Dietary habits and nutritional status of upper primary school children covered under Mid-Day Meal scheme in rural Punjab

Background: The objective of this study was to evaluate the dietary habits and nutritional status of upper primary school children covered under mid-day meal scheme (MDMS) in rural Punjab. Methods: This cross-sectional research was conducted among 336 adolescent (10-15 years) students of 6th to 8th standard randomly selected from 11 government/ municipality schools selected randomly from the total 112 schools rural Punjab in 2018. After taking informed written assent/ consent, pretested, semi structured questionnaire was administered. Anthropometric measurements were taken to establish malnutrition, underweight, stunting, wasting and overweight. Results: Majority (90%) liked the MDMS which was being served to them. There was 96% regularity in attending the school daily with a slightly less emphasis on the cleanliness maintenance (73%) of the children by the schoolteachers. Malnutrition and underweight were 59% and 50% prevalent, respectively. The prevalence of stunting was higher in girls (30%). In boys (154) both the stunting and wasting was 23%, with 5% and 6% prevalence of overweight and at risk of overweight respectively. Whereas in case of girls (182), the prevalence of stunting (30%) was more than wasting (25%) with less girls (3% each) being overweight and at risk of overweight. Conclusions: Regularity and attendance were up to mark due to increased likeliness of the food by majority of the students, though cleanliness should be improved further. Higher prevalence of malnutrition, wasting and stunting was observed which was even higher among girls. Overweight and risk of overweight was higher among boys. Hence, nutritional status was unsatisfactory.

Assessment of quality of mid-day meal in Khamanon, Fatehgarh Sahib, Punjab

Background: Mid-day meal (MDM) is a scheme implemented by Government of India to combat the problem of malnourishment. Periodic assessment of the food and nutritional quality of mid-day meals being served to the school children for nutrient consumption is imperative. This study was designed to evaluate the quality of food served under MDM. Methods: A cross-sectional study was conducted in randomly selected 11 government schools of Fatehgarh Sahib, Punjab (May-July, 2018). The cooked food samples were evaluated for assessing the food quality of MDM in different schools with respect to colour, consistency and taste by a panel of 5-6 judges. The amount of food grains, pulses, vegetables, etc. provided to all the upper primary school children were recorded and then evaluated for the nutritive content (calories, protein, fat) of MDM and its contribution per day. Results: In the present study, energy as well as protein requirement was fulfilled by mid-day meal but was low for fat (2.4 gm). The quantity of mid-day meal provided was adequate except for the vegetables (leafy also). Usage of green leafy vegetables was low (42 gm), served once in a week. There was 76% adequacy of nutrient intake in the present study. Conclusions: The present study shows that improvement in the quality and quantity of the Mid-day meal is essential to fill the nutrient gap. There is a need to improve fat content of the meal, as it was low. More leafy vegetables should be included in the meal or their substitutes should be encouraged.

How multimorbidity relates to road traffic accident among older adults and elderly population: insights from longitudinal aging study in India (1st wave)

Background: Multimorbidity and road traffic accidents increase with increasing age. Supplemented with increasing life expectancy at birth, both multimorbidity and RTAs will contribute significantly to the growing disease burden of the country. The objective of the study was to determine the association between multimorbidity and RTAs among older adults (above 45 years) and the elderly (above 60 years) population in India. Methods: A secondary data analysis was conducted using the Longitudinal Ageing Study in India (LASI)-1st wave data (April 2017 to December 2018). Participants having at least two chronic health conditions were described as multimorbidity. Road traffic accidents (RTAs) was taken as the outcome variable. Univariate followed by multivariable logistic regression was conducted between the outcome variable and each explanatory variable. Results: Data extracted consisted of 34704 (51.1%) older adults and 31902 (47.9%) elderly. Multimorbidity was present in 25054 (37.6%) individuals. Among the RTA group, 325 (26.5%) individuals had multimorbidity. The elderly with multimorbidity (at least two) were associated with the RTA with an adjusted odds ratio (CI) of 0.55 (0.45-0.67) and p value of <0.001 in comparison to older adults. Clerical and skilled individuals with multimorbidity were associated with RTA in comparison to unemployed individuals with multimorbidity with an adjusted odds ratio (CI) of 1.40 (1.10-1.79) and p value of 0.007. Conclusions: The RTA was evident among males aged 45-60 years with multimorbidity. Clerical and skilled individuals with multimorbidity were more prone to RTA. These individuals should be encouraged to take necessary measures to promote healthy living and adhere to them.

R-factor in Proteus vulgaris from ulcerative disease of fish, Channa punctatus.

A Proteus vulgaris isolated from external ulcers of the fresh water fish Channa punctatus showed multidrug resistance and heavy metal tolerance. The isolate from the ulcer showed resistance to chloramphenicol (Ch), nalidixic acid (Nx), streptomycin (Str) and tetracycline (Tet) with minimum inhibitory concentration (MIC) values of 750, 150, 75 and 125 microg/ml, respectively. The isolate showed growth in medium containing cadmium (Cd2+), up to a concentration of 2.5 mM indicating its heavy metal tolerance. Resistance to Ch, Str, Tet and Cd2+ of the isolate was lost after plasmid curing. Presence of plasmid DNA in the wild type and its absence in the cured P. vulgaris suggested that the resistance were plasmid mediated.

Insulinoma.

A case of insulinoma who had episoic bizarre behaviour is presented here. Pre-operative fasting and two hour post-prandial blood sugar values indicated hypoglycemia with inappropriately high insulin levels. USG and CT scan of the abdomen revealed a tumor of head of the pancreas. The tumour was enucleated surgically. Histopathological examination confirmed the origin as islet cells. The post-operative blood sugar and insulin levels were found to be in normal range. Since insulinoma is a rare pancreatic tumor, differential diagnoses along with a brief review of the literature is also presented.