Association of mobile screen media use among children ages 6 mo to 2 y with minimum dietary diversity: A case control study.

OBJECTIVES: Minimum dietary diversity (MDD) is the consumption of four or more food groups. Mobile screen media (MSM) refers to mobile electronic media devices. MSM use has become common, even among children at a very early age. This study aimed to determine whether there is any association between MSM use in children with MDD and associated factors. METHODS: A case-control study was conducted at the pediatric department of a tertiary care hospital in 2019. Children ages 6 mo to 2 y were included in the study. Patients without MDD were considered cases and those with MDD controls. A total of 110 age-matched participants were sampled as cases and controls after informed consent was obtained. Acutely ill children with congenital malformations or chronic malnutrition were excluded from the study. Data were collected using a questionnaire developed on Epicollect, consisting of sociodemographic profile, anthropometric measures, illness history, feeding behavior (including complementary feeds, last 24-h dietary history), and details on MSM use (during feeding and in general) of the child. A data analysis was performed using STATA, version 12.1 SE. A χ2 or similar test was performed for categorical variables and a t test or similar for continuous variables, with odds ratios calculated and a correlation analysis performed. RESULTS: Urban children had better dietary diversity than those in semiurban areas (χ2 = 11.286; df = 1; P = 0.004). Joint families had a greater association with MDD (χ2 = 6.191; df = 1; P = 0.045). MSM use during feeding was found to be significantly associated with a child not having MDD (χ2 = 5.026; df = 1; P = 0.025; odds ratio: 1.887). Most families had an MSM device at home (99.3%). The median age of MSM initiation was 9 mo (interquartile range, 6-12 mo), and the median duration of use was 10 min per d (interquartile range, 5-20 min). MSM use is one of the most common methods employed for feeding (36.4%). The duration of MSM use on the previous day was significantly positively correlated with regular usage (r = 0.845; P = 0.000). CONCLUSIONS: This study concluded that the use of an MSM device during feeding was associated with a higher risk of not having MDD.

Effectiveness of Mobile Application for Promotion of Physical Activity Among Newly Diagnosed Patients of Type II Diabetes - A Randomized Controlled Trial.

Background: Mobile health intervention shows the positive effects on the management of chronic diseases. Therefore, the study was planned to study the effectiveness of a mobile-based application promotion of physical activity among newly diagnosed patients with type II diabetes. Methods: The present study was a parallel-design randomized controlled trial conducted over 2 years. The participants were type II diabetes patients between 18 and 60 years within 3 months of diagnosis who attended the endocrinology outpatient department having knowledge of using smart phone. The sample size was calculated to be 66 and 33 for each arm. The block random design method was adopted for allocation into different arms. A pretested interview schedule was used for the collection of data. Outcomes included body mass index, waist circumference, body fat percentage, and changes in the physical activity was obtained by global physical activity questionnaire (GPAQ). The information thus collected were processed and analyzed using SPSS v 20. Results: The study included 66 patients aged between 18 and 60 years, out of which 33 were enrolled into control and 33 into intervention group. The mean age of the participants was 42.29 ± 9.5 years ranged from 25 years to 59 years, 65.2% were males and 34.8% were females. It was observed that a higher proportion of intervention participants met WHO recommendations of physical activity level. Total metabolic equivalent of task (MET) value per minute (Mean ± SD) was 1347.27 ± 1028.5 in the control group and 1223.03 ± 584.87 in intervention group at baseline and was not different (P = 0.538). The total MET value per minute was found to be higher among the intervention group in all follow-ups. There was a significant decrease in weight, BMI, waist circumference, hip circumference, body fat percentage, and systolic blood pressure (SBP) in the intervention group. Conclusions: Cost-effective, simple mobile applications may help in routine clinical practice to encourage the patients for the promotion of physical activity.

Prevalence, Patterns, and Predictors of Yoga Practice Among Adults in an Urban Population in Eastern India.

The objective of this study was to determine the prevalence and predictors of yoga practice. This cross-sectional study was conducted as a part of a larger study that included yoga as a form of physical activity. Data were collected during April and August 2019 from the adult urban population of Bhubaneswar, India. This study was conducted using a cluster random sampling method. A representative sample (n = 1,203) of adults aged 18-59 years, irrespective of gender, was interviewed using a questionnaire adapted from the 2012 U.S. National Health Interview Survey, with the Epicollect5 handheld data-collection tool. Predictors of yoga practice were explored using multivariable logistic regression. The mean age of the participants was 35.19 ± 10.67 years, with 55.3% males. The majority were Hindu (93.62%) and belonged to the unre s e rved category (65.60%), people generally of higher relative socioeconomic status. The lifetime prevalence of yoga was 16.9%. Prevalence of any form of yoga (yoga, pranayama, or meditation), all forms of yoga (yoga, pranayama, and meditation), pranayama, and meditation was 17.0%, 10.7%, 14.3%, and 11.4%, respectively. After adjusting for confounders, female gender, Hindu religion, minimum of higher-secondary or graduate-level education, and having received advice from professionals for yoga practice had significantly higher odds of practicing yoga, and those of higher socioeconomic status had significantly lower odds of practicing yoga. We found a low prevalence of yoga. Sociodemographic characteristics like gender, religion, education, socioeconomic status, and other factors like learning yoga from professionals may be important predictors of continued yoga practice.

Histopathological and Immunohistochemical Evaluation of CDX2 and Ki67 in Colorectal Lesions with their Expression Pattern in Different Histologic Variants, Grade, and Stage of Colorectal Carcinomas.

BACKGROUND: A variety of colorectal lesions are surgically treated encompassing both benign and malignant polyps and colorectal cancer (CRC). CRC is the third most common cause of death in developed countries. Over the last decade, CDX2 has been linked to CRC progression, with reduced expression of the protein associated with more advanced tumor stage, vessel invasion, and metastasis. AIMS AND OBJECTIVES: To analyze the histopathology and immunohistochemistry (IHC) of CDX2 and Ki67 with their expression pattern; in different lesions of colon and rectum with special reference to various grade/stage/histological variants of CRC and to find out whether they can be used as possible predictive marker. MATERIALS AND METHODS: The study conducted was hospital based, both retrospective and perspective type comprising colorectal samples of total 367 cases (N) within a period of 2½ years. Surgical samples were collected, then grossed, processed, stained with routine hematoxylin and eosin stain in our department followed by IHC of CDX2 and Ki67 in only 60 randomly selected cases (n = 60). RESULTS: Out of total 367 cases, 265 cases were prospective study and 102 cases were retrospective study (240 cases were colonic lesions, and 127 are rectal lesions). The samples included were both from colonoscopy biopsy (small) 319 cases and 48 colectomy specimen (large). Mean age of the study participants was 49.62 years with a standard deviation of 17.34 years and predominantly male, but the difference was not statistically significant (P > 0.05). Colon (238 cases, 64.9%) as a whole affected more than rectum and left sided tumors more than the right side. All 60 cases were found to be positive for CDX2 expression (i.e., 100%); majority (n = 38) being carcinoma cases possessing high score and was statistically significant (P = 0.008, using Chi-square test) indicating strong association, whereas Ki-67 showed an increased index from noneoplastic to neoplastic cases. CONCLUSION: These markers can be used as future predictive biomarkers which will precisely evaluate risk group, prognosis, and response to therapy hence can be used as target therapy reducing irrational treatment.

Challenges in Detection of Adolescent Anaemia: Validation of Point-of-Care Device (Mission® plus) for Haemoglobin Measurement among Tribal Residential School Children of Selected Districts of Odisha, India.

BACKGROUND: Screening for anemia among tribal school children has been a challenge. OBJECTIVES: To validate a point-of-care (POC) device (mission® plus hemoglobinometer) to the gold standard method, spectrophotometry. STUDY DESIGN: Cross-sectional study. PARTICIPANTS: The representative sample of 953 tribal adolescents from the residential schools of Odisha. METHODS: Hemoglobin was measured simultaneously by the POC and gold standard method during January to July 2019. The validity of the POC device was measured by sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The area under the curve was calculated using receiver operating characteristic (ROC) analysis. Concordance of the POC device with the gold standard method was determined by the Bland-Altman plot. The intraclass correlation coefficient (ICC), precision (⍴), a bias correction factor (Cb), and the concordance correlation coefficient were also calculated. Deming regression analysis was performed, and a linear equation was established. RESULTS: The mean age of the study participants was 13.07 (±1.48) years. The prevalence of anemia was 45.54% by the gold standard method. The sensitivity and specificity of the POC device were 94.9% and 56.1%, respectively. PPV and NPVs were 64.4% and 93.0%, respectively. The area under the ROC curve was found to be 0.856. The ICC was 0.887 (95% confidence interval: 0.872-0.901). CONCLUSIONS: Very good reliability/absolute agreement for hemoglobin measurements existed between the POC device and the gold standard method making it suitable as a screening device.

Metabolic Syndrome and Insulin Resistance in Schoolchildren From a Developing Country.

Background: Overweight and obesity are prevalent in schoolchildren due to dietary habits and lack of exercise. These children are prone to metabolic syndrome (MS) and future risk of type 2 diabetes mellitus and cardiovascular diseases. Materials and Methods: This cross-sectional study was conducted in Bhubaneswar City, Eastern India, among schoolchildren. Obesity and overweight were determined by the Indian Academy of Pediatrics guideline. Fasting venous blood samples were taken for insulin, blood glucose, and lipid levels measurement. Blood pressure was measured as per the protocol. The International Diabetic Federation (IDF) criteria for the definition of MS were followed. Insulin resistance was determined by a homeostatic model assessment (HOMA-IR). Results: A total of 1,930 children were screened, of which 545 (28.2%) were overweight and obese. The male to female ratio was 1.27. The overall prevalence of MS was 21.8% (11% in 6 to ≤10 years old and 30.6% in 11 to 16 years old). A history of cardiovascular disease, diabetes, obesity, and hypertension in the family was present in 42.7%. Acanthosis nigricans was present in 46.4%. A history of exclusive breast feeding for 6 months was present in 68.1%. The mean HOMA-IR in children with MS was 5.46 compared to 2.18 in those without MS (insulin resistance was more common in children with MS). Conclusions: The present study found a higher prevalence of MS and insulin resistance in schoolchildren from Eastern India who are overweight/obese.

Anabolic Androgenic Steroid Abuse and their Health Impacts: A Cross-sectional Study among Body Builders in a City of Eastern India.

BACKGROUND: Anabolic-androgenic steroids (AASs), when taken in supraphysiologic doses, increase muscle strength and athletic performance. Evidence suggests that long-term use of AAS in supraphysiologic doses have adverse effects on health. Therefore, the study was conducted to find crude estimate of the prevalence of AAS use among attendees of the gymnasium, the factors that could have influenced them for AAS abuse and to assess the short- and long-term side effects as perceived by them. METHODS: A cross-sectional study was conducted in selected gymnasiums of a smart city of India using a predesigned and pretested questionnaire. Snowball sampling method was undertaken. The study was from July 2015 to June 2016. Informed written consent was taken. The analysis was done using SPSS v. 20.0. RESULTS: Of 84 bodybuilders approached, 74 participants used AAS. All users were male with mean age of 26.5 + 0.55 years. The mean age of initiation of AAS abuse was 23 years, and 66.2% (49) were unmarried. Eighty-five percent (63) preferred injectable. Seventy percent (52) abusers were influenced by trainers for abuse. Most commonly abused was Nandrolone decanoate (55.4%). Seventy-three percent were not aware of any legal ban on steroids. Reported benefits include increased strength, muscle size, and power, while harms were increased acne, deepening of voice, swelling of feet, increased irritability, depressive thoughts, impaired judgment, panic disorder, and withdrawal effect. CONCLUSIONS: Frequency of ASS use was substantial among young bodybuilders. Awareness about side effects was not a deterrent factor. Abusers were highly influenced by coaches. Efforts should be made for preventing easy access to AAS.

Identification of bioactive constituents from different fractions of stems of Cuscuta reflexa Roxb. using GC-MS.

The GC-MS analysis of fractions of methanol extract of stem of Cuscuta reflexa (Family Convolvulaceae) was carried out using a THERMO TRACE 1300 Gas Chromatograph equipped and coupled to a mass detector THERMO TSQ 8000 spectrometer with an TG 5MS (30 m × 0.25 mm, 0.25 µm) of capillary column. Database of National Institute of Standards and Technology (NIST) library was used to identify the components. GC-MS revealed two known compounds i.e. 2-Methoxy-4-vinyl phenol (6.80%) and Benzofuran-2,3-dihydro (20.89%) and other 12 unknown compounds such as 3,5-di-tert-Butyl-4-hydroxyanisole (35.50%); Hexatriacontane (12.02%); n-Hexadecanoic acid (10.12%); Scoparone (7.97%); Hexadecanoic acid methyl ester (5.22%); 1,3-Benzenediamine, N, N, N', N' tetramethyl- (15.43%); Phenol, 4(3-hydroxy1propenyl), 2-methoxy (9.31%); Phenol, 2,4 bis (1,1dimethylethyl); 2,3,5,6-Tetramethyl para phenylene diamine (14.18%); Retinoic acid-5,6-epoxy-5,6-dihydro (20.46%); 2,4-Dihydroxy-2,5-dimethyl-3(2H)furan-3-one (10.13%); 2,3-dihydro-3,5-dihydroxy-6-methyl-2-Propyl-tetrahydro-pyran-3-ol (10.13%); Pregn-4-ene-18-oic acid (5.75%) as some of the major compounds in its different fractions. Retinoic acid-5,6-epoxy-5,6-dihydro found as major compound may be responsible for blood glucose lowering potency.

Anterior Superior Iliac Spine to the Tibial Tuberosity Length: An Easier, Accurate, and Faster Method for Predicting Orogastric Tube Length in Neonates-An Observational Study.

Orogastric tube (OGT) procedures are done in 20% of newborn unit cases. This study was contemplated to work out a formula to predict OGT length in terms of femur length in neonates and its agreement to existing standards. In this observational study, OGT length was estimated using NEMU (nose-ear-mid umbilicus) in 53 consecutive newborns. Their anterior superior iliac spine to tibial tuberosity length (AS-TT) was measured and equated using linear regression analysis in Stata. We further verified the accuracy of the new formula and comparison of time taken by both the methods. Strong positive correlation was seen between OGT and AS-TT (r = .88). OGT length was 10.14 + 0.88 AS-TT, which can be used in neonatal intensive care unit newborns with greater accuracy and with lesser time than the classical method. Strong agreement levels were seen. AS-TT closely relates to the femur length and can be chosen as a guide as it is faster when compared to other methods.

Association of personal hygiene with common morbidities among upper primary school children in rural Odisha.

CONTEXT: In India, children of upper primary school receive less attention from health-care providers. The majority of their health problems are preventable through hygienic practices. AIMS: The aim of this study was to find out the association of personal hygiene with common morbidities among upper primary school children. SETTINGS AND DESIGN: A cross-sectional study conducted in a rural upper primary school of Odisha. SUBJECTS AND METHODS: A semi-structured schedule based on the Global School Health Survey Questionnaire and necessary instruments for clinical examination were used. STATISTICAL ANALYSIS USED: Data were entered in Microsoft Excel 2007 and analyzed by SPSS version 20 software. RESULTS: Of 90 participants, 58 (64.4%) were girls. The mean age was 11.8 (±1.01) years. The mean body mass index of females was significantly higher than males (16.95 vs. 14.72; P = 0.001). More than 90% of children maintained good personal hygiene such as clean tongue, clean hair, handwashing, and using footwear. The most common morbidities found were dental caries (38.9%), history of worms in stool and lethargy (20%). A mean score of 6.14 ± 0.11 (out of 8) was seen for personal hygiene and not associated with any particular morbidity or gender. Brushing daily was significantly associated with reduced dental caries (χ2 = 8.7; P < 0.005) and foul-smelling breath (χ2 = 4.93; P < 0.05). Fungal infections were significantly less in children who bathed daily (χ2 = 28.7; <0.005) and wore clean clothes (χ2 = 5.06; P < 0.05). CONCLUSION: Dental caries, foul-smelling breath, and fungal infections were significantly associated with poor personal hygiene. School health services should also focus on upper primary school children for improvement of personal hygiene.

Antidiabetic effects of Cuscuta reflexa Roxb. in streptozotocin induced diabetic rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Cuscuta reflexa Roxb. (Convolvulaceae) is traditionally used to treat diabetes mellitus by tribal people of north-east India and Bangladesh. OBJECTIVES: To evaluate the anti-diabetic effects of methanol and aqueous extracts of the aerial parts of Cuscuta reflexa Roxb. in normal, glucose loaded and Streptozotocin (STZ) induced diabetic rats. MATERIALS AND METHODS: The methanol (MECR) and aqueous (AECR) extracts (200 and 400mg/kg body weight) were administered orally to normal and diabetic rats with Metformin and solvent control as comparison groups. Long term effects like FBG, OGTT, lipid profile, HbA1c, body weight, histopathology of major organs, etc. were investigated. RESULTS: MECR and AECR did not have hypoglycemic effects in normal rats. Both AECR and MECR (400mg/kg) treatments showed significant reduction in blood glucose during OGTT in diabetic rats at 3h. Single oral administration of methanol and aqueous extracts (400mg/kg) to diabetic rats significantly reduced (p<0.05) blood glucose level to 61.90% and 55.39% respectively as compared to the Metformin group i.e. 68.32% at the end of 8h. MECR (400mg/kg body weight for 30 days to diabetic rats) showed a significant decrease (p<0.01) of blood glucose level to 60.00% as compared to other groups. The treatment also resulted an improvement in body weights, decreased HbA1c and restored lipid profile. Histopathological injury was not observed, rather repair of beta cells was seen in extract treated diabetic rats. CONCLUSION: Methanolic extract of C. reflexa has significant antidiabetic effects and improves metabolic alterations thereby justifying its traditional folkloric claims.