Measuring Obesity among School-aged Youth in India: A Comparison of Three Growth References.

Objective: To compare three growth references that can be used to assess the weight status of school-aged youth living in India, with a particular focus on identifying overweight and obese youth. Study Design: Cross-sectional study. Kappa scores were used to measure agreement between growth references. Regression models were used to test for differences in weight status by grade level, gender, and school type, using each growth reference. Setting: Private (n=4) and Government schools (n=4) in Delhi, India. Participants: Students (n=1818) in eighth and tenth grade attending the schools. Main outcome measures: Weight status was derived using age- and gender-specific cut-points provided by: (a) a national growth reference specific to India; (b) an international reference recommended by the International Obesity Task Force (IOTF); and (c) a new international reference recommended by the World Health Organization (WHO). Results: The IOTF reference consistently classified participants in a lower weight status category, compared with the national reference (κ=0.57) and the WHO reference (κ=0.69). The agreement between the WHO and the national references was higher (κ=0.84). Conclusions: To date, all published studies of childhood obesity in India have used the IOTF reference, the national reference, or an old WHO reference to measure weight status among school-going youth. The new WHO reference may be a better choice. Compared to the IOTF reference, it does not appear to underestimate obesity and can still be used to compare trends, globally.

Coeliac sprue--new frontiers in diagnosis and role of capsule endoscopy.

The diagnosis of Coeliac Disease (CD) till now was done based on histological findings and response to gluten- free diet. Recently, Serological tests like IgA anti-endomysial antibodies (AEA) IgA tissue-transglutamin (tTG), IgA antigliadin antibodies (AGA) and IgG AGA antibodies have been added to the armamentarium. Being a small bowel disorder the upper GI endoscopy and colonoscopy are not of much help. The advent of Capsule Endoscopy (CE) which scans the entire small bowel and gives highly magnified and detailed view of mucosa has facilitated the diagnosis of CD to great extent. Moreover, CE is painless, well tolerated and safe diagnostic procedure. This article presents new frontiers in diagnosis, role of capsule endoscopy, and the first case of diagnosis of CD by CE in India.