Secular Trends in Prevalence of Overweight and Obesity over a Decade in Urban and Rural South Indian Children Integrated with Geographic Information System

Context: The globalization in the process most of the rural sectors are also upgrading technically with digitalization with more availability of smart phones and gaming along with the refined food influences on the present?day children is causing a trend of overweight among the children. Aims: To arrive at the prevalence of overweight and obesity considering the Indian Academy of Pediatrics (IAP) cut?offs for growth standards among children aged 12 years from the rural and urban areas of Mysuru District. Methods and Material: The present program was the third large scale community intervention project carried out including the 7 talukas of Mysuru District which focused on the measurement of the Body mass index (BMI). In this phase between the year 2019 and 2020 anthropometric measurements were undertaken in 1602 urban and rural children aged 12 years from government?funded and privately?funded schools of Mysuru District. Statistical Analysis Used: The results were analysed statistically using SPSS for Windows (version 23.0) and the t?test, Chi?square test and proportion tests, P value were reported. Results: As per the IAP reference ranges the prevalence of obesity was 5.5% and overweight was 7.1% among children of Mysuru District. Conclusions: We report that this increase was significantly higher in girls than boys. There was an increasing trend in rural sectors; however, the obese children were more predominantly distributed among the urban sectors. This calls for a precise preventive measure to fulfil the goal of the World Health Organization (WHO) to control prevalence of childhood obesity by the year 2022

Maternal pregnancy associated plasma protein-A (PAPP-A) and uterine artery Doppler changes as predictors of pre-eclampsia: a prospective observational study from a teaching hospital in Mysore, Karnataka, India

Background: Hypertensive disorder affects 10-12% of pregnancies. Identifying women, who are at risk is conducive to prompt gestational management. PAPP-A is a protein complex produced by the developing trophoblasts. Low levels of PAPP-A at 10–14 weeks is a marker of impaired placentation and a smaller placental mass. Doppler imaging permits non-invasive evaluation of the uteroplacental circulation and is invaluable in the management of high-risk pregnancies. The uterine artery Doppler screening identifies patients at risk for developing preeclampsia. To study the association of PAPP-A and the uterine artery Doppler changes as predictor of pre-eclampsia in pregnant women at 11-14 weeks of gestation.Methods: This was a prospective study of 150 pregnant women presenting at 11-14 weeks of gestation for a prenatal check-up. After considering the inclusion and exclusion criteria, serum samples for PAPP-A were assayed. Ultrasound Doppler was used to obtain uterine artery flow velocity waveforms and mean pulsatility index and resistance index of uterine arteries were calculated. Cases were followed up till term and observed for development of pre-eclampsia.Results: 48.6% had low serum PAPP-A levels, in which 77% developed PE. The Mean PI and RI is 2.34±1.16 and 0.58±0.1 respectively. 30% women with abnormal PI values and 24% of women with abnormal RI values developed PE.Conclusions: The combination of maternal history with low serum PAPP-A levels and abnormal uterine artery Doppler at 11-14 weeks can be used as predictor of pre-eclampsia.

Spontaneous Urinary Bladder Perforation As A Cause Of Recurrent, Progressive Ascites With Multiorgan Dysfunction Syndrome

Spontaneous rupture of the urinary bladder wall is a rare complication that may lead to intraperitoneal accumulation of urine and is mistaken for ascites from other causes. This often leads to repeated and inconclusive diagnostic tests. Here, we report the case of a 60-year-old female, with a past history of cervical cancer, who presented with recurrent episodes of pain abdomen and breathlessness over 1 year period. She was hospitalized multiple times and found to have ascites. Ultrasound and computed tomography scan of the abdomen along with an ascitic fluid analysis were done at each admission, which were inconclusive as to the cause of the ascites. A diagnostic laparoscopy to rule out peritoneal metastases showed perforation of the urinary bladder wall with intraperitoneal urine leakage. Bladder wall repair was done the following which the patient recovered uneventfully.

Study of post-operative pain incidence in patients with inguinal hernioplasty

Background: Continued chronic pain after inguinal hernioplasty is the most important current issues. Factor responsible for pain development mechanisms are still unclear. Influence of age as well as other factors is still controvertible. Objectives: To study the incidence of occurrence of postoperative pain in relation to age and duration of hernia. Materials and methods: A cross sectional prospective study includes 220 patients between 18-80 years. Participants willing for scheduled follow up of 7th, 30th, 90th and 180th day were considered for this study. All patients were explained for surgery and probable complications. Results: Study of chronic pain had shown that 12 (10.9%) had mild pain, 2 (1.4%) had mild pain but occasional taking drugs and 2 (1.4%) had moderate pain but not taking any drug on 90th day. On 180th day, 7 (6.4%) had chronic pam of which 6 (5.5%) had mild pain while 2 (0.9%) patients had moderate pain but none of the patients were taking any analgesics. Conclusion: There was significant association between age of the patients and pain. Chronic pain and the severity of pain decrease with advancing age.

Clinical features and management of amoebic liver abscesses in a rural teaching hospital – A cross-sectional study, Sangareddy

Background: Liver abscess is a major health problem in tropical and subtropical regions. Aim: The present study aimed to evaluate the clinical profile, management of amoebic liver abscess patients. Materials and methods: A cross-sectional study was conducted in Department of Surgery MNR Medical College Hospital, Sangareddy over a period of 2 years from June 2014 to July 2016. A total of 100 patients with liver abscess were included in this study. Clinical examination, detail case history, ultrasonography reports, case management and outcome were recorded during study. Results: Among 100 patients, 88 were males and 12 were females. Majority of cases were belongs to the age group of 30 -40 years (45%). Most common clinical features of amoebic liver abscess was fever (89%), abdominal pain (78%) and diarrhoea (37%). The major signs were hepatomegaly (87%), right lobe abscess (68%), left lobe abscess (36%) and pleural effusion (18%). Mortality rate was 3% out of 100 patients.

World health organization-body mass index for age criteria as a tool for prediction of childhood and adolescent morbidity: a novel approach in southern Karnataka, India

Health status of children and adolescents is determined to a larger extent by their nutritional status. There are no published studies available on the influence of thinness on childhood morbidity using new World Health Organization-body mass index [WHO-BMI] for age criteria. This cross-sectional study was conducted in primary, high schools, pre-university and degree colleges at southern Karnataka for a period of 1 year. Majority 6924 [53.6%] were in the age group of 15-19 years with the mean age of 14.2 +/- 3.1 years. 6167 [47.7%] were males and 6749 [52.3%] were females. As per WHO growth standards for children between 5 and 19 years, taking BMI for age criteria into account, 9092 [70.4%] subjects were found to be normal, 3660 [28.3%] thin and 164 [1.3%] overweight/obesity. 8224 [63.7%] subjects were suffering from some sort of morbidities. Mean morbidities rank for subjects with thinness was found to be significantly higher compared with normal and overweight/obese subjects. Thinness was found to be the major predictor of morbidity age, sex and residing in rural areas. Magnitude of thinness among children and adolescents was 28.3%. BMI for age criteria was found to be a significant predictor of childhood and adolescent morbidity