A 16-year-old boy was admitted to the gastrointestinal department of Taleghani hospital, a teaching referral center located in Tehran, Iran, with a complaint of dysphagia, fatigue, and delayed growth. . . .

Background & Objective: Failure To Thrive (FTT) refers to the insufficient physical growth or inability in keeping the desired growth rate in a period to time.It is a problem in Iran as far as hygienic nutrition is concerned. FTT is a multifactor problem which is caused by various organic and nonorganic agents. This study was conducted to pinpoint the major risk factors involved in the growth of children under 2 years of age who are the most vulnerable age-group in terms of growth disorders.Methods: This case-control study was conducted in 2002-2003 on 120 infants (60 cases with FTT and 60 controls) in Namin health centers. The case group was under the third percentage of their growth chart or they had -2SD in growth chart at least in three months. The control group was composed of infants with normal growth chart. The demographic characteristics of parents, and the nutritional and antropometric (height/weight, head circumference) characteristics of the subjects were measured. The collected data were analyzed by SPSS software, using chi-square and ANOVA. Results: The findings indicated higher frequency of respiratory infections, diarrhea and vomiting in case group (p<0.05). The control group, on the other hand, outnumbered the case group in terms of the number of infants under 6 months who were exclusively breast-fed (p<0.05). Most of the infants with FTT had a lower birth weight than control group (p<0.05). The number of mothers with lower level of education and those who were housewives and also the number of family members were significantly higher in case group than control group (p< 0.05). However, no significant difference was observed between two groups in terms of frequency of breast feeding and birth rank. Conclusions: The results indicated that some risk factors such as respiratory infections, birth weight, education, mothers knowledge, exclusive breast feeding and the frequency of diarrhea and vomiting have far more important role in growth disturbances in children compared to factors such as frequency of breasr feeding and birth rank.

Currently being conducted to determine the status of children using growth charts in this manner there are errors and exact fit is not determined growth condition. World health organization (WHO), recentlyhas designed software that solves this problem. The purpose of this study was to compare the efficacy of two methods for identifying children with growth disorders. In this cross-sectional study of 2132 children were assessed when they visit the Sanjesh site. Data were analyzed using Anthroplus software and growth charts. Anthroplus software identified more children with growth disorders. Only in one index current method more diagnosed (19 case) than software, but in other indices the software diagnosed more children with disorder (54 patients). Since this is a valid software, can be downloaded from the WHO website, and it is easy to use, thus for household electronic filing, its use in the health care system can useful.

Background and Objectives: The objective of this study was to determine and compare serum zinc concentration in children with failure to thrive and well thrived (Weight and Height above 50th percentile) at Northwest of Tabriz 2001.Materials and Methods: This cross sectional study was conducted on 172 failure to thrive (as a case) and 154 well thrived (control) children that had been matched from the view point of age and sex. From all children 3 milliliter vein blood was obtained. Serum zinc was measured by atomic absorbtion spectrophotometer. Mean of serum zinc in two groups was compared using student t test and Chi-Square test.Results: The mean of serum zinc concentration in failure to thrive children was 77.65 ± 20 µg/ dl, and well grown was 85.8± 16.9 µg/dl, The difference between two groups was significant ( p<0.001 ). Serum zinc level of 35.9 % of cases and 22% of control group was lower than normal (p=0.028) and 6.5% and 6.7 % of cases and control were higher than normal range, respectively.Conclusion: The mean of serum zinc level in children with failure to thrive was lower than well thrived children.

Background: Liver transplantation is the main treatment for tyrosinemia. The pre-operative conditions such as the presence of failure to thrive (FTT) would affect the prognosis of transplant recipients. Objective: To test whether the survival rate of liver transplant recipients with tyrosinemia was associated with pre-operative presence or absence of FTT. Methods: In a historical cohort study, the survival rate of 42 liver transplant recipients with FTT was compared with that of 68 patients without FTT during 6 months of the transplantation. Kaplan-Meier survival analysis and Cox regression were used for data analysis. Results: The recipients with and without FTT were matched for age, sex, baseline laboratory test results, and the frequency distribution of the underlying diseases. 35 (83%) of 42 recipients with FTT and 29 (43%) of 68 without FTT had rickets (p<0. 001). Histopathological study of the resected livers revealed that 50% of those with FTT and 77% of recipients without FTT had hepatocellular carcinoma or hepatoblastoma (p=0. 015). Recipients with FTT were followed for a median (IQR) of 62 (23–99) days,those without FTT, 31 (6–85) days. During the follow-up period, 9 (21%) of 42 recipients with FTT and 32 (47%) of 68 without FTT died. Recipients with FTT had a significantly (p=0. 013) better survival. The presence of FTT in recipients was associated with a 65% reduction (HR 0. 35, 95% CI 0. 158–0. 776) in the risk of death within 6 months of the transplantation. Conclusion: The presence of FTT in patients with tyrosinemia undergoing liver transplantation, would significantly decrease the short-term mortality rate in transplant recipients.

Failure to thrive (FTT) is a perplexing disorder commonly seen by primary care physicians. Identification of FTT and an assessment of severity of the undernutrition are important to identify children at risk, and to provide appropriate intervention for preventing malnutrition and developing sequela. One of different anthropometric methods for categorizing undernutrition in childhood is Waterlow and Gomez classifications. Unfortunately, these classifications are not an easy task for the practitioners due to its difficult calculations. In this paper, Waterlow and Gomez classifications have been shown on the Standard Growth Charts (WHO 2006). Using these curves, the practitioners can determine severity of FTT by plotting weight, height and age of the patients without any calculations.

Background Non-organic failure to thrive (NFTT) is the most common cause of failure to thrive (FTT) which is attributed to inadequate nutrition due to economic factors or parental neglect. NFTT can lead to a vicious cycle of poor and inadequate eating and severity of anemia. The aim of this study was to determine the hematological indices in children with NFTT. Materials and Methods In a cross sectional case control study, iron status and blood indices of forty five aged 6– 60 months children with NFTT were evaluated and compared with 45 healthy control children (with matching of age and sex). Results In this study, the prevalence of anemia was 48. 9% in NFTT compared to 11. 4% in the control group (p<0. 001). Microcytic anemia was significantly more prevalent among the subjects than the controls (77. 8% versus 27. 3%; p<0. 001). The serum iron level was 73. 2 and 62. 8 mcg/dl for the case and control groups (P=0. 29). The ferritin level in the study group was 29. 8 versus 35. 47 ng/ml in the control group (p=0. 227). The prevalence of iron deficiency anemia among children with mild, moderate, and severe underweight was 44. 4%, 45. 5%, and 48%, respectively. The highest prevalence of iron-deficiency anemia was seen between age group of 12 and 24 months (p<0. 05). Conclusion Based on the results of this study, a correlation between malnutrition and anemia was found. However, further studies are needed to assess and confirm the current outcomes.

Background and Objective: Children with congenital heart disease (CHD) suffer from failure to thrive (FTT) after delivery and severe growth retardation in these patients may lead to FTT continuity even after corrective surgery. Therefore, early detection of FTT and early and appropriate intervention can produce improvement of these conditions. In this study we evaluated FTT and its patterns in children with CHD.Subjects and Methods: Two hundred and fifty children with CHD, who were admitted in Ahvaz Golestan hospital and were visited Mehr hospital for echocardiography out-patiently, were enrolled in our retrospective-descriptive study during 2007. Patients were divided into six age groups and evaluated for weight and stature. Data were analyzed by SPSS software and Pearson, Chi Square, Phi and Cramer testsnwere used.Results: Weight loss was more common among our patients, which was seen more frequently among girls than in boys. Weight loss and short stature were more common in patients with acyanotic diseases (the most common) with pulmonary hypertension (PHTN), while weight loss and short stature were more common in patients with cyanotic diseases without PHTN. The majority of patients belonged to 1-5 month age group and in 6-11 month age group we had the majority of FTT forms.Conclusion: FTT was more common in patients who suffer from CHD with PHTN which was statistically significant (P<0.05). Large ventricular septal defect and patent ductus arteriosus were the first two diseases. While in other studies large ventricular septal defect and tetralogy of Fallot were the most common. The results suggest that early surgical intervention and nutritional support among the 6-12 month age group can be fruitful in prevention of these complications.