a mean age of 5.86 years received vosoritide therapy. The first participant was enrolled on August 4, 2020, and the final participant completed the 18-month trial on September 8, 2023. Vosoritide was well tolerated with no treatment-related serious adverse events. Injection site reactions occurred in 83.3% of participants. No participants discontinued therapy due to an adverse event. Annualized growth velocity increased by 2.26 standard deviations (SD) and height SDS increased by 0.36 SD during the treatment period versus the observation period. Hypochondroplasia specific height SDS increased by 0.38 SD. There was a 1.81cm/year increase in absolute annualized growth velocity. Vosoritide was safe and effective in increasing growth velocity in children with hypochondroplasia. Efficacy was similar to what has been reported in children with achondroplasia. This study was supported by an investigator-initiated grant from BioMarin Pharmaceutical.

Reference gender-specific neonatal size at birth growth curves for singleton and twin neonates from North India.

To construct reference growth curves for the preterm population from North India and compare it with global charts. This prospective study enrolled preterm neonates (23 to 36 weeks) from July 2018 to August 2019 after excluding stillbirths and those with congenital malformations. Anthropometry was performed within 18 hours of birth. Gestation age was assessed by the best estimate of a combination of the last menstrual period, antenatal first-trimester ultrasound, and Expanded New Ballard Score (ENBS). Centile curves were constructed for both genders for twins and singleton neonates separately using the GAMLSS method using R software. During the study period, of the 14,908 births, 3253 (21.8%) were born preterm. After excluding malformations and stillbirths, 2976 preterm neonates were eligible, out of which anthropometry within 18 hours was done for 2719 neonates. Data was analyzed for 2290 singleton and 414 twin preterm neonates. Smoothed reference growth curves were constructed for all anthropometric parameters for both genders for singleton as well as twin neonates. Indian preterm infants were smaller compared to international standards. The proportion of small for gestational age (SGA) neonates was 23.1% (Fenton's charts) but only 10.9% when the data from the newly constructed chart was used. The concordance with international standards was better for very preterm neonates <32 weeks than moderate and late preterm neonates (32 to 36 weeks). The reference charts derived from the present study can be used for the North Indian preterm population. The use of western growth charts tends to overestimate the incidence of SGA.

Disparities with global standards about growth references of mid-upper arm circumference-for-age for Pakistani children aged 6-60 months.

Growth reference values about mid-upper arm circumference (MUAC) are vital for assessing children's nutritional status. However, Pakistan lacks these reference values and growth charts. This study aims to develop these for children aged 6-60 months and compare them with global standards. The data were acquired from the 2018 National Nutrition Survey of Pakistan, which was conducted by the United Nations Children's Fund (UNICEF) during 2018-2019. The final study cohort comprised 57 285 children, with 51% being boys. Percentile values and charts for MUAC-for-age were developed using generalised additive models for location, scale and shape with the Box-Cox power exponential distribution. The mean MUAC was 14.21 cm (±2.07 cm) and 14.13 cm (±2.12 cm) for the boys and girls, respectively. At 60 months of age, the P3 and P97 percentiles for girls were slightly higher than those for boys. The median percentiles of Pakistani children were smaller than the World Health Organisation 2007 standards and with international references. We observed disparities in MUAC-for-age growth references among Pakistani children compared to global standards, highlighting regional, age and gender variations. This underscores the need for developing countries like Pakistan to establish their growth references.

Sex-based differences in growth-related IGF1 signaling in response to PAPP-A2 deficiency: comparative effects of rhGH, rhIGF1 and rhPAPP-A2 treatments

BackgroundChildren with pregnancy-associated plasma protein-A2 (PAPP-A2) mutations resulting in low levels of bioactive insulin-like growth factor-1 (IGF1) and progressive postnatal growth retardation have improved growth velocity and height following recombinant human (rh)IGF1 treatment. The present study aimed to evaluate whether Pappa2 deficiency and pharmacological manipulation of GH/IGF1 system are associated with sex-specific differences in growth-related signaling pathways.MethodsPlasma, hypothalamus, pituitary gland and liver of Pappa2ko/ko mice of both sexes, showing reduced skeletal growth, and liver of these mice treated with rhGH, rhIGF1 and rhPAPP-A2 from postnatal day (PND) 5 to PND35 were analyzed.ResultsReduced body and femur length of Pappa2ko/ko mice was associated with increases in: (1) components of IGF1 ternary complexes (IGF1, IGFBP5/Igfbp5, Igfbp3, Igfals) in plasma, hypothalamus and/or liver; and (2) key signaling regulators (phosphorylated PI3K, AKT, mTOR, GSK3β, ERK1/2 and AMPKα) in hypothalamus, pituitary gland and/or liver, with Pappa2ko/ko females having a more prominent effect. Compared to rhGH and rhIGF1, rhPAPP-A2 specifically induced: (1) increased body and femur length, and reduced plasma total IGF1 and IGFBP5 concentrations in Pappa2ko/ko females; and (2) increased Igf1 and Igf1r levels and decreased Ghr, Igfbp3 and Igfals levels in the liver of Pappa2ko/ko females. These changes were accompanied by lower phospho-STAT5, phospho-AKT and phospho-ERK2 levels and higher phospho-AMPK levels in the liver of Pappa2ko/ko females.ConclusionsSex-specific differences in IGF1 system and signaling pathways are associated with Pappa2 deficiency, pointing to rhPAPP-A2 as a promising drug to alleviate postnatal growth retardation underlying low IGF1 bioavailability in a female-specific manner.

Growth Charts for Shwachman-Diamond Syndrome at Ages 0 to 18 Years.

Shwachman-Diamond syndrome (SDS) is one of the most common inherited bone marrow failure syndromes. SDS is characterized by hypocellular bone marrow, with a severe impairment of the myeloid lineage, resulting in neutropenia, thrombocytopenia, and, more rarely, anemia. Almost 15% of patients with SDS develop myelodysplastic syndrome or acute myeloid leukemia as early as childhood or young adulthood. Exocrine pancreatic insufficiency is another common feature of SDS. Almost all patients with SDS show failure to thrive, which is associated with skeletal abnormalities due to defective ossification. Considering these observations, it remains unfeasible to use the common growth charts already available for the general population. To address this issue, we report how we drew up growth charts of patients with SDS aged 0 to 18 years. We analyzed height, weight, and body max index (BMI) in 121 Italian patients with SDS. Results indicated that the 50th and 3rd percentiles of weight and height of the pediatric general population correspond to the 97th and 50th percentiles of patients with SDS aged 0-18 years, respectively. In addition, the percentage increment in weight of subjects aged 14-18 years was higher in patients with SDS than in the general population. SDS-specific growth charts, such as those described here, afford a new tool, which is potentially useful for both clinical and research purposes in SDS.

The Role of Maternal Secretor Status and Human Milk Oligosaccharides on Early Childhood Development: A Systematic Review and Meta-Analysis.

Background: Breast milk is the gold standard of infant nutrition, delivering nutrients and bioactive molecules as needed to support optimal infant growth and cognitive development. Increasing evidence links human milk oligosaccharides (HMOs) to these early childhood development milestones. Aims: To summarize and synthesize the evidence relating to HMOs and infant brain development, physical growth, and cognitive development. In addition, HMO concentrations in secretor and nonsecretor mothers were compared via a meta-analysis. Study Design: A systematic review and meta-analysis were carried out in accordance with the PRISMA statement. This review used three databases (PubMed, Scopus, and Web of Science) and was limited to English-language articles published between 2000 and June 30, 2023. Results: The initial searches yielded 245 articles, 27 of which were included in the systematic review and 12 in the meta-analysis. The meta-analysis revealed a substantial between-study heterogeneity, I2 = 97.3%. The pooled effect was 0.21 (95% CI: -0.41 to 0.83; p = 0.484), indicating that secretors had higher HMO concentrations, although this difference was not statistically significant. At one month of age, 2'FL, 3FL, and 3'SL play an important role in brain maturation and thus play a critical role in cognitive development. Secretors produce higher concentrations of 2'FL and 3'SL, explaining the benefits to infants of secretor mothers. Growth velocity was correlated to fucosylated and sialylated HMO concentrations, with lower concentrations linked to stunting. Conclusions: According to evidence from the systematically reviewed articles, HMOs are essential for a child's early development, but the extent to which they have an impact depends on maternal secretor status.

Prognostic utility and characteristics of MIB-1 labeling index as a proliferative activity marker in childhood low-grade glioma: a retrospective observational study

PurposeThe prognostic utility of MIB-1 labeling index (LI) in pediatric low-grade glioma (PLGG) has not yet conclusively been described. We assess the correlation of MIB-1 LI and tumor growth velocity (TGV), aiming to contribute to the understanding of clinical implications and the predictive value of MIB-1 LI as an indicator of proliferative activity and progression-free survival (PFS) in PLGG.MethodsMIB-1 LI of a cohort of 172 nonependymal PLGGs were comprehensively characterized. Correlation to TGV, assessed by sequential MRI-based three-dimensional volumetry, and PFS was analyzed.ResultsMean MIB-1 LI accounted for 2.7% (range: < 1–10) and showed a significant decrease to 1.5% at secondary surgery (p = .0013). A significant difference of MIB-1 LI in different histopathological types and a correlation to tumor volume at diagnosis could be shown. Linear regression analysis showed a correlation between MIB-1 LI and preoperative TGV (R2 = .55, p < .0001), while correlation to TGV remarkably decreased after incomplete resection (R2 = .08, p = .013). Log-rank test showed no association of MIB-1 LI and 5-year PFS after incomplete (MIB-1 LI > 1 vs ≤ 1%: 48 vs 46%, p = .73) and gross-total resection (MIB-1 LI > 1 vs ≤ 1%: 89 vs 95%, p = .75).ConclusionThese data confirm a correlation of MIB-1 LI and radiologically detectable TGV in PLGG for the first time. Compared with preoperative TGV, a crucially decreasing correlation of MIB-1 LI and TGV after surgery may result in limited prognostic capability of MIB-1 LI in PLGG.

Association between taste sensitivity, taste preference, and obesity: study of healthy snacks in children aged 9–14 years

Healthy eating habits are essential to prevent childhood obesity. Children’s eating habits are influenced by many factors, such as taste sensitivity and taste preferences. This study aimed to analyze the correlation between taste sensitivity, taste preference, and obesity in children. This cross-sectional study enrolled 101 healthy children aged 9–14(34 boys and 67 girls). Nutritional status was assessed based on age- and sex-specific BMI z-scores, following CDC Growth Charts. Taste sensitivity was measured using graded sucralose (sweet)/ saline (salty) solution of 0.1709, 0.3418, and 0.6837 mol/L with distilled water (blanks). Taste preferences were assessed using a self-reported questionnaire, the gradation of sugar and salt, and four healthy snacks (two sweet snacks and two salty snacks). Statistical analysis was performed using correlation test. A quarter of the subjects were overweight and obese (25.8%). Most subjects had good taste sensitivity, and it was easier to recognize salty than sweet taste (89.1% vs. 58.4%). Moreover, the sweet taste and sweet food were preferred by almost all subjects. Correlation test showed a correlation between sweet taste sensitivity (r = 0.213; p = 0.032) and sweet preference (r = 0.374; p = 0.029) especially in boys to nutritional status, but not for salty taste. Obesity in children was associated with taste sensitivity and taste preferences especially for sweetness. Presenting healthy foods that consider the daily limit of sugar intake is very important to support optimal nutritional status for children.Graphical

Longitudinal Analysis of Latvian Child Growth: Anthropometric Parameters Dynamics from Birth to Adolescence.

This study provides a comprehensive analysis of the physical development patterns from birth to adolescence, utilizing a longitudinal dataset of 70 children monitored from birth until 17 years of age. The research focuses on the variability of growth trajectories, emphasizing the role of genetic and environmental factors in influencing these patterns. Key findings indicate that most children undergo one or two periods of accelerated growth, with significant variability in the timing and magnitude of these growth spurts. The study also highlights the adaptive nature of growth changes over generations, influenced by ecological, nutritional, and socio-economic conditions. The longitudinal approach reveals critical insights into the timing of peak growth velocities, demonstrating that girls reach their growth peak approximately one year earlier than boys. The analysis of intergenerational growth patterns suggests a significant increase in average height over the century, attributed to genetic diversity and changes in lifestyle and nutrition. This study's findings emphasize the importance of updating physical development standards regularly to reflect the changing genetic and environmental landscape. The variability in growth patterns and their correlation with health outcomes in later life highlights the need for targeted public health strategies that address the underlying socio-economic and environmental determinants of health. This research contributes to the understanding of physical development trajectories and provides a foundation for future studies aimed at optimizing health outcomes from early childhood through adolescence. The primary objective of this article is to meticulously analyze the dynamics of height growth and accurately identify the periods of accelerated bodily development within the context of longitudinal research.

The Isothermal and Non‐Isothermal Growth Behaviors of Ca2Nb2O7 in Molten Slag

AbstractCalcium pyroniobate (Ca2Nb2O7) as a kind of lead‐free piezoelectric material has been applied for different fields, but the study of isothermal and non‐isothermal growth behaviors of Ca2Nb2O7 in the molten slag is infrequent. In this paper, the in situ thermal analyzer with a single hot thermocouple technique (SHTT) is used to study the growth behaviors of Ca2Nb2O7 in molten slag. In the isothermal temperatures, the Ca2Nb2O7 presents two kinds of growth morphology, including three dimensional (3D) rhombus growth and fibrous one dimensional (1D) growth. The 3D rhombus is grown under the range of 1608 to 1628 K. When the temperature further decreases to 1593 K, the growth behavior of Ca2Nb2O7 becomes fibrous in 1D. Growth velocity affected by the degree of supercooling may account for the phenomenon of two kinds of growth behaviors in different temperatures. In the non‐isothermal growth process, the cooling rate over 10 K min−1 contributes to multiple crystal nucleuses growth of Ca2Nb2O7. The cooling rate below 5 K min−1 leads to single nuclear growth. This paper provides a control guideline for Ca2Nb2O7 growth.

IJCM_39A: To compare the World Health Organization growth charts with Indian Academy of Pediatrics growth charts of under-five children attending urban health center of a Medical College

Background: The nutritional status of the child can be measured by using anthropometry which is the valuable tool and the gold standard method. The magnitude of different measures of nutritional status is affected by choice of reference charts used. Objective: To compare the world Health Organization growth charts with Indian academy of pediatrics growth charts to assess the malnutrition among under 5 children attending Urban health center of a medical College. Methodology: A cross sectional study was conducted among 220 children attended urban health centre of SS. Institute of Medical Sciences for a period of 4 months. Height and weight were measured and plotted on World Health Organization and Indian Academy of Pediatrics charts. Results: In this study underweight was detected among 46.9% of the boys and 43.8% of the girls and stunting was detected among 50.4% of the boys and 43.8% of the girls by using World Health Organization Growth Charts. According to Indian academy of Pediatrics, 32.1% of the boys and 38% of the girls were found to be undernourished and Stunting was detected among 53.9% of the boys and 68.8% of the girls. Conclusion: In this study both the growth charts showed variation in the height and weight measurements.

IJCM_97A: Clinico-epidemiological profile and outcome of Severe Acute Malnutrition children admitted to the nutritional rehabilitation centre of a tertiary care hospital in Kalaburagi, Karnataka: a retrospective study

Background: Severe acute malnutrition is the major cause for under- five morbidity and mortality. According to NFHS 5 (2019-20), 7.7% of malnourished children under 5 years in India were severely wasted and in Karnataka it is 8.4 %. There is paucity of data on risk factors and clinical outcomes related to SAM children in North Karnataka, hence the present study was conducted. Objectives: 1. To assess the clinico-epidemiological profile of SAM children. 2. To determine the risk factors of SAM children admitted in NRC. 3. To study outcomes of SAM children admitted in NRC. Methodology: Study setting: Nutritional Rehabilitation Centre of Gulbarga Institute of Medical Sciences, a Tertiary care hospital in Kalaburagi. Study design: A retrospective record- based cross-sectional study Study population: All children under 5 years of age admitted with SAM in the NRC at GIMS, Kalaburagi. Study duration: December 2022- November 2023 Sample size: As per data from Medical Records Department, total number of SAM children admitted in NRC is 180 between December 2022 to November 2023. DATA COLLECTION METHOD: In all the admitted patients, a detailed history including socio demographic, clinical presentation, birth order, immunization and duration of stay in NRC, physical examination findings and investigations were collected from available records. Anthropometric measurements like weight, length /height, MUAC and weight for height were collected and analysed using WHO growth charts. The outcomes included whether the children completed duration of stay at NRC were cured with weight gain, no weight gain or succumbed to malnutrition. Inclusion criteria: All children under 5 years who were admitted and fulfilled the criteria of SAM by WHO. Exclusion Criteria: 1. Case sheets of admitted SAM children with incomplete data. STATISTICAL ANALYSIS: Data were entered in Microsoft excel sheet and analyzed using SPSS version 20. Results: Among 150 SAM children analysed,77 (51.7%) males and 73(48.3%) females had weight for height below - 3SD. Conclusion: Hospital-based management of SAM children in NRC with adherence to updated WHO standard guidelines has helped in reducing mortality and morbidity among undernourished children.

Knowledge and practice of breastfeeding among lactating mothers in AIIMS, Bhubaneswar - A hospital-based cross-sectional study.

44% of infants under 6 months of age worldwide are only adequately breastfed. It is also found that only 41.6% of women breastfeed their child within one hour of birth and less than 50% of women continue breastfeeding up to 2 years. This study was conducted to assess the prevalence of early initiation of breastfeeding practice, to explore the knowledge and practices about breastfeeding among lactating mothers, and to find the effect of breastfeeding on the nutritional status of the child. A hospital-based study was conducted among 160 lactating mothers of infants below six months of age presenting to the immunization clinic at AIIMS Bhubaneswar. A semi-structured questionnaire based on the CDC breastfeeding questionnaire was administered to assess the knowledge and practice. The nutritional status of the infant was assessed by plotting the weight for age and length for age of the infant in the WHO growth charts. 102 (75%) of mothers had initiated breastfeeding within the first hour of delivery. Adequate knowledge and practice of breastfeeding was present only in 4 (2.5%) and 3 (1.9%), respectively. It was found that 13.75% of women were using formula feed. The prevalence of underweight and less than normal length was 40% (n = 64) and 34.37% (n = 55) among infants, respectively. This study emphasizes the importance of awareness among lactating mothers about the hindmilk, appropriate practice, and to find its effect on the nourishment of the children.