Features
Under nutrition, growth failure, overweight and micronutrient deficiencies
Ekow Grimmond Thompson, Emotional Surgeon
Under nutrition, growth failure, overweight, micronutrient deficiencies, and osteopenia (a condition that begins as you lose bone mass and your bones get weaker) happen when the inside of your bones become brittle due to loss of calcium. It is very common as you age.
Total bone mass peaks around age 35. Sometimes, osteopenia is a precursor to osteoporosis (nutritional comorbidities that affect the neurologically impaired child). Monitoring neurologically impaired children for nutritional comorbidities is an integral part of their care.
Early involvement by a multidisciplinary team of emotional surgery specialists, physicians, nurses, dieticians, occupational and speech therapists, psychologists, and social workers is essential to prevent the adverse outcomes associated with feeding difficulties and poor nutritional status.
Careful evaluation and monitoring of severely disabled children for nutritional problems are warranted because of the increased risk of nutrition-related morbidity and mortality. Neurological impairment refers to a broad spectrum of neurological disorders that are characterised primarily by gross and fine motor dysfunction and may be associated with cognitive or speech delay.
Under nutrition and overweight lead to increased health care use, hospitalisation, and physician visits, as well as diminished participation in home and school activities. Adequate nutritional support may restore linear growth, normalise weight, improve health and quality of life, reduce the frequency of hospitalisation, decrease irritability and spasticity (muscle and joint deformities/muscle stiffness causing movement to be less precise and making certain tasks difficult to perform/muscle fatigue/abnormal muscle tightness due to prolonged muscle contraction).
It is a symptom associated with damage to the brain or motor nerves, increase alertness, enhance developmental progress, improve wound healing and peripheral circulation, decrease the frequency of aspiration, and ameliorate gastro esophageal reflux (acid reflux occurs when the stomach contents back up into the esophagus and or mouth) in these children.
Children with neurological disabilities usually have progressive weight deficits due to fat loss, although muscle and visceral proteins are maintained. Some children demonstrate a lack of weight gain in the presence of linear growth, leading to a decreased body mass index (BMI). Others have progressive muscle atrophy (decrease in size and wasting of muscle tissues. With muscle atrophy, your muscles look smaller than normal.
Muscle atrophy can occur due to malnutrition, age, genetics, a lack of physical activity or certain medical conditions unresponsive to nutritional intervention because of their underlying disorder. Although neurologically impaired children usually are shorter and weigh less than unaffected children, a small proportion may be overweight based on weight-for-height or triceps skinfold thickness criteria.
The prevalence of overweight may be underestimated because weight-for-height gains are overlooked in the presence of a small body size or an aberrant distribution of body fat that may be present in some neurological disorders. Weight-for-height comparisons may be monitored less frequently than weight alone because of the difficulty obtaining accurate height measurements.
Non-nutritional factors including the type and severity of neurological disability, ambulatory status, and cognitive ability contribute to growth failure in neurologically impaired children. Children with seizures or spastic quadriplegia (a form of cerebral palsy that affects both arms and legs and often the trunk of the human body and face) and those who are non-ambulatory have lower height Z scores than children who lack these disabilities.
Children with spastic hemiplegia (a type of cerebral palsy that occurs when the condition of muscle stiffness impacts one full side of the body) have smaller measures of breadth and length on the affected side, suggesting that the neurological defect influences growth. Inherent genetic factors may be associated with permanent linear stunting. Height-for-age Z-scores may decrease with advancing age independently of weight-for-age Z-scores, suggesting that the effect of scoliosis (abnormal lateral curvature of the spine). It is most often diagnosed in childhood or early adolescence.
The spine’s normal curves which occur at the cervical, thoracic and lumbar regions in the sagittal plane contractures worsens over time. Height and weight Z-score deficits generally correlate well in neurologically impaired children, suggesting that nutritional factors contribute to their growth failure.
Nutritional status explains 10 to 15 percent of the variability in linear growth in children with cerebral palsy. Nutritional status has a stronger effect on linear growth in younger than in older children, attesting to the irreversible effects of long-term under nutrition on growth.
THE typical itinerant salesman in Sikaman is a herbalist. He is normally a slim macho with the capacity to perambulate the expanse of area covering the triangle of Accra-Tema-Ashiaman. In short, he can walk a total of 60 miles a day, marketing a product that cures every disease, including poverty. 
The door-to-door herbal pharmacist advertises his product by word of mouth. He has nothing to do with the Food and Drugs Board (FDB). After all, his concoctions do not feature on FM stations.
Those herbalists who cannot walk to propagate the herbal gospel, liaise with drivers of mass transportation and their mates. They are, therefore, given the chance to sell their products on Benz buses that ply the routes.
Normally, the herbalist starts his sales message with a prayer and Bible study. He asks the passengers to bow down their heads in supplication to God the father, the son, the Holy Spirit.
When a herbalist asks the passengers to close their eyes and bow their heads, Moslems on board naturally feel offended. They feel that the herbalist has no right to assume that every passenger is a Christian. They think such an assumption is an affront to Islam.
So a Moslem on board will raise the hand for a point of order. He’ll remind the herbalist that it would be in his own interest to mind his language.
“Be careful the way you address people in a public place. Not every person here is a Christian,” he’d state assertively.
Of course, the herbalist will promptly ignore him, but would all the same “watch” his tongue. Who knows whether or not the Moslem brother is inspired by Quoranic zeal to defend the tenets of Islam to the hilt?
When he starts saying, “Wallahi!” and “Inshallah!” it could be the beginning of proclaiming Islam as supreme, a point which must be driven home with talibanic precision.
So the herbalist must tread carefully lest he steps on fire.
The herbalist could even add a measure of mirth to it all, by announcing that Christians on board today have very interesting company on the journey, but that should not detract from the business of the day.
The Moslem brother will weigh the words carefully and offer a wry smile.
He must be careful the occasion does not degenerate into the use of semantics and proverbial oration to deride his conviction that public utterances must be mindful of religious sensibilities. He has made his point very clear and expects that it is taken in good faith in the interest of a peaceful journey.
The herbalist will now open the New Testament and preach salvation, stating clearly that salvation can come only through Jesus Christ and NOBODY else.
The Moslem brother will now start twitching his moustache. The visible and almost revolutionary reflexes of his upper lip can be an indication that sentiments have begun superseding reason, and the outcome could well be tragic now shift uneasily in his seat.
The time has come for him to also express his right to the religion of his fore-bears. He’ll put his hand into his pocket and rise to his feet. The time has indeed come!
This article was first published on Saturday, September 9, 2006
When the cause of a particular problem like sickness, disease, sudden illness, a social issue etc. are not known, it stands to reason that resolving it becomes a huge challenge.
Citizens would understand the government when public announcements are made to the effect that government is trying to find a solution to the issue, even though it is taking a while for it to be resolved because citizens are rational beings.
On the other hand, if the solution to a particular issue is known to everybody but the government for whatever reason, is dragging its feet in resolving it, citizens become frustrated and begin to lose trust in their leaders.
One such issue is the heavy traffic along a section of the Kasoa – Odokor road. A short stretch of bad road between the traffic light at the Weija Government Hospital and the entrance to the entrance of the overhead that leads to the N1, is the cause of the problem but nothing is being done about it, day after day, week after week, month after month. Thus is clearly unacceptable.
Another issue that requires urgent attention is the lack of pavements along a lot of streets in parts of the various Municipal Assemblies. Exercise is a prerequisite for long life and healthy living and for those of us who it has become a way of life, this issue of people putting up structures right to the edge of the drains beside the roads, are making life difficult for us.
We are compelled to walk along the roads, putting our lives at serious risk. Pedestrians should never be compelled to compete with vehicles on our streets and roads. Roads and streets are made for vehicles and pavements are made for pedestrians. That is the norm. Any attempt to normalise a situation where pedestrians are mingling with vehicles is insanity.
It is the road regulations that makes it so and therefore district or municipal assemblies are to take responsibility and ensure that spaces for pavements are not encroached upon. Citizens have rights that must be protected by their leaders and making pavements available to pedestrians, is one of them.
When we hear of teachers having sex with students, it appears it is something recent. It is not a new phenomenon. It has been there since Adam. Perhaps this issue is getting much attention due to the proliferation of social media. It was an open secret in times past when Teachers were in relationships with female students and some married them immediately after completion of school.
Some teachers were also known to be having unholy interactions with female pupils but due to the times that these acts occurred, human rights issues and the awareness around it, allowed such unscrupulous teachers to get away with their crimes.
Now we are in a different era and so a Headmaster is now in hot waters. He is alleged to have raped about 19 female students and as usual, some officials tried to cover it up and are also in hot waters and their actions or inactions in the matter are under investigation.
Why the man has been allowed to roam freely without being arrested is simply mind boggling. It appears that the law applies differently, depending on who you are. This issue came to public attention sometime in August this year, yet the police had not arrested or invited this man for question regarding the rape allegation.
It has come out that he is a Constituency Secretary of the ruling party and the question in the public domain is that, is it because he is a political figure that is why he is still walking around without questioning? I believe in the rule of law so let us hold our breadth and let the proper thing be done.
The police must however be seen to be active in this matter. God bless.
SKIP THE QUEUE, TAP THE NEWS
You can now read the Ghanaian Times and The Spectator newspapers from the comfort of your device via TimesNewsPlus.
Join our WhatsApp Channel: https://whatsapp.com/channel/0029VbBElzjInlqHhl1aTU27
