Recommendations to scale up dietary diversity data at household and individual level in India.

BACKGROUND AND AIMS: An attempt to recommend scale up of dietary diversity data at household and individual level for improving the food and nutrition security, the study was conducted with the objective to explore the dietary diversity (DD) and its associated risk factors among reproductive age women in India. METHODOLOGY: A total of 5,48,806 women aged 15-49 years were asked how often they consume various types of food groups (daily, weekly, occasionally, or never). Association between adequate DD and its covariates such as individual and household were measured by using logistic regression. RESULTS: Most of the population consumed dark green leafy vegetables, milk/curd and pulses/beans. Only 1.7% of women consumed diet with adequate diversity or five or more food groups. Women's educations, gestation status, wealth status, sex of household head, household size, religion, place of residence and land ownership were significantly associated with adequate DD. The percentages of population with adequate DD varies from 7% to <1% in different states of India which shows that good-quality-diet is a major issue in entire country. CONCLUSION: There is an urgent need of programs focused on availability of food with maximum diversity at minimum cost in order to reduce maternal and child mortality in India. To reduce geographic variation in achieving adequate DD, new approaches are required in developing multiple interventions to address major preventable causes of DD. Individual state government should also take serious measure to improve the consumption of variety of food groups.

Prosthetic aortic valve dehiscence following infective endocarditis by a rare bacterium - Pandoraea pnomenusa.

Late prosthetic valve endocarditis (PVE) is a life-threatening condition, commonly caused by bacterial organisms such as staphylococci, streptococci, or enterococci. Infrequently, it can be caused by rare organisms. We hereby report a case of late PVE of the aortic valve, due to a rare gram-negative bacterium Pandoraea pnomenusa. It is the first reported case of PVE caused by this particular organism. The patient had infective endocarditis-induced prosthetic valve dehiscence, severe aortic regurgitation, and shock, which was managed with appropriate antibiotics and supportive medical treatment. .

Iodine Deficiency during Preconception Period of Adolescent Girls Residing in a District of Rajasthan, India.

BACKGROUND: In India, iodine deficiency (ID) still remains a serious concern even after five decades of enormous efforts. ID during the preconception period of adolescent girls may negatively affect future neonates, resulting in neonatal hypothyroidism. Hence, the present study was conducted to assess the prevalence of goiter and associated factors among adolescent girls in a poor socioeconomic district of Rajasthan. METHODOLOGY: A cross-sectional study was conducted during January-March 2015 in Tonk district of Rajasthan. A total of 1912 adolescent girls were selected from thirty schools using population proportionate to size sampling. Adolescent girls were clinically examined for thyroid using palpation method. Casual urine (n = 344) and salt samples (n = 370) were collected from a subgroup of girls for the estimation of urinary iodine concentration (UIC) and iodine content in salt, respectively. RESULTS: The overall goiter prevalence was 15.3% (95% confidence interval 13.6%-16.9%) and the median UIC was 266 µg/l (interquartile range: 150-300 µg/l) among 1912 adolescent girls (age, 15.7 ± 1.4 years). Around 16.8% of the families of adolescent girls were consuming salt with inadequate iodine (<15 ppm). Goiter prevalence was statistically significantly different with respect to age groups (P = 0.03). There was no statistically significant difference in goiter prevalence with respect to iodine content of salt (P = 0.98) and UIC (P = 0.41). The median UIC increased with an increase in consumption of iodine content of salt from inadequacy to adequacy (P = 0.15). CONCLUSION: Adolescent girls, residing in an underdeveloped district, are in the transition phase from mild ID (goiter prevalence 15.3%) to iodine sufficiency (median UIC 266 µg/l).

Prevalence of goiter and associated factors among pregnant mothers residing in a district with poor socioeconomic status in Rajasthan state, India.

BACKGROUND: National survey documented that none of the Indian state is free from iodine deficiency (ID). Hence, the study was conducted with the objective to assess prevalence of goiter and associated factors among pregnant mothers (PMs) in a backward district of Indian state, Rajasthan. METHODS: A cross-sectional survey was conducted during January to March 2015. Multistage random sampling was utilized to select PMs. A total of 1,183 villages were enlisted with their respective population, and 30 villages were selected using population proportionate to size sampling. Subjects were included from a cluster till the numbers reached to 17. PMs were clinically examined for goiter by palpation method. Casual urine (n = 226) and salt samples (n = 220), were collected from a subgroup of subjects, and iodine concentrations were analyzed by using wet digestion and iodometric titration methods, respectively. RESULTS: The prevalence of goiter was found to be 14.2% (95% CI; 11.2-17.2). Goiter prevalence did not significantly differ with respect to trimesters of pregnancy (P = 0.09), iodine content in salt (P = 0.8), and urinary iodine concentrations (UIC, P = 0.69). The median UIC was 174 µg/L (IQR; 116-300 µg/L), which indicated adequate iodine intake. There was higher prevalence of goiter in PMs consuming salt with inadequate iodine than those with adequate, which was not significant (P = 0.8). Goiter prevalence was also insignificantly higher among PMs with UIC <150 µg/L than those with UIC ≥150 µg/L (P = 0.69). CONCLUSION: The study population is in transition phase from mild ID (goiter prevalence 14.1%) to sufficiency (median UIC 174 µg/L).

Preparation and in vitro characterization of solid dispersion floating tablet by effervescent control release technique with improved floating capabilities.

In this Research, an effort has been done for the development of effervescent controlled release floating tablet (ECRFT) from solid dispersions (SDs) of diclofenac sodium (DS) for upsurge the solubility and dissolution rate. ECRFT of DS was prepared by using SDs of DS and its SDs prepared with PEG as carrier using thermal method (Simple fusion). SDs of DS were formulated in many ratio (1:1, 1:2, 1:3 and 1:4). Prepared SDs was optimized for its solubility, % drug content and % dissolution studies. Tablets were formulated by using optimized SDs products and all formulation was evaluated for various parameters. A clear rise in dissolution rate was detected with entirely SD, amid that the optimized SD (SD4) was considered for ECRFT. Among all the tablet formulations, its F3 formulation was better in all the terms of pre compression and post compression parameters. It had all the qualities of a good ECRFT, based on this F3 formulation was selected as the best formulation. Data of in vitro release was fitted in several kinetics models to explain release mechanism. The F3 formulation shows zero order release. From this study we can concluded that ECRFT containing SDs of DS can be successfully used for achieving better therapeutic objective.

Status of iodine deficiency among pregnant mothers in Himachal Pradesh, India.

OBJECTIVE: Iodine is an essential micronutrient needed for the production of thyroid hormones. Pregnant mothers who are deficient in iodine provide less iodine to the fetal thyroid. This results in low production of thyroid hormones by the fetal thyroid, thereby leading to compromised mental and physical development of the fetus. The current study aimed to assess the current status of iodine nutrition among pregnant mothers in Himachal Pradesh, India, a known endemic region for iodine deficiency. DESIGN: Three districts, namely Kangra, Kullu and Solan, were selected. SETTING: In each district, thirty clusters (villages) were identified by utilizing the population-proportional-to-size cluster sampling methodology. In each cluster, seventeen pregnant mothers attending the antenatal clinics were included. SUBJECTS: A total of 1711 pregnant mothers (647 from Kangra, 551 from Kullu and 513 from Solan) were studied. Clinical examination of the thyroid of each pregnant mother was conducted. Spot urine samples were collected from ten pregnant mothers in each cluster. Similarly, salt samples were collected from eleven pregnant mothers in each cluster. RESULTS: Total goitre rate was 42·2 % (Kangra), 42·0 % (Kullu) and 19·9 % (Solan). The median urinary iodine concentration was 200 µg/l (Kangra), 149 µg/l (Kullu) and 130 µg/l (Solan). The percentage of pregnant mothers consuming adequately iodized salt (iodine content of 15 ppm and more) was found to be 68·3 % (Kangra), 60·3 % (Kullu) and 48·5 % (Solan). CONCLUSION: Pregnant mothers in Kullu and Solan districts had iodine deficiency as indicated by a median urinary iodine concentration less than 150 µg/l.

Increase in iodine deficiency disorder due to inadequate sustainability of supply of iodized salt in District Solan, Himachal Pradesh.

Himachal Pradesh is a known endemic area for iodine deficiency disorders. A study was conducted in district Solan with the objective of assessing the prevalence of iodine deficiency disorders in school-age children. Thirty clusters were selected by using the probability-proportionate-to-size cluster sampling methodology. Clinical examination of the thyroid of 1898 children in the age-group of 6-12 years was conducted. Urine and salt samples were collected. The total goiter rate was found to be 15.4%. Median urinary iodine excretion level was 62.5 µg/l. Only 39% of the salt samples had iodine content of ≥15 ppm. Mild iodine deficiency was present in the subjects studied.