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Objective: To study the prevalence of Celiac disease (CD) in first-degree relatives (FDR) of CD children.Methods: This observational study was performed in FDR (parents and siblings) of consecutive newly diagnosed cases of CD enrolled from January 2011 through March 2012. Screening for CD in FDR was done using IgA tissue transglutaminase (tTG) levels in serum and the seropositive subset underwent upper gastrointestinal (UGI) endoscopy and biopsy to confirm the disease. In addition, HLA analysis for CD was performed in most of the index cases and FDR.Results: Of 202 FDR of the 64 index cases with CD, 17.3 % (35/202) were seropositive for IgA tTG while confirmed biopsy proven CD was diagnosed in 10.2 % (8/78) of children and 8.1 % (10/124) of adults. HLA DQ2/DQ8 was positive in 96.7 % of the index cases and all FDR with confirmed CD.Conclusions: The prevalence of CD among FDR is 9 fold higher than the general population. High prevalence of CD in presence of anemia and short stature in seropositive FDR in index study indicates need of targeted screening of this subgroup for the presence of CD.CD is unlikely in the absence of HLADQ2/DQ8. [ABSTRACT FROM AUTHOR]

Objective: Globally more than 1/3rd of the child deaths are attributed to under nutrition and it continues to be a major public health problem in developing countries. This research paper is an attempt towards intervention and management of severely malnourished children with the use of locally prepared therapeutic diets to bring down the case fatality rate.Methods: A cross-sectional longitudinal study was undertaken at a tertiary care hospital in North India. Children under 5 y of age fulfilling the WHO case definition of severe acute malnutrition and suffering from medical complications were enrolled and managed on standard WHO protocols using locally prepared therapeutic diet (Starter F-75 diet and Catch-up F-100 diet).Results: During the period of 11 mo, a total of 315 children (192 boys and 123 girls) under 5 y with severe acute malnutrition requiring in-patient care were enrolled and evaluated. The overall case fatality rate was 3.5% while average weight gain seen was 9.33 ± 8.28 g/kg body weight/day and average length of stay was 11.71 ± 7.59. The Nutrition Rehabilitation Centre (NRC) observed a cure rate of 47% and secondary failure rate of 19%.Conclusions: The present study highlights the integral role of locally prepared therapeutic diet (starter F-75 and F-100) besides standardized care provided at Nutrition Rehabilitation Centre (NRC) to combat malnutrition which is a major scourge in the developing world. To sustain the benefits and prevent relapse, there is a need to integrate the services at NRC with the community-based therapeutic care to deliver continuum of care from facility to door step and vice versa. [ABSTRACT FROM AUTHOR]

Deficiencies of micronutrients (zinc, iron, folic acid and iodine) during pregnancy are known causes of Low Birth Weight (LBW). Studies have documented status of one or two micronutrients amongst pregnant women (PW). However, no attempt has been made to concurrently assess the prevalence of multiple micronutrient deficiencies and the factors associated with them amongst PW. Objective: The present study was undertaken to assess the prevalence of multiple micronutrient deficiencies amongst PW in a rural area. Methods: A community based cross sectional survey was conducted in six villages of a rural area of district Faridabad in Haryana state, India during November 2000 and October 2001. All PW aged 18 years or more, with pregnancy duration of more than 28 weeks were enrolled. Data were collected on socio-economic status and other demographic parameters. Serum zinc, copper and magnesium levels were estimated by utilizing the Atomic absorption spectrophotometry (AAS); serum ferritin and folate was estimated by Enzyme Linked Immuno Sorbent Assay (ELISA) method and the Radio-lmmuno Assay (RIA) method, respectively and serum thyroid stimulating hormone (TSH) level was estimated by the Abbot AxSYM System. Serum zinc, copper, magnesium, ferritin, and folate levels less than 70.0 μg/dl, 80.0 μg/dl, 1.80 mg/dl, 15 ng/ml, and 3 ng/ml, respectively were considered as indicative of deficiency for respective micronutrients. The TSH levels of 4.670 and more indicated iodine deficiency status. Dietary intake of micronutrients was assessed utilizing 1-day 24-hour dietary recall methodology. Food consumption pattern was assessed utilizing the food frequency questionnaire methodology. Results: Nearly 73.5, 2.7, 43.6, 73.4, 26.3, and 6.4 percent PW were deficient in zinc, copper, magnesium, iron, folic acid and iodine, respectively. The highest concurrent prevalence of two, three, four and five micronutrient deficiency was of zinc and iron (54.9%); zinc, magnesium and iron (25.6%); zinc, magnesium, iron and folic acid (9.3%) and zinc, magnesium, iron, folic acid and iodine (0.8%), respectively. No pregnant woman was found to have concomitant deficiencies of all the six micronutrients. Dietary intake data revealed an inadequate nutrient intake. Over 19% PW were consuming less than 50% of the recommended calories. Similarly, 99, 86.2, 75.4, 23.6, 3.9 percent of the PW were consuming less than 50% of the recommended folic acid, zinc, iron, copper, and magnesium. The consumption of food groups rich in micronutrients (pulses, vegetables, fruits, nuts and oil seeds, animal foods) was infrequent. Univariate and Multivariate logistic regression analysis revealed that low dietary intake of nutrients, low frequency of consumption of food groups rich in micronutrients and increased reproductive cycles with short interpregnancy intervals were important factors leading to micronutrient deficiencies. Conclusion: There was a high prevalence of micronutrient deficiencies amongst the PW of the area, possibly due to the poor dietary intake of food and low frequency of consumption of food groups rich in micronutrients. The concurrent prevalence of two, three, four and five micronutrient deficiencies were common. [ABSTRACT FROM AUTHOR]

Thirty primary schools were selected in district Kangra utilizing the population proportionate to size cluster sampling methodology in the year 2004. A total of 6939 children were included in the study. The clinical examination of the thyroid of each child was conducted. On the spot casual urine sample and salt samples were collected from a ‘sub set of’ children included in the study. The Total goiter rate (TGR) was found to be 19.8%. The median Urinary iodine excretion level was 200 μg/l and only 64% of the salt samples had the stipulated level of iodine. The findings of the present study revealed that current iodine status of population is adequate, however, TGR showed mild iodine deficiency (chronic), and there is a need of continued monitoring the quality of iodised salt provided to the beneficiaries under the Universal salt iodisation programme in order to achieve the goal of elimination of lodine deficiency disorders from district Kangra. [ABSTRACT FROM AUTHOR]

Objective: Iodine deficiency disorders (IDD) is the most common cause of preventable mental retardation in world today. Out of 29 districts in Tamil Nadu, 24 have been surveyed and all have been found to be endemic to IDD. There is a complete ban on the sale of non iodised salt in the state since 1995. The present study was conducted to assess the iodine content of salt and urinary iodine excretion levels amongst the beneficiaries in the state to help the government to strengthen the existing Universal salt iodisation (USI) programme activities.Methods: The study was undertaken in 24 districts of Tamil Nadu during the year 2001. The guidelines recommended by WHO/UNICEF/ICCIDD for a rapid assessment of salt iodisation in a district was adopted. A minimum of 150 salt samples were collected from each district by utilising the uniform sampling methodology. The iodine content of salt samples was analysed using the standard iodometric titration method. At least 60 children from each school were randomly selected and were requested to provide "on the spot" casual urine samples. The urinary iodine excretion (UIE) levels were analysed using the wet digestion method.Results: It was observed that 62.3% of the families were consuming iodised salt with more than 5 ppm of iodine. It was found that district Perambalour had deficient iodine nutriture as revealed by the median UIE levels less than 100 micro g/l.Conclusion: The findings of the present study reveals the success of USI programme and highlights need for continued monitoring of the quality of salt provided to the population in order to achieve the goal of IDD elimination. [ABSTRACT FROM AUTHOR]

Objective: The present study was undertaken to assess the prevalence of iron, vitamin A and iodine deficiencies amongst rural Adolescent Pregnant Mothers (APM).Methods: Survey was conducted amongst APM in a rural block; district Udham Singh Nagar, Uttaranchal State. In the district, all blocks were enlisted and one block was randomly selected. Further, villages in the block were listed (n = 64) and five villages were randomly selected for the detailed study. All APM residing in the selected villages were included for the detailed study. The data on socio demographic parameters was collected utilizing a pre-tested semi-structured questionnaire. Anaemia was assessed by hemoglobin estimation with the help of the HemoCue instrument. Vitamin-A deficiency (VAD) was assessed by presence of night blindness utilizing a pre-tested semi structured proforma. Iodine Deficiency was assessed by the clinical examination of the thyroid gland and estimating the Urinary Iodine Excretion (UIE) levels of each subject. Nutrient intake was assessed by the 24-hr dietary recall method.Results: One hundred and fifty one APM, belonging to low socio economic group, were selected for the study. The occupation of the families was farming, but the APM were housewives. The mean age of the APM was 17.8 +/- 1.5 yr. Eighty nine percent of the APM were in the age group 16-19 yr. Sixty percent of the APM were in the gestational age of 24 weeks and more. It was found that 46.0% of the APM were anaemic (Hb < 11.0 gm/dl). Sixteen percent of the study subjects had presence of night blindness. Fifteen percent of the subjects had Goiter. Median UIE level in the subjects studied was 95.0 micrograms/l. Concomitant prevalence of the three deficiencies was amongst 2.0% of the population. The 24-hour dietary intake revealed that the mean consumption of retinol and iron was only 13 and 28% of the recommended dietary allowance, respectively.Conclusion: The findings of the present study indicated that Anaemia, Vitamin A, and Iodine deficiency existed as public health problems in the APM of the study area. [ABSTRACT FROM AUTHOR]

Objective: The present study was conducted in year 2002 in NCT of Delhi with the objective to re-assess the prevalence of iodine deficiency disorders.Methods: A total of 7009 children in the age group of 6-11 years were clinically examined for presence of goiter. A total of 991 salt samples were also collected randomly. On the spot casual urine samples were collected from 1395 children.Results: The total goiter prevalence was found to be 6.2%. The percentage of children with urinary iodine excretion (UIE) of < 20.0, 20.0- < 50.0, 50.0-99.9 and 100.0 microg/l and above was 0.8, 1.8, 8.7 and 88.7%, respectively. The median UIE level was 200 microg/L. The assessment of iodine content of salt revealed that only 16% of the families were consuming salt with iodine content less than 5 ppm.Conclusion: The findings of the present study indicated that the population is in a transition phase from iodine deficient (as revealed by Total Goiter Prevalence) to iodine sufficient nutriture (as revealed by median UIE 200 microg/l). A significant progress has been achieved towards elimination of IDD from NCT of Delhi. [ABSTRACT FROM AUTHOR]