Showing papers in "Journal of Nutritional Disorders & Therapy in 2015"

Recovery Rate and Determinants in Treatment of Children with SevereAcute Malnutrition using Outpatient Therapeutic Feeding Program inKamba District, South West Ethiopia

Abstract: Introduction: Globally approximately one million children die every year from severe acute malnutrition. It is reported that severe acute malnutrition(SAM) is the commonest reason for paediatric hospital admission in many poor countries; 25 to 30% of children with severe malnutrition die during hospital admissions. Objective: To assess the success rate of OTP in treatment of children with SAM and identify its determinants at Kamba district, South West Ethiopia. Method: Institution based retrospective longitudinal study was carried out on children who were treated on the OTP. A total sample of 711 was selected from 4 health centers and 12 satellite health posts. A structured and pretested data abstraction form were prepared and used for data collection. The data were cleaned, coded and entered into Epi-INFO, analyzed by SPSS. The results were estimated using Kaplan-Meier survival curves, log-rank test and Cox-regression. Result: The recovery rate was 67.7% and the median recovery time was 7.14 weeks (IQR 5.28-8.14). Children treated at a health centers have 1.36 times higher recovery rate than children treated at health post (AHR = 1.495, 95% CI = 1.188, 1.881). Controlling for other factors; the probability of a child to recover from SAM under OTP is 1.25 times higher among children aged greater than two years old than those children aged less than or equal to two years old (AHR = 1.255, 95% CI = 1.012, 1.556). Conclusion and Recommendation: The recovery rate was lower than the international standard. Type of health facility providing the OTP services and age of the child had significant association (at 0.05 P-value) with survival time among children who recovered from SAM under OTP. Special focus should be given to young children and decentralization of OTP service from health centers to health posts should be carried out with great caution.

Survival Status and Predictors of Mortality among Children Aged 0-59 Months with Severe Acute Malnutrition Admitted to Stabilization Center at Sekota Hospital Waghemra Zone

Abstract: Background: The mortality rate of children with complicated severe acute malnutrition that receive treatment in inpatient set ups has remained unacceptably high. Such high mortality in inpatient units has been attributed to either co-morbidity such as Human Immune Virus, Tuberculosis, diarrhea and malaria or due to poor adherence to the World Health Organization therapeutic guidelines for the management of severe acute malnutrition. Objective: To assess survival status and identify the predictors of mortality among children aged 0-59 months with severe acute malnutrition admitted to stabilization center in Sekota hospital, Waghemra zone of Amhara region. Method: A retrospective cohort was conducted on 415 children aged 0-59 months who were admitted for complicated severe acute malnutrition at Sekota hospital from January1/2011 to December 30/2013. The data collection was undertaken from March 15-25, 2014 using standardized checklist. Data were cleaned, edited and entered by Epi data version 3.1. and analysed by SPSS version 16.0. Descriptive summary of child characteristics and outcome of interests were computed by using tables, graphs and Kaplan Meier curves. After checking for assumptions Cox- proportional regression model was used to identify the potential predictors of survival status. Finally variables that had P-value < 0.25 in bivariate analysis were candidates for multivariate analysis to determine independent predictors of mortality. Results: From 441 expected samples, the data were collected on 415 children with baseline records. The most frequently 185(44.6%) associated co-morbid was diarrhoea. Independent predictors of mortality were Malaria (AHR= 2.13, 95% CI = 1.12.7.15), severe anemia (AHR = 6.71, 95% CI: 3.22, 13.97). And TB (AHR= 2.88, 95%CI = 1.72, 4.65). Other predictors of mortality of the children were: children not supplemented folic acid (AHR=2.30, 95% CI=1.54, 3.4), not supplemented for vitamin A (ARH= 1.53, 95% CI= 1.05, 2.24) and children not managed by intravenous antibiotic (AHR= 2.73, 95%CI = 1.9, 4.0). Conclusion: The overall mortality among children aged 0-59 months with complicated SAM admitted to Sekota hospital was higher than the minimum SPHERE standard for stabilization centers. The majority of death was attributed to malaria, severe anemia, TB and mismanagement of complicated severe acute malnutrition. So improving this gap may have paramount effect on child survival.

Health Behavior Knowledge and Self-efficacy as Predictors of Body Weight.

Abstract: Obesity is a public health concern with significant economic costs affecting employers. Worksite wellness programs benefit from developing tailored interventions that consider employees’ health-related knowledge and self-efficacy to change behavior. Correction is a high stress occupation with elevated rates of overweight and obesity. Poor stress management and barriers to achieve optimal health in the work environment increases the need for adequate knowledge and self-efficacy, or the level of confidence to eat healthy and be physically active. This cross-sectional pilot study used a sample of sixteen correctional employees who participated in a Nutrition and Physical Activity Questionnaire. This survey assesses knowledge and self-efficacy for nutrition and physical activity and current health behaviors, such as current dietary habits and level of physical activity. Demographic and anthropometric data were also collected for statistical analyses. Participants were primarily male correction officers working first shift with a mean (±SE) BMI of 29 (±1.05) kg/m2, classified as overweight. Multiple regression analyses revealed that knowledge and self-efficacy scores predicted variation in BMI when controlling for other scores in the model. Findings from this study may be applicable for future health promotion interventions in high-risk occupations. In high-risk occupations such as corrections, understanding environmental and organizational barriers to achieving good health and reducing chronic disease risk is important. However, in addition to reducing these barriers, increasing knowledge, improving skills and self-efficacy to achieve good health are also critical in order to develop effective interventions for this population.

Antimicrobial Activity of Cinnamomum tamala Leaves

Abstract: In the present study phytochemical constituents, elemental composition and antimicrobial potential of the crude methanolic extract of Cinnamomum tamala leaves were explored. Tannins, alkaloids, flavonoids and terpenoids were detected as major phytochemical constituents. Cd, Mn, Pb, Cr, Sb, Na, K, Ca, Cu and Fe concentration were determined by atomic absorption spectroscopy spectrometry (AAS). The results confirmed the presence of Ca as major metallic content i.e. 5634.25 mg/kg. The concentration of other heavy metals particularly Fe and Na were higher as compared to other metals while Cd was not detected. Antimicrobial potential of the crude extract and its fractions i.e. aqueous, n-hexane, dichloromethane and isobutanol were tested against six gram-negative, three gram-positive bacterial strains and one fungal strain by agar well diffusion method. The evaluated extracts evaluated showed variedable degree of inhibition zones against all tested microbes except dichloromethane, aqueous fraction and crude extract which were completely inactive against Salmonella typhi (a gram negative strain). The screening suggests that Cinnamomum tamala have interesting therapeutic potential and of course further biochemical tests are required to explore its possible mechanism of action.

Sedentary Lifestyle, Obesity, and Aging: Implication for Prevention

Abstract: With typical physical activity and dietary habits, an average American adult will experience a BMI increase of approximately 5% each decade [1]. The life expectancy in 2012 was 79 years old [2], with BMI generally increasing starting as early as age 20 [3]. However, approximately 35% of US adults in 2012 are reported to be overweight or obese [4], accelerating these normal age-related changes in body weight leading to further weight gain. Obesity is the cause of many serious medical problems and reduces the quality of life. In older adults the effects could be exacerbated due to a decline in physical functions as a person ages. Implicitly, studies have shown that in older individuals, an increase in body weight is not simply due to increase in energy intake but significant reduction in energy expenditure due to sedentarism. Obesity in the general population is the result of sedentary lifestyle and substantial reduction in everyday physical activity [5]. Thus, it could be assumed that the combination of aging and obesity further promote sedentary lifestyles in older adults.

Prevalence of Coronary Heart Diseases Risk Factors in Adults Population Living in Nigeria?s Largest Urban City

Abstract: Coronary Heart Disease (CHD) remains a major cause of morbidity and a leading contributor to mortality worldwide. This study was conducted to determine the prevalence of risk factors of CHD in apparently healthy adult’s population living in Nigeria’s largest urban city. Five hundred subjects were selected using systematic sampling technique. Data were collected using a pre-tested, semi-structured questionnaire to obtain information on sociodemographic characteristics, lifestyle, physical activities and other risk factors. Anthropometric measurements were made using standard procedures, while food intake data was collected using 24-hr dietary recall. Blood samples of the selected healthy subjects were analyzed for haematological indices. Data were analyzed using Pearson Product Moment Correlation to establish relationships among variables. Logit model was used in predicting major risk factors for CHD. The results showed that prevalence of overweight among urban and rural subjects was 37.6% and 26.8%, respectively while 28.4% of urban and 17.2% of rural subjects had waist-hip ratio indicating high risk of heart disease. Sixty-eight percent of urban subjects and 52% of rural had energy intake above 75% Recommended Dietary Allowance (RDA), while 80% urban and 68% rural subjects met above 75% RDA for protein. Total Cholesterol (TC) was above 240 mg/dl in 28% and 20% of urban and rural subjects, respectively. Triglycerides (TG) was >200 mg/dl in 36% of urban and 28% rural healthy subjects. Low density lipoprotein (LDL) (>l60 m g/dl) was similar in 20% of rural and urban subjects. High density lipoprotein (HDL) was <40 mg/dl in 16% and 20% of urban and rural subjects respectively. There was positive relationship between blood pressure and nature of job (r = 0.033, p<0.0l), blood pressure and age (r =0.122; p<0.0l), blood pressure and alcohol consumption (r = 0.021, p<0.05). Logit model used in predicting the probability of developing CHD showed that it is possible to predict to about 49% accuracy the probability of individuals developing CHD. This study has established high blood pressure, tobacco smoking, high lipid profile, physical Inactivity, obesity and diabetes as prevalent risk factors of CHD in healthy adults in Nigeria.

Prevalence of Childhood Overweight and Obesity and its Determinant Factors Among Elementary School Children in Addis Ababa, Ethiopia: A Cross Sectional Study

Abstract: Background: Obesity and overweight pose major risk for serious diet-related chronic diseases, including Type 2 diabetes, cardiovascular disease, hypertension and stroke, and certain forms of cancer. Even though there is no well-documented information recently, chronic diseases that are directly or indirectly related to overweight and obesity are increasing in Ethiopia especially in urban areas. Objective: the main aim of this study is to determine the prevalence of childhood overweight and obesity and its determinant factors. Methods: A cross-sectional survey was conducted among 463 elementary school children in Addis Ababa. Study participants were selected using multi stage sampling from 10 public and 10 private elementary Schools. Overweight and obesity was determined using CDC 2000, BMI percentile chart. Socio-demographic and other determinants of childhood overweight were assessed. Data were collected using combination of interview of children and self-administered questionnaire to their parents. Finally data were processed and analysed using Epi info version 3.5.4and SPSS version 21. Result: A total 463 children and 463 parents participated in the study. The overall prevalence of underweight, normal, overweight and obesity is 44(9.5%), 360(77.8%), 46(9.9%) and 13(2.8%) respectively. Sex specific prevalence of overweight and obesity shows 7.7% and 3.2% for male and 12%and 2.5% for female respectively. Significant association with overweight was observed among car ownership of the family (p<0.001), number of snacks per day (p=0.03), sweet food preference (p<0.001), buying ice cream (p=0.014), eating breakfast irregularly (p=0.034), walking or riding bicycle for at least 10 minutes per day (p=0.009) and family participation in regular physical activity (p=0.023). Conclusion and Recommendations: The prevalence of overweight was found to be high even comparable with the global prevalence. Among the factors identified are unhealthy dietary pattern like preferring sweet foods, eating breakfast irregularly, buying ice cream and frequent snacking are strongly associated with overweight. In addition physical inactivity are also important factors impacting on the risk of obesity in children. If Primary preventive measures is not taken immediately, prevalence of overweight and obesity among children in Addis Ababa might increase rapidly in the coming few years. Early interventions on modifiable risk factors by promoting active lifestyles and healthy diets are likely to decrease the rate of childhood obesity.

Prevalence of Stunting among Children Aged 6 to 36 Months, in the Eastern Province of Sri Lanka

Abstract: Objective: This study aims to assess the prevalence of stunting among children aged 6-36 months and to describe the underlying factors and feeding practices of infants and young children in 2 districts of the Eastern Province in Sri Lanka. Methodology: A cross-sectional quantitative survey was conducted in Batticaloa and Kalmunai health districts of the Eastern Province in Sri Lanka from July to December 2013. A sample of 1400 children was identified using a stratified cluster sampling method, and the data were obtained from mothers or care givers using an interviewer administered questionnaire. Anthropometric measurements were taken using standard procedure and equipment. Stunting was defined as the proportion of children whose height-for-age Z score was less than -2 according to WHO growth standards. Results: The prevalence of stunting was 16.8% (95% CI; 14.1, 18.0) among the children aged 6-36 months, in the Eastern Province of Sri Lanka. The prevalence of wasting was 21.5% (95% CI; 18.8, 24.3), and underweight was 27.2% (95% CI; 19.8, 28.7) in this age group. Boys were more stunted (20.3% (95% CI; 16.1, 24.2)) than girls (14.0% (95%CI; 9.6 and 16.5)). Underlying factors include: lower educational level of parents (OR=4.91, p=0.048); lower family income (OR=1.48, p=0.011); low birth weight (OR=1.28, p=0.049); exclusive breastfeeding period less than 6 months(OR=2.29, p=0.041); poor complementary feeding practices (OR=1.51, p=0.048); irregular clinic visits (OR=1.52, p=0.041) and not getting advice from health personnel (OR=1.41, p=0.041). Conclusion: Prevalence of stunting among children aged 6-36 months in the Eastern Province is higher than the rest of the country. Poor infant and young child feeding practices was identified as one of the modifiable factors. Breastfeeding and the complementary feeding practices need improvement through improved feeding behavior of mothers and/or care givers.

Green Coffee Bean Extract as a Weight Loss Supplement

Abstract: Background: Weight management is a long-standing goal of achieving a healthy lifestyle. Therefore, it is important to find a safe and effective way to reduce the body weight of overweight or obese people. In this regard, studies focusing on the components of the diet are very important. Methods: We reviewed the results of the studies assessing the efficacy of green coffee extract (GCE) as a weight-reducing agent. Results: The components of the diet may work synergistically to prevent or promote weight management. Conclusions: Recently, green coffee introduced as the richest sources of cholorogenic acid that can play a role in weight loss.

Protein-Energy Intakes and Nutritional Status of in-School Adolescents in Baham, Cameroon

Abstract: Poor nutritional status during adolescence is an important determinant of health outcomes at a later stage of life. Therefore, attention should be given to adolescent health and nutrition. The aim of the present study was to investigate the protein-energy intakes and nutritional status of in-school adolescents in Baham, Central sub-division of the upper plateau division of the western Region of Cameroon. A total of 770 in-school adolescents of Baham aged between 10 and 18 years were recruited for the study. Protein and energy intakes were estimated based on their food consumption recorded using a 7-days food diary. Protein and energy intakes obtained were compared with reference values. Anthropometric measurements included weight and height were analysed using the World Health Organizations’ (WHO) AnthroPlus® version 1.0.2 statistical software. No significant differences were observed in the daily intakes in protein and energy (p> 0.05) between male and female adolescents from 10 to 13 years. However, for adolescents aged 14 to 18, the daily intakes in proteins and energy were significantly higher for males compared to females (p<0.05). For all the subjects the protein intake was significantly higher than the needs while the energy intake was significantly lower than the needs (p<0.05). The prevalence of stunted and wasted was significantly higher in males than the females (p<0.05). In the contrary, the prevalence of overweight is significantly higher for females than for males (p<0.05).These results will be useful for nutritional advice and intervention in adolescent males and females in this community.

Childhood Obesity: Epidemiology, Determinants, and Prevention

Abstract: Recently, high prevalence of overweight and obesity has been reported in children and adolescents both in developed and in developing countries and these figures have been projected to increase further in coming years. Childhood obesity increases the risk of adulthood obesity and obesity related diseases such as hypertension, diabetes mellitus, and dyslipidemia. Several studies highlight recent evidence regarding the role of genetics, age, gender, birth weight, dietary pattern: eating fast foods and snacks and skipping breakfast and behavioral characteristics: sedentary activities, physical activity pattern, and sleeping hours related to occurrence of obesity in children and adolescents. Interventions related to changing dietary practices and maintenance of regular physical activity among children through parental initiative and social support in natural settings such as at home and in schools, or afterschool care services are the most important to prevent childhood obesity.

Food Justice: What is it? Where has it been? Where is it going?

Abstract: Food justice has been described as a social concern, an economic matter, and a political problem [1]. Broadly speaking, food justice encompasses a vision of social, environmental, and economic justice; improved nutrition and health; and community activism [2]. Sometimes viewed as an amalgamation of the concerns of alternative food movements and environmental rights, food justice addresses the disproportionate burden of environmental barriers to healthy food experienced by low-income communities and communities of color [3,4]. The concept of food justice aligns itself with the goals of social justice, which demand recognition of human rights, equal opportunity, and fair treatment. Existing food justice literature calls for the mainstream, or global, food system to address issues of social justice [5].

Calorie Restriction An Approach towards Obesity Management

Abstract: Obesity is increasing worldwide and has become a public health concern due to associated degenerative diseases and morbidity. Even though overweight and obesity are not life threatening, they qualify themselves as a disease entity. The bulk of literature on obesity says that the external environment largely influences the increase in food intake and is termed scientifically as “obesogenic environment”. A “dual approach” that uses both traditional and holistic health can be used to curb this rising trend. Dietary approaches like low calorie diets and increased physical activity are recommended for weight management and prevention of diseases. A number of studies indicate that there is an increased interest in enhancing the use of herbs, bioactive components of foods, traditional diets; owing to their wide spectrum of therapeutic properties for obesity and for the armed forces personnel (under the hypocaloric rations in the field). Therefore, taking the existing scenario of obesity into consideration and the protective role of calorie restriction, this paper provides an insight into the highly convoluted process of dietary restriction and highlights the implications of hypocaloric diets.

Dietary Habits and Intakes Associated with Obesity and Overweight among Adolescents in the State of Qatar

Abstract: Background: In Arab countries particularly in Qatar, nutrition transition in food choices and dietary habits have been changed from healthy diet pattern to unhealthy fast food pattern. As a result overweight and obesity rates are increasing to alarming figures. The aim of this study is to assess the prevalence of obesity and overweight among adolescents in Qatar and its relation with their eating pattern. Methods: A cross – sectional study of 1225 adolescents (51% male and 49% female), aged 15 to 18 years, were randomly selected from 21 secondary schools in Doha - the capital of Qatar during October 2012 and Feb 2013. Data was collected by using self – reporting questionnaire that included questions on their eating / drinking habits and anthropometric measurements, Statistical analysis were performed using the Statistical Package for Social Sciences software (SPSS, Version 15.0). The level of significance was set at P< 0.05. Results: This study showed that the overall prevalence of overweight and obesity were (18.5 % and 19.1 %) respectively. The prevalence of obesity among males (25.3%) was significantly higher than among females (12.6%) p<0.0001, while overweight prevalence of female (21.0%) was significantly higher than among males (16.3%). When the prevalence of obesity and overweight was combined together it was significantly higher among males (25.6%) than in females (23.7%). Waist circumference was significantly higher in males (77.82 ± 17.3) than in females (73.06 ± 10.2). Eating habits of the students showed that Frequency of foods intake (fruits, milk and energy drinks per week) was significantly higher among males than females, while intake of (sweets, French fries and cake/doughnuts) was higher among females than among males. Results shows there was no significance difference in frequency of other food items between males and females. Conclusion: Overweight and obesity is prevalent, unhealthy food habits are common among adolescents. Nutrition and health educational programs are required to reduce the tendency of overweight and obesity and to improve their eating habits.

Metallic Content of One Hundred Medicinal Plants

Abstract: Heavy metals are necessary for the normal functioning of cells and the survival of organisms. These are required for physiological and biochemical functioning of the body, but at higher concentration they causes the oxidative damage. In fact non-essential metals like (lead (Pb), mercury (Hg) and cadmium (Cd)) are more noxious even at very low concentration. It’s important to note that heavy metals are present in soil, air and water can easily enter into the organisms. Literature highlighted the role of metals like chromium (Cr), iron (Fe), nickel (Ni), copper (Cu), cadmium (Cd), lead (Pb) and arsenic (As) in oxidative damage. Fenton chemistry/Haber-Weiss reaction are most extensively studied mechanisms by which heavy metals produces reactive oxygen and nitrogen species (ROS and RNS) and ultimately causes oxidative stress. Both redox-active and inactive metals can diminish cellular antioxidant system specifically thiol- containing enzymes and antioxidants and may lead to cellular death. This review will contribute in providing valuable information on metallic contents of selected plants. For the purpose, data has been collected from the literature regarding ten mineral contents (sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), zinc (Zn), iron (Fe), copper (Cu), chromium (Cr), nickel (Ni) and manganese (Mn)) of 100 medicinal plants grown in Pakistan. The metallic contents shows that majority of the plants contain optimum values as compared with daily mineral intake standards. However, several factors may account for variations in mineral concentration, which include soil composition, different geographic areas and environmental changes.

Nutritional Properties and Toxicological Assessment of High Nutrient Biscuit Developed from Blends of Some Cereals and Legume

Abstract: This study sought to evaluate the nutritional and antioxidant properties of high nutrient biscuits from some cereals and legume. Toxicological investigations were also carried out on the biscuit developed alongside a commercial biscuit using some selected parameters. Proximate, mineral and vitamin composition of the biscuit were determined. Rats were fed with the high nutrient biscuits, commercial biscuit and normal rat feed for twenty-eight (28) days and were sacrificed by cervical dislocation. The Liver, heart and kidney tissues were analysed for liver (Alanine amino transferase [ALT], Alkaline Phosphatase [ALP], Aspartate amino transferase [AST], Albumin [ALB], Bilirubin [BIL] Total protein (TP)) and kidney (creatinine [CREA] and urea) enzyme and protein levels, including glutathione (GSH), glutathione peroxidase (GPX), glutathione –S- transferase, catalase, superoxide dismutase (SOD) activities, and malondialdehyde (MDA) levels as well as lipid profiles which cover for total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL). Feeding on the biscuits let to the significant (P<0.05) decrease in AST, ALT, ALP, BIL, urea and creatinine levels. However rats fed with the high nutrient biscuit (BRB) had lower concentration of these enzymes and proteins when compared to the conventional biscuit (ARB) and the control (BRC) although there was increase in the ALB and TP content of the BRB group compared to ARB and BRC. Furthermore BRB had significant reduction in the TC, TG, LDL, and HDL concentration followed by the ARB when compared to the BRC groups. Moreover there was significant increase in the levels of the antioxidant enzymes and decrease in malondialdehyde production in the liver, heart and kidney of BRB when compared to other groups. This result indicates high nutritional properties and antioxidant potential of the biscuits. Therefore the high nutrient biscuit could be used as functional food and an adjunct dietary therapy for malnourished children.

Overtime, Shift Work, Poor Sleep and the Effects on Obesity: A Public HealthProblem

Abstract: Over two-thirds (68.6%) of adults in the United States were overweight or obese in 2011-2012, and prevalence rates continue to increase at a dramatic pace [1]. A recent review of the literature revealed that direct medical costs of obesity and comorbidities such as cardiovascular disease and type 2 diabetes may be as high as $209.7 billion annually [2]. Indirect costs may sum near $66 million annually, with potential to yield significant savings to individuals, employers, and improve quality of life [2]. Understanding potential factors to reduce and prevent further increases in the obesity epidemic has the potential to yield over $500 billion dollars in savings by the year 2030 [2]. Analysis of work-related factors such as worksite health culture, overtime, shift work and lifestyle behaviors influenced by the workplace may be one approach to address the obesity epidemic.

The Cure is in the Roots: Turmeric

Abstract: This study aims to assess the core health benefits of Turmeric. According to most research, Turmeric is proclaimed as the most effective nutritional constituent in existence based on its unparalleled benefits for body and brain. The science supports this herb validating the compounds with medicinal properties.

Effects of Denosumab Treatment during Early Pregnancy A Case Report

Abstract: Background: Osteoporotic treatment during pregnancy is controversial. Denosumab, a fully human monoclonal antibody against receptor activator of nuclear factor-kB ligand (RANKL), is a potent new bone bone resorptive inhibitory drug for osteopenic and osteoporotic treatment. There has been no report on the effectiveness or adverse effect after denosumab treatment in a young osteoporotic patient. Case: We experienced a young lady with osteoporosis due to idiopathic menstrual irregularity. Prior to the therapy, we confirmed that she would not be pregnant during the treatment. Denosumab among numerous drugs after careful discussion was given who completed delivery without any serious complications for mother or child. We regularly examined the values of bone chemical markers during and after pregnancy, and the bone mineral density (BMD) before treatment and after giving birth. Those values improved at 6 months after an initial denosumab injection. Conclusion: These results suggest that BMD and bone turnover marker values improved at 6 months after the denosumab unintended administration during early pregnancy in a young woman with osteoporosis. To our knowledge, though contraindicated in pregnancy, this is the first report of its use in pregnancy, though inadvertent. The purpose is to demonstrate a case in which it was used in this context without adverse effect.

Stroke in Young Patients - A New Trend in Nepalese Perspective?

Abstract: Background: Stroke is caused by the loss of blood supply to the brain, commonly known as cerebral vascular accident (CVA). Strokes in younger people (below 45 years) are not common as it usually occurs in the middle-aged and elderly. The absolute definition of stroke in young does not exist, however conventionally “young stroke” is considered for people below 45 years. Objective: To analyse the trends in occurrence, risk factors, etiology and neuroimaging features of ischemic stroke in young adults. Methods: In this study the records of 281 strokes patients were reviewed, out of which 33 were young patients admitted to Neurology ward of College of Medical Sciences, Bharatpur, Nepal from 1st January to 31st December 2013. The records were analysed on the basis of age, sex, hypertension (HTN), body mass index (BMI), smoking habits, haemoglobin (Hb), diabetes mellitus (DM), lipid profile, atrial fibrillation (AF) and vascular territory with clinical and radiological evidences. Results: Most of the young stroke patients were between 40-45 years. Ischemic stroke was noted in 87.8%and haemorrhagic stroke was noted in 12.2% of patients. Middle cerebral artery (MCA) ischemia was noted in 57.6% of patients and anterior cerebral artery (ACA) ischemia was noted in 3% of patients. Multiple infarcts were noted in 9.1% of patients. About half of them were smoker, hypertension 42.4%, diabetes mellitus 18.2% and 9.1% had atrial fibrillation. Conclusion: The stroke is also seen in young people below 45 years. The common risk factors like smoking, Hypertension and Diabetes are increasingly recognized in young patients.

Changes in Antioxidant Enzymes in Metabolic Syndrome Patients after Consumption a Citrus-Based Juice Enriched with Aronia Melanocarpa

Abstract: Increased oxidative stress has been suggested as an early event in the development of the metabolic syndrome and, as such, might contribute to disease progression. The aim of de present study was to evaluate Total Antioxidant Status and endogenous antioxidant enzymes in metabolic syndrome patients after consumption of a citrus-based juice compared with control groups. Before, and at sixth month after treatment the following parameters were determined: Total Antioxidant Status, Superoxide Dismutase, Glutathione Peroxidase and Glutathione Reductases. After six months of citrus-based juice consuming, there was no significant differences at 95% confidence in Total Antioxidant Status between three groups, although it was found significant differences between groups in values of three antioxidant enzymes analysed. As a conclusion, the intake of a citrus-based juice increases the levels of antioxidant enzymes, despite do not increase the Total Antioxidant Status after its intake during 6 months.

Improving Public Health through Nutrition Education

Abstract: Education and nutrition are important fundamental conditions and resources for improving public health. Unhealthy nutrition is one of the key risk factors for developing main non-communicable diseases. Studies have confirmed that Macedonian population has unhealthy eating habits. Dietetics is not included in the curricula of Macedonian Medical Faculties. In order to improve population health, by improving the quality of nutrition education and research, after implementation of Master study for Nutrition and Food safety and quality [1], we determined the following objectives: -Supporting proactive partnership in defining national standards for the formulation of Doctoral study program for Innovation Technology for Food and Food Science and Nutrition; -Forming a set of competencies upon completion of studies; - Application of information and communication technology (ICT) and e-learning. Analysing the results of numerous scientific findings that confirm the important role of food and nutrition in health promotion and prevention of nutrition-related diseases, we developed the Doctoral study programs with two modules. The first one module is focused on “The innovative technologies for food” and the second module is related to the “Food science and nutrition”. The model of designing, planning and implementation of curriculum is in accordance with Dublin description 2005 [2], European standards for improvement of academic and practical curricula 2010 [3] and DIETS2 advanced competencies 2012 [4]. Proactive work with the industry and private companies is related to practice placement. Innovative application of ICT, e-learning and creating a website are intended for collaboration with EFAD, European Federation of Associations of Dieticians (EFAD) and other European and International Nutrition Networks. These doctoral study programs will allow education of our own nutritionists who will be able to meet the domestic and global issues relating to food and nutrition, inclusion of the researchers and experts in the projects and in the healthcare teams, HEIs, food industry and they will be qualified to be responsible for production of healthy, quality, safe, environmentally friendly and affordable food for domestic and export needs. Also, these nutritional experts will contribute to changes in public health policy and health education strategy (2014-2020) in the area of “Public Health Enhancing through Nutrition Education”.

The Role of Zinc in Renal Pathological Changes in Diabetic Status

Abstract: Diabetes mellitus (DM) was the 8th leading cause of death in 2011, resulting in 1.4 million deaths worldwide. One of the complications of DM is chronic kidney disease, which accounts for nearly 44% of all new cases of kidney failure in the US in 2011. Zinc (Zn), an essential trace element, plays an important role in regulating carbohydrate metabolism. Several studies have shown the beneficial effects of Zn on renal pathological changes in Type 1 and Type 2 diabetic subjects, by reducing levels of oxidative stress, glomerular damage, and urinary albumin excretion after Zn supplementation. In contrast, other studies have shown little effects of Zn supplementation on renal damage. This paper reviewed recent research developments and found promising results of Zn in reducing, and in some cases, completely preventing renal damage. Nevertheless, the use of Zn as a potential treatment and especially its long-term impact against renal pathological symptoms in DM patients needs to be further studied.

Value Changes in Bone Turnover Markers and Bone Mineral Density Using Ibandronate in Japanese Postmenopausal Osteoporotic Patients

Abstract: There has been no actual clinical report on the changes in bone turnover markers and bone mineral density (BMD) during ibandronate (IBN) treatment with or without vitamin D in Japanese postmenopausal osteoporotic patients. In this study, 48 treatment-naive primary osteoporotic patients were divided into the IBN group or IBN with alfacalcidol (ALF) group. Bone turnover markers, 1,25(OH)2D3, and whole parathyroid hormone (PTH) were examined just prior to treatment and at 1, 4, 8, 12, 16, and 20 weeks of therapy. BMD was measured at 0 and 16 weeks. Values of TRACP-5b were significantly and continuously lower than baseline after 1 week of treatment in both groups. TRACP-5b values were significantly lower in the IBN group with ALF than in the IBN alone group at 4 and 8 weeks of treatment. Values of BAP were comparable between the groups at all-time points. Lumbar and hip BMD was slightly increased in both groups at 16 weeks of treatment, however, there was no significant difference between both groups. We witnessed a significant reduction in bone markers in both treatment groups, as well as an increase in 1,25(OH)2D3 and PTH in the IBN alone group.

Coalesced Impact of Green Tea and Cinnamon on Metabolic Parameters of Overweight Subjects

Abstract: Obesity is pandemic worldwide and even in developing countries significantly shares the proportion of its prevalence. Beyond pharmaco-therapy, overweight individuals have been seeking functional food supplements to manage their weight. Several functional foods have been suggested for the management of obesity. Particularly, certain functional foods that contain bio active compounds are believed to interfere in cell metabolism that brings changes in the metabolic parameters. The two functional foods green tea and cinnamon have been intensively studied individually on insulin sensitivity, blood glucose, body weight and lipid fractions using animal and human models. However, there has been seldom study available experimenting with both the functional ingredients (Green Tea and Cinnamon) together in over weight individuals. The inmates of St. Joseph Prasanth Nivas Ashramam, Jeppu Mangalore, India were selected as participants. A total of forty volunteers were recruited according to predetermined inclusion criteria were grouped into experimental and control groups equally. Supplementation of green tea with cinnamon twice a day for 30 days yielded a significant reduction in BMI (P<0.05) waist circumferences (P<0.05) and lipid parameters like TGL (P=0.000), HDL (P=0.000) and that of LDL (P<0.05). Thus, it is imperative that regular consumption of Green Tea with Cinnamon can modulate lipids favourably and moderately reduce body weight which on a long run may help one to prevent or decrease the risk of CVD.

Obesity and its Therapy: A Short Review

Abstract: Weight increase is an understood reaction of treatment with psychotropic medications. Over fifty years prior, medications, for example, amitriptyline (Elavil) and lithium were known not connected with significant increments in weight and notwithstanding new eras of psychotropic medications, this unwelcome symptom has held on. The amount of weight is picked up changes however when all is said in one state of mind stabilizers and antipsychotics medications cause more generous weight pick up than antidepressants. Two antipsychotics, clozapine (Clozaril) and olanzapine (Zyprexa) are connected with the best pervasiveness of weight addition; up to 31% of patients treated with clozapine and 40% with olanzapine build their weight amid treatment. Some temperament stabilizers, for example, valproate (Depakote) likewise are connected with an also high rate of weight addition. Mirtazapine (Remeron) and paroxetine (Paxil) are two antidepressants with the best weight increase potential among the antidepressants in spite of the fact that aside from buproprion (Wellbutrin) weight addition has been accounted for among the greater part of alternate medications in this classification.

Mid Pregnancy Fetal Growth Restriction and Maternal Anaemia a Prospective Study

Abstract: Background: Fetal growth restriction (FGR) in anaemic women leads to high perinatal morbidity, mortality and long term sequelae too. Objective: Was to know relationship between mid gestation FGR, maternal anaemia and neonatal outcome. Materials and methods: Case control study was done in 500 study subjects with special criteria (primigravida with FGR at midgestation with or without anaemia, no other disorders), 500 controls were with similar criteria without FGR. Results: Of 500 study subjects with FGR at 20-24 weeks, 79.2% were anaemic, (53.3% had mild, 41.7% moderate, 5% severe anaemia), 20.8% nonanaemic. Amongst controls, 63.4% were anaemic, (66.2% mild, 30.5% moderate, 3.15% severe), 36.6% nonanaemic. Significantly more study subjects were anaemic, (moderately, severely) with 2.2 times more chances of anaemia in study compared to controls. 7.2% with mild, 14.5% with moderate, 43.9% with severe, 5.5% without anaemia had preterm birth, significant increase in preterm births with increasing severity of anaemia. There was significant (p<0.05) difference between mean birth weight. MBW decreasing with anemia severity. Risk for LBW, VLBW in mild, moderate, severe anaemia was 1.2 and 1.7, 3.8 and 1.5, and 1.9 and 4.2 respectively, MBW of study cases with mild anaemia was, (2085.72 ± 317.2 g), with moderate MBW, (1950.26 ± 410.3 g), with severe (1380.25 ± 480.1 g), without anaemia (2146.42 ± 279.1 g), significant difference in moderate and severe anaemia cases (p<0.01). None with anaemia at 20-24 weeks became nonanaemic with increasing gestation. Conclusion: FGR at midgestation is significantly associated with anaemia in mother, risk of FGR increases with severity of anaemia. With FGR and anaemia risk of preterm pains, preterm births increase with increase in severity of anaemia MBW decreases. In day to day practice women with anaemia at mid gestation do not become nonanaemic. In anaemic women, FGR can occur in later weeks of pregnancy also.

The Crisis of Obesity

Abstract: The prevalence of overweight and obesity is increasing in nearly every country around the world and that this public health crisis even affects infants and children of pre-school age. In discussing obesity, the prevalence, definition and the health and economic consequences of this global crisis are discussed, with a specific focus on childhood obesity.

Level of Zinc, Retinol, Blood Macrophages, T- Lymphocytes and Immunoglobulin G in Children with Tuberculosis and Non Tuberculosis

Abstract: Tuberculosis remains a major cause of morbidity and mortality in children in the world, but still lack of priority in overcomes them. Every year estimated 9 million new tuberculosis cases with 1 million of whom are children aged <15 years and 2 million of them died. Nutrients which are very influential on a child's immune system are fat, protein, vitamin A and zinc. The presence of zinc in the body greatly affects the immune function so it plays an important role in the prevention of infectious diseases, including tuberculosis. The purpose of this study is to determine differences in serum zinc levels, serum retinol levels, levels of blood macrophages, T-lymphocytes and IgG between children with tuberculosis with healthy children or non- tuberculosis. This study is a comparative observational study with cross sectional study design. The sampling technique of this study was simple random sampling. This study was conducted at RSUD Sidoarjo with each 11 children in tuberculosis and non-tuberculosis group as a sample. At the end of this study, it discovered that there are significant differences levels of zinc serum (p=0.003), retinol serum (p=0.018), blood macrophages (p=0.001), T-lymphocytes (p=0.001) and IgG (p=0.006) between tuberculosis and non-tuberculosis group. The levels of zinc, retinol and IgG on children with tuberculosis were lower than nontuberculosis children, but T-lymphocytes on children with tuberculosis were higher than non-tuberculosis children. It suggested for giving zinc and vitamin A regularly and appropriate dosing in children with tuberculosis where it is useful to improve the durability of the body and can improve the child's appetite.

Nutritional Status of Grade Five Students in Selected School of Batticaloa District, Sri Lanka

Abstract: Objective: To describe the nutritional status and the factors influencing nutritional status of grade five school children in Manmuni North educational division Batticaloa District, Sri Lanka. Methods: A descriptive cross-sectional study was carried out among grade five school children in Manmuni North educational division, Batticaloa. Six schools were selected for this study was receiving nutritional supplements. Body Mass Index (BMI) was calculated for each child. The age and sex specific BMI charts developed by the National Center for Health statistics 2000 were used as standards. Data were statistically analyzed using the STATA 8.2 software. Results: The prevalence of underweight (< 5th percentile) was 44.4% and the prevalence of overweight (≥ 85th percentile) was 10.5%.The relationship of malnutrition with sex, family type, number of siblings, mother’s occupation, monthly income, worm treatment, food allergy and dental caries were considered for analysis of the studied factors. Sex, number of siblings and worm treatment were statistically significant with malnutrition. Conclusion: Underweight (44.4%) is a problem among grade five children. About 11.0% of them were overweight. Most of the students (66.7%) did not get regular worm treatment; of them (48%) were from rural area. Dental caries were observed in (51%) of students. Students who were malnourished showed statistically significant associations with gender, number of sibling in the families and not taking of regular worm treatment. It is evident that a substantial population does not consume a varied and balanced diet, even though Sri Lankan Dietary Guideline has emphasized the importance of it.