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Background: Under nutrition is a major problem among Indian schoolchildren. Yet, routine height and weight measurements in schools are nor used for growth monitoring. This study attempts to evaluate mid-upper-arm-circumference (MUAC) as a quick assessment tool against body mass index (BMI) in schoolchildren. Objective: The objective of the study was to evaluate MUAC against BMI, height, and average skin fold thickness (ASFT) parameters and to estimate MUAC values across age, sex, and social categories. Subjects and Methods: The study was conducted in 2017–2018 in four randomly selected Ashram schools and an urban school in Nashik district. Girls (1187) and boys (1083) from age 6–18 were included, and height, weight, skinfold thickness, and MUAC were measured. MUAC was done on the left arm with Shakir's tape and tailor's tape (for MUAC >25 cm). Epi Info 7.1 and Excel were used for the data analysis. Results: MUAC had a consistently high correlation with BMI at all ages for boys (r = 0.8786, P < 0.0001) and girls (r = 0.8586, P < 0.0001). ASFT too was strongly correlated with MUAC (r = 0.5945, P < 0.0001). MUAC had strong but nonlinear correlation with heights in girls (r = 0.7751, P < 0.0001) and boys (r = 0.8267, P < 0.0001). MUAC was higher for girls than boys at all ages. MUAC values for scheduled tribe (ST) children were highly significantly lower than non-ST students. Conclusion: MUAC is a good and quick proxy tool for BMI and can serve as a sensitive nutritional indicator for school ages across socioeconomic categories. However, it is necessary to construct age-wise cutoff points and bandwidths using multicentric studies across income quintiles.

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. The first 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.

Background: The rising prevalence of type 2 diabetes (T 2 D) in India calls for screening of at-risk adults. Objectives were to assess IDRS (Indian diabetes risk score) of T 2 D in staff in tertiary care hospital, and to assess covariates random blood sugar (RBS), BMI, skinfold thickness (SFT), pre-existing T 2 D in the employees. Methods: In this cross sectional study, IDRS was used to assess all staff in a tertiary care institute. Anthropometric measurements, BP and RBS were done. Information on parental T 2 D, cereal intake and weekly physical activity (PA) was obtained in interview. Results: 370 subjects (F-117, M-273) with mean age 30.81 (7.99), BMI 22.89 (14.13) years were screened. Subjects in moderate and sedentary work were 185 each, 15% women and 39% men had higher waist size. Total 5.4% subjects had T 2 D including known diabetics. RBS in women and men was 113.1 (27.87), 114.7 (27.66), with IDRS score high in 29 (7.84%) and moderate in 144 (38.92%). Parental T 2 D was present in 19.5% subjects. IDRS risk was strongly associated with type of work (Chi-square 79.0283, df=4, p=0.00). Multiple logistic regression for IDRS risk outcome showed association of age (OR 1.4), BMI (OR1.3), parental T 2 D (OR 9.6) with highly significant p values. Multiple linear regression for RBS outcome was associated with age (OR 1.3) and BMI (OR 1.4) but the results were statistically not significant. Conclusions: Pooled IDRS risk was present in 47% subjects despite younger age of study population. Improvements in physical activity and reduction in waist size is the need of the hour.

Background: Institutional birth and Emergency Obstetric Care (EmOC) are important strategies of the National Rural Health Mission (NRHM). While the Community Health Center (CHC) is expected to serve EmOC needs in NRHM, the CHCs are hamstrung due to chronic shortage of specialist doctors. Alternative strategies are therefore needed for ensuring EmOC. Objectives: This study aims to estimate the EmOC needs in a private rural hospital from case records and find some useful predictors for caesarian section (C-section) and to assess C-section needs in the context of on-call specialist support. Materials and Methods: We analyzed a two-decade series of 2587 obstetric cases in a private rural hospital for normal deliveries and EmOC including C-section. Results: About 80% of the obstetric cases were normal deliveries. Of the remaining 20% cases that required EmOC, nearly one-third required C-section. In the series, two maternal deaths occurred due to hemorrhage. About 13% case records showed past abortion, which adds to EmOC workload. Primipararous mothers with higher age had a greater incidence (23%) of C-section. The C-section rate shows a steady rise from 3% to above 10% in the series. Conclusions : This rural hospital required C-section in 6.4% cases. This C-section workload was managed with the help of on-call specialists. The local hospital team could manage 93.6% of the cases and abortions with only two maternal deaths. This strategy of an on-call specialist team can be an option for CHCs till resident specialists are adequately available.

Background: Low birth weight remains a major reason behind childhood malnutrition. The NFHS findings show no dent in this problem. Objective: This study was undertaken to explore change in birth weights in a period from 1989 to 2007 and any associations thereof. Materials and Methods: All birth records of a private rural hospital spanning two decades (1989-2007) were analyzed for birth weight, age of mother, gender, birth order of the baby, proportion of pre-term babies and low birth weight babies. Results: No change was observed in the average birth weights (average 2.71 kg) over the period. Although the birth weight shows some expected variance with the age of mother, it was found to have no relation with the baby's birth order and gender. The low birth weight proportion is about 24% and shows little difference before and after the series midpoint of year 1998. Conclusion: The birth weights have hardly changed in this population in the two decades.