Prevalence and associated factors of stunting and thinness among adolescent students in Finote Selam Town, Northwest Ethiopia.

BACKGROUND: Undernutrition among adolescents is a major public health problem in developing nations including Ethiopia. Adolescents need to have good-quantity and good-quality nutrients to cope with this rapid growth and other health risks which increase nutritional demand. This study aimed to assess the prevalence and associated factors of stunting and thinness among school adolescents in Finote Selam Town, Northwest Ethiopia. METHODS: A school-based cross-sectional study among adolescent students aged 10-19 in public schools was carried out in Finote Selam Town from February 5 to March 27, 2018. A total of 397 school adolescents were included in this study. Stratified and simple random sampling techniques were employed to select study subjects. Pretested structured questionnaires were used to collect the data. Data were entered using Epi info version 7 and analyzed using SPSS version 20 and WHO AnthroPlus software. A multivariable logistic regression analysis was employed to identify factors associated with stunting and thinness. Crude and adjusted odds ratios with 95% level significance were used to measure the strength of association, and statistical significance was declared at a P value less than 0.05. RESULTS: The prevalence of stunting and thinness among school adolescents was 21.8% and 16.9%, respectively. About 9.7% of school adolescents experienced both stunting and thinness. Being male (P = 0.031), coming from rural area (P = 0.046), having a family monthly income of less than $28.37 (P = 0.044) and having less than four dietary diversity (P = 0.021) were significantly associated with stunting. Early adolescent stage (P = 0.034), being male adolescent students (P = 0.37), having a family monthly income of less than $28.37 (P = 0.016), having a family monthly income between $28.37 and $56.74 (P = 0.021) (35.25 Birr = 1 USD) and using well water (P = 0.045) were significantly associated with thinness. CONCLUSION: Undernutrition was a predominant problem in the study area. Sex, age, place of residence, dietary diversity, sources of drinking water and family monthly income were important factors associated with stunting and thinness among the respondents. Strategies to improve the nutritional status of adolescent students should be given much attention.

Prevalence and Associated Factors of Thinness among Adolescent Students in Finote Selam Town, Northwest Ethiopia.

Even if adolescence is a window of opportunity to break the intergenerational cycle of malnutrition, adolescents are the neglected age groups. Hence, information regarding the nutritional status of adolescents is lacking, making creating and implementing intervention programs difficult. This study aimed to assess the prevalence and determinants of thinness among school adolescents in Finote Selam Town, Northwest Ethiopia. A school-based cross-sectional study among adolescent students aged 10-19 in public primary and secondary schools was carried out in Finote Selam Town from February 05 to March 27, 2018. Stratified and simple random sampling techniques were employed to select study subjects. A total of 397 adolescent students were included in the study. Pretested structured questionnaires were used to collect the data. Data were entered using Epi Info version 7 and analyzed using SPSS version 20 and WHO AnthroPlus software. A multivariable binary logistic regression analysis was employed to identify factors associated with thinness. Crude and adjusted odds ratios with 95% level significance were used to measure the strength of association, and statistical significance was declared at p value less than 0.05. The prevalence of thinness among adolescents was 14.9%. Early adolescent stage (AOR = 4.81; 95% CI : 1.23, 18.51), being male adolescent students (AOR = 2.33; 95% CI : 1.60, 3.40), having less than 1000 birr family monthly income (AOR = 6.54; 95% CI : 3 : 82, 14.89), having 1000-2000 birr family monthly income (AOR = 3.47; 95% CI : 1.15, 7.45), and using well water (AOR = 3.82; 95% CI : 1.46, 10.04) were significantly associated with thinness at 95% confidence interval. The study revealed that prevalence of thinness was high in the study area. Sex, place of residence, and family monthly income were found to be important factors associated with thinness among the respondents.

Recovery time and associated factors of severe acute malnutrition among children in Bahir Dar city, Northwest Ethiopia: an institution based retrospective cohort study.

BACKGROUND: Malnutrition commonly affects all groups in a community, but infants and young children are the most vulnerable. Worldwide, nearly 24 million under five children experience severe acute malnutrition (SAM) which contributes to one million child deaths yearly and 19 million severely wasted children are living in developing countries. While the treatment of severe acute malnutrition (SAM) is well established, achieving desired outcomes has proven to be challenging. There is limited evidence showing the success of treatments in the study area. Therefore, this study aimed to determine recovery time from severe acute malnutrition and identify predictors among children of 6-59 months of age. METHODS: Facility based retrospective cohort study was conducted among 401 children 6-59 months of age who have been treated for SAM. Both descriptive and analytic analyses were executed. The results were determined using Kaplan-Meier procedure, log-rank test and Cox-regression. Variables having P-value ≤0.2 during binary analysis were entered into multivariate analysis. P value < 0.05 was considered as statistically significant. RESULTS: The recovery rate was 51.9% and the median recovery time was 16 days (95%CI: 14.233-17.767). Controlling for other factors; having anemia at admission, no plumpy nut provision, failing to enter in to phase 2 on day 10 and a weight gain of more than 8 g/kg/day were significant predictors of recovery time. CONCLUSIONS: Nutritional recovery rate was far outside of the accepted minimum international standard while median recovery time ranged in the accepted minimum international standard. Children had a lower chance of recovering early when they had anemia at admission, not provided plumpy nut, failed to enter phase 2 on day 10 and failed to gain more than 8 g/kg/day. Therefore, efforts should be strengthened to facilitate early recovery of children by considering the identified predictors of recovery time.

Genome-wide screening reveals the emergence and divergence of RTK homologues in basal Metazoan Hydra magnipapillata.

Receptor tyrosine kinases (RTKs) are key components of cell-cell signalling required for growth and development of multicellular organisms. It is therefore likely that the divergence of RTKs and associated components played a significant role in the evolution of multicellular organisms. We have carried out the present study in hydra, a diploblast, to investigate the divergence of RTKs after parazoa and before emergence of triploblast phyla. The domain-based screening using Hidden Markov Models (HMMs) for RTKs in Genomescan predicted gene models of the Hydra magnipapillata genome resulted in identification of 15 RTKs. These RTKs have been classified into eight families based on domain architecture and homology. Only 5 of these RTKs have been previously reported and a few of these have been partially characterized. A phylogeny-based analysis of these predicted RTKs revealed that seven subtype duplications occurred between 'parazoan-eumetazoan split' and 'diploblast-triploblast split' in animal phyla. These results suggest that most of the RTKs evolved before the radiata-bilateria divergence during animal evolution.

Diversity and divergence among the tribal populations of India.

Tribal populations of the Indian subcontinent have been of longstanding interest to anthropologists and human geneticists. To investigate the relationship of Indian tribes to Indian castes and continental populations, we analyzed 45 unlinked autosomal STR loci in 9 tribal groups, 8 castes, and 18 populations from Africa, Europe and East Asia. South Indian tribal populations demonstrate low within-population heterozygosity (range: 0.54 - 0.69), while tribal populations sampled further north and east have higher heterozygosity (range: 0.69 - 0.74). Genetic distance estimates show that tribal Indians are more closely related to caste Indians than to other major groups. Between-tribe differentiation is high and exceeds that for eight sub-Saharan African populations (4.8% vs. 3.7%). Telugu-speaking populations are less differentiated than non-Telugu speakers (F(ST): 0.029 vs. 0.079), but geographic distance was not predictive of genetic affinity between tribes. South Indian tribes show significant population structure, and individuals can be clustered statistically into groups that correspond with their tribal affiliation. These results are consistent with high levels of genetic drift and isolation in Indian tribal populations, particularly those of South India, and they imply that these populations may be potential candidates for linkage disequilibrium and association mapping.

Management of cardiac arrhythmias in acute coronary syndromes.

A variety of atrial and ventricular arrhythmias are encountered in patients with acute coronary syndromes. These include both brady and tachyarrhythmias of supraventricular and ventricular origin. Sinus bradycardia and atrial fibrillation are the most common of supraventricular origin. Ventricular arrhythmias that merit consideration include premature ventricular complexes, accelerated idioventricular rhythm, ventricular tachycardia, and ventricular fibrillation. Intraventricular and atrioventricular conduction blocks associated with acute coronary syndromes include bundle branch blocks, fascicular blocks, and various degrees of atrioventricular block. A review of management of these arrhythmias is presented.

Role of the catheter in the treatment of cardiac arrhythmias.

During the last decade, there has been a remarkable shift away from drug therapy toward catheter-based treatment of many tachyarrhythmias. Catheter ablation using radiofrequency energy has been shown to provide a cure for many supraventricular and ventricular tachycardias with excellent safety and has now become the first line of treatment. A review of biophysics and biology of radiofrequency energy, the technique of catheter ablation, and its application in the treatment of specific tachycardias encountered in clinical practice is presented.

Segregation analysis of regional fat distribution in families from Andhra Pradesh, India.

OBJECTIVE: Segregation analysis was used to examine the major gene evidence for regional fat distribution and whether the effects of covariates such as energy variables (intake and expenditure) or total subcutaneous fat, impact on the major gene inference. SUBJECTS: The data consist of measurements made on 1691 individuals in 432 pedigrees residing in the Chittor district of Andhra Pradesh, India, during the period from January 1989 to February 1990. MEASUREMENTS: Fat distribution was computed as the ratio of trunk skinfold sum (subscapular + suprailiac + abdominal) to extremity skinfold sum (biceps + triceps + medial calf). The trunk/extremity skinfold ratio (TER) was also analyzed after adjusting for the amount of energy expended in various activities and energy intake (TER-E), as well as after adjusting for overall level of fatness as measured by the sum of six skinfolds (TER-SF6). METHODS: Segregation analysis was applied using the unified model (POINTER). RESULTS: For the TER all of the conditions needed to satisfy a major gene hypothesis were met, and a putative recessive locus in the presence of a multifactorial component was inferred. Adjusting the TER for energy intake (EI) and energy expenditure (EE) did not change these results. However, adjusting for total subcutaneous fat did alter the results. Specifically, after removing the effects due to total fat, there was a major non-Mendelian effect (free tau s) with additional multifactorial influences, and with generation heterogeneity in both components. CONCLUSIONS: A putative major locus for fat distribution as indexed by the TER was found. However, further analyses suggested the hypothesis that this major gene may be primarily for total fat with secondary effects on fat distribution (that is, major gene pleiotropy). The possibility that there is a second locus that is modified by interactions with gender and age, and that impacts on the preferential accumulation of fat in the trunk vs extremity depots could be inferred.

Multiple origins of the mtDNA 9-bp deletion in populations of South India.

The origins and genetic affinities of the more than 500 tribal populations living in South Asia are widely disputed. This may reflect differential contributions that continental populations have made to tribal groups in South Asia. We assayed for the presence of the intergenic COII/tRNALys 9-bp deletion in human mtDNA in 646 individuals from 12 caste and 14 tribal populations of South India and compared them to individuals from Africa, Europe, and Asia. The 9-bp deletion is observed in four South Indian tribal populations, the Irula, Yanadi, Siddi, and Maria Gond, and in the Nicobarese. Length polymorphisms of the 9-bp motif are present in the Santal, Khonda Dora, and Jalari, all of whom live in a circumscribed region on the eastern Indian coast. Phylogenetic analyses of mtDNA control region sequence from individuals with the 9-bp deletion indicate that it has arisen independently in some Indian tribal populations. Other 9-bp deletion haplotypes are likely to be of Asian and African origin, implying multiple origins of the 9-bp deletion in South India. These results demonstrate varying genetic affinities of different South Indian tribes to continental populations and underscore the complex histories of the tribal populations living in South Asia.

Ventricular tachycardia and sudden cardiac death.

As we approach the new millennium, treatment of survivors of cardiac arrest and prevention of sudden cardiac death (SCD) are the two most important problems confronting contemporary cardiology practice. Sudden cardiac death occurs as a result of ventricular tachycardia (VT) degenerating into ventricular fibrillation (VF). Several major arrhythmia treatment trials completed during the last decade have significantly changed the way we treat patients with ventricular arrhythmias. In patients with sustained VT and aborted SCD, only treatment with implantable cardioverter defibrillator (ICD) has been shown to significantly increase survival. Amiodarone and sotalol, though very useful in the treatment of VT and VF, do not improve survival as significantly as ICD therapy. Use of Class I antiarrhythmics may adversely affect survival. Primary prevention of SCD in patients with a recent myocardial infarction (MI) and in patients with cardiomyopathy and congestive heart failure (CHF) is limited by our inability to accurately identify patients at risk of SCD. Among the many tests available to identify patients at risk of SCD, decreased left ventricular ejection fraction (LVEF) and presence of non-sustained VT appear to be most useful. To date, only beta adrenoceptor blockers have been shown to improve survival in post-MI patients as well as in patients with cardiomyopathy and CHF. Use of amiodarone is controversial in these patients. Treatment with ICD of post-MI patients with decreased LVEF and inducible sustained VT at electrophysiology study improves survival.

Arterial pressures in fish-consuming and non-fish-consuming populations of coastal south India.

It has been suggested that fish-consuming populations have lower blood pressure levels. The aim of this study was to determine and compare the mean blood pressure levels among fish-consuming populations with those among populations who do not consume fish, as a risk marker for cardiovascular disease. A cross-sectional study was conducted among 1000 healthy Indian adult men and women (aged >=20 years) randomly chosen from two representative age and sex-matched samples, one of which was fish-consuming (n = 500) and the other of which was non-fish-consuming (n = 500). The systolic and diastolic blood pressures and pulse rates were studied. The mean systolic and diastolic blood pressures and pulse rates were found to be lower in older men and women who were fish consumers in comparison with those who were non-fish consumers, and the levels increased with advancing age. The population and sex differences were significant for certain age groups. The percentile cut-off values for diagnosis of systolic hypertension showed lower prevalence in fish consumers than in non-fish consumers. The results indicate that people who ate fish regularly appeared to have a better cardiovascular risk profile than did non-fish consumers, which is of public health significance. The relationship between fish consumption and blood pressure deserves further studies in normotensive and hypertensive populations.

Mitral valve prolapse. A common cardiac diagnosis in women.

Mitral Valve Prolapse (MVP) is the most frequently diagnosed cardiac valvular abnormality. It is a primary disorder with familial occurrence. MVP is a disease of the young with a significantly higher incidence in women compared to men. The most characteristic clinical finding is a midsystolic click and late systolic murmur detected on cardiac auscultation. Two-dimensional echocardiography is the diagnostic tool of choice. 2D echo also helps in stratification of MVP patients at risk of developing serious complications. Although MVP runs a benign course in the majority of patients, significant complications may occur. These include progressive mitral regurgitation with heart failure, infective endocarditis, systemic emboli, cardiac arrhythmias, and rarely sudden death. The focus of therapy is reassurance and symptom relief when possible. It is important to recognize those patients that are at risk of developing significant complications, follow them closely, and intervene appropriately when complications occur.

Age and sex variation of blood pressure in the population of Andhra Pradesh.

The blood pressure investigation was carried out on 530 males and 745 females of the general population including ages from 10 to 80 years. The increase of blood pressure with advancing age was evident both in males and females. The mean systolic pressures were greater in males upto 40 to 49 years and thereafter females showed greater mean values. However, diastolic pressure values were greater in males although. This is in agreement with the studies from India. Sex difference was evident in younger ages only.

Dietary vitamin E and selenium effects on resistance to oxidative stress in rat liver mitochondria.

Mitochondria-rich fractions isolated from livers of rats fed diets differing in their vitamin E (E) and/or selenium (Se) contents were subjected to NADPH/ADP/Fe(3+)- dependent assays of lipid peroxidation. Addition of GSH resulted in an inhibition, or lag period, of lipid peroxidation in mitochondria from rats supplemented with E. This effect was independent of the Se status of the rats. Addition of GSH + GSSG did not potentiate the lag period over that observed with GSH alone. Significant changes in mitochondrial alpha-TH during lipid peroxidation, either in the presence or absence of GSH, were not observed. Total protein thiol (PrSH) content of native mitochondria was lower in rats fed a diet deficient in both E and Se, compared to the other dietary groups. Addition of GSH or GSH + GSSG maintained mitochondrial PrSH at higher levels during lipid peroxidation than in control assays without added GSH/GSSG. Addition of GSSG alone decreased PrSH in mitochondria prepared from all rats regardless of their E or Se status. Reduced ubiquinone-9 (U-9) and the % of total U-9 and U-10 in the reduced form were significantly decreased in liver tissue from rats fed the diet deficient in both E and Se.

Fatty acid profile and the atherogenic risk in fish consuming and non fish consuming people.

Epidemiological studies have indicated a lower incidence of cardiovascular disease in populations with a high habitual intake of marine fish and fish oils, and this apparent protection may be due to the presence of n-3 fatty acids in the dietary fish. Two populations, a rish consuming one from coastal area and an inland one with non fish consuming from Nellore district or South India were selected for the present study. A total of one thousand healthy subjects were randomly chosen (500 in each population) from both sexes, aged from 20 to 70 years. The concentration of serum cholesterol, triacylglycerol and LDL-cholesterol were significantly lower in fish consumers, whereas HDL-cholesterol was higher in fish consumers than in non fish consumers. The difference between the percent quantities of the three n-3 fatty acids (eicosapentaenoic, docosapentaenoic and docosahexaenoic acids) was highly significant (p < 0.001) with a greater value in fish consumers.

Commingling analysis of adiposity in an Indian population.

The distributions of five adiposity phenotypes were assessed for the presence of commingling in a sample of 756 adults (> or = 30 years old), residing in the Chittoor district of Andhra Pradesh, India. Three measures of generalized fatness (body mass index, the sum of six skinfolds and the sum of three trunk skinfolds) and two indicators of fat patterning (the ratio of trunk to extremity subcutaneous fat and the ratio of the subscapular skinfold to the sum of the subscapular and the supra-iliac skinfolds) were analysed. Each phenotype was adjusted for the effects of (i) age within sex, and (ii) age, energy intake and energy expenditure within sex. The distribution of each phenotype, under both adjustment schemes, was assessed for evidence of commingling. The commingling analyses were performed separately for males (n = 397) and females (n = 359), and evidence for heterogeneity in the distribution of each phenotype, by sex, was evaluated. There is evidence of commingling in the distribution of each phenotype, under both adjustment schemes. Conclusions regarding the distributions of these phenotypes are, however, influenced by the specific adjustments made to the data. In general, the measures of generalized fatness are more sensitive than measures of fat patterning to the specific adjustments applied to the data. Interestingly, and in contrast with the majority of commingling analyses of adiposity, the smallest components of the commingled distributions often have the lowest mean phenotypic value.

Assessment of adiposity in an Indian population: familial correlations.

Familial correlations for five measures of adiposity were assessed using data from 473 nuclear families residing in the Chittoor district of Andhra Pradesh, India. Fat patterning, measured as the ratio of trunk to extremity subcutaneous fat, and the ratio of the subscapular to the sum of the subscapular and suprailiac skinfolds, and three measures of generalized fatness: body mass index, the sum of six skinfolds and the sum of three trunk skinfolds were analyzed. Maximum likelihood estimates of the familial correlations were obtained for each phenotype, after adjusting for the effects of (1) age within sex, and (2) current levels of energy intake and expenditure, and age within sex. Hypotheses regarding sex-specific, and generational differences in these correlations were assessed for each phenotype, under both adjustment schemes. The strength and pattern of the familial correlations for the three measures of generalized fatness were markedly influenced by the specific adjustments applied to the data. In contrast, the familial correlations for the fat patterning phenotypes were quite similar under the two adjustment schemes. Comparison of our results with previously published data indicates that the familial correlations for a subset of these adiposity measures may be heterogeneous across populations.

Familial resemblance of blood pressure with residual household environmental effects in consanguineous and nonconsanguineous families from Andhra Pradesh, India.

Familial aggregation of blood pressure (BP), both systolic (SBP) and diastolic (DBP), was examined in consanguineous and nonconsanguineous families from southern India. Path analysis of BP suggests inbreeding effects, with the genetic variance for SBP being lower in the sample that included inbred families. Specifically, genetic heritability for SBP was 38% in the nonconsanguineous sample but only 23% in the combined sample. Genetic heritability for DBP (30%) did not vary by sample, nor were sample differences in cultural heritability detected for either SBP (over 35%) or DBP (about 18%). These findings are remarkably similar to those in a French-Canadian population of Quebec; both reports found a considerably larger effect of the home environment on BP than previous studies.

The electrocardiogram in the diagnosis of acute myocardial infarction.

Diagnosis of acute myocardial infarction as early in the course of its evolution as possible is an important requirement for successful coronary reperfusion. In spite of the availability of many newer diagnostic methods, electrocardiography retains its preeminent place in the diagnosis of acute myocardial infarction. The value and limitations of the electrocardiogram in the diagnosis of acute myocardial infarction are reviewed.

Blood pressure in relation to skinfold thickness in the population of Andhra Pradesh.

The blood pressure of 1275 subjects of both sexes in relation to four skinfolds at biceps, triceps, subscapular and supra-iliac was studied. A positive relationship is observed between these two variables. The mean systolic and diastolic pressures increase from lower to higher skinfold thickness groups in both sexes for all the four skinfolds. The sex difference is conspicuous and significant for systolic pressure. However only a few groups show significant sex difference for diastolic pressure. In males the correlations between blood pressure and skinfolds were significant, while in females it is significant between diastolic blood pressure and biceps and triceps skin thicknesses only.