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BACKGROUND: A comprehensive screening at delivery revealed that roughly 14% of pregnant women who tested positive for COVID-19 did not exhibit any symptoms. The SARS-CoV-2 antigen swab test is frequently utilized as a diagnostic technique. Inadequate implementation of health protocol compliance can enhance the vulnerability of a community to the COVID-19 virus, according to previous findings. This suggests that these health protocol compliance and the vaccination program are important for preventing and controlling the spread of the virus. AIM: This study aims to determine the relationship of vaccination history and health protocol compliance with positive antigen swab results among pregnant women at the Community Health Center in Medan. METHOD(S): This is a cross-sectional and observational study that was conducted in February 2022 at the Community Health Center in Medan, North Sumatra, Indonesia. Two hundred pregnant women who met the inclusion and exclusion criteria make up the sample population. Antigen sampling for SARS-CoV-2 was performed in the Pramita laboratory. Following the collection and processing of sample and antigen swab data, IBM SPSS version was utilized to conduct statistical analysis. RESULT(S): The result showed that four of the pregnant women were infected with COVID-19, and they accounted for 2% of the sample population. The health protocol carried out by pregnant women was not significantly related to the swab results. Therefore, vaccination history had no significant association with COVID-19 symptoms, but people who received vaccines had more negative swab test results compared to those who did not, where three out of four positive samples were unvaccinated. CONCLUSION(S): Based on the results, only 2% of pregnant women were infected with COVID-19 at the Community Health Centre in Medan, because this study was carried out when COVID-19 cases had decreased. The statistical analysis results showed that the history of vaccination was not significantly related to SARS-CoV-2 antigen swab results. However, there was a clinical tendency that vaccines can reduce the number of positive cases, where three out of four positive samples were not vaccinated.Copyright © 2023 Sarma Nursani Lumbanraja, Reni Hayati, Khairani Sukatendel, Johny Marpaung, Muhammad Rusda, Edy Ardiansyah.
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Objective: While there are several studies that have focused on the role of face masks in preventing airborne transmission of SARS-CoV-2, few data are available on their effects on physiological measures, and no study has examined their effects on blood pressure (BP). The purpose of our study was to investigate the effect of surgical masks on BP in drug-treated hypertensive patients who had a routine follow-up visit to a university hospital outpatient hypertension clinic. Design and method: The study included already treated hypertensive patients aged > 18 years, while the exclusion criteria were atrial fibrillation or any other arrhythmia affecting the BP measurement, an arm circumference > 42 cm, mental disorders, Parkinson disease, pregnancy, intolerance to the BP measurement method, or unwillingness to participate. A new surgical mask was provided to all participants to replace the face mask that was already in use. After the routine mask-on office BP measurement, patients were left alone and randomized to automated office BP measurement, with measurements taken after first wearing a mask for 10 min, then without wearing the mask for 10 min, and vice versa. Results: A total number of 265 patients were included in the study. Among the participants, 115 were women (43.4%), the mean age was 62 ± 12 years, and the mean office BP was 134 ± 15 / 81 ± 12 mmHg. There was no significant difference between mask-on unattended systolic BP (133 ± 15 mmHg) and mask-off unattended systolic BP (132 ± 15 mmHg) (P = 0.13) or between mask-on unattended diastolic BP (77 ± 13 mmHg) and mask-off unattended diastolic BP (76 ± 13 mmHg) (P = 0.32). Moreover, there was no difference in the heart rate (mask-on first, 69 ± 11 bpm;mask-off first, 69 ± 11 bpm, P = 0.7). Conclusions: Common surgical masks do not affect systolic/diastolic BP levels during unattended BP measurements in treated hypertensive patients.
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BACKGROUND: There are growing interests in the use of medicinal mushrooms in controlling overweight and obesity. OBJECTIVE(S): The aim of the present study was to assess the effect of Lingzhi on anthropometric indices, fasting blood sugar, lipid profile and blood pressure of overweight individuals METHODS: This randomized double-blind clinical trial was performed on seventy-two overweight individuals (Body Mass Index (BMI)?=?25-29.9?kg/m2) received 3 capsule Ganoderma Lucidum (each capsule containing 220?mg of whole powder and 30?mg of pure aqueous extract) daily or matching placebo for 6 weeks. Anthropometric indices, metabolic tests (fasting blood sugar (FBS) and serum lipid profile) and blood pressure were measured before and after treatment. RESULT(S): Data analyses indicated that body weight and BMI were decreased after 6-week intervention (P?<?0.05). The beneficial effect of supplementation was evident on some anthropometric indices. Changes in LDL-cholesterol were significantly different between two treatment and placebo groups (P?<?0.05). FBS, other components of lipid profile and blood pressure did not significantly change by Lingzi treatment. CONCLUSION(S): Results showed that Ganoderma Lucidum might have some potential benefits on anthropometric indices and mild effects on lipid profile, but and there is no claim for weight lose function. Hence, further long-term studies are recommended. Copyright © 2022 - IOS Press. All rights reserved.
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Background: The COVID-19 pandemic has spread worldwide, forcing governments to implement quarantines as a preventive measure against the spread of the virus. Quarantine causes changes in lifestyle and anthropometry status among communities. Objective: To describe the lifestyle and anthropometric status of medical students batch 2018 FM UA during the pandemic. Methods: This was a descriptive study using online questionnaires from September 2020 to February 2021. Results: There were variations in students’ anthropometry. Students’ average height is 161.110 cm, the average weight is 60.308 cm, the average body mass index is 23.193 cm, the average upper arm circumference is 27.846 cm, and the average abdominal circumference is 79.621 cm. Furthermore, 145 respondents (81.9%) stated that they experienced changes in their lifestyle during the pandemic. A total of 89 respondents (50.3%) continued to exercise and the other 88 respondents (49.7%) did not. Regarding the sleep pattern, 108 respondents (61%) had quite good sleep quality and 50 respondents (28.2%) had quite poor sleep quality. For the food consumption pattern, 46 respondents (26%) ate more sweet foods. Furthermore, 156 respondents (88.1%) did sedentary activities, with 77 respondents (43.5%) doing sedentary behavior for more than 6 hours a day. Conclusion: During the COVID-19 pandemic, the anthropometric status of medical students batch 2018 FMUA varied;and tend to maintain their physical activity, have quite good sleep quality, prefer eating sweet foods, and do a sedentary behavior for a longer duration
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Objective: Although the effect of face masks on preventing airborne transmission of SARS-CoV-2 is well studied, few data are available on their effects on physiological measures and no study has evaluated their effect on blood pressure (BP). The purpose of our study was to investigate the effect of surgical masks on BP in drug-treated hypertensive patients who had a routine follow-up visit to a university hospital outpatient hypertension clinic. Design and method: The study included already treated hypertensive patients aged > 18 years, while the exclusion criteria were atrial fibrillation or any other arrhythmia affecting the BP measurement, an arm circumference > 42 cm, mental disorders, Parkinson's disease, pregnancy, intolerance to the BP measurement method, or unwillingness to participate. Following the routine mask-on office BP measurement, patients were left alone and randomized to automated office BP measurement, with measurements taken after first wearing a mask for 10 min, then without wearing the mask for 10 min, and vice versa. Results: A total number of 265 patients were included in the study. Among the participants, 115 were women (43.4%), the mean age was 62 ± 12 years, and the mean office BP was 134 ± 15/81 ± 12 mmHg. There was no significant difference between mask-on unattended systolic BP (133 ± 15 mmHg) and mask-off unattended systolic BP (132 ± 15 mmHg) (P = 0.13) or between mask-on unattended diastolic BP (77 ± 13 mmHg) and mask-off unattended diastolic BP (76 ± 13 mmHg) (P = 0.32). Moreover, there was no difference in the heart rate (mask-on, 69 ± 11 bpm;mask-off, 69 ± 11 bpm, P = 0.7). Conclusions: The results of our study indicate that common surgical masks do not affect systolic/diastolic BP levels during unattended BP measurements.
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GLOBAL. What we know: The COVID-19 pandemic required that outpatient and community-based management of acute malnutrition (CMAM) programmes was adapted to reduce the risk of virus transmission. What this article adds: Experiences and lessons learned around initial adaptations made to CMAM programmes in the light of COVID-19 were gathered through multiple surveys and interviews with programmers in over 40 countries. The adaptations implemented most frequently were Family mid-upper arm circumference (MUAC), a change in the frequency and method of follow-up visits and modified admissions and discharge criteria. This article presents initial lessons learned and recommendations for each of these adaptations. Regardless of the adaptation made, close collaboration and clear communication between caregivers, communities, partners and government entities were found to be critical. Programme implementers should continue to aim to protect staff and programme participants while continuing service provision, using personal protective equipment and capitalising on virtual trainings and meetings as much as possible. Building staff surge capacity may also mitigate unexpected shifts in staffing structures due to illness or travel restrictions. Innovations and adaptability in the face of supply chain and other programmatic disruptions require flexible funding sources and partnerships.
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What we know: There is growing evidence of the effectiveness of mid-upper arm circumference (MUAC) in identifying infants under six months at increased risk of mortality but no globally agreed thresholds yet exist for this age group which limits community-based screening. What this article adds: In response to the COVID-19 pandemic, GOAL adapted its community-based Management of At-risk Mothers and Infants under 6 months (MAMI) programme in Gambella, Ethiopia by introducing the Family MUAC approach to enable home-based screening of infants under six months and a new type of reversible MUAC tape, specially adapted for the screening of infants under six months of age. Following implementation, the average number of monthly referrals increased (from 11.6 infants pre-training to 19.1 post-training). Pre-training, monthly outreach contributed to most referrals (average 77.0%) and there were no self-referrals. Post-training, the average monthly outreach referrals reduced to 45.3% and self-referrals increased to 41.4%. Measurement accuracy analysis showed that most caregivers trained by Community Outreach Agents (COAs) correctly identified the MUAC of their infants. Based on these results, GOAL will explore the feasibility of moving to using Family MUAC alone for the screening of infants under six months of age.
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Purpose>In Indonesia, 29.3% of Indonesian women were obese. Dehydrated women have 1.6 times higher risk of becoming obese than normal ones. This study was aimed to further explore the association between gestational weight gain (GWG) and maternal hydration status.Design/methodology/approach>This longitudinal study involved 50 pregnant women aged 18–35 years. Subject identity, age, parity and household expenses were collected using questionnaire. Urine specific gravity (USG) was used as an indicator for hydration status. Venous blood was collected to measured haemoglobin (Hb) by anemometer method. Anthropometric data such as pre-pregnancy weight, maternal body weight, GWG, body mass index (BMI) and mid-upper arm circumference (MUAC) was collected using standardized tools. Dietary and total water intake (TWI) were measured through three consecutive days of a 24-h food recall. Pearson’s correlation, independent t-test and analysis of covariance were used to appraise the hypothesis.Findings>The subject’s mean age was 29.3 ± 5.6 years;BMI was 23.5 ± 4.1 kg/m2. MUAC (28.2 ± 4.0 cm) and Hb (11.5 ± 1.0 g/dl) were still in the normal range. Most subjects were well hydrated, with an average USG of 1.016 g/mL. GWG and TWI are significantly correlated (p < 0.01). Based on the hydration status, after corrected with TWI, GWG was not significantly different.Originality/value>It calls to mind that nutrition and water intake, alongside weight gain monitoring during pregnancy, are part of an effort to prevent pregnancy risks.
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OBJECTIVES: During the COVID-19 pandemic, the authorities made a change in the classification of malnutrition and concomitant service delivery protocol among the Rohingya children, residing in world's largest refugee camp, located in Cox's Bazar, Bangladesh. In this paper, we discussed the potential implications of this updated protocol on the malnutrition status among children residing in the Rohingya camps. DESIGN: This paper reviewed relevant literature and authors' own experience to provide a perspective of the updated protocol for the classification of malnutrition among the children in the Rohingya camps and its implication from a broader perspective. SETTING: Rohingya refugee camps, Bangladesh. PARTICIPANTS: Children aged less than five years residing in the Rohingya camps. RESULTS: Major adaptation during this COVID-19 was the discontinuation of using weight-for-height z-score (WHZ) and the use of only mid upper arm circumference (MUAC) and presence of oedema for admission, follow-up and discharge of malnourished children in the camps. However, evidence suggests that use of MUAC only can underestimate the prevalence of malnutrition among the children in Rohingya camps. These apparently non-malnourished children are devoid of the rations that they would otherwise receive if classified as malnourished, making them susceptible to more severe malnutrition. CONCLUSIONS: Our analysis suggests that policymakers should consider using the original protocol of using both MUAC and WHZ to classify malnutrition and retain the guided ration size. We also believe that it would not take an extra effort to adopt the original guideline as even with MUAC only guideline, certain health measures needed to adopt during this pandemic.
Subject(s)
COVID-19 , Malnutrition , Body Weight , COVID-19/epidemiology , Child , Child, Preschool , Humans , Malnutrition/diagnosis , Malnutrition/epidemiology , Pandemics , Refugee CampsABSTRACT
Geographical and economic access barriers to health facilities (HF) have been identified as some of the most important causes of the low coverage of severe acute malnutrition (SAM) treatment. The objective of this study is to assess the effectiveness and coverage of SAM treatment delivered by community health workers (CHWs) in the Guidimakha region in Mauritania, compared to the HF based approach. This study was a nonrandomized controlled trial, including two rural areas. The control group received outpatient treatment for uncomplicated SAM from HF, whilst the intervention group received outpatient treatment for uncomplicated SAM from HF or CHWs. A total of 869 children aged 6-59 months with SAM without medical complications were included in the study. The proportion of cured children was 82.3% in the control group, and 76.4% in the intervention group, we found no significant difference between the groups. Coverage in the intervention zone increased from 53.6% to 71.7%. In contrast, coverage remained at approximately 44% in the control zone from baseline to end-line. This study is the first to demonstrate in Mauritania that the decentralization model of CHWs treating SAM improves acute malnutrition treatment coverage and complies with the international quality standards for community treatment of acute malnutrition. The non-randomized study design may limit the quality of the evidence, but these results could be used by political decision-makers as a first step in revising the protocol for acute malnutrition management.
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Background: The key role of patient self-monitoring, already well established by large-scale forward planning initiative such the British National Health Service's (NHS) long-term plan, has been emphasised by the COVID19 pandemic. In the management of hypertension, much can be achieved through the provision of blood pressure monitors to patients, along with appropriate education and online blood pressure (BP) recording facilities. However, it is important to ensure that patients have the correct equipment to reliably measure their own blood pressures and to ensure they purchase or are supplied with validated monitors and, as undersized cuffs yield artefactually elevated BP readings, with correctly sized cuffs. Purpose: To demonstrate the use of Body Mass Index (BMI) as an estimate of Middle Upper Arm Circumference (MUAC) for purposes of blood pressure monitor cuff size requirement estimation and the application of this strategy to a national Home Blood Pressure Monitoring (HBPM) programme. Methods: The relationship between MUAC and BMI is well established;MUAC is used surrogate measure of BMI particularly in identifying underweight patients especially in environments where accurate recording of weight and height is challenging. Here, we reverse this relationship to use the BMI (one of the most commonly recorded datum in primary care patient records) to estimate patient MUACs. First, using manufacturer recommended cuff arm-circumference ranges and aggregate pre-established MUAC to BMI linear equations, we generate a simplified BMI to cuff-size scheme. Second, we apply this scheme to a UK Integrated Care System (a regional NHS organisation supporting 1.7 million adult patients in an English city) to estimate cuff requirement under NHS England's BPM@h HBPM initiative (in which patients with poorly controlled hypertension are allocated free home BP monitors). Lastly, we propose a patient-level tool for BP monitor cuff size prediction. Results: Our simplified scheme proposes the following cuff predictions: Small (S: 17-22cm): BMI <18kg/m2;Medium (M: 22-32cm): BMI ≥18 and <28kg/m2;Large (M: 32-42cm): BMI ≥28 and <38kg/m2 and Extra-large (X: 42-50cm): BMI ≥38kg/m2. In our population of approximately 157,000 adult hypertensive patients, 6,039 were eligible for a BP monitor under the NHS England's BPM@h HBPM initiative. Using our simplified scheme, we predict cuff requirements as follows: S: 2%, M: 32%, L: 46%, X: 19%. Conclusion: Patient BMIs are a useful predictor of BP monitor cuff size requirement. They are readily available or calculatable from primary care records and their application to cuff size identification will improve accuracy of BP readings in HBPM initiatives. Our preliminary results suggest that the most commonly supplied standard cuff may be unsittable for well over 50% of patients and that extra-large cuff may be required for nearly 1 in 5 patients.