Medicine and Health Sciences Commons^™

What Is The Additive Value Of Nutritional Deficiency To Va-Fi In The Risk Assessment For Heart Failure Patients?, Seulgi Erica Kim, Mehrnaz Azarian, Aanand D Naik, Catherine Park, Molly J Horstman, Salim S Virani, Orna Intrator, Christopher I Amos, Ariela Orkaby, Javad Razjouyan

Journal Articles

OBJECTIVES: to assess the impact of adding the Prognostic Nutritional Index (PNI) to the U.S. Veterans Health Administration frailty index (VA-FI) for the prediction of time-to-death and other clinical outcomes in Veterans hospitalized with Heart Failure.

METHODS: A retrospective cohort study of veterans hospitalized for heart failure (HF) from October 2015 to October 2018. Veterans ≥50 years with albumin and lymphocyte counts, needed to calculate the PNI, in the year prior to hospitalization were included. We defined malnutrition as PNI ≤43.6, based on the Youden index. VA-FI was calculated from the year prior to the hospitalization and identified three groups: …

Follow-Up Care After Metabolic Surgery – A Prospective Study In The North-Eastern Region Of Romania, Sorina Boariu, Ana Maria Scutariu, Adrian Cureniuc, Anamaria Meuca, Roxana Adriana Stoica, Anca Mihaela Pantea Stoian, Delia Reurean Pintilei

Journal of Mind and Medical Sciences

Background. Anti-obesity therapeutic strategies are continuously evolving. Bariatric procedures or metabolic surgery are among the most effective and long-lasting therapies for obesity and its complications. Our objective was to investigate the clinical and biological evolution after metabolic surgery in a group of patients from North-Eastern Romania and to evaluate a nutritional intervention plan for this population. Materials and Methods. Our clinic surveyed 50 patients who received nutritional counselling before and after bariatric surgery. The patient's weight loss, metabolic markers, and lifestyle changes from January to December 2021 were recorded. SPSS Statistics v.18 was used for statistical analyses. Results and Discussions. …

Challenges In Diagnosing Staphylococcal Scalded Skin Syndrome In Children With Kwashiorkor: A Case Report, Christie Hamdali, Sondang Sirait, Adria Rusvita, Bawono Bhakti

Journal of General - Procedural Dermatology & Venereology Indonesia

Staphylococcal scalded skin syndrome (SSSS) is a type of exfoliating skin disease with high incidence in children. This condition can cause serious morbidity and even mortality with certain comorbid diseases such as malnutrition. Malnutrition could mask the diagnosis of SSSS because of its similarity to numerous differential diagnoses. Accuracy of clinical diagnosis is then essential to determine the proper initial management. This case report presents a 6-month-old male baby with staphylococcal scalded skin syndrome and kwashiorkor. The patient presented with complaints of multiple erythematous plaques and widespread vesicular lesions that subsequently ruptured, resulting in erosions. Physical examination revealed edema, coarse …

Effect Of Nesfatin-1 On The Nutritional Status Of Hemodialysis Patients, Ahmed H. M. Elthakaby, Hany Y. Esso, Huda M. Elsayed, Karima Youssef Ahmed, Nagwa Abd El-Ghaffar Mohamed, Ragaa R. Mohamed

Journal of Medicine in Scientific Research

Background Nesfatin-1 is considered an anorexigenic peptide that plays an important role in appetite regulation, weight loss, and malnutrition. Although the cause of anorexia in CKD patients is not totally understood, both anorexia and malnutrition are common presentations of chronic kidney disease (CKD) patients who are susceptible to worse outcomes. Our aim of the work To study the relation of serum nesfatin-1 and its relation to the nutritional status of end-stage renal disease (ESRD), who are maintained on regular hemodialysis. Patients and methods A total of 60 ESRD patients are maintained on regular hemodialysis, and apparently healthy thirty persons (control …

Neurodevelopment And Recovery From Wasting, Harriet M. Babikako, Celine Bourdon, Emmie Mbale, Peace Aber, Annet Birabwa, Josephine Chimoyo, Wieger Voskuijl, Zaubina Kazi, John Mukisa, Ali Faisal Saleem

Department of Paediatrics and Child Health

Background and objectives: Acute illness with malnutrition is a common indication for hospitalization among children in low- and middle-income countries. We investigated the association between wasting recovery trajectories and neurodevelopmental outcomes in young children 6 months after hospitalization for an acute illness.
Methods: Children aged 2 to 23 months were enrolled in a prospective observational cohort of the Childhood Acute Illness & Nutrition Network, in Uganda, Malawi, and Pakistan between January 2017 and January 2019. We grouped children on the basis of their wasting recovery trajectories using change in mid-upper arm circumference for age z-score. Neurodevelopment was assessed with the …

Vitamin C Deficiency In A Food Insecure Patient: A Rare Case Report, Gersham J. Rainone, Tatiana J. Han, Muhammed Rahim, Gregory J. Pirolli, Alina Popa, Jayaram Thimmapuram

Transformative Medicine (T-Med)

Introduction: Scurvy is rarely seen in developed countries and is characterized by deficiency of vitamin C, which can lead to symptoms including wound impairment, bleeding manifestations, and loss of teeth. Case Description: We present a case of a 53-year-old male with a right knee hemarthrosis after a fall. The patient also noted progressively enlarging spontaneous hematomas, denying any recent trauma except for the fall to the knee. He denied family history of bleeding and clotting disorders and endorsed aspirin use in the setting of a prior stroke. He actively resided at a local shelter with limited means of transportation for …

How Climate Change May Threaten Progress In Neonatal Health In The African Region, Britt Nakstad, Veronique Filippi, Adelaide Lusambili, Nathalie Roos, Fiona Scorgie, Matthew F. Chersich, Stanley Luchters, Sari Kovats

Institute for Human Development

Climate change is likely to have wide-ranging impacts on maternal and neonatal health in Africa. Populations in low-resource settings already experience adverse impacts from weather extremes, a high burden of disease from environmental exposures, and limited access to high-quality clinical care. Climate change is already increasing local temperatures. Neonates are at high risk of heat stress and dehydration due to their unique metabolism, physiology, growth, and developmental characteristics. Infants in low-income settings may have little protection against extreme heat due to housing design and limited access to affordable space cooling. Climate change may increase risks to neonatal health from weather …

Dietary Supplements In People With Metastatic Cancer Who Are Experiencing Malnutrition, Cachexia, Sarcopenia, And Frailty: A Scoping Review, Jolyn Johal, Chad Yixian Han, Ria Joseph, Zachary Munn, Oluwaseyifunmi Andi Agbejule, Fiona Crawford‐Williams, Matthew P. Wallen, Raymond J. Chan, Nicolas H. Hart

Research outputs 2022 to 2026

Cancer‐associated malnutrition, or cachexia, stemming from cancer or its treatments, is particularly prevalent in metastatic cancers, and is often interrelated with sarcopenia and frailty. Evidence suggests that dietary supplements play a role in managing these conditions. As metastatic cancer cells are associated with notable genomic and phenotypic alterations, response to dietary supplements may differ between metastatic and non‐metastatic cancers. However, research in this area is lacking. This scoping review aims to identify the dietary supplements that have been studied in patients with metastatic cancers and malnutrition‐related conditions, along with their proposed effects, mechanisms, outcome measures, and tools used. A systematic …

Optimizing Prevention And Community-Based Management Of Severe Malnutrition In Children, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Zulfiqar A. Bhutta discusses prevention and treatment strategies for optimization of community-based management of severe acute malnutrition in children

Nutritional Status And Dietary Intake Of School-Age Children And Early Adolescents: Systematic Review In A Developing Country And Lessons For The Global Perspective, Durray Shahwar Abid Khan, Jai K. Das, Shagufta Zareen, Zohra S. Lassi, Afsah Salman, Muhammad Raashid, Aftab A. Dero, Aijaz Khanzada, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: The prevalence of double burden of malnutrition (DBM) is high in low- and middle-income countries (LMICs). Data on malnutrition trends is present for children age, however the data for school-going children and adolescents aged 5-15 years is scarce.
Objective: This systematic review presents the pooled prevalence of nutritional status and dietary intake among school-going children and adolescents (5-15 years of age) in an LMIC of Pakistan and the perspective for broader global nutrition in this age group.
Methods: An electronic search of databases was run on Pubmed and Medline (via Ovid) along with gray literature and archives of local …

Supporting Patient Education During Infant Formula Shortage: Washington County, Vt, Rachel A. Wayne

Family Medicine Clerkship Student Projects

The infant formula shortage is a current national public health concern. Many guardians of formula-fed infants are struggling to find appropriate nutrition for their babies. Families of low socioeconomic status are being disproportionately affected because many of them rely on the Women, Infants, and Children program (WIC) to obtain formula, and their formula options through this program are limited. This project aims to provide Vermont families who have formula-fed infants with education and resources to navigate the formula shortage and keep their children healthy and fed.

Malnutrition And Liver Disease In A Developing Country, Asra Tus Saleha Siddiqui, Om Parkash, Syeda Amrah Hashmi

Section of Gastroenterology

Malnutrition is a highly prevalent and under recognized condition in developing countries of South Asia. The presence of malnutrition causes a severe impact on patients with liver cirrhosis. The etiology of cirrhosis differs in the South Asian region compared to the West, with hepatitis B and C still being the leading causes and the prevalence of nonalcoholic fatty liver disease increasing over time. Comorbid malnutrition worsens outcomes for cirrhosis patients. Urgent attention to address malnutrition is needed to improve patient outcomes. The etiology and pathophysiology of malnutrition in liver diseases is multifactorial, as reduction in liver function affects both macronutrients …

Evaluating Motor Performance With The Bruininks-Oseretsky Test Of Motor Proficiency In Impoverished Pakistani Children, Zehra Habib Hasan, Fariha Shaheen, Arjumand Rizvi, Jelena Obradovic, Aisha Khan Yousafzai

Department of Paediatrics and Child Health

Objective: To evaluate the sensitivity of the modified Brief Form of Bruininks Oseretsky Test in identifying motor differences secondary to malnutrition and poverty.
Methods: This longitudinal cohort study was conducted at Nowshero Feroze, Sindh from 2013 to 2014 and comprised data drawn from children who participated in a randomised controlled trial, that assessed responsive stimulation and nutrition interventions in the first two years of life. Outcome measures included motor development assessed using Brief Form of Bruininks Oseretsky Test, child anthropometry and household economic and demographic information. Data was analysed using SPSS 15 and STATA 12.
Results: Of the 1058 children, …

Gestational Weight Gain In 4 Low- And Middle-Income Countries And Associations With Birth Outcomes: A Secondary Analysis Of The Women First Trial, Melissa S. Bauserman, Carla M. Bann, K Michael Hambidge, Ana L. Garces, Lester Figueroa, Jamie L. Westcott, Jackie K. Patterson, Elizabeth M. Mcclure, Sumera Ali Aziz, Sarah Saleem

Community Health Sciences

Background: Adequate gestational weight gain (GWG) is essential for healthy fetal growth. However, in low- and middle-income countries, where malnutrition is prevalent, little information is available about GWG and how it might be modified by nutritional status and interventions.
Objective: We describe GWG and its associations with fetal growth and birth outcomes. We also examined the extent to which prepregnancy BMI, and preconception and early weight gain modify GWG, and its effects on fetal growth.
Methods: This was a secondary analysis of the Women First Trial, including 2331 women within the Democratic Republic of Congo (DRC), Guatemala, India, and Pakistan, …

Vitamin D Supplementation Among Bangladeshi Children Under-Five Years Of Age Hospitalised For Severe Pneumonia: A Randomised Placebo Controlled Trial, Fahmida Chowdhury, Abu Sadat Mohammad Sayeem Bin Shahid, Mosharrat Tabassum, Irin Parvin, Probir Kumar Ghosh, Mohammad Iqbal Hossain, Nur Haque Alam, A. S. G. Faruque, Sayeeda Huq, Lubaba Shahrin, Nusrat Homaira, Zakiul Hassan, Zubair Akhtar, S. Mah-E-Muneer, George J. Fuchs Iii, Tahmeed Ahmed, Mohammod Jobayer Chisti

Pediatrics Faculty Publications

INTRODUCTION: Vitamin D is important for its immunomodulatory role and there is an independent association between vitamin D deficiency and pneumonia. We assessed the effect of vitamin D supplementation on the outcome in children hospitalized for severe pneumonia.

METHODS: This was a randomised, double blinded, placebo-controlled clinical trial in children aged >2–59 months with severe pneumonia attending Dhaka Hospital, icddr,b. Children received age-specific megadose of vitamin D3 (20,000IU: < 6 months, 50,000 IU: 6–12 months, 100,000 IU:13–59 months) or placebo on first day and 10,000 IU as maintenance dose for next 4 days or until discharge (if discharged earlier) along with standard therapy. This trial is registered at ClinicalTrials.gov, number NCT02185196.

FINDINGS: We enrolled 100 children in placebo group and 97 in vitamin D group. On admission, 50 (52%) and 49 (49%) of children in vitamin D and placebo groups, respectively were vitamin …

Screening For Malnutrition In Oral Cavity Cancer Patients Prior To Treatment: A Cross-Sectional Study, Haissan Iftikhar, Anwar Suhail, Amna Urooba, Karim Rizwan Nathani, Zeeshan Shaikh, Muhammad Wasif

Section of Otolaryngology, Head & Neck Surgery

This study was conducted to assess the frequency of pre-operative malnourishment in patients being treated for oral cavity squamous cell carcinoma. A retrospective chart review was carried out at the Aga Khan University Hospital, Karachi, on 62 patients. Patients were screened pre-operatively through a standard nutritional assessment tool at the time of admission to assess for malnutrition. Mean age of presentation was 48.34±13.11 years, mean height was 165 ± 8.62cm, weight 66.09±14.98 kg and BMI of 24.09±4.84. Males were 82.3% and 17.7% were females. At the time of admission, a significant number or patients, 12 (19.4%) were prone to malnourishment, …

Assessment Of The Nutritional Status Of Malnourished School-Age Egyptian Children, Hoda A. Abed-El Salam, Sally R. Eid, Salwa M. Saleh

Journal of Medicine in Scientific Research

Background The nutritional status of school-age children is a primary determinant of children's health, as it influences their physical and mental development. The aim of this study was to assess the nutritional status and dietary intake of macronutrients and micronutrients in a sample of malnourished school-age children (5–12 years) in Egypt. Patients and methods This was a cross-sectional study that included school-age children (5–12 years) recruited from the outpatient clinic of the National Nutrition Institute, Cairo, Egypt. Participants sampling was performed during the period from June to August 2019. In this study, 85 children of both sexes were enr?olled. Results …

Translating Evidence-Based Guidelines Into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit Of Nutrition Care In Patients With Foregut Tumors (Inform), Merran Findlay, Judith D. Bauer, Rupinder Dhaliwal, Marian De Van Der Schueren, Alessandro Laviano, Adrianne Widaman, Lisa Martin, Andrew G. Day, Leah M. Gramlich

Faculty Research, Scholarly, and Creative Activity

Malnutrition is highly prevalent in patients with foregut tumors comprising head and neck (HNC) and esophageal (EC) cancers, negatively impacting outcomes. International evidence-based guidelines (EBGs) for nutrition care exist; however, translation of research evidence into practice commonly presents considerable challenges and consequently lags. This study aimed to describe and evaluate current international nutrition care practices compared with the best-available evidence for patients with foregut tumors who are at high risk of malnutrition. A multi-centre prospective cohort study enrolled 170 patients commencing treatment of curative intent for HNC (n = 119) or EC (n = 51) in 11 cancer …

Adversity In Childhood Is Linked To Mental And Physical Health Throughout Life, Charles A. Nelson, Richard David Scott, Zulfiqar Ahmed Bhutta, Nadine Burke Harri, Andrea Danes, Muthanna Samara

Woman and Child Health

The prevalence of “toxic stress” and huge downstream consequences in disease, suffering, and financial costs make prevention and early intervention crucial, say Charles A Nelson and colleagues.

The Intertwined Relationship Between Malnutrition And Poverty, Faareha Siddiqui, Rehana Salam, Zohra S. Lassi, Jai K. Das

Woman and Child Health

Despite social and economic development, the burden of malnutrition across the globe remains unacceptably high. A vital relationship exists between nutritional status, human capital, and economic standing. Malnutrition adversely affects the physiological and mental capacity of individuals; which in turn hampers productivity levels, making them and their respective countries more susceptible to poverty. A two-way link exists between malnutrition and poverty, creating a vicious cycle with each fueling the other. Malnutrition produces conditions of poverty by reducing the economic potential of the population and likewise, poverty reinforces malnutrition by increasing the risk of food insecurity. The aim of the paper …

The Nutritional Status Of Children Living Within Institutionalized Care: A Systematic Review, Emily Delacey, Cally Tann, Nora Groce, Maria Kett, Michael Quiring, Ethan Bergman, Caryl Garcia, Marko Kerac

All Faculty Scholarship for the College of the Sciences

Background. There are an estimated 2.7 million children living within institutionalized care worldwide. This review aimed to evaluate currently available data on the nutrition status of children living within institutionalized care.

Methods. We searched four databases (Pubmed/Medline, CINHAL Plus, Embase and Global Health Database) for relevant articles published from January 1990 to January 2019. Studies that included information on anthropometry or micronutrient status of children living within institutionalized care were eligible for inclusion. The review is registered on PROSPERO: CRD42019117103.

Results. From 3,602 titles screened, we reviewed 98 full texts, of which 25 papers were eligible. Two (8%) studies reported …

Preoperative Maximization To Reduce Complications In Spinal Surgery, Sukanta Maitra, Christopher Mikhail, Samuel K. Cho, Michael D. Daubs

School of Medicine Faculty Publications

Study design: Invited narrative review. Objectives: The aim of this review was to summarize current literature regarding risk factors that surgeons can optimize in the preoperative setting in the spinal surgery patient, in order to reduce complications and improve patient-reported outcomes. Methods: Review of the relevant literature by the authors. Results: Modifiable risk factors identified relative to the patient include obesity, malnutrition/nutrient deficiency, diabetes/hyperglycemia, preoperative anemia, vitamin D/DEXA (dual-energy radiograph absorptiometry), nicotine use/smoking, and opioid use/psychosocial factors. Conclusion: By maximizing a patient's physiological and psychological status prior to elective spine surgery, we may move closer to achieving the goals of …

Determinants Of Linear Growth Faltering Among Children With Moderate-To-Severe Diarrhea In The Global Enteric Multicenter Study, Rebecca L. Brander, Patricia B. Pavlinac, Judd L. Walson, Grace C. John-Stewart, Marcia R. Weaver, Abu S. G Faruque, Anita K. M. Zaidi, Dipika Sur, Samba O. Sow, M Jahangir Hossain

Department of Paediatrics and Child Health

Background: Moderate-to-severe diarrhea (MSD) in the first 2 years of life can impair linear growth. We sought to determine risk factors for linear growth faltering and to build a clinical prediction tool to identify children most likely to experience growth faltering following an episode of MSD.
Methods: Using data from the Global Enteric Multicenter Study of children 0-23 months old presenting with MSD in Africa and Asia, we performed log-binomial regression to determine clinical and sociodemographic factors associated with severe linear growth faltering (loss of ≥ 0.5 length-for-age z-score [LAZ]). Linear regression was used to estimate associations with ΔLAZ. A …

Malnutrition In The Elderly, Clodagh Corcoran, Craig Murphy, Eamonn P. Culligan, Janette Walton, Roy D. Sleator

Department of Biological Sciences Publications

Changes that occur naturally throughout the ageing process place the elderly population at greater risk of malnourishment. This review discusses the significance, causes, consequences and assessment of malnutrition in the elderly.

Childhood Acute Illness And Nutrition (Chain) Network: A Protocol For A Multi-Site Prospective Cohort Study To Identify Modifiable Risk Factors For Mortality Among Acutely Ill Children In Africa And Asia, Childhood Acute Illness And Nutrition Network, J A. Berkley, J L. Walson, A H. Diallo, Asmsb Shahid, A Gwela, Ali Faisal Saleem Dr, Syed Asad Ali, C C. Tigoi, C Bourdon

Department of Paediatrics and Child Health

Introduction: Children admitted to hospitals in resource-poor settings remain at risk of both inpatient and post-discharge mortality. While known risk factors such as young age and nutritional status can identify children at risk, they do not provide clear mechanistic targets for intervention. The Childhood Acute Illness and Nutrition (CHAIN) cohort study aims to characterise the biomedical and social risk factors for mortality in acutely ill children in hospitals and after discharge to identify targeted interventions to reduce mortality.
Methods and analysis: The CHAIN network is currently undertaking a multi-site, prospective, observational cohort study, enrolling children aged 1 week to 2 …

An Overview Of Diabetes And Community Health Concerns In Guatemala, Jennifer A. Davidson, Halie M. Higgins, Alex Krona, Danny R. Luna

All Electronic Theses and Dissertations

Type 2 diabetes mellitus (T2DM) has emerged as a worldwide epidemic in recent years. Rates of this disease continue to rise annually. While many countries have adequate access to prevent and treat T2DM, developing countries often lack education and resources to combat the diabetes epidemic. This shortcoming results in alarming rates of uncontrolled T2DM cases among individuals in developing countries, namely, Guatemala. Additionally, the lack of resources in Guatemala results in a myriad of other health disparities beyond T2DM including deficiencies in sanitation and adequate nutrition. This community service project specifically aims to address the disproportionate burden of T2DM, sanitation, …

Reducing Micronutrient Deficiencies In Pakistani Children: Are Subsidies On Fortified Complementary Foods Cost-Effective?, Simon Wieser, Beatrice Brunner, Christina Tzogiou, Rafael Plessow, Michael B. Zimmermann, Jessica Farebrother, Sajid Bashir Soofi, Zaid Ahmad Bhatti, Imran Ahmed, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Objective: To estimate the cost-effectiveness of price subsidies on fortified packaged complementary foods (FPCF) in reducing iodine deficiency, iron-deficiency anaemia and vitamin A deficiency in Pakistani children.
Design: The study proceeded in three steps: (i) we determined the current lifetime costs of the three micronutrient deficiencies with a health economic model; (ii) we assessed the price sensitivity of demand for FPCF with a market survey in two Pakistani districts; (iii) we combined the findings of the first two steps with the results of a systematic review on the effectiveness of FPCF in reducing micronutrient deficiencies. The cost-effectiveness was estimated by …

Assessment Of Malnutrition In Patients With Liver Cirrhosis Using Protein Calorie Malnutrition (Pcm) Score Verses Bio-Electrical Impedance Analysis (Bia), Om Parkash, Wasim Jafri, S. M. Munir, Romaina Iqbal

Section of Gastroenterology

Objective: Malnutrition is a common problem in patients with liver cirrhosis and tools for nutritional assessment are under debate. We conducted this study to assess prevalence of malnutrition in cirrhotic patients using PCM score and BIA. Additionally we compared BIA to PCM score for detecting malnutrition in this patient population.

Results: This was a cross sectional study conducted in two tertiary care hospitals of Karachi Pakistan on adults with liver cirrhosis. Malnutrition was assessed by PCM score using anthropometric measurements and biological specimens and (ii) Body cell mass was assessed using BIA. Malnutrition as estimated by the PCM score was …

Spoon Nails: Still Seen In Today's World, Bushra Moiz

Department of Pathology and Laboratory Medicine

Koilonychia is a nail abnormality characterized by thin, brittle, and spoon-shaped nails. It is frequently observed in chronic iron deficiency secondary to malnutrition, chronic blood loss, or malabsorption. It may also be idiopathic or related to occupation and rare systemic disorders. Presence of koilonychia should prompt investigations for iron deficiency.

Failure To Thrive: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunisation Safety Data, Elizabeth Ross, Flor M. Munoz, Bassey Edem, Cassandra Nan, Fyezah Jehan, Julie Quinn, Tamala Mallett Moore, Sanie Sesay, Hans Spiegel, Librada Fortuna

Department of Paediatrics and Child Health

No abstract provided.