Perceptual development in relation to nutritional status.

The present study was conducted on 180 children in the age group 5-10 years. These children were divided accordingly their ages into 3 sub-groups i.e. 5-6, 7-8 and 9-10 years respectively. In each group 60 children were studied. For the assessment of perceptual skills each child was tested with the help of Picture Ambiguity Test. Responses to the ambiguous cards were scored with respect to time taken to react in each card and ability of the child to perceive figure and ground relationship i.e. centration and decentration. The observations showed that with increase in age, centration effect reduces and majority of the children start decentring their perception by middle childhood. Further, children in higher age group took lesser time to respond on different ambiguous cards. When the responses of well-nourished and undernourished children were compared for perceptual flexibility in terms of part-whole perception i.e. centration and decentration; no difference was observed between the two groups. There was a significant difference in the performance of well-nourished and undernourished children when time to respond on ambiguous card was compared. Well-nourished children took lesser time to respond on different ambiguous cards. These observations in general suggest that poor nutrition may result in impaired perceptual abilities in children.

Sequelae of early undernutrition on reaction time of rural children at 11-14 years.

85 undernourished rural school children at 11-14 yr of age were randomly selected on the basis of their nutritional status during first five years of life for assessment of reaction time (RT). Audio-visual RT apparatus and electromyograph were used for the study. Early life undernourished children had prolonged RT as compared to their matched control maintaining normal nutrition status in first five years of life. The total, premotor and motor RT for audio as well as visual stimuli were affected in these undernourished children. The RT increased with severity of current undernutrition; those achieving normal nutritional status at this age continued to have prolonged RT. The study suggests that the early life undernutrition affects perceptual abilities, information processing and analytical capabilities.

Physical and sexual growth pattern of affluent Indian children from 5 to 18 years of age.

The present study was conducted to study growth parameters on 12,899 boys and 9,951 girls of affluent class from 8 States of the country. In pooled data, the 50th centile height approached 30-40th centile till 6 1/2 years in boys and up to 10 years in girls, and ultimately the height growth curves for both fell between the 10-20th centile of NCHS standards. Similarly, for weight, they approached 10-20th centile of NCHS at the age of 17 yr. Comparison with other European countries showed that Indian affluents are shorter and lighter; however, they are similar to their counterparts of Asian origin. The secular trend for height in Delhi showed increase of 2.1 cm for boys, and 2.7 cm for girls per decade at 17 yr and 14 yr, respectively. In Varanasi, the corresponding trend was 1.5 and 2.1 cm at 16 yr for boys and girls, respectively. The mean ages for genital development stages G 2-5 were 11.9, 13.3, 14.6 and 15.9 yr; respectively. In girls, the breast development Stages B 2-5 had mean ages of 10.9, 12.8, 13.9 and 14.8 yr, respectively. The mean age for menarche was 12.6 yr. In 14 yr old boys, the mean height may vary between 150.3, 155.8, 161.2 and 165.2 cm and mean weight between 38.0, 42.5, 46.8 and 52.9 kg for genital stages G 2-5, respectively. Similarly, girls of 12.5 yr (close to menarcheal age of 12.6 yr) had mean height 145.3, 150.3, 152.1 and 153.8 cm and mean weight 34.7, 41.2, 45.4 and 54.4 kg for breast stages B 2-5, respectively. It is recommended that for growth assessment during adolescence these charts in relation to sexual development and age be used for comparison.

In vitro evaluation of three topical antimycotics against ring-worm fungi singly and in combination.

Three antimycotic drugs, viz., Miconazole nitrate, Econazole nitrate and ciclopirox olamine were tested singly and in combination of miconazole nitrate and Econazole nitrate, Miconazole nitrate and Ciclopirox olamine, and Econazole nitrate and Ciclopirox olamine to evaluate in vitro efficacy against Trichophyton mentagrophytes and Macrosporum nanum. The best efficacy was shown by Ciclopirox olamine (MIC 0.78 microgram/ml) and a combination of Miconazole nitrate and Econazole nitrate (MIC 0.78 microgram/ml).

Growth and behavior development in rural infants in relation to malnutrition and environment.

A group of 224 children from a rural cohort of 625 children registered from 1981 to 1983 in 10 villages of KV Block, Varanasi was assessed for morbidity, physical growth, and behavior development (Gesell's developmental schedule). By first birthday children of normal nutrition grade were reduced to one fourth and numbers in Grade II and III malnutrition doubled. This deterioration in nutritional status was probably due to high morbidity, i.e., gastrointestinal, respiratory infections, etc. The skull circumference was 43 cm at the age of one year, being lower by 3 cm than the average size. Children having Grades II and III malnutrition showed poor development in all the areas of behavior, i.e., motor, adaptive, language and personal social. Besides malnutrition, environmental factors like mother's involvement in teaching, encouraging the child, talking to him or being within the visual range; the parental education, their caste and the child's birth order contributed significantly to the development of the child during infancy.

Growth, behavior, development and intelligence in rural children between 1-3 years of life.

In a rural cohort of 625 children registered from 1981 to 1983 in 10 villages of K.V. Block, Varanasi, 196 children were assessed for physical growth, development, intelligence and concept development between 1 and 3 years of age. Home environment was also assessed using Caldwell Home inventory. These rural children remained below 3rd centile of NCHS standard for weight, height, skull and mid-arm circumferences throughout the study. Malnourished children scored poorly in all the areas of development, i.e., motor, adaptive, language and personal social, 9% in Grade I and 16.6% children in Grade II + III had IQ less than 79 (inferior). Concept for color shape and size was poorly developed in malnourished children. Maternal involvement and stimulation was strongly associated with better behavior development and intelligence. Multiple regression analysis showed that the effect of home environment on development and intelligence was of a higher magnitude as compared to status and family variables and nutritional status during 1-3 years of age.

Learning disability in rural primary school children.

In rural primary school children observed for two years, 12.97 per cent of those having IQ greater than or equal to 90 were found to have poor achievement in arithmetic test and teacher's assessment. These learning disabled children had impaired perceptual maturity and conceptual grasp as observed on MISIC (Indian modification of WISC), Bender Gestalt test and Piaget's test. On WISC Bannatyne categories learning disabled children scored highest in verbal conceptualization (similarities, vocabulary, comprehension), followed by spatial (picture completion, object assembly, block design) and sequencing (arithmetic, digit span, coding) abilities. These children on Bender Gestalt test made more errors particularly distortions (distortion of parts, incorrect number of dots, shape of design lost etc). They also showed delayed development on Piagetian tasks class inclusion, conservation (for length, substance, liquid and number) ordinal relation and one to one correspondence. These observations indicate impaired perceptual maturity, conception and information processing deficit.

Influence of malnutrition on intellectual development.

The relationship between malnutrition and intellectual performance was studied in 1336 rural primary school children (6-8 yr). Observations showed that the relative risk of having an IQ less than or equal to 89 in severe, moderate and mild malnutrition was 3.5, 2.7 and 1.4 times for boys and in girls it was 2.4, 1.7 and 1.4 times respectively. Mean full scale, verbal and performance IQ as well as the scores for various subtests decreased with the severity of malnutrition. However, though the decrease in IQ scores was significant, below average performance of malnourished children was observed only for performance IQ (87.6 +/- 9.13), and subtests information (87.9 +/- 10.5), digit span (79.6 +/- 11.9), picture completion (88.6 +/- 13.9), object assembly (81.1 +/- 18.1), and coding (80.5 +/- 14.4). Further, the stunted children had lower IQ scores as compared to those who were wasted. Multiple regression analysis showed that besides nutrition, socio-economic status had significant influence on verbal IQ; economic sufficiency on picture completion and block design, psychosocial and family environment on vocabulary and digit span subtests. However, the values of correlations obtained were too low to be used for prediction of scores. The overall observations demonstrate that even moderate degree of malnutrition influences the IQ scores and its effect is of a higher magnitude on immediate memory, visual perception, and visual motor integration as compared to verbal reasoning and comprehension.

Influence of malnutrition on social maturity, visual motor coordination & memory in rural school children.

The social competence, visual motor coordination and memory functions of 1336 rural primary school children in the age group 6-8 yr were studied in relation to their nutritional status and socio-environmental factors. Children with grades, I, II and III malnutrition scored 4.4, 8.5 and 11.8 points lower respectively as compared to those in normal nutrition for the total social quotient. The effect was more marked in stunted wasted children. These rural children performed poorly on areas; communication, socialization and occupation, in grades II and III malnutrition their scores being below average (less than 90). Environmental factors like family size and type, economic sufficiency, and father's education also played a significant role in determining the social competence in girls. The scores for visual motor coordination (Bender Gestalt test) increased with severity of malnutrition (scores normal, 9.9 and grade III, 11.3) being statistically significant (P less than 0.01). Observations on memory test indicated that malnutrition had a significant but very weak relationship with immediate and delayed memory. The boys in grade II malnutrition had significantly lower immediate memory scores, as compared to normal boys for all the 3 modes of presentation (P less than 0.05, P less than 0.05; and P less than 0.001 respectively). In the girls, this was true only with respect to pictures. Further, for delayed memory, boys in grade II malnutrition scored poorly for pictures and words (P less than 0.05 for both).

Effect of mid-day meal programme on physical growth & mental function.

The effect of food supplementation in rural primary school children was studied on physical growth and mental functions. Children (146) received 450-500 calories with 10-12 g of protein for an average of 172 days a year, for 2 yr (1984-1986). Height was found not to differ significantly in the supplemented group as compared to controls. However, there was marginally better weight gain. More children in the supplemented group remained in grade I in contrast to the controls who shifted to grade II nutritional status after 2 yr. Children receiving the supplementation showed marginal increment in full scale, verbal and performance IQ. The improvement was significant for all subtests except for comprehension and maze tests. The observations on unstructured Piagetian developmental tasks also indicated that the performance of children on task conservation of liquid was improved marginally after supplementation. However, on Bender Gestalt test, no change was observed. The scores on arithmetic achievement test showed improvement of 12-14 points in the supplementation group. It appears that nutrition supplementation is beneficial for better school attendance, and reduction in the drop out rate; it also improves intelligence and cognitive function to a marginal extent. However, as this age group falls in the slow growth period, no catch up was observed in physical growth.