Nutritional Status of Newly Diagnosed Tuberculous Patients at the National Tuberculosis Institute in Baghdad

ABSTRACT Background: Tuberculosis (TB) is an infectious disease that mainly affects people in developing countries. It is affected by nutritional status. The aim of this study was to determine the prevalence of malnutrition and the effect of associated sociodemographic and clinical variables on the nutritional status among adult TB patients. Methodology: A convenient sample of 100 newly diagnosed adult Tuberculous patients whether pulmonary or extrapulmonary who attended the General Tuberculosis Institute in Baghdad governorate from October 2022 to January 2023 was taken. Their nutritional status was measured by BMI. Result: Out of the total patients included in the study, (53%) were males and (47%) were females. More than half of patients had a normal BMI (55%), while 19% had undernutrition which is mainly seen in the pulmonary type, and 26% were overweight and obese which is seen in the extrapulmonary type. High educational level, high socioeconomic status, eating frequent meals (>3/day), not having anemia, and not having significant weight loss appear to be protective against malnutrition in tuberculous patients. Conclusion: Tuberculosis and malnutrition with dual effects so every TB patient needs a baseline nutritional assessment prior to the start of treatment. Also important to improve nutritional knowledge by counseling on a balanced diet and increasing awareness about the risk factors of undernutrition and its consequences for tuberculous patients and their family members

Assessment of Serum Ferritin, Serum Calcium, and Vitamin D Status in β-thalassemia Major Children and Adolescents in Al Rusafa Side in Baghdad

<p>ABSTRACT</p><p><strong>Background:</strong> Beta Thalassemia is a genetic disorder inherited by autosomal recessive and occurs throughout the world, including Iraq. Patients with beta-thalassemia require blood transfusions for life, and this can lead to the accumulation of iron in the skin, kidneys, and liver, resulting in a decrease in vitamin D synthesis. <strong>Methodology:</strong> This cross-sectional study was conducted at the Hereditary Blood Disorder Center in Ibn Al balady Hospital in Al Rusafa side in Baghdad from May to August 2023. The population of this study was children and adolescents diagnosed with beta-thalassemia major and on regular blood transfusions. Serum 25-OH-vitamin D, Serum calcium, and Serum ferritin were assessed in those patients. <strong>Result: </strong>Out of 100 patients involved in this study, (38%) were children and (62%) were adolescents, the male-to-female ratio was 0.52. The mean age of the studied sample was 11.52±4.094 years. The mean 25-OH Vit D level was 24.94±14.66 ng/ml, only 23% of the patients had normal levels of serum vitamin D concentration, 56% had deficient levels and 21% had insufficient levels. The mean serum Ca level was 2.28±0.18 mmol/l, only 19% had low total serum calcium levels, 2% had high levels, and 79% had normal serum calcium levels. The mean serum ferritin level was 3940.48 ± 2287.76 ng/ml, no one had a normal serum ferritin level. <strong>Conclusion: </strong>A high prevalence of 25 hydroxy vitamin D deficiency and insufficiency levels among thalassemia patients is found, so frequent monitoring and appropriate therapeutic interventions to maintain normal levels of serum vitamin D are indicated to improve bone health and quality of life of those patients. Also, high levels of serum ferritin were noted among those patients who need frequent follow-up and proper chelation therapy.</p&gt

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially