Upper arm length along with mid-upper arm circumference to enhance wasting prevalence estimation and diagnosis: sensitivity and specificity in 6–59-months-old children

ObjectiveTo evaluate the added value of the use of upper arm length (UAL) along with mid-upper arm circumference (MUAC) to diagnose and estimate the prevalence of wasting in comparison to current WHO standard and other MUAC-based methods.DesignUAL and usual anthropometric measurements were collected during a national cross-sectional nutritional survey. Children were classified into three upper arm length groups (UALGs): UALG1, UALG2 and UALG3 according to the following UAL limits: ≤150, 151–180 and ≥181 mm, respectively. Receiver operating characteristic curves were used to determine the best MUAC cut-off for each group using weight-for-height Z-score (WHZ) as a reference standard. Wasting prevalence, sensitivity and specificity of all diagnostic methods were compared.SettingThis study was conducted in Mauritania.ParticipantsNational representative sample of children from 6 to 59 months old.ResultsIn total, 12 590 children were included in the study. Wasting prevalence was 16.1%, 5.0% and 12.5% when diagnosed by WHZ <−2, MUAC <125 mm and MUAC–UALG methods, respectively. Using the MUAC–UALG method increased the sensitivity for wasting diagnosis from 17.98% with MUAC <125 mm to 39.43% with MUAC–UALG. The specificity decreased from 97.49% with MUAC <125 mm to 92.71% with MUAC–UALG. With MUAC–height Z score and MUAC <138 mm, sensitivity was 26.04% and 69.76% and specificity were 97.40% and 75.64% respectively.ConclusionThis alternative method using MUAC tape to measure UAL increases the wasting diagnosis accuracy and allows for a better estimation of wasting prevalence. This method could be used as a potential alternative method for quick surveys in emergency settings such as Corona virus disease 2019 context.

Anthropometric Characteristics of Children Living in Food Insecure Households in the United States

Objective: This study provides information on food insecurity and child malnutrition in a technologically advanced nation. Design: Population-based study using multistage probability cluster sampling design to collect survey data. Multivariable regression models were used to determine associations between food security status and various malnutrition indices. Setting: We used a national sample from the United States National Health and Nutrition Examination Survey (NHANES) 2011-2014. Participants: The anthropometric and demographic datasets of 4,121 children <7 years old were analyzed for this study. Results: Food insecure infants younger than 6 months had shorter upper arm length (−0.4 cm, p=0.012) and smaller mid-upper arm circumference (−0.5 cm, p=0.004), likewise those aged 6 months-1 year who had shorter upper arm length (−0.4 cm, p=0.008), body length (−1.7 cm, p=0.007) and lower body weight (−0.5 kg, p=0.008). Food insecure children younger than 2 years were more likely to be underweight (OR: 4.34; 95% CI: 1.99-9.46) compared to their food secure counterparts. Contrarywise, food insecure children older than 5 years were more likely to be obese (OR: 3.12; 95% CI: 1.23-7.96). Conclusion: Food insecurity associates with child growth deficits in the United States. Food insecure infants and young children are generally smaller and shorter, whereas older children are heavier than their food secure counterparts, implying a double burden of undernutrition-overnutrition associated with child food insecurity. Child food and nutrition programs to improve food insecurity should focus on infants and children in the transition ages.

Estimation of Stature from Upper Arm Length

Introduction: Reconstruction of stature from long bones of the upper extremity is of great medico-legal relevance. Upper arm length (UAL) estimate stature with reasonable accuracy and is reliable factor for predicting stature. There is a strong relationship between stature and UAL and many sets of linear equation have been developed which are easiest and reliable methods for predicting relation between stature and body segments. These derived regression equations are population specific and cannot be applied in other populations. Studies on UAL for estimation of stature is lacking among Nepalese population. Hence, present study was conducted to investigate relationship between stature and UAL and to formulate regression formula for estimation of stature from UAL among Nepalese population. Method: A cross-sectional study was conducted among 150 attendees of patient visiting male and female clinic in Patan hospital, Nepal. Among 150 participants 75 were male and 75 were female. In present study stature, right and left upper arm length was measured. Pearson’s correlation coefficient (r) was calculated. Regression equation was formulated for reconstruction of stature from upper arm length of both sides as well as for both male and female separately. Result: All the measured parameters i.e. stature, right upper arm length and left upper arm length were higher in male than female (p<0.001). Strong positive correlation was found between stature and UAL in both males and females thereby indicating that stature can be estimated from UAL. Conclusion: UAL is a reliable body parameter for predicting stature. It can be of great help to anatomists, clinicians and anthropologists. Key words: Stature, upper arm length, correlation coefficient and regression equation.

Upper arm length along with mid-upper arm circumference to enhance wasting prevalence estimation and diagnosis : sensitivity and specificity in 6 to 59 month-old children.

Objective: To evaluate the added value of the use of upper arm length (UAL) along with MUAC (mid-upper arm circumference) to diagnose and estimate the prevalence of wasting in comparison to current WHO standard and others MUAC based methods. Design: We included UAL to usual anthropometric measurements during a Mauritanian national 6-59-month-old cross-sectional nutritional survey. Children were classified into 3 groups UALG1, UALG2 and UALG3 according to the following UAL limits: ≤ 150 mm, 151-180, and > 180mm respectively. We used a Receiver Operating Characteristic curve to determine the best MUAC cut-off for each group with weight-for-height Z score as a reference standard. We compared the wasting prevalence, sensitivity, and specificity, of all diagnostic methods. Findings: In total, 12 619 children were included in the study. Wasting prevalence was 16.1%, 5.0% and 12.5% when diagnosed by WHZ < -2, MUAC < 125 mm and MUAC-UALG methods respectively. Using the MUAC-UALG method increased the sensitivity for wasting diagnosis from 17.98 % with MUAC < 125 mm to 39.43% with MUAC-UALG. The specificity decreased from 97.49% with MUAC < 125 to 92.71% with MUAC-UALG. With MUAC-height Z score and MUAC < 138 mm, sensitivity was 26.04% and 69.76%and specificity were 97.40%and 75.64% respectively. Conclusion: This alternative method using MUAC measuring tape to measure UAL increases the wasting diagnosis accuracy and allows for a better estimation of wasting prevalence. This method could be used as a potential alternative method for quick surveys in emergency settings such as Corona virus disease 2019 context.

ESTIMATION OF STATURE

Objectives: Estimation of height from upper arm length in healthy adult medicalstudents in Lahore. Design: Cross sectional, observational. Place and Duration of Study:FMH College of Medicine & Dentistry, Lahore from November 2017 to January 2018. Materialand Methods: This study included 100 healthy medical students (50 males and 50 females)aged 19-25 years. The stature and upper arm length were measured for each subject inanatomical position. The data was compiled on excel and then analyzed on SPSS version11. Results: Stature in males was between 162 and 192 cm with the mean of 173.4 cm andstandard deviation of 6.03 cm while the stature in females was from 147 to 169.5 cm with themean of 159.9 cm and standard deviation of 5.39 cm. Overall, there was positive correlationbetween stature and UAL of subjects (r2=0.86, p=2.85E-44). Also this correlation was evidentfor male cases (r2=0.88, P=5.85E-24) as well as female cases (r=0.96, P=5.72E-35) whenevaluated as separate entities. All these correlations were statistically significant. Conclusion:The study suggested that upper arm length is a reliable factor for predicting the stature inmedical students in Lahore.

Faktor-faktor yang mempengaruhi kemampuan kognitif pada lansia obesitas di Indonesia

Background: Elderly (>60 years old) population is growing in Indonesia. It is important to prevent degradation of cognitive capacity by risk factor identification and treatment.Objective: To identify the relationship between anthropometric status and cognitive capacity on elderly population.Method: This is an analysis of The Fifth Wave of the Indonesia Family Life Survey (IFLS5) data with cross-sectional design. Anthropometric status is consisted of: body weight, body height, body mass index (BMI), knee height, upper arm length, waist circumference, hip circumference, and waist-hip ratio (WHR). Cognitive capacity is measured by modified telephone survey of cognitive status (TICS). Chi-Square and Mann-Whitney test are used for bivariate analysis, logistic regression is used for multivariate analysis.Results: Variables with significant relationship to cognitive capacity are body weight (p=0.0002), body height (p=0.0001), knee height (p=0.0387), upper arm length (p=0.0114), age (p=0.011), sex (p=0.014), and history of hypercholesterolemia (p=0.003). Logistic regression shows that body height, age, and history of hypercholesterolemia are simultaneously affecting cognitive capacity.Conclusion: There is significant relationship between body height, body weight, upper arm length, knee height, and cognitive capacity on elderly population with obesity.

HUBUNGAN PANJANG SARAF ULNARIS DI KOMPARTEMEN POSTERIOR DENGAN PANJANG LENGAN ATAS SEBAGAI ACUAN TERAPI

CORRELATION BETWEEN ULNARIS NERVE LENGTH IN POSTERIOR COMPARTMENT AND UPPER LIMB LENGTH AS:A REFERENCE FOR THERAPYABSTRACT Introduction: Ulnar nerve is the second most common affected nerve by compression in upper extremity. Medial intermuscular septum separating upper arm into anterior and posterior compartments is suspect to be the sites of ulnar nerve compression. Various examinations attempt to locate accurate nerve compression sites to minimize surgery side effects.Aim: This study analyze ratio of ulnar nerve length in posterior compartment using anatomical dissection method with upper arm length using anthropometry method and to analyze correlation of ulnar nerve length in posterior compartment with upper arm length.Methods: This is a descriptive analytical study with a cross sectional design on cadaver between May to June2017 at Anatomy Laboratorium Medical Faculty University of Padjajaran, Bandung. The length of cadaver upper arm was measured with antropometry method and ulnar nerve length in posterior compartment by anatomical dissection. The measurements were statistically analyzed with Pearson correlation.Result: The average length of 9 cadaver or 18 right upper arm (right and left) was 38.3cm for right and 38.0cm for left. While the average length of right and left ulnar nerve in posterior compartment were 11.7cm and 11.4cm respectively, thus the average ratio length of upper arm with ulnar nerve length was 1:3. Analysis using Pearson correlation show a positive correlation on left and right arm, although not significant. Contrast to existing theory, the ulnar nerve crossed in one-third of the posterior upper arm compartment. In minimal invasive decompression this finding could be reference to extend the incission to become 11.7cm for right and 11.4cm for left arm to avoid re-decompression.Discussion: The average ratio length of upper arm with ulnar nerve length was 1:3. There is a positive between thelength of ulnar nerve on the posterior compartment and the length of upper arm, although not significant.Keyword: Posterior compartment, ulnar nerve length, upper arm length ratioABSTRAKPendahuluan: Saraf ulnaris menempati urutan kedua saraf yang sering terkena sindrom kompresi pada ekstremitas atas. Septum intermuskularis medial yang memisahkan lengan atas menjadi bagian kompartemen anterior dan posterior dicurigai menjadi salah satu tempat terjadinya kompresi saraf ulnaris. Berbagai pemeriksaan berupaya menemukan lokasi kompresi saraf yang akurat untuk meminimalisir efek samping dari terapi khususnya operasi.Tujuan: Menilai hubungan perbandingan panjang saraf ulnaris di kompartemen posterior berdasarkan diseksi anatomis dengan panjang lengan atas secara antropometri.Metode: Penelitian deskriptif analitik secara potong lintang pada kadaver pada bulan Mei hingga Juni 2017 di Laboratorium Anatomi Fakultas Kedokteran Universitas Padjajaran, Jatinangor. Panjang lengan atas kadaver diukur secara antropometri, sedangkan panjang saraf ulnaris pada kompartemen posterior berdasarkan diseksi anatomi. Hasil pengukuran dinilai secara statistik menggunakan uji korelasi Pearson.Hasil: Pengukuran terhadap 9 kadaver atau 18 lengan atas (kanan dan kiri) mendapatkan rerata panjang lengan atas kanan 38,3cm dan kiri 38cm. Adapun rerata panjang saraf ulnaris kanan dan kiri di kompartemen posterior masing- masing 11,7cm dan 11,4cm, sehingga didapatkan perbandingan rerata panjang jarak lengan atas dengan panjang saraf ulnaris adalah 1:3. Analisis uji korelasi Pearson menunjukkan hubungan positif pada lengan kiri dan kanan walaupun tidak signifikan. Saraf ulnaris didapatkan menyilang di sepertiga kompartemen posterior lengan atas, berbeda dengan teori yang ada. Pada operasi yang memakai metode minimal invasive decompression, temuan ini dapat menjadi pertimbangan untuk memperluas garis insisi 11,7cm pada lengan kanan dan 11,4cm kiri untuk menghindari dekompresi ulang.Diskusi: Didapatkan perbandingan rerata panjang saraf ulnaris di kompartemen posterior dengan panjang lengan atas 1:3. Terdapat hubungan positif antara panjang saraf ulnaris di kompartemen posterior dengan panjang lengan atas walaupun tidak bermakna.Kata kunci: Kompartemen posterior, panjang saraf ulnaris, perbandingan panjang lengan atas