Low Birth Weight, the Differentiating Risk Factor for Stunting among Preschool Children in India.

Background: The prevalence of low birth weight (LBW) is a major public health issue in India; however, the optimal growth pattern for such infants is not clear. The purpose of this study is to understand the causal association between LBW and stunting of preschool children in India. Methods: The National Family Health Survey-4 is a large cross-sectional survey based on a nationally representative sample of 699,686 women in the age group of 15−49 years and was conducted during 2015−2016 in India. The study used the children's file with a sample of 259,002 of 0−59 months for investigation. Results: The data revealed that 38.7% of the children in India were stunted. The bivariate analysis revealed that, of the women who did not attend any antenatal care (ANC) meetings, 46.8% had stunted children compared to the women who attended more than three ANC meetings, which 30.7% had stunted children. The low birth weight children experienced a much higher chance of stunting compared to children with a normal birth weight (44.3% vs. 33.8%). The multivariable odds ratios of logistic regression, after adjusting for the confounding characteristics, showed that pregnant women attending more than three ANC meetings compared to not attending any ANC meetings experienced a 19% lower adjusted odds ratio (AOR) of having stunted children (AOR = 0.81; CI 0.78, 0.85; p < 0.001). Another important variable, such as women with underweight body mass index (BMI) compared with normal BMI, had 6% higher odds of having stunted children (AOR = 1.06; CI 1.03, 1.10; p < 0.001). Similarly, women who belong to the Scheduled Caste compared to the General Caste had 36% higher odds of having stunted children (AOR = 1.36; CI 1.30, 1.42; p < 0.001); and children aged 13−23 months compared to children up to one-year-old or younger had 141% higher odds of being stunted (AOR = 2.41; CI 2.32, 2.51; p < 0.001). The conspicuous finding is that LBW babies, after adjusting for other important confounding factors, such as BMI and ANC, experienced 19% higher odds of stunted children (AOR = 1.19; CI 1.14, 1.24; p < 0.001) compared to normal birth weight babies. Conclusions: The results revealed LBW is associated with stunting of preschool children in India.

A descriptive analysis of food pantries in twelve American states: hours of operation, faith-based affiliation, and location.

BACKGROUND: Our objectives were to describe both the development, and content, of a charitable food dataset that includes geographic information for food pantries in 12 American states. METHODS: Food pantries were identified from the foodpantries.org website for 12 states, which were linked to state-, county-, and census-level demographic information. The publicly available 2015 Food Access Research Atlas and the 2010 US Census of Population and Housing were used to obtain demographic information of each study state. We conducted a descriptive analysis and chi-square tests were used to test for differences in patterns of food pantries according to various factors. RESULTS: We identified 3777 food pantries in 12 US states, providing an estimated 4.84 food pantries per 100,000 people, but ranged from 2.60 to 7.76 within individual states. The majority of counties (61.2%) had at least one food pantry. In contrast, only 15.7% of all census tracts in the study states had at least one food pantry. A higher proportion of urban census tracts had food pantries compared to rural tracts. We identified 2388 (63.2%) as being faith-based food pantries. More than a third (34.4%) of food pantries did not have information on their days of operation available. Among the food pantries displaying days of operation, 78.1% were open at least once per week. Only 13.6% of food pantries were open ≤1 day per month. CONCLUSIONS: The dataset developed in this study may be linked to food access and food environment data to further examine associations between food pantries and other aspects of the consumer food system (e.g. food deserts) and population health from a systems perspective. Additional linkage with the U.S. Religion Census Data may be useful to examine associations between church communities and the spatial distribution of food pantries.

Biomechanical fracture mechanics of composite layered skin-like materials.

Most protective biological tissues are structurally comprised of a stiff and thin outer layer on top of a soft underlying substrate. Examples include mammalian skin, fish scales, crustacean shells, and nut and seed shells. While these composite skin-like tissues are ubiquitous in nature, their mechanics of failure and what potential mechanical advantages their composite structures offer remains unclear. In this work, changes in the puncture mechanics of composite hyperelastic elastomers with differing non-dimensional layer thicknesses are explored. Puncture behavior of these membranes is measured for dull and sharp conical indenters. Membranes with a stiff outer layer of only 1% of the overall composite thickness exhibit a puncture energy comparable to membranes with a stiff outer layer approximately 20 times thicker. This puncture energy, scaled by its flexural capacity, achieves a local maximum when the top layer is approximately 1% of the total membrane, similar to the structure of numerous mammalian species. The mode of failure for these regimes is also investigated. In contrast with puncture directly beneath sharp tips caused by high stress concentrations, a new type of 'coring' type fracture emerges at large indentation depths, resulting from accumulated tensile strain energy along the sides of the divot as the membrane is deformed with a blunt indenter. These results could enhance the durability and robustness of stretchable materials used for products such as surgical gloves, packaging, and flexible electronics.

Anaemia status of preconception young married women in India.

The early detection of anaemia is important for its subsequent control and incidence among women of childbearing age. This study aimed to assess the anaemia status of preconception young married women in India using National Family Health Survey-4 data collected in 2015-16. A total 65,238 sample preconception young married women were analysed using univariate, bivariate and multivariate techniques. A majority belonged to the Hindu religion (81.7%), lived in rural areas (64.5%) and had secondary level education (51.8%), and 41.7% had not yet given birth. The percentage suffering from anaemia was 51.3%. The prevalence of anaemia was higher among younger women (55.3%), those from Scheduled Tribes (59.0%), those living in rural areas (52.8%), the non-educated (55.9%), those in the poorest wealth quintile (56.9%), those from the East region (57.0%) and those with a low body mass index (BMI) (58.4%). The adjusted odds ratios indicated that, after controlling for significant background factors, Hindu, Scheduled Tribe, Scheduled Caste, East region, already having a child, too thin for their height and poorer and poorest wealth quintiles had higher odds of suffering from anaemia compared with the reference groups. The odds of suffering from anaemia decreased with age and education. The study showed a high burden of anaemia and associated risk factors among preconception young married women in India. The finding will inform decision-makers when planning interventions to decrease anaemia among women of childbearing age in India.

Burden of increased blood glucose due to modifiable risk factors among men in India.

BACKGROUND AND AIMS: Worldwide, many diabetes cases are occurring mainly due to lifestyle risk factors. Hence, to quantify and compare the attributable burden of key modifiable risk factors associated with increased Blood Glucose (BG) among Indian states and districts. METHODS: The study used the National Family Health Survey (2015-16) data to estimate Population Attributable Risk (PAR) for increased BG (>140 mg/dl) among men aged 15-54 years in 640 districts of 36 States/Union Territories (UTs), India. We have considered three key modifiable factors such as high Body Mass Index (BMI), use of tobacco and alcohol. Population Attributable Risk techniques were employed to address the attributable burden of increased blood glucose due to modifiable risk factors. RESULTS: Substantial variations were found in the burden of increased BG due to high BMI, alcohol and tobacco use in India. The overall burden of increased BG due to high BMI, tobacco and alcohol in India was 28.5%, 2.1% and 6.4%, respectively. Regional variations in BG were found in high BMI, tobacco and alcohol consumption groups. The high burden of increased BG related to the above key modifiable risk factors mostly seen in North-Eastern' districts due to alcohol, Southern and Northern' districts was due to high BMI. However, the higher burden due to tobacco was reported in Central, Eastern and North-Eastern' districts. CONCLUSION: Three modifiable risk factors are contributing significantly to increased BG among men. Since there are regional differences in their contributions, state/district, specific targeted interventions may be necessary to control increased BG among men in India.

Trends in and determinants of neonatal and infant mortality in Nigeria based on Demographic and Health Survey data.

This study aimed to assess the changes in neonatal and infant mortality rates in Nigeria over the period 1990 to 2018 using Nigerian Demographic and Health Survey (NDHS) data, and assess their socio-demographic determinants using data from the most recent survey conducted in 2018. The infant mortality rate was 87 per 1000 live births in 1990, and this increased to 100 per 1000 live births in 2003 - an increase of around 15% over 13 years. Neonatal and infant mortality rates started to decline steadily thereafter and continued to do so until 2013. After 2013, neonatal morality rose slightly by the year 2018. Information for 27,465 infants under 1 year of age from the NDHS-2018 was analysed using bivariate and multivariate analysis and the Cox proportional hazard technique. In 2018, infant deaths decreased as wealth increased, and the incidence of infant deaths was greater among those of Islam religion than among those of other religions. A negative association was found between infant deaths and the size of a child at birth. Infant mortality was higher in rural than in urban areas, and was higher among male than female children. Both neonatal and infant death rates varied by region and were found to be highest in the North West region and lowest in the South region. An increasing trend was observed in neonatal mortality in the 5-year period from 2013 to 2018. Policy interventions should be focused on the poor classes, women with a birth interval of less than 2 years and those living in the North West region of the country.

Increased blood glucose level following hysterectomy among reproductive women in India.

BACKGROUND: In recent years, the hysterectomy, a surgical removal of the uterus, has received increased attention in health policy debates in India. The trigger for this was a series of media reports that highlighted an unusual surge in the number of women undergoing hysterectomies with a significant number of cases involving young and early menopausal women from low-income families. When menopause occurs as a result of hysterectomy, then the hormones such as estrogen and progesterone affect how the body cells respond to insulin. To date, we have not come across a national study following blood glucose levels among women who undergo a hysterectomy. METHODS: The study used the Indian fourth round of National Family Health Survey data, which is a cross-sectional nationally representative sample of 699,686 women in the age group 15-49 years and conducted during 2015-16. Bivariate and multivariate logistic regressions were used to examine the effect of hysterectomy on blood glucose level of > 140 mg/dl among women of reproductive age groups. RESULTS: The blood glucose level of > 140 mg/dl was much higher among women who had undergone a hysterectomy (12.2%) compared to non-hysterectomy women (5.7%). The pattern holds true among relevant background characteristics such as age, place of residence, education, caste, religion, wealth, marital status, body mass index (BMI), anaemia and consumption of tobacco. The adjusted odds after controlling for significant background factors, women who underwent hysterectomy experienced 15% higher odds of blood glucose level of > 140 mg/dl compared those who did not. CONCLUSIONS: The results indicated increased blood glucose level among women post hysterectomy. Hence, the government of India should consider developing evidence-based policies and programming to provide effective targeted interventions for the better reproductive health of women.

Gender differences in the risk factors for high and very high blood glucose levels: A study of Kerala.

BACKGROUND AND AIMS: Worldwide, lifestyle is a significant risk factor for diabetes. Lifestyle changes can lead to differences in the extent of risk of diabetes among women and men. Kerala, a state with one of the best health indicators in India, has a high prevalence of diabetes. This study aimed at comparing the variations in the risk factors for HBG and VHBG among adult women and men in Kerala. METHODS: Data from the fourth round of the National Family Health Survey (2015-16) used to examine the differences in the risk factors for HBG and VHBG in men and women aged 15-49 years. We used bivariate, multivariate and Population Attributable Risk (PAR) techniques for analysing the data. RESULTS: Bivariate results have shown the pattern of HBG and VHBG prevalence in women and men was same among all the age groups; however, men show a higher HBG and VHBG than women in all the age groups. Prevalence of HBG and VHBG was higher in women with a primary education, who were poor and not working as compared to their male counterparts. PARs results show that the prevalence of VHBG was higher among obese men and women as compared to normal men and underweight women. Prevalence of HBG was higher among men as compared to women due to alcohol use and weekly consumption of non-vegetarian food. CONCLUSIONS: The study suggests that there is an urgent need for targeted intervention programs to address the problem of HBG and VHBG in both men and women in Kerala to control blood glucose levels.

Increased hypertension following hysterectomy among reproductive women in India.

BACKGROUND: In recent years, hysterectomy has received increased attention in health policy debates in India. On the other hand, based non-communicable disease specific data for India, in 2011, WHO portray a grim picture and recommended to the government a 20% reduction in hypertension by 2020; however, the trends show that it is increasing. Yet, to date, there has not been a single nationally representative study of hypertension prevalence among women who undergo a hysterectomy. METHODS: The study has used the Indian fourth round of National Family Health Survey data, which is a cross-sectional nationally representative sample of 699,686 women in the age group 15-49 years and conducted during 2015-16. Bivariate and multivariate logistic regressions were used to examine the effect of hysterectomy on increased odds of hypertension among women of reproductive age groups. RESULTS: The age adjusted prevalence of hypertension was higher among women those who undergone hysterectomy (11.9%) compared to non-hysterectomy women (10.6%). The pattern holds true among relevant background characteristics such as age, place of residence, education, caste, religion, wealth, family size, years since hysterectomy, body mass index (BMI), anaemia and consumption of tobacco. The adjusted odds of hypertension among women who underwent hysterectomy compared to those who did not was 1.72 (95% CI: 1.14-2.58). CONCLUSIONS: The results indicated increased hypertension level among hysterectomy women. However, these results are based on a cross-sectional study, and hence, further through investigation based on a prospective study is necessary before undertaking any policy changes. Meanwhile, the government of India may like to suggest surveillance to the general practitioners as well as obstetricians and gynaecologists following a hysterectomy in order to better understand the effect of hysterectomy on hypertension.

Cytogenetic evaluation of gold nanorods using Allium cepa test.

The current study reveals the impact of gold nanorods (NRs) capped with CTAB (cetyltrimethylammonium bromide) or PEG (polyethylene glycol) on Allium cepa. The morphology and surface charge of CTAB- and PEG-capped gold NRs were characterized by electron microscopic and zeta potential analyses. The chromosomal aberrations like clumped chromosome, chromosomal break, chromosomal bridge, diagonal anaphase, disturbed metaphase, laggard chromosome, and sticky chromosome were observed in the root tip cells exposed to different concentrations (0.1, 1, and 10 µg/mL) of CTAB- and PEG-capped gold NRs. We found that both CTAB- and PEG-capped gold NRs were able to induce toxicity in the plant system after 4-h interaction. At a maximum concentration of 10 µg/mL, the mitotic index reduction induced by CTAB-capped gold NRs was 40-fold higher than that induced by PEG-capped gold NRs. The toxicity of gold NRs was further confirmed by lipid peroxidation and oxidative stress analyses. The unbound CTAB also contributed to the toxicity in root tip cells, while PEG alone shows less toxicity to the cells. The vehicle control CTAB contributed to the toxic effects in root tip cells, while PEG alone did not show any toxicity to the cells. The results revealed that even though both the particles have adverse effects on A. cepa, there was a significant difference in the mitotic index and oxidative stress generation in root cells exposed to CTAB-capped gold NRs. Thus, this study concludes that the surface polymerization of gold NRs by PEG can reduce the toxicity of CTAB-capped gold NRs.

Fluorescence Based Study for Melamine Detection Using Gold Colloidal Solutions.

A comparative study on detection of melamine with different sized citrate capped AuNPs namely 15 nm (AuNPs-I), 30 nm (AuNPs-II), and 40 nm (AuNPs-III) was carried out by fluorescence spectroscopy. The AuNPs emitted strong fluorescence at 421 nm with different intensity at 116.122, 220.511 and 253.665 for AuNPs-I, AuNPs-II and AuNPs-III respectively on excitation with 308 nm. On interaction with melamine, the AuNPs aggregated resulting in the enhancement of the fluorescent intensity of AuNPs. The sensitivity of melamine detection was studied for three different sizes of AuNPs by drawing a calibration curve between the concentration of melamine and fluorescence intensity. A good sensitivity was observed for AuNPs-II having the detection limit as low as 0.66 nM (3σ) which was lower in comparison to the detection limit of AuNPs-I (2.78 nM) and AuNPs-III (7.74 nM). The cost of synthesis was low as the usage of HAuCl4 in the synthesis of AuNPs-II was lower compared to the other sizes of AuNPs resulting in low cost of chemicals. The AuNPs-II was further chosen for carrying out selectivity study and for detecting the concentration of melamine. The recovery percentage of melamine in raw milk, liquid milk and milk powder after pre-treatment was found to be 100 %, 97 % to 100 % and 94 % to 99 % respectively.

Anti-aggregation-based spectrometric detection of Hg(II) at physiological pH using gold nanorods.

An efficient detection method for Hg (II) ions at physiological pH (pH7.4) was developed using tween 20-modified gold nanorods (NRs) in the presence of dithiothreitol (DTT). Thiol groups (-SH) at the end of DTT have a higher affinity towards gold atoms, and they can covalently interact with gold NRs and leads to their aggregation. The addition of Hg(II) ions prevents the aggregation of gold NRs due to the covalent bond formation between the -SH group of DTT and Hg(II) ions in the buffer system. The changes in the longitudinal surface plasmon resonance peak of gold NRs were characterized using a UV-visible spectrophotometer. The absorption intensity peak of gold NRs at 679nm was observed to reduce after interaction with DTT, and the absorption intensity was noted to increase by increasing the concentration of Hg(II) ions. The TEM analysis confirms the morphological changes of gold NRs before and after addition of Hg(II) ions in the presence of DTT. Further, the aggregation and disaggregation of gold NRs were confirmed by particle size and zeta potential analysis. The developed method shows an excellent linearity (y=0.001x+0.794) for the graph plotted between the absorption ratio and Hg(II) concentration (1 to 100pM) under the optimized conditions. The limit of detection was noted to be 0.42pM in the buffer system. The developed method was tested in simulated body fluid, and it was found to have a good recovery rate.

A comparative study with biologically and chemically synthesized nZVI: applications in Cr (VI) removal and ecotoxicity assessment using indigenous microorganisms from chromium-contaminated site.

In the present communication, we report a comparative study of Cr (VI) removal using biologically synthesized nano zero valent iron (BS-nZVI) and chemically synthesized nZVI (CS-nZVI), both immobilized in calcium alginate beads. The parameters like initial Cr (VI) concentration, nZVI concentration, and the contact time for Cr (VI) removal were optimized based on Box-Behnken design (BBD) by response surface modeling at a constant pH 7. Under the optimized conditions (concentration of nZVI = 1000 mg L(-1), contact time = ∼ 80 min, and initial concentration of Cr (VI) = 10 mg L(-1)), the Cr (VI) removal by the immobilized BS-nZVI and CS-nZVI alginate beads was 80.04 and 81.08 %, respectively. The adsorption of Cr (VI) onto the surface of alginate beads was confirmed by scanning electron microscopy with energy-dispersive x-ray spectroscopy (SEM-EDX), Fourier transform infrared spectroscopy (FT-IR), and Brunauer-Emmett-Teller (BET) analysis. The applicability of the process using both the sorbents was successfully test medium Cr (VI) spiked environmental water samples. In order to assess the ecotoxic effects of nZVI, the decline in cell viability, generation of intracellular reactive oxygen species (ROS), cell membrane damage, and biouptake was studied at 1000 mg L(-1) concentration, with five indigenous bacterial isolates from chromium-contaminated lake sediments and their consortium.

Cytogenetic studies of chromium (III) oxide nanoparticles on Allium cepa root tip cells.

The current study evaluates the cytogenetic effects of chromium (III) oxide nanoparticles on the root cells of Allium cepa. The root tip cells of A. cepa were treated with the aqueous dispersions of Cr2O3 nanoparticles (NPs) at five different concentrations (0.01, 0.1, 1, 10, and 100µg/mL) for 4hr. The colloidal stability of the nanoparticle suspensions during the exposure period were ascertained by particle size analyses. After 4hr exposure to Cr2O3 NPs, a significant decrease in mitotic index (MI) from 35.56% (Control) to 35.26% (0.01µg/mL), 34.64% (0.1µg/mL), 32.73% (1µg/mL), 29.6% (10µg/mL) and 20.92% (100µg/mL) was noted. The optical, fluorescence and confocal laser scanning microscopic analyses demonstrated specific chromosomal aberrations such as-chromosome stickiness, chromosome breaks, laggard chromosome, clumped chromosome, multipolar phases, nuclear notch, and nuclear bud at different exposure concentrations. The concentration-dependent internalization/bio-uptake of Cr2O3 NPs may have contributed to the enhanced production of anti oxidant enzyme, superoxide dismutase to counteract the oxidative stress, which in turn resulted in observed chromosomal aberrations and cytogenetic effects. These results suggest that A. cepa root tip assay can be successfully applied for evaluating environmental risk of Cr2O3 NPs over a wide range of concentrations.

Individual and Co Transport Study of Titanium Dioxide NPs and Zinc Oxide NPs in Porous Media.

The impact of pH and ionic strength on the mobility (individual and co-transport) and deposition kinetics of TiO2 and ZnO NPs in porous media was systematically investigated in this study. Packed column experiments were performed over a series of environmentally relevant ionic strengths with both NaCl (0.1-10 mM) and CaCl2 (0.01-0.1mM) solutions and at pH 5, 7, and 9. The transport of TiO2 NPs at pH 5 was not significantly affected by ZnO NPs in solution. At pH 7, a decrease in TiO2 NP transport was noted with co-existence of ZnO NPs, while at pH 9 an increase in the transport was observed. At pH 5 and 7, the transport of ZnO NPs was decreased when TiO2 NPs was present in the solution, and at pH 9, an increase was noted. The breakthrough curves (BTC) were noted to be sensitive to the solution chemistries; the decrease in the breakthrough plateau with increasing ionic strength was observed under all examined pH (5, 7, and 9). The retention profiles were the inverse of the plateaus of BTCs, as expected from mass balance considerations. Overall, the results from this study suggest that solution chemistries (ionic strength and pH) are likely the key factors that govern the individual and co-transport behavior of TiO2 and ZnO NPs in sand.

Cytotoxicity of aluminum oxide nanoparticles on Allium cepa root tip--effects of oxidative stress generation and biouptake.

The commercial usage of Al2O3 nanoparticles (Al2O3 NPs) has gone up significantly in the recent times, enhancing the risk of environmental contamination with these agents and their consequent adverse effects on living systems. The current study has been designed to evaluate the cytogenetic potential of Al2O3 NPs in Allium cepa (root tip cells) at a range of exposure concentrations (0.01, 0.1, 1, 10, and 100 µg/mL), their uptake/internalization profile, and the oxidative stress generated. We noted a dose-dependent decrease in the mitotic index (42 to 28 %) and an increase in the number of chromosomal aberrations. Various chromosomal aberrations, e.g. sticky, multipolar and laggard chromosomes, chromosomal breaks, and the formation of binucleate cells, were observed by optical, fluorescence, and confocal laser scanning microscopy. FT-IR analysis demonstrated the surface chemical interaction between the nanoparticles and root tip cells. The biouptake of Al2O3 in particulate form led to reactive oxygen species generation, which in turn probably contributed to the induction of chromosomal aberrations.

Human otoacariasis.

Accidental entry of foreign bodies into the ear canal is very common. Animate foreign bodies constitute upto 14% of cases, majority being the cockroaches. Not many cases of ticks entering into human ears are found in the scientific literature. Even the available reports are from South Africa, Nepal, Malaysia, Chile and Srilanka. This Indian study discusses the occurence, clinical features, the methods adopted in the removal and the complications of tick infestation of human ear. A total of 144 cases of ticks entering the human ears were studied over a period of two years from Jan 2004 to Dec 2005. This report represents one of the largest recorded series of human otoacariasis available in the Indian literature.

Pyle's disease: an incidental finding in a routine dental patient.

Pyle's disease (PD) or metaphyseal dysplasia is an extremely rare genetic disorder, transmitted as an autosomal recessive trait. The peculiarity of the disease is that the striking radiographic manifestations contrast with the relatively normal clinical features. The oral findings and radiographic features of the disease are not well documented. The present paper describes the radiographic features of Pyle's disease in a 17-year-old girl and draws attention to the findings in the jaw bones.

Schwannoma of the brachial plexus presenting as a cystic swelling.

Schwannomas are benign nerve sheath tumours. A small percentage of these tumours arise from the brachial plexus. Cystic degeneration and hemorrhagic necrosis can occur in these tumours in up to 40% of the cases. Detailed preoperative evaluation and careful dissection during surgery will avoid post operative neurological complications. We report a case of schwannoma of the brachial plexus presenting as a cystic neck swelling which was successfully managed by us.

Oral tuberculosis : a case report.

Tuberculosis can affect any part of the body and oral cavity remains no exception. The oral lesions of tuberculosis, though not common, are seen in various forms. The purpose of this article is to emphasize the importance of early diagnosis of primary tuberculosis of the mouth, which may be misdiagnosed when the oral lesions are the sole manifestation of the disease.