Poor Nutritional Status Research Articles

Oral health problems are associated with malnutrition in hospitalised adult patients

Hospitalised patients are especially vulnerable to malnutrition, which is associated with an increased risk of complications, leading to longer hospital stays, increased healthcare costs, and with a potentially negative effect on the prognosis. Poor oral health may make food intake difficult and contribute to poor nutritional status. The aim of the present cross-sectional study was to assess the occurrence of poor oral health and malnutrition in adult hospitalised patients, and further to investigate associations between oral health problems and malnutrition. The Patient-Generated Subjective Global Assessment (PG-SGA) determined the patients' nutritional status. The oral health condition was evaluated according to the Revised Oral Assessment Guide-Jönköping (ROAG-J) and unstimulated salivary flow rate. Clinical information was collected from medical records. The study population included 118 patients from 15 somatic and 3 psychiatric wards at a University Hospital in Norway. Nearly half the patients (46%) were categorised as malnourished and in need of symptom alleviation or nutritional intervention. Malnutrition was found in all diagnostic conditions. According to ROAG-J, at least one oral health problem was identified in 93% of the patients. Severe oral health problems were more frequent in malnourished patients. Overall, both the number and total score of oral health problems were associated with malnutrition (OR 1.57, 95% CI 1.20-2.06 and OR 1.47, 95% CI 1.17-1.83, respectively). Of specific oral health items, problems with lips and mucous membranes were significantly associated with malnutrition. One-fifth of all patients had hyposalivation, but this was not associated with malnutrition. Oral health problems and malnutrition are commonly seen in hospitalised adult patients. The association between the two calls for raised awareness of oral health issues in assessing patients' nutritional status. Further study is required to clarify whether oral health problems constitute a causal factor in malnutrition.

Predictive Validity of Mortality after Surgically Treated Proximal Femur Fractures Based on Four Nutrition Scores-A Retrospective Data Analysis.

Hip fractures are becoming a growing concern due to an aging population. The high costs to the healthcare system and far-reaching consequences for those affected, including a loss of independence and increased mortality rates, make this issue important. Poor nutritional status is a common problem among geriatric patients and is associated with a worse prognosis. Nutritional screening tools can help identify high-risk patients and enable individualized care to improve survival rates. This retrospective study investigates four nutritional scores and laboratory parameters' predictive significance concerning postoperative mortality after surgical treatment of proximal femur fractures at 1, 3, 6, and 12 month/s for patients over 60 years using the chi-square test, Cox regression analysis, and receiver operating characteristics (ROC). The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines were used as part of the screening of the respective nutritional status of the patients, in particular to filter out malnutrition. A total of 1080 patients were included in this study, whereas 8.05% suffered from malnutrition, defined as a body mass index (BMI) below 18.5 kg/m2. The Mini Nutritional Assessment (MNA) screening tool identified the highest proportion of malnourished patients at 14.54%. A total of 36.39% of patients were at risk of malnutrition according to three nutrition scores, with MNA providing the most significant proportion at 41.20%. Patients identified as malnourished had a higher mortality rate, and MNA screening was the only tool to show a significant correlation with postoperative mortality in all survey intervals. The MNA presented the best predictive significance among the screening tools, with a maximum area under the curve (AUC) of 0.7 at 12 month postoperatively. MNA screening has a solid correlation and predictive significance regarding postoperative mortality-therefore routine implementation of this screening in orthopedic/traumatology wards is recommended. Moreover, nutritional substitution therapy can offer a relatively inexpensive and easy-to-implement measure. The Graz malnutrition screening (GMS) shows moderate predictive power and could be considered as an alternative for patients under 60 years of age. A higher albumin level is associated with improved survival probability, but cannot be indicative of nutritional status.

Association of Stunting with Socio-Demographic Factors and Feeding Practices among Children under Two Years in Informal Settlements in Gauteng, South Africa.

Despite improvements in childhood undernutrition through integrated nutritional programs in South Africa, stunting among children remains persistent, and is attributed to poor socio-demographic status. This context has been implicated in disrupting mothers' decisions regarding effective infant feeding, ultimately meaning that children's nutritional demands remain unmet. In view of this, we conducted a cross-sectional study to determine the association between socio-demographic factors and infant and young child feeding (IYCF) practices and stunting among children under two years receiving primary health care in informal settlements in Gauteng, South Africa. A validated questionnaire was used to assess mothers' socio-demographic status and feeding practices using WHO core indicators. Stunting was defined as length-for age z-scores (LAZ) below -2 standard deviation, computed using WHO Anthro software version 3.2.2.1 using age, sex, and anthropometric measurements of children. Univariate and multivariate analyses were stratified by stunting to determine the relationship with socio-demographic, infant, and IYCF factors using STATA 17. The prevalence of stunting was 16% among surveyed children under two years (with a mean age of 8 ± 5 months) living in poor socio-demographic households. Poor feeding practices were characterized by delayed initiation of breastfeeding (58%), sub-optimal exclusive breastfeeding (29%), discontinued breastfeeding (44%), early introduction of solid foods (41%), and low dietary diversity (97%). Significant differences in terms of child's age, monthly household income, and ever being breastfed were observed (Chi square test and univariate analysis). After controlling for potential confounders, stunting was significantly associated with child's age [12-23 months: AOR = 0.35, 95% CI: 0.16-0.76], and monthly household income [ZAR 3000-ZAR 5000: AOR = 0.47, 95% CI: 0.26-0.86]. Despite the few aforementioned socio-demographic and IYCF factors associated with stunting, this study reiterates stunting as the commonest poor nutritional status indicator among children under two years, suggesting the presence of chronic undernutrition in these poverty-stricken informal settlements. A multisectoral approach to address stunting should be context-specific and incorporate tailor-made interventions to promote optimal infant-feeding practices. Conducting future nutrient assessments focusing on children is imperative.

Risk Factors of Uterovaginal Prolapse

Background: Pelvic organ prolapse refers to protrusions of the pelvic organs into or out of the vaginal canal. Vaginal prolapse can occur without uterine prolapse but uterus cannot descend without carrying the upper vagina with it. Therefore, genital prolapse is divided into two broad categories; one is uterine prolapse the other is vaginal prolapse. They are again divided into different subgroups. Objective: To find out risk factors that will help to reduce the incidence of uterovaginal prolapse. Method: It is a retrospective case control study conducted in the department of Obst & Gynae, BSMMU, Dhaka during the period of October 2009 to June 2010. We included 50 uterovaginal prolapse women as a case and 50 reasonably healthy women as a control. Vault prolapse after abdominal hysterectomy, vaginal hysterectomy, only cystocele, only rectocele, was excluded from study. Results: In this study, 62% women were 45-65 years of age and in control group this was 46%, P value was .001. In case group most of the women were multiparous, 84% were > 5, in control group this was 20%. P value was .001. Most of the patients had history of repeated childbirth, <3yrs, in control group it was >5yrs, p value is 0.001 which is highly sigficant. Most of the patients were coming from low socio-economic condition. In case group it was 56% and control group 34%, P value was 0.191. In this study, most of the patient had history of prolong labour (14.6%). Instrumental delivery 0.4% In case group, 80% patients showed easy vaginal delivery, 4.2% had obstructed labour. Almost 100% patients had history of something coming down per vagina. 42% complaining of frequency, 58% incomplete voiding, 10% retention of urine, 4% had stress incontinence, P value of incomplete voiding .001. 74% patients had history of constipation and 30% patients had history of difficulty in defecation. P value .001. 68% in case group complaining watery per vaginal discharge, 12% in control group. P Value .001. 22% in case group complaining of chronic cough, P value .001. 74% cases signifiquent history of heavy physical work. P value .001. 72% cases were 2nd degree uterine prolapse, 18% 1st degree and 10% 3rd degree prolapse. Conclusion: Early marriage, difficult childbirth, low socio-economic condition, poor nutrition status, delivery conducted by untrained dais, no rest in puerperium and complication of delivery are found to be recommended risk factors of utero-vaginal prolapse. In our socio-economic condition, it is need of ours to strengthen the existing maternal services at the basic level of community and build up the awareness to overcome & remove the risk factors of prolapse.

Novel XIAP mutation with early-onset Crohn’s disease complicated with acute heart failure: a case report

BackgroundThe X-linked inhibitor of apoptosis (XIAP) protein is encoded by the XIAP gene and is critical for multiple cell responses and plays a role in preventing cell death. XIAP mutations are associated with several diseases, primarily including hemophagocytic lymphohistiocytosis and inflammatory bowel disease (IBD). We report the clinical features and results associated with hemizygous mutation of the XIAP gene in a young male with Crohn’s disease complicated with acute heart failure.This 16-year-old patient ultimately died of heart failure.Case presentationA young male of 16 years of age was initially diagnosed with Crohn’s disease based on evidences from endoscopic and histological findings. Although supportive care, anti-infective drugs and biologics were administered consecutively for 11 months, his clinical manifestations and laboratory indices (patient’s condition) did not improved. Additionally, the patient exhibited a poor nutritional status and sustained weight loss. Subsequently, acute heart failure led to the exacerbation of the patient’s condition. He was diagnosed with wet beriberi according to thiamine deficiency, but the standard medical therapy for heart failure and thiamine supplementation did not reverse the adverse outcomes. Comprehensive genetic analysis of peripheral blood-derived DNA revealed a novel hemizygous mutation of the XIAP gene (c.1259_1262 delACAG), which was inherited from his mother.ConclusionA novel XIAP mutation (c.1259_1262 delACAG) was identified in this study. It may be one of the potential pathogenic factors in Crohn’s disease and plays an important role in the progression of heart failure. Additionally, thiamine deficiency triggers a vicious cycle.

Depression and Anxiety Mediate the Associations between Nutritional Status, Functional Capacity, and Quality of Life in Patients with Cancer

Cancer patients are at risk of malnutrition, which influences their functional status, mental health (MH), and quality of life (QoL). This study aimed to examine the associations between nutritional status, functional capacity, and aspects of QoL in cancer patients, as well as the potential mediating role of depression and anxiety in these associations. Patients with various types of cancer (n = 152) were recruited from the Attikon University Hospital, Greece. Validated questionnaires were used to assess nutritional status (PG-SGA), QoL (SF-36 and EQ-5D-3L), functional capacity (ECOG), depression, and anxiety (HADS and BEDS). Handgrip strength (HGS) was also measured. Poor nutritional status was inversely associated with functional capacity, QoL, depression, and anxiety, after adjusting for confounding factors (all P ≤ 0.05). Mediation analysis indicated a significant indirect effect of nutritional status on various parameters of functional capacity and QoL through depression and anxiety, after adjusting for age and sex. Mediated proportion ranged from 26.3–34% to 23.1–82.8% for functional capacity and QoL, respectively. A significant proportion of the effect of nutritional status on QoL and functional capacity can be partly attributed to psychological effects, highlighting the significance of integrating all aforementioned aspects in the nutritional intervention for cancer patients.

Feeding of hospitalised children, how important is it?

Malnutrition among hospitalised children, although an under-recognised entity has a vital impact on patient outcomes, In Paediatric Intensive Care Units, malnutrition is often not recognised and not treated properly, which may lead to bad outcomes. A detailed history and clinical examination alone is inadequate for accurate evaluation of malnutrition and an accurate anthropometric assessment is essential. A combination of poor food intake and the severity of disease are good predictors of poor nutrition status in children and fundamental corrective steps with this regard will aid in early recovery. Hence, feeding of hospitalised children should be considered a priority as a part of critical care. Two types of nutritional support are practiced (i) enteral nutrition (EN) and (ii) parenteral nutrition. Early EN is preferred because of many advantages such as earlier gut function, lesser infections, low cost, and short duration of hospital stay. This article aims to provide an outline for assessing nutrition and providing nutritional support in hospitalised children.

Analysis of the nutritional status in the Palestinian territory: a review study.

Food insecurity, occupation, and poverty contribute to the poor nutritional status of Palestine. This review study aimed to analyze the nutritional status in the Palestinian Territory by analyzing published data from 2011 to 2023. Searching for relevant publications yielded 67 studies. Based on reviewing these studies, five major themes were identified: low birth weight, breastfeeding, obesity and overweight, protein-energy malnutrition, and micronutrient deficiency. Based on the review of these studies, five major themes were identified, namely, low birth weight, breastfeeding, obesity and overweight, protein-energy malnutrition, and micronutrient deficiency. Based on the literature, the prevalence rate of exclusive breastfeeding was 24.4% in the Gaza Strip, compared to a national rate of 39.9% in 2020. Smoking, anemia in mothers, diet during pregnancy, and indoor pollution were associated with low birth weight. One-fifth of the boys and girls were stunted by 2 years of age in the Gaza Strip, and girls were more stunted than boys. The prevalence rates of underweight, overweight, and obesity among school children in the West Bank were 7.3%, 14.5%, and 15.7%, respectively. Age, gender, and living area were significant predictors of being overweight among school children. The prevalence rates of overweight and obesity among adults in Palestine were 57.8% and 26.8%, respectively. Obesity is associated with a family history, chronic diseases, and low physical activity among adults. Exclusive breastfeeding was below the WHO recommendations, while significant rates of obesity and overweight were found among children and adults. Iron-deficiency anemia (IDA) among pregnant women and children remains a challenging public health issue, while other micronutrient deficiencies are high among children. This review emphasizes the need for multi-sectoral interventions to address malnutrition and nutritional shifts. It identifies gaps and addresses nutrition-related issues in the Palestinian Territory, which can serve as a basis for guiding United Nations agencies and governments in formulating evidence-based policies and strategies for prioritizing nutritional interventions to meet sustainable development goals.

Nutritional status and its influencing factors in children with newly diagnosed inflammatory bowel disease

To investigate the nutritional status and its influencing factors in children with newly diagnosed inflammatory bowel disease (IBD). A retrospective analysis was conducted on the clinical data of children who were diagnosed with IBD for the first time in Hunan Children's Hospital from January 2015 to December 2021. Diagnostic delay was defined as the time from the symptom onset to IBD diagnosis being in the upper quartile (P76-P100) of all IBD children in the study. Multivariate logistic regression analysis was used to explore the risk factors for emaciation and growth retardation. A total of 125 children with newly diagnosed IBD were included, with Crohn's disease being the main type (91.2%). The rates of emaciation and growth retardation were 42.4% (53 cases) and 7.2% (9 cases), respectively, and the rate of anemia was 77.6% (97 cases). Diagnostic delay was noted in 31 children (24.8%), with the time from the symptom onset to IBD diagnosis of 366 to 7 211 days. Multivariate logistic regression analysis showed that diagnostic delay was a risk factor for emaciation and growth retardation (OR=2.73 and OR=4.42, respectively; P<0.05) and that age was positively associated with emaciation (OR=1.30, P<0.05). Children with newly diagnosed IBD have poor nutritional status, and the rates of anemia, emaciation, and growth retardation are high. Diagnostic delay is associated with malnutrition in children with IBD.

Nutritional Risks in Patients Undergoing Total Pancreatectomy Islet AutoTransplantation in the POST Consortium

Background and AimsTotal pancreatectomy with islet autotransplantation (TPIAT) can relieve pain for individuals with acute recurrent or chronic pancreatitis. However, TPIAT may increase the risk of poor nutritional status with complete exocrine pancreatic insufficiency, partial duodenectomy, and intestinal reconstruction. Our study's objective was to evaluate nutritional status, anthropometrics, and vitamin levels before and after TPIAT. MethodsThe multicenter Prospective Observational Study of TPIAT (POST) collects measures including vitamins A, D, and E levels, pancreatic enzyme dose, and multivitamin (MVI) administration before and 1-year after TPIAT. Using these data, we studied nutritional and vitamin status before and after TPIAT. Results348 TPIAT recipients were included (68% adult, 37% male, 93% Caucasian). In paired analyses at 1-year follow-up, vitamin A was low in 23% (vs 9% pre-TPIAT, p < 0.001); vitamin E was low in 11% (vs 5% pre-TPIAT, p = 0.066), and 19% had vitamin D deficiency (vs 12% pre-TPIAT, p = 0.035). Taking a fat-soluble multivitamin (pancreatic MVI) was associated with lower risk for vitamin D deficiency (p = 0.002). Adults were less likely to be on a pancreatic MVI at follow-up (34% vs 66% respectively, p < 0.001). Enzyme dosing was adequate. More adults versus children were overweight or underweight pre- and post-TPIAT. Underweight status was associated with vitamin A (p = 0.014) and E (p = 0.02) deficiency at follow-up. ConclusionsPrevalence of fat-soluble vitamin deficiencies increased after TPIAT, especially if underweight. We strongly advocate that all TPIAT recipients have close post-operative nutritional monitoring, including vitamin levels. Pancreatic MVIs should be given to minimize risk of developing deficiencies.

Shunt fracture as ventriculoperitoneal shunt complication in pediatric: a case series

Link of Video Abstract: https://youtu.be/7m2n6og9EUIBackground: Shunt fracture is a ventriculoperitoneal (VP) complication requiring shunt revision. The author discusses the experience of treating 5 cases of hydrocephalus patients with shunt fracture, including a clinical manifestation, nutritional status, and age of VP shunt insertion as a risk factor of shunt fracture will be discussed further in this case series report. Case Presentation: This study analyzed all cases treated in 6 years from 2016 to 2021, with an inclusion criterion of all pediatric patients with shunt fractures. This study is a retrospective report of the clinical manifestations and diagnoses assessed for pre-procedural and post-procedural conditions. Eight hundred fifty-two patients with hydrocephalus with VP shunt insertion and 5 patients with shunt fracture were reported. Headache, lump in the shunt line, vomiting, and seizure were the main complaints of all patients. Four of the five patients had poor nutritional status (&lt;50th and &lt;3rd percentile). One patient had a shunt removal, two had a shunt revision, and two had a laparoscopic shunt extraction and VP shunt insertion. All patients had improved clinical outcomes. Conclusion: Knowing the process of shunt fracture is essential as a modality to determine the subsequent management. A comprehensive clinical and radiological examination is mandatory to rule out a shunt fracture. Monitoring patients with VP shunt is an important thing that must be done to prevent further complications.

Neutrophil reactive oxygen formation, bacterial infections and mortality in malnourished hemodialysis patients: Evaluation of clinical outcomes.

Patients with end stage kidney disease undergoing maintenance hemodialysis (MHD) are prone to malnutrition and infections. The objective of this study was to evaluate the effect of polymorphonuclear (PMN) cell dysfunction on clinical outcomes of MHD patients, in association with nutritional status. This prospective study investigated 39 MHD patients by evaluating the oxidative activity of their PMN cells using Phorbol 12-Myristate-13-Acetate (PMA) stimulation. Blood samples were taken from each participant at dialysis initiation. Demographics, laboratory data, and clinical outcomes during a 24-month follow-up period were obtained from electronic medical records. Phagocytic activity was described in percentiles of mean fluorescence intensity (MFI) of PMA levels. There were no differences in comorbidities between patients with low or high MFI-PMA percentiles. Patients in the lowest (25th) MFI-PMA percentile (N = 10) had poorer nutritional status and more frequent severe infections compared to the other 29 patients (4.3 ± 3.4 events versus 2 ± 2.2 events, p = 0.017). Furthermore, they had more frequent hospitalizations (>3) due to infections (70% versus 41%, p = 0.073) and their mortality rate was higher (80% versus 31%, p = 0.007). The odds ratio for all-cause mortality was 8.85. In multivariate analysis, the MFI-PMA percentile and ischemic heart disease were the strongest predictors of all-cause mortality (p = 0.02 and p = 0.005, respectively). Low MFI-PMA levels were associated with poor nutritional status and adverse clinical outcomes and might serve as a prognostic biomarker, predicting severe infections and mortality among malnourished MHD patients.

Prognostic impact of the controlling nutritional status score in Chinese patients undergoing cardiac surgery

Prognostic impact of the controlling nutritional status score in Chinese patients undergoing cardiac surgery

Correlation between Mother’s Nutritional Knowledge with Nutritional Status (Height for Age and BMI for Age) of Children

Malnutrition problems usually occur in early childhood. It is pretty concerning because early childhood is a group whose nutritional needs must be considered and are still growing. Lack of maternal nutritional knowledge is one of the causes of nutritional problems in children. This study analyzed the relationship between mothers' nutritional knowledge and children's nutritional status (TB/U and IMT/U) at Raudlatul Ulum, Ambarawa District, Pringsewu Regency. The research design was cross-sectional, with 31 subjects. The research subjects were mothers with children aged 60 months. The type of analysis used is Fisher's Test. The results of the study showed that the number of children with stunting nutritional status (TB/U) was seven people (22.6%), which became a public health problem (stunting prevalence 20%). The number of children with poor nutritional status (IMT/U) is one person (3.2%). Statistical test results showed that there was no significant relationship (p0.05) between the mother's nutritional knowledge and the toddler's nutritional status (TB/A and IMT/U). Still, there was a significant relationship due to the difference in the proportion of 20%. In conclusion, a mother's nutrition knowledge is essential in providing nutritious food and can support children's nutritional status.

Prevalence of anemia in children with cleft lip and palate in Karnataka: A cohort study

ABSTRACT Introduction: The poor nutritional status and lower socioeconomic conditions among the Indian population have influenced the decisions on elective cleft lip surgeries. These factors may delay the treatment, as well as affect the overall development of the child. This study aims to identify the prevalence of microcytic hypochromic anemia in the Indian population to formulate the protocol in need for iron and nutritional supplementation in elective surgical planning of cleft lip and palate, thereby providing a comprehensive care in clefts. Methodology: A cohort study was designed comparing 100 children with nonsyndromic cleft lip or palate, who were undergoing surgical repair in our institution cleft deformity and without congenital anomalies under the age of 2 years. The blood parameters (hemoglobin [Hb], mean corpuscular volume, mean corpuscular Hb concentration [MCHC], MCHC, and red cell distribution width cell volume) for identifying the microcytic hypochromic anemia were assessed before the surgical repair and compared with the normal population. Descriptive analysis was performed to extract results. Results: The study population had a mean age of 10.56 ± 7.02 months (55 boys and 45 girls). We identified 61% of the population having anemia, with 2% having severe anemia (Hb &lt;7 g/dL). It was observed that higher levels of Hb were in the age group of 4–6 months, and the lowest was documented in the older children. Conclusion: The study helps in identifying the prevalence of iron-deficiency anemia in children who are undergoing surgical repair for nonsyndromic cleft lip or palate. Therefore, the comprehensive cleft care should be the focus, addressing the feeding difficulties, malnutrition, and failure to thrive, before surgical intervention.

Implication of nutritional status for adverse outcomes after surgery for metastatic spine tumors.

Surgery for metastatic spinal tumors can have a substantial impact on patients' quality of life by alleviating pain, improving function, and correcting spinal instability when indicated. The decision to operate is difficult because many patients with cancer are frail. Studies have highlighted the importance of preoperative nutritional status assessments; however, little is known about which aspects of nutrition accurately inform clinical outcomes. This study investigates the interaction and prognostic importance of various nutritional and frailty measures in patients with spinal metastases. A retrospective analysis of consecutive patients who underwent surgery for spinal metastases between 2014 and 2020 at the Massachusetts General Hospital was performed. Patients were stratified according to the New England Spinal Metastasis Score (NESMS). Frailty was assessed using the metastatic spinal tumor frailty index. Nutrition was assessed using the prognostic nutritional index (PNI), preoperative body mass index, albumin, albumin-to-globulin ratio, and platelet-to-lymphocyte ratio. Outcomes included postoperative survival and complication rates, with focus on wound-related complications. This study included 154 individuals (39% female; mean [SD] age 63.23 [13.14] years). NESMS 0 and NESMS 3 demonstrated the highest proportions of severely frail patients (56.2%) and nonfrail patients (16.1%), respectively. Patients with normal nutritional status (albumin-to-globulin ratio and PNI) had a better prognosis than those with poor nutritional status when stratified by NESMS. Multivariable regression adjusted for NESMS and frailty showed that a PNI > 40.4 was significantly associated with decreased odds of 90-day complications (OR 0.93, 95% CI 0.85-0.98). After accounting for age, sex, primary tumor pathology, physical function, nutritional status, and frailty, a preoperative nutrition consultation was associated with a decrease in postoperative wound-related complications (average marginal effect -5.00%; 95% CI -1.50% to -8.9%). The PNI was most predictive of complications and may be a key biomarker for risk stratification in the 90 days following surgery. Nutrition consultation was associated with a reduced risk of wound-related complications, attesting to the importance of this preoperative intervention. These findings suggest that nutrition plays an important role in the postsurgical course and should be considered when developing a treatment plan for spinal metastases.

Characteristics, Clinical Manifestations, Length of Hospitalization, and Nutritional Status of COVID-19 Patients

BACKGROUND: The disease that is endemic and has become a global pandemic is COVID-19 due to reports of thousands of cases. The pandemic is weighing on intensive care units with an influx of COVID-19 patients. The clinical manifestations of COVID-19 vary, diagnostic examinations and treatment are also experiencing dynamic developments. This study aims to provide an overview of the characteristics, clinical manifestations, length of treatment, and nutritional status of COVID-19 patients. METHODS: This study used a descriptive analytic cross-sectional method with inclusion criteria that were positive for COVID-19. The research data were obtained from 130 hospital medical records for the period June to August 2021. The collected data were then analyzed using SPSS. RESULTS: The study found that men were more exposed to COVID-19 (71.5%) and 70% of patients worked as medical personnel. The age range of the majority of patients was more than 40 years (78.5%). Most of the comorbidities were hypertensive patients. Clinical manifestations of COVID-19 patients were cough (44.6%), fever (40%), flu-like symptoms (32.3%), painful swallowing (26.2%), anosmia (16.2%), shortness of breath (15.4%), nausea (14.6%), vomiting (13.8%), and diarrhea (0.9%). The average length of stay is 7–14 days (9.2%) with adequate nutritional status (14.6%). Patients with length of treatment (p = 0.01) and poor nutritional status (p =0.000) were significantly different. CONCLUSION: The majority of COVID-19 sufferers are male, over 40 years old, with cough symptoms, and the most comorbid hypertension, as well as deaths from hypertension and the elderly. Better treatment is needed for people with COVID-19.

Clinical significance of C-reactive protein-to-prealbumin ratio in predicting early recurrence in resectable pancreatic cancer.

Resectable pancreatic ductal adenocarcinoma (PDAC) has a high risk of recurrence after curative resection; despite this, the preoperative risk factors for predicting early recurrence remain unclear. This study therefore aimed to identify preoperative inflammation and nutrition factors associated with early recurrence of resectable PDAC. From March 2021 to November 2021, a total of 20 patients who underwent curative resection for PDAC were enrolled in this study. We evaluated the risk factors for early recurrence within 1 year by univariate and multivariate analyses using Cox hazard proportional regression. The cutoff values for predicting recurrence were examined using receiver operating characteristic (ROC) curves. In our univariate and multivariate analyses, C-reactive protein (CRP), CRP-albumin ratio, and CRP-prealbumin ratio, as well as sex and age, were significant independent prognostic factors for early recurrence in PDAC. However, known inflammatory factors (neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios), nutritional factors (albumin, prealbumin, ferritin, vitamin D), and inflammatory-nutritional factors (Glasgow Prognostic Score, modified Glasgow Prognostic Score, albumin-bilirubin) showed no association with early recurrence. In addition, using cutoff values by ROC curve analysis, a high preoperative CRP level of >5 mg/L, as well as high CRP-to-albumin (>5.3) and CRP-to-prealbumin (>1.3) ratios showed no prognostic value. Our results showed that inflammatory and perioperative nutritional factors, especially CRP-to-prealbumin ratio, have significant associations with early recurrence after curative resection in resectable PDAC. Therefore, for such patients, a cautious approach is needed when inflammation and poor nutritional status are present.

Prevalence and determinants of diarrhoea and acute respiratory infections among children aged under five years in West Africa: evidence from demographic and health surveys.

Diarrhoea and pneumonia are the leading causes of morbidity and mortality in children aged <5 y (under five) globally. This study sought to investigate the prevalence and determinants of diarrhoea and acute respiratory infections (ARIs) among children under five in West Africa. The most recent demographic and health survey (DHS) standard for 13 West African countries was used in the study. We calculated the prevalence of diarrhoea and ARIs (2 wk prior to the survey) and performed multivariable complex logistic regression analysis to identify possible predictors of diarrhoea and ARIs. The weighted prevalence of diarrhoea and ARI was 13.7% and 15.9%, respectively. The prevalence of comorbid diarrhoea and ARI was 4.4%. Children aged <2 y (p<0.001), mothers aged <30 y (p<0.003), mothers without formal education (p<0.001), poor households (p<0.001) and poor nutritional status, wasting (p=0.005) and underweight (p<0.001), were the independent predictors of diarrhoea. The independent predictors of ARIs were children with no childhood vaccinations (p=0.002), use of solid fuel in the household (p=0.007), being underweight (p=0.05) and diarrhoea (p<0.001). The findings imply the need for holistic public health interventions such as increased vaccination coverage, population-based nutritional programmes and campaigns on the use of cleaner cooking fuel targeted at high-risk subgroups in the population to reduce the burden and adverse effects of diarrhoea and ARIs in the West African region.

Kejadian Anemia Ibu Hamil Di Wilayah Kepulauan

Introduction: Anemia in pregnancy is one of the health problems in Indonesia, especially in archipelagic areas such as Sangihe Regency. Anemia in pregnancy caused by many factors such as age, knowledge, parity, gestational distance, nutritional status and ANC visits. The purpose of this study is to analyze the factors that influence the incidence of anemia in pregnant women in the island region. Method: : This is a correlational study with a cross-sectional approach. This research was conducted in the work area of ​​the Enemawira Health Center, Sangihe Islands Regency in April-October 2021. The respondents in this study were 61 pregnant women. Factors analyzed were age, knowledge, parity, gestational distance, nutritional status and ANC visits. The data obtained were analyzed univariatly and multivariatly. Results: The results of this study indicate that respondents are most widely distributed at the age of 20-35 years (59.0%), less knowledgeable (47.5%), 5 times parity (50.8%), pregnancy interval &lt;2 years (70, 5%), poor nutritional status (62.3%), ANC visits &lt;4 times (52.5%) and not anemia (55.7%). The results of this study also show that the variables of knowledge and ANC visits are the most influential variables on the incidence of anemia in in pregnancy in the island region. Conclusion: That can be concluded the most influential factors on the incidence of anemia in pregnant women in the archipelago are maternal knowledge about anemia and ANC visits. Based on this research, further research can examine the direct causes of anemia in pregnancy such as Fe intake and infectious diseases.