Intervention Study for Reducing Schoolbag Weights in Two Rural Schools in Maharashtra.

CONTEXT: Heavy schoolbags are reported worldwide including India. The prescribed safe upper limit was 10% of student bodyweight. AIMS: This intervention study explored (a) impact of awareness measures among stakeholders and (b) any systemic constraints for reducing bag loads. SETTINGS AND DESIGN: This is a two-stage intervention study following a 2016-2017 baseline study of schoolbag weights in two rural schools. SUBJECTS AND METHODS: The study involved 175 students (male: 79 and female: 96) from 8th to 9th standards. The intervention consisted of sharing the baseline findings of schoolbag weight, guidelines, and necessary measures for the same. Thefirst intervention involved creating awareness among teachers regarding the harmful effects and the second intervention involved students. Bag weights were recorded on digital luggage scale in prelunch sessions in the following weeks after the intervention. STATISTICAL ANALYSIS: The impact of interventions was tested with (a) Paired t-test for mean bag weights and (b) Chi-square test for the proportion of heavy schoolbags. RESULTS: The mean baseline bag weight of 3.77 kg declined statistically significantly after successive interventions to 3.4 and 3.2 kg. The baseline proportion of 51% of heavy bags (>10% of body weight) declined to 38% and 29%. Despite interventions, 19% students in 8th carried heavier bags than the 3.4 kg cap set by Government guidelines. Subjects taught in 8th standard were above 6/day. CONCLUSIONS: Awareness programs for stakeholders only partially succeeded in reducing bag weights. Hence, reducing the daily subject load is necessary.

Invasive squamous cell carcinoma with osteomyelitis of the foot a case report.

Squamous cell carcinomas are often seen on the sun-exposed areas of the skin and are rarely observed on the digits of the foot. However, there have been incidences of squamous cell carcinoma developing in the presence of chronic wounds with osteomyelitis, thus complicating the treatment. We present a patient with osteomyelitis who developed invasive squamous cell carcinoma of the third digit. We conclude that wounds with osteomyelitis may have underlying pathologic abnormalities that are not obvious on initial presentation.