It is well known that some patients with renal lithiasis due to idiopathic hypercalciuria (IH) may exhibit decreased bone mineral density (BMD). We have studied a large group of children with IH and related their BMD values to several renal function parameters and calcium and bone metabolism markers. Children with IH had higher osteocalcin and calcitriol levels and higher urinary excretion of magnesium and prostaglandin E2, as well as lower tubular reabsorption of phosphate, urinary excretion of ammonium, maximum urinary PCO2, and BMD compared with control group of children. In children with IH we observed a negative correlation between BMD and age. We found osteopenia in 22 of 73 children with IH (30.1%); these children showed lower citraturia levels and higher fractional excretion of uric acid than children with normal BMD. In osteopenic children there was a negative correlation between BMD and calcitriol levels. Several possible pathogenetic factors have been proposed for the bone mass loss. Our results demonstrate that, at least in some cases, it may be related to high levels of calcitriol, which has a wellknown resorption ability. Whether a certain degree of intracellular acidosis or a higher production of prostaglandin E2 could play a role in some cases is still an open question. In children with normal BMD we observed a direct correlation between osteocalcin and tartrate-resistant acid phosphatase levels; this correlation did not hold for children with osteopenia.
Objective To assess the knowledge and attitudes towards attention deficit hyperactivity disorder (ADHD) among primary school teachers in the Gampaha District. Methods A descriptive cross sectional study was conducted in randomly selected schools of Gampaha district using a stratified sampling method. The knowledge and attitudes on ADHD were assessed by a self-administered questionnaire distributed among all the consenting primary school teachers in the selected schools. Results Total of 202 completed questionnaires of 210 distributed were returned. The majority showed good understanding about ill effects of ADHD, teachers' role in management and counterproductive effects of punishment. Three-fourths had a positive attitude towards behavioural therapy. However, only a minority had adequate knowledge about the presentation of ADHD and its treatment with medication. More than 80% of teachers believed that the parents were to be blamed for the child's ADHD. The majority of participating teachers also believed that behavioural disturbances caused by ADHD children were deliberate and malicious. Teachers who had training in child psychology recorded a significantly higher knowledge and had a more favourable attitude. Conclusions The knowledge of ADHD and its treatment among primary school teachers needs to be improved. Particular focus should be on improving attitudes and disseminating the message that timely interventions can make a difference in the educational and social development of the child.
Associations between lean mass, fat mass, and bone mass have been reported earlier; however, most of those studies have been done in Caucasian populations, and data from Asian countries, especially those in South Asia, are limited. We examined the associations between lean mass, fat mass, bone mineral density (BMD), and bone mineral content (BMC), determined by dual-energy X-ray absorptiometry technology, in a group of healthy, middle-aged, premenopausal female volunteers. The mean (SD) age of the women (n = 106) was 42.1 (6.1) years and the mean (SD) body mass index was 24.3 (3.6) kg/m(2). Total body BMD, total body BMC, and BMD in total spine, total hip, and femoral neck showed statistically significant partial correlations (adjusted for age) with total fat mass (r = 0.19-0.43, P < 0.05) and lean body mass (r = 0.28-0.54, P < 0.05). Truncal fat mass correlated positively with total body BMC and BMD at total hip and femoral neck (r = 0.33-0.40, P < 0.001). When a stepwise regression model was fitted, lean mass remained the strongest predictor of total body BMD, total body BMC, and total spine BMD (regression coefficients = 0.004-0.008 g/cm(2) per 1-kg change in lean mass, P < 0.001). Similarly, crude BMD and BMC increased across the tertiles of lean mass (P trend < 0.05). We show that lean mass is the strongest predictor of total body BMC and BMD at different sites, although positive correlations with fat mass also exist.
Background Although techniques such as dual energy xray absorptiometry (DXA) and quantitative CT are available to estimate global and regional adiposity, anthropometric measurements are often used to detect adiposity in clinical practice.Objectives To assess the association between the anthropometric measurements of obesity with total and regional fat mass determined by DXA.Design A cross-sectional, descriptive study.Patients and method 106 healthy women volunteers, aged between 30 and 54 years were studied. Anthropometric measurements including body mass index (BMI), waist circumference (WC), hip circumference (HC), height adjusted WC (WC/HT), waist-hip ratio (WHR), and skin-fold thickness (SFT) over triceps, infrascapular, and iliac regions were made. All women underwent assessment of total fat mass (TFM) and visceral fat mass (VFM) using a Hologic DXA scan.Results TFM and VFM showed positive correlations with all the anthropometric measurements examined, the strongest correlation was with BMI (r= 0.89 and 0.77 for TFM and VFM respectively, p<0.001). Correlations of TFM with WC, HC, and WC/HT were 0.72, 0.87, and 0.65, (p<0001 for all) respectively. Corresponding figures for VFM were 0.73, 0.74, and 0.68, (p<0001 for all). WHR showed a poor correlation with TFM (r=18, p=0.09) and VFM (r=0.33, p=0.002). SFTs measured at three sites showed less strong correlations with TFM and VFM (r = 0.48 to 0.69, p<0.001).Conclusions BMI has the strongest association with total and visceral fat mass among these women. Waist and hip circumferences showed high correlations with total and visceral fat mass, but adjusting waist circumference for height did not improve the correlation.
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