Obesity in Adolescents: Prevalence and Association with Sociodemographic and Lifestyle Factors

Introduction: Overweight and obesity has become a worldwide epidemic and is a growing public health concern. The increase in prevalence and severity of obesity among children and adolescents has been attributed largely to behavioral factors such as changing eating habits and sedentary lifestyles. Objective: To determine prevalence of obesity and abdominal obesity among adolescents and its association with sociodemographic factors and lifestyle. Methods: Present cross-sectional study was conducted in the urban field practice area under the Community Medicine Department of LLRM Medical College, Meerut, among 872 adolescents. All localities in the field area were covered and house to house survey was done. Questions were asked about eating patterns, physical activity and sedentary lifestyle. Data was collected and analyzed using appropriate statistical tests. Results: The prevalence of overweight and obesity was 17.43, 6.88%, respectively. Obesity was significantly higher among females, those who indulged in unhealthy eating habits were physically inactive, watched television for a longer duration and ate junk while watching television. Conclusion: In the present study, we found that high junk food consumption and a sedentary lifestyle were found to be significantly associated with childhood overweight/obesity. As a result, timely interventions should be taken to improve awareness about healthy lifestyle behavior to prevent obesity and its complications among adolescents.

Intra-natal Care Practices in Rural Areas of Gaya District, Bihar

Context: Antenatal care (ANC) effectively reduces infant and maternal mortality rates mainly by promoting institutional deliveries. In view of this, the Government of India introduced Janani Suraksha Yojna (JSY) in 2005 and Janani Shishu Suraksha Karyakram (JSSK) in 2011. Aims: To estimate the proportion of home and institutional deliveries in the district, assess the impact of JSK and JSSY on institutional deliveries, and identify the different intranatal care providers. Settings and Design: This cross-sectional study was conducted in the Gaya district, Bihar. A total of 657 females of the reproductive age group (15-49 years) were included in the study. Methods and Material: Predesigned, pre-tested & semi-structured questionnaire was used to collect information on place of delivery, type of delivery, knowledge regarding JSY and JSSK schemes and source of information Statistical analysis used: Data was entered into excel sheets and analyzed using SPSS version 23 utilizing appropriate statistical methods. Results: Out of 519 deliveries, 63% were institutional and 37% were home deliveries. About 91 and 11.4% of respondents were aware of JSY and JSSK schemes. There was a significant association between those who opted for institutional delivery and awareness regarding JSY and JSSK services. Conclusion: Despite awareness and running of various government programs, the percentage of institutional deliveries is still less. An increase in institutional deliveries at primary care level through JSY and JSSK will not only decrease the Out of Pocket expenditure of the population but also help build faith in the government health facilities. Most read articles by the same author(s) Mahendra Singh, Surekha Kishore , Bhavan Jain, Sanjeev Kishore, Pradeep Aggarwal, Shikhar K Verma , Prevalence of Diabetes Mellitus and its associated risk factors , Indian Journal of Community Health: Vol. 32 No. 1 (2020) Chandramani Singh, Bijit Biswas, Naveen KG, Haripriya Hari, Sanjay Pandey, Bijaya Nanda Naik, Epidemiological investigation of a food poisoning outbreak: a study among hostel dwelling students and resident doctors of a tertiary healthcare facility of India , Indian Journal of Community Health: Vol. 33 No. 3 (2021) Bhavan Jain, Seema Jain, Harivansh Chopra, Sunil Kumar Garg, Ganesh Singh, Chhaya Mittal, Impact of Sociodemographic factors on prevalence of overweight and obesity among adolescents of urban Meerut , Indian Journal of Community Health: Vol. 30 No. 1 (2018) Raj Shekhar, Ditipriya Bhar, Chandramani Singh, Awareness, Knowledge and Practices of Contraceptive Methods among Married Males of Slums of Phulwarisharif block of Patna District, Bihar , Indian Journal of Community Health: Vol. 31 No. 2 (2019)

Awareness and knowledge among paramedical staff about glaucoma surgeries and post-surgery counseling – A questionnaire based study at a tertiary eye care center in Central Rural India

Purpose: To determine the level of awareness and knowledge about glaucoma surgery and post?surgery counseling amongst paramedical staff at a tertiary eye?care hospital. Methods: This observational cross?sectional study included a random sample of 94 hospital personnel: 37 general nurse midwives, 47 ophthalmic assistants, and 10 patient caretakers (PCTs). Participants were administered a questionnaire about glaucoma surgery and post?surgery counseling of patients. Results: The study included 41 (43.6%) females and 53 (56.4%) males. The mean age of the participants was 24.85 ± 4.54 years. All participants were aware of trabeculectomy surgery in glaucoma (100%). A total of 95.7% knew that surgery helps in controlling IOP, of whom 57 (60.6%) participants got information during their course of learning. Overall 53 (56.4%) believed that surgery is done when medication failure occurs, and 58 (61.7%) knew that surgery helps in preserving vision. A total of 63 (67.0%) participants knew to counsel patients to visit an ophthalmologist when called for and take the treatment as advised, whereas 74 (78.7%) correctly said to visit an ophthalmologist immediately if pain/diminution of vision/discharge occurs. Overall, PCTs were found to be having significantly better knowledge (P = 0.01) compared to others and they also reported ophthalmologists as the chief source of information. Conclusion: This study revealed that paramedical staff had an excellent awareness of trabeculectomy surgery. However, the knowledge and counseling parts of the questionnaire revealed less than satisfactory responses. So, there is a need to continuously educate paramedical staff members so that they can help in propagating information about the role of glaucoma surgery and the importance of proper follow?up

Gonioscopic angle evaluation and its correlation with graft survival and post-operative ocular hypertension in patients of Descemet’s stripping endothelial keratoplasty

Purpose: To evaluate the gonioscopic changes in patients receiving Descemet’s stripping endothelial keratoplasty (DSEK) without pre?existing ocular hypertension (OHT) and to report its correlation with post?surgery OHT, graft survival, and visual outcomes. Methods: Adult patients who underwent DSEK surgery from April 2014 to March 2018 with at least 2 years of follow?up were analyzed in this retrospective study. Demographic details, indication of DSEK, necessary anterior and posterior segment findings, and the post?DSEK OHT details were documented. Results: A total of 58 patients (23 males and 35 females) with a mean age of 61.44 ± 8.8 years were included in the study. The most common etiology for DSEK surgery was pseudophakic bullous keratopathy in 47 eyes (81.03%). A total of 22.41% (13/58) eyes showed elevated intra?ocular pressure (IOP) following DSEK surgery. The most common cause of IOP elevation was steroid?induced OHT in seven eyes (12.06%). Gonioscopy examination revealed areas of peripheral anterior synechiae (PAS) in 17 (29.3%) eyes. OHT was found in 4/17 (23.5%) eyes having PAS. Three of these cases required trabeculectomy + goniosynechiolysis (GSL), and the fourth case required GSL alone to control IOP. These four cases also required repeat DSEK for failed grafts. The mean pre?operative best corrected visual acuity was 1.62 logMAR (range 1.17–1.77), which gradually improved to 0.79 logMAR (range 0.3–1.77) after 2 years (p < 0.00001). Conclusion: PAS was found to be an important factor associated with post?DSEK ocular hypertension in our study. OHT in PAS cases required definitive surgical treatments to control IOP. It adversely affected the graft survival and in turn affected visual outcomes also.

Effect Of Blumea Lacera On Tissue Gsh, Lipid Peroxidation And Hepatic Cells In Ethanol Induced Hepatotoxicity In Rats

Objective: To evaluate hepatoprotective effects of ethanol extract of aerial part of Blumea lacera (BLEE) against ethanol-induced hepatotoxicity in rats. Methods: The in vivo antioxidant activity of BLEE was assessed by determining the tissue glutathione (GSH) and lipid peroxidation (LPO) levels. The BLEE at the doses of 200 and 400 mg/kg and silymarin 100 mg/kg administered to the ethanol challenged rats. The effects of BLEE and silymarin on Physical and Biochemical Parameters were measured. Similarly, histopathological changes of the liver were studied. Results: The BLEE showed in vivo antioxidant activity. A significant (P<0.001) decrease in SGOT, SGPT, ALP, total and direct bilirubin was observed in BLEE treated group at doses i.e. 200 mg/kg and 400 mg/kg as compared to intoxicated group. Liver damage in animal pretreated with BLEE was minimal with distinct preservation of structures and the architectural frame of the hepatic cells. Conclusion: These findings demonstrated the hepatoprotective effects of BLEE against ethanol-induced liver damage.

Rising trend of Non-Communicable Diseases in India

The 21st century has witnessed multiple public health emergencies (viz. Fukushima nuclear disaster, the Ebola outbreak in West Africa, civil wars, natural calamities, etc.), which are mostly associated with many adverse consequences locally, nationally, and internationally. (1,2) Simultaneously, an unexpected rise in the global magnitude of noncommunicable diseases (NCDs) has also been observed. The Lancet Commission on Global Health 2035 foresees that the threat of pandemics, antimicrobial resistance and noncommunicable diseases will represent the greatest threats to global public health in the future. (3) The disease burden in India is changing. While communicable diseases remain a significant threat, non-communicable diseases (NCDs) are also posing threat to country’s public health and wellbeing.

Impact of Sociodemographic factors on prevalence of overweight and obesity among adolescents of urban Meerut

Background: Adolescent obesity is becoming a major public health problem in urban areas of India and its prevalence is increasing in all socioeconomic groups irrespective of religion, region and caste. Aims & Objectives: To find out prevalence of overweight & obesity among adolescents and to study its association with sociodemographic factors. Material & Methods: This cross-sectional study was carried out in the area covered by Urban Health and Training Centre of Lala Lajpat Rai Memorial Medical College, Meerut. Sample size was estimated by keeping the prevalence as 10% with 95% confidence interval and relative precision of 20%. A total of 872 adolescents were selected randomly using proportional allocation method. Results: The prevalence of overweight was found to be 17.4% and obesity 6.9%. The prevalence was significantly higher among females and in those belonging to nuclear families as well as higher socioeconomic status. Conclusion: The prevalence of overweight and obesity is quite high in the urban area and there is a need to develop an effective programme for the prevention of obesity in these areas.

Viral aetiology of acute lower respiratory tract illness in hospitalised paediatric patients of a tertiary hospital: One year prospective study.

Context: Acute lower respiratory tract infections (ALRI), ranked as the second leading cause of death are the primary cause of hospitalisation in children. Viruses are the most important causative agents of ALRI. Aim: To study the viral aetiology of ALRI in children at a tertiary care hospital. Setting and Design: One year prospective observational study in a tertiary care hospital of King George’s Medical University, Lucknow. Material and Methods: Nasopharyngeal aspirate (NPA) was collected from children admitted with signs and symptoms of ALRI who were aged 0-14 years. Samples were transported to the laboratory at 4°C in viral transport media and processed for detection of respiratory syncytial virus (RSV) A and B, infl uenza virus A and B, adenovirus (ADV), human Boca virus (HBoV), human metapneumo virus (hMPV) and parainfl uenzavirus 1, 2, 3 and 4 using mono/multiplex real-time polymerase chain reaction (RT-PCR). STATA was used for statistical analysis. Results: In one year, 188 NPAs were screened for respiratory viruses, of which 45.7% tested positive. RSV was most commonly detected with 21.3% positivity followed by measles virus (8.5%), infl uenza A virus (7.4%), ADV (5.3%), infl uenza B virus (1.6%), hMPV (1.1%) and HBoV (0.5%). Month wise maximum positivity was seen in December and January. Positivity rate of RSV was highest in children aged < 1 year, which decreased with increase in age, while positive rate of infl uenza virus increased with increasing age. Conclusion: The occurrence of viral predominance in ALRI is highlighted.

Bioremediation of industrial waste through mushroom cultivation.

Handmade paper and cardboard industries are involved in processing of cellulosic and ligno-cellulosic substances for making paper by hand or simple machinery. In the present study, solid sludge and effluent of both cardboard and handmade paper industries was collected for developing a mushroom cultivation technique to achieve zero waste discharges. Findings of present research work reveals that when 50% paper industries waste is used by mixing with 50% (w/w) wheat straw, significant increase (96.38%) in biological efficiency over control of wheat straw was observed. Further, cultivated basidiocarps showed normal morphology of stipe and pileus. Cross section of lamellae did not show any abnormality in the attachment of basidiospores, hymenal trama and basidium. No toxicity was found when fruiting bodies were tested chemically.

Pediatric cataract and surgery outcomes in Central India: a hospital based study.

BACKGROUND: A review of pediatric cataract cases operated between January 2003 and March 2005 in the tribal belt of central India was carried out. AIM: We present the profile of cataract cases in children <or=18 years and postoperative visual status in the eyes operated upon. SETTINGS AND DESIGN: This was a retrospective medical record retrieval type of cohort study in a hospital setting. MATERIALS AND METHODS: Pediatric ophthalmologists examined children and operated eyes with cataract. The personal profile, preoperative, intraoperative and postoperative details were noted. The surgical procedures included cataract extraction, intraocular lens implantation, posterior capsulorrhaxis and anterior vitrectomy in most of the cases. We evaluated the visual status of eyes with cataract before and 6 weeks after surgery. STATISTICAL ANALYSIS: We used univariate type of parametric type of statistical analysis. RESULTS: A total of 575 eyes of 502 children had cataract. Cataract in 65 children was bilateral and in 437 cases it was unilateral. Congenital cataracts were in 88 (17.5%) eyes. Traumatic cataracts were noted in 170 (33.9%) eyes. The proportion of cataract was higher in males than in females. Variation in 'number of cataracts' among different age groups was noted. Vision following surgery was more than 6/18 in 84 (16.4%) eyes. The vision could not be assessed in 256 (44%) eyes. CONCLUSION: Improvement of child health care is needed for early detection of cataract in children. Role of rubella and trauma in childhood cataract should be investigated and addressed. Visual assessment and postoperative care should be further improved.

Prevalence of celiac disease among siblings of celiac disease patients.

AIMS: To determine the prevalence of celiac disease (CD) in siblings of patients with this disease in Punjab, where wheat is the staple diet. METHODS : Families of 80 patients with CD diagnosed as per modified ESPGAN criteria were offered family screening. Their siblings aged 2-15 years were tested for serum IgA anti-tissue transglutaminase antibody (anti-tTG) antibody. Those with positive or borderline test and some of those with negative test underwent endoscopic duodenal biopsy. Siblings with characteristics histological findings and showing improvement on follow-up were labeled as having celiac disease. RESULTS: Of the 63 siblings of 48 index cases studied, 15 tested positive for anti-tTG; of these 13 had celiac disease. Three tested borderline for anti-tTG; none of them had CD. Of the 45 anti-tTG-negative subjects, two agreed to undergo biopsy; one of these had features of CD. Overall, 14 of 63 (22%) siblings had CD, including 8 who had no symptoms suggestive of CD. CONCLUSIONS: CD is common among siblings of patients with CD in Punjab and may be asymptomatic.

Primary liposarcoma of the omentum: a case report and review of the literature.

A case of round cell liposarcoma of omentum in a 45-year-old man is reported. The patient presented with abdominal pain, swelling and fever of 4-month duration. Abdominal ultrasonography and computed tomogram confirmed the presence of an abdominal mass, but the omental origin of the tumour was revealed only on laparotomy. In addition to the main tumour mass, multiple nodules were present in the omentum. The tumour was excised with omentum. Histopathology of the tumour revealed a round cell liposarcoma. The patient expired 9 months after operation. Eight other cases of liposarcoma of omentum reported in English literature are reviewed.

Bleeding gastric lipoma: case report and review of the literature.

We present a rare case of a bleeding gastric lipoma diagnosed by computed tomography. Surgical treatment was followed by an uneventful recovery. Histopathological confirmed the diagnosis.

Intracranial hemorrhage in late hemorrhagic disease of the newborn.

This study was conducted to evaluate the clinical profile and outcome in late hemorrhagic disease of the newborn (HDN) with particular reference to intracranial hemorrhage. Infants (n = 42) presenting with late HDN from January 1998 to December 2001 were studied. Majority (76%) were in the age group of 1-3 months. All were term babies on exclusive breast-feeding and none received vitamin K at birth. 71% patients presented with intracranial hemorrhage, commonest site being intracerebral and multiple ICH. Visible external bleeding was noted in 1/3rd of patients only. Three patients expired. Late HDN is still an important cause of mortality and morbidity in developing countries where vitamin K prophylaxis is not routinely practiced. Isolated intracranial hemorrhage is a common mode of presentation.

Solitary tuberculous abscess of liver.

Tuberculous liver abscess (TLA) is an extremely rare condition even in the country where tuberculosis is an alarming public health problem. Here a case of TLA is reported from Nepal with diagnostic and management principles and review of literature.

Agenesis of gallbladder in symptomatic patients.

Three women and one man among 771 patients, who underwent laparotomy with diagnosis of symptomatic gallbladder disease over a period of 5 years, were found to have agenesis of the gallbladder. Preoperative ultrasonography suggested cholelithiasis in all the four patients; three patients with jaundice had choledocholithiasis in addition. The absence of gallbladder was established by meticulous operative exploration and carefully repeated ultrasonography in postoperative period. The patients having choledocholithiasis underwent choledocholithotomy, while the fourth patient had no definitive procedure. One patient expired on 17th postoperative day following biliary leak, septicemia and liver failure. Another two patients were well and symptom free, while the fourth patient remained symptomatic. Awareness of the possibility of agenesis of gallbladder may allow the surgeon to attempt confirmation of diagnosis by non-operative methods and avoid surgical exploration in specific instances.

Prevalence of atherosclerosis risk factors in adolescent school children.

The emerging epidemic of atherosclerotic cardiovascular diseases in developing countries may have its roots in childhood. We studied atherosclerosis risk factors--tobacco use, obesity, hypertension, total cholesterol level and dietary intake of atherogenic nutrients in adolescent school children aged 13-17 years in Western India. Two hundred thirty-seven children (89 boys, 148 girls) were examined and prevalence of risk factors determined. Family history of coronary heart disease was found in 16 (6.8%), smoking or tobacco use in one (0.4%) and obesity (BMI > 90th percentile) in 24 (10.1%), borderline hypertension (> or = 136/86) in 65 (27.4%) and definite hypertension (> or = 142/92) in 17 (7.2%). Borderline hypercholesterolaemia (170-199 mg/dL) was in 78 (32.9%) and definite hypercholesterolaemia (> or = 200 mg/dL) in 16 (6.8%). Mean calorie intake was 1450 +/- 348 per day. Fats provided 38.4 +/- 8 percent of the calories, saturated fats contributed to 20.3 +/- 6.4 percent of calories, monounsaturated fats to 12.9 +/- 2.4 percent and polyunsaturated fats to 5.0 +/- 3.7 percent. Dietary cholesterol intake was 164 +/- 95 mg/day, sodium chloride intake 12.8 +/- 5.7 gm/day and fibre intake 6.5 +/- 4.6 gm/day. This study shows a high prevalence of metabolic and dietetic coronary risk factors among adolescents of the middle- and upper-middle class in India.