Prognostic ability of nutritional assessment methods in surgical cancer patients

To identify patients at high-risk for post-operative infections, several methods have been proposed, including prognostic nutritional index (PNI), instant nutritional assessment (INA) and nutritional assessment (NA). Weight loss (WL) has also been related to post-operative morbidity. We have evaluated the prognostic ability of PNI, INA, NA and WL in a prospective study carried out in 94 patients affected by gastro-intestinal malignancy, who underwent major surgery. Post-operative infections occurred in 26 (27.7%) patients. PNI, INA and NA identified classes of patients with a progressive risk of septic complications. To determine the prognostic ability of PNI, INA, NA and WL, sensitivity, specificity, Youden index and predictive values were evaluated. All methods had a Youden index greater than one, with a positive predictive value ranging from 0.33 to 0.36. Since all the methods studied showed a similar predictive ability, it seems reasonable to identify the high-risk surgical patient by using weight loss in association with those nutritional parameters derived from routine hospital laboratory tests.     

The value of nutritional assessment in the surgical patient

The prevalence of malnutrition in Veterans Administration Hospitals has been well documented. Several methods have been proposed to assess nutritional status including prognostic nutritional index (PNI) and instant nutritional assessment (INA). A prospective study was done to evaluate the currently used nutritional assessments and determine their efficacy based on sensitivity and specificity in predicting surgical morbidity and mortality. Data on 46 patients were evaluated for the multiparameter index of PNI, total lymphocyte count and serum albumin for INA, and weight loss alone. In this analysis, intermediate and high risk PNI were combined as positive predictor of complications. Any abnormal value in INA was considered positive as was weight loss of greater than 6% of usual body weight. Sensitivity and specificity of each assessment method were determined by 2 X 2 contingency table, and significance of observed differences between methods was determined by chi 2 analysis. There were no complications or deaths in patients with less than 6% weight loss. All three patients with abnormal albumin and total lymphocyte count had complications as compared to only three of 32 patients when both of these parameters were normal. The PNI was also able to predict complications with an increasing incidence as the PNI increased. Only the difference between specificity of weight loss alone vs INA was statistically significant, p less than 0.05. Thus, weight loss alone can be used as a rapid, inexpensive assessment of nutritional status for predicting postoperative complications.     

Nutritive value of various breads in Saudi Arabia

The nutritive value of nine Saudi breads prepared from wheat, millet and corn were measured chemically by proximate, minerals and vitamins analyses. On fresh weight basis, the bread contained 26.4-44.7% moisture, 6.6-10.4% protein, 0.4-2.4% fat, 40.2-60.6% available carbohydrates, 1.8-5.7% dietary fibre, 0.6-2.4% ash and 190-273 Kcal (metabolizable) per 100 g. All the breads were low in Ca (2.2-12.5mg/100 g), P ranged from 41.9-320.8, Na 83.2-794.6, K 0.7-224.2 and Fe 1.6-7.8mg/100 g. The contents of vitamin A (RE), thiamin and riboflavin ranged from 0-145mug, 0.01-0.26mg, 0.02-0.13 mg/100g respectively. The bread contributed 12-18, 2-8 and 77-84% of the total food energy from protein, fat and carbohydrates respectively. Wheat bread (355 g/head/day) provided 45 and 61% of energy and protein requirements respectively at national level per person per day.     

Nutritive value of various breads in Saudi Arabia

The nutritive value of nine Saudi breads prepared from wheat, millet and corn were measured chemically by proximate, minerals and vitamins analyses. On fresh weight basis, the bread contained 26.4-44.7% moisture, 6.6-10.4% protein, 0.4-2.4% fat, 40.2-60.6% available carbohydrates, 1.8-5.7% dietary fibre, 0.6-2.4% ash and 190-273 Kcal (metabolizable) per 100 g. All the breads were low in Ca (2.2-12.5 mg/100 g), P ranged from 41.9-320.8, Na 83.2-794.6, K 0.7-224.2 and Fe 1.6-7.8 mg/100 g. The contents of vitamin A (RE), thiamin and riboflavin ranged from 0-145 micrograms, 0.01-0.26 mg, 0.02-0.13 mg/100 g respectively. The bread contributed 12-18, 2-8 and 77-84% of the total food energy from protein, fat and carbohydrates respectively. Wheat bread (355 g/head/day) provided 45 and 61% of energy and protein requirements respectively at national level per person per day.     

The adjunctive value of routine biochemistry in nutritional assessment of hospitalized patients

Nutritional screening and assessment of patients are not part of the routine procedures at hospital admission, although a large percentage of patients is malnourished. Similarly, nutritional status of patients and dietary intake is usually not monitored during hospitalization. In contrast a great number of laboratory investigations for screening purposes accompanies most, if not all, hospital admissions. Several of those routine markers carry important nutritional information and could convey several aspects of patients' nutritional requirements. This review proposes that laboratories in particular could provide a service for the nutritional interpretation of available routine data which would help clinicians to focus on nutrition related problems. The nutritional meaning of basic physical characteristics (age, sex, height, and weight), urinary excretion of ketone bodies, urea and creatinine, and serum concentrations of urea, phosphate, iron and albumin are discussed in detail and the assessment of protein malnutrition, metabolism, and requirements is emphasized. Finally, a proposed sample layout for the nutritional interpretation of routinely available biochemical and basic physical data is presented.     

Brucellosis in Saudi Arabia

This paper describes the history of brucellosis and the current public health picture in the Kingdom of Saudi Arabia. Health protection is made more difficult by several factors: (a) the local custom of drinking raw and warm milk of sheep, goats, and camels, (b) the animal reservoir of infection in the country complicated by importation of live animals both for sacrifice during Haj periods and to increase commercial flocks, and (c) by uncontrolled movements of humans and stock across political borders.     

Prevalence of nutritional anaemia among primary school girls in Riyadh City, Saudi Arabia

The prevalence of iron deficiency anaemia was investigated among 1,210 school girls in Riyadh, Saudi Arabia. Anthropometric measurements were recorded. A dietary and socio-economic status questionnaire was administered and heamoglobin (Hb), serum iron and ferritin were estimated. Wasting and stunting is common among the 7- and 14-year-old girls. A total of 8.5% of children showed Hb level below 10 g/dL while 55.4% showed Hb level below 12 g/dL. It was found that 26.3% of the girls have serum iron below 10 mumol/dL while 16.1% of subsample of the girls showed serum ferritin level of less than 12 micrograms/dL. The most affected ones are those in the age group of 7-14 years old. The dietary questionnaire revealed that 16.5% of the girls did not take breakfast at home and depend on snacks offered in the school canteen which consist mostly of biscuits, chocolate bars, potato chips and carbonated cola drinks. No association between education of mother and father and breakfast consumption at home was detected. Tea drinking is common among these girls while fresh fruits and vegetable consumption is infrequent. Iron deficiency anaemia is highly prevalent among these schoolgirls which seriously affects the growth of 7- and 14-year-old girls. An in-depth investigation of the etiological factors of iron deficiency is urgently needed and meanwhile a suitable iron supplementation program is recommended.     

Prevalence of nutritional anaemia among primary school girls in Riyadh City,Saudi Arabia

The aim of this study was to determine whether there is an association between the nutritional status of the mother and that of her 2-year-old to 5-year-old child in a rural village in South Africa where there is a high prevalence of childhood malnutrition (in particular, deficiencies of vitamin A and iron) and of maternal obesity.

A blood sample and anthropometric measurements were obtained for 118 child–mother pairs. There was a positive mother–child correlation for serum ferritin (R=0.2304, P<0.05) and haemoglobin (R=0.2664, P<0.01) concentrations, respectively. The child of an anaemic mother had a relative risk of 1.632 of also being anaemic. There was no mother–child association for either serum retinol concentration or anthropometric measurements. Serum retinol concentrations showed a positive correlation with both serum ferritin (mothers only; R=0.2161, P<0.01) and haemoglobin (R=0.2807, P<0.01 for mothers; and R=0.2710, P?<?0.01 for children) concentrations.

The mother–child association for iron status is probably because of an inadequate dietary intake and low bioavailability of dietary iron, which are major causes of iron deficiency. The lack of mother–child association for serum retinol concentration could probably be ascribed to the fact that children are more susceptible to vitamin A deficiency than adults because of childhood diseases.     

小儿外科住院病人营养评定

通过对150例小儿外科住院病人进行营养评定。发现21％～55％患者有不同程度营养不良,轻中度为主。少年儿童发病率高于婴幼儿。统计学分析表明:营养评定指标一致性差,独立性强,营养评定宜多指标综合分析。建议在临床小儿病人营养评定采用全面人体测量结合白蛋白和转铁蛋白测定。     

Breast-feeding patterns in Saudi Arabia

A survey was conducted on 1019 mothers in 79 primary health care centers in Saudi Arabia to determine the patterns of breast feeding. A large percentage of mothers (98%) had breastfed their infants at birth. This rate dropped to 96.5% during the first week of life. There were 635 (64.1%) mothers who started to breastfeed their babies within 6 hours of delivery. Over two-thirds (68.9%) of mothers gave supplemental liquids to infants during the first 3 days of their life. More than half fed their infants on demand rather than on schedule. A high proportion (94.4%) breastfed at night, with 88.1% feeding their infants more than once. There was no significant relationship between the duration of suckling and the mother's age or work status (p 0.05). However, a significant relationship (p 0.001) was found between the duration of suckling and the mother's literacy. More than three-quarters of mothers slept in the same bed with their infants or in the same room. A large percentage of women initiated breast feeding; however, many introduced a supplement too early, a practice that should be discouraged.     

Occupational health in Saudi Arabia

The Kingdom of Saudi Arabia is rapidly industrializing, and the economy is now less dependent on oil. The future of industrial growth is very bright. Two industrial complexes (at the Arabian Gulf and the Red Sea coasts) of eight provide the basis for the Kingdom s programs to develop hydrocarbon-based and energy-intensive industries. Expatriates form the driving workforce in industry. Today, more Saudis are being recruited and trained to man the factories. Occupation-related disorders in industry vary from minor irritations to injuries and cancers. However, the risk of massive releases of toxic chemicals is not great. The national Occupational Health Service directorate is based at the Ministry of Health. Together with the Ministry of Labor, it assumes the overall supervision of industrial health and safety. However, there are constraints the most important of which is the lack of enough qualified Saudis in this field.     

4种营养状况评价方法的比较及意义

目的　分析比较身高标准体重法、离差法、体质指数、体质指数校正法等四种方法在大学生营养评价中的意义。　方法　随机抽取 187名大学生 ,用四种方法对其营养状况进行评价 ,结果用单因素卡方分析法和Ridit分析法比较。　结果　用四种方法评价同一群体大学生的营养状况时 ,其结果的差异有显著意义。　结论　作为 18～ 2 2岁的大学生 ,以身高标准体重法的评价结果更为客观 ;由于这一年龄段的发育水平影响其评价结果 ,因此 ,以发育水平分组评价时 ,可能更有意义     

The carotenoids of some food stuffs in Saudi Arabia

Abstract

The present study reports the use of high-performance liquid chromatography for the analysis of fruits (n = 12), vegetables (n = 14), corn products (n = 6) and egg products (n = 6) commonly found in Saudi Arabia. The highest content of lutein and β-carotene was found in spinach, and zeaxanthin was high in pepper (orange).     

The syphilis problem in Asir province,Saudi Arabia

A combined national and international venereal disease team began activities in Saudi Arabia in November 1952, moving from Mecca to Asir province in May 1953, where it remained for two months examining and treating various groups of the population. A total of 309 cases of syphilis among a population of approximately 3,000 at Abha was given complete clinical and serological examination and treatment with PAM, in doses varying from 2.4 to 6.0 million units. Serological tests were made on 2,359 blood samples. Only one primary lesion was found; but secondary lesions were quite common, amounting to 5.8% of all cases treated, while tertiary lesions represented 12.6% of all cases treated and 67.2% of all clinical cases.