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Background@#Maternal malnutrition is a major cause of low birth weight (LBW) newborn outcome especially among adolescent mothers. It is one of the key drivers of child stunting and initiates the vicious cycle of intergenerational malnutrition. The body mass index prior to pregnancy or at the initial trimester is currently being used to establish the desired weight gain throughout pregnancy. However, Filipino adolescents often delay their first antenatal visit at a later stage of pregnancy. Without a baseline weight, the establishment of appropriate weight gain and nutritional status is often challenging. Mid-upper arm circumference (MUAC) was proven to be a good proxy measure of acute malnutrition, however, there was no global consensus on what MUAC cut-off point to use to identify pregnant adolescents at risk for delivering LBW babies. Finding the optimal cut-off could facilitate early identification and intervention of pregnant adolescents who are nutritionally at risk and could eventually break the cycle of intergenerational malnutrition.@*Objectives@#The study aims to determine the association of maternal MUAC and the birth weight outcomes among newborn deliveries of adolescents in a tertiary hospital for a period of six months and to identify the optimal maternal MUAC cut-off point that can be used to predict low birth weight outcome among newborn deliveries of adolescents in a tertiary hospital. Methods. A cross-sectional study was conducted among adolescents ages 10 to 19 years who delivered babies in a tertiary hospital in the Philippines for a period of six months. Maternal MUAC and LBW outcome were documented, and their association was determined using a logistic regression analysis. To measure diagnostic accuracy, the sensitivity, specificity, and the area under the curve were taken for each MUAC point. A receiver operating characteristic (ROC) curve was used to aid the MUAC cut-off determination.@*Results@#Out of 237 newborn deliveries, 35% were noted with low birth weight while 65% had normal birth weight. Most of the mothers were in their late adolescence at 78%. The crude association for the MUAC cut-offs ≤23.00 cm, ≤23.50 cm, and ≤24.00 cm and LBW showed a significant value of 2.19, 2.25, and 2.39 at 95% CI, respectively. However, it is only the cut-off ≤24.00 cm that showed significant results for adjusted association by the logistic regression analysis. The MUAC cut-off ≤24.00 cm also showed a better trade-off value between the sensitivity and specificity. Furthermore, the optimal maternal MUAC measurement that predicts LBW newborn outcome points to ≤24.00 cm cut-off based on the ROC curve.@*Conclusion@#This study shows that the maternal MUAC is predictive of LBW outcome among adolescent deliveries.A MUAC cut-off of ≤24.00 cm was superior to lower cut-offs studied. The pregnant adolescents might need a higher MUAC cut-off than adults to allow timely intervention and prevention of poor neonatal outcomes. By doing this simple screening test, suspected pregnant adolescents can be easily identified and referred for further confirmatory testing.
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Pregnancy in AdolescenceABSTRACT
Introduction: In elderly persons, due to physiological, anatomical, and functional changes, body mass index (BMI) may not be suitable for the assessment of nutritional status. Mid-upper arm circumference (MUAC) can be a proxy indicator to identify underweight and overweight/obesity among elderly persons. This study aimed to estimate the correlation between MUAC and BMI, and the cutoffs for MUAC using receiver operating characteristic (ROC) analysis. Material and Methods: This survey was carried out in a resettlement colony of Delhi. The participants were residents of the area who were aged 60 years or older, and selected by a simple random sampling technique. The arm span, weight, and MUAC of the participants were measured. The correlation between MUAC and BMI for gender and age group was calculated. The ROC curve was also constructed. Results: A total of 946 eligible participants were enrolled. The correlation between MUAC and BMI was 0.67 (P < 0.001) and 0.76 (P < 0.001) among men and women, respectively. The MUAC cutoff for underweight was <25 cm with a sensitivity of 68.8% and specificity of 84.9%. The area under the curve (AUC) was 0.84 (0.80–0.88). The MUAC cutoff for overweight/obesity was ?27 cm with a sensitivity of 83.9% and specificity of 64.9%, and AUC was 0.78 (0.75–0.82). Conclusion: The MUAC of the participants increased as the BMI of the participants increased. MUAC cutoff was determined using the ROC curve for underweight and overweight/obesity among elderly persons.
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Objective@#To examine the application of arm circumference to evaluating the nutritional risk among cancer patients, so as to provide insights into nutritional risk screening among cancer patients.@*Methods@#Totally 332 cancer patients hospitalized in the Department of Oncology of The First Affiliated Hospital of Guangxi Medical University from September 2020 to March 2021 were selected as the study subjects. Subjects'demographic data and disease history were collected, and the height, body weight, arm circumference and serum nutritional indicators were measured. The indicators related to nutritional risk were identified by logistic regression models. The value of arm circumference in assessment of nutritional risk was examined among cancer patients using the receiver operating characteristic ( ROC ) curve analysis, and the Nutritional Risk Screening ( NRS 2002 ) scores were used as the gold standard.@*Results@#The subjects included 188 males ( 56.63% ) and 144 females ( 43.37% ), and had a mean age of ( 51.62±12.31 ) years. The detection rate of nutritional risk was 36.75% among the subjects according to NRS 2002, with 29.78% in males and 45.83% in females. Multivariable logistic regression analysis identified arm circumference as an independent factor affecting the nutritional risk among cancer patients ( P<0.05 ). The area under the ROC curve, cut-off, sensitivity and specificity of arm circumference in predicting nutritional risk were 0.857 ( 95%CI: 0.795-0.918, P<0.001 ), 24.4 cm, 83.3% and 78.6% among male cancer patients, and 0.727 ( 95%CI: 0.643-0.810, P<0.001 ), 23.9 cm, 78.2% and 57.6% among female cancer patients, respectively.@*Conclusions@#Arm circumference is feasible for screening nutritional risk among cancer patients. The cut-off value of nutritional risk was determined by arm circumference less than 24.4 cm in men and less than 23.9 cm in women with good accuracy.
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Objective:To explore the correlation of upper arm circumference and calf circumference with muscle mass, and the screening effect and the cut-off values for low muscle mass and sarcopenia. Methods:From March to August, 2020, a total of 831 community-dwelling old people (≥ 60 years old) were recruited by using convenience sampling. Muscle mass and other body composition indicators were tested by body composition tester. The upper arm circumference, calf circumference, grip strength and gait speed were measured at the same day. Pearson cofficient was used to analyze the correlation of upper arm circumference and calf circumference with muscle mass, and receiver operation characteristic (ROC) curve was used to analyze the diagnostic effect of upper arm circumference and calf circumference on low muscle mass and sarcopenia, and the Youden index (YI) was used to determine the cut-off values. Results:Upper arm circumference and calf circumference were positively correlated with appendicular skeletal muscle mass (ASM) and skeletal mass index (SMI) (r = 0.6 to 0.8, P < 0.001). For diagnosing low muscle mass, the areas under the ROC curve (AUC) of upper arm circumference were 0.888 for male, 0.787 for female; and that of calf circumference were 0.933 for male, 0.854 for female, respectively. The cut-off values of upper arm circumference for low muscle mass were 26 cm for both male and female; and that of calf circumference were 34 cm for male and 33 cm for female, respectively. For diagnosing sarcopenia, the AUC of upper arm circumference was 0.902 for male, 0.744 for female; and that of calf circumference was 0.923 for male, 0.832 for female, respectively. The cut-off values of upper arm circumference and calf circumference for sarcopenia were 26 cm and 33 cm for both male and female. The AUC of combined diagnosis with age, upper arm circumference, calf circumference, grip strength and gait speed for low muscle mass and sarcopenia in males and females was all greater than 0.85. Conclusion:In the community old adults, upper arm circumference and calf circumference are positively correlated with muscle mass, and both indices can be used to diagnose low muscle mass and sarcopenia. multi-indices combination can improve the diagnosis effect of upper arm circumference in females.
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Background: Recording an accurate birth weight by primary health worker has been a problem in rural areas, leading to search for an alternative, inexpensive, age independent and noninvasive method to predict newborn birth weight and wellbeing. With this background I aimed to found out whether the neonatal-MUAC is associated with birth weight or not?Methods: This hospital based prospective observational study was conducted in SNCU and postnatal ward, Kamla Raja Hospital, G.R. Medical College, and Gwalior (M.P). A total of 1303 newborns were included in the study. The Mid upper arm circumference (MUAC) of newborns were taken and Birth weight recorded were filled in a proforma.Results: Total 1303 neonates were evaluated. The mean MUAC and birth weight in preterm was found to be 1854.80'387.3 and 7.47'0.9 as compared to full term newborn having mean birth weight(2818.95'328.1) and mean MUAC (9.58+0.7).The Pearson coefficient of correlation between neonatal MUAC (N-MUAC) and birth weight was found to be r= 0.987 and p<0.01. Birth weight can be predicted from regression equation: Birth weight (gms)=422.99 (N-MUAC) + (-1272.66). Cut-off value of neonatal mid upper arm circumference (N-MUAC) was found to be 8.85cm to predict low birth weight newborn.Conclusions: Birth weight of newborn can be predicted from neonatal mid upper arm circumference (N-MUAC) in areas where the conventional scale are not easily available for measuring the birth weight of newborn.
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Background: Moderate Acute Malnutrition (MAM) is defined as Weight for Height between -2SD to -3SD, and/or Mid Upper Arm Circumference (MUAC) 11.5 cm to 12.5 cm. Effect of not treating MAM has a significant impact on Severe Acute Malnutrition (SAM) burden. Management of MAM is possible through supplementary feeding or Community centre counselling.Methods: Present study was a prospective case control study done in 2013-14 in 200 children in adjacent communities. Community in which intervention (dietary counselling) was planned, it was labelled as case group. For dietary counselling 'structured group counselling' method was selected in which at a time parents of six MAM children were involved. Counselling was done by a trained counsellor using all techniques proposed by IYCF. Counselling sessions were scheduled at 0, 1, 3 and 6 months.Results: 60% children of case group moved to improved or well- nourished nutritional status (p-value 0.00001). Amongst improved group, weight for height improvement is statistically significant (p-value 0.001), average weight attained is 2-3 kg in 6 months with average weight gain of 1.5-3 grams/kg/day. MUAC improvement was also found to be statistically significant (p-value 0.003), there was 47% improvement in case group with average MUAC gain is 0.6 cm to 1 cm in 6 months (0.13 cm/month). Also, there is early rise in weight for height then MUAC. Average duration to achieve target weight for height is 4.3 months in case group as compare to 5.3 months in control group.Conclusions: Structured and integrated group counselling using all counselling skills by a trained counsellor should be an integral part of managing MAM in community. Weight for height should be primary indicator in early phase of response as compare to MUAC in measuring impact of counselling.
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BACKGROUND :Leukemia is the most common malignancy, with incidence of 3.7 – 4.9 case per 100.000 children and the majority are children 2 to 5 years old. There are various nutritional status and one of them depend on the measurement method. In a case presence with organomegali, mass, and ascites, the past way to measure the nutritional status is by measuring the mid-arm muscle area (MAMA) and upper arm circumference (UAC)OBJECTIVE :to assess sensitivity of MAMA and UAC to determine the nutritional status in patient with ALL induction phaseMETHODS :Cross sectional study on 35 patient with ALL that had induction phase chemotherapy. Sample were taken with consecutive sampling, and MAMA and UAC were measured. ROC analysis was performed to obtain the cut off point. Bivariate analysis was performed with chi-squareRESULT:From 35 sample that meet the inclusion and exclusion criteria, there were 20 patient with severe malnutrition by measuring the MAMA and the other 15 patient by measuring the UAC. We found the AUC values MAMA is 70%, the cut off point is 1033,07 mm2 and AUC values UAC is 87,8% with cut-off point 152,5mm by using ROC analysis.CONCLUSION :The sensitivity value of the measurement of the MAMA 47% and UAC 80% with specicity value MAMA 70% and UAC 85%. and the sensitivity value UAC 80% and specicity 85%. From result measuring MAMA not more sensitive to assess the nutritional status of ALL patients in the induction phase
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Background: The incidence of low birth weight babies continues to be high in India at about 30% in contrast to 5-7% in developed countries. Perinatal, neonatal and infant mortality as well as morbidity is associated with low birth weight (LBW) neonates of which, it is the Small for Gestational Age (SGA) neonates that are at increased risk. Henceforth, it becomes important to study the prevalence of SGA babies and to compare various anthropometric measurements among term neonates for assessing as to which of these could be taken as surrogate markers of small for gestational age babies.Methods: It was a cross sectional study conducted over a period of 2 years among 100 term neonates delivered in a private medical college in Puducherry, India.Results: The prevalence of low birth weight babies and small for gestational age was found to be 40% and 30% respectively. Using mid arm circumference as a predictor, the sensitivity, specificity, positive predictive value and negative predictive value of SGA was found to be 100%, 57.14%, 50% and 100% respectively. Using MAC/HC ratio as a predictor, the sensitivity, specificity, positive predictive value and negative predictive value was found to be 46.67%, 100%, 100% and 81.4% respectively.Conclusions: In predicting SGA babies, mid arm circumference has the highest sensitivity whereas MAC/HC ratio has the highest specificity followed by mid arm circumference. Present study concluded that mid arm circumference and ratio of MAC/HC are very helpful in identifying SGA neonates among term neonates.
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Background: In clinical settings, wasting in childhood has primarily been assessed with the use of a weight-for-height z score (WHZ), and in community settings, it has been assessed via the mid upper arm circumference (MUAC) with a cutoff <115mm for severe wasting and 115-125mm for moderate wasting. Our recent experience indicates that many wasted children were not identified when these cutoffs for MUAC were used.Methods: Authors determined the cutoffs for MUAC to detect wasting in Indian children aged 6-60 mo. A secondary analysis was carried out on data from 1446 children aged 6-59 mo. The area under the receiver operating curve was used to indicate the most appropriate choice for cutoffs that related MUAC with WHZ. The MUAC measurement of each subject was taken using standard technique. Following the World Health Organization (WHO) age and sex-specific cut-off points, nutritional status of children was determined.Results: The mean'SD age for the entire group was 19.8'13.6 mo, MUAC was 132'13mm, and 45% of subjects were girls. Age-stratified analyses revealed that, for ages 6-24 mo, MUAC cutoffs were <120mm for a WHZ <-3 and <125mm for a WHZ <-2 with a sensitivity of 68.3% and 64.7%, respectively, and a specificity of 82.6% and 83.4%, respectively; for ages 25-60 mo, MUAC cutoffs were <135mm for a WHZ <-3 and <140mm for a WHZ <-2 with a sensitivity of 63.7% and 65.4%, respectively, and a specificity of 81.6% and 78.3%, respectively.Conclusions: The respective cutoffs for MUAC to better capture the vulnerability and risk of severe (WHZ <-3) and moderate (WHZ <-2) wasting would be <120 and <125mm for ages 6-24 mo, <135 and <140mm for ages 37-60 mo.
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Objective:To compare arm circumference (AC) and upper limb volume (ULV) in assessment of breast cancer related lymphedema (BCRL). Methods:From November, 2013 to February, 2015, 281 women with one-sided breast cancer accepting radiotherapy were consecutively enrolled. AC was measured as the means of circumference 10 cm above and 5 cm below the most eminent midpoint of olecranon. ULV was measured as the water displacement volume when the water surface reached at 15 cm above the midpoint of olecranon. Univariate and multivariable linear regressions were used between AC and ULV. Results:All the correlated coefficients between AC and In(ULV) were above 0.959 (P < 0.001). For linear equations, the R2 > 0.90. The consistency of diagnoses of BCRL with AC and ULV were above 90% (Kappa > 0.492, P < 0.001). Conclusions:AC and ULV are consistent in measurement of BCRL. AC is reliable and easier.
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Objective·To investigate the association between mid-upper arm circumference (MUAC) and non-alcoholic fatty liver disease (NAFLD) or insulin resistance in middle-aged and elderly Chinese community population. Methods·A cross-sectional study was conducted in 6570 residents aged 40 years or older in Jiading District of Shanghai in 2014. All participants received standard questionnaire, anthropometric measurements, biochemical evaluation and ultrasonic examination. NAFLD was defined by hepatic ultrasonography, after excluding subjects with excess alcohol consumption and medical history of liver diseases. Participants were divided into 4 groups according to the quartiles of MUAC, then association between MUAC and NAFLD or insulin resistance was analyzed. Results·With the increase of MUAC level, body mass index (BMI), waist circumference, systolic blood pressure, diastolic blood pressure, triacylglycerol, fasting insulin, HOMA-IR levels, low-density lipoprotein-cholesterol, alanine aminotransferase,γ-glutamyl transpeptidase, and aspartic transaminase levels were increased significantly (all P<0.01), as well as the prevalence of NAFLD, hypertension,dyslipidemia, and insulin resistance (all P<0.01). A fully adjusted multivariate Logistic regression analysis revealed that with the increase of MUAC level, the risk of having NAFLD and insulin resistance were increased among women. However, among men, there was no correlation between MUAC and NAFLD or insulin resistance. Conclusion·MUAC is significantly associated with NAFLD and insulin resistance in middle-aged and elderly female Chinese community population.
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Objective·To investigate the association between mid-upper arm circumference (MUAC) and non-alcoholic fatty liver disease (NAFLD) or insulin resistance in middle-aged and elderly Chinese community population. Methods·A cross-sectional study was conducted in 6570 residents aged 40 years or older in Jiading District of Shanghai in 2014. All participants received standard questionnaire, anthropometric measurements, biochemical evaluation and ultrasonic examination. NAFLD was defined by hepatic ultrasonography, after excluding subjects with excess alcohol consumption and medical history of liver diseases. Participants were divided into 4 groups according to the quartiles of MUAC, then association between MUAC and NAFLD or insulin resistance was analyzed. Results·With the increase of MUAC level, body mass index (BMI), waist circumference, systolic blood pressure, diastolic blood pressure, triacylglycerol, fasting insulin, HOMA-IR levels, low-density lipoprotein-cholesterol, alanine aminotransferase,γ-glutamyl transpeptidase, and aspartic transaminase levels were increased significantly (all P<0.01), as well as the prevalence of NAFLD, hypertension,dyslipidemia, and insulin resistance (all P<0.01). A fully adjusted multivariate Logistic regression analysis revealed that with the increase of MUAC level, the risk of having NAFLD and insulin resistance were increased among women. However, among men, there was no correlation between MUAC and NAFLD or insulin resistance. Conclusion·MUAC is significantly associated with NAFLD and insulin resistance in middle-aged and elderly female Chinese community population.
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The purpose of this study was to compare the dietary status of elderly people according to the degree of obesity and mid-arm circumference in order to provide individualized and efficient nutrition management according to the physical condition of the elderly. Among the total 328 subjects, 72.2% were female, and the mean age and body mass index of the subjects were 76.5 years and 23.4 kg/m₂, respectively. The distribution of obesity degree was 47.9% for the normal group, 23.5% for the overweight group, and 28.7% for the obesity group. The distribution of mid-arm circumference was 18.0% for the under-21 cm group, 37.2% for the 21~22 cm group, and 44.8% for the over-22 cm group. About 82.9% of the subjects were consumed at least three meals a day, and 67.8% of the subjects regularly ate alone. The responses for meal time, regular meal, and meal reduction for 3 months were highest in the 10~20 min. (43.4%), yes (79.3%), and no (58.5%) group, respectively. The responses for eating alone were significantly highest in the overweight group (97.4%), followed by the normal group and obesity group according to the degree of obesity (P<0.05). There were no significant differences in preference for five flavors according to the degree of obesity and mid-arm circumference. Among the dietary habits, 31.1% of all subjects ate milk and dairy products more than once a day, and the response for eating vegetables and fruits more than three times a day was highest in the over-22 cm group (61.9%) while the drinking rate was highest in the under-21 cm group (27.1%; P<0.05). In conclusion, the degree of obesity was related to eating ability, and mid-arm the circumference was related with fruit and vegetable consumption and drinking rate.
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Aged , Female , Humans , Body Mass Index , Dairy Products , Diet , Drinking , Eating , Feeding Behavior , Fruit , Meals , Milk , Obesity , Overweight , VegetablesABSTRACT
Objetivo: analisar as associações entre a pressão arterial, a medida da circunferência braquial e a circunferência abdominal em pessoas com Hipertensão Arterial Sistêmica (HAS). Método: estudo descritivo, transversal, de abordagem quantitativa realizado com 397 pessoas de Estratégia de Saúde da Família de Minas Gerais. Dados coletados em 2013 e 2014 em visita domiciliária com instrumentos validados, obtendo-se, inclusive, medidas antropométricas e de pressão arterial (PA). Aplicados os testes quiquadrado e exato Fisher. Projeto aprovado pelo Comitê de Ética. Resultados: em 41,1% dos participantes com circunferência braquial igual ou superior a 27cm, os valores da PA encontravam-se iguais ou superiores a 140/90 mmHg e em 38,6% daqueles com circunferência abdominal com risco aumentado e muito aumentado, a PA encontrava-se igual ou superior a 140/90 mmHg. Conclusão: embora as associações não tenham significância estatística, devem constituir critérios importantes para avaliação não apenas da HAS, mas como fatores de risco para outras condições cardiovasculares.
Objective: to analyze the associations between blood pressure, and mid-upper arm and waist circumferences in adults with systemic arterial hypertension (SAH). Method: this quantitative, descriptive, cross-sectional study examined 397 individuals in the Family Health Strategy in Minas Gerais. Data was collected using validated instruments during home visits in 2013 and 2014, when anthropometric and blood pressure measurements were taken. Chi-square and Fisher's exact tests were applied. Results: 41.1% of participants with mid-upper arm circumference equal to or greater than 27 cm had blood pressure values equal to or greater than 140/90 mmHg, and 38.6% of those with increased-risk or much-increased-risk waist circumference had blood pressure equal to or greater than 140/90 mmHg. Conclusion: although the associations showed no statistical significance, they do constitute important criteria for assessing not only SAH, but also risk factors for other cardiovascular conditions.
Objetivo: analizar las asociaciones entre la presión arterial, la medición de la circunferencia braquial y la circunferencia abdominal en adultos con hipertensión arterial sistémica. Método: estudio descriptivo, transversal, con enfoque cuantitativo, realizado junto a 397 personas de la Estrategia de salud de la familia de Minas Gerais. Datos recolectados en 2013 y 2014 en visita a domicilio con instrumentos validados, obteniéndose, incluso, mediciones antropométricas y de presión arterial. Se han aplicado las pruebas de Chi cuadrado y exacto Fisher. Proyecto aprobado por el Comité de Ética. Resultados: en un 41.1% de los participantes con circunferencia braquial igual o superior a 27 cm, los valores de la presión arterial fueron iguales o superiores a 140/90mmHg y en 38.6% de aquéllos con circunferencia abdominal con riesgo aumentado y muy aumentado, la presión arterial estaba igual o superior a 140/90mmHg.Conclusión: aunque las asociaciones no posean significancia estadística, deben constituir criterios importantes para evaluar no sólo la hipertensión arterial sistémica, sino también factores de riesgo para otras enfermedades cardiovasculares.
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Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Mid-Upper Arm Circumference , Abdominal Circumference , Arterial Pressure , Hypertension , Epidemiology, Descriptive , Cross-Sectional Studies , Noncommunicable Diseases , ObesityABSTRACT
Aim: To evaluate alternate anthropometric index for obesity in type 2 diabetes and metabolic syndrome. Study Design: This is a cross sectional study. Place and Duration of the Study: Department of Medicine, Kasturba medical college-hospital, Mangalore, Manipal university, between January 2012 - July 2015. Methodology: We recruited 207 type 2 diabetic and 101 metabolic syndrome subjects with their age and sex matched controls. Anthropometric parameters like BMI, Waist circumference and mid arm circumference (MAC) were measured. Biochemical details were collected from case record. Results: The mean differences in anthropometric and biochemical parameters were compared between cases and controls by independent T test. MAC was correlated with clinical parameters in control subjects by Karl pearson’s correlation and multiple linear regression analysis. There was significant difference in MAC between metS and their control subjects (31.35±4.21 vs 28.04±2.86, P<.001). There was significant positive linear correlation of MAC with BMI (P<.001), WC (P<.05), post prandial blood sugar (P<.05) and HbA1c (P<.05) in controls. Further multivariate analysis after adjusting for conventional risk factors showed a significant association of MAC with BMI (β=0.611, P<.001). Conclusion: These findings show that MAC can be useful as an alternate index for obesity in South Indians.
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Background: Protein energy malnutrition is a significant cause of morbidity and mortality in children between the ages of 12 and 59 months and diarrhoea has been shown to have a bi-directional relationship with malnutrition. Mid upper arm circumference (MUAC) has been shown to be a useful indicator of malnutrition in children aged 12 to 59 months. Objective: To determine the nutritional status of children aged 12 to 59 months with diarrhoea using mid upper arm circumference (MUAC). Method: Over a 6 month period, all children aged 12 to 59 months who presented to the Niger Delta University Teaching Hospital (NDUTH) with diarrhoea were consecutively recruited into the study. Information on their ages, diarrhoeal type, duration and frequency as well as parental educational level and occupation were obtained and recorded into a proforma. MUACs were measured and recorded to the nearest 0.1cm. Results: There were 144 children with a male to female ratio of 1.3:1. The mean MUAC was 14.25 ± 2.46cm with a steady increase with age from13.45 ± 1.99cm at 12 to 23 months to 16.50 ± 0.58cm at 48 to 59 months. Using MUAC measurements, 19 (13.2%) of the children were malnourished, with 7 (4.9%) having severe acute malnutrition and 12 (8.3%) having moderate acute malnutrition (MAM). Seventeen (11.8%) of the children were at risk of malnutrition. Children with chronic diarrhoea and ages ranging from 12 to 23 months had significantly lower MUACs with χ2 and p values of 19.58 (0.000) and 7.99 (0.005) respectively. Conclusion: Under nutrition is an important problem in children aged 12 to 59 months with diarrhoea. There is need to pay extra attention to nutritional status of this age group especially during episodes of diarrhoea.
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OBJECTIVES: This study was carried out to determine nutritional status of elderly patients in a long-term care hospital according to meal type and eating ability. METHODS: Subjects were 47 female patients aged over 65 (79.3 +/- 7.1 years) who resided in a long-term care hospital in Seoul. Thirty seven patients who ate diet orally were grouped according to meal type (27 general diet and 10 soft diet) and eating ability (26 eating by oneself and 11 eaten with help) and 10 were on tube feeding. Nutritional status was determined by food consumption and mid-arm circumference. RESULTS: The mean adequacy ratios (MARs) of 12 nutrients (protein, calcium, phosphorus, zinc, vitamin A, vitamin B1, vitamin B2, vitamin B6, niacin, folic acid, vitamin C) were 0.687 for general diet, 0.565 for soft diet, 0.680 for eating by oneself and 0.677 for eaten with help, which were significantly lower than 0.982 for tube feeding (p < 0.05 or p < 0.01). The patients on tube feeding had significantly lower % arm circumference compared to those who ate general diet (84.0% vs. 95.4%, respectively, p < 0.05). Nutrients intakes, nutrient adequacy ratio (NAR) and index of nutritional quality (INQ) were not different between meal types as well as eating ability. The most insufficiently consumed nutrients by the patients on diet were folic acid, vitamin B2, and calcium (NAR 0.334~0.453, 0.515~0.539, and 0.516~0.533, respectively). CONCLUSIONS: The results suggested that regardless of meal type or eating ability, the subjects who were on diets in this study might have inadequate intake of folic acid as well as vitamin B2, and calcium, which need to be reflected on menu planning. The measurement of mid-arm circumference presented more risk of malnutrition of patients on tube feeding than those on diets, despite apparently better nutrient consumption.
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Aged , Female , Humans , Arm , Calcium , Diet , Eating , Enteral Nutrition , Folic Acid , Long-Term Care , Malnutrition , Meals , Menu Planning , Niacin , Nutritional Status , Nutritive Value , Phosphorus , Riboflavin , Seoul , Thiamine , Vitamin A , Vitamin B 6 , Vitamins , ZincABSTRACT
Pupil cycle time (PCT) is a simple way to measure the parasympathetic activity in the eye. This is a sensitive and specific test for the study of parasympathetic function. The cardiac parasympathetic tone is a good indicator to predict morbidity and mortality in an individual. The PCT is correlated with cardiac parasympathetic tone. In the present study we have aimed to look at the PCT in different nutritional status in human subjects. Sixty-three healthy adult male volunteers in the age group of 18–50 yrs were studied. They were divided in three groups based on their BMIs as undernourished, normal and preobese/obese. The mid-arm circumference (MAC) and waist- hip ratio (W:H) are incorporated as adjuvant to strengthen that they are divided into three different nutritional groups. The PCTs of undernourished (818±145 ms), normal control (904±63 ms) and overweight (991±106 ms) is expressed as mean and SD (P<0.001). A linear regression analysis was performed taking BMI, MAC, W:H and PCT as parameters, which shows a positive linear correlation. The results showed that the PNS activity in the eye is greatly modulated in different states of nutrition. Pupil cycle time is a simple, noninvasive investigative tool to assess and differentiate the PNS function in obese and chronic undernourished subjects.
ABSTRACT
Verificar se o tamanho dos manguitos utilizados nas Unidades Básicas de Saúde (UBS) para aferição da pressão arterial estão adequados à circunferência braquial dos pacientes. Métodos - Realizou-se pesquisa quantitativa, não experimental, descritiva, transversal, e de campo, onde foram medidas circunferências braquiais, de 80 pacientes, em 8 UBS. Resultados - As circunferências braquiais variaram de 22 a 52 cm, e os manguitos correspondentes, de 10 a 42 cm. O manguito padrão, 13x30cm (adulto), único disponível nas UBS, foi apropriado apenas para 50% dos sujeitos da amostra, cujas circunferências braquiais variaram entre 27 e 34 cm. A análise dos resultados deste estudo, indicam que os manguitos padrão disponíveis nas UBS, não estão adequadas aos outros 50% das circunferências braquiais encontradas, resultando em registros superestimados ou subestimados da pressão arterial, sendo provável que muitos pacientes hipertensos erroneamente avaliados, estejam seguindo tratamento incorreto. Conclusão - Conclui-se que, 50% dos pacientes da amostra, o tamanho dos manguitos utilizados nas UBS para aferição de sua pressão arterial, estavam adequados com a circunferência braquial, ou seja, tamanho adulto. A falta de disponibilidade de diferentes tamanhos de manguitos continua sendo um desafiante problema a ser encarado na rede pública de saúde, sendo necessária uma revisão nas práticas adotadas...
To check if the cuffs size used at Basic Health Units (BHUs) to blood pressure measurement are adequate to patient's arm circumference. Methods - It was conducted a quantitative research, non-experimental, descriptive, transversal, and , where it were measured arm circumferences, of 80 patients, at 8 BHUs. Results - The arm circumferences varied from 22 to 52 cm, and the correspondent cuffs, 10 to 42 cm. The standard cuff, 13x30 cm (adult), the only one available at BHUs, it was just appropriate to 50% of the sample subjects, whose arm circumferences varied between 27 and 34 cm. The results' analysis of this study, indicate that the standard cuff available at BHUs do not meet the other 50% of arm circumferences identified, resulting in overestimated or underestimated records of blood pressure, being likely that many hypertensive patients erroneously evaluated are following incorrect treatment. Conclusion - It was concluded that, 50% of the sample patients, the cuffs size used at BHUs to its blood pressure measurement, were adequate for the arm circumference, or, adult size.The lack of availability of different cuff size continue being a challenging problem to be faced in the public health being necessary a review in practices adopted...
Subject(s)
Humans , Male , Female , Young Adult , Arterial Pressure , Blood Pressure Determination , Mid-Upper Arm CircumferenceABSTRACT
Severe malnutrition can significantly compromise autonomic nervous system. However, less is known about the cardiac autonomic activity in mild and moderate grades of malnutrition in children. Therefore, the objective of this study was to assess the effect of mild/moderate malnutrition on heart rate variability (HRV), a non invasive tool to estimate the cardiac autonomic activity. A cross sectional, community based study was conducted in which 35 malnourished children (mean age: 6.06±2.04 yrs), on the basis of anthropometric parameters, were enrolled in the study group by random samplings, who were the children of urban slum dwellers and 35 age and sex matched healthy children, were taken as controls. Grading of malnutrition was done according to Indian Academy of Pediatrics (IAP) classification. Anthropometry, basal heart rate (BHR), blood pressure were determined. Time domain and frequency domain indices of HRV were assessed using RMS Polyrite D (version 2.4). Weight, height, mid arm circumference (MAC) and body mass index (BMI) were found to be statistically lower in the study group. There was a strong negative correlation between MAC and LF component (P<0.01). BHR was found to be increased in the malnourished group (P=0.027). Low frequency (LFnu) & LF-HF ratio were found to be increased (P=0.000 & P=0.001 respectively) while high frequency (HFnu) component was decreased (P=0.000) in malnourished group. Our results suggested that impaired cardiac autonomic nerve function characterized by sympathetic over activity may occur in malnourished children. This study also enables us to compare, in future works, HRV in pediatric subjects with different grades of malnutrition.