Detection and comparison of fetal malnutrition by CANSCORE and other methods.

Background: Objective of current study was clinical assessment of nutritional status of neonate using CANSCORE and comparison with other methods of determining fetal malnutrition. Design: Cross sectional study. Setting: Tertiary care hospital. Study subjects: 384 live born singleton neonates with known gestational age and no major congenital malformation. Methods: Birth weight, length, midarm circumference and head circumference recorded in new-borns. Ponderal index and mid arm to head circumference ratio was calculated. Clinical assessment of nutritional status was done on the basis of CANSCORE and compared with other methods. Results: CANSCORE <25 separated 67.71% of the babies as well-nourished and 32.29% as malnourished. Weight for age and MAC/HC classified nearly 70% of babies as well-nourished and 30% as malnourished. Also Ponderal index classified 75.52% the babies as well-nourished and 24.48% as malnourished. Conclusion: CANSCORE may be a simple clinical index for identifying fetal malnutrition and for prediction of neonatal morbidity associated with it, without the aid of any sophisticated equipments.

Biomass Fuel Use and Risk of Cataract: Systematic Review and Meta-Analysis.

Aims: There is an increasing recognition of the putative association between the use of biomass fuels and the risk of cataracts. However, the exact strength of this association is currently unknown. Our aim was to synthetically quantify the association between biomass fuel use and cataract. Study Design: Systematic review and meta-analysis. Methodology: Using results from the MEDLINE®, Scopus®, Web of Science® and Google® searches, we conducted a random-effects meta-analysis of the published studies. We also conducted subgroup meta-analyses, meta-regressions and sensitivity analyses to determine the contribution of potential confounders to between-study heterogeneity which was measured by the tau-squared and I2 statistics. Summary effect sizes (SES) were estimated using the DerSimonian and Laird method and the 95% confidence intervals (CI) and 95% prediction intervals (PI) were also estimated. Publication bias was examined using funnel plots and Egger’s test. Results: In spite of significant between-study heterogeneity (I2 70%, p=8.1x10-5), biomass fuel use was associated with a significantly increased risk of cataract (SES 2.12; 95% CI 1.61-2.80; 95% PI 0.88-5.09). Age-, gender- and other methodological differences did not significantly contribute to between-study heterogeneity but Indian studies showed a statistically significant association between biomass fuel use and cataract. Statistically homogeneous studies (n = 8) showed an SES of 2.01 (95% CI and PI 1.67-2.41). Conclusion: Synthetic evidence from observational studies indicates that biomass fuel use may increase the risk of cataract. Public health initiatives aimed at avoidance of biomass fuel use may reduce the burden of cataracts especially in settings where biomass fuels are commonly used.

Effect of indoor air pollution during cooking on peak expiratory flow rate and its association with exposure index in rural women.

Routine exposure to domestic cooking fuels is an important source of indoor air pollution causing deterioration of lung function. We conducted a community based cross-sectional study in 760 non-smoking rural women involved in household cooking with four types of cooking fuels i.e. Biomass, Kerosene stove, Liquid Petroleum Gas (LPG) and Mixed (combination of two and more cooking fuels). Peak Expiratory Flow Rate (PEFR) less than 80% of the predicted was considered as abnormal PEFR. The overall prevalence of abnormal PEFR was found to be 29.1% with greater predominance among biomass fuel users (43.3%) with high risk ratio (1.86) as compared to kerosene (0.63), LPG (0.75) and mixed (0.66) fuel users. However the pair wise comparison of different groups of cooking fuels by Marascuilo procedure reported significant differences within different groups except kerosene - mixed group. The study also demonstrated a negative correlation between observed PEFR and exposure indices in different cooking fuels (r=–0.51). Our results indicate that prolonged exposure to cooking fuels particularly biomass fuels as a source of cooking adversely affects PEFR in nonsmoking rural women.

Landscaping biostatistics education in India.

Biostatistics plays an important role in measuring, understanding, and describing the overall health and well-being of a population. Biostatistics as a subject evolved from the application of statistics in various research aspects of biology, biomedical care, and public health. However, with a recent increase in number of health and pharmacy related research, the demand for trained biostatisticians is also increasing. The present paper is an attempt to undertake a situational analysis of biostatistics education in India. A systematic, predefined approach, with three parallel strategies was used to collect and assemble the data regarding training in biostatistics in India. Our study results show that there is paucity of programs providing specialized training in biostatistics in India. Only about 19 institutions in India are offering various courses in biostatistics/medical statistics/health statistics/biometry. It is important to look into the current capacity building initiatives in this domain. Some other means for giving importance to biostatistics could be by making it a separate branch/specialization in a majority of the institutions, particularly in medical colleges.

Urban-Rural Differences in Menstrual Problems and Practices of Girl Students in Nagpur, India.

Menstruation in adolescent girls is often associated with menstruation related problems and poor practices. The study was planned to investigate the menstrual related problems and menstrual practices among school going adolescent girls. The study was a community based cross sectional study in a girls’ school in Nagpur. Majority of menstrual practices were significantly better in urban girls as compared to rural girls (P<0.05). Majority of the girls (71.83%) had at least one problem related to menstrual cycles. There was a significant difference in proportion of menstrual problems in rural and urban girls (P<0.01). Menstrual problems are a common source of morbidity in this population.