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Background/Objectives: Women of reproductive age are reported to be the largest population that practises geophagia. The short-term and long-term health related conditions originating from the practise of geophagia are often not understood by geophagic women of reproductive age. This study has explored the health-related experiences of geophagia among women of reproductive age of Tshwane District, Gauteng Province. Methods: This was a qualitative study design following inductive thematic content analysis. In-depth interviews and focus group discussions were used to collect data using an interview guide and audio record. Data collection took place in 2023. Results: Mental health disorders, pregnancy complications, appendicitis, cancers, breathing complications, fatigue, premature deaths, worms, piles, and nutrients deficiencies were reported as some of the health-related challenges and diseases experienced by women of reproductive age of Tshwane District, Gauteng Province resulting from the practise of geophagia. Conclusions: The practise of geophagia was associated with various negative health outcomes. The reproductive health statuses of women of reproductive age were negatively impacted by the practise of geophagia affecting maternal and childhood mortalities and morbidities. [ABSTRACT FROM AUTHOR]

Congenital lead toxicity is rare. Lead freely crosses the placenta, therefore, placing the developing fetus at a higher risk for lead toxicity. This can lead to adverse consequences, such as spontaneous abortion, low birth weight, low IQ, and neurodevelopmental impairment. We present a rare case of siblings born to a mother with pica behaviors. Her venous lead level was 42 μg/dL at the time of disclosure. The repeat venous level at delivery 2 weeks later was 61 μg/dL. The infant's venous level shortly after birth was 89 μg/dL. The neonate was transferred to the NICU, where he received 9 doses of intramuscular dimercaprol and 5 days of intravenous Ca2Na2EDTA. Seventy-two hours after completing chelation, the blood lead level rebounded to 46 μg/dL. A 19-day course of dimercaptosuccinic acid was then initiated. As of 12 months of age, he has not required additional chelation. Shortly after, the mother conceived another child, who was born prematurely at 29 weeks. Twelve days before delivery, the mother's lead level was 30 ug/dL. The infant's lead level was 32 ug/dL at the time of delivery. The infant's lead trended down without requiring chelation. Both children have since demonstrated developmental delays and have needed early intervention services. [ABSTRACT FROM AUTHOR]

Objectives: Previous analyses of New York City (NYC) health department's lead registry indicated that, among children with lead poisoning, an increased prevalence of sickle cell disease (SCD) exists. However, SCD is not considered a risk factor for lead poisoning. We assessed the association between SCD and childhood lead poisoning to determine if specific lead poisoning prevention efforts are needed for children with SCD. Methods: We analyzed NYC's lead registry data for children with venous blood lead levels (BLLs) ≥15 mcg/dL during 2005 to 2019. t tests and χ² tests were performed to compare demographic characteristics, BLLs, and lead exposure risks in non-Hispanic Black children with and without SCD. A t test was used to compare observed SCD prevalence among Black children with BLLs ≥15 mcg/dL with an estimated 0.43% SCD prevalence among Black NYC children. Results: Among 1728 Black children with BLLs ≥15 mcg/dL identified, 37 (2.14%) had SCD. When comparing children with and without SCD, both mean age at peak BLL (62.8 versus 42.7 months; P = .003) and peak BLL (42.59 versus 23.06 mcg/dL; P = .008) were higher for children with SCD. Among risk factors for lead exposure, children with SCD had higher prevalence of pica. Observed SCD prevalence was 1.71% higher than estimated SCD prevalence among Black NYC children (P < .001). Conclusions: We found a potential association between SCD and childhood lead poisoning. Pica emerged as a potentially important risk factor. Our findings might have implications for lead poisoning prevention guidelines for children with SCD. [ABSTRACT FROM AUTHOR]

Pica is a life-threatening behavior that is relatively common among individuals with intellectual and developmental disabilities. Pica can be conceptualized as a response chain in which the pica item acts as a discriminative stimulus for the next response (i.e. picking up the pica item), which itself acts as a discriminative stimulus for the final response (i.e. consumption). Interventions that disrupt this response chain and alter the discriminative properties of the pica stimulus may be clinically indicated. Preliminary research supports response-interruption and redirection (RIRD) with differential reinforcement of alternative behavior (DRA) as an effective intervention for pica. We evaluated this procedure in an inpatient unit with a young boy with who engaged in pica. Our outcomes provide additional support for DRA with RIRD as an effective pica treatment. [ABSTRACT FROM AUTHOR]

Haemolytic Uraemic Syndrome (HUS) is a rare medical condition characterised by microangiopathic haemolytic anaemia, thrombocytopenia, and acute kidney injury. Neurological complications are documented but rarely involve the cerebellum. We present a unique case of a 23-month-old male with HUS triggered by Escherichia coli-O157 (E.coli-O157) infection leading to an isolated cerebellar stroke. The patient initially presented with fever, bloody stools, and seizures. Confirmation of E.coli-O157 infection was obtained, and MRI revealed an isolated cerebellar stroke. Treatment included supportive care, anticoagulation for a right atrial thrombus, with gradual improvement observed. This case highlights the unusual occurrence of isolated cerebellar stroke in HUS patients, emphasising the importance of promptly recognizing manifestations of the central nervous system and the necessity for a multidisciplinary approach. Finally, a comprehensive literature review was conducted to identify cases of HUS patients with cerebellar involvement. [ABSTRACT FROM AUTHOR]

Pica is an eating disorder characterized by compulsive eating of non-food items. It can present to dentists through patient medical histories, and also through causing atypical patterns of non-carious tooth surface loss. In highlighting two cases of pica presenting in general practice, we aim to raise awareness of this condition and its dental implications. CPD/Clinical Relevance: This article advises on how pica may present to a general dentist and gives advice on management. [ABSTRACT FROM AUTHOR]

The article focuses on the diagnostic challenges faced by children with autism spectrum disorder and lead poisoning. It notes the majority of children having above the reference value blood lead levels (BLL) by the Centers for Disease Control and Prevention (CDC), the lead which is a neurotoxin for metabolic perturbations.

Iron deficiency anemia (IDA) is a major public health problem especially in underdeveloped and developing countries. Zinc is the co-factor of several enzymes and plays a role in iron metabolism, so zinc deficiency is associated with IDA. In this study, it was aimed to investigate the relationship of symptoms of IDA and zinc deficiency in adult IDA patients. The study included 43 IDA patients and 43 healthy control subjects. All patients were asked to provide a detailed history and were subjected to a physical examination. The hematological parameters evaluated included hemoglobin (Hb); hematocrit (Ht); red blood cell (erythrocyte) count (RBC); and red cell indices mean corpuscular volume (MCV), mean corpuscular hemoglobin (МСН), mean corpuscular hemoglobin concentration (МСНС), and red cell distribution width (RDW). Anemia was defined according to the criteria defined by the World Health Organization (WHO). Serum zinc levels were measured in the flame unit of atomic absorption spectrophotometer. Symptoms attributed to iron deficiency or depletion, defined as fatigue, cardiopulmonary symptoms, mental manifestations, epithelial manifestations, and neuromuscular symptoms, were also recorded and categorized. Serum zinc levels were lower in anemic patients (103.51 ± 34.64 μ/dL) than in the control subjects (256.92 ± 88.54 μ/dL; <0.001). Patients with zinc level <99 μ/dL had significantly more frequent mental manifestations (p < 0.001), cardiopulmonary symptoms (p = 0.004), restless leg syndrome (p = 0.016), and epithelial manifestations (p < 0.001) than patients with zinc level > 100 μ/dL. When the serum zinc level was compared with pica, no statistically significant correlation was found (p = 0.742). Zinc is a trace element that functions in several processes in the body, and zinc deficiency aggravates IDA symptoms. Measurement of zinc levels and supplementation if necessary should be considered for IDA patients. [ABSTRACT FROM AUTHOR]

Background and purpose The study aims to review a condition defined by the desire to consume ice in order to satisfy an addictive-like compulsion, rather than for purposes of hydration or pain relief. This condition is called ice pica, or pagophagia. Associations between ice pica and iron deficiency, suggestions for clinical screening of at risk populations, and recommendations for treatment and follow-up care are provided. Data Sources An extensive literature review of original research articles, reviews, clinical practice manuscripts, and scientific publications on pica and pagophagia. Conclusions A compulsion or craving for the consumption of ice is often overlooked in clinical practice. It is therefore important for clinicians to include ice pica as part of the review of systems for certain patient populations. Ice pica is frequently associated with iron deficiency, and iron supplementation is an effective therapy in most cases. Implications for practice Knowledge gained from screening for ice pica can generate valuable patient information and lead to the diagnosis and treatment of iron deficiency. The populations at risk include young women and blood donors of either sex. [ABSTRACT FROM AUTHOR]

This article is a case study of a patient who initially attended a minor illness clinic with restless leg syndrome. During the consultation it became obvious that the patient had pica. Pica is an eating disorder where people ingest a non-nutritive substance for at least 1 month. Angela (pseudonym) had been eating one full sheet of sand paper a day. The case study reviews the assessment and management of the patient. The usual management is a multidisciplinary approach to care. [ABSTRACT FROM AUTHOR]

A 40-year-old mentally retarded Japanese man was admitted at rehabilitation facility for handicapped persons and found dead in his bed. His neonatal period was complicated by seizures, and he had a medical history of schizophrenia. A postmortem computed tomography scan suggested an intestinal obstruction, but the cause was unknown. To clarify the cause of death, a medicolegal autopsy was carried out. The gastrointestinal tract was found to contain copious amounts of cloth pieces. A diagnosis of intestinal obstruction secondary to pica of clothes was made. Despite still being an essentially neglect condition; mental retardation is cause to significant burden to the patient, his relatives and caregivers and the whole society. Moreover, people with mental retardation may be at increased risk for potentially self-injury due to ingestion of non-eating substance or incongruent intake of eating substances, which may on turn lead to severe or even life-threatening medical and surgical complications as herein reported. Specific attention also to pica in mentally-retarded patients with sudden, severe, gastrointestinal events, should therefore be placed in order to prevent potential death or otherwise severe chronic consequences, ideally aiming at enhancing the early recognition and multi-disciplinary management of those psychological stressors or triggers potentially responsible for pica too. [ABSTRACT FROM AUTHOR]

Pica is a potentially deadly form of self-injurious behavior most frequently exhibited by individuals with developmental and intellectual disabilities. Research indicates that pica can be decreased with behavioral interventions; however, the existing literature reflects treatment effects for small samples ( n = 1-4) and the overall success of such treatments is not well-understood. This study quantified the overall effect size by examining treatment data from all patients seen for treatment of pica at an intensive day-treatment clinical setting ( n = 11), irrespective of treatment success. Results demonstrate that behavioral interventions are highly effective treatments for pica, as determined by the large effect size for individual participants (i.e., NAP scores ≥ .70) and large overall treatment effect size (Cohen's d = 1.80). [ABSTRACT FROM AUTHOR]

In 2009, the Institute of Medicine reexamined the guidelines for weight gain during pregnancy. The committee noted that if a woman's gestational weight gain is not within the recommended guidelines, clinicians should consider modifiable factors that might be causing excessive or inadequate weight gain before suggesting that a woman modify her pattern of weight gain. We present 2 cases from our clinics where pregnant women's practice of pica affects their weight gain. A brief summary of the current literature describing the global practice of pica, including the United States, is presented. Although the Institute of Medicine guidelines discuss determinants of gestational weight gain such as culture, the practice of pica is not included in that report. [ABSTRACT FROM AUTHOR]

We sought to describe the impact of pica, the craving for and intentional ingestion of substances not defined as food, as a risk factor for lead poisoning in New York City (NYC) pregnant women. In order to describe pregnant women with elevated blood lead levels (BLLs) who report pica, NYC health department data from 491 cases of lead-poisoned pregnant women from January 2001 to June 2009 were reviewed. Descriptive frequencies were obtained for women reporting pica. Data were compared between women reporting and not reporting pica. In NYC, of the 43 (9%) lead-poisoned pregnant women reporting pica, 42 (97.7%) were immigrants and 28 (64.6%) had consumed soil. Compared to lead-poisoned pregnant women not reporting pica, women reporting pica had higher peak BLLs (29.5 vs. 23.8 μg/dL, P = 0.0001), were more likely to have had a BLL ≥ 45 μg/dL (OR = 3.3, 95% CI, 1.25, 8.68) and receive chelation (OR = 10.88, 95% CI, 1.49, 79.25), more likely to have emigrated from Mexico (OR = 3.05, 95% CI, 1.38-6.72), and less likely to have completed high school (OR = indeterminate; 0 vs. 34%; P = 0.003). Among NYC lead-poisoned pregnant women, pica was associated with higher peak BLLs. Providers in NYC, and possibly other urban settings, should be vigilant and question pregnant women, especially immigrants, about pica and strongly consider testing this at-risk population for lead poisoning. [ABSTRACT FROM AUTHOR]

Background: Pica is frequently observed in people with autism and learning disabilities. It can result in many life threatening health complications, such as intestinal obstruction and gastrointestinal bleeding. People in this population have complex needs and are particularly vulnerable to experiencing health care and social inequalities. Pica reduces the quality of life in this population, and is a distressing disorder for patients and their families, especially if little is known about the disorder. Methodology: A search of databases that included OVID, EMBASE and MEDLINE was conducted looking specifically at behavioural management of pica in the learning disabled population. All age groups and severity of learning disability were included. A total of 316 results were obtained from this search. After screening, a total of 8 papers were reviewed. Results: This review summarises 8 published studies that examined the assessment and use of behavioural interventions in the management of pica in people with learning disabilities and autism. The interventions discussed include differential reinforcement of pica, exposing participants to mild forms of punishment contingent upon pica, and discrimination training. The review explores the acceptability of such interventions, especially of punishment procedures, and highlights some areas for future research. Conclusion: Future research is required to explore the efficacy of managing pica via behavioural interventions in the adult population with learning disabilities, as this review found papers only on the child and adolescent population. The interventions studied in this review were primarily based in inpatient settings; therefore we need to establish whether they are applicable in the community, and how they can be generalized to a modern day society. With this knowledge, it may be possible to further develop successful behavioural interventions appropriate to the needs of the population. [ABSTRACT FROM AUTHOR]

Pica displayed by two individuals with autism was decreased by a treatment involving differential reinforcement and response interruption that altered the chain of behavior involved in pica (i.e., picking up items and placing them in the mouth). The treatment involved establishing prompts to 'clean-up' as a new discriminative stimulus (SD) for picking up items from the floor; and holding potential pica items was established as an SD for discarding those items in a trash receptacle, putting them away, or using them appropriately. After demonstrating the effectiveness of the treatment in an analog setting, the treatment package was systematically generalized to community settings. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Presents a study that conducted a survey of the prevalence of the various forms of pica in patients with iron deficiency from chronic blood loss. Presence of pagophagia; Frequency of geophagia and other forms of pica; Correlation of serum iron levels with symptoms of pagophagia.

A letter to the editor is presented in response to an article about a case of pathological salt ingestion or salinophagia as a symptom of anorexia nervosa.

The article presents the clinical study concerning coprophagia among adult patients in psychiatric hospitals in Great Britain. Coprophagia refers to the eating of one's own feces. A total of fourteen patients who suffer from coprophagia from two large psychiatric hospitals were studied. An examination was made on the case notes of these patients for the data including pica, cissa, boredom, and aggressive behavior. Pica, cissa, and food fads had been found to be phenomenogically similar to and potentially linked with coprophagia. Nine of the patients appeared to be affected with madness or insanity and two of them had been found to have a definite history of alcoholism. Eight of the patients were discovered as wanderers and 4 were seen to have persistent abnormal mouth movements.

Describes a patient with severe hypokalemia and a microcytic anemia of iron deficiency secondary to geophagia. Medical history of the patient; Association of the patient's hypokalemia with clay ingestion; Appearance of iron deficiency anemia in other forms of pica.

A letter to the editor is presented in response to the article that discusses the implications of geophagia on nutrition published in the previous issue.

Presents a case report involving a woman diagnosed with sideroblastic anemia. Symptoms of woman upon arrival to hospital including unsteady gait, generalized weakness, dizziness, asthenia, and vomiting; Tomography showing oedema and suspected cerebellar tumor; How the patient was treating her paranoid schizophrenia by eating jewelry.

Presents a case report of an Afro-American woman with an unusual pica associated with severe iron deficiency. Medical history of the woman; Forms of pica; Controversy on the origin of geophagia and amylophagia.