Methods: This study included 224 mothers of under-five children living in urban slums of Udupi Taluk, Karnataka. A total of 17 urban slums were selected randomly using random cluster sampling.
Results: Undernutrition was high among children of illiterate mothers (63.8%), and the children of working mothers were affected by more morbidity (96.6%) as compared with housewives. Morbidity was also found to be high among children belonging to families with low incomes (66.1%) and low socio-economic backgrounds (93.1%). Safe drinking water, water supply, sanitation, hygiene, age of the child, mother's and father's education, mother's occupation and age, number of children in the family, use of mosquito nets, type of household, and family income were significantly associated with child morbidity, nutritional status, immunization status, and personal hygiene of under-five children living in urban slums.
Conclusion: Overall, in our study, family characteristics including parental education, occupation and income were significantly associated with outcomes among under-five children. The availability of safe drinking water and sanitation, and the use of mosquito nets to prevent vector-borne diseases are basic needs that need to be urgently met to improve child health.
Funding: Self-funded.
METHODS: This cross-sectional study recruited children below 18 years old admitting into general paediatric ward in a public hospital. The PNST and Subjective Global Nutritional Assessment (SGNA) were performed on 100 children (64 boys and 36 girls). The objective measurements include anthropometry (z-scores for weight, height and body mass index), dietary history and biochemical markers were measured. These were used to classify malnutrition as per Academy of Nutrition and Dietetics/American Society of Parental and Enteral Nutrition (AND/ASPEN) Consensus Statement for identification of paediatric malnutrition and WHO growth standards for children. Cohen's kappa was computed to report the level of agreement.
RESULTS: The PNST identified 57% of hospitalized children as being at risk of malnutrition. In this study, there was a stronger agreement between PNST with AND/ASPEN malnutrition classification (k = 0.602) as when PNST was compared with WHO (k = 0.225) and SGNA (k = 0.431). The PNST shows higher specificity (85.29%) and sensitivity (78.79%) when compared with AND/ASPEN than with WHO malnutrition criteria (55.81% specificity and 66.67% sensitivity).
CONCLUSION: This study showed the usefulness of routine use of PNST for screening the malnutrition risk of hospitalized children in Malaysian tertiary hospital settings.
METHODS: This is a prospective observational study involving patients from the orthopaedic oncology unit who were undergoing surgery. They were assessed with Patient Generated Subjective Global Assessment (PG-SGA), Malnutrition Screening Tool (MST) and 3-minute Nutritional Screening (3MinNS) questionnaires. Anthropometric data such as body mass index, mid upper arm circumference (MUAC) and blood parameters such as serum albumin, total lymphocyte count and haemoglobin were also investigated. Patients were then followed up for 3 months. Post-operative complications were divided into infectious and non-infectious groups. Length of stay and unplanned readmission were also documented.
RESULTS: Prevalence of malnutrition ranged from 13.3% to 45.8% under different nutritional assessment methods. Patients who were determined as malnourished were significantly associated with both infectious and non-infectious post-operative complications ( p < 0.001). PG-SGA and 3MinNS values were also significant in univariate and multivariate analysis, respectively. Low serum albumin (<35 g/L) was associated with post-operative infectious complications, especially surgical site infection ( p < 0.001), prolonged hospital stay ( p = 0.009) and unplanned readmission ( p = 0.017). 3MinNS and Charlson Comorbidity Index were predictive of non-infectious complications, whereas serum albumin and the presence of metastasis were predictive of infectious complications.
CONCLUSION: This pilot study of patients with soft tissue and bone sarcoma of upper and lower limbs showed that malnutrition is a significant independent factor related to infectious and non-infectious complications which leads to unplanned readmission and prolonged length of stay. Periodic screening using the PG-SGA or 3MinNS questionnaires, MUAC and evaluation of serum albumin levels is recommended during clinic session and pre-surgery assessment rounds to identify those predisposed to malnutrition and help in reducing incidence of post-operative complications.
RESULTS: Out of 339 participants, 24.8% (95% CI 20.21-29.30) fell into the normal nutritional status range; 49.6% (95% CI 44.29-54.91) were at risk for malnutrition while 24.8% (95% CI 20.21-29.30) were in the malnourished range, based on Mini Nutritional Assessment scores. Our findings revealed that belonging to a Dalit community, being unemployed, having experience of any form of mistreatment, lack of physical exercise, experiencing problems with concentration in past 30 days and taking medication for more than one co-morbidity was significantly associated with the malnutrition status of the elderly.
METHODS: A cross-sectional study was conducted among 134 geriatric patients with a mean age of 68.9 ± 8.4 who stayed at acute care wards in Hospital Tuanku Ampuan Rahimah, Klang from July 2017 to August 2017. The SGA, MNA, and GNRI were administered through face-to-face interviews with all the participants who gave their consent. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the GNRI and MNA were analyzed against the SGA. Receiver-operating characteristic (ROC) curve analysis was used to obtain the area under the curve (AUC) and suitable optimal cutoff values for both the GNRI and MNA.
RESULTS: According to the SGA, MNA, and GNRI, 26.9%, 42.5%, and 44.0% of the participants were malnourished, respectively. The sensitivity, specificity, PPV, and NPV for the GNRI were 0.622, 0.977, 0.982, and 0.558, respectively, while those for the MNA were 0.611, 0.909, 0.932, and 0.533, respectively. The AUC of the GNRI was comparable to that of the MNA (0.831 and 0.898, respectively). Moreover, the optimal malnutrition cutoff value for the GNRI was 94.95.
CONCLUSIONS: The prevalence of malnutrition remains high among hospitalized elderly patients. Validity of the GNRI is comparable to that of the MNA, and use of the GNRI to assess the nutritional status of this group is proposed with the new suggested cutoff value (GNRI ≤ 94.95), as it is simpler and more efficient. Underdiagnosis of malnutrition can be prevented, possibly reducing the prevalence of malnourished hospitalized elderly patients and improving the quality of the nutritional care process practiced in Malaysia.
METHODS: We performed a meta-analysis of PEW prevalence from contemporary studies including more than 50 subjects with kidney disease, published during 2000-2014 and reporting on PEW prevalence by subjective global assessment or malnutrition-inflammation score. Data were reviewed throughout different strata: (1) acute kidney injury (AKI), (2) pediatric chronic kidney disease (CKD), (3) nondialyzed CKD 3-5, (4) maintenance dialysis, and (5) subjects undergoing kidney transplantation (Tx). Sample size, period of publication, reporting quality, methods, dialysis technique, country, geographical region, and gross national income were a priori considered factors influencing between-study variability.
RESULTS: Two studies including 189 AKI patients reported a PEW prevalence of 60% and 82%. Five studies including 1776 patients with CKD stages 3-5 reported PEW prevalence ranging from 11% to 54%. Finally, 90 studies from 34 countries including 16,434 patients on maintenance dialysis were identified. The 25th-75th percentiles range in PEW prevalence among dialysis studies was 28-54%. Large variation in PEW prevalence across studies remained even when accounting for moderators. Mixed-effects meta-regression identified geographical region as the only significant moderator explaining 23% of the observed data heterogeneity. Finally, two studies including 1067 Tx patients reported a PEW prevalence of 28% and 52%, and no studies recruiting pediatric CKD patients were identified.
CONCLUSION: By providing evidence-based ranges of PEW prevalence, we conclude that PEW is a common phenomenon across the spectrum of AKI and CKD. This, together with the well-documented impact of PEW on patient outcomes, justifies the need for increased medical attention.
METHODS: A cross-sectional study was conducted in the Kandy district, Sri Lanka. The nutritional status of older persons was assessed using the Mini Nutritional Assessment -Short Form (MNA-SF). A standardised questionnaire was used to record factors associated with malnutrition: demographic characteristics, financial characteristics, food and appetite, lifestyle, psychological characteristics, physical characteristics, disease and care, oral health, and social factors. Complex sample multinomial logistic regression analysis was performed.
RESULTS: Among the 999 participants included in the study, 748 (69.3%) were females and 251 (25.1%) were males. The mean age was 70.80 years (95% CI: 70.13, 71.47). The prevalence of malnutrition, risk of malnutrition and well-nutrition was 12.5%, 52.4% and 35.1% respectively. In the multivariate model, hypertension (adjusted OR = 1.71; 95% CI: 1.02, 2.89), alcohol consumption (aOR = 4.06; 95% CI: 1.17, 14.07), and increased age (aOR = 1.06; 95% CI: 1.01, 1.11) were positively associated with malnutrition. An increased number of people living with the older person (aOR: 0.91; 95% CI: 0.85, 0.97) was a protective factor among those at risk for malnutrition.
CONCLUSION: Both the prevalence of malnutrition and risk of malnutrition were commonly observed among community-dwelling older persons in Sri Lanka. The associated factors identified in this study might help public health professionals to implement necessary interventions that improve the nutritional status of this population.
METHODS: MICOS is a prospective cohort study conducted at selected government health clinics in two states, namely Selangor and Wilayah Persekutuan Kuala Lumpur, Malaysia. Women in their third trimester of pregnancy are recruited into the study and their infants will be followed-up at 3, 6, and 12 months of age. Information on prenatal factors including socio-demographic characteristics, obstetric history, pre-pregnancy body mass index, gestational weight gain, smoking, family history of allergic diseases, maternal dietary intake and sunlight exposure during pregnancy are obtained through face-to-face interviews. Postnatal factors including dietary intake, sun exposure, and anthropometric measurements of the mothers, as well as feeding practices, dietary intake, anthropometric measurements, and development of allergic diseases of the infants are assessed at each follow-up. Blood samples are collected from the mothers in the third trimester to determine 25-hydroxyvitamin D levels as well as from the infants at age 12 months to determine atopic sensitisation.
DISCUSSION: The concept of developmental origins of health and disease (DOHaD) which emphasises on the role of early life environments in shaping future health and disease susceptibility in adulthood has gained a huge interest in recent years. The DOHaD paradigm has influenced many fields of research including malnutrition and allergic diseases. While findings from the developed countries remain controversial, such studies are scarce in developing countries including Malaysia. The present study will determine the cause and effect relationship between early nutrition and the development of malnutrition and allergic diseases in infants' first year of life.
METHODS: A cross-sectional study design was conducted in the Gaza Strip. A total of 357 children aged 2-5 years and their mothers aged 18-50 years were recruited. A multistage cluster sampling was used in the selection of the study participants from three geographical areas in the Gaza Strip: Jabalia refugee camp, El Remal urban area, and Al Qarara rural area. A structured questionnaire was used for face- to -face interviews with the respective child's mother to collect sociodemographic information and feeding practice. Anthropometric measurements for children were taken to classify height-for-age (HAZ), while maternal height was measured as well. Descriptive and binary logistic regression analyses were applied to determine the prevalence and associated factors with stunting.
RESULTS: The total prevalence of stunting in this study was 19.6%, with the highest prevalence being (22.6%) in Jabalia refugee camp. It turns out that shorter mothers had increased the odds of stunting in preschool children in the Gaza Strip. Children born to mothers whose height was 1.55-1.60 m or <1.55 m were more likely to be stunted (p = 0. 008), or (p 1.60 m. Moreover, parental consanguinity increased the risk of stunted children (p = 0. 015).
CONCLUSIONS: This study showed the prevalence of stunting was of alarming magnitude in the Gaza Strip. Our results also demonstrated that parental consanguinity and short maternal stature were associated with stunting. Culturally appropriate interventions and appropriate strategies should be implemented to discourage these types of marriages. Policy makers must also raise awareness of the importance of the prevention and control of nutritional problems to combat stunting among children in the Gaza Strip.
METHODS: In this cross-sectional, hospital-based study, anthropometric measurements [weight, length/height, mid-upper arm circumference (MUAC), triceps skinfold thickness were performed in 285 children aged from 3 months to 15 years who were admitted to University Malaya Medical Centre, Kuala Lumpur in November 2013. Acute (wasting) and chronic (stunting) undernutrition were defined as weight-for-height (WFH) and height-for-age (HFA) < -2 standard deviation (S.D.), respectively. Underweight was defined as weight-for-age < -2 S.D. For children aged between 1 and 5 years of age, World Health Organization definition for acute undernutrition (HFA
METHODS: Patients at a single academic institution who underwent bariatric surgery and developed neurologic complications secondary to low levels of vitamins B1, B2, B6, and B12 between the years 2004 and 2015 were studied.
RESULTS: In total, 47 (0.7%) bariatric surgical patients (Roux-en-Y gastric bypass n = 36, sleeve gastrectomy n = 9, and duodenal switch n = 2) developed neurologic manifestations secondary to vitamin B deficiencies. Eleven (23%) patients developed postoperative anatomical complications contributed to poor oral intake. Median duration to onset of neurologic manifestation following surgery was 12 months (IQR, 5-32). Vitamin deficiencies reported in the cohort included B1 (n = 30), B2 (n = 1), B6 (n = 12), and B12 (n = 12) deficiency. The most common manifestations were paresthesia (n = 31), muscle weakness (n = 15), abnormal gait (n = 11), and polyneuropathy (n = 7). Four patients were diagnosed with Wernicke-Korsakoff syndrome (WKS) which was developed after gastric bypass (n = 3) and sleeve gastrectomy (n = 1). Seven patients required readmission for management of severe vitamin B deficiencies. Overall, resolution of neurologic symptoms with nutritional interventions and pharmacotherapy was noted in 40 patients (85%). The WKS was not reversible, and all four patients had residual mild ataxia and nystagmus at the last follow-up time.
CONCLUSIONS: Nutritional neurologic disorders secondary to vitamin B deficiency are relatively uncommon after bariatric surgery. While neurologic disorders are reversible in most patients (85%) with vitamin replacements, persistent residual neurologic symptoms are common in patients with WKS.
METHODS: An exhaustive literature search was performed, in order to identify the relevant studies describing the epidemiology, pathogenesis, nutritional intervention and outcome of PEW in ESRD on hemodialysis.
RESULTS AND CONCLUSION: The pathogenesis of PEW is multifactorial. Loss of appetite, reduced intake of nutrients and altered lean body mass anabolism/catabolism play a key role. Nutritional approach to PEW should be based on a careful and periodic assessment of nutritional status and on timely dietary counseling. When protein and energy intakes are reduced, nutritional supplementation by means of specific oral formulations administered during the hemodialysis session may be the first-step intervention, and represents a valid nutritional approach to PEW prevention and treatment since it is easy, effective and safe. Omega-3 fatty acids and fibers, now included in commercially available preparations for renal patients, could lend relevant added value to macronutrient supplementation. When oral supplementation fails, intradialytic parenteral nutrition can be implemented in selected patients.
METHODS: Sociodemographic data, anthropometric measurements and 3 day dietary intake record were collected from 54 ADHD children and 54 typical development (TD) children. The Behavioral Pediatrics Feeding Assessment Scale was used to assess feeding problems.
RESULTS: Mean subject age was 8.6 ± 2.1 years. On anthropometric assessment, 11.1% of the ADHD children had wasting, while 1.9% had severe wasting. In contrast, none of the TD children had wasting. Approximately 5.6% of the ADHD children had stunting, as compared with 3.7% of the TD children, while none of the TD children had severe stunting compared with 3.7% of the ADHD children. More than half of the ADHD children had mid-upper arm circumference (MUAC) below the 5th percentile, indicating undernutrition, compared with only 35.2% of TD children. More than one-third of the ADHD children had feeding problems compared with 9.3% of TD children. There was a significant negative relationship between the ADHD children's feeding problems and bodyweight (r = -0338, P = 0.012), body mass index (r = -0322, P = 0.017) and MUAC (r = -0384, P = 0.004).
CONCLUSION: Almost half of the ADHD children had suboptimal nutrition compared with 11.1% of the TD children. It is imperative to screen ADHD children for nutritional status and feeding problems to prevent negative health impacts later on.
METHODS: A literature search was performed on six databases using the terms "malnutrition", "hospitalised elderly", "nutritional assessment", "Mini Nutritional Assessment (MNA)", "Geriatric Nutrition Risk Index (GNRI)", and "Subjective Global Assessment (SGA)".
RESULTS: According to the previous studies, the prevalence of malnutrition among hospitalized elderly shows an increasing trend not only locally but also across the world. Under-recognition of malnutrition causes the number of malnourished hospitalized elderly to remain high throughout the years. Thus, the development of nutritional screening and assessment tools has been widely studied, and these tools are readily available nowadays. SGA, MNA, and GNRI are the nutritional assessment tools developed specifically for the elderly and are well validated in most countries. However, to date, there is no single tool that can be considered as the universal gold standard for the diagnosis of nutritional status in hospitalized patients.
CONCLUSION: It is important to identify which nutritional assessment tool is suitable to be used in this group to ensure that a structured assessment and documentation of nutritional status can be established. An early and accurate identification of the appropriate treatment of malnutrition can be done as soon as possible, and thus, the malnutrition rate among this group can be minimized in the future.
OBJECTIVES: This study aims to determine the prevalence of the dual form of malnutrition (overweight mother/underweight child) in the same household and its associated factors in the Gaza Strip.
METHODS: A total of 357 mother-child pairs from the same households were surveyed from three different geographical locations in the Gaza Strip, namely, El Remal urban area, Jabalia refugee camp, and Al Qarara rural area. The height and weight of mothers aged 18-50 years were measured, and their body mass index (BMI) was computed. The mothers were categorized according to the criterion of the World Health Organization (WHO) for BMI as overweight if they have a BMI ≥ 25 kg/m2. Anthropometric indices were measured for children aged two to five years to classify the underweight children Z-score