Nutritional Status of Adolescent Girls from Rural Communities of Tigray, Northern Ethiopia

Background: Addressing the nutritional needs of adolescents could be an important step towards breaking the vicious cycle of intergenerational malnutrition. Objective: Assess nutritional status of rural adolescent girls. Design: Cross-sectional. Methods: Anthropometric and socio-demographic information from 211 adolescent girls representing 650 randomly selected households from thirteen communities in Tigray was used in data analysis. Height-for-age and BMI-for-age were compared to the 2007 WHO growth reference. Data were analyzed using SAS, Version 9.1. Results: None of the households reported access to adolescent micronutrient supplementation. The girls were shorter and thinner than the 2007 WHO reference population. The cross-sectional prevalence of stunting and thinness were 26.5% and 58.3%, respectively. Lack of latrine facilities was significantly associated with stunting (p = 0.0033) and thinness (p <0.0001). Age was strong predictor of stunting (r(2) = 0.8838, p <0.0001) and thinness (r(2) = 0.3324, p <0.0001). Conclusion: Undernutrition was prevalent among the girls. Strategies to improve the nutritional status of girls need to go beyond the conventional maternal and child health care programs to reach girls before conception to break the intergenerational cycle of malnutrition. Further, carefully designed longitudinal studies are needed to identify the reasons for poor growth throughout the period of adolescence in this population. [Ethiop. J. Health Dev. 2009; 23(1):5-11

Nutritional Status and Menarcheal Age of Rural Adolescent Girls of Salboni Block of Paschim Medinipur, West Bengal, India

Age at menarche is a significant indicator of growth and sexual maturation in girls. During adolescence, anthropometry provides a tool for monitoring and evaluating the hormone-mediated changes in growth and reproductive maturation. Menarche is defined as the first menstrual period. It is considered to be the most obvious sign of puberty in girls. It has been regarded in many cultures as a transitional step to womanhood. This is a cross-sectional study which is done on 1009 school girls who belonged to Salboni block of district Paschim Medinipur of West Bengal, India. To study effect of nutrition on age at menarche, different anthropometric measurements were applied. The study had been done on 10-19 adolescents school girls (1009). For this study, different types of anthropometric measurements were taken like weight and height. Height is measured through anthropometric rod, and weight by a weighing machine. Triceps and biceps Skinfolds are taken by skinfold caliper. Structured questionnaires were followed to know details of socio-economic status. Height was measured to the nearest 0.1 cm and weight to the nearest 0.5 kg. Each subject was weighed with minimum clothing and no footwear. Among studied sample, 896 girls had experienced menarche. Their mean age at menarche was 11.88 years (1.23). To compare anthropometric variable premenarchel and postmenarcheal girls that mean anthropometric measurement of premenarcheal girls more higher than post menarcheal girls in studied girls minimum age at menarche is 9 years and maximum age at menarche was 17 years. Body mass index increased progressively from 13 years to 19 years of age where overall increase was 1.89 kg/m2 from 10 to 19 years which was statistically significant with age (F=17.3, P<0.001), percent body fat was statistically significant with age (F=38.7, P<0.001). Nutritional status was better in postmenarcheal girls than in premenarcheal girls. The study represents typical differential rates of positive change in different body composition measures after the attainment of menarche

Neoadjuvant or adjuvant therapy for resectable esophageal cancer: a clinical practice guideline

BACKGROUND: Carcinoma of the esophagus is an aggressive malignancy with an increasing incidence. Its virulence, in terms of symptoms and mortality, justifies a continued search for optimal therapy. A clinical practice guideline was developed based on a systematic review investigating neoadjuvant or adjuvant therapy on resectable thoracic esophageal cancer. METHODS: A systematic review with meta-analysis was developed and clinical recommendations were drafted. External review of the practice guideline report by practitioners in Ontario, Canada was obtained through a mailed survey, and incorporated. Final approval of the practice guideline was obtained from the Practice Guidelines Coordinating Committee. RESULTS: The systematic review was developed and recommendations were drafted, and the report was mailed to Ontario practitioners for external review. Ninety percent of respondents agreed with both the evidence summary and the draft recommendations, while only 69% approved of the draft recommendations as a practice guideline. Based on the external review, a revised document was created. The revised practice guideline was submitted to the Practice Guidelines Coordinating Committee for review. All 11 members of the PGCC returned ballots. Eight PGCC members approved the practice guideline report as written and three members approved the guideline conditional on specific concerns being addressed. After these recommended changes were made, the final practice guideline report was approved. CONCLUSION: In consideration of the systematic review, external review, and subsequent Practice Guidelines Coordinating Committee revision suggestions, and final approval, the Gastrointestinal Cancer Disease Site Group recommends the following: For adult patients with resectable thoracic esophageal cancer for whom surgery is considered appropriate, surgery alone (i.e., without neoadjuvant or adjuvant therapy) is recommended as the standard practice

New localities of the Eurasian otter Lutra lutra (Linnaeus, 1758) in the upper Euphrates river basin, a remarkable range extension in western Iraq

Records of the Eurasian Otter (Lutra lutra) have been confined to the waterbodies of southern, central, and northern Iraq (Kurdistan). Although its status in the Upper Euphrates River Basin in western Iraq is not fully explored, it seems to be rare. In August 2019, two adult Eurasian otters were reported from two new localities in Anbar Province after being strangled by fishing nets. These records represent the first photographic evidence for a remarkable range extension of the Eurasian Otter distribution range in western Iraq

Nutritional Status of Adolescent Girls from Rural Communities of Tigray, Northern Ethiopia

Background: Addressing the nutritional needs of adolescents could be an important step towards breaking the vicious cycle of intergenerational malnutrition.Objective: Assess nutritional status of rural adolescent girls.Design: Cross-sectional.Methods: Anthropometric and socio-demographic information from 211 adolescent girls representing 650 randomly selected households from thirteen communities in Tigray was used in data analysis. Height-for-age and BMI-for-age were compared to the 2007 WHO growth reference. Data were analyzed using SAS, Version 9.1.Results: None of the households reported access to adolescent micronutrient supplementation. The girls were shorter and thinner than the 2007 WHO reference population. The cross-sectional prevalence of stunting and thinness were 26.5% and 58.3%, respectively. Lack of latrine facilities was significantly associated with stunting (p = 0.0033) andthinness (

CONCEPTT: Continuous Glucose Monitoring in Women with Type 1 Diabetes in Pregnancy Trial: A multi-center, multi-national, randomized controlled trial - Study protocol.

BACKGROUND: Women with type 1 diabetes strive for optimal glycemic control before and during pregnancy to avoid adverse obstetric and perinatal outcomes. For most women, optimal glycemic control is challenging to achieve and maintain. The aim of this study is to determine whether the use of real-time continuous glucose monitoring (RT-CGM) will improve glycemic control in women with type 1 diabetes who are pregnant or planning pregnancy. METHODS/DESIGN: A multi-center, open label, randomized, controlled trial of women with type 1 diabetes who are either planning pregnancy with an HbA1c of 7.0 % to ≤10.0 % (53 to ≤ 86 mmol/mol) or are in early pregnancy (<13 weeks 6 days) with an HbA1c of 6.5 % to ≤10.0 % (48 to ≤ 86 mmol/mol). Participants will be randomized to either RT-CGM alongside conventional intermittent home glucose monitoring (HGM), or HGM alone. Eligible women will wear a CGM which does not display the glucose result for 6 days during the run-in phase. To be eligible for randomization, a minimum of 4 HGM measurements per day and a minimum of 96 hours total with 24 hours overnight (11 pm-7 am) of CGM glucose values are required. Those meeting these criteria are randomized to RT- CGM or HGM. A total of 324 women will be recruited (110 planning pregnancy, 214 pregnant). This takes into account 15 and 20 % attrition rates for the planning pregnancy and pregnant cohorts and will detect a clinically relevant 0.5 % difference between groups at 90 % power with 5 % significance. Randomization will stratify for type of insulin treatment (pump or multiple daily injections) and baseline HbA1c. Analyses will be performed according to intention to treat. The primary outcome is the change in glycemic control as measured by HbA1c from baseline to 24 weeks or conception in women planning pregnancy, and from baseline to 34 weeks gestation during pregnancy. Secondary outcomes include maternal hypoglycemia, CGM time in, above and below target (3.5-7.8 mmol/l), glucose variability measures, maternal and neonatal outcomes. DISCUSSION: This will be the first international multicenter randomized controlled trial to evaluate the impact of RT- CGM before and during pregnancy in women with type 1 diabetes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01788527 Registration Date: December 19, 2012

Anthropometric Measurements in Adolescent Students: A Comparison among Three Ethnic Groups Living in North-Central Nigeria

Weight and height measurements together with Body Mass Index (BMI) are commonly used anthropometric measurements for the estimation of relative weight, which has a direct relationship with nutritional status, and for the classification of individuals as underweight, normal, overweight or obese. A randomized cross-sectional study of 1,057 adolescent students from three different ethnic groups living in Katsina-Ala town, North-Central Nigeria, was conducted. The students were aged 10-19 years, and were divided into two age groups: 10-14 years and 15-19 years. The two groups were later separated by gender into male and female subgroups. The One-way Analysis of Variance (ANOVA) was used to assess if the differences observed across the age, gender and ethnic groups were statistically significant. Further statistical testing was carried out using the Tukey-Kramer Multiple Comparisons Test. The results showed extremely significant differences, with P-Values up to ≤ 0.0001 amongst the various groups, in weight, height and BMI. Keywords: anthropometric measurements, adolescents, body mass index, ethnic groups, Katsina-Ala

Pseudo-Conformal Actions of the M{\"o}bius Group

We study compact connected pseudo-Riemannian manifolds $(M,g)$ on which the conformal group $\operatorname{Conf}(M,g)$ acts essentially and transitively. We prove, in particular, that if the non-compact semi-simple part of $\operatorname{Conf}(M,g)$ is the M{\"o}bius group, then $(M,g)$ is conformally flat