Prevention of overweight and obesity in preschool children: an updated review.

An increasing number of children are becoming overweight and obese. Overweight and obesity are arbitrarily defined as excess adipose tissue in the body. Although many risk factors for overweight and obesity have been identified for school-age children, less is known for preschool children. Prevention of overweight and obesity in preschool children is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well-being. This review was performed to study determinants and risk factors for overweight and obesity development in early age, effectiveness of preventive strategies in preschool children and outcome measurements of intervention programme in preschool children.

Determinants of delays in diagnosis and treatment of pulmonary tuberculosis in a new urban township in India: A cross-sectional study.

Background: The period of infectiousness of a new sputum smear-positive pulmonary tuberculosis case is important in determining the risk of exposure faced by the community. Early detection and effective treatment of TB case reduces the period of transmission and the risk of exposure of the community. It is for this reason that the delay in TB diagnosis and treatment should be minimal to control disease transmission and patient suffering. Aims & Objective: To measure delays in diagnosis and treatment of pulmonary tuberculosis, and to identify and assess the risk factors associated with these delays. Material and Methods: A cross-sectional study was conducted of all new smear-positive pulmonary TB patients diagnosed between January 2012 and June 2013 at RNTCP clinic. The time from the onset of symptoms to first health care consultation (patient delay) and the time from first health care consultation to the date of TB diagnosis (health system delay) were analysed. Bivariate and logistics regression were applied to analyse the risk factors of delays. Results: A total of 122 patients with a mean age of 29.9 years were included in the study. Mean total delay between the onset of symptoms and treatment initiation was 53.42 days (median 50, range 14-128), with a mean patient delay of 29.24 days (median 25, range 5-94) and mean health system delay of 21.7 days (median 17, range 3–93). The mean treatment delay was 2.48 days (median 2, range 1-6). Factors independently associated with total delay were cough symptom (OR 3.36, P = 0.038), completed secondary school (OR 0.41, P = 0.018), good knowledge of TB symptoms (OR 0.39, P = 0.011), first visit to a public health facility (OR 0.45, P = 0.044), sputum testing at first health care consultation (OR 0.46, P = 0.048) and stigma attached to TB disease (OR 2.89, P = 0.021). Those associated with patient delay were male sex (OR 0.42, P = 0.020), large family size (OR 2.30, P = 0.027), completed secondary school (OR 0.43, P = 0.025) and good knowledge of TB symptoms (OR 0.45, P = 0.029); while those associated with health system delay were first visit to a public health facility (OR 0.31, P = 0.006), sputum testing at first health care consultation (OR 0.22, P = 0.001), number of health care consultations (OR 4.41, P < 0.001) and pre-diagnosis health care cost (OR 3.35, P = 0.001). Conclusion: Health system delay was an important problem in the area studied, with patient delay being of most concern.

Primary marginal zone B-cell lymphoma of appendix.

Primary lymphomas of appendix are extremely rare tumors. The first case of primary lymphoma of appendix was reported by Warren in the year 1898. Incidence of primary lymphoma of appendix is 0.015% of all gastrointestinal lymphomas. This is a report of primary marginal zone B-cell lymphoma of appendix which presented as appendicular mass. As some cases are incidentally discovered, this case emphasizes that histological examination of all appendicectomy specimens is mandatory.

Paratesticular malignant peripheral nerve sheath tumour: a case report.

Primary malignant peripheral nerve sheath tumours (MPNST) of intrascrotal extra testicular site are extremely rare with only few cases reported in literature. These are highly malignant tumours most often associated with neurofibromatosis. The incidence in general population is 0.001%. A 35-year-old male presented with swelling of the scrotal sac of three months duration. There were no features of neurofibromatosis. The lesion was excised and was diagnosed as MPNST. The patient developed recurrence within two months.

Primary small intestinal adenocarcinoma.

Seven patients with adeno-carcinoma of the small intestine were seen over a period of five years. Four were localized to the duodenum, the jejunum was involved in two and the ileum in one. Abdominal pain, weight loss, anemia and obstruction were the most common presenting complaints. Endoscopy was the primary diagnostic modality for the duodenal tumours. Diagnostic accuracy of barium contrast examination was 83%. Curative resections were performed in two patients and palliative surgery in the rest.

Profile of a cancer detection camp.

The organisation and management of a cancer detection camp in rural area of Andhra Pradesh with the help of Lions Club and medical college staff were described. People with any one of the seven warning signals of cancer were asked to attend the camp. More women, most of them in reproductive age, attended the camp with unusual vaginal bleeding and lump in the breast. Among men, a large group complained of chronic cough. Smear for Papanicolaou's stain was used as a tool for screening of cervical cancer. Ten patients (2.5%) had malignant lesions and 16 patients (4.0%) had premalignant lesions. The programme of prevention, public health education and early detection of cancer can be put into action, successfully through cancer detection camps organised in rural areas.

Seven warning signals of cancer (SWSC) and screening for cancer.

SWSC was used as a tool to detect cancer in persons who attended the Cancer Detection Camps. Seven Cancer Detection Camps were conducted in rural and urban areas of Andhra Pradesh, India. Out of 1,079 persons screened, 517 complained of one of the SWSC. Fifty five malignant and eight premalignant lesions were detected. SWSC as a tool for detection of Cancer in a camp setting appears effective.