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RESUMEN La paracoccidioidomicosis es una micosis profunda sistémica, endémica en algunos países de Latinoamérica, de presentación clínica es de evolución aguda/subaguda, en nuestro país es el principal diagnóstico diferencial de la tuberculosis pulmonar. Se describe el caso clínico de un hombre de 48 años, procedente de zona rural, inmunocompetente, que se presentó clínicamente por dificultad respiratoria, pérdida de peso de forma progresiva y lesiones en mucosas oral; como hallazgos radiológicos presentó infiltrados reticulares bilaterales. Desde el punto de vista micológico se evidenció la presencia del microorganismo en diversas muestras biológicas: biopsias de lesiones orofaríngeas y estudio micológico del esputo. Se realizó tratamiento dirigido con antimicótico intravenoso presentando buena respuesta al mismo con mejoría clínica.
ABSTRACT Paracoccidioidomycosis is a deep systemic mycosis, endemic in some Latin American countries, with an acute/subacute clinical presentation. In our country, it is the main differential diagnosis of pulmonary tuberculosis. We describe the clinical case of a 48-year-old man from a rural area, immunocompetent, who presented clinically with respiratory distress, progressive weight loss and lesions in the oral mucosa; as radiological findings, he presented bilateral reticular infiltrates. From a mycological point of view, the presence of the microorganism was evidenced in various biological samples: biopsies of oropharyngeal lesions and mycological study of sputum. Targeted treatment with intravenous antifungals was performed, presenting a good response to it with clinical improvement.
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La desnutrición por enfermedad afecta a un número elevado de pacientes hospitalizados que provoca una prolongada estancia hospitalaria por el retraso en la recuperación. Con el objetivo de determinar la relación de la intervención nutricional con los días de estancia hospitalaria en pacientes con malnutrición internados en el Hospital de Clínicas, Facultad de Ciencias Médicas -Universidad Nacional Asunción entre el año 2015 al 2021, se realizó un estudio observacional descriptivo retrospectivo de corte transverso que incluyó 49 registros de pacientes internados de los cuales 30 correspondieron a mujeres y 19 a hombres, el promedio de edad en mujeres fue de 53.7±18.9 años y para hombres de 50.7±17.9 años. Los resultados muestran la presencia de desnutrición calórico proteica en el 53.1% de los pacientes a través de la Nutritional Risk Screenig 2002, el 26.5% mostró desnutrición calórica proteica por Valoración Global Subjetiva, se observó sobrepeso en el 8.2% de los pacientes, así como obesidad y normopeso en el 6.1%. Tras asociar la intervención nutricional que recibieron los pacientes internados se pudo evidenciar asociación en aquellos que permanecieron menos días internados, por otra parte, no se encontró relación entre la edad, el peso y el índice de masa corporal con la estancia hospitalaria. Se pudo demostrar que la intervención nutricional a través del soporte nutricional puede favorecer a la mejoría del paciente y a una menor estancia hospitalaria, sin embargo, no puede ser ampliamente confirmada por el número reducido de registros al cual se pudo acceder.
Disease malnutrition affects a high number of hospitalized patients that causes a prolonged hospital stay due to recovery delay. With the objective of determining the relationship of nutritional intervention with the days of hospital stay in patients with malnutrition admitted to the Hospital de Clinics, Faculty of Medical Sciences - National University Asunción between 2015 and 2021, a retrospective descriptive observational study was conducted Transverse cutting that included 49 records of interned patients of which 30 corresponded to women and 19 to men, the average age in women was 53.7 ± 18.9 years and for men of 50.7 ± 17.9 years. The results show the presence of protein calorical malnutrition in 53.1% of patients through the Nutritional Risk Screenig 2002, 26.5% showed protein caloric malnutrition by subjective global assessment, overweight was observed in 8.2% of patients, as well as Obesity and Normopese in 6.1%. After associating the nutritional intervention that the interned patients received, association could be evidenced in those who remained less interned, on the other hand, there was no relationship between age, weight and body mass index with hospital stay. It could be demonstrated that nutritional intervention through nutritional support can favor the improvement of the patient and a lower hospital stay, however, it cannot be widely confirmed by the reduced number of records to which it could be accessed.
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Nutrition Assessment , Nutrition DisordersABSTRACT
Severe acute malnutrition serves a high risk of mortality among children aged 6-59 months. At a community level anganwadi centers play a vital role in identifying malnutrition among children and enabling resources for growth and development. The aim of this study was to develop a nutrient dense mix using pearl millet and pigeon pea and evaluate its sensory, physicochemical and proximate properties. The nutrient dense mix was formulated using pearl millet and pigeon pea in several variations and the best accepted variation was selected through sensory evaluation and analyzed for its physiochemical and proximate composition. Variation 3 of the nutrient dense mix prepared by balancing pearl millet with rice had the highest acceptability in all sensory parameters. It had favorable physicochemical properties including water solubility index (20.1%), swelling power (3.7%) and low moisture content (3.7%). The proximate analysis revealed high energy (347.10±0.85 kcals), protein (14.28±0.04 g), fat (19.53±0.03) and calcium content (154.63±2.2 mg). The percentage adequacy of the nutrients from the nutrient dense mix showed that 31.27% of energy as per the estimated average requirements was met for 1-3 year olds and 25.5% for 4-6 year olds. The high sensory acceptability, low cost and good micro and macronutrient profile encourages further exploration for the product in curbing malnutrition.
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Introducción. La isquemia mesentérica crónica es una entidad infrecuente, con una prevalencia de 0,03 %, donde más del 90 % son debidas a enfermedad arterioesclerótica que compromete principalmente la arteria mesentérica superior. Sus síntomas son dolor abdominal crónico y pérdida de peso, asociado a alteraciones imagenológicas que hacen el diagnóstico. El tratamiento depende de las condiciones clínicas del paciente y el número de vasos comprometidos. Es claro que la enfermedad multivaso sintomática requiere revascularización. Caso clínico. Mujer de 67 años, fumadora activa con antecedentes de hipertensión arterial y dislipidemia, con cuadro de crisis hipertensiva tipo urgencia que requirió manejo en Unidad de Cuidados Intensivos. Se hizo diagnóstico de aneurisma toracoabdominal Crawford IV, oclusión aorto-ilíaca (TASC D) y oclusión crónica del tronco celíaco y la arteria mesentérica superior. Por los síntomas de isquemia mesentérica crónica fue llevada a tratamiento quirúrgico con baipás aorto-bifemoral más baipás retrógrado a la arteria mesentérica superior por vía abierta. Resultado. La paciente tuvo mejoría de la sintomatología y aumentó 13 % del peso al seguimiento a los 3 meses. Conclusión. La isquemia mesentérica crónica es una condición subdiagnosticada, marcador de riesgo cardiovascular, con alta carga de morbilidad y mortalidad, en la cual, con una identificación temprana se puede ofrecer una terapia de revascularización, sea por vía endovascular o abierta, con el fin de mejorar la calidad de vida y la ganancia de peso, y evitar la necrosis intestinal.
Introduction. Chronic mesenteric ischemia is a rare entity, with a prevalence of 0.03%, where more than 90% are due to arteriosclerotic disease that mainly affects the superior mesenteric artery. Its symptoms are chronic abdominal pain and weight loss, associated with imaging alterations that make the diagnosis. Treatment depends on the patient's clinical conditions and the number of vessels involved. It is clear that symptomatic multivessel disease requires revascularization. Clinical case. A 67-year-old woman, an active smoker with a history of high blood pressure and dyslipidemia, presented with an emergency-type hypertensive crisis that required management in the Intensive Care Unit. A diagnosis of Crawford IV thoracoabdominal aneurysm, aorto-iliac occlusion (TASC D), and chronic occlusion of the celiac trunk and superior mesenteric artery was made. Due to the symptoms of chronic mesenteric ischemia, she underwent surgical treatment with aorto-bifemoral bypass plus retrograde bypass to the superior mesenteric artery via an open approach. Result. The patient had improvement in symptoms and gained 13% weight at 3-month follow-up. Conclusion. Chronic mesenteric ischemia is an underdiagnosed condition, a marker of cardiovascular risk, with a high burden of morbidity and mortality, in which, with early identification, revascularization therapy can be offered, either endovascularly or open, in order to improve quality of life and weight gain, and avoiding intestinal necrosis.
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Humans , Mesenteric Artery, Superior , Mesenteric Ischemia , Aortic Aneurysm , Malnutrition , Peripheral Arterial Disease , LaparotomyABSTRACT
Background: This study aims to identify factors related to the nutritional status of children aged 6-24 months of the Cham ethnic group in Tan Chau town, An Giang province in 2018.Methods: It was a cross-sectional study. Cham ethnic children aged from 6 to 24 months at the time of the survey and their mothers living in Tan Chau town, An Giang province were included in the study as subjects.Results: In the underweight group, the risk of malnutrition for subsequent children is 2.5 times higher compared to the first-born children in the family, and this difference is statistically significant with p<0.05. Among the underweight, stunted, and wasted groups, children with a birth weight of less than 2500 grams have a higher rate of malnutrition compared to those with a birth weight of 2500 grams or more, but this difference is not statistically significant with p>0.05. In the underweight and wasted groups, children who frequently fall ill have a higher rate of malnutrition compared to those who do not fall ill often; however, this difference is not statistically significant with p>0.05. No correlation has been found between the presence of congenital disabilities and the condition of stunting in children with p>0.05.Conclusions: Several factors related to the personal lives of Cham ethnic children aged 6-24 months contribute to the state of malnutrition. It is necessary to enhance communication and counseling efforts to help reduce the malnutrition rate among children in the area as well as within the community.
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Background: The incidence of malnutrition in children admitted to pediatric intensive care unit (PICU), has always been significant. In addition, nutritional status of critically ill children deteriorates further during their PICU stay and may have negative effect on patients` outcome. This study aims to determine the critically ill children, to analyse and document its impact on outcome and to survey current nutritional practices and support in PICU.Methods: This was a prospective observational study done over a period of 10 months on critically ill patients admitted in PICU of department of pediatrics at Baroda medical college and Sir Sayajirao Gaekwad hospital, Vadodara.Results: Total of 350 patients admitted in PICU of S. S. G. hospital, Vadodara were enrolled in the study. Malnutrition was higher in age 6-60-month age group (57%) of patients admitted in PICU, 81% of severe acute malnutrition patients required mechanical ventilation and 19% required HFNC support, there was statistically significant difference in mortality (51.1%) of SAM patients as compared to normal patients.Conclusions: Malnutrition is one of the leading causes of mortality in patients admitted to PICU, with more complications with prolonged ventilator support, longer duration of stay in PICU.
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Background: This study aims to explore the nutritional care practices for children from 6 to 24 months old by Cham ethnic mothers in Tan Chau town, An Giang province in 2018.Methods: A cross-sectional study was conducted on Cham ethnic children aged from 6 to 24 months and their mothers living in Tan Chau town, An Giang province.Results: The rate of mothers practicing proper and sufficient prenatal care during pregnancy is 74.4%; the rate of mothers engaging in lighter work than before pregnancy is 64.2%; the rate of mothers eating more than before pregnancy is 72.2%; the rate of mothers taking iron supplements during pregnancy is high at 85%. Practices regarding the timing of weaning children are not good, with 36.8% of mothers weaning children at the wrong time. Practices for feeding children supplementary foods are relatively good: 90.7% of mothers feed their children at the right time, however, the rate of mothers providing children with a complete range of food groups is only 23.0%. Maternal care practices for sick children have many shortcomings, with 81.7% of mothers feeding children incorrectly when they have diarrhea, and only 38.4% of children receiving oral rehydration solution (ORS) when they have diarrhea. Personal hygiene practices of the mother and child care are not good, with 24.3% of mothers not properly performing hand hygiene for themselves and their children.Conclusions: We need to strengthen propaganda and consulting work for each group of subjects, especially the Cham ethnic people, on nutritional care practices for children from 6-24 months old.
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Background: School-going children constitute one-fifth of the total population. They are the future of the nation's successor generation; therefore, high-performing students are important investments in building the nation's future. This study aimed to identify the health problems among school-going children. Methods: The current research was a cross-sectional study conducted in the Akhorigola block of Rohtas, targeting school-going children. A total of 650 participants were selected through a purposive sampling technique and assessed using a pre-structured format. The acquired data was analyzed using the statistical package for the social sciences (SPSS) to calculate the results based on objectives and hypotheses. Results: The outcomes of the study showed that among the 360 school-age boy participants, 210 (58.33%) had a normal weight, 100 (27.79%) were underweight, and 50 (13.88%) were overweight. Among the 290 girl participants, 150 (51.82%) had a normal weight, 110 (37.84%) were underweight, and 30 (10.34%) were overweight. The study also revealed that the majority of the 650 participants, 149 (22.92%), had inadequate personal hygiene, 109 (16.76%) had dental caries, 78 (12%) were affected by worm infestation, 55 (8.46%) were anemic, 47 (7.23%) had vitamin-A deficiency, 44 (6.76%) had scalp and hair problems, 38 (5.84%) had ear problems, and 30 (4.61%) had impaired visual acuity. Conclusions: Implementing school health programs can pose several challenges, but these can be effectively tackled through the integration of activities between the health and education departments.
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Background: Nutritional status is an important indicator in measuring the quality of life of children. Galkadapthana is a rural agricultural village in the Nuwara Eliya district, Sri Lanka. Villagers confront difficulties regarding their nutritional status due to low income, inadequate education and poor infrastructure facilities. This study was undertaken to identify the relationships between the nutritional status of school children in Galakadapathana village and their dietary patterns. Methods: A community-based cross-sectional study was carried out using a deductive approach. A total of 85 households with 137 school children aged 6-18 years were randomly selected. Data was collected using structured surveys and conducting face-to-face interviews. The nutritional status of children was assessed through anthropometric measurements. Results: A severely stunted condition was observed in 5.8% of children, while 7.3% represent severely underweight conditions according to the WHO growth references, 2007. The maximum number of 6 was scored in the Individual Dietary Diversity Score (IDDS) by 24.8% of the population. The maximum number of 7 in the Household Dietary Diversity Score (HDDS) was scored by 21.2% of the population. There was no significant (P>0.05) relationship between the BMI-for-age status and the aggregate level of education of the breadwinner, birthweight of the child, IDDS, and HDDS. However, the amount of starchy food intake significantly (P<0.05) impacted the BMI-for-age status. Conclusions: The amount of starchy food intake showed a significant impact on the prevalence of wasting (P<0.05), but not the aggregate level of education of the breadwinner, birthweight of the child and dietary diversity.
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Objetivo: Identificar los patrones alimentarios de las madres y el estado nutricional de los lactantes de una zona periurbana de la sierra central del Perú. Métodos: El estudio fue observacional, transversal y prospectivo. La población censal fueron 93 madres y sus lactantes, se aplicó un cuestionario de patrones alimentarios; para medir el peso y la talla de los lactantes se aplicaron instrumentos mecánicos. Se aplicó la prueba de Fisher y Rho de Spearman, considerándose p < 0,05. Resultados: Los patrones alimentarios de las madres, fueron adecuados 95,7 % (89). Al valorar el estado nutricional de los lactantes, en el peso para la edad, la mayoría tuvo la condición de normal con 79,6 % (74); 15,1 % (14) tuvieron sobrepeso, un 5,4 % (5) tuvieron desnutrición global; en el peso para la talla, 64,5 % (60) tuvieron el diagnóstico de normal, seguido de los desnutridos agudos 24,7 % (23), sobrepeso 7,5 % (7) fueron el 3,2 % (3). Y, en la talla para la edad, 77,4 % (72) fueron normales. A mayor cantidad de miembros en la familia el estado nutricional del lactante era peor (Rho = -0,294; p-valor = 0,004) y la talla para la edad del lactante tuvo relación con la visita de la madre al nutricionista (p-valor = 0,018). Conclusión: A mayor cantidad de miembros en la familia, el estado nutricional del lactante era peor, en el peso para la edad y la talla para la edad del lactante se halló relación con la visita al nutricionista.
Objective: Identify the dietary patterns of mothers and the nutritional status of nursing children of a peri-urban zone of the central highlands of Perú. Methodology: The study was observational, cross-sectional and prospective. Census population were 93 mothers and their nursing children, It was applied a dietary patterns questionnaire; to measure the weight and height of the nursing children was applied machanics instruments. It was applied Fisher y Rho de Spearman test, considering p<0,05. Results: The dietary patterns of mothers were proper 95,7 % (89). To value the nutritional status of nursing children; in the weight for age, the most of them had the normal condition with 79,6 % (74); 15.1 % (14) al lof them had overweight, 5,4 % (5) underweight; in weight-for-height, 64,5 % (60) had the normal diagnosis, followed by acuate malnutrition 24,7 % (23), overweight 7,5 % (7) were 3,2 % (3). And, in height for age, 77,4 % (72) were normals. The higher the amount of family members the nutritional status of nursing children was worse (Rho = -0,294; p-value = 0,004) and the height for age of nursing children had relation with the mother visit had to the nutricionist (p-value = 0,018). Conclusion: The higher amount of members family, the nutritional status of nursing children was worse, in weight for age and height for age of nursing children was found relation with the visit to the nutritionist.
Objetivo: Identificar os padrões alimentares das mães e o estado nutricional dos bebês em uma área periurbana do planalto central do Peru. Métodos: O estudo foi observacional, transversal e prospectivo. A população censitária foi de 93 mães e seus bebês, foi aplicado um questionário sobre padrões alimentares; Instrumentos mecânicos foram aplicados para medir o peso e a altura dos bebês. Foi aplicado o teste Rho de Fisher e Spearman, considerando p < 0,05. Resultados: O padrão alimentar das mães estava adequado em 95,7% (89). Ao avaliar o estado nutricional dos lactentes, em peso para idade, a maioria apresentou estado normal com 79,6% (74); 15,1% (14) apresentavam excesso de peso, 5,4% (5) apresentavam desnutrição global; no peso para estatura, 64,5% (60) tiveram o diagnóstico de normalidade, seguido de desnutrição aguda 24,7% (23), excesso de peso 7,5% (7) foram 3,2% (3). E, na altura para idade, 77,4% (72) eram normais. Quanto maior o número de familiares, pior o estado nutricional do lactente (Rho = -0,294; p-valor = 0,004) e a altura do lactente para a idade esteve relacionada com a visita da mãe ao nutricionista (p-valor = 0,018). Conclusão: Quanto maior o número de membros na família pior o estado nutricional do lactente. No peso para idade e altura para idade do lactente foi encontrada relação com a visita ao nutricionista.
Subject(s)
Female , Infant , Adolescent , Adult , Nutritional Status , Weight by Age , Body Height , Feeding BehaviorABSTRACT
Objetivo: identificar los patrones alimentarios de las madres y el estado nutricional de los lactantes de una zona periurbana de la sierra central del Perú. Métodos: el estudio fue observacional, transversal y prospectivo. La población censal fueron 93 madres y sus lactantes, se aplicó un cuestionario de patrones alimentarios; para medir el peso y la talla de los lactantes se aplicaron instrumentos mecánicos. Se aplicó la prueba de Fisher y Rho de Spearman, considerándose p < 0,05. Resultados: los patrones alimentarios de las madres, fueron adecuados 95,7 % (89). Al valorar el estado nutricional de los lactantes, en el peso para la edad, la mayoría tuvo la condición de normal con 79,6 % (74); 15,1 % (14) tuvieron sobrepeso, un 5,4 % (5) tuvieron desnutrición global; en el peso para la talla, 64,5 % (60) tuvieron el diagnóstico de normal, seguido de los desnutridos agudos 24,7 % (23), sobrepeso 7,5 % (7) fueron el 3,2 % (3). Y, en la talla para la edad, 77,4 % (72) fueron normales. A mayor cantidad de miembros en la familia el estado nutricional del lactante era peor (Rho = -0,294; p-valor = 0,004) y la talla para la edad del lactante tuvo relación con la visita de la madre al nutricionista (p-valor = 0,018). Conclusión: a mayor cantidad de miembros en la familia, el estado nutricional del lactante era peor, en el peso para la edad y la talla para la edad del lactante se halló relación con la visita al nutricionista.
Objective: identify the dietary patterns of mothers and the nutritional status of nursing children of a peri-urban zone of the central highlands of Perú. Methodology: the study was observational, cross-sectional and prospective. Census population were 93 mothers and their nursing children, It was applied a dietary patterns questionnaire; to measure the weight and height of the nursing children was applied machanics instruments. It was applied Fisher y Rho de Spearman test, considering p<0,05. Results: the dietary patterns of mothers were proper 95,7 % (89). To value the nutritional status of nursing children; in the weight for age, the most of them had the normal condition with 79,6 % (74); 15.1 % (14) al lof them had overweight, 5,4 % (5) underweight; in weight-for-height, 64,5 % (60) had the normal diagnosis, followed by acuate malnutrition 24,7 % (23), overweight 7,5 % (7) were 3,2 % (3). And, in height for age, 77,4 % (72) were normals. The higher the amount of family members the nutritional status of nursing children was worse (Rho = -0,294; p-value = 0,004) and the height for age of nursing children had relation with the mother visit had to the nutricionist (p-value = 0,018). Conclusion: the higher amount of members family, the nutritional status of nursing children was worse, in weight for age and height for age of nursing children was found relation with the visit to the nutritionist.
Objetivo: identificar os padrões alimentares das mães e o estado nutricional dos bebês em uma área periurbana do planalto central do Peru. Métodos: o estudo foi observacional, transversal e prospectivo. A população censitária foi de 93 mães e seus bebês, foi aplicado um questionário sobre padrões alimentares; Instrumentos mecânicos foram aplicados para medir o peso e a altura dos bebês. Foi aplicado o teste Rho de Fisher e Spearman, considerando p < 0,05. Resultados: o padrão alimentar das mães estava adequado em 95,7% (89). Ao avaliar o estado nutricional dos lactentes, em peso para idade, a maioria apresentou estado normal com 79,6% (74); 15,1% (14) apresentavam excesso de peso, 5,4% (5) apresentavam desnutrição global; no peso para estatura, 64,5% (60) tiveram o diagnóstico de normalidade, seguido de desnutrição aguda 24,7% (23), excesso de peso 7,5% (7) foram 3,2% (3). E, na altura para idade, 77,4% (72) eram normais. Quanto maior o número de familiares, pior o estado nutricional do lactente (Rho = -0,294; p-valor = 0,004) e a altura do lactente para a idade esteve relacionada com a visita da mãe ao nutricionista (p-valor = 0,018). Conclusão: quanto maior o número de membros na família pior o estado nutricional do lactente. No peso para idade e altura para idade do lactente foi encontrada relação com a visita ao nutricionista.
Subject(s)
Humans , Female , InfantABSTRACT
Gastric antral web is a rare cause of gastric outlet obstruction in children. Common complaints include intermittent non-bilious vomiting, bloating, pain, loss of appetite, and weight loss. Herein, we report a case of gastric antral web presenting with esophageal stricture and malnutrition, which was followed for many years with a misdiagnosis. An 8-year-old African boy was referred to our pediatric gastroenterology clinic due to recurrent vomiting and severe malnutrition. According to his medical history, the patient began experiencing non-bilious vomiting at 40 days of age and a diagnosis of gastroesophageal reflux was made. He was hospitalized multiple times and received nasogastric tube feedings in the following 4 years. He was re-evaluated for growth retardation and malnutrition at 4 years of age. He had been diagnosed with gluten enteropathy and was fed a gluten-free diet. Recently, he developed difficulty swallowing solid food and was only able to consume liquid meals. Esophagography revealed segmental stenosis in the distal portion of the esophagus. After stricture excision with thoracotomy, upper gastrointestinal series with a radiopaque substance indicated normal esophageal passage; however, prolonged gastric emptying time was also noted. Upon examination during laparotomy, a congenital web was detected in the antral region and was excised. Esophageal and gastric pathologies were consistent with stricture caused by reflux esophagitis and gastric antral web. Today, gastric antral web is mostly diagnosed and treated in infancy. Near total obstruction is relatively easy to diagnose; however, many patients with partial obstruction are followed-up for years with an incorrect diagnosis. Therefore, it should be considered in such cases, persistent vomiting and gastroesophageal reflux may be associated with esophageal stricture.
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Background: Severe acute malnutrition (SAM) with severe wasting remains a major killer of children. In Bihar, 48% of children are stunted, 21 % are wasted, and 7% are severely wasted. Even during the first six months of life, 31% are wasted. The objective of this study was to study wasting trends and contributing factors responsible for changes in Bihar among children 0-5 years. Methods: This cross-sectional study was done using a data of NFHS-5 survey in Bihar (N=35,834) conducted in all 38 districts of the state from July, 2019 to February, 2020. The Bihar NFHS-5 report and factsheets, including NFHS-4 data, were downloaded and converted to excel to enable data visualization and trend analysis. The outcome variable Wasting was measured using NFHS-5 relevant questionnaires given under nutrition category. We analyzed trends between NFHS-5 and NFHS-4 Bihar data for severe wasting/wasting, determinants, and coverage of interventions.Results: The prevalence of severe wasting has increased from 7% to 8.8%, while wasting increased from 20.8% to 22.9% (NFHS-5). The severe wasting and wasting has reversed or worsened in 27 districts. There is a mixed picture of infant feeding- early initiation of breastfeeding worsening and some improvements in exclusive breastfeeding and timely introduction of complementary feeding. Consistent improvement across districts for underlying determinants, but slight, in women抯 education, teenage pregnancy, and marriage before 18 years. Conclusions: Need to invest in improving maternal determinants-age at marriage, education, ANC coverage, and teenage pregnancy. It is imperative to focus on preventing, identifying, and treating wasting.
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Background: Severe acute malnutrition (SAM) is the leading cause of death in children. SAM affects approximately 20 million preschool children, mainly in Africa and South Asia. Children with severe acute malnutrition and severe edema (+++) have an increased risk of death compared with children with severe acute malnutrition and no edema. This study evaluated the nutritional outcome of SAM patients in the presence and absence of edema.Methods: This retrospective study was conducted in malnutrition treatment centre, JK Lon Hospital attached with Govt Medical College, Kota from January 2021 to December 2022 on children of age 6 months to 59 months, with clinical diagnosis of severe acute malnutrition. Ethics committee approval was not required as the study was a retrospective observational study. Patients were divided into three categories, viz. recovered, defaulted and non-responders.Results: A total of 270 patients were selected for this study on the basis of date made available through past records. Of the total patients studied, 32.2% (87) had bilateral edema while the rest (183) were non edematous. From edematous arm, 79.9% children recovered, 9.1% defaulted, and 11% were non-respondents. Conversely, of those without oedema 55.7% recovered, 7.0% defaulted, and 37.3% were non-respondents.Conclusions: Severe acute malnutrition is a preventable and treatable cause of childhood morbidity and mortality. The determinants of SAM include illiteracy, low socio-economic status, malnourished mother, low birth weight, ignorance about specific nutritional requirements of infants and young children, repeated infections, etc. In this study, we documented that the edematous children in the study area had a better likelihood of recovery as compared to those with severe wasting.
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Background: Pneumonia is the leading cause of morbidity and mortality in the pediatric population. In developing countries like India, multiple sociodemographic and environmental factors influence the outcome of severe pneumonia so this study explores these risk factors with aim of finding ways to improve the outcome.Methods: It is a prospective observational study conducted over a period of 12 months on 2 months to 5 years, children with severe pneumonia admitted in ward and PICU of tertiary medical care institute. A total of 100 patients were enrolled in the given study after meeting the inclusion criteria. Predesigned proforma was used to record sociodemographic details, patient history, detailed examination findings and laboratory reports. Outcome in terms of mortality and morbidity was noted. Data analyzed using appropriate statistical tests, p values <0.05 accepted as statistically significant.Results: The severe pneumonia was more common in the age group of 2 months to 1 year of age (59%) and in males (60%). Malnutrition and leukocytosis was statistically significant. 53 subjects were exclusively breastfed. Type of family, mother & father抯 education status, mother抯 employment status, tobacco exposure and contact with tuberculosis were not found statistically significant in the given study. 21 participants required PICU and 10 patients required mechanical ventilation. 92 patients were discharged, while 2 patients expired.Conclusions: Pneumonia is an important preventable and treatable cause of under 5 mortalities. In developing countries like India an awareness and proper management of risk factors like malnutrition, low birth weight, immunization status can improve the outcome.
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Background: Childhood undernutrition contributes to childhood diseases and is a major cause of child mortality in India. According to National Family Health Survey (NFHS-5), 32% under-five children in India were under-weight, and 36% were stunted. In Karnataka, the prevalence of underweight among under-five children was 33% and stunting 35%. The objective of the study was to assess the nutritional status of under five-years children in rural communities. Methods: A community based cross sectional study was conducted among 1887 under-five children from rural Yadgir, Karnataka. Weight and height of children were measured using standard protocols. The World Health Organization (WHO) Anthro software version 3.2.2.1 was used for analyzing data. Children whose Z-scores on weight-for-age, height-for-age and weight-for-height indices were below -2SD from the median of the WHO reference population were considered as underweight, stunted, and wasted respectively. Results: The result revealed that 53.6% of children were stunted, 39.4% were underweight and 15.3% were wasted. Severe forms of underweight, stunting and wasting were observed among 9.4%, 24.2% and 4% children respectively. The frequency of being underweight and stunted has increased with age, which was accelerated after 6 months and about 34% and 52% of children were underweight and stunted by the age 12-23 months. While wasting was higher among children aged 6-11 (24.2%) months than their counterparts. Conclusions: Special attention is required to reduce nutrition vulnerability among young children (12-24 months). An appropriate strategy needs to be implemented to educate rural mothers on the importance of exclusive breastfeeding and complementary feeding practices.
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Background: The nutritional status of preschool children is a critical indicator of their overall health and development. Breastfeeding provides best start of life to babies as well as improves the health of mothers and babies. Objectives were to assess the nutritional status of preschool children and to Investigate the impact of breastfeeding practices on children’s nutritional outcomes and breastfeeding practices of their mothers. Methods: This cross-sectional study was conducted in an urban slum area and involved a sample of preschool children aged 3 to 6 years. Complete enumeration of children of 3-6 years age group was done. Nutritional status was assessed through anthropometric measurements, including height, weight and mid upper arm circumference. Data on breastfeeding practices were collected through structured interviews. Data was analysed using MS excel and chi-square statistical tests was applied. Results: There were 334 study participants of which 7.5% had stunting and 62.87% were underweight. It was found that 18.56% had history of low birth weight. 90.12% were exclusively breastfed and breastfeeding was continued up to 2 years for 28.14% and more than 2 years for 71.86% children. It was also found that history of low birth weight of children is significantly associated with malnourishment (p?0.05). Conclusions: The study revealed that a substantial proportion of preschool children in the urban area were experiencing malnutrition. The breastfeeding practices were fair among the mothers of the children. Targeted education and awareness programs to enhance the nutrition can improve the overall health of preschool children in the urban setting.
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Introducción: El labio y paladar hendido (LPH) son una alteración cráneo facial de etiología multifactorial. La alimentación de los niños con LPH puede llegar a ser deficiente, comprometiendo el crecimiento y el desarrollo. Objetivo: Determinar la evolución del estado nutricional pre y post quirúrgico y las prácticas alimentarias en lactantes de 6 a 24 meses de edad, con labio y/o paladar hendido que acudieron a la Clínica de la Fundación Operación Sonrisa durante el periodo de setiembre 2020 a mayo del 2021. Materiales y métodos: Estudio observacional, prospectivo con componente analítico. Se incluyó a 50 niños con diagnóstico de LPH de 6 a 24 meses de edad. Se evaluó el estado nutricional según estándares del MSP y BS. Resultados: Fueron evaluados 50 lactantes de 6 a 24 meses, el 60 % entre 6 -11 meses, el 64 % fueron varones, el 54 % provenía del interior del país y fueron sometidos a cierre primario de labios el 86 % y el 12 % a reconstrucción de paladar hendido. El 88 % de los niños recibieron lactancia materna. El estado nutricional pre quirúrgico fue adecuado (94 %) por indicador peso para la edad. Post quirúrgico hubo una diferencia significativa de 0,927Kg para el peso para la talla (p< 0,001), lo mismo para el peso para la edad(p<0,001). Para la talla para la edad se encontró una diferencia de 0,8cm(p=ns). Conclusiones: El estado nutricional de los niños con labio o paladar hendido, mejora a los 4 meses post cirugía reconstructiva para los indicadores peso para la edad y peso para la talla.
Introduction: Cleft lip and palate (CLP) is a craniofacial alteration of multifactorial etiology. The diet of children with CLP can become deficient, compromising growth and development. Objective: To determine the evolution of the pre- and post-surgical nutritional status and feeding practices in infants between 6 and 24 months of age, with cleft lip and/or palate who attended the "Operation Smile" Foundation Clinic from September 2020 to May 2021. Materials and methods: This was an observational and prospective study with an analytical component. 50 children with a diagnosis of CLP from 6 to 24 months of age were included. Nutritional status was evaluated according to National Health Ministry standards. Results: 50 infants from 6 to 24 months were evaluated, 60% were between 6 -11 months, 64% were males, 54% came from the rural areas. 86% underwent primary lip closure and 12% cleft palate reconstruction. 88% of the children were breastfed. The pre-surgical nutritional status was adequate (94%) by weight for age indicator. Post surgery there was a significant difference of 0.927 kg for weight for height (p < 0.001), the same for weight for age (p < 0.001). For height for age, a difference of 0.8 cm was found (p=ns). Conclusions: The nutritional status of children with cleft lip or palate improves 4 months after reconstructive surgery for the indicators weight for age and weight for height.
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Introducción: La desnutrición es una condición frecuente en pacientes oncológicos y puede estar presente en un 40-80% de éstos. En cirugía gastrointestinal, es ampliamente conocida la relación entre la desnutrición preoperatoria y las complicaciones. El objetivo de este estudio es conocer la asociación entre el estado nutricional preoperatorio según el índice de masa corporal (IMC), la valoración global subjetiva (VGS) y la frecuencia de complicaciones postoperatorias en pacientes sometidos a cirugía oncodigestiva electiva. Metodología: Estudio observacional de cohorte retrospectiva. Se incluyeron pacientes sometidos a cirugía digestiva entre abril de 2019 y abril de 2020. Se excluyeron aquellos pacientes con enfermedad fuera de alcance terapéutico curativo. Los pacientes fueron categorizados según el tipo de cáncer, la cirugía realizada, el tratamiento neoadyuvante, los parámetros nutricionales (IMC y VGS) y la albumina preoperatoria. Se registraron las complicaciones postoperatorias de acuerdo con la clasificación de Clavien-Dindo (III-V). Resultados: Se incluyeron 201 pacientes sometidos a cirugía digestiva. El 83,6% calificó en la categoría B o C según VGS. Diecinueve pacientes (9,5%) presentaron complicaciones postoperatorias. Tener una VGS de categoría C se asoció con un mayor riesgo de complicaciones postoperatorias. Otras variables significativas para desarrollar complicaciones fueron recibir tratamiento neoadyuvante combinado (QT + RT) y ser intervenido por una cirugía de alto riesgo nutricional. Conclusión: Tener un estado nutricional deteriorado previo a una cirugía oncológica según VGS, someterse a una cirugía de alto riesgo nutricional y/o someterse a un tratamiento neoadyuvante combinado presentan un mayor riesgo de desarrollar complicaciones postoperatorias. Se destaca la importancia de incorporar protocolos de evaluación y soporte nutricional como parte del tratamiento multimodal impartido desde el diagnóstico oncológico.
Introduction: Malnutrition is a frequent condition in cancer patients and may be present in 40-80% of them. In gastrointestinal surgery, the relationship between preoperative malnutrition and complications has been widely studied, due to the increased risk of postoperative complications. The aim of this study is to determine the association between preoperative nutritional status, according to body mass index (BMI), subjective global assessment (SGA) and the frequency of postoperative complications in patients undergoing elective oncological digestive surgery. Methodology: Observational retrospective cohort study. Patients undergoing elective surgery between April 2019 and April 2020 were included. Patients with disease outside the curative therapeutic scope were excluded. Patients were categorized by type of cancer, surgery performed, neoadjuvant treatment, nutritional parameters (BMI and SGA) and albumin prior to surgery. Postoperative complications were recorded according to the Clavien-Dindo classification (III-V). Results: A total of 201 patients undergoing digestive surgery were included. 83.6% qualified in category B or C according to VGS. Nineteen patients (9.5%) presented postoperative complications. Having a SGA category C is associated with a higher risk of postoperative complications. Other significant variables for developing complications were receiving combined neoadjuvant treatment (CT + RT) and undergoing high nutritional risk surgery. Conclusion: Having a deteriorated nutritional status prior to oncological surgery according to SGA, undergoing high nutritional risk surgery, and/or undergoing combined neoadjuvant treatment significantly increases the risk of developing postoperative complications. The importance of incorporating nutritional assessment and support protocols as part of the multimodal treatment given to the patient from the moment of cancer diagnosis stands out.
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Objetivo: Objetiva-se avaliar a relação entre consumo de proteínas (CP), atividade física (AF) e massa muscular (MM) em indivíduos com 60 anos ou mais de idade. Metodologia: Trata-se de um estudo prospectivo a partir da linha de base e segunda onda do estudo ELSA-Brasil. O CP foi avaliado por meio de um questionário de frequência alimentar semiquantitativo (QFA). A AF foi mensurada pelo International Physical Activity Questionnaire (IPAQ). A MM foi estimada por meio de equação de predição, e calculada a diferença de MM entre a 2a e a 1a onda. Análises bivariadas foram realizadas adotando o valor de p < 0,05. Para as análises multivariadas, utilizou-se a regressão de Poisson, com quatro modelos distintos, que incluíram as covariáveis com valor de p < 0,20. Utilizou-se o pacote estatístico SPSS versão 21. Resultados: A amostra foi constituída de 2216 idosos, sendo 55,10% de mulheres, com média de idade de 65,20 ± 4,15. Indivíduos com redução de MM entre as duas ondas estão situados no primeiro quartil de consumo de proteína. Além disso, a média de AF mostrou diferença significativa entre os grupos e a AF no lazer apenas para as mulheres (p < 0,05). Após ajuste por variáveis sociodemográficas, de saúde e hábitos de vida, indivíduos com menor consumo de proteínas apresentaram risco de 1,45 (1,29 1,63) de apresentar MM diminuída. Conclusões: O menor CP e AF forte estão associados à MM diminuída, e aqueles com menor CP no primeiro e segundo quartis apresentam maior risco de possuir MM diminuída. (AU)
Objective: The objective was to evaluate the relationship between protein consumption, physical activity, and muscle mass in individuals aged ≥ 60 years. Methods: This prospective study was based on the baseline and second wave of the ELSA Brazil study. Protein consumption was assessed using a semiquantitative food frequency questionnaire. Physical activity was measured using the International Physical Activity Questionnaire. Muscle mass was estimated using a prediction equation, and the difference in MM between the first and second waves was calculated. Bivariate analyses were performed, with p < 0.05 considered significant. Multivariate analysis consisted of 4 Poisson regression models including covariates with p < 0.20. The statistical analysis was performed in IBM SPSS Statistics 21. Results: The sample included 2216 older adults, 55.10% of whom were women, with a mean age of 65.20 (SD, 4.15). Participants whose muscle mass decreased between the waves were in the first quartile of protein consumption. Mean physical activity significantly differed between the groups, while leisure-time physical activity differed only for women (p < 0.05). After adjusting for sociodemographic, health, and lifestyle variables, participants with lower protein intake had a 1.45 (1.291.63) relative risk of muscle mass loss. Conclusions: Lower protein consumption and higher physical activity were associated with decreased muscle mass, and those with protein consumption in the first and second quartiles are at higher risk of muscle mass loss. (AU)