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     Journal of Indian Association of Pediatric Surgeons
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LETTER TO THE EDITOR
Year : 2017  |  Volume : 22  |  Issue : 4  |  Page : 257
 

Assessment of nutritional status of patients of congenital pouch colon following definitive surgery


Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Web Publication12-Sep-2017

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaps.JIAPS_47_17

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How to cite this article:
Al-Mendalawi MD. Assessment of nutritional status of patients of congenital pouch colon following definitive surgery. J Indian Assoc Pediatr Surg 2017;22:257

How to cite this URL:
Al-Mendalawi MD. Assessment of nutritional status of patients of congenital pouch colon following definitive surgery. J Indian Assoc Pediatr Surg [serial online] 2017 [cited 2019 Aug 19];22:257. Available from: http://www.jiaps.com/text.asp?2017/22/4/257/214452


Sir,

I read with interest the study by Shinde et al. on the assessment of nutritional status of patients of congenital pouch colon (CPC) following definitive surgery.[1] Based on employing World Health Organization (WHO) reference standards 2006, Shinde et al., found a significant malnutrition in 53.85%–95.45% of the studied patients. Various markers of malnutrition were detected, including wasting, stunting, underweight, and low mid-upper arm circumference.[1] I presume that these results ought to be cautiously interpreted owing to the presence of the following methodological limitation. In the clinical field, there are many growth standards used to evaluate pediatric anthropometric measurements, notably WHO standards, Center for Disease Control data standards, and national standards. Evaluating different forms of growth standards suggested that the use of country-specific growth standards might describe the growth of children more precisely.[2],[3] To the best of my knowledge, Indian Academy of Pediatrics (IAP) growth standards 2007 were constructed to evaluate the growth of Indian children. I wonder why the authors did not refer to IAP growth standards 2007 to evaluate the growth of the studied cohort rather than the WHO standards 2006. I presume that if Shinde et al. employed IAP standards 2007, the study results might be changed. Recently, growth standards committee of IAP has revised the growth standards for children in January 2015 as India is in nutrition transition, and previous IAP standards 2007 were based on data which are over two decades old. At present, IAP growth standards committee recommends the use of these new standards to replace the IAP standards 2007 in the clinical practice and researches field.[4] Despite the above-mentioned methodological limitation, some sorts of malnutrition and growth faltering are expected to be seen in CPC patients following surgery, particularly those who have associated comorbidities. Therefore, meticulous monitoring of anthropometric parameters and nutritional status as well as instituting proper nutritional rehabilitation represents critical cornerstones in the management protocol of CPC patients.

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   References Top

1.
Shinde NK, Kumar P, Dabla PK, Jhanwar P, Chadha R, Choudhury SR. Assessment of nutritional status of patients of congenital pouch colon following definitive surgery. J Indian Assoc Pediatr Surg 2017;22:13-18.  Back to cited text no. 1
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2.
Ziegler EE, Nelson SE. The WHO growth standards: strengths and limitations. Curr Opin Clin Nutr Metab Care 2012;15:298-302.  Back to cited text no. 2
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3.
Natale V, Rajagopalan A. Worldwide variation in human growth and the World Health Organization growth standards: a systematic review. BMJ Open 2014;4:e003735.  Back to cited text no. 3
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4.
Khadilkar VV, Khadilkar AV. Revised Indian Academy of Pediatrics 2015 growth charts for height, weight and body mass index for 5-18-year-old Indian children. Indian J Endocrinol Metab 2015;19:470-6.  Back to cited text no. 4
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