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Humanitarian Charter And Minimum Standards In Disaster Response

The role of nutrition and diet in the development of non-alcoholic fatty liver disease (NAFLD) is still not fully understood In the present study, we determined if dietary pattern and markers of intestinal permeability differ between overweight children with and without NAFLD In addition, in a feasibility study, we assessed the effect of a moderate dietary intervention only focusing on nutrients identified to differ between groups on markers of intestinal barrier function and health status Anthropometric data, dietary intake, metabolic parameters, and markers of inflammation, as well as of intestinal permeability, were assessed in overweight children (n = 89, aged 5⁻9) and normal-weight healthy controls (n = 36, aged 5⁻9) Sixteen children suffered from early signs of NAFLD, eg, steatosis grade 1 as determined by ultrasound Twelve children showing early signs of NAFLD were enrolled in the intervention study (n = 6 intervention, n = 6 control) Body mass index (BMI), BMI standard deviation score (BMI-SDS), and waist circumference were significantly higher in NAFLD children than in overweight children without NAFLD Levels of bacterial endotoxin, lipopolysaccharide-binding protein (LBP), and proinflammatory markers like interleukin 6 (IL-6) and tumor necrosis factor α (TNFα) were also significantly higher in overweight children with NAFLD compared to those without Total energy and carbohydrate intake were higher in NAFLD children than in those without The higher carbohydrate intake mainly resulted from a higher total fructose and glucose intake derived from a significantly higher consumption of sugar-sweetened beverages When counseling children with NAFLD regarding fructose intake (four times, 30⁻60 min within 1 year; one one-on-one counseling and three group counselings), neither alanine aminotransferase (ALT) nor aspartate aminotransferase (AST) activity in serum changed; however, diastolic blood pressure (p < 005) and bacterial endotoxin levels (p = 006) decreased markedly in the intervention group after one year Similar changes were not found in uncounseled children Our results suggest that a sugar-rich diet might contribute to the development of early stages of NAFLD in overweight children, and that moderate dietary counseling might improve the metabolic status of overweight children with NAFLD

https://www.mdpi.com/2072-6643/10/9/1329/pdf

Non-Alcoholic Fatty Liver Disease in Overweight Children: Role of Fructose Intake and Dietary Pattern

Difference between kwashiorkor and marasmus: Comparative meta-analysis of pathogenic characteristics and implications for treatment.

Globally, approximately 19 million children under 5 years are suffering from Severe Acute Malnutrition (SAM) It is a major cause of morbidity and mortality in low-income countries including Ethiopia However, little is known regarding predictors of mortality among these children in Ethiopia The current study aimed to assess the potential predictors of mortality among under-five children with SAM admitted to a stabilization center A retrospective cohort study was conducted in 527 under-five children who were admitted for SAM at the University of Gondar comprehensive specialized hospital from 2014 to 2016 Data were collected from a randomly selected chart after getting ethical clearance Data were cleaned, coded and entered to Epi-info (version 7) and analyzed using STATA (version14) The outcome was computed by using tables and graphs A multivariable cox proportional hazards model was fitted to identify predictors of mortality Overall, the median follow-up period was 10 days with interquartile range (Q1, Q3: 8, 17) At the end of the follow-up, the mortality rate was 66(1252%) Anemia (AHR(Adjusted Hazard Ratio): 23, 95% CI: 12, 45), Shock (AHR: 79, 95% CI: 37, 167), no intake of antibiotics (AHR: 23 95% CI: 12, 44), IV-Fluid (AHR: 32, 95% CI: 17, 58), no intake of F75 (AHR: 66,95% CI: 29, 147) and no intake of F100 (AHR: 3, 95% CI: 16, 54) were independent predictors of mortality The survival status of under-five children with SAM was lower than the national standard protocol Altered general conditions such as shock, anemia, not adhering to medical and nutritional therapies were identified as predictors of mortality among SAM children Health education on early medical seeking behavior and adherence on the routine regimens may improve this gap in child survival

/pdf/predictors-of-mortality-among-under-five-children-with-2qprigatqy.pdf

Predictors of mortality among under-five children with severe acute malnutrition, Northwest Ethiopia: an institution based retrospective cohort study

Background More than 29 million that is an estimated 5%, under-five children suffer from severe acute malnutrition (SAM) globally, with a nine times higher risk of mortality than that of well-nourished children. However, little is known regarding outcomes and predictors of SAM in Ethiopia. Therefore, this study aims to determine treatment cure rate and its predictors among children aged 6–59 months with SAM admitted to a stabilization center. Methodology A retrospective record review was employed in SAM children at the University of Gondar Comprehensive Specialized Hospital (UOGCSH) from 2014 to 2016. SAM defined as weight for height below -3 z scores of the median World Health Organization (WHO) growth standards or presence of bilateral edema or mid upper arm circumference < 115mm for a child 6months age. All SAM patients with medical complication(s) or failure to pass appetite test are admitted to the malnutrition treatment center for inpatient follow-up. Data were extracted from a randomly selected records after getting ethical clearance. Data were cleaned, coded and entered to Epi-info version-7, and analyzed using STATA/se version-14. Descriptive statistics and analytic analyses schemes including bivariable and multivariable Cox proportional hazards model were conducted. Result Among a total of 416 records recruited for this study, 288 (69.2%) SAM children were cured at the end of the follow up, with a median cure time of 11 days. Kwash-dermatosis (AHR (Adjusted Hazard Ratio): 1.48(95% CI: 1.01, 2.16)), anemia (AHR: 1.36(95% CI: 1.07, 1.74)), tuberculosis (AHR: 1.6(95% CI: 1.04, 2.43)) and altered body temperature at admission (AHR: 1.58(95% CI: 1.04, 2.4) were independent predictors of time to cure. Conclusion The cure rate in SAM children was low relative to sphere standard guideline. Prognosis of SAM largely depends on the presence of other comorbidities at admission. Available intervention modalities need to address coexisting morbidities to achieve better outcomes in SAM children.

/pdf/treatment-cure-rate-and-its-predictors-among-children-with-2e291mg6qm.pdf

Treatment cure rate and its predictors among children with severe acute malnutrition in northwest Ethiopia: A retrospective record review.

Objective. This study investigated the treatment outcomes and determinant factors likely to be associated with recovery rate. Methods. A retrospective chart review (RCR) was performed on 348 patients who were enrolled in the outpatient care (OPC) during the study period. Results. Of the 348 cases, 33.6% recovered (having MUAC ≥125 mm), 49.1% defaulted, and 11.5% transferred to other OPC units to continue with treatment. There were 187 (53.7%) males and 161 (46.3%) females with severe malnutrition. The average weight gain rate was 28 g/kg/day. Controlling for other factors, patients who completed the treatment plan had 3.2 times higher probability of recovery from severe acute malnutrition (SAM) as compared to patients who defaulted (adjusted odds ratio (AOR) = 3.2, 95% CI = 1.9, 5.3, and p < 0.001). The children aged 24-59 months had 5.8 times higher probability of recovery from SAM as compared to children aged 6-11 months (AOR = 5.8, 95% CI = 2.5, 10.6, and p < 0.001). Conclusions. Cure rate was low and the default rate was quite high. Children who were diagnosed as having marasmus on admission stayed longer before recovery than their kwashiorkor counterparts. Younger children were of greater risk of nonrecovery.

/pdf/treatment-outcome-of-severe-acute-malnutrition-cases-at-the-1rsihb27bq.pdf

Treatment Outcome of Severe Acute Malnutrition Cases at the Tamale Teaching Hospital

Numerous risk factors have been implicated in the development of a gastric ulcer. Common risk factors are Helicobacter pylori infection, chronic non-steroidal anti-inflammatory intake, and alcohol consumption. The aim of the current study was to identify environmental risk factors for a gastric ulcer in northern Ghana. The data for this retrospective study were obtained from 2035 patient records from the Minimal Access Therapy and Operative Endoscopy unit of the Tamale Teaching Hospital in Tamale, Ghana from 2010 to 2014. A separate questionnaire was administered to assess the environmental risk factors. The rapid urease test was used to determine the presence of H. pylori. The Statistical Package for Social Sciences version 20.0 was used to analyse the data. Univariate and bivariate analyses were performed, and the results were presented in tables provided. The Chi-square values of the bivariate analysis were considered statistically significant when P < 0.05. Bivariate analysis revealed a strong association between gastric ulcer and various risk factors such as smoking (P = 0.001, χ2 = 27.3), fasting (P = 0.001, χ2 = 42.6), H. pylori infection (P = 0.01, χ2 = 19.9), and alcohol consumption (P = 0.001, χ2 = 30.6). There was no association between the traditional herbal preparation usage (P = 0.251, χ2 = 1.8) and the gastric ulcer. Environmental risk factors responsible for the development of a gastric ulcer in people of the northern part of Ghana show a similar pattern to other geographical regions of the world.

Assessment of the environmental risk factors for a gastric ulcer in northern Ghana.

Background : Though treatment of severe acute malnutrition cases in both the in-patient care and the out-patient care has been going on since 2011 at the Tamale Teaching Hospital, little is known about the clinical treatment outcomes and factors that may be associated with the recovery rate in the in-patient setting. This study investigated the clinical treatment outcomes and determinant factors likely to be associated with recovery rates at the Hospital. Methods : We performed a retrospective chart review (RCR) of all pediatric patients aged (0-11 years of age) who were diagnosed of severe acute malnutrition between March 2011 and December 2013. Logistic regression modeling was used to determine the risk factors of severe malnutrition. Results : Of the 630 cases that were reviewed, only 19.5 % recovered (having mid-upper-arm-circumference measure â‰¥125 mm, or oedema resolved, or gained 5g/kg/body weight for 2 consecutive days at the time of discharge), 1.7 % defaulted, and 65.2 % were referred to out-patient care units for continued treatment. The observed case fatality rate was 13.5 %. Marasmic cases had more chronic co-morbid conditions at admission compared to kwashiorkor patients (81.7% vs. 69.3%, p=0.01). Conclusions : Case fatality rate in this population was quite high. Case referral to out-patient care unit was appropriately high. Malaria was the most common co-morbid condition diagnosed among the cases reviewed. Younger age, 15% or more increase in weight, and type of malnutrition were the main predictors of recovery from severe acute malnutrition in the in-patient care setting.

/pdf/clinical-outcomes-and-determinants-of-recovery-rates-of-3le9ahif7q.pdf

Clinical Outcomes and Determinants of Recovery Rates of Pediatric Inpatients Treated for Severe Acute Malnutrition

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Treatment Outcome of Severe Acute Malnutrition Cases at the Tamale Teaching Hospital

Assessment of the environmental risk factors for a gastric ulcer in northern Ghana.

Clinical Outcomes and Determinants of Recovery Rates of Pediatric Inpatients Treated for Severe Acute Malnutrition