Physical Activity of School-Going Adolescents During the COVID-19 Pandemic: A Natural Experiment Study.

OBJECTIVE: To assess the impact of the COVID-19 pandemic associated governmental restrictions on physical activity and sedentary behavior of school-going adolescents in India and its effect on nutrition and health status. METHODS: This was a before-after natural experiment study that recorded paired data of 449 (206 boys) school-going adolescents. COVID-19 related governmental measures (March 24, 2020 till February 2021) were taken as the natural experiment. The change in proportion of adolescents who met the recommended amount of physical activity guidelines and change in sedentary and dietary behaviors and body mass index (BMI) were compared. RESULTS: The proportion of adolescents performing adequate physical activity decreased from 33.9% to 30.7% (OR 1.2,95% CI 0.9,1.6) during the pandemic. Fruit intake increased by 8.1% during the pandemic while junk food intake decreased by 17% during the pandemic. Mean (SD) BMI z-scores increased from -0.7 )1.4) to -0.5 )1.3) (P < 0.001). CONCLUSION: While there was a small decrease in the proportion of physically active adolescents during the pandemic, a shift towards healthier dietary habits was seen.

Translation and Validation of Hindi Version of Adolescent Peer Relation Instrument for Bullying Victimization.

OBJECTIVES: To translate and validate Hindi version of Adolescent Peer Relation Instrument (APRI) and to evaluate burden of bullying victimization among school-going adolescents. METHODS: A school-based cross-sectional study was performed from July 2021 to June 2022 on 9th-12thclass students. Adolescent peer relation instrument was used to evaluate bullying victimization. Reliability and validity of tool, prevalence and strength of association was analyzed by appropriate statistical methods. RESULTS: Bullying and victimization were present in 70.8% and 62.9% adolescents, respectively. Total bullying was significantly less in students <16 years of age (OR 0.995, 95% CI 0.483, 2.049) and those with less than three friends (OR 0.816, 95% CI 0.482, 1.383). Total bullying and total victimization was significantly more in boys (OR 1.993, 95% CI 1.281, 3.099 for bullying and OR 1.584, 95% CI 1.047, 2.397 for victimization). Cronbach's alpha for bullying and victimization was 0.89 and 0.897, respectively. Convergent validity between items of different subscales of bullying and victimization was observed (r value > 0.7) except for social bullying and social victimization. There was weak correlation between subscales of bullying and victimization suggestive of discriminant validity (r value < 0.4). CONCLUSIONS: The Hindi version of APRI has a good reliability and construct validity. About three-fourths and two-thirds of adolescents were involved in bullying and victimization, respectively, with a few identified risk factors. Special counselling sessions at schools must be implemented for children involved in bullying.

Prevalence and risk factors for neurocysticercosis in children with a first-onset seizure in rural North India.

BACKGROUND: Neurocysticercosis (NCC) is a parasitic infection acquired by consuming food and water contaminated by the faeces of a Taenia solium tapeworm carrier. It is an important cause of acquired seizures and also the common identifiable cause of new-onset seizures in children. METHODS: A hospital-based prospective cross-sectional study of NCC was undertaken in a medical college in north-west India. All patients aged 1-15 years admitted to the paediatric emergency room with a first-onset seizure were selected.NCC was diagnosed and staged on the basis of MRI findings. A structured, pretested schedule was administered to each patient's parent for analysis of risk factors for NCC. RESULTS: Of 79 patients with first-onset seizure, 43 (54.4% were diagnosed with NCC based on MRI findings. The association of NCC with age and pig-rearing near the patients' homes was statistically significant (p = 0.01 and 0.02, respectively). The association between NCC and other risk factors such as gender, religion, father's occupation, parents' literacy, source and storage of drinking water, the washing and peeling of fruit and vegetables and distance of refuse disposal from residential areas was not statistically significant. Although open defaecation is an important risk factor for transmission of NCC, there was no significant association with NCC. CONCLUSION: In India, NCC is a common cause of first-onset seizure. The major risk factors are poor environmental sanitation and poor food and drinking water hygiene. NCC can be controlled and prevented by generating awareness of hygienic consumption of food and water and the provision of good sanitation.

Hepatitis C, a silent threat to the community of Haryana, India: a community-based study.

BACKGROUND: Hepatitis C is a global public health problem. As many as 12 million people may be chronically infected in India and most are unaware of it. AIMS: To determine the incidence of hepatitis C in the Ratia block of the Fatehabad district, Haryana, India. METHOD: This cross-sectional study was carried out by house-tohouse visits over 2 weeks. After obtaining written consent, a blood sample was drawn from suspected cases by a laboratory technician maintaining all necessary safety precautions and sterilization. RESULTS: Of the samples, 1,630 (22.3 per cent) were found to be positive for hepatitis C by ELISA, 253 (15.5 per cent) patients were previously hepatitis C positive, and adults (21-60 years) were affected maximally (70.0 per cent). CONCLUSION: The study emphasises the need for public awareness campaigns at various levels and prevention of HCV infection. It also suggests the need to develop and strengthen evaluation methodology for the Integrated Disease Surveillance Project (IDSP).

Regression models to predict corrected weight, height and obesity prevalence from self-reported data: data from BRFSS 1999-2007.

BACKGROUND: Surveys such as the Behavioral Risk Factor Surveillance System (BRFSS) collect only self-reported data on height and weight to estimate obesity prevalence rates. Because of biased self-reporting of height and weight, obesity prevalence rates reported by these surveys are too low. OBJECTIVE: To develop regression models that can predict corrected height, weight and obesity prevalence from self-reported data, as well as to compare obesity prevalence rates based on self-reported and modeled data and test for trends in obesity prevalence by gender, age and race/ethnicity. DESIGN: Data from the National Health and Nutrition Examination Survey (NHANES) for the period 1999-2006 were used to develop regression models to predict corrected height, weight and obesity prevalence. Regression coefficients estimated from these models were used to predict corrected height, weight and obesity prevalence for BRFSS data for 1999-2007. RESULTS: Self-reported weights for males were higher by 0.1-0.2 kg and lower by about 1.25 kg than corrected weights for females. Underreporting of weights was lowest for Hispanics when compared with other race/ethnicities. In addition, underreporting of weight increased with an increase in body mass index. Self-reported heights for males were higher than corrected heights by about 2 cm, and for females, by about 1 cm. Overreporting of height increased with an increase in age. Self-reported obesity prevalence was 4.5-5.8% lower than corrected rates for males and by 4.4-5.1% for females. Underreporting of obesity prevalence increased with an increase in age. Obesity prevalence rates increased over time for each gender, race/ethnicity and age group for BRFSS data. CONCLUSION: Obesity prevalence calculated from self-reported data is too low and should be used with caution for health-care planning purposes. When it is not possible to have measured data, corrected heights and weights may be predicted by using models such as those presented by us from a relatively large data set that has both measured and self-reported data.

Health education at PHC level -- status and strategies.

PIP: The Government of India's National Health Policy emphasizes the importance of health education programs to primary health care. Implementation of this strategy was evaluated through both quantitative and qualitative methods among 32 multipurpose health workers, 5 health supervisors, 60 anganwadi workers, 32 adult education instructors, 73 school teachers, and 10 women's groups in Haryana, India. Despite the official emphasis on health education, this function is not included in the job descriptions of health workers, training is not provided, and locally relevant IEC materials are not available or distributed. Home visits focus mainly on family planning, deliveries, and malaria and rarely include a health education component. Management of health education is the responsibility of the Block Extension Educator, who failed to distribute many IEC materials or conduct training activities. 62.5% of health workers indicated they used IEC materials only once a month. Moreover, monitoring of health education activities was sporadic and incomplete. Work plans emphasize physical targets (i.e., number of meetings) rather than the quality of educational interventions. No operations research studies were conducted. Overall, these findings suggest a need for integration of health care delivery and communication activities, training of health workers in health education techniques, field evaluation of IEC materials, establishment of a system to provide field workers with feedback on their work, and greater use of mothers' groups and school-based programs for interpersonal communication.^ieng

Participatory health communication and action through women groups in rural areas.

Twelve women groups in 10 villages of block Beri were identified and activized through participatory health communication actions for mother and child development. Women could undertaken responsibilities on key health problems concerning mothers and children. In these villages over 58% of antenatal mothers now used home made clean packets for delivery and chose right place for delivery. Most of them (60%) now initiate breast feeding immediately after delivery as against 23% in the year 1988. Over 54% of women now drink chlorinated water and almost same proportion used sugar salt solution in diarrheal diseases. Thus women have become self reliant in chlorination of wells and pots as also in diarrheal diseases management. Practice of hand washing has been almost universalized.

Craniofacial growth in clefting from one month to ten years as studied by P-A headfilms.

Craniofacial growth of 64 children with a unilateral cleft of lip and palate, 32 children with a bilateral cleft of lip and palate, and 78 children with a cleft of palate only were studied at the ages of one month, three months, six months, one year, 18 months, two years, and annually till the age of 10 years. Nine width and 12 height measurements are obtained from the tracings of p-a X-ray headfilms and analysed. It was found that the cleft type differences were mainly restricted to the base line width, interorbital width, optic foramen width, basal maxillary width, interorbital height, optic foramen height, and gonial height. For all these measurements except basal maxillary width, the means are in the order BCLP greater than UCLP greater than CPO. For basal maxillary breadth it was UCLP greater than BCLP greater than CPO. Sex differences are restricted to base line width, basal maxillary width, bizygomatic width, interorbital height, and optic foramen height. For these width measurements, males have larger means than females. For the height measurements, females have larger means than males.

Cleft type and sex differences in craniofacial growth in clefting from one month to ten years.

Craniofacial growth of 145 children born with a cleft was studied by analyzing the sex and cleft-type differences for 11 linear dimensions and three angular relationships as observed on lateral x-ray headfilms. The sample consisted of 58 children with complete unilateral cleft of lip and palate (UCLP), 29 children with complete bilateral cleft of lip and palate (BCLP), and 58 children with cleft of palate only (CPO). None of these children had any syndrome at the time of birth. The growth was studied for the first postnatal decade. The data were analyzed by stepwise discriminant analysis and univariate analysis of variance. The results show that differences in cranial base size are associated with sex and not with cleft type. Differences in cranial base angle are associated with cleft-type but in case of females only. Face heights do not differ across cleft types but they do differ across sexes when CPO is involved. Cleft type differences are observed for midfacial depths and basifacial angle but sex differences are observed only when CPO is involved. The mandibular dimensions do not differ with cleft type. Gonial angle shows sex differences for BCLP only. The body length also varies with sex when CPO is involved.

Possible sex-discriminant variables in craniofacial growth in clefting.

In this investigation, 174 patients with orofacial clefts were examined for identification of possible sex differences in craniodentofacial measurements. The patients were selected from the longitudinal growth files of the H. K. Cooper Clinic. Records available for analysis were serial lateral cephalometric radiographs from the age of 1 month to 10 years. Patients were grouped by cleft type and sex within each cleft group (78 cleft palate only, 64 unilateral cleft of lip and palate, 32 bilateral cleft of lip and palate). Stepwise discriminant analysis of fourteen linear and angular craniofacial dimensions was used to identify those variables which contributed to sex differences within each cleft group over the growth/time intervals examined. Results suggested the possibility of sex-related differences in growth timing, that is, earlier maturation and growth in females in several craniofacial areas which did not appear to be related to the presence, absence, or type of cleft but which could possibly modify cleft-specific responses to treatment (cranial base dimensions, face heights). Other sex-related differences appeared to be more specifically related to known sex differences in original cleft type and severity (mandibular size and position, midfacial dimensions). The manner in which these various sex factors interface with environmental and therapeutic influences in producing the ultimate craniodentofacial morphology in a given sex and cleft type is discussed.

Craniofacial growth in different cleft types from one month to ten years.

This study is based on serial cephalometric radiographs from one month to ten years of 64 children with unilateral cleft lip and palate (UCLP), 32 children with bilateral cleft lip and palate (BCLP), and 78 children with cleft palate only (CPO). Eleven dimensions and three angles were measured in the cranial base, the midface, and the mandible. The 10-year period was divided into infancy (birth to one year), early childhood (one to six years), and mid childhood (six to ten years). Growth differences for each measurement at each age for the three cleft pairs (UCLP/BCLP, UCLP/CPO, and BCLP/CPO) were evaluated by analysis of variance. Cranial base was not affected by cleft-type in males, although sellar angle was found to be significantly larger in BCLP females. Upper face heights in BCLP were different from UCLP and CPO in both sexes. Midfacial depths Ptm'-ANS, Ptm'-A, and anterior segment of palatal length KR-ANS were different for each cleft type. The same was true for the basifacial angle S-N-A. The mandible was relatively unaffected by cleft-types.

Sex differences in craniofacial growth from one month to ten years of cleft lip and palate.

This study is based on serial lateral X-ray headfilms from one month to ten years for 64 children with unilateral cleft of lip and palate (UCLP), 32 children with bilateral cleft lip and palate (BCLP), and 78 children with cleft palate only (CPO). Measurements for eleven dimensions and three angles were obtained. These included measurements for the cranial base, facial heights, midfacial depths, and the mandible. The 10-year period was divided into infancy, i.e., birth to one year; early childhood, i.e., one to six years; and mid childhood, i.e., six to ten years. All measurements were evaluated on the basis of growth time and growth velocity. The shape of the cranial base as seen in the sellar angle was influenced by clefting whereas the size, i.e., the clival length and the anterior cranial base length were affected by sex. No sex differences were observed for the angle S-N-A. Face heights, midfacial depths, and mandibular body length were all found to be larger for males.

Fundus changes in incontinentia pigmenti (Bloch-Sulzberger syndrome): a case report.

A case of incontinentia pigmenti is reported with fundus changes in 1 eye. She had microaneurysms temporal to the macula, with an abnormal branch of inferior temporal vein. There was extensive retinitis proliferans in the upper temporal equatorial region, which showed leakage on fluorescein angiography.