Prevalence of obesity and overweight in affluent adolescents from Ludhiana, Punjab.

The objective was to study the prevalence of obesity among adolescents in public schools of Ludhiana, catering to the affluent segment of population. We selected 1000 students from these schools by random, purposive sampling. Their anthropometry was taken. Students also filled-up a prevalidated questionnaire regarding dietary habits and lifestyle. Overweight/Obesity was defined using age and sex specific Body mass index (BMI) cut off points. Incidence of obesity was 3.4% and overweight was 12.7%. A significantly greater number of boys (15%) were overweight as compared to girls (10%).

A clinical profile of shock in children in Punjab, India.

This prospective study was conducted to determine the frequency, etiology, type and outcome of shock in hospitalized children in the age group of 1 month to 15 years. There were 98 cases of shock, constituting 4.3% out of total admissions. Mean age was 2.8 +/-3.4 years. Maximum number of patients (39) was seen in infancy. Hypovolemic shock due to acute diarrheal disease was the commonest type (45.9%) followed by septic, cardiogenic and distributive shock. Compensated stage was common in hypovolemic shock (88.9%) whereas majority of patients with septic shock (73.5%) presented in decompensated stage. Overall survival was 73.6%. The survival rate was best in hypovolemic shock (97.7%;) followed by septic(53.3%) and cardiogenic shock(43.7%). Inotropes and ventilatory support were required in 46% and 23% patients, respectively. Diagnosis and management of shock in compensated stage carried better prognosis than in uncompensated shock irrespective of the age of the patient.

Mid-arm circumference for detecting malnutrition during infancy.

Mid-arm circumference (MAC) has been extensively used at 1-5 years of age as an age-independent indicator of protein-energy malnutrition (PEM). Its role below 12 months of age has not been studied adequately and a search for a clinically reliable cut-off point has not been systematically done. This study was planned to establish the age-independent character of MAC within the 6-12 month age group and identify a cut-off point demonstrating the maximum sensitivity and specificity in detection of PEM. Two hundred and forty malnourished infants [< 80% weight for age (W/A) of 50th percentile of NCHS standard] were included with even distribution into 6 subgroups; 240 healthy infants were taken as controls. MAC within the age of 6-12 months was found to be age independent with an overall increase of 5.1%. By using various cut-off points a value of < or = 12.5 cm of MAC proved to be having maximum sensitivity (92.1%) and specificity (88.3%). MAC is, therefore, a simple, age independent, informative measurement for early assessment of PEM by using single cut-off point < or = 12.5 cm, and can serve as a screening test for targeting infants for meaningful utilization of nutritional programmes. Since nearly all MAC tapes in current use already have < or = 12.5 cm colour coded cut-off, no new tapes are necessary.

Stool electrolytes in acute dehydrating gastroenteritis.

Stool electrolytes were studied in 100 cases of gastroenteritis. The duration of illness was 24-48 hours in 32% and 72-96 hours in 28% of the cases. On stool culture, 43% children had no growth, 23% had Enteropathogenic E. coli and 10% had cholera and rotavirus each. The stool sodium loss was more in cholera and shigella cases, diarrhea of shorter duration and in children between 24-30 months of age. Potassium loss in the stool was more in shiegella cases, diarrhea of short duration and in children between 30-36 months of age. In cases of gastroenteritis with severe malnutrition, stool sodium loss was less; stool potassium loss was not affected by the nutritional status. Total electrolytes lost in stools can be estimated by knowing purging rate and rehydration therapy can be planned accordingly.

Extent of occurrence of the six vaccine preventable diseases in vaccinated/unvaccinated children.

Sixty two children who were diagnosed to be suffering from any of the six vaccine preventable diseases were studied to know their vaccination status prior to the occurrence of these diseases. A total of 33.9% of these children had developed these diseases inspite of full immunization. Nearly 75% of immunized children had received the vaccine from Government sources. The break-up diseases among the children studied was tetanus (35.5%), poliomyelitis and pulmonary tuberculosis (22.6% each), measles (11.3%), diphtheria (6.4%) and pertussis (1.6%). The vaccinated children who developed poliomyelitis belonged to a relatively higher age group. Seventy one per cent of measles cases developed bronchopneumonia as a complication. Seventy five per cent of the mortality in the children studied was due to tetanus neonatorum. Since one third of the children studied had developed diseases inspite of full immunization, it is inferred that closer monitoring of the Cold Chain System and intensive surveillance at peripheral levels are required.

Skinfolds in affluent Punjabi preschool children.

The skinfold thickness at three different sites (triceps, subscapular and suprailiac) were measured using Holtain Skin Fold Caliper in 941 children of 0-5 years of age. The sample consisted of children from affluent families of Ludhiana (Punjab) in order to include only the optimally growing children. The skinfold thickness at all the three sites showed a progressive rise in mean values upto the age of 1 year and thereafter the trend was downwards till the age of 5 years in both the sexes. The values were higher in girls in all age groups. The mean triceps skinfold thickness was the highest followed by subscapular and suprailiac thickness in both sexes in almost all age groups. There was no correlation between the body weight and skinfold thickness values (mean r value = 0.09). Triceps and suprailiac skinfold thickness were significantly lower than the corresponding British values in both the sexes in all age groups. However, the subscapular values were comparable with British values in the females of all age groups and also in males above three years of age. Larger multicentric studies are recommended to frame the norms for Indian children.