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Background: Central and general obesity are commonly measured using tools like waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). However, the universally recognized cutoffs for these measures may be inadequate for individuals of Ethiopian descent. Due to the lack of universally applicable cutoffs, studies recommend tailoring the optimal screening thresholds to each population's specific characteristics. Therefore, this study aimed to determine body composition-based WC, WHR, and WHtR cutoffs for the healthy adult population of Ethiopia. Method: A population based cross-sectional study was conducted in the Amhara region of Ethiopia from June to August 2023, collecting anthropometric and body composition data from 838 adult participants. Data were analyzed using Stata, and MedCalc software. The cut-off values were determined using ROC analysis, and performance was assessed using area under the curve (AUC), Youden index, sensitivity, and specificity. Result: The optimal cut-off values for WC, HC, WHR, and WHtR to define obesity in men were 85.0 cm, 93.5 cm, 0.89, and 0.53 respectively. Correspondingly, these values in women were 81.1 cm, 97.2 cm, 0.84, and 0.5. These cutoff values showed the highest effectiveness in defining obesity especially for WC and WHtR. The new proposed cutoff values for waist circumference, hip circumference, and waist-to-height ratio had sensitivity ranging 76–93% and specificity of 83–94% in accurately identifying obesity. The current study also determined the cut-off values for underweight, normal weight, and overweight body weight categories. Accordingly, for men, the WC cut-offs were: ≤ 74.55 cm (underweight), 74.56–78.95 cm (normal), and 79.0–85.0 cm (overweight). For women, the cut-offs were: ≤ 68.25 cm (underweight), 68.26–79.59 cm (normal), and 79.60–81.10 cm (overweight). The WHtR thresholds were: ≤0.43 (underweight), 0.44–0.47 (normal), and 0.48–0.53 (overweight) in men; ≤0.43 (underweight), 0.44–0.50 (normal), and 0.50–0.51 (overweight) in women. Conclusion: The findings indicate that the WC, WHR, and WHtR cutoff values for defining obesity in Ethiopian adults are lower than international standards. The newly proposed cutoff values showed improved sensitivity and specificity, suggesting their potential diagnostic relevance. Considering these country-specific cutoffs may be beneficial for clinical practice and obesity-related research in Ethiopia. [ABSTRACT FROM AUTHOR]

Abstract Background Central and general obesity are commonly measured using tools like waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). However, the universally recognized cutoffs for these measures may be inadequate for individuals of Ethiopian descent. Due to the lack of universally applicable cutoffs, studies recommend tailoring the optimal screening thresholds to each population’s specific characteristics. Therefore, this study aimed to determine body composition-based WC, WHR, and WHtR cutoffs for the healthy adult population of Ethiopia. Method A population based cross-sectional study was conducted in the Amhara region of Ethiopia from June to August 2023, collecting anthropometric and body composition data from 838 adult participants. Data were analyzed using Stata, and MedCalc software. The cut-off values were determined using ROC analysis, and performance was assessed using area under the curve (AUC), Youden index, sensitivity, and specificity. Result The optimal cut-off values for WC, HC, WHR, and WHtR to define obesity in men were 85.0 cm, 93.5 cm, 0.89, and 0.53 respectively. Correspondingly, these values in women were 81.1 cm, 97.2 cm, 0.84, and 0.5. These cutoff values showed the highest effectiveness in defining obesity especially for WC and WHtR. The new proposed cutoff values for waist circumference, hip circumference, and waist-to-height ratio had sensitivity ranging 76–93% and specificity of 83–94% in accurately identifying obesity. The current study also determined the cut-off values for underweight, normal weight, and overweight body weight categories. Accordingly, for men, the WC cut-offs were: ≤ 74.55 cm (underweight), 74.56–78.95 cm (normal), and 79.0–85.0 cm (overweight). For women, the cut-offs were: ≤ 68.25 cm (underweight), 68.26–79.59 cm (normal), and 79.60–81.10 cm (overweight). The WHtR thresholds were: ≤0.43 (underweight), 0.44–0.47 (normal), and 0.48–0.53 (overweight) in men; ≤0.43 (underweight), 0.44–0.50 (normal), and 0.50–0.51 (overweight) in women. Conclusion The findings indicate that the WC, WHR, and WHtR cutoff values for defining obesity in Ethiopian adults are lower than international standards. The newly proposed cutoff values showed improved sensitivity and specificity, suggesting their potential diagnostic relevance. Considering these country-specific cutoffs may be beneficial for clinical practice and obesity-related research in Ethiopia.

The purpose of this study was to explore the impact of central obesity on spinal sagittal balance in adults aged 18 and older by examining correlations between waist circumference (WC) and abdominal circumference (AC) and spinopelvic alignment parameters. This prospective cohort study included 350 adults aged 18 and older. Participants underwent whole-body biplanar radiography using the EOS imaging system. Spinal and pelvic parameters were measured and correlated with body mass index, WC, and AC. Statistical analyses included one-way analysis of variance, Wilcoxon rank-sum tests for data with nonhomogeneous variances, and chi-squared tests for categorical data. Intra-rater and inter-rater reliability were assessed using intraclass correlation coefficients, with subsequent analyses to explore correlations between body measurements and spinal parameters. The study found significant correlations between increased WC and AC and changes in spinopelvic parameters. However, obesity did not uniformly influence all sagittal alignment parameters. Significant variations in spinal measurements indicate that central obesity plays a role in altering spinal stability and alignment. The findings highlight the impact of central obesity on spinal alignment and emphasize the importance of considering central obesity in clinical assessments of spinal pathologies. Further research is essential to better understand the relationship between obesity, spinal sagittal balance, and related health conditions. [ABSTRACT FROM AUTHOR]

Introduction: High periods of sedentary behavior characterize most police duties. In addition, the profession is highly stressful and exposes policemen to higher adverse health outcome risks, such as obesity and hypertension. Purpose: This study aimed to analyze the imapct of higher body mass index (BMI) on ambulatory BP and heart rate variability (HRV) and, to examine the correlation between obesity indicators, lipid profile, ambulatory BP and HRV in police officers. Methods: Operational police officers (n= 38) were categorized into BMI: lower (< 26.47 kg·m-2) and higher (> 26.47 kg·m-2)). Clinical and ambulatory (24h, awake and asleep) BP, and HRV indices were assessed. Results: Officers with higher BMI group exhibited higher clinical systolic (SBP) and diastolic BP (DBP) compared to those with lower BMI. Similarly, the higher BMI showed higher (p < 0.05) values of 24h (71 ±7 vs 66 ± 6 mmHg), awake (73 ± 7 vs 68 ± 6) and asleep (64 ± 9 vs 58 ± 8) DBP compared to the lower BMI group, without impairment ambulatory HRV indices. Moreover, this group also attained less distance in 12-min running test (2,305.26 ± 236.22 vs 2,486.47 ± 222.72; p = 0.02) and VO2max (40.25 ± 5.28 vs 44.36 ± 4.97 mL·kg-1·min-1; p = 0.02). Abdominal circumference correlated significantly with ambulatory BP (r = 0.35 to 0.49). Triglycerides (Rho/r = - 0.31 to - 0.33) and total cholesterol (Rho/r = - 0.37 to - 0.42) correlated significantly with ambulatory SDNN. Besides, triglycerides correlated significantly to awake and asleep (r/Rho = 0.34 and 0.38) DBP. Conclusion: Police officers with higher BMI showed higher ambulatory DBP, without evidence of cardiac autonomic modulation impairment. Obesity indicators correlated with ambulatory BP, while the lipid profile correlated with ambulatory DBP and HRV. [ABSTRACT FROM AUTHOR]

Background/Objectives: To evaluate the quality of an ultrasound practice, both large-scale and focused audits are recommended by professional organizations, but such audits can be time-consuming, inefficient, and expensive. Our objective was to develop a time-efficient, quantitative, objective, large-scale method to evaluate fetal biometry measurements for an entire practice, combined with a process for focused image review for personnel whose measurements are outliers. Methods: Ultrasound exam data for a full year are exported from commercial ultrasound reporting software to a statistical package. Fetal biometry measurements are converted to z-scores to standardize across gestational ages. For a large-scale audit, sonographer mean z-scores are compared using analysis of variance (ANOVA) with Scheffe multiple comparisons test. A focused image review is performed on a random sample of exams for sonographers whose mean z-scores differ significantly from the practice mean. A similar large-scale audit is performed, comparing physician mean z-scores. Results: Using fetal abdominal circumference measurements as an example, significant differences between sonographer mean z-scores are readily identified by the ANOVA and Scheffe test. A method is described for the blinded image audit of sonographers with outlier mean z-scores. Examples are also given for the identification and interpretation of several types of systematic errors that are unlikely to be detectable by image review, including z-scores with large or small standard deviations and physicians with outlier mean z-scores. Conclusions: The large-scale quantitative analysis provides an overview of the biometry measurements of all the sonographers and physicians in a practice, so that image audits can be focused on those whose measurements are outliers. The analysis takes little time to perform after initial development and avoids the time, complexity, and expense of auditing providers whose measurements fall within the expected range. We encourage commercial software developers to include tools in their ultrasound reporting software to facilitate such quantitative reviews. [ABSTRACT FROM AUTHOR]

Background: A recently discovered measurement called transverse cerebellar diameter (TCD) is used to estimate a fetus's gestational age (GA). When determining GA, the measurement of TCD is incredibly accurate, especially when the last menstrual period (LMP) date is uncertain. Objective: This study aimed to assess the diagnostic accuracy of fetal TCD as independent parameter in diagnosis of intrauterine growth restriction (IUGR). Patients and methods: This prospective observatory study was conducted in Obstetrics and Gynecology Department, Menoufia University Hospital and Berket El-Sabaa Central Hospital through the period from November 2022 to February 2024. 200 pregnant women attended to Antenatal Care Outpatient Clinic for follow up with a mean age of 26.43 ± 6.115 years old, singleton pregnancy, GA more than 13 weeks and clinically suspected intra uterine fetal growth restriction (FGR) were enrolled. Results: The study included individuals with a mean parity of 1.47 ± 1.5, a mean BMI of 26.32 ± 5.028 kg/m², and 19% of patients were obese. There was a highly statistically significant lower mean value of GA by TCD in IUGR was 27.18 ± 7.454 compared to Non-IUGR that was 34.95 ± 3.502 (p<0.001). Conclusion: TCD is a critical measure for identifying IUGR and appropriately measuring GA. This is especially crucial for patients who arrived at the hospital without any medical records or prior prenatal care visits, particularly those from low-income families. These individuals frequently do not recall their LMP or estimated date of delivery (EDD), making it difficult for clinicians to precisely determine the GA of the fetus, especially in situations of IUGR. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to compare maternal and neonatal outcomes when the diagnosis of FGR was based on isolated abdominal circumference < 10th percentile for gestational age (GA) (iAC group) versus overall estimated fetal weight < 10th percentile (EFW group). Methods: This was a retrospective cohort study of singleton gestations who underwent growth ultrasounds and delivered at a single health system from 1/1/19–9/4/20. The study group was comprised of patients with AC < 10th percentile and EFW ≥ than the 10th percentile (iAC group). The control group included patients with overall EFW < 10th percentile (EFW group). Outcomes evaluated included GA at delivery, mode of delivery, fetal and neonatal outcomes. Data was analyzed using Mann Whitney U, X2, and Fisher exact tests with significance defined as p < 0.05. Results: 635 women met the inclusion criteria, 259 women in the iAC group and 376 women in the EFW group. The iAC group was noted to have a later GA at diagnosis and delivery. iAC was associated with lower rates of preterm birth (PTB), NICU admission, SGA at delivery and umbilical artery cord gas < 7.0. Conclusion: Using iAC as a definition of FGR increased the number of FGR cases by 1.69-fold over EFW criteria alone. However, obstetrical and neonatal outcomes for the iAC group appear to be significantly better than those in the EFW group, with low rates of PTB, NICU admission, and umbilical artery cord gas < 7.0. [ABSTRACT FROM AUTHOR]

Objective Fetal growth restriction (FGR) is defined as an estimated fetal weight (EFW) or abdominal circumference (AC) <10th percentile (%ile) for gestational age (GA). An EFW <3rd %ile for GA is considered severe FGR (sFGR). It remains unknown if fetuses with isolated AC <3rd %ile should be considered sFGR. Our primary objective was to assess composite neonatal outcomes in fetuses with an AC <3 rd %ile and overall EFW 3rd to 9th %ile compared with those with an EFW <3rd %ile. Study Design This retrospective cohort study was undertaken at a tertiary academic center from January 2016 to December 2021. Inclusion criteria were singleton fetuses with an EFW <3rd %ile (Group 1) or AC <3rd %ile with EFW 3rd to 9th %ile (Group 2) at 28 weeks' gestation or greater. Exclusion criteria were multiple gestations, presence of a major fetal anomaly, resolution of FGR, genetic syndrome, or infection. Composite neonatal outcome was defined by any of the following: neonatal intensive care unit admission >48 hours, necrotizing enterocolitis, sepsis, respiratory distress syndrome, mechanical ventilation, retinopathy of prematurity, seizures, intraventricular hemorrhage, stillbirth, or death before discharge. Small for gestational age (SGA) was defined as birth weight <10th %ile for GA. Results A total of 743 patients fulfilled our study criteria, with 489 in Group 1 and 254 in Group 2. The composite neonatal outcome occurred in 281 (57.5%) neonates in Group 1 and 53 (20.9%) in Group 2 (p < 0.01). The rates of SGA at birth were 94.9 and 75.6% for Group 1 and Group 2, respectively (OR 5.99, 95% confidence interval 3.65–9.82). Conclusion Although AC <3rd %ile with EFW 3rd to 9th %ile is associated with a lower frequency of SGA and neonatal morbidity than EFW <3 %ile, fetuses with AC <3 %ile still exhibited moderate rates of these adverse perinatal outcomes. Consideration should be given to inclusion of an AC <3rd %ile with EFW 3rd to 9th %ile as a criterion for sFGR. However, prospective studies comparing delivery at 37 versus 38 to 39 weeks' gestation are needed to ensure improved outcomes before widespread adaptation in clinical practice. Key Points The composite neonatal outcome occurred in 57.5% of fetuses with an overall EFW <3rd %ile and 20.9% of fetuses with an AC <3rd %ile but EFW 3rd to 9th %ile. Both groups demonstrated a high positive predictive value for SGA birth weight. Consideration should be given to inclusion of an AC <3rd %ile as a criterion for sFGR. [ABSTRACT FROM AUTHOR]

Background: Spinal anesthesia is the safest and most popular technique used for cesarean section worldwide. Certain maternal and fetal conditions such as increased maternal abdominal circumference and fetal weight can have profound effect on degree of hypotension cause by Spinal anesthesia. The study aims to determine the occurrence of spinal hypotension in relation to abdominal circumference and fetal weight. Objective: To assess the relationship between term parturient’s abdominal circumference and the fetal weight with the occurrence of hypotension during cesarean delivery with spinal anesthesia. Study type, settings & duration:This prospective observational study conducted at Department of Anesthesiology, Dr. Ruth K. M. Pfau Civil Hospital, Karachi from February to June 2022. Methodology: Total 116 terms parturient at 37 weeks or greater were enrolled after taking consent. The patient’s height and abdominal circumference in centimeters was measured using a measuring tape while weight was measured using a digital weighing scale. Two groups of patients were made according to the abdominal circumference. Baseline readings were taken of pulse, blood pressure and mean arterial pressure prior to the surgery. Patients were preloaded using crystalloids and then intra-thecal bupivacaine was administered, following the administration of spinal anesthesia mean arterial pressure, heart rate and blood pressure were recorded every three minutes till the delivery of the baby. Results: Total 39 patients out of 116 developed hypotension. Out of these 39 patients 31 had an abdominal circumference of more than 101 cm. This indicates that large AC has linear relationship with the degree of hypotension and it was not found to be related to increased fetal weight. Conclusion: There was no relation found between fetal weight and the occurrence of hypotension, however, the larger abdominal circumference to be more likely to develop a greater degree of hypotension following spinal anesthesia in term parturient.

Purpose: This study aimed to investigate the association between simple markers in fetal abdominal plane, intra-abdominal umbilical venous diameter (DIUV) and abdominal circumference (AC) discordance at 15–20 weeks' gestation, and adverse pregnancy outcomes in monochorionic diamniotic (MCDA) twins. Methods: We performed a retrospective analysis of MCDA twins with two live fetuses examined at 15–20 weeks from Jun 2020 to Dec 2021 at Beijing Obstetrics and Gynecology Hospital. Measurement of fetal AC and DIUV was performed according to standard protocols. Twin pregnancies with major fetal structural anomalies, chromosomal abnormalities, miscarriage, and twin reversed arterial perfusion sequence were excluded. DIUV and AC discordance in MCDA twins with an adverse pregnancy outcome was compared with a normal pregnancy outcome. Furthermore, the performance of DIUV and AC discordance in predicting adverse pregnancy outcomes in MCDA twins was assessed. Results: A total of 105 women with MCDA twin pregnancies were enrolled, contributing 179 visits. Adverse pregnancy outcomes occurred in 33.3% (35/105) of cases in our study. The intra-observer and inter-observer intraclass correlation coefficient (ICC) of both AC and DIUV were very good or excellent. There was no statistical difference in AC and DIUV discordance (%) between 15–16, 17–18, and 19–20 weeks (χ2 = 3.928, P = 0.140; χ2 = 2.840, P = 0.242). Both AC and DIUV discordance were greater in twins with adverse pregnancy outcomes than that in twins with normal pregnancy outcome at each pregnancy periods. Both AC discordance (OR 1.2, 95% CI 1.1–1.3) and DIUV discordance (OR 1.2, 95% CI 1.1–1.2) were associated with adverse pregnancy outcomes. The AUC for predicting adverse pregnancy outcomes by AC discordance was 0.75 (95% CI 0.68–0.83), with a sensitivity of 58.7% (95% CI 51.9–64.5) and a specificity of 86.2% (95% CI 81.7–88.4). The AUC for predicting adverse pregnancy outcomes by DIUV was 0.78 (95% CI 0.70–0.86), with sensitivity and specificity of 65.1% (95% CI 58.1–70.3) and 86.2% (95% CI 81.7–88.4), respectively. Conclusions: The AC discordance and DIUV discordance could predict adverse pregnancy outcomes in MCDA twins. When these simple markers occurred, intensive surveillance was recommended. [ABSTRACT FROM AUTHOR]

OBJECTIVES: We aimed to evaluate the screening performance of estimated fetal weight (EFW) and abdominal circumference (AC) measurements in predicting newborns with birth weight (BW) less than the 10th percentile for birth age (BW <10p). STUDY DESIGN: Three hundred thirty-one pregnant women who met the inclusion and exclusion criteria were included in this retrospective cohort study. The groups were divided into two groups: those diagnosed with FGR (FGR group) and those not diagnosed (non-FGR)after the 32nd week of gestation. Demographic and obstetric histories, ultrasonographic and clinical features, and neonatal outcomes of the groups were recorded, and comparisons between the groups were conducted. The screening performances of AC and EFW were compared for predicting newborns with BW<10p and assessing neonatal outcomes. RESULTS: AC or EFW measures below 10% (AC<10p or EFW<10p) demonstrated the highest screening performance for BW<10p, with 91.7% sensitivity and 91% specificity. AC<10p demonstrated the highest performance in predicting neonatal intensive care unit (NICU) admission, with 75.9% sensitivity and 89.1% specificity. For neonates with a 5-minute APGAR score of less than 7, AC<10p or EFW<10p had 88.2% sensitivity and 69.7% specificity. CONCLUSION: This study shows that AC and EFW measurements can be used together or separately to predict newborns who are small for their gestational age (SGA). Using values below 10% of either AC or EFW together gives the best results in terms of sensitivity and specificity. [ABSTRACT FROM AUTHOR]

Background: Heart failure is a major cause of morbidity and mortality worldwide; left ventricular diastolic dysfunction plays a leading role in this clinical context. Diastolic dysfunction may be predisposed by increased abdominal fat and, consequently, increased pericardial and epicardial adiposity. This study aimed to determine whether pericardial fat (PF) and epicardial fat (EF) are associated with left ventricular diastolic function. Methods: A total of 82 patients had their abdominal circumference measured and underwent transthoracic echocardiography to measure the thickness of PF and EF and assess the left ventricular diastolic function. Two groups were created based on mean pericardial fat (PF) thickness (4.644 mm) and were related to abdominal circumference and echocardiographic parameters. Results: Subjects in the PF High group showed a significant decrease in septal e' (p < 0.0001), lateral e' (p < 0.0001), and E/A ratio (p = 0.003), as well as a significant increase in E/e' ratio (p < 0.0001), E wave deceleration time (p = 0.013), left atrial volume (p < 0.0001), the left ventricle mass (p = 0.003), tricuspid regurgitant jet velocity (p < 0.0001), and the left ventricle diameter (p = 0.014) compared to the PF Low group. Correlations were found between pericardial fat and nine echocardiographic parameters in the study, while epicardial fat (EP) only correlated with eight. Conclusions: Measurement of abdominal circumference, PF, and EF is an early indicator of diastolic changes with transthoracic echocardiography being the gold standard exam. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of hypotension in cesarean section operations performed with spinal anesthesia varies between 55-90%. In this study, the relationship between the patient's abdominal circumference, symphyseal fundal height, and vertebral column length with the incidence of hypotension and the level of block in cesarean section operations performed under spinal anesthesia was investigated. Methods: The prospective, single-center study was conducted with patients who had undergone cesarean section with spinal anesthesia at the Training and Research Hospital. Pregnant and ASA II group patients older than 37 weeks who were to undergo cesarean section with spinal anesthesia were included in the study. Patients with multiple pregnancies, patients with premature rupture of membranes, preterm patients, and patients in active labor were excluded from the study. Those with diagnoses of abnormal presentation, polyhydramnios, oligohydramnios, macrosomic babies, and intrauterine growth retardation were also excluded from the study. Abdominal circumference was measured at the umbilicus level at the end of expiration in the supine position. Vertebral column length was measured and recorded from the C7 vertebra to the sacral hiatus. The distance of the patient from the symphysis pubis to the highest point of the uterine fundus in the supine position was measured and recorded. Spinal anesthesia was performed in the sitting position with a 26G Quincke spinal needle for the first time through the L4-5 interval and 2 mL of 0.5% hyperbaric bupivacaine was administered. When the block reached T6, the operation was started. Electrocardiogram (ECG), SpO2, and arterial blood pressure were monitored, and the first values were recorded. Results: A total of 98 parturient patients were included in this study. Overall, the incidence of hypotension was 87.78% (87 out of 98 parturients). Symphyseal fundal height correlated positively with spinal blockade levels at each different time point except for "Min. 4". Discussion and Conclusion: Symphyseal fundal height is a sensitive marker to determine the risk of hypotension after spinal anesthesia. We found that the symphyseal fundal height is a more sensitive marker for hypotension that will develop after spinal anesthesia compared to the other two parameters. [ABSTRACT FROM AUTHOR]

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Background: Metabolic syndrome consists of cardiometabolic risk factors that promote the development of atherosclerotic cardiovascular disease, type 2 'DM' and obesity. These are associated with increased cardiovascular mortality and morbidity. Metabolic disorders (MD) are becoming more prevalent both in developing countries and developed countries and are now considered as lifestyle diseases. In women of reproductive age group, especially pregnancy, the blood glucose level is increasing which adversely affects the health of mother and child. Similarly, high blood pressure also precipitates the problems. This study was carried out to find the prevalence of hypertension, diabetes mellitus, obesity and 'MD' among the women living in remote rural set-up. Materials and Methods: This cross-sectional study was done among women of reproductive age group in 15 villages from 5 panchayats of field practice area of Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan. They were screened for 'MD' through investigative procedures (weight, height, BMR, abdominal girth, blood pressure through sphygmomanometer, blood glucose through the glucometer method), serum HDL and triglycerides. Respondents from the family were asked about the common/general information of house. The tool used for collecting general and relevant information from the respondent was a questionnaire, which was pretested for validity before being used in the field. Results: Four-hundred and sixty-seven women of reproductive age group participated in the study. Half of the participants were with qualification of matriculate and 9.2% participants were illiterate. Three-fourths of the participants were married women and 89% were vegetarian. Sixty-four per cent of participants were housewives. Half of the participants had a normal BMI, whereas 28.9% were overweight and 10% were obese. The prevalence of hypertension and diabetes among the participants were 12.5% and 9.8%, respectively. Forty-seven per cent participants had a waist circumference above 80 cm. Conclusion: The level of non-communicable diseases is related with the MD which has the adverse effect on the various systems and organs of the subjects. The MD can be controlled with the certain changes in the life style pattern. The GOI is also concerned with such scenarios in the country. It is recommended that women of reproductive age group undergo regular blood pressure and blood sugar screenings to detect hypertension and diabetes early and take appropriate measures to manage them.

Background: Intrauterine growth restriction is associated with increased fetal mortality rate, and its early detection is important for determining delivery timing and planning neonatal care. This study aimed to examine the usefulness of the fetal transverse cerebellar diameter (TCD) to abdominal circumference (AC) ratio in fetal growth evaluation that can predict intrauterine growth restriction and propose a reference value for normal Korean fetuses. Methods: This study included a total of 1011 fetuses between 19 and 34 weeks of gestation from January 2021 to December 2022. A simple regression analysis was conducted to determine the relationship between TCD and AC and gestational age, and the normal mean values and percentiles of the TCD/AC ratio by gestational age were calculated. Results: TCD and AC correlated strongly with gestational age, increasing along with gestational age. The TCD/AC ratio in normal fetuses between 19 and 34 weeks of gestation was 13.26, with a 95th percentile of 14.39. Conclusions: The TCD/AC ratio can be utilized as a useful variable to predict intrauterine growth restriction when evaluating the growth of Korean fetuses. Furthermore, close observation is required when the TCD/AC ratio exceeds 14.39, allowing for early prediction and management of intrauterine growth restriction.

Objective: Increased subcutaneous fat deposition in abdomen in large for gestational age (LGA) fetuses of mothers with gestational diabetes mellitus can be measured by fetal abdominal subcutaneous tissue thickness (FASTT) using ultrasound. The current study aimed to evaluate the correlation between FASTT and birth weight and compare FASTT and abdominal circumference (AC) for prediction of LGA babies in gestational diabetes. Materials and methods: 150 term GDM women were enrolled into the study. FASTT was measured weekly. Birth weight was measured immediately after delivery and categorized into SGA, AGA and LGA according to International growth charts. The last FASTT and AC values were recorded for analysis. Correlation statistics was used to determine the relation between FASTT with birth weight and ROC curves were used to compare FASTT and AC for prediction of LGA fetuses. Results: There was weak positive correlation between FASTT and birth weight with Pearson's co-efficient (r) of 0.375. The cut-off value for FASTT to predict LGA fetuses obtained by ROC curve was =8.05 mm with sensitivity and specificity of 68.8% and 68.7%. The mean values of FASTT for small for gestational age (SGA), appropriate for gestational age (AGA) and LGA fetuses were significantly different. AUC for FASTT was 0.692 and for AC was 0.755. Conclusion: FASTT had a positive but weak correlation with birth weight. The utility of FASTT as a screening tool may not be impressive. FASTT can discriminate between SGA, AGA and LGA fetuses. AC is a better predictor than FASTT for LGA neonates. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome consists of cardiometabolic risk factors that promote the development of atherosclerotic cardiovascular disease, type 2 'DM' and obesity. These are associated with increased cardiovascular mortality and morbidity. Metabolic disorders (MD) are becoming more prevalent both in developing countries and developed countries and are now considered as lifestyle diseases. In women of reproductive age group, especially pregnancy, the blood glucose level is increasing which adversely affects the health of mother and child. Similarly, high blood pressure also precipitates the problems. This study was carried out to find the prevalence of hypertension, diabetes mellitus, obesity and 'MD' among the women living in remote rural set-up. Materials and Methods: This cross-sectional study was done among women of reproductive age group in 15 villages from 5 panchayats of field practice area of Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan. They were screened for 'MD' through investigative procedures (weight, height, BMR, abdominal girth, blood pressure through sphygmomanometer, blood glucose through the glucometer method), serum HDL and triglycerides. Respondents from the family were asked about the common/general information of house. The tool used for collecting general and relevant information from the respondent was a questionnaire, which was pretested for validity before being used in the field. Results: Four-hundred and sixty-seven women of reproductive age group participated in the study. Half of the participants were with qualification of matriculate and 9.2% participants were illiterate. Three-fourths of the participants were married women and 89% were vegetarian. Sixty-four per cent of participants were housewives. Half of the participants had a normal BMI, whereas 28.9% were overweight and 10% were obese. The prevalence of hypertension and diabetes among the participants were 12.5% and 9.8%, respectively. Forty-seven per cent participants had a waist circumference above 80 cm. Conclusion: The level of non-communicable diseases is related with the MD which has the adverse effect on the various systems and organs of the subjects. The MD can be controlled with the certain changes in the life style pattern. The GOI is also concerned with such scenarios in the country. It is recommended that women of reproductive age group undergo regular blood pressure and blood sugar screenings to detect hypertension and diabetes early and take appropriate measures to manage them. [ABSTRACT FROM AUTHOR]

Objective: To assess the reproducibility of ultrasound measurements of fetal biometry using a 'focus point' to assist the acquisition of the relevant plane. Methods: This was a study of 80 women with a singleton non‐anomalous pregnancy who attended University College London Hospital, London, UK, between 18 and 37 weeks' gestation. Planes to measure head circumference (HC), abdominal circumference (AC) and femur length (FL) were obtained four times by two different sonographers with different levels of experience, who were blinded to one another; the first set of images was obtained with reference to a standard image, and the second set of images was obtained using the focus point technique. The focus point was defined as a unique fetal anatomical landmark in each plane (cavum septi pellucidi for HC, two‐thirds of the umbilical vein for AC and one of the two extremities of the diaphysis for FL). Once identified, the focus point was maintained in view while the sonographer rotated the probe along three axes (x, y, z) to acquire the relevant plane. Sonographers were either in training or had > 3000 scans worth of experience. Intra‐ and interobserver reproducibility were assessed using Bland–Altman plots, and absolute values and percentages for mean difference and 95% limits of agreement (LoA) were reported. Results: Overall reproducibility was good, with all 95% LoA < 8%. Reproducibility was improved by use of the focus point compared with the standard technique for both intraobserver comparison (95% LoA, < 4% vs < 6%) and interobserver comparison (95% LoA, < 7% vs < 8%). These findings were independent of sonographer seniority and plane acquired. Conclusions: Reproducibility of fetal biometry assessment is improved with use of the focus point for plane acquisition, regardless of sonographer experience. We propose that this method should be implemented in clinical practice and training programs in fetal biometry. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Background: Spinal anesthesia is the safest and most popular technique used for cesarean section worldwide. Certain maternal and fetal conditions such as increased maternal abdominal circumference and fetal weight can have profound effect on degree of hypotension cause by Spinal anesthesia. The study aims to determine the occurrence of spinal hypotension in relation to abdominal circumference and fetal weight. Objective: To assess the relationship between term parturient's abdominal circumference and the fetal weight with the occurrence of hypotension during cesarean delivery with spinal anesthesia. Study type, settings & duration: This prospective observational study conducted at Department of Anesthesiology, Dr. Ruth K. M. Pfau Civil Hospital, Karachi from February to June 2022. Methodology: Total 116 terms parturient at 37 weeks or greater were enrolled after taking consent. The patient's height and abdominal circumference in centimeters was measured using a measuring tape while weight was measured using a digital weighing scale. Two groups of patients were made according to the abdominal circumference. Baseline readings were taken of pulse, blood pressure and mean arterial pressure prior to the surgery. Patients were preloaded using crystalloids and then intra-thecal bupivacaine was administered, following the administration of spinal anesthesia mean arterial pressure, heart rate and blood pressure were recorded every three minutes till the delivery of the baby. Results: Total 39 patients out of 116 developed hypotension. Out of these 39 patients 31 had an abdominal circumference of more than 101 cm. This indicates that large AC has linear relationship with the degree of hypotension and it was not found to be related to increased fetal weight. Conclusion: There was no relation found between fetal weight and the occurrence of hypotension, however, the larger abdominal circumference to be more likely to develop a greater degree of hypotension following spinal anesthesia in term parturient. [ABSTRACT FROM AUTHOR]

Objective: Increased subcutaneous fat deposition in abdomen in large for gestational age (LGA) fetuses of mothers with gestational diabetes mellitus can be measured by fetal abdominal subcutaneous tissue thickness (FASTT) using ultrasound. The current study aimed to evaluate the correlation between FASTT and birth weight and compare FASTT and abdominal circumference (AC) for prediction of LGA babies in gestational diabetes. Materials and methods: 150 term GDM women were enrolled into the study. FASTT was measured weekly. Birth weight was measured immediately after delivery and categorized into SGA, AGA and LGA according to International growth charts. The last FASTT and AC values were recorded for analysis. Correlation statistics was used to determine the relation between FASTT with birth weight and ROC curves were used to compare FASTT and AC for prediction of LGA fetuses. Results: There was weak positive correlation between FASTT and birth weight with Pearson’s co-efficient (r) of 0.375. The cut-off value for FASTT to predict LGA fetuses obtained by ROC curve was ≥8.05 mm with sensitivity and specificity of 68.8% and 68.7%. The mean values of FASTT for small for gestational age (SGA), appropriate for gestational age (AGA) and LGA fetuses were significantly different. AUC for FASTT was 0.692 and for AC was 0.755. Conclusion: FASTT had a positive but weak correlation with birth weight. The utility of FASTT as a screening tool may not be impressive. FASTT can discriminate between SGA, AGA and LGA fetuses. AC is a better predictor than FASTT for LGA neonates.

The purpose of this study is to examine associations between maternal lipid profiles in pregnancy and offspring growth trajectories in a largely macrosomic cohort. This is a secondary analysis of the ROLO birth cohort (n = 293), which took place in the National Maternity Hospital, Dublin, Ireland. Infants were mostly macrosomic, with 55% having a birthweight > 4 kg. Maternal mean age was 32.4 years (SD 3.9 years), mean BMI was 26.1 kg/m2 (SD 4.4 kg/m2) and 48% of children born were males. Total cholesterol, high density lipoprotein cholesterol (HDL-cholesterol), low density lipoprotein cholesterol (LDL-cholesterol) and triglycerides were measured from fasting blood samples of mothers at 14 and 28 week gestation. The change in maternal lipid levels from early to late pregnancy was also examined. Offspring abdominal circumference and weight were measured at 20- and 34-week gestation, birth, 6 months, 2 years and 5 years postnatal. Linear spline multilevel models examined associations between maternal blood lipid profiles and offspring growth. We found some weak, significant associations between maternal blood lipids and trajectories of offspring growth. Significant findings were close to the null, providing limited evidence. For instance, 1 mmol/L increase in maternal triglycerides was associated with faster infant weight growth from 20- to 34-week gestation (0.01 kg/week, 95% CI − 0.02, − 0.001) and slower abdominal circumference from 2 to 5 years (0.01 cm/week, 95% CI − 0.02, − 0.001). These findings do not provide evidence of a clinically meaningful effect. Conclusion: These findings raise questions about the efficacy of interventions targeting maternal blood lipid profiles in pregnancies at risk of macrosomia. New studies on this topic are needed. What is Known: • Maternal fat accumulation during early pregnancy may potentially support fetal growth in the third trimester by providing a reserve of lipids that are broken down and transferred to the infant across the placental barrier. • There are limited studies exploring the impact of maternal lipid profiles on infant and child health using growth trajectories spanning prenatal to postnatal life. What is New: • Maternal blood lipid profiles were not associated with offspring growth trajectories of weight and abdominal circumference during pregnancy up to 5 years of age in a largely macrosomic cohort, as significant findings were close to the null, providing limited evidence for a clinically meaningful relationship. • Strengths of this work include the use of infant growth trajectories that span prenatal to postnatal life and inclusion of analyses of the change of maternal lipid levels from early to late pregnancy and their associations with offspring growth trajectories from 20-week gestation to 5 years of age. [ABSTRACT FROM AUTHOR]

Introduction: The basis for an obstetrician's capacity to successfully organise an intervention, administer prenatal care, and conduct prenatal testing. exact awareness of the gestational age. This study conducted to find out correlation of foetal kidney length with foetal biometric parameters like BPD, AC, HC and FL in the third trimester of pregnancy. Methodology: A cross-sectional observational research was carried out on third-trimester pregnant patients who were seen in the obstetrics and gynaecology outpatient department at a tertiary care hospital in India. The study included all women who were singleton pregnant in the third trimester (28 to 40 weeks), had date scans that were documented, were certain of their last menstrual cycle, had a normal prenatal period, and had no risk factors connected with them. Results: A reasonably excellent positive correlation between MKL and GA. With a decent fit and a R squared (R2) value of 0.599. There is a reasonably strong positive correlation (r) between MKL and GA by HC. With a decent fit and a R squared (R2) value of 0.545, this regression model explains 54.5 percent of changes in GA by HC with MKL. According to the Pearson Association Coefficient (r), there is a relatively strong positive correlation (r) between MKL and GA via AC. A high positive correlation (very good) between MKL and GA via FL. With a decent fit and a R squared (R2) value of 0.668, this regression model explains 66.8% of changes in GA by FL with MKL. Conclusion: That there is a high correlation between the mean kidney length of the foetus and established biometric markers of gestational age, including femur length, head size, belly circumference, and biparietal diameter. [ABSTRACT FROM AUTHOR]

Introduction: Aesthetic radiofrequency treatment is a therapeutic method focused on reducing adiposity, of reducing body weight, concomitant with the use of aesthetic techniques using herbal medicines and medicinal plants. One of the plants still little explored by health professionals is Rosmarinus officinalis. Objective: To evaluate the impact of aesthetic radiofrequency treatment, combined with the use of standardized dry extract R. officinalis, on anthropometric variables in healthy women. Materials and Methods: Thirtytwo healthy women were subjected to radiofrequency cosmetic treatment for 4 weeks. These women were divided into Control Group (CG) and Intervention Group (IG). In CG (n=8), placebo capsules were included in the diet. The intervention group was divided into: Group A (n=8) 100 mg day-1; Group B (n=8) 500 mg day-1; Group C (n=8): 1,000 mg day-1. Anthropometric data regarding abdominal skinfolds, abdominal circumferences, and bioimpedance were collected before and after the interventions. Results: The aesthetic treatment with radiofrequency did not change the parameters evaluated. Significant changes were observed for the use of R. officinalis, through the significant increase in skinfolds, for all doses evaluated, as well as reduction in abdominal circumference with the use of 500 mg. Conclusion: Aesthetic radiofrequency treatment did not result in significant changes in anthropometric variables. Oral supplementation with R. officinalis extract can increase abdominal skinfolds in a linear, dose-dependent way. In addition, oral supplementation can significantly change abdominal circumferences. [ABSTRACT FROM AUTHOR]

Background. As a chronic inflammatory disease, psoriasis affects not only the skin but also the metabolic profile of the patients. Biologic therapies, including tumor necrosis alpha (TNF-a) inhibitors and interleukin (IL)-12/23 and IL-17 antagonists, have proven effective in the reduction of psoriasis severity; however their impact on the metabolic and chronic inflammatory profiles of the patients remains incompletely elucidated. Methods. We performed a longitudinal case-control study on 106 psoriasis patients and an equal number of controls without the disease, as well as a prospective study on the patient group with the end point being 6 months of biologic therapy. Patients received either ixekizumab, secukinumab, guselkumab, certolizumab, ustekinumab, risankizumab, or adalimumab. Abdominal circumference, serum fasting glucose, triglycerides (TG), high-density lipoproteins (HDL), erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) were measured for both patients and controls, with an additional measurement for patients after 6 months. Results. At baseline, the number of psoriasis patients suffering from obesity, metabolic syndrome, and chronic inflammation significantly outnumbered controls (p<0.05), with the calculated odds ratio being 1.88, 6.83, and 81.84 for these conditions in psoriasis, respectively. Biologic therapies increased the abdominal circumference of patients in a slight but significant fashion (p<0.05), as well as significantly improved HDL, CRP, ESR levels at 6 months (p<0.05). Moreover, after 6 months, the number of patients meeting the diagnostic criteria for metabolic syndrome and chronic inflammation was significantly lower than at baseline (p<0.001). Conclusions. According to our results, biologic therapies improve the overall metabolic and inflammatory profiles of psoriasis patients, the most significant ameliorations being noticed for serum HDL, CRP, and ESR. [ABSTRACT FROM AUTHOR]

Copyright of Die Dermatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To predict fetal growth restriction using transcerebellar diameter and abdominal circumference ratio (TCD/AC) in women with clinically diagnosed FGR. Materials and Methods: A prospective observational cohort study was conducted on women >28 weeks of gestation with clinically diagnosed fetal growth restriction, at the Tertiary care centre. Total 120 women were enrolled,over a period of 18 months,from December 2020 to July 2022 .Biometry was performed using ultrasonography and transcerebellar diameter and abdominal circumference ratio (TCD/AC) and head circumference and abdominal circumference ratio (HC/AC) were calculated. All women were followed up till delivery and fetomaternal outcome was recorded. After birth height, weight and ponderal index of the newborn were also noted. TCD/AC ratio was correlated with birth weight and ponderal index, for predicting FGR. TCD/AC ratio was also compared with routinely used HC/AC ratio for predicting FGR. Statistical Analysis: The final analysis was done with the use of Statistical Package for Social Sciences (SPSS) software, IBM manufacturer, Chicago, USA, version 21.0®. Results: A cut off value of TCD/AC >0.14 was found to have a sensitivity, specificity, PPV and NPV of 87.36%, 75.76%, 90.5% and 69.4% respectively with a diagnostic accuracy of 84.17%, in diagnosing FGR. There was a significant negative correlation between TCD/AC ratio with birth weight and ponderal index, with a correlation coefficient of 0.463 and 0.501 respectively. (p value < 0.001) TCD/AC was better predictor of fetal growth restriction with a diagnostic accuracy of 84.17% versus 40.83% with HC/AC. Significant positive correlation was observed between period of gestation (weeks) with transcerebellar diameter (mm),with correlation coefficient of 0.497 (p<0.001). Conclusions: TCD/AC ratio is an effective gestational age independent parameter to predict FGR on ultrasonography, with better diagnostic accuracy than routinely used HC/AC. Hence it should be performed for all antenatal women clinically suspected to have FGR. [ABSTRACT FROM AUTHOR]

Background: We aimed to investigate risk factors predicting oxygen demand in COVID-19 patients. Methods: Patients admitted to Shizuoka General Hospital with COVID-19 from August 2020 to August 2021 were included. First, we divided patients into groups with and without oxygen demand. Then, we compared patients' clinical characteristics and laboratory and radiological findings to determine factors predicting oxygen demand. Results: One hundred seventy patients with COVID-19 (aged 58±15 years, 57 females) were enrolled. Common comorbidities were cardiovascular diseases (47.6%), diabetes mellitus (28.8%), and dyslipidemia (26.5%). Elder age, higher body mass index, cardiovascular diseases, diabetes mellitus, lower lymphocyte count, albumin, hepatic attenuation value, and the liver-to-spleen ratio (L/S), higher D-dimer, aspartate aminotransferase, lactate dehydrogenase, troponin-T, C-reactive protein, KL-6, chest and abdominal circumference, and visceral fat were found in patients with oxygen demand. According to the multivariate logistic regression analysis, L/S, lymphocyte count, D-dimer, and abdominal circumference under the diaphragm were independent risk factors predicting oxygen demand in COVID-19 patients. Conclusions: On admission, L/S, lymphocyte count, D-dimer, and abdominal circumference were predictive factors for oxygen demand. These factors may help in the appropriate triage of COVID-19 patients in the decision to admit them to the hospital.

Background: The objective of this systematic review was to determine the efficacy of the mat Pilates method on body composition in healthy adult subjects compared with traditional exercise or control condition models. Design: Systematic review with meta-analysis. Data sources: MEDLINE, EMBASE, SPORTDiscus, PEDro, SciELO, CINAHAL, and the Cochrane Library. Results: A total of 10 eligible studies were selected for revision. The findings of this review demonstrated that the mat Pilates method was not more effective than the traditional exercise or control condition models for the analyzed variables (body mass index, lean mass, body fat percentage, and abdominal circumference). Moreover, in the exploratory analysis with older people, adults, and overweight/obese individuals, the mat Pilates method was also not superior for the analyzed outcomes. Conclusion: The findings of this study suggest that the mat Pilates method is no better than the control condition or other types of training to reduce body composition. [ABSTRACT FROM AUTHOR]

Introduction: The basis for an obstetrician's capacity to successfully organise an intervention, administer prenatal care, and conduct prenatal testing. exact awareness of the gestational age. This study conducted to find out correlation of foetal kidney length with foetal biometric parameters like BPD, AC, HC and FL in the third trimester of pregnancy Methodology: A cross-sectional observational research was carried out on third-trimester pregnant patients who were seen in the obstetrics and gynaecology outpatient department at a tertiary care hospital in India. The study included all women who were singleton pregnant in the third trimester (28 to 40 weeks), had date scans that were documented, were certain of their last menstrual cycle, had a normal prenatal period, and had no risk factors connected with them. Results: A reasonably excellent positive correlation between MKL and GA. With a decent fit and a R squared (R2) value of 0.599. There is a reasonably strong positive correlation (r) between MKL and GA by HC. With a decent fit and a R squared (R2) value of 0.545, this regression model explains 54.5 percent of changes in GA by HC with MKL. According to the Pearson Association Coefficient (r), there is a relatively strong positive correlation (r) between MKL and GA via AC. A high positive correlation (very good) between MKL and GA via FL. With a decent fit and a R squared (R2) value of 0.668, this regression model explains 66.8% of changes in GA by FL with MKL. Conclusion: That there is a high correlation between the mean kidney length of the foetus and established biometric markers of gestational age, including femur length, head size, belly circumference, and biparietal diameter.

Back pain is the most common musculoskeletal problem in both developed and developing countries. The prevalence and burden of back pain increases with age, and the management of back pain becomes increasingly important in the context of global aging. There is increasing evidence that obesity is a modifiable risk factor for musculoskeletal pain in different locations. Understanding the role of obesity in back pain holds great potential for improving understanding of the mechanisms of back pain and for developing new preventive and therapeutic approaches. To evaluate the role of weight, body mass index (BMI) and abdominal circumference (AC) in risk of back pain over 96 months. Prospective cohort study. The sample was from 4,793 adults in the Osteoarthritis Initiative (OAI) database who had or were at increased risk for knee Osteoarthritis. Outcome variables included the presence, severity, and frequency of back pain, using the past 30 days as the time frame. Longitudinal analysis of data from 4,793 participants enrolled in the Osteoarthritis Initiative, assessed every 12 or 24 months for weight, BMI (kg/m2), AC (cm), and presence, severity (none, mild, moderate, severe), and frequency (none, rarely, sometimes, often, always) of back pain. BMI and AC were decomposed into between-person and with-person components. Data analyses were performed using mixed-effects logistic (for presence of back pain) or ordered logistic regression (for severity and frequency of back pain) models. Back pain was reported in 58% of participants at baseline; 70% of those without back pain had incident back pain over 96 months. Both between-person (average value across a participant's all measurements) and within-person (deviations from the participant's average) effects of weight and BMI increased risk of presence, severity, and frequency of back pain (Odds radios (OR) per kg/m2: 1.010–1.046, p<.05) in females but not males, with statistically significant weight*sex and BMI*sex interactions. Similar findings were observed for between-person effects of AC on back pain, and the within-person effect of AC was only associated with back pain severity (OR per cm: 1.009, 95% confidence interval 1.002–1.017, p=.019) in females. Greater average weight and BMI and increases in them increased odds of presence, severity, and frequency of back pain over 96 months in middle aged and older women but not men. Only average AC increased odds of back pain over time, in women. These findings suggest that preventing obesity and slowing weight gain is important for the management of back pain. [ABSTRACT FROM AUTHOR]

Background and Aims: Spinal anesthesia (SA) is the most widely practiced neuraxial anesthesia. Lumbar puncture (LP) at multiple levels and multiple attempts due to any reason may cause discomfort and even serious complications. Hence the study was conducted to evaluate the patient variables that can predict difficult LP thus allowing for the use of alternate techniques. Material and Methods: We included 200 patients of ASA physical status I-II, scheduled to undergo elective infra-umbilical surgical procedures under spinal anesthesia. During preanesthetic evaluation, difficulty score was assessed using the 5 variables: Age, abdominal circumference, spinal deformity - assessed as axial trunk rotation (ATR) value, anatomical spine assessed by spinous process landmark grading system (SLGS) and patient position, by assigning a score of 0- 3 for each variable, with a total score of 0 – 15. The difficulty of LP was graded as easy, moderate or difficult based on total number of attempts and spinal levels by independent experienced investigator. The scores obtained during preanesthetic evaluation and the data collected after performing LP were analyzed using multivariate analysis and P value noted. Results: Our study showed that above patient variables correlated well with difficult LP scoring (P < 0.001). SLGS was noted to be a strong predictor, while ATR value a weak predictor. The correlation between the total score and grades of SA had a positive association (R = 0.6832, P < 0.00001) and was statistically significant. A median difficulty score of 2, 5 and 8 predicted easy, moderate and difficult LP respectively. Conclusion: The scoring system provides for a useful tool to predict difficult LP and helps both patient and anesthesiologist to choose an alternative technique.

Hypopressive exercises (HE) are part of the Low Pressure Fitness training program which is widely used by physical therapists in the rehabilitation of the pelvic floor, abdominal and spinal musculature. The aim of this study was to compare the effects of HE on the sagittal lumbo-pelvic posture in athletic and non-athletic females. It was hypothesized that a 5-week training program of HE could influence lumbo-pelvic position while reducing abdominal circumference and low back pain in athletic and non-athletic females. Twenty normoweight females (mean age = 24.8 (SD 3.5) years; body mass index = 22.4 (SD 1.6) kg/m2) participated in this study. Ten athletic females were rugby players (RG), and 10 females were non-athletic (SG). Participants completed twenty minutes of HE twice weekly for 5 weeks. Before and after the intervention, two-dimension photogrammetry was used to assess lumbar lordosis and pelvic horizontal alignment. A Visual Analog Scale was used to assess low back pain and cirtometry was used to assess abdominal circumferences at umbilical, supra and infra-umbilical levels. An analysis of variance between moments revealed no significant differences in lumbar lordosis and pelvic positioning but showed significant differences for abdominal circumferences between groups. No significant differences between groups were found for other variables. Significant correlations were found between the three different abdominal circumference measurements (p > 0.05) but not between lumbar lordosis and abdominal circumferences. These preliminary findings indicate that a 5-week HE intervention displayed non-significant changes in lumbar lordosis, pelvic horizontal alignment, and low back pain but a significant reduction in abdominal circumferences in non-athletic and athletic females. [ABSTRACT FROM AUTHOR]

Since vertebral kyphosis and abdominal circumference are thought to influence sarcopenia and fall risk in osteoporosis, we evaluated sarcopenia and fall risk in patients with different measurements of abdominal circumference and sagittal longitudinal axis (SVA). In this post hoc study, 227 patients aged 65 years or more who visited an outpatient osteoporosis clinic were included in the analysis. Sarcopenia was determined from lean body mass, grip strength, and walking speed by dual energy X-ray absorptiometry; SVA (median 40 mm) and abdominal circumference (median 80 cm) were compared between the four groups, each divided into two groups. Nutritional management, falls, and fall anxiety scores were also examined. The incidence of sarcopenia was significantly increased in those with abdominal circumference < 80 cm in both the SVA < 40 mm and SVA ≥ 40 mm groups (p < 0.05). Nonetheless, the fall scores of those with SVA < 40 mm were lower than those of individuals with SVA ≥ 40 mm (p < 0.01). Based on the results of this study, SVA and abdominal circumference values may predict the risk of sarcopenia and falls. More research is needed before our results can be translated into clinical practice. [ABSTRACT FROM AUTHOR]

The prevalence of metabolic syndrome among individuals with severe mental illness is considerably higher than in the general population, contributing to the 15–20-year shorter life expectancy of this client population. The aim of this pilot study was to evaluate the effectiveness of a novel, complex psychosocial program to reduce metabolic syndrome. Members of both the intervention (n = 78) and control (n = 31) group were psychiatric outpatients with severe/persistent mental illness struggling with one or more symptoms of metabolic syndrome. Beyond the default elements of similar programs such as diet and exercise, the intervention covered medication use, sleep hygiene, stress management, as well as addressing spiritual needs, mindfulness, addictions, and self-care. Assessment of metabolic indicators were completed at baseline, at the end of the 11-week intervention, and 6 months post-intervention. The trajectory of change over time was significantly more favorable in the treatment than in the control group in terms of waist circumference (p = 0.013, η2 = 0.093) and a positive trend emerged in relation to blood glucose level (p = 0.082, η2 = 0.057). However, no statistically reliable difference was observed between the intervention and the control group regarding the other outcome variables (body mass index, systolic and diastolic blood pressure, serum triglyceride level, serum HDL cholesterol level, overall metabolic syndrome severity). These findings suggest that to produce more robust benefits, psychosocial interventions targeting the metabolic health of individuals with complex mental health needs should be either longer in duration if resources permit or narrower in focus (diet and exercise mainly) if resources are scarce. [ABSTRACT FROM AUTHOR]

Aim: Maternal hypotension caused by extensive sympathetic blockade is a serious complication of spinal anesthesia during cesarean section. This study planned to determine the relationship between weight, height, BMI, abdominal circumference (AC), hip circumference (HC), and AC-to-hip ratio with the ephedrine consumption in patients who underwent cesarean section with subarachnoid block. Materials and Methods: The study population comprised 60 women. Prior to spinal anesthesia; patients’ demographic characteristics (age, weight, height), abdominal and hip circumferences, basal hemodynamic parameters, and ASA physical status were recorded. To minimize errors, three consecutive measurements were obtained; results were averaged and the AC-to-hip ratio was calculated by dividing the values of the abdominal (cm) and hip circumference (cm). In all patients, spinal anesthesia was done in the sitting position using 2.4 ml 0.5% hyperbaric bupivacaine (12 mg). Persistent hypotension was treated with intravenous ephedrine (5 mg). The number of patients who used ephedrine and the total amount of ephedrine used during surgery were recorded. Results: Of these 60 participants, 40 (66.6%) patients had hypotension requiring ephedrine administration. There is a positive correlation between ephedrine consumption (mg) and abdominal circumferences (r=0.280, p=0.03). Also, there is a significant positive correlation between ephedrine consumption (mg) and AC-to-hip ratio (r=0.608, p<0.001). The correlation coefficient between the ephedrine dose with the AC-to-hip ratio was 56.805, the p-value was <0.001 and AC was 0.211, with a p-value of 0.030 which means the correlation was statistically significant. Conclusion: Abdominal circumference and AC-to-hip ratio have a significant correlation with ephedrine consumption in patients who underwent cesarean section via subarachnoid block with a given dose of 2.4 ml 0.5% hyperbaric bupivacaine. [ABSTRACT FROM AUTHOR]

Background: Determination of gestational age and expected date of delivery are important for maternal and fetal well-being. Most commonly used method is last menstrual period (LMP). To overcome the limitations of the LMP, ultrasonographic parameters are used. Objective: To study the correlation of gestational age based on LMP with various ultrasonographic parameters among healthy pregnant women. Methods: Hospital based cross-sectional study was carried out among 285 healthy pregnant women. LMP was determined by asking the women their last menstrual period and also cross-checked from the available records. The ultrasonographic parameters like biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) and transverse cerebellar diameter (TCD) were studied. Results: Majority of the women belonged to the age of 18-24 years (49.5%). Majority (41.4%) were primi. BPD, AC and TCD were positively correlated with gestational age by LMP (p<0.05). FL and HC were also positively correlated with gestational age by LMP but their coefficient of determination was not significant (p>0.05). For all parameters, as gestational age increased, their values also increased. Scatter plots of TCD, BPD and AC showed that there is a linear relation with the gestational age by LMP. But, the scatter plot of the HC and FL had no linear relation between the gestational age by LMP. Conclusion: The biparietal diameter, transverse cerebellar diameter and abdominal circumference showed a strong linear relationship with the gestational age by LMP. The FL and AC had no linear relation with it. [ABSTRACT FROM AUTHOR]

The objective of this paper was to analyze the metabolic model for the monitoring and management of gestational diabetes. This is a descriptive, retrospective and observational study, based on the medical records from the database of the “Alessandrescu-Rusescu” Institute for Maternal and Child Health, Bucharest. There were included 157 patients who showed up for consult in every trimester of pregnancy. Fat accumulation during pregnancy is variable and may depend on the woman’s pre-pregnancy metabolic status and other lifestyle variables such as diet and physical activity. Pregnancy represents a critical period of growth, development and physiological change, providing an opportunity for early lifestyle intervention. The goal of identifying an effective lifestyle program for the gestational period that leads to healthy fetal development and subsequent normal weight offspring less likely to develop obesity and its comorbidities is unique and could mitigate the intergenerational cycle of obesity. The main objective in the management of obesity during pregnancy is prevention. Basically, apart from pre-conceptional weight loss in the management of obese pregnant women, glucose screening should be considered in obese women in early pregnancy to rule out undiagnosed pregestational diabetes. [ABSTRACT FROM AUTHOR]

Objective: To study the association between prenatal diagnosis of isolated abdominal circumference (AC) below the 10th percentile (AC <10th) in appropriate for gestational age (AGA) neonates and placental vascular lesions. Methods: A prospective study was conducted of healthy women who underwent sonographic fetal biometric measurements, up to 7 days before delivery, and delivered AGA neonates. The study cohort was divided into those with and without prenatal isolated AC <10th. Placental histopathology lesions were classified into maternal and fetal vascular malperfusion (MVM, FVM) lesions. Results: Compared to the AC over 10th percentile group (n = 85), the AC <10th group (n = 85) was characterized by lower maternal body mass index, higher rate of smokers, and increased rate of induced labor (P = 0.029, P = 0.029, P = 0.001, respectively). There were no between‐group differences regarding maternal age, gestational age, and neonatal outcome. Mean placental weight was lower in the isolated AC <10th (P < 0.001). The rate of MVM or FVM lesions did not differ between the groups. By multivariate logistic regression analysis, isolated AC <10th was not found to be associated with increased risk for placental vascular lesions. Conclusion: Isolated AC <10th is associated with increased rate of induction of labor; however, it is not associated with increased placental vascular lesions. [ABSTRACT FROM AUTHOR]

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Background: The association between obesity and depression has been frequently reported. However, it still remains unclear which anthropometric indicators for obesity could be the best measure to explain its linkage with depressive symptoms. Methods: This is a cross-sectional analytical study. Secondary data was analyzed using information from the Demographic and Health Survey of Peru (ENDES in Spanish). Data from the years 2018 to 2021 were reviewed. The outcome of interest was the presence of depressive symptoms, assessed with the Patient Health Questionnaire-9 (PHQ-9). The exposure variable was the presence of obesity, which was evaluated by body mass index (BMI) and abdominal circumference. Crude and adjusted odds ratios (cOR and aOR) were calculated using logistic regression. Both prevalence and association measures were presented with 95% confidence intervals (95% CI). Results: A total of 141,134 subjects were included in the study. Depression was present in 2.51% (95% CI 2.38–2.65). Obesity according to BMI was present in 25.42% (95% CI 24.97–25.88), while abdominal obesity was shown in 41.67% (95% CI 41.19–42.15). In the multivariate analysis, a statistically significant association was found in regard to symptoms of depression in patients with abdominal obesity (aOR: 1.13; 95% CI 1.03–1.24), while no association was found with obesity according to BMI. Conclusions: Abdominal circumference could be a better anthropometric measure than BMI to evaluate the association between obesity and depressive symptoms in the Peruvian population.

Abstract Background The incidence rates of obesity and gestational diabetes mellitus (GDM) are increasing in parallel. This study aimed to evaluate the relationship between different obesity indices, including prepregnancy body mass index (preBMI), the first-trimester abdominal circumference (AC), and first-trimester abdominal circumference/height ratio (ACHtR), and GDM, and the efficacy of these three indices in predicting GDM was assessed. Methods A total of 15,472 pregnant women gave birth to a singleton at the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. Prepregnancy weight was self-reported by study participants, body height and AC were measured by nurses at the first prenatal visit during weeks 11 to 13+6 of pregnancy. GDM was diagnosed through a 75-g oral glucose tolerance test at 24–28 gestational weeks. Using receiver operator characteristic (ROC) curve analysis, we evaluated the association between obesity indices and GDM. Results A total of 1912 women (12.4%) were diagnosed with GDM. Logistic regression analysis showed that AC, ACHtR, and preBMI (P

The objective of this study was to evaluate the morphometric characteristics of finishing pigs fed cottonseed meal and enzymes. Thirty castrated male pigs with an average weight of 55.47 ± 5.3 kg were used in an experiment in a randomized block design, with 5 treatments and 6 replicates, whose treatments consisted of the following: control diet (0), control diet plus enzymatic complex (0E), diet with 5% (5E); 10% (10E) or 15% (15E) cottonseed meal plus enzymatic complex. The following measurements were taken: body length, thoracic perimeter, waist circumference, rump width, rump height, withers height and weight in the different periods of in vivo measurements. The measurements were performed in four different periods throughout the experiment at 105, 122, 137 and 154 days of age. The inclusion of the enzyme complex and cottonseed meal in the replacement of soybean meal in the diets of pigs in the finishing phase had no effect on the morphometric characteristics (P> 0.05) of body length, thoracic perimeter, abdominal circumference, rump width, rump height, withers height and weight in the different measurement periods.

Being overweight, which results in a large belly circumference, is often overlooked, despite the fact that belly fat accumulation can endanger health. The purpose of this study was to determine the effect of changes in abdominal circumference and BMI after giving tabata training for 16 meetings. This study is a quasi-experiment that employs a one-group pre-test post-test group design with a population of all Powerfit Daru members and a total sample of 15 using a purposive sampling technique with sample criteria of having an abdominal circumference > 80 cm, being 25-40 years old, and being obese. The obtained data were processed using IBM SPSS version 26 and the paired T-test. The results showed that the average decrease in pre-test and post-test abdominal circumference was (94.86 8.79; 90.46 8.85) with a P value of 0.005 0.05. The results showed that the average change in BMI was 30.51 2.18; 29.96 2.65, with a P value of 0.418 > 0.05. The average decrease in abdominal circumference was -4.4 cm, and the BMI was -0.54 kg/m2. The conclusion of this study was that there was a significant decrease in changes in abdominal circumference with tabata exercise for 5 weeks of treatment but no significant decrease in BMI.

ABSTRACT Objective: To analyze different anatomical sites in the abdominal region, in order to determine the positional parameter that identifies a higher level of visceral adipose tissue (VAT) and confers a greater cardiometabolic risk. Materials and methods: This is a methodological study in which VAT was evaluated by ultrasonography (USG) in three anatomical sites in the abdomen, while the abdominal circumference (AC) was measured using seven different protocols. Additionally, the glycemic and lipid profile, C-reactive protein, and the presence of systemic arterial hypertension were evaluated. Results: One hundred and six individuals with an average age of 42 (36.8-46.2) years were included. The evaluation of the calibration of the ultrasound procedure for the analysis of VAT by intra- and inter-evaluators showed high reproducibility. The pattern of abdominal fat distribution differed between sexes, with higher mean VAT in males (p < 0.05) and higher mean SAT (subcutaneous adipose tissue) in females (p < 0.005). In the abdominal scan applied to women, higher levels of VAT and lower levels of SAT were observed in the narrower waist region, between the iliac crest and the last rib (p < 0.001). In males, the profile of adipose disposition along the abdomen was uniform (p > 0.05). Correlations between VAT measured by USG and cardiometabolic parameters were relatively stronger in the upper abdomen (p < 0.05). Conclusion: Women accumulate more VAT in the narrower waist region, while men accumulate VAT uniformly across the abdomen. There was relative superiority in predicting cardiometabolic risk in the upper abdomen for both sexes.

Objective: The perinatal outcomes in second-trimester abdominal circumference (AC) discordant twins are yet to be established. The aim of this study was to ascertain perinatal risks associated with second-trimester AC discordance in monochorionic (MC) twins. Method: We conducted a retrospective study of all MC twin pregnancies over a 7-year period. Intertwin AC discordance at 14–26 gestational weeks was analyzed in relation to Doppler abnormalities, obstetric complications, and perinatal adverse outcomes. Results: A total of 246 MC twin pregnancies were included in the analysis. The smaller twins of second-trimester AC discordant pairs were at increased prevalence of abnormal umbilical artery flow (50% versus 24%, p < .001) and low positive A wave of ductus venous flow (24% versus 9%, p = .002). The second-trimester AC discordant twins were at increased risk of oligohydramnios in smaller twin (OR = 2.44, 95% CI = 1.37–4.32, p < .01), cardiomegaly in larger twin (OR = 2.95, 95% CI = 1.01–8.60, p < .05), birth weight of either twin below the 10th percentile for gestational age (OR = 5.56, 95% CI = 2.67–11.59, p < .001), birth weight discordance > 25% (OR = 9.41, 95% CI = 4.46–19.87, p < .001), IUFD (OR = 3.26, 95% CI = 1.76–6.05, p < .001), and severe neonatal morbidity (OR = 1.83, 95% CI = 1.03–3.26, p < .05). The intact survival rate in discordant and concordant twin pairs was 70% and 89%, respectively (p < .001). Conclusions: Early and increase fetal surveillance of the second-trimester AC discordant twins should be utilized to establish perinatal risks, thus allowing prenatal care to improve. [ABSTRACT FROM AUTHOR]

Objective Large-for-gestational-age (LGA) is associated with both fetal and maternal complications. One of the few modifiable risk factors for LGA is Gestational Diabetes Mellitus (GDM); for this reason, fetal growth is usually monitored by ultrasound in the third trimester. This prospective study compared a panel of ten established biomarkers measured at the time of selective screening for GDM at 26–28 weeks gestation with the ultrasound prediction of LGA. Method Women were recruited using convenience sampling and consented at the first antenatal visit. Women with maternal risk factors for GDM attended for the one-step 75 g oral glucose tolerance test. An additional blood sample was taken for biomarker measurement. GDM was diagnosed according to the 2013 World Health Organization (WHO) criteria. Fetal biometry, including the abdominal circumference (AC) and the fetal abdominal subcutaneous tissue (FAST) thickness, were measured at 37 weeks gestation. Results Of the 195 women included, 105 (53.8%) had GDM. Of the 195 babies, 36 (18.5%) were LGA. Whether the woman had GDM or not, fetal biometry was strongly predictive of LGA but none of the following biomarkers measured at 26–28 weeks gestation alone or in combination were predictive: c-peptide, ghrelin, gastric inhibitory polypeptide, glucagon-like peptide-1 (GLP-1), glucagon, insulin, leptin, plasminogen activator inhibitor-1, resistin and visfatin. Conclusions In women diagnosed with GDM, surveillance of fetal growth to identify LGA by ultrasound should continue in the third trimester. None of the ten established maternal biomarkers measured at the time of the OGTT was as strongly predictive of LGA as ultrasound. [ABSTRACT FROM AUTHOR]