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

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 ≥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

Facilitate Utilization of Lessons Learned from Previous Product Development into New Development Procedure

Due to the medical applications of products of Dynamic Controls and the size of investment that the company has in this industry, the company decided to improve the design and development process by improving its Lessons Leaned (LL) procedure. Based on academic literature and industry guidelines a LL procedure is a process that allows an organisation to take advantage from its successes and failures. An effective LL process should assist the organisation to repeat its successes and prevent the repetition of previous mistakes. Each LL procedure has three fundamentals: “Culture, Process and Tools”. This improvement assists Dynamic Controls to development of products and services to better meet the customer needs, with higher reliability and lesser in-field failures. It also provides more comprehensive design inputs to reduce development cost and time. The objective of this project was to investigate the current LL process in the business, identify the best practice, investigate enabling processes, technologies and tools for taking the most advantages from both upcoming and previous LL, define appropriate categories for LL, and determine an implementation plan for the company. The project started on 1st October 2012 and was delivered by the 8th of February 2013

A comparison of pregnancy outcomes in Ghanaian women with varying dietary diversity: a prospective cohort study protocol

INTRODUCTION: Poor dietary intake during pregnancy can have negative repercussions on the mother and fetus. This study therefore aims to explore the dietary diversity (DD) of pregnant women and its associations with pregnancy outcomes among women in Northern Ghana. The main outcome variables to be measured are gestational weight gain and birth weight. METHODS AND ANALYSIS: A prospective cohort study design will be used and 600 pregnant women in their first trimester will be systematically recruited at health facilities and followed until delivery. In three follow-up visits after recruitment, information on sociodemographic and general characteristics, physical activity (International Physical Activity Questionnaire (IPAQ) short form, dietary intake (24-hour food recall), anthropometry and pregnancy outcomes will be collected. DD will be measured three times using the minimum DD-women (MDD-W) indicator and the mean of the three values overall will be used to determine low (<5 food groups) and high (≥5 food groups) DD. Data will be analysed using SPSS. Comparisons between groups (categorical data) will be made using the χ2 test for proportions, and t-tests and ANOVA will be performed on continuous variables. Regression analysis will be used to identify independent outcome predictors while controlling for possible confounding factors. The results may help to identify differences in DD between healthy and unhealthy pregnancy outcomes. ETHICS AND DISSEMINATION: The study protocol has been approved by the ethics committee of Tehran University of Medical Sciences and the ethical review committee of the Tamale Teaching Hospital. Written informed consent will be obtained from all subjects. The results will be published in due course