Underweight Research Articles

Can the Traditional Food - be Used for Treating Diarrhea?

Normal microflora is important as protection of the host against diseases in the gastrointestinal tract. During periods of acute diarrhea, the normal gastrointestinal microflora is radically changed, including decrease of Lactobacillus, Bacteroides, and Bifidobacterium species. Several studies have indicated that the administration of probiotic agents may modulate the microbial balance of the host and reduce the acute episodes of diarrhea. Meta analysis showed that probiotic has strong evidence to overcome diarrhea.1 In daily food products, yoghurt is daily food that enriched by probiotics. Some observational study showed that people who drink yoghurt routinely be healthier than people who don’t drink yoghurt. In Indonesian culture, the food that have functional ingredient such as probiotic can be found in Indonesian community. Milk curd or “dadih” is a traditional fermented buffalo milk that have functional ingredients.2 It may be used to support or maintain normal body functions or reduce the risk of disease in the generally healthy population. However, this food need further study to evaluate what are its function and role for human health. A study from Surono, et al found that one of a novel probiotic from “dadih”, Enterococcus faecium IS 27-526 has significant positive effects on humoral immune response, salivary sIgA, in underweight pre-school children, and on weight gain of pre-school children.3 One of clinical study of this issue reported the effect of Pediococcus pentosaceus (P. pentosaceus) on stool frequency, TNF-α level, gut microflora balance in diarrhea-induced Mice. In this study, Yuliawati et al, was aimed to recognize the effect of P. pentosaceus supplementation on stool frequency, tumor necrosis factor-α (TNF-α) and gut microflora balance in experimental mice with EPEC-induced diarrhea.4 This study used P. pentosaceus that was isolated from “dadih”, a traditional fermented buffalo milk. P. pentosaceus are Gram-positive, facultatively anaerobic, nonmotile and non-spore-forming, members of lactic acid bacteria. Like other lactic acid bacteria, P. pentosaceus Can the Traditional Food “Dadih” be Used for Treating Diarrhea?

Hydration, pH, pigmentation, sebum and skin texture: an in vivo non invasive study in centenaries

Skin is the largest organ of the human body and during aging it shows easily modifications caused by the senescence. Hydration, pH, pigmentation, sebum and skin texture may undergo modifications, above all in centenaries. We can find some papers that analyse the modifications induced by aging (Marrakchi et al., 2007); but no one of these studies people in the range 90-110 years old. Thus, our work has the aim to verify how these parameters can change. In our study we recruited 80 volunteers of Sardinian population divided in two groups: young and old people. We analyzed levels of sebum, hydration, pigmentation and pH with instruments of Courage + Khazaka electronic GmbH. Then we prepared the imprint that must be observed at SEM. The microscope used was a FEI INSPECT S, wherewith we took some photos of each imprint. The modifications are: hydration and sebum decrease significantly in centenaries; pigmentation and pH levels were higher in the old volunteers like demonstrated by other authors (Stucker et al., 2002). Studying skin texture, we found a diminution of furrows in old people. We can say that decrease of hydration and sebum is mainly linked to low level of hormones, such as estrogens and androgens, while the augmentation of pigmentation is due to the thinness of skin; the higher values of pH have probably a relation with a minor presence of sebum and water in cutaneous surface. Furthermore, accuracy of the pictures taken with SEM demonstrates that the study of skin texture associated with analysis of pH, sebum, pigmentation and hydration can help the comprehension of skin aging.

Changes in quality of cardiopulmonary resuscitation over time on CPR and related rescuer

Purpose : Inadequate chest compression during cardiopulmonary resuscitation(CPR) may result in the insufficient blood flow to preserve critical organ function. The study evaluated changes of quality of cardiopulmonary resuscitation over time in 30:2 CPR by laypersons and analyzed rescuer factors affecting the quality of chest compressions over time. Methods : This study was designed to know quality of CPR changes during 5 minutes. 47 students completed CPR training courses. They were performed 30:2 CPR using a manikin with Skill-Reporter for 5 minutes continuously to get data of depth, rate of chest compression, volume and correct rate of ventilation. Results : Time dependent analysis showed significant ineffective compression depth in females and under weight rescuers. In case of female, we found effective compression depth has maintained up to 2 minutes, but it decreased significantly after 2 minutes. However, underweight rescuers maintained effective compression depth up to a minute but it decreased after 1 minute. Conclusion : Although compression rate maintained over time, chest compression quality declined significantly. It suggested switching compression at an interval of 2 minutes is reasonable for 30:2 CPR by layperson but underweight rescuers may provide effective chest compression by switching shift every one minute.

A study on the perception of nutrition labeling among high school boys based on their weight

This study was conducted to investigate the relationship between knowledge of nutrition labeling and the effect on eating habits with 300 high school boys in Seoul. The subjects were divided into an underweight (UW) group (BMI ＜ 18.5 kg/m 2 , n = 42), a normal weight (NW) group (18.5 kg/m 2 ≤ BMI ＜ 23 kg/m 2 , n = 129) and an overweight (OW) group (BMI ≥ 23 kg/m 2 , n = 79) based on their body mass index (BMI). The average age of participants was 17.8 years old and their mean height and weight were 174.9 cm and 66.5 kg. The mean BMI of subjects was 21.7 kg/m 2 which fell within the normal range. Seventy six point four percent of subjects perceived nutrition labeling and they acquired the information pertaining to it through TV and internet. The UW group and the OW group obtained it from their parents, relatives and friends, while NW group acquired it from school. There were significant differences among groups in the acquired source of the information on nutrition labeling (p ＜ 0.05). The NW group and the OW group trusted nutrition labeling more than the UW group, but there were no significant differences among them. Forty five point five percent of the UW group and 40.7% the NW group were satisfied with nutrition labeling education, while only 15.8% of the OW group did it. The OW group checked nutrition labeling more than the UW group and the NW group at the point of food purchase. The primary reason for examining nutrition labeling was ‘to check nutrient contents’ in the UW group and the NW group, while the OW group examined it to improve health including regulation of body weight. There were significant differences among groups with regards to the rea son for examining nutrition labeling (p ＜ 0.001). The OW group was aware that nutrition labeling affected their eating habits significantly more than the other groups (p ＜ 0.05). Therefore, application-centered education on nutrition labeling and the strong support of the government is needed in order to improve nutrition labeling use and to apply the information from nutrition labeling into student dietary life. (Korean J Nutr 2012; 45(2): 150 ~ 158)

State of child health among poor and non-poor in urban India

This paper examines the gaps in four child health indicators, namely, underweight, stunting, wasting, and infant mortality among the urban poor and non-poor in India, using data from the National Family Health Surveys, 1992–93 and 2005–06. Based on economic proxies, a composite wealth index is computed for urban areas using Principal Component Analysis. The urban poor, derived from the composite wealth index, are equated with the official poverty estimates of the selected state. Poor non-poor ratio, concentration index, logistic regression, and Cox Proportional Hazard regression models are used in the analyses. Results depict considerable gaps between the urban poor and non-poor for all selected child health indicators in the country. However, regional patterns in inequalities are mixed. Controlling for other variables, poverty is found to be a significant determinant of all selected child health indicators over the periods (1992-93 and 2005-06). The study calls for specific programs to improve the health of children belonging to poor households in urban India. Abhishek KUMAR , Research Scholar, International Institute for Population Sciences, Govandi Station Road, Deonar Mumbai, 400088, India. E.mail: abhi85_iips@rediffmail.com . Sanjay K. MOHANTY, Associate Professor, Department of Fertility Studies, International Institute for Population Sciences, Mumbai, India. E-mail: sanjayiips@yahoo.co.in .

A study on cases developed pulmonary tuberculosis after receiving gastrectomy

Patients who had undergone gastric resection are considered to be high risk of developing tuberculosis. We investigated the factors leading to pulmonary tuberculosis after gastrectomy. We retrospectively examined 654 pulmonary tuberculosis patients discharged from Chiba-East National Hospital from January 1999 to December 2001. Fifty-five patients (31-84 years old, mean 63.5 +/- 12.5 years, 48 males and 7 females) had the history of gastric resection. The proportion of patients receiving gastrectomy among patients with pulmonary tuberculosis was 8.4 percent. The mean age of patients received gastric resection was 50.2 +/- 16.6 years, and the mean interval from gastrectomy to the development of pulmonary tuberculosis was 13.6 +/- 11.0 years. On admission to our hospital, 34 out of 55 cases were smear positive by sputum examination for acid-fast bacilli and 39 cases had cavitary lesions on chest X-ray. Gastrectomy was done due to carcinoma of the stomach in 31 cases, peptic ulcer in 21 cases, adenomatous polyp in two cases, and accidental injury in one case. Out of total 55 cases, 52 patients improved, but three cases died of pulmonary tuberculosis. None had the recurrence of carcinoma of the stomach. Body weight, Body mass index, Prognostic nutritional index (PNI; 10 x serum albumin concentration + 0.005 x peripheral lymphocyte count) which was proposed by Onodera, serum albumin level and serum total cholesterol level were lower in the gastrectomy group than in the non-gastrectomy group. The odds ratio of developing tuberculosis among gastrectomy patients compared with the appropriate controls in 30 to 59 year-old-men was 3.8. This study confirms that gastrectomy is one of the risk factors of developing tuberculosis in 30 to 59 year-old-men. However, whether gastrectomy in itself is a risk factor or whether it is secondarily associated with another risk factor such as underweight status and/or inadequate nutrition following surgery remains unclear.

Body mass index: A potential risk factor for breast cancer in minority patients.

1599 Background: Breast cancer (BC), the most common cancer among women in the United States, has many established risk factors including reproductive factors, hormone use, and obesity. Obesity has also been associated with a poorer prognosis. Serum estrogen levels are higher in obesity, and may influence the characteristics and development of BC. African-Americans (AA) have been found to have a poorer prognosis for undefined reasons. In previous studies linking obesity to BC prognosis, AA women have been under-represented. This study was undertaken to look at the association of body mass index (BMI), estrogen receptor (ER) status, and stage at diagnosis (dx) in minority patients (pts). Methods: A retrospective review of the tumor registry at an urban, tertiary care medical center identified 474 women with pathologically confirmed BC from 2005 to 2010. Clinical information at dx including race, age, family history, stage, height and weight, and menopausal status was obtained. The BMI (lb/in²) at dx was calculated and pts were categorized into four groups: obese (OB) (>30), over-weight (OW) (25-29.9), normal weight (NW) (18.5-24.9), and underweight (UW) (<18.5). Pathology was reviewed to confirm ER status. 60% (284/474) of pts had complete information and were evaluable. Results: Of the 284 pts, 71% were AA, 3% Asian, 5% Hispanic, 14% White Non-Hispanic, and 7% other. The age range was 28 to 96 years (mean 60 years). 80% of pts were post-menopausal. 41% had a family history of malignancy. Staging was as follows: 16%, DCIS, 22% stage I, 37% stage II, 18% stage III, and 7% stage IV. 70% were ER (+). 2% were UW. 20% were NW. 30% were OW. 48% were OB. Higher BMI pts were more likely to have ER (+) BC (p==0.044) (see table). There was statistically significant correlation between higher BMI and advanced stage in this cohort (p==0.050). Conclusions: The majority of BC pts in this cohort were AA and OW or OB. A higher BMI correlated with ER (+) status and advanced stage. The impact that obesity has on BC characteristics and prognosis is complicated as it is influenced by path-physiology, as well as psycho-social factors. Further studies including evaluation of weight control on BC in AA women is warranted. BMI No. of ER-positive pts No. of ER-negative pts OB 101 35 OW 59 25 NW 36 21 UW 2 5

Prevalence of Nutritional and Lifestyle Disorders among School Going Children in Urban and Rural Areas of Coimbatore in Tamil Nadu, India

The prevalence of both nutritional as well as lifestyle disorders is common among children as quoted by the World Health Organization (2010) and we studied this in both urban and rural areas of Coimbatore city. The students were selected from 5 schools each of Matriculation, Corporation and Panchayat in the age group of 6-15 years. Background information of the 2180 students from Matriculation schools, 2122 students from Corporation and 1870 from Panchayat schools was obtained using an interview schedule. Nutritional deficiencies among children were recorded using the physical signs and symptoms. Lifestyle disorders, particularly the prevalence of hypertension was observed among the students by measurement of systolic and diastolic blood pressures. Anthropometric measurements like height, weight, mid upper arm circumference were done using standardized procedures. It could be deciphered from the anthropometric measurements that 8.44% of boys and 7.43% of girls from Matriculation schools were obese, while in Corporation schools, 5.73% boys and 4.45 % girls and in Panchayat schools 2.65% boys and 1.59% girls were found to be obese. Common nutritional deficiencies identified among the students include anemia prevalent among 24.22% boys and 21.54% girls in Matriculation schools while it was 35.43% boys and 46% girls in the Corporation schools and 34.4% boys and 41.92% girls from Panchayat schools among the pre-adolescent group. Among the adolescents, 47.11% boys and 66.82% girls in Matriculation schools, 64.65% boys and 69.52% girls in Corporation schools and 58.67% boys and 67.5% girls in Panchayat schools had anemia. Other common nutritional deficiencies identified were vitamin A and skin infections. Thus, the extremities of obesity as well as underweight and nutritional deficiencies are prevalent among the school going children. The common lifestyle disorders prevalent among the children were obesity and hypertension.

Plasma Orexin-A Levels in COPD Patients with Hypercapnic Respiratory Failure

Orexins have previously been shown to promote wakefulness, regulate lipid metabolism and participate in energy homeostasis. The aim of the study was to determine the relationship between plasma orexin-A and body composition in COPD in-patients with hypercapnic respiratory failure. 40 patients with hypercapnic respiratory failure and 22 healthy individuals were enrolled prospectively in this study. Plasma orexin-A levels, BMI, SaO2, PaCO2 and PaO2 were noted for all the patients. Plasma orexin-A levels were higher in the underweight (UW) group, normal weight (NW) group and overweight (OW) group of COPD patients as compared with UW, NW and OW group of the control group (P < .05). Plasma orexin-A in COPD patients were higher in the OW group than in the NW group and the UW group. Plasma orexin-A levels showed significant correlation with body mass index (BMI), independent of PaO2 (r = 0.576; P < .05) and %fat (r = 0.367; P < .05); a negative correlation was noted between plasma orexin-A levels and PaO2 (r = −0.738; P < .05) and SaO2 (r = −0.616; P < .05). Our results suggest that orexin-A levels are high in COPD patients with hypercapnic respiratory failure, and vary according to BMI and body composition. Orexin-A may be associated with the severity of hypoxemia in COPD patients with hypercapnic respiratory failure.

Influence of Different Sociodemographic Factors on Body Mass Index - A Cross Sectional Survey from KEMU, Lahore

Abstract Background: Body mass index (BMI) is an important parameter of measurement of health status. Its signifi-cance is particularly high with relation to the medical students as they are the future health bearers of the nation. Therefore this study was conducted to explore the influence of different factors on the body mass index and give recommendations to improve the health status. Subject and Methods: The height and weight of the students was measured and the data was collected on a structured questionnaire. The results were analyzed using SPSS 11.5, mean ± S.D, confidence interval (C.I), ANOVA and Chi-Square was applied for des-criptive and inferential statistics. P-value ≤ 0.05 was considered significant. Study Design: A cross - sectional study. Place and Duration of Study: The study was con-ducted in the September 2010 in King Edward Medi-cal University and was completed in 5 months. Results: Study population consisted of 506 students, 252 (50%) male and 254 (50%) female students. 351 students (69.3%) had normal BMI, 98 (19.4%) under-weight, 51 (10%) overweight and 6 (1%) obese. The prevalence of normal BMI was significantly higher in the male gender (p-value 0.000) students who con-sumed milk (p-value 0.000) children of housewife mothers (p-value 0001) and non-smoking students (P-value .000) and children of educated parents (p-value 0.041 for mothers and 0.000 for fathers) and good physical activity. No significant association was found between BMI and class, living in rural and urban areas, living in hostel or at home father's occupation, economic status and lifestyle. Conclusion: About 30 percent of medical students are either underweight or overweight. Policies must be made to address the condition. Key words: Body mass Index, Medical Students.

Nutritional status, food habits and energy profile of young adult Cameroonian university students

In Cameroon, malnutrition and micronutrient deficiencies are associated to emerging chronic diseases and are serious public health as reported on last nutritional surveys. The aim of this study was to evaluate the food and macronutrient intakes of 58 students comprising 39 male and 19 female, aged 21 to 31 years, in Douala, Cameroon. Average daily intakes of energy were then calculated from the protein, lipid and carbohydrate content of the food as reported on food composition tables. For males, the averages were 26 years, 22.43 Kg/m2and 2681 ± 1138 Kcal, for age, BMI and energy intakes respectively. For females, they were 25 years, 23.04 Kg/m2 and 2266 ± 874 Kcal for age, BMI and energy intakes respectively. No case of underweight was observed. Education on food intakes of this group of Cameroonians is therefore needed along with further large scale studies. Key words: Foods, macronutrient, energy, intakes, young-adults, Cameroon.

Persistent child malnutrition in Tanzania: risks associated with traditional complementary foods (A review)

Despite numerous nutritional interventions that have taken place in Tanzania, the Country still experiences a high rate of child malnutrition. Millions of children suffer from one or more forms of malnutrition resulting in stunting, underweight, wasting and anemia. The growth of children often declines with the introduction of complementary foods around the age of 6 months and continues to decline up to 24 months that have greater implications for health during adult-hood. Poor breastfeeding and child feeding practices augmented by very early introduction of nutritionally inadequate and contaminated complementary foods are major factors contributing to persistent child malnutrition in Tanzania. These complementary foods comprise mainly cereal-based porridges with little or no vegetables and often lacking animal proteins. The promotion of exclusive breastfeeding during the first 6 months and appropriate feeding practices has been the integral parts of the intervention processes taking place in Tanzania. Food safety education is a critical prerequisite in the child health programs and is a cost effective intervention with long term positive impacts. This paper reviews the persistent child malnutrition in Tanzania and the causative factors to highlight risks associated with use of complimentary. Key words: Child malnutrition, complementary foods, feeding practices, microbial contamination and energy density.

Factors associated with anxiety and depression among adolescent elite athletes in Guangzhou city XIE

Objective To examine the relationships between a number of potential risk or protective factors and the risk of depression and anxiety among a population of adolescent elite athletes in Guangzhou city. Methods A whole sample was consisted of 520 students,and the information of their age,gender,characteristics and others was investigated. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scales(HADS). Data were analyzed using multiple stepwise regression analysis. Results After adjusting for other variables,students who had a high risk of anxiety were underweight (sβ =2.482) when compared to those who were of normal weight. Reduced risk of anxiety was associated with older students ( sβ = 4. 365), students with moderate educated mothersβ=3. 153) , and students who perceived very high pressure from teachers/coaches (sβ=5.372). A significant increase in the risk of depression was associated with variables including: students aged between 15 and 16 years(sβ =3.367) ,students who had a family history of chronic diseases (sβ =2.765) , and poor overall support(sβ = 4.365). Reduced risk of depression was associated with students with moderate educated mothers( sβ = 6.764) and students who perceived very high pressure from teachers/coaches(sβ = 4. 167). Conclusion Various risk and protective factors have been identified for anxiety and depression. These results have direct implications on the development of appropriate preventive strategies for mental problems among young elite athletes. Key words: Anxiety; Depression; Adolescents; Athletes

Preschool Children's Nutrition Risks Assessed from Caregiver's Reports of Food Intake in Detroit Head Start (HS) Centers

Consuming excessive foods high in energy density contributes to obesity, a major health issue in low income preschool children. The primary aim of this research was to explore preschoolers' nutrition risks related to overweight or obesity based on caregiver (CG) report of their child's food intake. Participants included 198 CGs who had a preschool children (mean age: 3 yr 10 ± 7 mo, 95% African American, 57% male) enrolled in one of six Detroit HS centers. CGs completed a 12‐item food‐group food frequency questionnaire for their children using a 3‐point rating scale (0 = no risk, 0.5 = moderate, 1 = high risk), from which a total nutrition risk score was calculated. Based on BMI for age percentile, 8% of the children were underweight (UW), 53% normal weight (NW), 12% overweight (OW) and 27% obese (OB). When separated by weight category, nutrition risk (range: 0–5.5) did not differ among groups (UW=2.5±1, NW=2.4±1.6, OW=2.3±1.6, OB=2.4±1.4, ns). When the food groups were examined as individual items, more than 50% of the children scored at moderate or high risk for intakes of sugar, sweetened beverages, plant protein, fatty and salty foods groups. Among all of the children, higher risks were found in less healthy, energy dense food intake. Reducing intake of fat, sugar‐sweetened soda and salt will help decrease nutrition risks in preschool children in Detroit HS centers and reduce chronic disease in adulthood.

Experts call on media to end glamorisation of underweight models

Experts call on media to end glamorisation of underweight models

광주.전남 일부 지역 중학생들의 BMI 수준에 따른 식행동, 체형인식 및 체중조절 양상에 관한 연구

This study was performed to investigate the food habits, eating behaviors, perception of body shape, statuses of body weight control by BMI (Body Mass Index) of 732 middle school students in Gwangju and Jeonnam. The results of this study were compared among under weight (UW), normal weight (NW), and overweight (OW) groups according to BMI levels. In the OW group, female students had low scores in eating at night only, while male students had low scores in eating at night, eating speed, and food selection. All subjects wanted more height than measured. Only male students in the UW group wanted weight loss, whereas female students in the OW and NW groups did. Higher BMI in female students resulted in more weight difference between measured and wanted. All subjects responded properly themselves in perception of body shape but the OW groups showed a big difference between their present weight and wanted weights. Higher BMI in all students corresponded to more interest in concern and experience of weight management. In the male students, the reason for weight management showed high tendency in being healthy, whereas the female students had high tendency in having a slender figure. Higher BMI in all students corresponded to bigger difference between wanted and perceived body shape. In contrast, lower BMI in all students meant more stress. Greater difference between wanted and measured weight and greater difference between wanted and perceived body shape corresponded to less satisfaction in body shape. In conclusion, compared to the NW and UW groups, the OW group had overeating habits highly linked to stress. Also the OW group didn't have desirable eating behaviors and attitudes because of their greater interest in concern and experience of weight control and stress accumulation, and finally there was difference in food habits and behaviors according to the BMI level. Therefore these results suggest that effective nutritional programs should be developed including correct body image and good dietary habits.

Histopathologic study on endoscopic cyclophotocoagulation and trans-scleral cyclophotocoagulation in rabbit eyes

Background Endoscopic cyclophotocoagulation(ECP) is a new approach to treat refractory glaucoma.But,the histopathological change of ciliary body after ECP has not been reported yet.ObjectivePurpose of the present study is to explore the histopathologic change of ciliary body after ECP and investigate the mechanism of lowing intraocular pressure(IOP) of ECP and compared with trans-scleral cyclophotocoagulation (TSCP).MethodECP was performed on the right eyes of 30 adult pigmented rabbits and TSCP was taken in the fellow eyes.Other two normal pigmented rabbits were as control group.The clinical examinations were performed in day 1,3,5,7,14,28,42 and 56 after operation under the slim lamp to evaluate the inflammatory reactions of conjunctiva,sclera and cornea,and the IOP was detected in the same time points.The animals were sacrificed and the eyeballs were extracted for the examination of structure of ciliary body under the light microscope in day 7,14,28,42 and 56 after surgery respectively.ResultsThe mild inflammatory response and local opacity of lens were seen under the slim lamp in the eyes after ECP,and severe inflammatory reaction was in the eyes received TSCP.No opacity of lens was found after TSCP through the observing period.The lowing-IOP extent was significantly higher in ECP group than TSCP group after operation(P＜0.01).The structure of ciliary body epithelium was normal in normal rabbit eyes.The disruption of ciliary body epithelium,especially for non-pigment epithelial layer,edema of ciliary process were seen in the early period after ECP.Fourty-two days later,the irregulation of ciliary body epithelium and atrophy of ciliary process were exhibited under the light microscope.In TSCP group,the edema,blooding and damage of ciliary process were seen,but slight inflammatory response was in the ciliary epithelium.After 42 days of surgery,atrophy of ciliary body,irregular proliferation of pigmental and non-pigmental epithelial cells,thinness of sclera and scarring of ciliary stroma were revealed.ConclusionCompared with TSCP,ECP can selectively destroy ciliary epithelium effectively and thoroughly and therefore reduce IOP.The adverse effect of ECP is the opacity of lens.Less damage of adjacent tissue is found in ECP compared with TSCP. Key words: endoscope; cyclophotocoagulation; trans-scleral cyclophotocoagulation; ciliary body; intraocular pressure

A Study of the Anthropometric and Demographical Profile of Patients Presenting with Coronary Artery Disease at Mayo Hospital, Lahore

Coronary artery disease (CAD) is very common in the South Asian sub-continent, yet there is relatively little published rese-arch available from these countries. Although we have a very active Cardiology Department in Mayo Hospital, Lahore, there is a parallel need for documentation of the data generated and its analysis for research and publication. This study was carried out to gain an insight into the nature of the risk factors and presentation of CAD in patients coming to our setup. Objectives: The objective was to study the relation of CAD with anthropometric (BMI, waist circumference, waist – to – height ratio) and demographical (age and gender) factors. Methodology: This study was carried out in the Department of Cardiology, Mayo Hospital, Lahore, for a duration of 17 months. We collected the required information (such as name, gender, and family history, demographical data and anthro-pometric measurements) on a prescribed proforma, managed and then analyzed accordingly. Results: In this study there were 302 (80.5%) males and 73 (19.5%) females. The number of males was significantly higher (p-value 0.000), but the frequency of different diagnoses was statistically the same in both males and females, i.e. p-value = 0.062. According to the WHO recommended criteria for the BMI of South Asian populations, there were 9(2.4%) people who were under weight, among these 7 (77.8%) were males and 2 (22.2%) were females patients. Out of 302 males, 7(2.3%) were under weight, 36 (11.9%) were of normal weight, 115 (38.1%) were overweight and the rest of 144 (47.7%) were obese. Among 73 females, 2 (2.7%) were under weight, 8 (11%) had normal weight, 15 (20.5%) were overweight and 48 (65.8%) were obese. The proportion of obesity was more in females in this study, p-value (0.000). The mean waist circumference of all patients was 95.57 ± 17.14 cm with a range of 53 – 190 cm. The waist circumference was statistically higher in males than females, p-value = 0.000. In 7 under weight males, 6 patients had WC < 90 cm while one had ≥ 90 cm. Among 36 male patients of normal weight, 19 had WC < 90 and 17 had ≥ 90 cm, while in 115 over weight males 28 patients had WC < 90 cm and 87 had ≥ 90 cm. In 144 obese males 13 patients had WC < 90 cm and 131 had ≥ 90 cm. In males the mean waist to height ratio (WHtR) was 0.5789 ± 0.091 with the range (0.31 – 1.23) and in females it was 0.64 ± 0.11 cm with range (0.36 – 1.28). Conclusion: Obesity as a risk factor is significantly present in our patients of coronary heart disease, more so in females, in which it appears to be more central or abdominal in character as compared to males, although there is considerable central adiposity in males, too. There is an imperfect correlation between the various measures of obesity, i.e., BMI, WC and WHtR when applied to our patients. More than one parameter should be used to reduce the chances of missing cases. Key words: Heart Disease, Obesity, Risk Factors of Heart Disease.

Socio-Demographic Risk Factors of Child Undernutrition

Abstract: Objectives: (1) To find the extent of undernutrition among under-five children in terms of stunting, wasting and underweight and also by composite index of anthropometric failure (CIAF). (2) To investigate some socio-demographic risk factors of child undernutrition. Study Design: Cross-sectional. Methods: A total of 371 under-five children from 816 households selected by stratified multi-stage random sampling technique. Collected information included weight, height, age, gender, social background, total calorie availability in the family, standard of living Index etc. Nutritional status was assessed by WHO criterion and CIAF. Statistical tests like Normal test of proportions, Chi-square test, Kolomogrov-Smirnov one sample test. Analysis of Variance (ANOVA) technique, Tukey's test and Multivariate Logistic Regression Model were used. Results: Proportions of underweight, stunting and wasting were found respectively 49.1%, 40.7% and 14.6% respectively. Children belonging to slum area and of low standard of living index were at significantly higher risk of being underweight. Anthropometric failure was observed in 62.8% children. Mean TCA for urban area was significantly higher than those for rural and slum areas. There were 57.1% children (72.3% in slums 71.3% from low SLI category) who were from TCA deficient families. About seventy five percent families of low standard of living, total calorie availability was below RDI and 73.1% children belonging to these families were having anthropometric failure. TCA deficiency was significantly associated with both SLI and social background. Low standard of living comes out to be an important risk factor of anthropometric failure irrespective of social background Conclusions: Undernutrition among under-five children should also be assessed by using composite index of anthropometric failure in order to avoid overlapping of different subgroups formed on the basis of standard indices of stunting, wasting and underweight. Low SLI comes out to be a risk factor of child undernutrition irrespective of social background. Nutritional status of children can be improved through social development by raising standard of living of people.

Use of Pedometer to Assess the Requirement and Consumption of Calories by Service Dogs

The assessment of the type and amount of food given to dogs, the diet formulation and the evaluation of the intake of calories according to the physical work of the dog, are essential conditions to maintaining the health status and performance of the service dogs. The housing and climate conditions also play a major role in maintaining the health status of the dogs and in expressing their genetic potential. The research used service dogs, German Shepherd breed, aged 1.6 to 9 years, which were observed and monitored during their performance of specific duties, without taking them out of the environment where they live and work. The requirement of energy and the amount of food required each day are calculated function of the body weight (BW) and of the intensity of the effort. The BW categories that were surveyed were: normal weight (40 kg BW, case A), over weight (50 kg BW, case B), and under weight (35 kg BW, case C). BMI evaluation (body mass index) was done according tot the international specifications, between 1 – emaciated, to 9 – very obese. The analytical methods evaluated the chemical structure of the given food; the amount of dry commercial food required for maintenance according to the physical work; the consumption of calories of the dog function of the walked distance (expressed in meters and steps) during the physical work. The consumption of calories during the physical work was calculated with a Dista T300 pedometer, which recorded the walked distance in terms of meters and steps, and the consumption of calories during the physical work. Caloric consumption=0.14*caloric necessary+43.61*(travelled) distance-7.57 In this case, the caloric necessary and the (travelled) distance influence the caloric consumption by 99,86% and the result will be estimated with 4.51 error. Instead, if entries 1 and 3 are eliminated (because of the low number of kilometers, which statistically speaking could be considered extreme values), we can observe a decrease of the two factors’ influence, but with a growth in the precision of the estimates. Caloric consumption=0.05*caloric necessary+55.8*(travelled) distance-115.23 In this case, the caloric necessary and the (travelled) distance influence the caloric consumption by 98,42%. The daily consumption of food of the dogs monitored with the pedometer was 593 Kcal in average, which requires an additional 167 g food per day, to the requirement for maintenance of 529 g food/day, giving a total of 696 g (40 kg average dog BW; 3.55 Kcal/g dry commercial food). The results revealed that the permanent monitoring of the consumption of calories in the dogs making constant physical work, but different in terms of intensity and duration, may be of use for the fast adjustment of their feed requirement, which must meet the daily requirement of calories.