ABSTRACT
Background: Community-based management of acute malnutrition (CMAM) program has saved millions of children with severe acute malnutrition (SAM) globally. World Health Organization recommended discharge indices include Midupper arm circumference (MUAC) =12.5cm, =15-20% weight gain and weight-for-height Z score (WHZ) =-2. We compared MUAC with WHZ and percentage weight gain as discharge criteria from CMAM. Methods: It was a community based cohort study of children aged 6-59 months with SAM discharged from CMAM clinics in Jigawa State, Nigeria. Socio-demographic data, nutrition history and anthropometry were recorded at enrolment and discharge. Results: Of a total of 405 children studied, 209(51.6%) were females and had a peak age group of 12-23months (43.7%, range 6-42 months). At discharge, 353(87.2%) had MUAC = 12.5cm while 231(57.0%) and 204(50.4%) had percentage weight-gain =15% and WHZ=-2 respectively. There was weak agreement between MUAC and WHZ (agreement 50.8%, ê=0.012) and MUAC and percent weight-gain (agreement 54.8%, ê=-0.004). Children aged between 11-23 months (OR 2.12, p=0.006) and 24-35 months (OR 2.60, p=0.002) had increased risk of discharge with inadequate percentage weight gain. WHZ <-3 at enrolment was associated with increased risk of discharge with WHZ <-3 (OR 3.21, p<0.001) and reduced risk of discharge with inadequate percentage weight gain (OR 0.45, p<0.001). Age sex, WHZ at enrollment were not associated with MUAC at discharge. Conclusion: The use of MUAC alone as discharge criterion allows a significant proportion of children still needing urgent care exiting CMAM clinic prematurely. Stratifying these criteria may lead to better recovery before discharge
Subject(s)
Child , Female , Malnutrition , Nigeria , Severe Acute MalnutritionABSTRACT
Rubella infections acquired postnatally are usually mild, but maternal infection during pregnancy is associated with considerable risk of intrauterine fetal infection with multi-system damage.Detection of anti-rubella IgM specific antibodies among pregnant and childbearing women in Baquba city and to explore the effects of certain demographic factors. The present study was conducted in Baquba-Diyala province during the period from April/2007 to September/2008. Ninety pregnant women were chosen from those attending the primary health care centers in Baquba. They include 30 [33.3%] pregnant women who had previous abortions with a mean age 27.2 +/- 5.3 years, and 60 [66, 7%] pregnant women without previous abortion with mean age 23.7+/- 5.1 years. Additionally, 94 non-pregnant childbearing women were enrolled as a control group. Of those, 37[39.4%] had previous abortions with mean age 33.5 +/- 7.8 years, and 57 [60.6%] without abortion, the mean age was 30.7+/-7.8 years. Certain demographic factors were collected by personal interview. Anti-rubella IgM specific antibody was detected by enzyme-linked immunosorbant assay [ELISA]. Data were statistically analyzed using SPSS computer assisted processing. P value of < 0.05 was considered significant. The results revealed that 3[5%] of pregnant women without previous abortion and 8[26.7%] of pregnant women who had previous abortions were seropositive for anti-rubella IgM antibody. The difference between the two groups was statistically significant [p= 0.003].Whereas, the IgM seropositivity was insignificantly higher in childbearing women without previous abortion compared to childbearing women who had previous abortions [4.6% vs 16.2%], [p=0.33]. Furthermore, the IgM seropositivity among childbearing women without previous abortion was significantly higher compared to pregnant women without previous abortion [24.6% vs 5%], [p=0.003].The presence of life births, time of gestation, and the levels of education significantly affect the seropositivity rate of IgM. Prenatal screening for anti-rubella IgM antibody is an important tool to identify active infection and to provide obstetric management to avoid the risk of congenital rubella syndrome
ABSTRACT
To report our experience of varied presentations and diverse histopathological spectrum of parotid gland malignancies. This retrospective analysis incorporated patients with histological evidence of malignant parotid tumors at King Khalid University Hospital, Riyadh, Saudi Arabia over a 20-year period from 1984 through 2004. The medical records of these patients were analyzed for their demographic characteristics, clinical features, operations performed, and pathological diversity. Thirty-two patients comprised this study group. There is a male preponderance over females with a ratio of 2.2:1 22 men and 10 women and mean age of 51.8 range 28-81 years. A painless lump was the most frequent clinical manifestation observed in 23 71.8% patients followed by facial nerve dysfunction in 14 43.7% patients. Parotidectomy was performed in 22 68.7% patients: 16 superficial and 6 total. A partial facial nerve sacrifice was undertaken in 14 43.7%, and total nerve sacrifice in 9 28.1% patients. Four 12.5% patients presented with cervical lymph node metastases necessitating radical neck dissection. Nine 28.1% patients had mucoepidermoid carcinoma, 8 25% adenoid cystic carcinoma, 6 18.7% adenocarcinoma, not otherwise specified, and 2 6.2% were reported to have carcinoma in pleomorphic adenoma. Twenty 62.5% specimens revealed high-grade aggressive lesions, and out of these, 19 59.3% patients presented with stage III/IV disease. Malignant parotid tumors are exceedingly rare, occurring at a relatively earlier age group with male preponderance, and invariably declare at a late clinical stage in our community. Histopathological features hallmark a locally advanced disease with an aggressive behavior