Triceps Skinfold Research Articles

Assessment of Anthropometric Parameters and Selected Macronutrients Status in Children Attending Primary Health Care Centre Babban Dodo Zaria, Kaduna State

Malnutrition is an independent risk factor for patient morbidity and mortality as a result of socioeconomic challenges. The aim of the study is to assess the anthropometric indices and some selected macronutrients status in children attending clinic at Primary Health Care Centre Babban Dodo Zaria, Kaduna State. Sixty (60) participants were recruited for socio-demographic study using structured questionnaire. Anthropometric parameters (Body Mass Index, Mid Upper Arm Circumference and Hip), total protein, serum albumin and globulin were determined from the children attending the clinic. It was observed that, children of 8 months old and above showed significant decrease (p<0.01) in serum total protein compared to the children of lesser ages. Similarly, children of 1 month 5 months and 8-55 months showed significant decrease (p<0.01) in serum albumin. Significant decrease (p<0.01) in serum globulin level was seen in Children of 2-3 months, 6 months and 8-55 months compared to the children of less than 2 months. The Body Mass Index (BMI) shows that 58.33% were underweight, 25.00% were normal and 16.67% were overweight. Significant increase (p<0.01) in head circumference were seen in children of 8-55 months old compared to the children of below 8 months. Children of 20-25 months old and also showed significant decrease (p<0.01) in Waist/Hip ratio compared with other group of children. Results indicate that, stunted growth, Protein energy malnutrition symptoms were seen in most of the children which in turn will affect their mental state.

Evaluation of Nutritional Status in Cancer Patients Underwent Radiotherapy: The Results of Biochemical, Body Composition with Bioelectrical Impedance Analysis, Anthropometric Measurements, and Patient-Generated Subjective Global Assessment

Aim: This study aims to evaluate the nutritional status and the effect of radiotherapy (RT) on nutrition in all ambulatory cancer patients. Material and Method: In this prospective observational study 105 cancer patients with various diagnoses treated between 2013 and 2014 were evaluated. All patients were ≥18 years old and had Karnofsky Performance Status ≥70. Anthropometric measurements, body composition with bioelectric impedance, and patient-generated Subjective Global Assessment (PG-SGA) tools were used. The height, weight, body mass index (BMI), triceps skin fold thickness, mid-upper arm circumference, hemoglobin, and serum albumin levels were determined twice before and after RT. Additionally, nutrition-related symptoms and short-term weight loss results were determined by PG-SGA questionnaires. Results: The patients’ median age was 53 years (range, 18-82 years). At initial evaluation 74 patients were well nourished using the PG-SGA global rating. Malnutrition developed in totally 33 of these 74 patients after RT. The PG-SGA results after RT were significantly worse than before treatment. PG-SGA revealed no significant relationship between nutritional status prior to RT and the parameters including gender, age, mean weight, BMI, disease duration, pre-RT hemoglobin and albumin levels. Post-RT evaluation showed a significant relationship between deterioration (PG-SGA B-C) and mean weight, BMI, serum albumin, hemoglobin levels, and concomitant chemotherapy. Gastrointestinal and head and neck cancer patients had the most deterioration after RT. The patients' weight, BMI, fat-free mass, total body water, and the percentage weight loss at the end of RT were significantly lower than the initial assessment. Conclusion: It is considerable to use multiple tools for nutritional monitoring. Patients who received RT to the head and neck and upper abdomen region had a high risk of deterioration after treatment. These patients should be monitored carefully during all treatment periods.

SOCIO-CULTURAL DETERMINANTS OF EXCLUSIVE BREASTFEEDING AND INFANT FEEDING PRACTICES IN NIGER

Background
 Niger has one of the lowest exclusive breastfeeding (EBF) rates in the world. Prelacteal feeding practices may contribute to low EBF rates, but research on the barriers related to EBF in Niger is limited.
 Objective
 The purpose of this study was to identify socio-cultural determinants for, and barriers to, EBF during an infant’s first 6 months through maternal perspectives in Niamey, the capital of Niger.
 Methods
 Participants were mothers with children aged 0 to 24 months in Niamey, Niger. Participants completed an interview including a 20-item questionnaire on socio-demographics, breastfeeding support and knowledge, a short food security survey, and a 24-hour diet recall. Infant anthropometric data (height, weight, upper arm circumference) was collected from patient records.
 Results
 All participants (n=31) breastfed and a majority of the mothers were planning to breastfeed until the child reached 18 months old. No mother among the participants practiced EBF for the recommended 6 months because of the common practice of prelacteal feeding, where solid or liquid foods were introduced before 6 months of age. Most participants stated that they were instructed on how to feed their child by a close relative such as their mother or sister, while health professionals rarely gave such instructions.
 Conclusions
 Exclusive breastfeeding is not a common practice among mothers in Niamey. Even though many breastfeed their infant for a relatively long duration, the participants disclosed that they often feed their infants solid and liquid foods before they reach the recommended age for complementary feeding, and sometimes within 48 hours after birth. Study results may inform the development of breastfeeding education components in clinics where mothers attend pre and postnatal consultations.

Evaluation of the nutritional status of patients hospitalized in a university hospital

Aim: Malnutrition is a common condition in hospitalized patients. This study aimed to evaluate the nutritional status of patients hospitalized in the Recep Tayyip Erdoğan University Medical Faculty Training and Research Hospital and to determine physicians' awareness of this issue. Methods: In this study, patients hospitalized in different wards were evaluated prospectively. The 485 patients over the age of 18 who were hospitalized in different wards were included in the study. The chronic disease history of the patients was evaluated. The patients were evaluated twice, at admission and on the 7th day of hospitalization. Height, weight, body mass index, and upper arm circumference were measured with the NRS 2002 (Nutritional Risk Scoring) screening test to determine the nutritional status of the patients. Descriptive statistical methods were used in the evaluation of the data, and the chi-square test was used in the comparison of qualitative data (p<0.05). Results: Of the patients included in the study, 42% were female and 58% were male. There was no statistical difference in the comparison of the presence of malnutrition by gender. According to the first NRS 2002 measurements of the patients, malnutrition was not found in 78.1% of all patients, while the presence of malnutrition was found in 21.9% of the patients. 100 of the 105 patients with malnutrition were found to be over 65 years old. According to the second NRS 2002 measurements, while 31.2% of patients over 65 years of age had malnutrition, 3.1% of patients under 65 years of age had malnutrition. Conclusion: The rate of malnutrition increased as the presence of chronic disease and age increased. It was seen that most of the patients who were found to have malnutrition in the first evaluation were not provided with nutritional support, and the rate of noticing and treating malnutrition by physicians was not sufficient. How to cite this article: Bardak S, Beyazal Polat H. Evaluation of the nutritional status of patients hospitalized in a university hospital. J Med Dent Invest 2023; 4: e230357. https://doi.org/10.5577/jomdi.e230357

The Effect of Semangit Tempeh Cookies on MUAC, Hb, and Serum Ferritin in Pregnant Women with CED

This study aimed to analyze the effect of semangit tempeh cookies on Mid-Upper Arm Circumference (MUAC), Hemoglobin (Hb), and Serum Ferritin (SF) of pregnant women with Chronic Energy Deficiency (CED) in Lebak, Banten. The study included 47 pregnant women with MUAC<23.5 cm who were divided into Control Group (CG) (n=22) and Intervention Group (TSG) (n=25). The mean increase in MUAC in the intervention group was 0.72±0.97 cm, while that in the control group was 0.75±1.23 cm (p>0.05), and there was an increase in hemoglobin levels of 0.84 mg/dL in the control group and 0.18 mg in the intervention group. The level of adherence to consumption of semangit tempeh cookies in the intervention group was lower than in the control group (p>0.05). The supplemental feeding of semangit tempeh cookies to pregnant women in intervention group did not have a significant effect on MUAC, Hb and serum ferritin compared to control group.

Anthropometric status and macronutrient intake of bodybuilding athletes in Limpopo province, South Africa

Bodybuilders in Limpopo Province adhere to various training and dietary routines to attain their desired physique. However, the anthropometric status and macronutrient intake of these athletes remain unknown. A total of ninety-three bodybuilders from the Capricorn District, Limpopo Province, who were members of IFBBSA, participated in the study. Ethics approval was granted by the University of the Free State Health Science. Athletes signed informed consent before participation Measurements of weight and height were taken to calculate body mass index (BMI), waist circumference (WC), mid-upper arm circumference (MUAC), and body fat percentage (BF%). Three 24-hour-recall questionnaires were completed. The SAMRC FoodFinder-3 was used to analyse macronutrients, with the mean values considered. Data were exported to the SPSS (v28), and descriptive statistics were applied. Pearson’s correlation test was used to determine the relationship between variables. The BMI was 25.8±4.4 kg/m2 in males and 24.9±3.6 kg/m2 in females, while MUAC was 35.6 cm for males and 28.3 cm for females. About half of both genders exhibited excess BF% (9.9% for males and 17.3% for females). Most males (81.6%) and all females had acceptable WC. Energy intake was 148 kJ/kg/day and 142 kJ/kg/day while carbohydrate intake was 4.7 g/kg/day for males and 4.3 g/kg/day for females. Fat intake was high in both genders. However, protein intake was optimal in males (1.4 g/kg/day) and suboptimal in females (1.1 g/kg/day). About half of the bodybuilders exceeded the sport-specific recommendations for BF%. However, the energy and carbohydrate intakes were suboptimal, while protein and fat intakes were optimal and high respectively.

Milk Supplementation as a Potential Intervention for Overcoming Anemia and Chronic Energy Deficiency during Pregnancy

This study aimed to determine the effect of milk supplementation on Mid-Upper Arm Circumference (MUAC) and hemoglobin level in pregnant women. It is a quasi-experimental study conducted from May to August 2019. The sampling was done by purposive sampling, and 108 pregnant women were recruited and divided into two groups: intervention group and non-intervention group. The intervention group received Fe-fortified milk supplementation, and the non-intervention group received education on anemia prevention. Data were analyzed using paired t-test. The result was that providing milk supplementation to pregnant women for three months could significantly increase MUAC and prevent further decline in hemoglobin levels.

Association between Pre-Conception Health and Nutrition Knowledge- Attitude-Practice and Anemia among Pre-Marital Women in Sleman, Indonesia

The study aimed to assess the association between pre-conception health and nutrition Knowledge-Attitude-Practice (KAP) and anemia among Pre-Marital Women (PMW). In this cross-sectional study, Mid-Upper Arm Circumference (MUAC) measurement, 24-hour food recall interview, blood sample collection, and validated KAP questionnaire interview were conducted to 111 PMW in Sleman in 2021. The study found that 21.6%, 14.4%, and 49.1% of PMW had Chronic Energy Deficiency (CED), anemia, and lack of minimum dietary diversity, respectively. The proportions of PMW with adequate KAP were 70.5%, 67.8%, and 64.3%, respectively. Pre-conception health and nutrition practices are associated with anemia (p<0.05), but knowledge and attitude are not.

A comparison of mid-upper arm circumference and weight-for-height Z score of world health organization growth standards in detecting moderate and severe acute malnutrition in children aged 6-60 months

Background: World health organization (WHO) had defined severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) by weight for height Z score (WHZ) and mid upper arm circumference (MUAC) criteria. Several studies indicate discrepancies in the prevalence of malnutrition on using either WHZ or MUAC. The prevalence of SAM was nearly same when using either criterion and only 40% children showed overlapping by using both the criteria. Present study was taken to identify the overlapping of cases by applying both the WHO criteria in children aged 6-60 months. It also identifies the optimal screening cut off values of MUAC if used as a sole criterion. Method: It was a hospital based descriptive cross-sectional study done on 640 cases who were assessed for MAM /SAM by using anthropometric WHO criteria. Results: From 67 SAM cases who were identified by WHZ, only17 cases had SAM on using MUAC too. The sensitivity of MUAC was 25.4% and specificity of 92.0%. From 94 MAM cases, 19 cases showed overlapping by using both the WHO criteria. At MUAC of <13.5 cm, the sensitivity increased to 86.6% for SAM and 81.6% for MAM cases at the cost of decreased specificity which was at around 36% for both the types of malnutrition. Conclusions: The number of malnourished cases, identified by using either of WHO criteria were nearly same but both these criteria detect different subgroups of malnourished children in most cases. A MUAC of <13.5 cm may be used as a sole-criteria in the community by the health workers to detect acute malnutrition.

Hybrid total alloplastic temporomandibular joint replacement prosthesis: a pilot study to evaluate feasibility, functional performance and impact on post-operative quality of life.

The aim of the present study was to investigate the clinical efficiency of hybrid alloplastic temporomandibular joint (TMJ) prosthesis in patients undergoing TMJ total alloplastic joint replacement (TMJR). The prosthesis utilized for this study for TMJR is a hybrid variant with combination of stock prototype design and a partial customization of components. A prospective clinical study was conducted involving five patients with unilateral TMJ ankylosis or end-stage joint disease (ESJD) indicated for and requiring TMJR. The patients underwent resection of the joint or gap arthroplasty followed by TMJR using the hybrid alloplastic TMJ prosthesis. The subjective and objective variables that included the jaw function (JF), inter-incisal opening (IO), diet intake (DI) and quality of life (QoL) were assessed using the psychometric modified Likert scale. The nutritional status of the patients was evaluated using the mid-upper arm circumference (MUAC) as reference. The assessed study variables demonstrated functional and observational improvement in the post-operative follow-up when compared to the pre-operative period. The patients showed an improvement in overall QoL and nutritional status post-operatively. The follow-up period showed subjective and objective improvement in the parameters assessed among the study population. There is a technical and clinical feasibility to utilize the hybrid alloplastic TMJ prosthesis as a reliable alloplastic option for treating patients requiring TMJR, with prudent indications.

Hubungan Asupan Zat Gizi Makro dengan Status Gizi Berdasarkan LILA pada Remaja Putri di SMA Negeri 2 dan 4 Kecamatan Tuban

Problem: Chronic energy deficiency is a condition in which a person experiences a long-lasting and chronic lack of energy and protein. This condition can be determined through the measurement of MUAC (Upper Arm Circumference) as one of the indicators of nutritional status measurement. with a threshold of 23.5 cm. Objective: This study is to determine the relationship between macronutrient intake, iron and physical activity with nutritional status based on MUAC in SMA Negeri 2 and 4 Tuban District. Method : Analytical research method with a cross sectional approach. The sample of adolescents in SMA Negeri 2 and 4 Tuban Sub-district amounted to 237 respondents, determined by cluster random sampling technique. Analysis of the study using spearman correlation statistical test. Result: showed that adolescent girls with weight deficit energy intake had Chronic energy deficiency nutritional status with a percentage (93.5%), protein (76.5%), fat (76.6%), carbohydrates (86.2%). The results of statistical tests found a significant relationship between macronutrient intake and Chronic energy deficiency (p-value = 0.000). Conclusion: of this study is that macronutrients can affect the incidence of Chronic energy deficiency in adolescents. The lower the intake of macronutrients, the more adolescent girls are at risk of chronic energy deficiency

PENA EMAS: A MODEL OF COMMUNITY EMPOWERMENT AND INDEPENDENT PARTICIPATION IN HANDLING STUNTING

Various national efforts and programs have been launched to overcome the problem of stunting. However, the incidence of stunting still cannot be resolved optimally. One real effort to overcome the problem of stunting is to empower the community itself. In implementing this community empowerment activity, the PRA (Participatory Rural Appraisal) method is used because this method emphasizes the full involvement of partner communities in the program to be carried out. The three program priorities that will be implemented are providing additional food (PMT) to stunted toddlers and toddlers as well as pregnant women with chronic energy deficiency (KEK), increasing knowledge of partner communities through information communication and education (KIE) activities for target groups, and economic empowerment. family. The aim of implementing this activity is to provide assistance and trigger partner communities in overcoming the stunting problem that occurs. A total of 16 people attended the Ecoprint Workshop, and 15 people attended catfish cultivation training. The output targets targeted in implementing this activity include reducing the number of toddlers and toddlers with stunting, increasing hemoglobin levels and upper arm circumference in pregnant women who experience chronic energy deficiency, publishing articles in national journals, and documenting the implementation of community empowerment activities with stunting problems.

Effect of bodybuilding athletes' weight loss method on performance factors and immune function.

This study was conducted on elite bodybuilders for 6 weeks using two weight loss methods (traditional method=high-weight loss vs. new method=low-weight loss). The subjects of this study were 26 male active elite bodybuilders who voluntarily wanted to participate in this experiment, and were divided into experimental group and traditional group. The traditional and experimental groups underwent dietary restrictions and training for 6 weeks. The conclusion obtained from the results of this study is that in the case of anthropometric variables, there is a difference in weight class between the two groups. The experimental group's upper arm circumference was maintained compared to the pre-measured value after post-measurement, while the traditional group decreased, and a significant interaction effect was observed. In particular, a significant interaction effect was observed. In that the absolute value of maximum oxygen intake was significantly increased only in the post-experimental group compared to the pretest, and an interaction effect was observed, the use of low-weight loss method is more effective than the traditional method of high-weight loss method. An increase in some cytokines was observed despite traditional weight loss, but it did not cause an excessive decrease in immunity or a sharp decrease in performance factors. As a result of this experiment, it is judged that the use of a low-weight loss method is more preferable than the traditional high-weight loss method in relation to performance variables.

Inequalities in adiposity trends between 1979 and 1999 in Guatemalan children.

Guatemala suffered from civil war and high levels of inequality and childhood stunting in the second half of the 20th century, but little is known about inequalities in secular trends in adiposity. To investigate differences in childhood body mass index (BMI) and skinfold thickness trajectories from 1979 to 1999 between three groups of children: High socioeconomic position (SEP) Ladino, Low SEP Ladino, and Low SEP Indigenous Maya. The sample comprised 19 346 children aged 7-17 years with 54 638 observations. The outcomes were height, BMI, triceps skinfold thickness (TST), and subscapular skinfold thickness (SST) Z-scores according to the Centers for Disease Control and Prevention (CDC) references. Sex-specific multilevel models were used to estimate and compare mean trajectories from 1979 to 1999 between the three groups. Mean Z-scores were always highest for High SEP Ladino children and lowest for Low SEP Maya children. Despite their very short stature, the Low SEP groups had SST trajectories that were above the 50th centile. The BMI trajectories were relatively flat and within one major centile band of the CDC median, with differences between the three groups that were small (0.2-0.3 Z-scores) and did not attenuate over time. Conversely, the TST Z-score trajectories demonstrated larger positive secular trends (e.g., from -1.25 in 1979 to -0.06 in 1999 for Low SEP Maya boys), with differences between the three groups that were large (0.5-1.2 Z-scores) and did attenuate over time (in boys). Secular trends and between-group difference in the SST Z-score trajectories were less pronounced, but again we found stronger evidence in boys that the estimated inequalities attenuated over time. Secular trends and inequalities in skinfolds differ from those for BMI in Guatemalan children. Differences between groups in skinfolds attenuated over time, at least in boys, but whether this is good news is questionable given the very short stature yet relatively large subscapular skinfolds of the Low SEP groups.

The effect of nutrition education based on hybrid model on iron deficiency anemia and upper arm circumference among female students

This study aimed to analyze the impact of nutrition education on anemia and upper arm circumference in adolescent women. A total of 97 adolescent women participated in the cluster-randomized control study. The nutrition education intervention, which included both offline and online sessions, made use of a self-created booklet and was delivered by trained nutrition education personnel. Data on socio-demographics were obtained through the interview method. Nutritional status was determined by measuring upper arm circumference (MUAC), and anemia was diagnosed by health personnel after blood hemoglobin levels were examined. The chi-square test and paired and independent t-tests were used to analyze the data. When compared to the control group, nutrition education using booklets showed significant differences in the parameters of knowledge, attitudes, self-efficacy, reinforcing factors, supporting factors, and anemia prevention behavior with each p-value of 0.05. However, the intervention group's hemoglobin level increased more than the control groups. MUAC in the intervention group increased by 0.31 cm, while in the control group it increased by 0.3 cm. However, the difference in difference (DID) analysis did not show a significant difference between the two parameters (p=0.296 and p=0.084). Nutrition education for two months did not increase mean hemoglobin or LILA significantly. However, given the decreasing trend of anemia and the prevalence of CED in the intervention group, structured and routine nutrition education can be implemented as part of nutritional interventions in teenagers to prevent anemia and CED, allowing for long-term effects of interventions to be seen.

ASSESSMENT OF NUTRITIONAL STATUS OF ANGANWADI CHILDREN

Good nutrition helps to improve child survival, promote healthy growth and development and contribute to better cognitive development. This study aims to assess the nutritional status of Anganwadi children in Dantiwada Taluka. Study was done amongst 30 Anganwadi centers of Dantiwada Taluka selected by simple random sampling. A total of 300 children of age 2 to 6 years were enrolled in the study. All mothers/informants were interviewed, and anthropometric measurements such as weight, height, mid upper arm circumference (MUAC), chest circumference and head circumference were taken by using appropriate technique. Data were analyzed using SPSS and Pearson’s correlation to find the association between two qualitative variables. With respect to BMI-for-age, out of 300 Anganwadi children, the maximum number of Anganwadi children 61.30 per cent were normal followed by 35.30 per cent being underweight, 2.30 per cent were overweight and only 1.00 per cent were obese. A positive correlation was observed between the nutritional status of the children and the parents’ educational level and family monthly income.The study concludes that skill-oriented training must be imparted to mothers for effective utilization of locally available eatable materials to prepare nutritious and balanced dietsfor children, create awareness programme and educate them to improvetheir nutritional status further.

Comparison of biochemical and anthropometric parameters in complicated and uncomplicated severe acute malnutrition among children aged 6 to 59 months: a cross-sectional study

Aim: The frequency of severe acute malnutrition (SAM) is the highest in India. Although it should receive more attention, severe anemia is one of the comorbidities that increases mortality in children who are severely undernourished. In SAM children, the liver function test (LFT), kidney function test (KFT), and complete blood count (CBC) are deranged, but their correlation with the prognosis is not well defined. The aim was to describe the anthropometric assessment and biochemical profile of children with SAM. Methods: This cross-sectional cohort study was performed at the Departments of Paediatrics and Biochemistry at G.S.V.M. Medical College, Kanpur, and at the Department of Biotechnology at Amity University Rajasthan, Jaipur. One hundred and six patients with SAM were enrolled; 53 were grouped as complicated SAM (Group 1) (dehydration and severe dehydration) and 53 were diagnosed as non-complicated SAM (Group 2). Results: Group II had significantly higher mean values for height, weight, mid-upper arm circumference (MUAC), head circumference, and body mass index (BMI) for age percentile compared to Group I, with P-values of 0.001. Group I had a significantly lower level of hemoglobin (8.86 g/dL ± 2.21 g/dL) compared to Group II (10.0 g/dL ± 1.83 g/dL) with a P-value of 0.003. The difference in the frequency of anemia between the groups was statistically significant, with a P-value of 0.026. Anemia significantly increased the risk of complicated SAM with an odds ratio of 2.60 [95% confidence interval (CI), 1.07–6.31, P = 0.001]. Conclusions: This study suggests that there may be a significant relationship between anemia and the development of complications in high-risk children with SAM.

Measuring body composition in pediatric patients with complex diagnoses: Acceptability, practicality, and validation of different techniques.

Body composition could help identify malnutrition in pediatric patients, but there is uncertainty over which techniques are most suitable and prevailing opinion that measurements are difficult to obtain in practice. This study examined the acceptability, practicality, reliability, and validity of different anthropometric and body composition measurements in patients with complex diagnoses in a tertiary pediatric hospital. A total of 152 children aged 5-18 years had weight, height, body mass index (BMI), mid-upper arm circumference (MUAC), 4-site skinfold thicknesses (SFT), bioelectrical impedance analysis (BIA), and dual-energy x-ray absorptiometry (DXA) assessed on admission and discharge. Acceptability was assessed in a continuous scale, practicality with number/percentage of successful measurements, reliability with intraclass correlation coefficients and coefficients of repeatability, and validity between "simpler" techniques and DXA with Bland-Altman analysis of agreement and Cohen kappa. Techniques were overall acceptable. Measurements were successful in >50%, with patient refusal uncommon. Coefficients of repeatability were good (0.3 cm MUAC and height, 0.2 kg weight, and 1.0 mm SFTs). All techniques significantly overestimated DXA fat mass, but BMI and triceps SFT better identified abnormal fat mass (κ = 0.46 and 0.49). BIA fat-free mass was not significantly different from DXA, with substantial agreement between techniques (κ = 0.65). Body composition by a range of techniques is acceptable, practical, and reliable in a diverse group of children with complex diagnoses. BIA seems a good alternative to DXA for assessing fat-free mass, triceps SFT, and BMI for fat mass but should be used with care as it could overestimate total fat mass in individuals.

Malnutrition and associated factors among sick children needing hospital care in District Umerkot, Pakistan

Background: In the Umerkot area of Pakistan, where malnutrition is common, a local hospital discovered that one-third of the hospitalized children were undernourished. The purpose of this research was to identify the prevalence of malnutrition and its associated among pediatric inpatients. 
 Methods: A cross-sectional research was carried out on 298 children who were hospitalized to the District Headquarter Hospital in Umerkot and ranged in age from 06 months to 05 years. In order to determine malnutrition in accordance with WHO guidelines, anthropometry measures such as mid-upper arm circumference (MUAC) were taken. The clinical diagnosis, immunization history, and food intake were documented. 
 Results: The prevalence of malnutrition was 34.6%, with moderate (26.5%) and severe (8.1%) cases included. In children, underweight afflicted 29.5%. Common diagnoses during admission were measles (18.8%), pneumonia (17.4%), and diarrhea (15.8%). Malnutrition was significantly correlated with inadequate food intake and an age-inappropriate vaccination rate of 8.7%, which is in agreement with previous research results. 
 Conclusions: In order to address the critically high prevalence of inpatient malnutrition, pediatric care must include standards for nutritional assessment and treatment as well as capacity development. In local communities, it's also critical to do routine growth monitoring and to promote immunization, proper hygiene, and balanced diets.
 Keywords: Malnutrition; Pediatrics; Nutritional status; Mid-upper arm circumference; Pakistan

Association of sarcopenia defined by different skeletal muscle mass measurements with prognosis and quality of life in older patients with heart failure

BackgroundDiagnosing sarcopenia in heart failure (HF) patients is important, but how to assess skeletal muscle mass in HF patients with fluid retention is controversial. We aimed to examine the association between sarcopenia, defined by different skeletal muscle mass measurements, and clinical outcomes in older HF patients. MethodsWe included 546 older HF patients (≥ 65 years) who were assessed for sarcopenia at discharge (median age 77 years, 309 males). Sarcopenia was diagnosed using grip strength, usual gait speed, and skeletal muscle mass according to international criteria. We used mid-upper arm circumference (MUAC), mid-upper arm muscle circumference (MAMC), calf circumference (CC), and skeletal muscle mass index (SMI) assessed by bioelectrical impedance analysis to assess skeletal muscle mass and defined sarcopenia in each of these measurements. Prognostic outcomes were composite events (all-cause death and HF rehospitalization) and cardiovascular disease (CVD) events (CVD death and CVD rehospitalization). Quality of life (QOL) was assessed using the 36-item Short-Form Health Survey physical functioning (SF-36PF) score. ResultsThe sarcopenia defined by MUAC [hazard ratio (HR): 2.50; 95 % confidence interval (95 % CI): 1.64–3.81; p < 0.001] or MAMC (HR: 1.98; 95 % CI: 1.35–2.92; p = 0.001) were associated with higher composite event rates than the non-sarcopenia. The sarcopenia defined by MUAC (HR: 1.88; 95 % CI: 1.25–2.83; p = 0.002) or MAMC (HR: 1.70; 95 % CI: 1.16–2.49; p = 0.007) were associated with higher CVD event rates than the non-sarcopenia. The sarcopenia defined by CC or SMI were not associated with prognoses. The sarcopenia defined by MUAC, MAMC, or CC were associated with low SF-36PF scores (all p < 0.05). ConclusionsThese results suggest that a diagnosis of sarcopenia based on MUAC or MAMC rather than CC or SMI reflects prognosis and QOL in older HF patients.