Specific Nutritional Deficiencies Research Articles

The association between osimertinib and nutritional deficiency among patients with non-small cell lung cancer.

8031 Background: Osimertinib, a third-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), is the standard-of-care in EGFR mutation-positive non-small-cell lung cancer (NSCLC) in various settings. Osimertinib commonly causes gastrointestinal adverse effects thereby potentially leading to nutritional deficiencies. Therefore, we aim to evaluate the association between the use of osimertinib and nutritional deficiencies among patients with NSCLC. Methods: We performed a retrospective, propensity score matched study using the TriNetX database, a network comprising deidentified data across more than 120 participating healthcare institutions. We included patients with NSCLC who received either osimertinib or other EGFR-TKIs (afatinib, dacomitinib, erlotinib, gefitinib). The outcomes of interest included vitamin B deficiency, vitamin D deficiency, iron deficiency as well as associated anemia including vitamin B12 deficiency anemia, folate deficiency anemia, and iron deficiency anemia within 5 years of EGFR-TKI initiation. Results: We matched 4264 patients who received osimertinib to patients who received other EGFR-TKIs. In Cox proportional hazard analysis, osimertinib was associated with a 50% higher risk of vitamin B deficiency (Hazard ratio, 1.52 [95% CI: 1.07-2.16]) compared to other EGFR-TKIs. Consistent with this observation, osimertinib was associated with an increased risk of vitamin B12 deficiency anemia and a tendency towards folate deficiency anemia. We also noted a 2-fold higher risk of vitamin D and 5-fold higher risk of iron deficiency in the osimertinib cohort. Consistent with this observation, osimertinib was associated with an increased risk of iron deficiency anemia compared to other EGFR-TKIs. Conclusions: The use of osimertinib is associated with a higher risk of nutritional deficiencies and associated anemias compared to other EGFR-TKIs. One potential explanation is the extended duration of osimertinib therapy, driven by its potent anti-cancer effects. Therefore, it is advisable to consider screening for specific nutritional deficiencies in individuals receiving osimertinib therapy. [Table: see text]

In Vitro Digestion Assessment (Standard vs. Older Adult Model) on Antioxidant Properties and Mineral Bioaccessibility of Fermented Dried Lentils and Quinoa

The growing number of older adults necessitates tailored food options that accommodate the specific diseases and nutritional deficiencies linked with ageing. This study aims to investigate the influence of age-related digestive conditions in vitro on the phenolic profile, antioxidant activity, and bioaccessibility of minerals (Ca, Fe, and Mg) in two types of unfermented, fermented, and fermented dried quinoa and lentils. Solid-state fermentation, combined with drying at 70 °C, significantly boosted the total phenolic content in Castellana and Pardina lentils from 5.05 and 6.6 to 10.5 and 7.5 mg gallic acid/g dry weight, respectively, in the bioaccessible fraction following the standard digestion model, compared to the unfermented samples. The phenolic profile post-digestion revealed elevated levels of vanillic and caffeic acids in Castellana lentils, and vanillic acid in Pardina lentils, while caffeic acids in Castellana lentils were not detected in the bioaccessible fraction. The highest antioxidant potency composite index was observed in digested fermented dried Castellana lentils, with white quinoa samples exhibiting potency above 80%. Mineral bioaccessibility was greater in fermented and fermented dried samples compared to unfermented ones. Finally, the digestive changes that occur with ageing did not significantly affect mineral bioaccessibility, but compromised the phenolic profile and antioxidant activity.

Vegan Diet in Dermatology: A Review.

Diet is known to play a role in the development of skin disorders. While a vegan diet is frequently described as a risk factor for skin disease secondary to nutritional deficiency, this risk may be overestimated. This review aims to debunk myths and provide information on skin disorders and inflammatory skin conditions that have associations with specific nutritional deficiencies in the context of a vegan diet. A literature search was performed for each nutrient and inflammatory skin disease using the PubMed/MEDLINE database and public health website pages concerning a vegan diet. The literature has individual cases reporting skin disease due to deficiencies in vitamin B2 and vitamin A in patients following a vegan diet. The recommended daily amounts of nutrients and vitamins can be fulfilled on a vegan diet. Vegan diets also avoid food groups such as dairy and other animal-based products, which holds benefits in inflammatory skin diseases including acne, psoriasis, hidradenitis suppurativa, and atopic dermatitis. Overall, the risk of skin disease secondary to nutritional deficiency in patients following a vegan diet is very low and likely over-emphasized. A well-balanced and conscientiously planned vegan diet can adequately provide the necessary amounts of proteins, vitamins, and minerals to support skin health.

The Role of Nutrients and Diet Characteristics in the Management of Diabetic Foot Ulcers: A Systematic Review.

Diabetic foot ulcers (DFUs) are common complications of diabetes mellitus that affect patients' quality of life and pose a burden on the healthcare system. Although malnutrition and specific nutritional deficiencies can seriously impact wound healing in patients with chronic nonhealing wounds, the role of nutrition in the prevention and management of DFUs is still not clear. This review discusses the significance of frequent diet assessment and nutritional education of patients with DFUs with individualized correction of deficiencies and emphasis on adequate protein intake along with correction of vitamins D, C, E, and selenium status. Future research should clarify the impact of nutritional interventions, potentially involving the use of probiotics, zinc, and omega-3 fatty acids, and successfully translating the findings into practical guidelines for use in everyday clinical practice.

Effects of microalgal diet on growth, survival and fatty acid composition of larvae rock oyster Striostrea prismatica (Gray, 1825)

The biochemical nature and composition of fatty acids (FA's) in microalgae influence the nutritional quality and efficiency of this food source in bivalve larviculture. This research analyses the effect FA's content of Chaetoceros gracilis and Tisochrysis lutea on the FA's composition, growth and survival of Striostrea prismatica larvae. We analysed the FA's profiles of the microalgae, and the tissue of the larvae during a S. prismatica larviculture at day 1 (“D” larvae), day 8 (umbonate larvae) and day 22 (pediveliger) post fertilization (PF). Larvae growth and survival were evaluated during two phases: phase I from day 1 to day 8 PF and phase II from day 9 to day 22 PF. In phase I, we recorded a daily growth rate of 4.76 μm.day−1, while in phase II we recorded increases of 13.24 μm.day−1. In phase I, survival was 36.6%, and decreased further to 9.3% at the end of phase II. The sharp decrease in survival and low growth during phase I could possibly be explained by a specific nutritional deficiency of the microalgae diet (absence of FA's 15:0, 20:4n-3, 20:4n-6 and 22:5n- 3), especially if we consider the starting FA's profile of the “D” larvae. The larvae showed a high nutritional requirement for palmitic, stearic and oleic FA's and long-chain PUFA's, especially 20:5n-3 and 22:6n-3. The absence of these FA's in the diet and their presence in the larval profile suggest that S. prismatica could have the ability to synthesize these FA's; however, more research is needed to corroborate this hypothesis.

Squamous Cancer of the Esophagus in Africa: A Causal Pathway Established

Squamous cancer of the esophagus has been endemic in much of East, Central and Southern Africa since the 1940s. Much research has concentrated on attempts to identify major carcinogenic influences, and failure to do so has made it clear that the problem in high incidence areas (HIAs) is not primarily of potent environmental carcinogens, but of population susceptibility. In Africa the association with maize is constant and strong. Research in the last decade has helped to explain that association. Considered along with historical findings there is now enough evidence to establish causal associations of a nutritionally deficient maize diet and use of maize meal with squamous cancer of the esophagus. Evidence is available in a high incidence area of degenerating maize meal resulting in excess production of PGE2, gastric hypochlorhydria and a predominant pattern of non-acid gastroesophageal reflux. This pathway explains the existence of major population susceptibility: a poor maize-based diet provides specific nutritional deficiencies and n-6 fatty acid dominance which cause failure of homeostasis of the arachidonic acid cascade; with this background chemically degenerating maize meal then triggers duodenogastric reflux and non-acid gastro-esophageal reflux; non-acid reflux causes squamous cancer of the esophagus. Within a susceptible population, environmental carcinogens including tobacco increase individual risk. There is sufficient evidence that this is an active pathway, and the dominant pathway to SCCE in high incidence areas in Africa.There is sufficient evidence to justify appropriate preventative measures.

Elements That Influence the Development of Attention Deficit Hyperactivity Disorder (ADHD) in Children.

Various factors may have a role in the development of attention deficit hyperactivity disorder (ADHD). Although the specific pathophysiology of this disease is still not entirely understood, it is believed to be caused by a mix of genetic, maternal, dietary, and environmental factors. The effect of these factors can determine the severity of ADHD; for example, some of them are dose-dependent, but there is a typical pattern that all are known to be associated with either early childhood exposure or maternal exposure during pregnancy. Some factors share a similar mechanism of affecting pathways and increasing the risk of ADHD.ADHD is not a disorder that can be detected before symptoms appear in a child, making it more challenging to anticipate even if a child has been exposed to a known trigger. Environmental pollutants were investigated, and it was shown that there was a link between ADHD in childhood and exposure to pollutants throughout childhood or during pregnancy. It is well known that maternal health is a significant factor in the unborn child's development in many health aspects. The central nervous system (CNS) is a primary system that can suffer irreversible damage from health conditions, stress, depression, or specific nutritional deficiency when the pregnant mother is subjected to these conditions. Even though numerous studies have been conducted to investigate the probable causes of ADHD, with some of them having robust findings, no conclusive explanation can be provided to identify a definitive cause or a risk factor.

Long-term nutritional deficiencies following sleeve gastrectomy: a 6-year single-centre retrospective study.

IntroductionSleeve gastrectomy (SG) is associated with short-term nutritional deficiencies postoperatively. This study evaluates the long-term percentage of excess weight loss (% EWL), and nutritional deficiencies in a single-centre cohort undergoing SG as a primary procedure, with a 6-year follow-up.Material and methodsFrom January 2005 to December 2010 the records of 209 patients who underwent laparoscopic SG were retrieved from a computer database for analysis. Sixty out of the 209 paients completed follow-ups for 6 years.ResultsMedian % EWL at 1, 2, 3, 4, 5, and 6 years postoperatively was 80.9%, 79.1%, 73.8%, 71.8%, 71.5%, and 64.9%, respectively. Prior to surgery, 17.2% had anaemia. Deficiencies of iron, ferritin, folic acid, vitamin B12, magnesium, and phosphorus were 22%, 5.3%, 1.4%, 3.8%, 29.7%, and 5.3%, respectively. Six years post-surgery, deficiencies of haemoglobin, ferritin, and B12 worsened (36.7%, 43.3%, and 11.7%, p = 0.001, p < 0.001, p = 0.019, respectively), whereas there was no significant difference in deficiencies of iron, folic acid, magnesium, and phosphorus (25%, 1.7%, 20%, and 3%, p = 0.625, p = 0.896, p = 0.139, p = 0.539, respectively). There was elevated PTH before and 6 years after surgery (2.9% and 1.7%, p = 0.606).ConclusionsThis retrospective study shows that laparoscopic sleeve gastrectomy had a considerable effect on specific nutritional deficiencies in our patients at 6 years post-surgery. Knowledge of micronutrient deficiencies in these patients is beneficial for both prevention and management of nutritional complications associated with SG with the administration of oral nutritional supplementation according to the patient’s needs.

Dietary and Nutritional Influences on Allergy Prevention

Nutritional status has a profound effect on immune function, and vitamin D, omega-3 fats, and other nutrients have long been suspected of influencing the development of the allergic march, and the incidence and severity of allergic conditions. This review provides an overview of research and opinion published during the past decade and summarizes clinically actionable information about dietary and nutritional influences on allergy prevention. There is now enough evidence of effects of vitamin D, omega-3 fats, the Mediterranean diet, and antioxidants to recommend their use in routine clinical practice for prevention and treatment of allergic conditions. Uncertain areas remain, especially in methods to best identify persons with specific nutritional deficiencies, and in determining optimal target levels for all essential nutrients. The potential gain in individual quality of life, especially by asthma reduction, makes achieving good nutrition a key goal for every clinician.

Micronutrient supplementation in gastric bypass surgery: prospective study on inflammation and iron metabolism in premenopausal women.

Low-grade chronic inflammation in morbid obesity is associated with impaired iron metabolism. Bariatric surgery is effective in weight loss; however, it can induce specific nutritional deficiencies, such as iron, especially in premenopausal women. Alternatively, after surgery, there is an improvement in systemic inflammation, raising questions concerning the dosages of micronutrient supplementation. This study aimed to assess the effect of two micronutrient supplementation schemes before and 6 months after a Roux-en-Y gastric bypass (RYGB) surgery on inflammation and iron metabolism in premenopausal women. This prospective study included 45 premenopausal women (aged 20-45 years; body mass index [BMI] ≥ 35 kg/m2) divided into two supplementation schemes: group 1 (n = 34): daily supplemental dose of 1 RDA 30 days before surgery and 2 RDAs during the six months following surgery; and group 2 (n = 11): daily supplementation of 1 RDA during the 6 months postsurgery. Anthropometry, dietary intake, inflammation, and iron metabolism were monitored. Evident reductions in BMI, high-sensitivity C-reactive protein, and ferritin levels for both groups occurred 6 months after surgery. Additionally, anemia was 9% in both groups after surgery. However, group 1 exhibited an increased transferrin saturation index and reduced transferrin levels. Multivariate regression analysis suggested serum iron, hepcidin, and iron intake determined ferritin values before and after RYGB surgery. Six months after RYGB, systemic inflammation was reduced in both supplementation schemes. However, supplementation of 1 RDA before and 2 RDAs after surgery resulted in better improvements on iron metabolism.

Parasites, nutrition, immune responses and biology of metabolic tissues.

Nutritional immunology, immunometabolism and identification of novel immunotherapeutic targets are areas of active investigation in parasitology. There is a well-documented crosstalk among immune cells and cells in metabolically active tissues that is important for homeostasis. The numbers and function of these cells are altered by obesity leading to inflammation. A variety of helminths spend some part of their life cycle in the gastrointestinal tract and even entirely enteral nematode infections exert beneficial effects on glucose and lipid metabolism. The foundation of this review is the ability of enteric nematode infections to improve obesity-induced type 2 diabetes and the metabolic syndrome, which are significant health issues in developed areas. It considers the impact of nutrition and specific nutritional deficiencies, which are occur in both undeveloped and developed areas, on the host's ability mount a protective immune response against parasitic nematodes. There are a number of proposed mechanisms by which parasitic nematodes can impact metabolism including effects gastrointestinal hormones, altering epithelial function and changing the number and/or phenotype of immune cells in metabolic tissues. Nematodes can also exert their beneficial effects through Th2 cytokines that activate the transcription factor STAT6, which upregulates genes that regulate glucose and lipid metabolism.

Precipitating factors and targeted therapies in combating the perils of sickle cell disease--- A special nutritional consideration.

Nutritional research in sickle cell disease has been the focus in recent times owing to not only specific nutritional deficiencies, but also the improvements associated with less painful episodes. Though hydroxyurea remains the drug of choice, certain adverse health effects on long term supplementation makes room for researches of different compounds. Macro and micro nutrient deficiencies, along with vitamins, play an important role in not only meeting the calorific needs, but also reducing clinical complications and growth abnormalities. Symptoms of hyper protein metabolism, increased cell turnover, increased cardiac output, and appetite suppression due to enhanced cytokine production, might give us leads for better understanding of the mechanisms involved. Different nutritional approaches comprising of traditional herbal therapies, antioxidants, flavonoids, vitamins, minerals etc., reducing oxidative stress and blood aggregation, have been tried out to increase the health potential. Nutritional therapies may also serve complementary to the newer therapies using ozone, hematopoietic stem cell transplantation, antifungal medications, erythropoietin etc. Herein we try to present a holistic picture of the different patho-physiological mechanisms, and nutritional strategies adopted.

Development of powdered food with the addition of Spirulina for food supplementation of the elderly population

Abstract The elderly are prone to developing nutritional deficiencies of vitamins, minerals, and proteins as well as energy. The addition of Spirulina biomass to food is of interest because of the microalga's nutritional content. Therefore, this study sought to develop chocolate flavor shake-type powdered food, enriched with Spirulina. The chemical composition of the products was analyzed, and they were subjected to sensory testing and shelf life estimation. Food developed presented a mean 42% (w·w− 1) protein and 46% (w·w− 1) carbohydrates content. The average acceptance rates were 7.68 and 7.77, for shakes with and without Spirulina, respectively. The shelf life was estimated at 19 months for the product with incorporated biomass and 24 months for product without Spirulina. Sensory analysis showed that the addition of Spirulina in foods was well accepted by the target public. Products with added microalgal biomass can provide energy and protein and can contribute to the elderly population's nutritional requirements. Industrial relevance The preparation of food products for specific population groups pose major challenges for the food industry. These processes involve large investments in research, but tend to generate competitive advantages for the investing companies. One of the groups that deserve special attention are the elderly, who may present a number of specific nutritional deficiencies that must be supplied by diet. Within this scenario, the enrichment products for seniors with Spirulina becomes very interesting, because it makes food a source of protein and carbohydrates, as well as providing a number of dietary bioactive compounds, essential fatty acids and vitamins.

Ecosystem services and food security: assessing inequality at community, household and individual scales

SUMMARYWildlife populations provide harvestable meat to people and contribute to local food security. Throughout the year, and particularly at times of agricultural food shortages, wildlife and other wild foods play a critical role in supporting food security and enhancing local human nutrition. We explored the distribution of food security benefits of agricultural food production and a particular ecosystem provisioning service – wildlife harvest in the Makira Natural Park (MNP) of Madagascar – at community, household and individual levels. We found strong variation in wildlife consumption both among communities and among households and less variation among individuals within households. Mean household wildlife consumption in the target community was 10 kg per year ranging by approximately two orders of magnitude, with poorer and more food insecure households more reliant on wildlife for food. Meats (including wildlife) appeared to be evenly distributed within households, unaffected by age, sex, birth order and body weight, while other foods (including stew, rice and other staples) appeared to be allocated based on body mass. Reductions in wildlife consumption cause increased risk of food insecurity and specific nutritional deficiencies. The findings from our multilevel study suggest that disaggregated analysis that merges ecosystem services theory and the microeconomics of resource allocation allows for a more accurate valuation approach.

Bariatric Surgeries in Pregnancy—As Different as One May Think? [17R

INTRODUCTION: Bariatric surgery pregnant patients are at risk for nutrient deficiencies. The objective is to identify specific nutritional deficiencies, monitor the degree of deficiency, the pre-pregnancy BMI, gestational weight gain, and pregnancy outcomes among different bariatric surgeries. METHODS: Over a three year period, bariatric pregnant patients were identified. Data included: type of bariatric surgery, interval between surgery and pregnancy, pre and last visit BMI, gestational weight gain, diagnosis of diabetes, nutritional deficiencies in the beginning and end of pregnancy, supplements, birthweight, and mode of delivery. Logistic regression analysis assessed associations between each type of bariatric surgery and above data points. RESULTS: 125 patients with a history of bariatric surgery were identified. 41% Roux-en-Y, 28% gastric sleeve, 8% gastric band, 2% biliopancreatic diversion, and 21% unsure of the type. Postpartum hemoglobin was significant (P=.006). All other nutrients did not differ significantly. Pre-pregnancy BMI's did not differ significantly but 100% of gastric band patients were obese, 66% of Roux-en-Y, and 52% of gastric sleeve. Women gained too much weight in all groups. The last visit BMI was significant among the groups (P=.04). As the years post surgery increases, so does the last visit weight (P=.03). At delivery, no difference was noted in primary cesarean rate or birth weight. CONCLUSION: No significant difference in nutrition among different bariatric surgeries exists. Supplementation is needed in each type and nutritional screening is essential. Most women remain obese and gain too much weight. Delivery risks are no different among the surgeries.

Validation of a Novel Method for Use in Studies of Iron Status, Brain Function (EEG), and Recognition Memory Performance in Infancy

BackgroundEarly infancy is a time of peak cortical development when young infants are more susceptible to cognitive deficits from nutritional deficiencies. Previous studies link EEG measures of brain function to behavioral measures during recognition memory tasks in early infancy, but few in the context of nutrition deficiencies. Animal studies have shown that specific nutritional deficiencies affect the brain in targeted areas rather than as a broad cognitive change, but many current studies of nutrition and cognition in human infants only use general measures of cognition.ObjectiveOur study is unique in looking at early infant recognition memory, brain function, and iron status. This analysis examines the relationship between behavioral and brain (EEG) measures of memory as a validation of methods that could be applied in subsequent studies of the relationship between infant iron status and cognitive function.MethodsEEG data were collected from infants (4–6 mo, N=30) during a memory task (Oddball) in which the infants observed novel and familiar stimuli of emotionally neutral female faces. During a related memory behavior task (Paired Comparison), infants viewed two faces simultaneously and the length of infant gaze at each stimulus by stimulus type was measured. Hemoglobin and serum ferritin were measured to assess anemia and iron stores, respectively. The main EEG outcomes were the difference in amplitude and slope of the late slow wave (ΔLSW) between novel and familiar stimuli, a known measure of memory. The percent of time spent looking at the novel versus familiar stimuli (%Nov), as well as the total time spent in attention were the main memory behavior outcomes. Student's t‐tests and regression modeling were used to analyze the association between ΔLSW and %Nov. Age, sex, race, birth weight, and maternal education were assessed as potential confounders in regression models.Results and ConclusionsPreliminary results show that ΔLSW was significantly associated with %Nov (β = 0.52 ± 0.27; p=.04). These results show that our novel combination of methods successfully measures recognition memory and improves on previous work by using specific behavioral tasks and measures of brain function in the context of infant iron deficiency. This study will inform future work in the fields of nutrition and cognition.Support or Funding InformationFunded by USDA/CUAES (Hatch #NYC399413) and Cornell Human Ecology Alumni Association; JEHN supported by NSF GRFP

Advances in nutritional therapy in inflammatory bowel diseases: Review.

Inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn's disease are chronic, life-long, and relapsing diseases of the gastrointestinal tract. Currently, there are no complete cure possibilities, but combined pharmacological and nutritional therapy may induce remission of the disease. Malnutrition and specific nutritional deficiencies are frequent among IBD patients, so the majority of them need nutritional treatment, which not only improves the state of nutrition of the patients but has strong anti-inflammatory activity as well. Moreover, some nutrients, from early stages of life are suspected as triggering factors in the etiopathogenesis of IBD. Both parenteral and enteral nutrition is used in IBD therapy, but their practical utility in different populations and in different countries is not clearly established, and there are sometimes conflicting theories concerning the role of nutrition in IBD. This review presents the actual data from research studies on the influence of nutrition on the etiopathogenesis of IBD and the latest findings regarding its mechanisms of action. The use of both parenteral and enteral nutrition as therapeutic methods in induction and maintenance therapy in IBD treatment is also extensively discussed. Comparison of the latest research data, scientific theories concerning the role of nutrition in IBD, and different opinions about them are also presented and discussed. Additionally, some potential future perspectives for nutritional therapy are highlighted.

Pharmacotherapy of alcoholic liver disease in clinical practice.

Alcohol is the most commonly used addictive substance and alcoholic liver disease (ALD) is a major cause of chronic liver disease worldwide, responsible for 47.9% of all liver chronic deaths. Despite ALD has a significant burden on the health, few therapeutic advances have been made in the last 40 years, particularly in the long-term management of these patients. we searched in PubMed, Scopus, Google Scholar, and MEDLINE databases to identify relevant English language publications focused on long-term therapy of ALD. From the huge literature on this topic, including about 755 studies, 75 were selected as eligible including clinical trials and meta-analysis. Abstinence remains the cornerstone of ALD therapy but it is also the most difficult therapeutic target to achieve and the risk of recidivism is very high at any time. Several drugs (disulfiram, naltrexone, acamprosate, sodium oxybate) have proven to be effective to prevent alcohol relapse and increase the abstinence, although the psychotherapeutic support remains crucial. Baclofen seems to be effective to improve abstinence, showing an excellent safety and tolerability. ALD is often complicated by a state of malnutrition, which is related to a worst mortality. A nutritional therapy may improve survival in cirrhotic patients, reversing muscle wasting, weight loss and specific nutritional deficiencies. While in aggressive forms of alcoholic hepatitis are recommended specific drug treatments, including glucocorticoids or pentoxifylline, for the long-term treatment of ALD, specific treatments aimed at stopping the progression of fibrosis are not yet approved, but there are some future perspective in this field, including probiotics and antibiotics, caspase inhibitors, osteopontin and endocannabinoids.

To study the impact of dietary habits and nutritional intake on the behaviour of the adolescents

Present study was conducted to know the dietary habits and nutritional intake of the adolescents. The present study critically examines different dimensions of health, nutrition and socio-psycho behaviour of both rural and urban adolescents of Ghaziabad. The suggestions of the study demand interventions to be initiated by Government, parents, teachers, NGOs, academic institutes and newline health workers. Adolescence is a period between childhood and adulthood during which the individual learns the skills needed to flourish as an adult. Although adolescence begins with the biological series of events called puberty, some authors suggest that adolescence was culturally invented during the last century and defined it as a period in which the individual could gain the newline complex skills necessary to navigate adulthood in a Western culture. Newline Puberty, the beginning of adolescence, is marked by dramatic physical changes in both growth rate and sexual characteristics (Glucksberg and Darly, 1980; Field, 1995).Study was carried out on 1500 adolescents (750 boys and 750 girls) from Ghaziabad. The results show that some of the adolescents lag behind the standard weight and height. Most of the adolescent were found to have one or more than one medical problems at present and in the past also. The diet of adolescent were lacking in most of nutrients with some specific nutritional deficiencies seen in the sample. The psychosocial behaviour of adolescents shows that they have few behavioral problems and indulge in uncivilized and unhealthy addictions like smoking and substance abuse.

Cognition enhancers for the treatment of dementia.

Dementia is a broad term used to describe several chronic progressive neurological disorders that adversely affect higher mental functions including memory, language, behaviour, abstract thinking, comprehension, calculation, learning capacity and judgement. Alzheimer's disease is the most common form of dementia but other neurological conditions such as Parkinson's disease, cerebrovascular disease and chronic infections such as syphilis can also lead to the clinical syndrome of dementia. Initial investigations should always focus on finding any treatable cause for dementia such as HIV, structural lesions such as subdural haematomas or specific nutritional deficiency states such as that due to vitamin B12 and treated appropriately. Where no treatable or reversible aetiology is found, a referral to a specialist should be considered who may initiate further investigations including magnetic resonance imaging or perfusion single-photon emission computerised tomography scans of the brain, and sometimes cerebrospinal fluid examination or an electroencephalogram.