Dietary intake of trace elements and minerals among adults in underprivileged communities of rural Rajasthan, India.

In developing countries, data on dietary intake of trace elements, and even major elements, is limited. The dietary intake of 1277 adults of underprivileged communities of rural Rajasthan was studied. Intake was assessed by the 24-h dietary recall method from which the average daily intake of macronutrients, some major elements, and trace elements was computed. The zinc intake was 69.7 and 49.7% of the recommended daily allowance in males and non-pregnant non-lactating females, respectively. The intakes of manganese and molybdenum were adequate when compared with the suggested daily intakes. Element intake during the physiological stress conditions of pregnancy and lactation was 42.4 and 53.0% for zinc, 36.5 and 29.8% for copper, and 21.0 and 23.1% for calcium, respectively. The intake of iron was less than 20 mg/day for all female subjects studied. No significant difference was observed in the trace element intake of subjects with different grades of malnutrition. Assessment of dietary intake may provide a useful indication of the possible status of major and trace elements among adult subjects.

Status of growth monitoring activities in selected ICDS projects of Rajasthan.

PIP: Growth monitoring (GM) is conducted in India on a regular basis as part of the Integrated Child Development Service (ICDS) scheme operative in over 3900 administrative blocks. GM can serve as a focal point for offering child and family welfare services and provide data for the assessment of a community's nutritional status. To evaluate GM knowledge and practices among Anganwadi workers (AWWs), a survey of 120 AWWs from ICDS projects in Jaipur, Ajmer, Udaipur, Bharatput, and Bikaner districts was conducted. 67% of AWWs had worked in the ICDS program for more than 5 years and 88% had completed primary school. Although 88.3% received pre-placement training and 67.5% participated in subsequent in-service training, GM was not included. Growth charts were available to 83.3% of AWWs, but 75% were unable to use weighing scales properly. Half plotted weights incorrectly on the chart, and 57% were unable to interpret a flattened growth curve. 90% lacked knowledge of the sequence of steps involved in GM. Only 33% conducted GM, primarily to identify malnourished children. A record review indicated the weights of only 60% of children were being recorded regularly. 40% of the severely malnourished children were not being weighed regularly. Mothers' participation in improving their child's nutritional status was not solicited. These findings suggest that the potential of GM activities in India is being impeded by inadequate knowledge and training on the part of AWWs, faulty equipment, and a lack of community participation.^ieng

Nutrient intake amongst adolescent girls belonging to poor socioeconomic group of rural area of Rajasthan.

OBJECTIVE: To assess the nutrient intake of adolescent girls belonging to low socio-economic group of rural Rajasthan. DESIGN: Cross-sectional, using probability proportionate to size, cluster sampling method. SETTING: 18 villages of Jaipur district. SUBJECTS: 941 adolescent girls of age 10-18 yr. METHODS: Anthropometric measurements for height, weight, mid-upper arm circumference, triceps skin fold and chest circumference; 24 h recall method to assess nutrient intake. Nutrient intake was compared with Indian Council of Medical Research recommended dietary allowances. RESULTS: The diets were deficient in calories by 26 to 36%, and in proteins by 23 to 32%. Nutritional status as assessed by body mass index revealed that 8.1% of adolescent girls suffered from chronic energy deficiency (CED) grade I, 6.6% grade II CED, and 78.8% grade III CED. About 73.7% of subjects suffered from anemia and 43.6% had signs of vitamin B complex deficiency. CONCLUSIONS: Intervention strategies are needed to improve the dietary intake of adolescent girls so that their requirements of energy, protein, vitamins and minerals are met.

Assessment of vitamin A deficiency indicators in urban slum communities of National Capital Territory of Delhi.

A study was conducted to assess the magnitude of Vitamin A deficiency in two urban slum communities of Delhi. Biological and ecological indicators suggested by WHO/UNICEF 1992, were used. Five hundred and fifty two children in the age group of 0-5 years were studied. Data was collected on socio- economic status, breastfeeding pattern, immunisation, morbidity profile and presence of vitamin A deficiency. Height and weight were recorded using standard techniques. Vitamin A intake of subjects was assessed using food frequency and 24 hr recall methods. It was found that 63.9% children >1 year of age were fully immunised. Colostrum was received by only 28.1% of children. Only 32% infants <4 months of age were exclusively breastfed. Breast milk was being received by 93.5% children <6 months old. 18.1% children had diarrhoea within last 15 days of survey. 7.1% children gave history of helminthic infestations. 47.8% children <3 yrs were stunted while 26.9% were wasted. None of the children had Bitot's spots but nightblindness was observed in 1.2% children. 35.7% children (12-24 months) consumed vitamin A rich foods less than once A week. The frequency of consumption of vitamin A rich foods was significantly higher in winter as compared to summer and rainy seasons (p<0.05). The mean daily vitamin A intake for 6-11 months and 12-71 months old children was 1187±755 m g and 847±111m g respectively. It was concluded that moderate vitamin A deficiency was present in the study area.

Use of milk based commercial weaning foods amongst scheduled caste communities in Haryana.

PIP: Although breast milk is the best food for an infant until age 4-6 months, there has been a recent trend in urban areas to increasingly provide milk-based commercial weaning foods (CWF). This study was conducted to assess the use of CWF among the scheduled caste population in two districts of Haryana State. The data presented are part of a larger study on breast feeding and weaning practices in Haryana. 818 children aged 0-35 months from 44 villages were included in the study. 68 had received milk-based CWF at the time of survey or sometime previously. There was no significant difference between the socioeconomic characteristics of children who were given milk-based CWF and those who did not receive it. 36% of women who used CWF reported having done so because of insufficient lactation, while 37% cited the high price of animal milk. Family members were the most important source of advice for initiating the use of CWF, followed by medical functionaries. 65% of all children surveyed received home-based weaning foods. The percentages of children receiving such foods in the age groups 0-5, 6-11, 12-17, 18-23, 24-29, and 30-35 months were 1%, 56%, 77%, 97%, 95%, and 96%, respectively. Only 73.7% of children older than age 3 months were breastfed together with CWF.^ieng

An epidemiological study of prevalence of pain in head & neck cancers.

This study was undertaken on 117 consecutive patients referred to a head and neck oncology clinic at a major hospital in New Delhi. 89.5 per cent patients were in clinical stage III or IV at the time of referral. The prevalence of pain was 83.8 per cent with a mean pain duration of 6.2 +/- 5.9 months and a mean pain intensity of 5.0 +/- 2.7 on a modified numerical rating scale ranging from 0 to 10. The mean intensity of pain was not significantly different for age groups or stage of the disease but patients with oro-pharyngeal cancers had significantly higher pain scores than patients with hypopharyngeal cancers (4.6 +/- 3.0 vs 2.9 +/- 2.5, P < 0.05).

Nutritional status of married adolescent girls in rural Rajasthan.

Adolescence is period of rapid growth and development. The present study was undertaken to assess the nutritional status of 941 adolescent girls, aged 10-18 years belonging to Scheduled Caste communities in rural Rajasthan, using the probability proportionate to size sampling procedure. Data on 93 married adolescent girls was analysed in detail. Nutritional status of the subjects was assessed by anthropometry, dietary intake and by clinical examination of nutritional deficiency disorders. Anthropometric measurements were recorded for height, weight, chest circumference, MUAC and TSF using standardised techniques. On comparing the present study's data with ICMR's study data (1956-65) it was found that there has been a significant improvement in the height, weight and chest circumference of the adolescent girls but the values were below the well-to-do group study data. Dietary intake was assessed by 24 hours recall method. The dietary intake was compared against ICMR's RDA. It was found that the diets were deficient in calories by 30 to 40% in proteins by 25 to 37%, by 39 to 55% in iron and by 10 to 34% in vitamin A. 78% of the subjects suffered from various grades of anaemia and 40% of the subjects had B-complex deficiency.

Breast-feeding practices in Schedule Caste communities in Haryana state.

A study was conducted to assess exclusive breast-feeding, continued breast-feeding, bottle-feeding, predominant breast-feeding, timely complementary feeding and other breast-feeding practices in 818 children in the age group of 0-3 years belonging to the Schedule Caste communities of Haryana. The exclusive breast-feeding rate was 0.15 and the predominant breast-feeding rate 0.75 in children < 4 months. Timely complementary feeding rate was 0.42. The continued breast-feeding rate at 1 year and 2 years was 0.84 and 0.58, respectively. The bottle-feeding rate, ever breast-fed rate, timely first-suckling rate and exclusive breast-feeding rate by mother were 0.09, 1.0, 0.0 and 0.15, respectively. The median duration of breast-feeding was 16 months.

PIP: Data on 818 children aged 0-3 years belonging to the schedule caste population from 44 villages in Faridabad and Hisar districts of Haryana State, India, were analyzed to determine the current status of breast feeding practices in this underprivileged population. All the children had been breast fed. The exclusive breast feeding rate during the first 4 months of life was only 15%. Even though water intake increases the risk of diarrhea, mothers supplemented breast feeding with water in 85% of children to improve hydration status. 98% of the children were given ghutti (an herbal decoction) to improve their digestive abilities. The median duration of breast feeding was 16 months. 2% of infants aged less than 1 year received infant formula. Overall, bottle feeding rate among this age group was 9%. 75% of infants aged less than 4 months were predominantly breast fed. 42% of infants aged 6-9 months received supplementary feedings. 84% of children aged 12-15 months were still breast feeding at 12 months. The timely first-suckling rate was zero. Other baseline surveys should be conducted in other areas of India so breast feeding promotional programs can be evaluated.

Comparison of piroxicam and acetylsalicylic acid for pain in head and neck cancers: a double-blind study.

This double-blind, placebo controlled study compared the analgesic efficacy of piroxicam with acetylsalicylic acid (ASA) in patients having continuous pain with advanced head and neck cancers. They were randomly divided into two groups of 25 patients each; 36 of these 50 patients completed the study. After four days of treatment, there was a significant reduction in a modified numerical rating scale (NRS) of pain in the piroxicam group as well as in the ASA group. There was a concomitant increase in the hours of sleep in the piroxicam group and in the ASA group. The decrease in NRS and the increase in sleeping hours was not statistically significantly different between the two groups. Patients receiving piroxicam had a low incidence of upper gastrointestinal side-effects compared with those receiving ASA. The results of this study suggest that piroxicam can be used as first line treatment in place of ASA in patients with head and neck cancers suffering from moderate to severe pain. The advantages are less frequent dosing, better patient compliance and few side-effects.