Physical Activity as a Clinical Tool in the Assessment of Malnutrition.

Objective: To measure physical activity in children with wasting and to look for association between poor physical activity and wasting. Methods: Physical activity was measured in 56 children with wasting, using Children’s Activity Rating Scale, and compared with age- and sex-matched controls. Results: A significant association was found between poor physical activity and malnutrition as determined by weight-for-height Z Score <-2 (P=0.001) and midupper- arm circumference (P=0.002). Conclusion: Physical activity can be used as clinical parameter to assess malnutrition.

Prevalence and pattern of childhood morbidity in a tribal area of Maharastra.

Previous studies have demonstrated that tribal children suffer from a higher rate of morbidity. Gender discrimination in the form of dietary neglect of the female children has also been noted. The community based cross-sectional study was carried out in tribal PHC Salona of Chikhaldara Block, Amaravati District, Maharashtra to study the prevalence and pattern of morbidities in children. 2603 study children between 0-72 months of age were covered in a house to house survey by the investigator. Parents of eligible children were interviewed using a pre-tested questionnaire for socio-demographic details, personal habits, past and current medical history. The prevalence of overall morbidities was 34.7% and it was higher in female as compared to male children (34.8% vs. 29.7%; chi2 = 9.3, p <0.005). Among individual morbidities, the prevalence of acute respiratory infections was the highest (25.5%) followed by acute diarrhoeal diseases (5.8%), conjunctivitis (1.5%), and skin infections (1.2%).

Cirumstances and motivations for seeking abortions: a community based study in Chandrapur District, Maharashtra.

The present population based group comparison study was undertaken to study the circumstances, motivations and influencing factors for seeking abortion in women in Chandrapur District of Maharashtra. Participants of the study included 500 cases of induced abortion and the equal number of normal delivered women during the same period and in the same area as comparison group. Having two children, domestic problems and unwanted pregnancy were conditions acceptable to study subjects to terminate the pregnancy. Family and domestic problems, poor socio-economic status, short inter-pregnancy interval and completed family size were some of the important reasons quoted by study subjects for not desiring to continue the current pregnancy. Majority of the subjects felt that the decision to terminate or keep pregnancy is usually taken jointly by both the husband and wife. Family and domestic problems, poor socioeconomic status and short inter pregnancy interval were the important reasons quoted by abortion cases for seeking abortion in the current pregnancy. Only 1.80% of the cases reported failure of contraceptive method as a cause of seeking abortion services. In 78.4% of abortion cases as compared to 5.4% subjects from the comparison group, pregnancy was un-planned.

Can anti-Helicobacter pylori and anti-CagA antibodies be used to select patients with dyspepsia for gastroscopy?

BACKGROUND: agA IgG antibody in sera may indicate presence of peptic ulcer disease among dyspeptic patients and therefore may be used as a serological marker to identify high risk patients for peptic ulcer who can be subjected to endoscopy. Present study was performed to identify association of CagA IgG antibody in patients with peptic ulcer. METHODS: Consecutive patients with dyspepsia were subjected to endoscopy and sera was collected from each. Rapid urease test in antral tissue collected from each patient by endoscopic biopsy was performed. Antral tissue was also examined histologically. IgG Antibody against H. Pylori and CagA IgG antibody was tested in each patients sera. RESULTS: Out of 82 patients with dyspepsia included in the study 28 had peptic ulcer. Of whom 26 were positive for anti IgG H. Pylori antibody. More than 80% patients with peptic ulcer patients had detectable anti Cag A antibody in contrast to 33% patients with non ulcer dyspepsia (P < 0.001). CONCLUSION: Anti-Cag A antibody may be used as a screening test in patients with dyspepsia to select high risk patients for peptic ulcer for upper gastrointestinal endoscopy.

Factors responsible for delayed immunisation among children under 5 years of age.

Although immunisation coverage has increased substantially in recent years, still a sizable proportion of children are not being immunised at appropriate time. The present hospital based, pair matched, case control study was carried out at immunoprophylactic centre of Government Medical College and Hospital, Nagpur, to identify risk factors associated with delayed immunisation among children. This study included 139 children with a delay of more than 90 days for scheduled primary immunisation and equal number of matched control (for dose) receiving immunisation at appropriate time. The study identified significant association of family size [Odd's ratio (OR) = 7.3, 95% confidence interval (CI) = 1.5-35.6], number of children < 5 years (OR = 3.17, 95% CI = 1.1-9.9), sex (OR = 3, 95% CI = 1.2-7.4), paternal education (OR = 3.7, 95% CI = 1.6-8.5), maternal education (OR = 4, 95% CI = 1.5-10.9), socio-economic status (OR = 3.7, 95% CI = 1.1-13.2) and distance from health centre (OR = 4.7, 95% CI = 1.2-17.6) with delayed immunisation. Negligence (56%) and unawareness (22.7%) of parents were main reasons for delayed immunisation. Hence more stress on identified risk factors in the study will indirectly help in reducing the frequency of delayed immunisation.

Dehydrational crisis from severe diarrhoea and risk of age-related cataract.

A group matched hospital based case-control study of 463 cases and equal number of controls was carried out at Government Medical College and Hospital, Nagpur to evaluate role of severe dehydrational crisis in age-related cataract development. The overall relative risk of age related cataract in relation to dehydrational crisis from severe diarrhoea was estimated to be 3.10 (2.28-4.20). The overall estimates of attributable risk per cent and population attributable risk per cent were calculated to be 0.67 (0.56-0.76) and 0.26 (0.18-0.35) respectively. In conclusion this study identified significant role of dehydrational crisis from severe diarrhoea in cataractogenesis.

Risk factors for cataract: a case control study.

The present study was designed as a hospital-based, group-matched, case-control investigation into the risk factors associated with age-related cataract in central India. The study included 262 cases of age-related cataract and an equal number of controls. A total of 21 risk factors were evaluated: namely, low socioeconomic status (SES), illiteracy, marital status, history of diarrhoea, history of diabetes, glaucoma, use of cholinesterase inhibitors, steroids, spironolactone, nifedipine, analgesics, myopia early in life, renal failure, heavy smoking, heavy alcohol consumption, hypertension, low body mass index (BMI), use of cheaper cooking fuel, working in direct sunlight, family history of cataract, and occupational exposure. In univariate analysis, except marital status, low BMI, renal failure, use of steroids, spironolactone, analgesics, and occupational exposure, all 14 other risk factors were found significantly associated with age-related cataract. Unconditional multiple logistic regression analysis confirmed the significance of low SES, illiteracy, history of diarrhoea, diabetes, glaucoma, myopia, smoking, hypertension and cheap cooking fuel. The etiological role of these risk factors in the outcome of cataract is confirmed by the estimates of attributable risk proportion. The estimates of population attributable risk proportion for these factors highlight the impact of elimination of these risk factors on the reduction of cataract in this population.

Tobacco consumption practices and risk of oro-pharyngeal cancer: a case-control study in Central India.

A hospital based, group matched case control study was conducted with the objective to assess the association between tobacco consumption practices and risk of development of oro-pharyngeal cancer in Central India. The study included 123 cases of oro-pharyngeal cancer, diagnosed on the basis of histopathology at three tertiary care centers in Nagpur city. Each case was matched for age and sex with two hospital controls: one selected from non-cancer patients and another from patients having cancer of other sites. Tobacco chewing (OR=7.98, 95% CI 4.11-13.58) and tobacco smoking (OR=2.25, 95% CI 1.22-3.70) were found to be significantly associated with oro-pharyngeal cancer on unconditional multiple logistic regression analysis. Further analysis revealed a dose-response relationship between increasing frequency, duration and retention time of tobacco in mouth and risk of oro-pharyngeal cancer. Other risk factors which were also found to contribute significantly in the outcome of oro-pharyngeal cancer in the study population were: use of traditional/local substances (eg pan, betel nut, lime) with or without tobacco, use of tobacco containing material for teeth cleaning, type of smoking (eg bidi, chillum, cigarette) and outdoor occupations. High values of estimates of attributable risk percent (ARP) and population attributable risk percent (PARP) confirmed the positive impact of reduction or elimination of the tobacco consumption practices on reducing the risk of oro-pharyngeal cancer in the population of Central India.