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Objective: To document the prevalence of non-alcoholic fatty liver disease (NAFLD) and metabolic parameters among normalweight and overweight schoolchildren. Design: Cross-sectional study. Setting: Thirteen private schools in urban Faridabad, Haryana. Participants: 961 school children aged 5-10 years. Methods: Ultrasound testing was done, and 215 with fatty liver on ultrasound underwent further clinical, biochemical and virological testing. Outcome measures: Prevalence of fatty liver on ultrasound, and NAFLD and its association with biochemical abnormalities and demographic risk factors. Results: On ultrasound, 215 (22.4%) children had fatty liver; 18.9% in normal-weight and 45.6% in overweight category. Presence and severity of fatty liver disease increased with body mass index (BMI) and age. Among the children with NAFLD, elevated SGOT and SGPT was observed in 21.5% and 10.4% children, respectively. Liver enzyme derangement was significantly higher in overweight children (27% vs 19.4% in normal-weight) and severity of fatty liver (28% vs 20% in mild fatty liver cases). Eleven (8.1%) children with NAFLD had metabolic syndrome. Higher BMI (OR 35.9), severe fatty liver disease (OR 1.7) and female sex (OR 1.9) had strong association with metabolic syndrome. Conclusions: 22.4% of normal-weight and overweight children aged 5-10 years had fatty liver. A high proportion (18.9%) of normal-weight children with fatty liver on ultrasound indicates the silent burden in the population. [ABSTRACT FROM AUTHOR]

This paper presents the measurements of gaseous SO2, NO2, HNO3 and NH3 and particulate NH4+, NO3−and SO42− at Rampur, a rural site of semi-arid region of India and annual mean concentrations are 3.7±2.2, 7.3±3.7, 0.7±0.6 and 6.7±4.2 and 1.0±0.4, 1.1±1.3 and 2.6±1.6 μg m−3, respectively. Seasonal variation with higher concentration in winter is observed for gaseous SO2, NO2, and NH3 and particulate NH4+. The concentration of HNO3 and particulate NO3−and SO42− are higher in summer. Summer to winter ratio of HNO3 and particulate NO3− are 3.8 and 1.8, respectively, showing seasonal variation is more pronounced in case of HNO3 than particulate NO3−. The ratio of gaseous NH3 to particulate NH4+ (NH3/NH4+) is more than 1 probably due to basic nature of aerosol. Examination of equilibrium between gaseous NH3 and HNO3 and particulate NH4NO3 shows observed equilibrium constant is lower than theoretical equilibrium constant in summer and vice versa in winter. [Copyright &y& Elsevier]

Objective: To evaluate first-trimester screening protocols for detecting trisomy 21 in an Indian population.Methods: The present prospective study collected data from women with singleton pregnancies and a crown-to-rump length of 45-84 mm who presented at the fetal medicine unit of a tertiary care center in North India between June 1, 2006, and December 31, 2015, for combined first-trimester screening. Maternal age, nuchal translucency, nasal bone, and maternal serum levels of free beta human chorionic gonadotropin and pregnancy-associated plasma protein A were assessed for calculating the risk of trisomy 21. Tricuspid regurgitation and qualitative analysis of ductus venosus data were available from June 2010, and were included where available. Trisomy-21 detection rates were calculated for various screening protocols and were compared.Results: There were 4523 women screened and 24 records of trisomy 21. Combined screening with maternal age, nuchal translucency, nasal bone, tricuspid regurgitation, and ductus venosus demonstrated optimal detection and false-positive rates of 93.8% and 1.9%, respectively. Screening using only maternal age yielded a detection rate of 37.5%; using fixed nuchal translucency cut-off values of 2.5 and 3 mm resulted in detection rates of 66.7% and 37.5%, respectively.Conclusion: Combined first-trimester screening performed well in an Indian population; combining maternal age, nuchal translucency, nasal bone, ductus venosus, and tricuspid regurgitation yielded the most accurate screening. [ABSTRACT FROM AUTHOR]

Betel quid (paan) chewing is common in India, especially in Uttar Pradesh. Betel quid has multifaceted relationship with health, including metabolic and psychosocial health. The current recommendations have been released keeping in view the public health and clinical importance of this addictive behavior. The objective of this document is to offer clinical guidance for screening, diagnosis and management of co-occurring betel quid chewing among persons with Diabetes Mellitus (DM). The document aims to provide education and guidance to clinicians engaged in care and management of persons with DM, and improve access to treatment for co-occurring betel quid chewing among persons with DM. The current recommendation grades are based on published evidence, and categorized as strong, intermediate, weak and no evidence. The strength of these recommendations is based on the level of evidence., (© Journal of the Association of Physicians of India 2011.)

Tobacco use is one of the main preventable causes of mortality and morbidity worldwide. The global disease burden due to tobacco use is huge with projected mortality of eight million lives per year by 2030. Metabolic syndrome (MS) is defined as a constellation of cardiovascular and endocrine risk factors such as insulin resistance, obesity, raised blood pressure, and abnormal lipid profile. The relationship between tobacco use and MS has been well established. Also, the causal association between tobacco use and development of individual components of MS is well established. The Uttar Pradesh Association of Physicians of India (UP API) has drafted this position statement on managing tobacco use among persons with or at risk of developing Metabolic Syndrome (MS). This position statement presents evidence-based recommendations as described below. Scope and purpose The objective of this position statement is to offer clinical recommendations for screening, diagnosis and management of tobacco use among persons with or at risk of developing Metabolic Syndrome (MS). The purpose of this document is to aid in identification and treatment of maladaptive patterns of tobacco use i.e. tobacco use disorder (tobacco dependence, harmful use, abuse) in person with or at risk of developing MS. Intended Audience The position statement is targeted at the clinicians engaged in care and management of person with or at risk of developing Metabolic Syndrome (MS). This might also be of relevance to the policy makers considering the public health burden of both MS and tobacco use disorders., (© Journal of the Association of Physicians of India 2011.)

Dry deposition flux of major ions (Na+, K+, Ca2+, Mg2+, NH4+, F-, Cl-, NO3- and SO4(2-) to natural surfaces [guava (Psidium guyava) and peepal (Ficus religiosa) leaves] are determined at Rampur, a rural site of semi-arid region of India. Dry deposition flux is the highest for Ca2+ on guava leaves and for NH4+ on peepal leaves. Overall dry deposition flux is higher on guava leaves than of peepal leaves. The variation in deposition flux may be due to surface characteristics (surface roughness) and arrangement of leaves. Peepal leaves are arranged along the axis of the stem, whereas guava leaves are at right angles to the stem. The deposition flux of cations contributes 66% and 76% of dry deposition of all major ions on guava and peepal leaves, respectively as soil is major contributor towards dry deposition flux in tropical regions. ANOVA revealed no significant seasonal difference in deposition, although there is a trend for higher in winter. Deposition velocities of NH4+, NO3- and SO4(2-) are greater on guava leaves than peepal leaves, which can be attributed to the rougher surface of the guava leaf.