ABSTRACT
OBJECTIVES: To determine the relationship between maternal nutrition and their breastfed infants' anthropometric measures during the first 14 weeks after delivery. METHODS: A prospective, observational study, comprising 200 mothers and their infants. The weight, length, and head circumference of the infants and the weight and dietary intake of the mothers were recorded at 6, 10, and 14 weeks. RESULTS: The relationship between weight gain in babies and calorie intake at 6, 10, and 14 weeks were significant (P value < 0.05). The relationship between weight gain in babies and protein intake at 6 and 10 weeks was not significant (P value at 6 weeks = 0.896, P value at 10 weeks = 0.127) but was significant at 14 weeks (<0.05). Mothers' weight gain during 14 weeks was significant (P value < 0.05). When mothers were distributed into four groups according to their calorie and protein intake for comparison (median value: calorie-2034 kilocalorie, protein- 78.7 grams), the weight, length and head circumference gain in infants and mothers' weight were significantly higher in Group I and Group II compared to Group III and Group IV with P value < 0.05 at 6, 10, and 14 weeks. CONCLUSIONS: Calorie intake was low in mothers when compared to RDA recommendations. Infants showed lower weight, length, and head circumference gain than WHO Child Growth Standards. There is a direct relationship between the maternal diet and anthropometric measures of their infants. During postnatal period, mothers showed an increase in weight, rather than the decrease that is usually expected.
ABSTRACT
BACKGROUND: Acanthosis nigricans (AN) is one of the signs suggestive of high insulin resistance (IR). IR is one of the mechanisms involved in pathogenesis of diabetes mellitus type-2 (DM Type-2). Thus, early detection of IR in children may allow us time to intervene well before the development of DM Type-2. In this study, 62% of children having AN had high IR. In children having both, AN and high body mass index (BMI), the incidence of IR was about 80%. This suggests that these easily detectable parameters alone can be useful in screening children at high risk of developing DM Type-2 in future. These simple criteria thus hold promise for use in high throughput screening programs for diabetes. CONTEXT: A pilot study conducted by the authors showed that children with AN have a high incidence of IR. The detection of IR in children may allow us time to intervene well before the development of DM Type-2. Detection of DM Type-2 by hyperglycemia may be too late to prevent the onset of microvascular changes. AIMS: This study aims to determine whether easily observable presence of AN can be used to screen for increased IR in children, and thereby to detect this important risk factor for DM Type-2. SETTINGS AND DESIGN: Cross-sectional, observational study. Two schools, one with children belonging to average economic background and the other, a residential school with children of affluent parents. Selection of children was done randomly. SUBJECTS AND METHODS: The study was conducted among 507 children in the age group of 10-18 years. Physical examination for the detection of AN, height and weight measurements, waist circumference, fasting plasma glucose, fasting plasma insulin, and lipid profile was done. Homeostatic model assessment of insulin resistance was calculated. STATISTICAL ANALYSIS USED: Data analysis was performed using descriptive statistics and inferential statistical methods. The association between categorical variables was done by Chi-square test. RESULTS: The presence of AN positively correlated with high IR, and when combined with increased BMI, the incidence rate of IR is 80%. CONCLUSIONS: AN can be used as a screening method to identify children at risk of DM Type-2-since those who have high IR have a high possibility of having DM Type-2 in future. Hence, early screening and simple, but effective interventional strategies can be instituted at this age, which may prevent or delay diabetes in the long run.
ABSTRACT
CONTEXT: Drowning is a major, but often neglected, public health problem. Drowning is the second leading cause of death from unintentional injuries, after road traffic injuries. According to the World Health Organization, 0.7% of all deaths worldwide (>500,000 deaths) each year are due to unintentional drowning. In India, very little is known about the epidemiology of drowning. There is almost no awareness or protocols to prevent drowning. OBJECTIVES: The objective is to study the prevalence, risk factors, and types of drowning among school children in the Malabar region. MATERIALS AND METHODS: A cross-sectional, population-based study by semistructured interview method was performed among 8433 school children of 5-15 years. STATISTICAL METHODS: The prevalence of drowning was calculated. Odds ratio was calculated and represented under 95% confidence interval. Risk factors were analyzed as frequency with percentage. RESULTS AND DISCUSSION: The total study population was 8433 students, comprising 4795 boys (56.86%) and 3638 (43.13%) girls. A total of 342 (4.06%) students had a history of drowning. These survivors were further interviewed. The prevalence of drowning was much higher compared to figures reported in literature. CONCLUSIONS: Contrary to the general perception, drowning is a common occurrence among children. Swimming skills have no role in the prevention of drowning. Public awareness regarding supervision of children and restricting unsupervised access of children to water bodies need to be emphasized.
