Triceps Skinfold Research Articles

The relationship between mid-upper arm circumference and blood pressure in Walter Sisulu University community.

Prevalence of hypertension is increasing to higher levels in South Africa. Anthropometric measures for obesity are well known to predict the development of hypertension. However, the relationship between mid-upper arm circumference (MUAC) and blood pressure (BP) is scant in South African communities such as universities. Therefore, this study was aimed at investigating the correlation between MUAC and BP among the community of Walter Sisulu University (WSU). A total of 230 participants from WSU (students and staff members), 113 females and 117 males aged ≥ 18 years participated in this cross-sectional study. MUAC, systolic BP (SBP) and diastolic BP (DBP) were measured using standard procedures. In a Pearson's correlation analysis, MUAC was positively correlated with SBP and DBP in both women (SBP; r = 0.53, P< 0.001; DBP; r = 0.45 P < 0.001) and men (SBP; r = 0.29 P = 0.001; DBP; r = 0.25 P = 0.007). Furthermore, in the multivariable-adjusted regression analysis, MUAC was positively associated with SBP in women only (adjusted R2 = 0.489, β = 0.29 (95% CI = 0.16; 2.08)), P =0.023) after adjusted for age, body fat percentage, waist-to-height ratio, smoking and alcohol. MUAC is positively correlated with BP in women, not in men of WSU community. MUAC, as a simple and low-cost quantifiable parameter, could be employed as a risk indicator in the early detection and prevention of cardiovascular diseases (CVDs) in women.

Associations between maternal urinary kisspeptin in late pregnancy and decreased fetal growth: a pregnancy-birth cohort study.

Kisspeptin has been indicated to be a biomarker of fetal growth. Although some evidence suggested that maternal kisspeptin concentrations in early pregnancy were associated with increased fetal growth, studies are still limited and the effect of kisspeptin in late pregnancy remains unknown. This study aimed to investigate the associations between maternal kisspeptin in late pregnancy and fetal growth. Based on the Shanghai-Minhang Birth Cohort study, 724 mother-neonate pairs were included in this study. We measured maternal kisspeptin concentrations in the urine samples collected in late pregnancy and neonatal anthropometric indices at birth. The associations between maternal kisspeptin and neonatal anthropometry were investigated using multiple linear regression models. Higher maternal urinary kisspeptin concentrations were associated with lower neonatal birth weight, head circumference, upper arm circumference, abdominal skinfold thickness, triceps skinfold thickness, and back skinfold thickness. The inverse associations were more pronounced for the highest kisspeptin levels versus the lowest. These patterns were consistent in analyses stratified by neonatal sex, with notably stable associations between maternal kisspeptin concentrations and skinfold thickness. The present study suggested that maternal kisspeptin concentrations in late pregnancy might be inversely associated with fetal growth. The physiological mechanisms of maternal kisspeptin might differ from those in early pregnancy. Further studies are required to assess associations between maternal kisspeptin and energy homeostasis and explore the physiological roles of kisspeptin in late pregnancy.

Risk factors for moderate acute malnutrition among children with acute diarrhoea in India and Tanzania: a secondary analysis of data from a randomized trial

BackgroundModerate acute malnutrition (MAM) affects over 30 million children aged < 5 years worldwide. MAM may confer a greater risk of developing severe malnutrition and even mortality in children. Assessing risk factors for MAM may allow for earlier recognition of children at risk of deleterious health outcomes.ObjectiveTo determine risk factors associated with the prevalence and development of MAM among children aged 6 to 59 months with acute diarrhoea who received treatment with oral rehydration solution and zinc supplementation.MethodsWe conducted a secondary analysis of data from a randomized, dose-finding trial of zinc among children with acute diarrhoea in India and Tanzania. We used regression models to assess risk factors for prevalent MAM at the start of diarrhoea treatment and to identify risk factors associated with the development of MAM at 60 days. MAM was defined as weight for length (or height) Z score ≤—2 and > -3 or mid-upper arm circumference < 12.5 and ≥ 11.5 cm.ResultsA total of 4,500 children were enrolled; 593 (13.2%) had MAM at the baseline. MAM at baseline was significantly less common among children in Tanzania than in India (adjusted risk ratio [aRR] 0.37, 95% confidence interval [CI]: 0.30, 0.44, P < 0.001), in children aged 24- < 60 months versus 6- < 12 months (aRR 0.46, 95% CI: 0.38, 0.56, P < 0.001), and in families with household wealth index higher than the median (aRR 0.79, 95% CI: 0.68, 0.92, P = 0.002). Sixty days after outpatient treatment and follow-up, 87 (2.5%) children developed MAM. When compared to children aged 6- < 12 months, children aged 24- < 60 months had a 52% lower risk of developing MAM. Every one unit increase in weight for length (or height) Z score at enrolment was associated with a 93% lower risk of developing MAM during follow-up.ConclusionsAmong children with diarrhoea, younger children and those from households with lower wealth were at greater risk of MAM. These children may benefit from targeted interventions focusing on feeding (targeted nutrition support for at-risk households) and follow up in order to reduce the occurrence of MAM and its consequences.

High burden of wasting among children under-five with hydrocephalus receiving care at CURE children’s hospital in Uganda: a cross-sectional study

BackgroundHydrocephalus is one of the most common neurological disabilities presenting in children. Although there are limited studies on its association with wasting, neurological comorbidities such as dysphagia have been associated with an increased risk of wasting in children. In this study, we aimed to determine the prevalence and factors associated with wasting in children less than five years with hydrocephalus.MethodsWe conducted a cross-sectional study at various satellite clinics of CURE Children’s Hospital in Uganda between September and November 2021. Children with hydrocephalus were identified at the outpatient departments of the satellite clinics of the Cure Children’s Hospital and these include Mbale, Gulu, Lira, Jinja and Katalemwa. A structured questionnaire was used to collect information on several variables including (1) for the mother: socio-demographic characteristics, partner support, and wealth index (2) for the child: socio-demographic characteristics, clinical symptoms, feeding difficulties and neural comorbidity. Anthropometric measurements were also taken and these included the mid-upper arm circumference. Data were analysed using Stata version 14. We estimated adjusted odds ratios and their corresponding 95% confidence intervals while relying on multivariable logistic regression models.ResultsThe prevalence of wasting among children with hydrocephalus was 23.2% (n = 89/384) (95%CI: 19 − 27.7%). Their mean age was 19.5 months (SD 16.8). Most of the children were below 12 months (47.9%) and were male (57.5%). The factors associated with wasting among children with hydrocephalus included: having; difficulty in chewing and swallowing (AOR = 2.6, (95%CI:1.05–3.94), a poor appetite (AOR = 1.74, (95%CI: 1.31–2.32), difficulty in breathing (AOR = 1.9, (95%CI: 1.18–3.16), chocking on food (AOR = 1.42, (95%CI:1.1–1.9) and attending the Mbale satellite clinic (AOR = 2.1 (95% CI 1.19–3.7). Children under 5 years of age with hydrocephalus that were born to women whose highest level of education was 7 to 10 years of formal schooling (AOR = 0.32, 95%CI: (0.12–0.87) were less likely to be wasted.Conclusions and recommendationsThe prevalence of wasting among children with hydrocephalus was high. The factors associated with wasting were mainly feeding challenges. We recommend that children with hydrocephalus should be given greater attention regarding their nutrition especially those with various forms of feeding difficulties. The caregivers of children with hydrocephalus should receive counseling on nutrition and on the best modalities to rely on while feeding their children.

Predictor of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia: a case-control study.

Anemia during pregnancy is a public health problem and is related to negative birth outcomes, especially in developing countries. The main aim of this study was to assess predictors of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia. Unmatched case-control study design was employed among 352 individuals. A face-to-face interview was used to gather data, and each pregnant woman's antenatal care follow-up record cards were reviewed in addition to the interview. EpiData version 3.1 and IBM SPSS version 26 was used for data entry and analysis, respectively. Bivariable and multivariable analyses were conducted to identify predictors of anemia, a p-value of <0.05 was considered a statistically significant association. The common determinants for anemia in pregnant mothers were: rural residency (AOR=2.25, 95% CI: 1.14-4.8), no formal education (AOR=4.4, 95% CI: 1.94-9.9), inter-pregnancy interval (AOR=2.7, 95% CI: 1.24-5.8), and mid-upper arm circumference (AOR=5.0, 95% CI: 2.0-12.7). In this study, the identified determinant factors for anemia were: rural residency, maternal educational status, inter-pregnancy-interval, and mid-upper arm circumference. Therefore, providing health education and promotion for pregnant women regarding anemia by focusing on rural residents and counseling to lengthen their birth spacing is an important task. Moreover, counseling on taking iron supplementation as suggested and consuming a diet rich in iron during antenatal care will be recommended.

Application of the Boruta algorithm to assess the multidimensional determinants of malnutrition among children under five years living in southern Punjab, Pakistan

BackgroundMalnutrition causes nutrient deficiencies that have both physical and clinical consequences in severe acute malnutrition children. Globally, there were 47 million wasted children under the age of five in 2019. One in four were located in sub-Saharan Africa, with half being in South Asia. This study aims to apply the Boruta algorithm to identify the determinants of undernutrition among children under five living in Dera Ghazi Khan, one of the marginalized districts of densely populated Punjab Province in Pakistan.MethodsA multicenter cross-sectional study design was used to collect data from 185 children with severe acute malnutrition aged under five years visiting the OTPs centers located in Dera Ghazi Khan, Punjab, Pakistan. A purposive sampling technique was used to collect data using a pretested structured questionnaire from parents/caregivers regarding family sociodemographic characteristics, child nutrition, and biological and healthcare characteristics. Anthropometric measurements, including height, weight, and mid-upper arm circumference, were collected. The Boruta models were used to incorporate the children’s anthropometric, nutritional, and household factors to determine the important predictive variables for undernutrition using the Boruta package in R studio.ResultsThis study included 185 children, with a mean age of 15.36 ± 10.23 months and an MUAC of 10.19 ± 0.96 cm. The Boruta analysis identifies age, mid-upper arm circumference, weaning practices, and immunization status as important predictors of undernutrition. Income per month, exclusive breastfeeding, and immunization status were found to be key factors of undernutrition in children under the age of five.ConclusionThis study highlights age, mid-upper arm circumference, weaning practices, and immunization status as key determinants of weight-for-height and weight-for-age in children under five years. It also suggests that economic context may influence undernutrition. The findings can guide targeted strategies for combating undernutrition.

Mid-upper arm circumference only protocol in Pakistan: missed opportunities for children suffering from severe acute malnutrition? A mixed-methods observational study.

We investigated the missed treatment opportunities affecting programmes using mid-upper arm circumference (MUAC) as the sole anthropometric criterion for identification and monitoring of children suffering from severe acute malnutrition (SAM). Alongside MUAC, we assessed weight-for-height Z-score (WHZ) in children screened and treated according to the national MUAC only protocol in Pakistan. Besides, we collected parents' perceptions regarding the treatment received by their children through qualitative interviews. Data were collected from October to December 2021 in Tando Allah Yar District, Sindh. All children screened in the health facilities (n 8818) and all those discharged as recovered (n 686), throughout the district, contributed to the study. All children screened in the community in the catchment areas of five selected health facilities also contributed (n 8459). Parents of forty-one children randomly selected from these same facilities participated in the interviews. Overall, 80·3 % of the SAM cases identified during community screening and 64·1 % of those identified in the health facilities presented a 'WHZ-only' diagnosis. These figures reached 93·9 % and 84·5 %, respectively, in children aged over 24 months. Among children treated for SAM and discharged as recovered, 25·3 % were still severely wasted according to WHZ. While parents positively appraised the treatment received by their children, they also recommended to extend eligibility to other malnourished children in their neighbourhood. In this context, using MUAC as the sole anthropometric criterion for treatment decisions (referral, admission and discharge) resulted in a large number of missed opportunities for children in need of timely and adequate care.

Nutritional treatment of children 6–59 months with severely low weight-for-age z-score: a study protocol for a 3-arm randomized controlled trial

BackgroundAdmission criteria that treat children with low mid-upper-arm circumference (MUAC), and low weight-for-height z-score (WHZ) are not aligned with the evidence on which children are at risk of mortality. An analysis of community-based cohort data from Senegal found that a combination of weight-for-age (WAZ) and MUAC criteria identified all children at risk of near-term death associated with severe anthropometric deficits. This study will address whether children with WAZ <−3 but MUAC ≥125 mm benefit from therapeutic feeding with ready-to-use therapeutic foods (RUTF) and whether a simplified protocol is non-inferior to the weight-based standard protocol.MethodsThis is a prospective individually randomized controlled 3-arm trial conducted in the Nara health district in Mali. Children aged 6–59 months presenting with MUAC ≥125 mm and WAZ <−3 will be randomized to (1) control group receiving no treatment, (2) simplified treatment receiving 1 sachet of RUTF daily until WAZ ≥−3 for 2 visits, (3) standard treatment receiving RUTF according to WHZ category: (a) WHZ <−3 receive 200 kcal/kg/day until WHZ ≥−2 for 2 visits, (b) WHZ ≥−3 but <−2 receive 1 sachet daily until WHZ ≥−2 for 2 visits or (c) WHZ ≥−2 receive no treatment. All children will be followed up first fortnightly for 12 weeks and then monthly until 6 months post-enrolment. The primary endpoint will be measured at 2 months with the primary outcome being WAZ as a continuous measure. Other outcomes include other anthropometric measurements and a secondary endpoint will be observed at 6 months. A total of 1397 children will be recruited including 209 in the control and 594 in both the simplified and standard arms. The sample size should enable us to conclude on the superiority of the simplified treatment compared to no treatment and on the non-inferiority of the simplified treatment versus standard treatment with a margin of non-inferiority of 0.2 WAZ.DiscussionThis trial aims to generate new evidence on the benefit of treating children with WAZ <−3 but MUAC ≥125 mm in order to guide the choice of admission criteria to malnutrition treatment and build evidence on the most efficient treatment protocol.Trial registrationThis trial was registered at ClinicalTrials.gov: NCT05248516 on February 21, 2022.

Effects of the royal jelly consumption on post-stroke complications in patients with ischemic stroke: results of a randomized controlled trial.

There is a paucity of evidence regarding the benefit of royal jelly (RJ) on post-stroke complications in patients with ischemic stroke. To address this knowledge gap, this randomized, triple-blind, placebo-controlled clinical trial was carried out to determine the effects of RJ consumption on post-stroke clinical outcomes. Of 64 eligible ischemic stroke patients (45-80 years), 32 were randomized to the RJ and 32 to the placebo groups and completed a 12-week intervention. The intervention group was advised to receive 1,000 mg of RJ dragee daily after breakfast. Post-stroke complications including cognition, fatigue, mental health, and appetite, along with serum levels of brain-derived neurotrophic factor (BDNF), and mid-upper arm circumference (MUAC) were assessed in groups pre-and post-intervention. After 12 weeks of RJ consumption, cognitive function [adjusted mean difference, 4.71; 95% confidence interval (CI), 1.75 to 7.67], serum levels of BDNF (adjusted mean difference, 0.36; 95% CI, 0.05 to 0.67), stress (adjusted mean difference, -3.33; 95% CI, -6.50 to -0.17), and appetite (adjusted mean difference, 1.38; 95% CI, 0.19 to 2.56) were significantly improved. However, the findings for fatigue (adjusted mean difference, -4.32; 95% CI, -10.28 to 1.63), depression (adjusted mean difference, -1.71; 95% CI, -5.58 to 2.16), anxiety (adjusted mean difference, -2.50; 95% CI, -5.50 to 0.49), and MUAC (adjusted mean difference, 0.36; 95% CI, -0.11 to 0.84) were less favorable. Findings support the benefits of RJ consumption in improving post-stroke complications and clinical outcomes.Clinical trial registration: https://www.irct.ir/trial/59275, Identifier IRCT20180818040827N4.

Short-term dynamics of linear growth among Peruvian infants in the first year of life in a population with linear growth faltering.

Infant growth is recognized to vary over the short term, with periods of greater and lesser linear growth velocity. Our objectives were to (1) examine the potential differences in overall growth profiles between children who experienced cumulative growth faltering in the first year of life consistent with that seen by many children living in poverty in low- and middle-income countries, versus children without growth faltering and (2) test whether biological factors were associated with the timing of magnitude of growth saltations. Thrice-weekly measurements of length were recorded for n = 61 Peruvian infants (28 boys and 33 girls) enrolled from birth to 1 year. A total of 6040 measurements were analyzed. We tested for the evidence of saltatory growth and used hurdle models to test whether the timing and magnitude of saltations varied between children with greater or lesser growth faltering. There were no differences in the duration of stasis periods or magnitude of growth saltations between children who were stunted at 1 year old (N = 18) versus those who were not stunted (N = 43). Children who experienced greater declines in LAZ in the first year of life trended toward longer periods between saltations than those with less of a decline (14.5 days vs. 13.4 days, p = .0512). A 1-unit increase in mid upper arm circumference for age Z-score in the 21 days prior was associated with 35% greater odds of a saltation occurring (p < .001), and a 0.128 cm greater saltation (p < .001). After characterizing infant growth into periods of saltation and stasis, our results suggest that increases in weight preceded increases in length.

The relationship between the severity of intellectual and developmental disabilities (IDDs) in adults with IDDs and eating and drinking problems and nutritional status.

Adults with intellectual and developmental disabilities (IDDs) experience eating, drinking and swallowing problems, such as chewing problems, choking, gagging, coughing during eating, aspiration and rumination syndrome, which may lead to poor nutritional status. This study aimed to determine the relationship between IDD levels, eating, drinking and swallowing problems and nutritional status in adults with IDDs. The sample consisted of 71 participants (37 men and 34 women) with a mean age of 22.5±7years (range 18-60years). Professionals classified intellectual disability as mild, moderate or severe. The Screening Tool of Feeding Problems scale was applied to the caregivers of adults with IDDs to identify eating, drinking and swallowing problems. Dietary intake was assessed using a 24-h dietary recall and a food and nutrition photograph catalogue. The researchers measured body weight, height and middle upper arm circumference. Body mass index was calculated. Four body mass index categories were determined: underweight (<18.5kg/m2 ), normal weight (18.5-24.9kg/m2 ), overweight (25.0-29.9kg/m2 ) and obese (≥30kg/m2 ). Chi-squared tests were used to detect the relationship between IDD levels and eating and drinking problems, and analysis of variance tests were conducted to detect the relationship between IDD levels with anthropometric measurements and dietary intake. Participants had mild (42.3%; n=30), moderate (29.6%; n=21) or severe IDD (28.2%; n=20). They were underweight (12.7%; n=9), normal weight (59.2%; n=42) or overweight and/or obese (28.2%; n=20). Participants with severe IDD had significantly higher Screening Tool of Feeding Problems 'nutrition-related behaviour' and 'eating and drinking skill deficit problem' sub-scale scores than those with mild IDD. However, the groups had no significant difference in 'food refusal and selectivity' sub-scale scores. Participants with severe IDD also had anorexia prevalence similar to those with mild IDD. The groups did not significantly differ in anthropometric measurements, daily energy intake and macronutrient and micronutrient intake. While adults with severe IDD had more eating and drinking skill deficits (e.g. chewing problems and independent eating difficulties) and nutrition-related behaviour problems than those with mild IDD, the eating, drinking and swallowing problems, which may critically affect their food intake, were similar to adults with mild IDD. The anthropometric measurements and energy and nutrient intakes of adults with severe IDD were not significantly different from those with mild IDD consistently. Findings indicate that nutritional deficiencies and nutritional behaviour problems may be avoidable in adults with IDDs.

Vitamin D deficiency and its associated factors in active TB patients at a tertiary hospital and three primary health care level facilities in Lusaka, Zambia: A cross sectional analytical study

Background: Tuberculosis (TB) remains a leading infectious cause of morbidity and mortality in Zambia. Vitamin D deficiency has been associated with increased TB incidence and severity but data for the Zambian setting is lacking, inclusive of the general population. We sought to determine the prevalence of vitamin D deficiency and its associated factors in active TB patients in comparison to matched adults from the general population without TB, and to compare clinical and radiological severity of TB based on vitamin D status.&#x0D; Methods: We enrolled 89 TB patients and 78 matched adults from the general population. Demographic and clinical data was collected. The key findings on physical examination were body mass index (BMI), mid upper arm circumference (MUAC), and signs of undernutrition. Clinical severity was assessed using the TB I Score and the Karnofsky Performance Index (KPI).Chest x-ray and measurement of serum vitamin D levels were done. Radiological severity was assessed using the Timika chest x-ray score. Vitamin D was measured using the Cobas® E411 analyser from Roche Diagnostics (Germany) with vitamin D deficiency defined as &lt;30 ng/ml and chi square used to analyse vitamin D deficiency as a categorical variable.&#x0D; Results: The median (IQR) age was 27.5 (24-38) years in the TB patients and 32 (25-37) years in the non-TB adults (p=0.30).Sixty-nine (77.53%) of the TB patients and 57 (73.08%) of the comparison group were male (p=0.51). The prevalence of vitamin D deficiency was 33.71 % in the TB patients and 15.38% in the comparison group (p &lt;0.01). Associations with vitamin D deficiency were active TB (AOR =2.27; 95% CI = 1.04- 4.95; p=0.04) and undernutrition (AOR 14.5; 95% CI 1.65-126.97; p=0.02). Median (IQR) KPI was 70 (60-80) in the vitamin D deficient patients compared to 80 (70-90) in non- vitamin D deficient patients (p=0.01). Median (IQR) Timika chest x-ray score was 75 (45-115) in the vitamin D deficient TB patients compared to 42.5 (20-75) in the non- vitamin D deficient patients (p&lt;0.01).&#x0D; Conclusions: We found a significant difference in the prevalence of vitamin D deficiency in active TB patients compared with matched non-TB adults. Vitamin D deficiency was associated with active TB and under nutrition. TB patients with vitamin D deficiency had more clinical and radiological severe disease than those with normal vitamin D levels. These findings warrant further studies on the role of vitamin D supplementation in TB in Zambia.&#x0D;

Occupational Safety and Health for Adult Saudi Arabian Women: Utilizing National Anthropometric Data.

In the last five years, the female labor force has increased rapidly in Saudi Arabia. This is due to the new government's vision to empower women. For many decades, Saudi females were excluded from working in certain fields due to cultural restrictions. Nowadays, Saudi women are not only joining the service workforce but are currently employed in more physically demanding careers, such as manufacturing and military jobs, which were previously dominated by males. It becomes necessary to design workplaces, tools, and equipment to safely accommodate the female physical attributes, which include body dimensions. This study presents the anthropometric measurements of Saudi Arabian adult females. In total, 504 female subjects aged 20-70 participated in the study. Thirty-eight body measurements, including weight and triceps skinfold, were taken in sitting and standing postures. The main contribution of this study is to provide a national anthropometric database of Saudi females, which is very limited, especially for females in the age groups under study. The availability of such data will allow foreign and local manufacturers to design usable and safe products and workspaces for a wide range of Saudi adult females. The findings reveal that there are no significant differences in the body dimensions of Saudi females across all age groups, except for stature height, eye height, chest depth, skinfold (mm), sitting height, buttock-knee length, and hip breadth. The study also reveals that Saudi females' body sizes are different from other Asian, Middle Eastern, and British nations, which invalidates the assumption of using other nations' body measurements to estimate Saudis' body measurements. Utilizing the supermarket cashier workstation to assess the appropriateness of commercial station fit for Saudi females' body dimensions, the results underscore the crucial role of anthropometric measurements in addressing differences between product design and the unique body dimensions of Saudi females. The identified anthropometric mismatch highlights potential risks, emphasizing the threat to the working safety of Saudi females. Moreover, the data can be used by health professionals as a base to evaluate the health of Saudi adult females. Descriptive statistics and extreme values are determined. The data are presented in standard anthropometric tables.

Anthropometric Linear Measurements as Surrogate Marker in Low Birth Weight Infants: A Cross-sectional Study

Introduction: Low Birth Weight (LBW) is linked to perinatal mortality and morbidity, growth, and cognitive developmental defects, along with a greater tendency to develop non communicable diseases later in life. In many settings, the birth weight of infants is not properly noted; weight is either not measured appropriately or tabulated accurately. This has necessitated the use of alternative indices in lieu of birth weight to reliably identify LBW babies, especially in settings where the availability of weighing scales is very limited. Aim: To determine the reliability of anthropometric measurements as a surrogate marker of weight in LBW infants born in a tertiary care hospital. Materials and Methods: This hospital-based cross-sectional study was conducted at Department of Paediatrics and Neonatology, Assam Medical College, Dibrugarh, Assam, India from March 2023 to May 2023. Admitted inborn babies (n=2074) in the postnatal ward and inborn Neonatal Intensive Care Unit (NICU) were included. LBW was defined as &lt;2500 grams. Crown-heel Length (CHL), Chest Circumference (CC), Head Circumference (HC), and Mid-upper Arm Circumference (MUAC) were measured. Student’s t-test and Receiver Operating Characteristic (ROC) curve analysis were used to statistically analyse the data. Results: Out of the 2074 included babies, 1123 were male, and 471 were LBW. The mean birth weight of the LBW cohort was 1.98±0.45 kg compared to 2.78±0.33 kg in the NBW cohort (p-value&lt;0.05). CHL, CC, HC, and MUAC were all significantly lower in the LBW cohort compared to the NBW cohort. MUAC seemed to be the best indicator of LBW. The cut-offs for CHL, HC, CC, and MUAC were 48.5cm, 33.5cm, 30.5cm, and 10.5cm, respectively. Conclusion: The MUAC was strongly correlated with birth weight. MUAC is easy to obtain, simple to perform, and does not require sophisticated equipment.

Low Hand Grip Strength, Mid-Upper Arm Muscle Area, Calf Circumference, Serum Albumin Level, and Muscle Fiber Diameter as Risk Factors for Independent Walking Inability in Patients with Hip Fracture 6 Weeks after Bipolar Hemiarthroplasty Surgery.

Bipolar hemiarthroplasty, one of the main treatment modalities for hip fracture, does not always promise the ability to walk independently after surgery. Patients with the same fracture characteristics and comorbidities, implants, and operators may also have different outcomes. Sarcopenia is thought to be one of the causes of the inability to walk independently after this operation; however, it has not been widely studied and is often overlooked. This study used a case-control design with 23 patients in the case group (patients unable to walk independently) and 23 patients in the control group (patients able to walk independently). Sampling was carried out consecutively according to the inclusion and exclusion criteria based on the medical records of patients with hip fractures after bipolar hemiarthroplasty at our hospital. In the preoperative period, hand grip strength (HGS), mid-upper arm muscle area (MUAMA), calf circumference (CC), serum albumin level, and total lymphocyte count were measured. A muscle biopsy was performed intraoperatively from the gluteus muscle with the amount of 200-350 mg. The patient's walking ability was assessed in the polyclinic using the Timed Up and Go test 6 weeks postoperatively. The statistical tests used were descriptive statistics, proportion comparison analysis with the chi-square test, and multiple logistic regression test. Univariate analysis using chi-square test proved HGS, MUAMA, CC, serum albumin level, and muscle fiber diameter as risk factors for inability to walk independently 6 weeks after bipolar hemiarthroplasty (p = 0.003, p = 0.003, p = 0.006, p = 0.044, and p = 0.000, respectively). Logistic regression test proved 3 direct risk factors for the inability to walk independently 6 weeks after bipolar hemiarthroplasty, namely MUAMA, serum albumin level, and muscle fiber diameter, as the strongest predictive factor (adjusted odds ratio, 63.12). Low MUAMA, serum albumin levels, and muscle fiber diameter are direct risk factors for the inability to walk independently in hip fracture patients 6 weeks after bipolar hemiarthroplasty.

Assessment of preschool preparedness intervention package on adoption of nutrition friendly school initiative in rural Sindh, Pakistan: a pre-and post-intervention design.

In 1995, the World Health Organization launched its Global School Health Initiative intending to expand this health promotion approach throughout schools globally. In this study, we aim to assess the preparedness of preschools in the adoption of intervention packages under the Nutrition Friendly School Initiative (NFSI) checklist. From three campuses of the Aga Khan School located in the Thatta and Sujawal districts of the Sindh province, Pakistan, all eligible preschool children were selected for this study. Using a pre-and post-intervention design, we assessed preschool preparedness using the NFSI checklist, knowledge of parents/caregivers regarding health and nutrition promoting behaviors, and anthropometric measurements (i.e., mid-upper arm circumference (MUAC), weight, and height) for preschool children. The NFSI checklist was analyzed with differential scores, while descriptive statistics were used for anthropometric and knowledge data. Continuous variables (i.e., height, weight, MUAC) were presented as means, while categorical variables (knowledge) were expressed as numbers and percentages. Paired t-tests for dependent samples were used to statistically assess mean differences in MUAC, height, weight, height-for-age Z-score, weight-for-age Z-score, weight-for-height Z-score, and changes in parental knowledge of preschool children. Data from 164 preschool children (ages 24-84 months, mean age 56.7 months) were analyzed over 3 months. School preparedness scores improved from 10 to 22 points (out of 26). Parental knowledge on nutrition and health increased by 7.2 points (out of 25). Children showed mean increases in MUAC (0.27 cm), weight (0.36 kg), and height (0.62 cm) (p < 0.001). Stunting and overweight/obesity rates remained the same (7.3 and 4.3%), while underweight and wasting rates dropped from 10.4 to 7.3% and 7.9 to 6.1%, respectively. The initiative effectively reduced underweight and wasting but did not impact stunting and overweight. The NFSI has greatly enhanced preschool readiness for nutrition-friendly schools. Engaging the private sector in addressing nutritional challenges has paved the way for future public-private partnerships to tackle malnutrition. The nutrition policy formulated through this initiative could serve as a blueprint for a National School Nutrition Policy.

Maternal mental health and nutritional status of infants aged under 6 months: A secondary analysis of a cross-sectional survey.

Maternal/caregivers' mental health (MMH) and child nutrition are both poor in low- and middle-income countries. Links between the two are plausible but poorly researched. Our aim was to inform future malnutrition management programmes by better understanding associations between MMH and nutritional status of infants aged under six month (u6m). We conducted a health facility-based cross-sectional survey of 1060 infants in rural Ethiopia, between October 2020 and January 2021. We collected data on: MMH status (main exposure) measured using the Patient Health Questionnaire (PHQ-9) and infant anthropometry indicators (outcome); length for age Z-score (LAZ), weight for age Z-score (WAZ), weight for length Z-score (WLZ), mid upper arm circumference (MUAC), head circumference for age Z-score (HCAZ) and lower leg length (LLL). Analysis of secondary data using linear regression was employed to determine associations between the main exposure and outcome variables. The result showed infants' mean (SD) age was 13.4 (6.2) weeks. The median score for MMH problem was 0 (inter quartile range 0-2) points, and 29.5% and 11.2% reported minimal and mild to severe depression score of 1-4 and 5-27 points, respectively. Mean (SD) LAZ was -0.4 (1.4), WAZ -0.7 (1.3), WLZ -0.5 (1.2), MUAC 12.4 (1.3) cm, HCAZ 0.4 (1.3) and LLL 148 (13.9) mm. In adjusted linear regression analysis, minimal MMH problem was negatively associated with infant LAZ marginally (β = -0.2; 95% CI: -0.4, 0.00; p = 0.05) and LLL (β = -2.0; 95% CI: -3.8, -0.1; p = 0.04), but not with other anthropometric indicators. Statistically significant associations were not found between mild to severe depressive symptoms and infant anthropometric outcomes. In conclusion, only minimal, but not mild, moderate or severe, maternal/caregivers' depressive symptoms are associated with infant anthropometry outcomes in this data set. Whilst there is a plausible relationship between maternal mental health problems and offspring nutritional status, we did not observed this. Possible reasons include: PHQ-9 not suited to our population; and only a small number of participants reporting moderate to severe level of depression. Further research to investigate and understand the relationship and pathways between maternal mental health and offspring nutritional status is required.

Диагностика нутритивных нарушений у детей после перенесенной черепно-мозговой травмы (обзор современных рекомендаций)

Traumatic brain injury (TBI) is one of the main causes of disability and mortality in the population, and in young people it ranks first. Children after TBI, in addition to neurological problems, have a number of somatic ones, such as malnutrition, dysphagia, and motor disorders of the gastrointestinal tract. Hypercatabolism causes the formation of malnutrition and loss of a significant part of muscle mass in these patients. Gastrointestinal problems limit adequate nutrition. In combination with neurological disorders – motor disorders, long-term immobilization, epilepsy – this can lead to the development of sarcopenia. The presence of sarcopenia, in turn, reduces the rehabilitation potential and directly affects the restoration and acquisition of motor functions. Therefore, it is important to assess and correct nutritional status in children with TBI not only in the acute period, but also during the early restorative treatment. The purpose — to analyze the available literature on the features of assessing nutritional status in children after traumatic brain injury. Results. Children after TBI are prone to immobilization, which leads to loss of muscle mass and bone mineral density, as well as an increase in fat mass. According to the guidelines of the European Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists (ESPGHAN), it is recommended to assess the nutritional status of children with neurological diseases using anthropometry, body composition, and some laboratory parameters. To date, a universal marker of nutritional status disorders in children with neurological diseases in general and with TBI in particular has not been identified. The clinical recommendations «Traumatic brain injury in children» (2022) indicate that such routine laboratory markers of nutrition assessment as total protein, serum albumin, prealbumin, retinol-binding protein, as well as anthropometry have not proven their effectiveness in assessing the state of muscle mass. The «gold standard» in determining the body composition is the bioimpedansometry method, which allows assessing the content of active cell mass, muscle mass, fat and fat-free mass, the total water content. To achieve optimal anthropometric parameters, body composition and rehabilitation prognosis, it is recommended to use indirect calorimetry instead of equations to calculate the resting energy expenditure. Conclusion. The current Federal Clinical Guidelines for the Treatment of Children with TBI (2022) do not have an algorithm and a clear approach to assessing nutritional status and prescribing nutritional support for children of this vulnerable group. To assess the nutritional status, regardless of the level of the hospital, it is recommended to use anthropometry with dynamic control. To assess the body composition it is recommended to use bioimpedansometry, if it is unavailable — mid-upper arm circumference using MUAC tapes, as well as caliperometry. It is also recommended to assess the level of trace elements, with dynamic control at 6 months or annually.

Hand Washing Practice and Food Insecurity are Associated With Undernutrition of Breastfeeding Mothers in Rural Ethiopia: A Cross-sectional Study.

Breastfeeding mothers are prone to undernutrition. However, factors contributing to maternal undernutrition are not exhaustively understood. Hence, this study aimed to determine prevalence of undernutrition among breastfeeding mothers and identify associated factors. A cross-sectional study was conducted among 606 breastfeeding mothers from selected rural districts in Oromia and Sidama regional states of Ethiopia. Data were collected through an interviewer-administered questionnaire. Nutritional status was assessed using body mass index (BMI) and mid-upper-arm-circumference (MUAC). Logistic regression analysis was used to identify factors associated with maternal undernutrition. One out of ten breastfeeding mothers was found undernourished as determined by BMI (12.6%) and MUAC (10.7%). Mothers who did not practice hand washing after cleaning children's bottom were 2 and 3 times more likely to be undernourished compared to their counters, as measured by BMI (AOR = 2.29, P = .002) and MUAC (AOR = 3.03, P < .001), respectively. Mothers living in mildly or moderately food insecure households (AOR = 2.37, P = .019) were more than two times more likely to be undernourished as determined by MUAC. Mothers who breastfed children in the age range of 9 to 11 (AOR = 2.79, P = .025) or 12 to 23 (AOR = 2.57, P = .018) months were more than two and half times more likely to be undernourished as determined by BMI. Maternal undernutrition is a medium-level public health problem in rural districts of Oromia and Sidama regional states in Ethiopia. The lack of hand washing practice after cleaning a child's bottom, household food insecurity and higher child age increased the odds of maternal undernutrition. Mothers should prioritize and improve their nutritional care as the age of their breastfed child increases. Nutrition programs in rural districts of Ethiopia should also aim to improve personal hygiene practices and food insecurity integrated with implementation researches to evaluate program's impact on nutritional status of breastfeeding mothers.

The Role of Continuity of Care (CoC) in Supporting Pregnant Women at Risk of Chronic Energy Deficiency (CED) in Improving Nutritional Status: A Case Report

Background: Nutritional issues in pregnant women occur during the 1,000 Days of Life (HPK) period. If nutritional problems during pregnancy are not addressed, they can disrupt fetal development. The government has undertaken efforts such as providing supplementary feeding (PMT). This PMT activity should also be accompanied by nutritional education to promote behavioral change. Midwives are among the healthcare professionals who can provide comprehensive support. This support is aimed at optimizing continuous midwifery care, with the expectation of reducing the impact of Chronic Energy Deficiency (CED) on both pregnant women and their fetuses. Methods: This case report is compiled using a descriptive method with a case study approach. The researcher supported Continuity of Care (CoC) to one patient in the working area of the Surabaya Community Health Center, from the pregnancy period through to the postpartum period and the newborn phase. Case Presentation: A 20-year-old pregnant woman was identified as at risk for Chronic Energy Deficiency (CED) due to a measurement of Mid-Upper Arm Circumference (MUAC) &lt; 23.5 cm. The woman received continuous support, including monitoring her intake of prenatal vitamins, Antenatal Care (ANC) support, counseling, and nutritional education. By the end of the pregnancy, there was an increase in her MUAC, and she was no longer at risk of CED. Conclusion: With support in the form of monitoring and holistic, comprehensive, and collaborative midwifery care from the beginning of pregnancy, optimal care targets can be achieved. The role of support throughout the pregnancy and postpartum period has been carried out effectively, resulting in the mother being free from the risk of Chronic Energy Deficiency (CED) and the baby not experiencing Low Birth Weight (LBW).