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India has not only maintained its top position among countries with the largest number of underweight adults but has also jumped to a higher position among countries with largest increase in the proportion of overweight people in the last three decades. More studies focus on double burden of malnutrition among women than on men. This study uses the quantile regression model to analyse the covariates associated with low and high body mass index (BMI) primarily among men aged 20–54 years during 2015–2016 in India. Occupations that involve more manual work help in maintaining a normal BMI along with better education, dietary diversity, and less sedentary lifestyle. A gendered comparison of men and their spouses highlights the differences in the association of covariates with BMI for men and women. The results from this study will provide insights for behavioural change at an individual level and inputs for public health intervention for addressing ill health concerns arising from underweight, overweight, or obesity. [ABSTRACT FROM AUTHOR]

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This article analyses how linguistic minorities in the province of Bihar navigated the era of linguistic territorialism, when mainstream political organisations and figures within India largely agreed that specific linguistic communities 'belonged' in particular regions. Indian scholarship has tended to focus on the mechanisms that brought about the linguistic reorganisation of states in India, therefore, concentrating largely on the ways in which territory and language became intrinsically connected. This article will examine the link of language and belonging with regard to a 'community', which demanded that states remain linguistically and culturally heterogenous. It focuses on the section of Biharis that identified Bengali as their 'mother-tongue' and tracks the transformation of Bengali politics within the province/state during the transition from colonial rule to independence. It explores the ways in which narratives of historical Bengali settlement were deployed for different reasons across this period, and argues that Bengalis in Bihar conceptualised the ordering of the Indian nation in a way that was inherently different from mainstream understandings of how the country should be ordered during this period. Bengali-Bihari figures and publications deployed rhetoric that attached much greater value to territorial belonging than to linguistic or cultural belonging. This article demonstrates that contrary to common assumptions, there were large groups of people who conceptualised India not just as a linguistically heterogenous nation, but one that consisted of linguistically heterogenous states that protected minority linguistic communities. [ABSTRACT FROM AUTHOR]

Background and Objectives: The purpose of research was to investigate the incidence of non-alcoholic fatty liver disease, also known as fatty liver, in diabetic patients. Methods: The research was done from June 2019 to May 2020 at Department of General Medicine, Katuri Medical College and Hospital, Guntur, Andhra Pradesh, India. 85 type 1 and type 2 diabetics were examined. IPD and OPD patients participated. The study group included 20 males and 65 females, ages 19 to 73. Results: 3 males (3.5%) had fatty liver and 30 females (35.3%). In 36 of 85 diabetics tested, fatty liver was detected. Patients with fatty liver and central obesity (waist-hip ratio >1): 25 (69.44%). Patients with fatty liver had >180 triglycerides 31 (86.1%). Overweight patients with fatty liver numbered 24 (66.67%). 12 fatty liver patients had normal BMIs (33.33%). Patients with fatty liver and high cholesterol (>200 mg %): 23 (69.69%). No change in serum protein or albumin globulin ratio. Conclusion: Non-alcoholic fatty liver disease was 42.35% frequent, especially in type 2 diabetics. It affected women (35.3%) more than males. NAFLD is more common in extremely obese and centrally obese people. 90% of fatty liver sufferers had dyslipidaemia's (particularly hypertriglyceridemia). [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is a chronic condition that can cause complications due to poor glycaemic control. The demographic characteristics, information related to DM and management, anthropometric variables, and the body fat composition of T2DM individuals are important factors influencing glycaemic control. This study was conducted to explore the association between glycaemic control and selected demographic characteristics, information on T2DM management, and body fat composition in T2DM patients. This cross-sectional survey amongst people with T2DM was conducted in the Udupi district of South India. A number of 467 participants were selected for the study using a simple random sampling technique. The survey included three parts: a questionnaire, an anthropometric and body fat composition measurement, and a biochemical assessment. The multivariate logistic regression model showed that not consulting the dietician (OR=6.074); the presence of complications (OR=2.955); visceral fat ≥10 (OR=2.037); non-compliance to exercise (OR=2.007); availing treatment from the private sector (OR=1.85); and non-consumption of traditional remedies (OR=1.651) were the associated factors to poor glycaemic control in T2DM patients. Not consulting dieticians, complications, non-compliance to exercise, not consuming traditional remedies, visceral fat ≥10 and availing treatment at private setup were the significant associated factors for the poor glycemic control. [ABSTRACT FROM AUTHOR]

Jeremy Bentham regarded "law" as a tool for achieving the greatest good for the largest number of people 1. Aristotle stated that man is a social animal. A group of individuals is referred to as a society when they engage with one another to meet their needs. As surrogacy is a long-standing practice in India, laws are created to establish a civilized society. Typically, the term "surrogacy" refers to the act of one woman acting on behalf of another2. We live in a technological age now. As a result, modern science has created several reproductive methods. One way an infertile couple can fulfill their wish to have their own biological child is through surrogacy. In the process of becoming a surrogate, a woman is artificially inseminated with a man's sperm, or donated eggs/wife are fertilized with the husband's sperm through IVF technology, and the embryo is put into a surrogate uterus. The surrogate mother then gives birth to the surrogate child after a predetermined amount of time and gives the infant to the commissioning parents. On the other side, the word "surrogacy" describes a contract where a surrogate mother conceives a child "for" an intended couple. Since commercial surrogacy became legal in 2002, foreigners favor India. Although all parties appear to benefit from this arrangement, there are several sensitive concerns that require careful consideration in the creation of regulations in order to safeguard the interests of those participating in the surrogacy process. For prospective couples who are unable to conceive owing to a variety of physical, genetic, or medical issues, the ART process is like a blessing. In landmark cases Baby Manji3 and Jan Balez4 case various issues were raised regarding parenting to surrogate mothers, children, and commissioning parents. India has become a hub of surrogacy practice. Thus, the surrogacy process identifies several socio-legal, ethical, and physiological issues. [ABSTRACT FROM AUTHOR]

We focus on capacity planning and admission control of people accessing a system consisting of paths, where the flow varies along spatial, temporal, or event‐based dimensions. People arrive during a time window, are admitted, travel through specified paths, and leave the system within a provided admission time guarantee. The decisions include choosing capacity for disruption plans and reactive capacity, adaptive path adjustment through redirection, and admission control in response to realized demand scenarios. We first develop a continuous‐time model to choose optimal capacity for disruption plans corresponding to an expected admission time guarantee. The next model determines the optimal upfront versus reactive capacity decisions given demand scenarios. For each disruption plan, a mathematical programming model chooses optimal capacity by path segment, redirection, and admission control over time to manage realized demand under an admission time guarantee. We quantify the value of flexible capacity deployment and: (a) provide the optimal capacity by disruption plan to ensure an admission time guarantee, (b) provide the optimal long term capacity and reactive capacity, and (c) provide the optimal adaptive routing and admission control decisions to minimize capacity costs to ensure an admission time guarantee. We apply the model to data from the Kumbh Mela at Ujjain, a bathing festival in India that attracts close to 85 million people over a 25‐day period, to provide insights for managers. The models can assist managers of food festivals, music events, religious walks, and other events involving managing people flow across paths during specific time windows. [ABSTRACT FROM AUTHOR]

Amrita Pritam is one of the most celebrated luminaries of Indian literature that had dexterity over both Punjabi and English languages. She had been a great creative genius among all the born poets and writers who achieved the greatest milestones in the field of literature and expressed the voice of not only their heart but also the common people at large. She had a bold and clear voice for all those feelings that make our eyes full of tears and sometimes give us the greatest joy of life and sometimes tell us the greatest truth of life. She is the writer whose works have been translated in various languages of India as well as the world and has won the most prestigious awards like Sahitya Academy, Janpith, and various other awards not only in India but also abroad. In this chapter, I would like to focus on the two most striking conflicts of her life which changed her perceptions of the world of metaphysics and that of reality: her conflict about the existence of god and her conflict in love. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus is one of the non-communicable disease which has become a major global health problem. A study done by the Indian Council of Medical research (ICMR) in 1970s reported a prevalence of 2.3% in urban areas(1,2) which has risen to 12-19% in 2000s. Although improving control of diabetes in India is important, the associated risks of tight control in high risk groups should also be kept in mind. Objectives: To study the prevalence of diabetes in urban population and to estimate the usefulness of the Indian diabetes risk score for detecting undiagnosed diabetes. Materials and Method: This is a community-based cross-sectional (descriptive) study carried out in the urban field practice area of Basaveswara Medical College and hospital which covers a population of 31186 from July to October 2019. Data was collected by using a validated questionnaire by house to house visit to find out the prevalence and the risk of diabetes mellitus in general population by using Indian diabetes risk score. Results: A total of 624 respondents were interviewed. Among them 298(24.35%) females and 326(26.63%) were males. Most 422(34.48%) had no family history of diabetes mellitus and 338 (27.61%) individuals were in the overweight category. Out of these overweight persons, 36.6% had high diabetic risk score. [ABSTRACT FROM AUTHOR]

Crowd Management is always a challenging task when people gather in large numbers. Crowd disasters in India, including recurring incidents at religious venues, demands a crowd management system developed on the characteristics of the place, event, and participants. Assessment of carrying capacity is the prime process to design crowd management protocols and regulations. Carrying capacity assessment of religious gathering venues in India is often an overlooked process. The present study assessed the crowd carrying capacity of Sabarimala pilgrimage, Kerala, India. Physical carrying capacity assessment methods used for tourism venues have been applied and contextualised for crowd carrying capacity assessment. Characteristics of the venue, pilgrimage and pilgrims were studied to map the active crowd area and space utilisation zones. The physical carrying capacity was estimated based on the comfortable crowd density and threshold crowd density assessments. The study identified two factors influencing pilgrim movement within the venue viz. service level at the holy step and capacity of the darshan facility. Service level at the holy step is the prime factor that regulates the flow of the pilgrim within the venue including the pilgrim movement for deity darshan and hence the comfortable capacity of the holy step was distinguished as the effective carrying capacity of the venue. Physical carrying capacity at the comfortable crowd density has to be maintained throughout the event to avoid the triggering of crowd crushes. The crowd carrying capacity assessment (CCCA) method applied in this study is a simple process. Considering the crowd density and crowd regulation factors, the CCCA method can be applied to design crowd management protocols of other religious pilgrimage destinations in India. [ABSTRACT FROM AUTHOR]

The informal economy in India provides more than 90 per cent of the labour force. This leads to the largest number of people in informal settings being trained informally and their skills are considered to be low. Previous research findings, however, have not supported this general assumption about low skill levels. The current study is concerned with the sub-sector of urban tailoring that has not yet been the focus of much research. The main questions of interest are: What kinds of skills do Indian tailors have and where and in what ways are these skills acquired? Twelve interviews with tailors were conducted in Delhi and ten in or near Vellore, Tamil Nadu. The results show clearly that tailors in the informal sector in India not only have a wide range of skills in tailoring, but also in organizing and running their business in economic terms. [ABSTRACT FROM AUTHOR]

The objective of the study was to analyse selected anthropometric features of children, adolescents and young adults from middle-class families in Kolkata, India, by BMI and adiposity categories. Standardized anthropometric measurements of 4194 individuals (1999 male and 2195 female) aged 7-21 were carried out between the years 2005 and 2011. The results were compared by BMI and adiposity categories. Statistical significance was assessed using two-way-ANOVA and linear regression analysis was performed. The study population could be differentiated in terms of BMI and adiposity categories for all examined anthropometric characteristics (p ≤ 0.001). After taking age into consideration, differences were observed for males in the case of body height and humerus breadth in BMI and adiposity categories, and for femur breadth in the case of adiposity categories. For females, differences were noted in body height measurements in BMI and adiposity categories, a sum of skinfold thicknesses in BMI categories, and upper-arm and calf circumferences in adiposity categories. The patterns of differences in the BMI categories were found to be similar to those in adiposity categories. The linear regression analysis results showed that there was a significant relationship between BMI and body fat ratio in the examined population. Underweight individuals, and those with low adiposity, were characterized by lower extremity circumferences and skeletal breadths. These features reached highest values in overweight/obese persons, characterized by high body fat. However, the differences observed between each BMI and adiposity category, in most cases, were only present in early childhood. [ABSTRACT FROM AUTHOR]

The advent of Buddhism in India is usually dated back to 6th century BCE. Siddhartha Goutama, a Sakya Prince left for quest of truth and reality of life. He was showered with the divine light of enlightenment, then, instead of keeping it to himself, Gautama preferred to enlighten others. The teachings preached and propounded by Gautama Buddha were warmly accepted by a large number of people and emerged as a new school of thought i.e. Buddhism which later turned into a major religion of the world and the Buddhist remains discovered through archaeological investigations help us to reconstruct our past. (Chakrabarti, 2006: 315) It is a well known fact that various the kings of different kingdoms like Magadha, Vaisali, the Sakayas, the Bullis, the Koliyas, the Mallas, the Moriyas and Kalinga (Ancient Odisha) sought for the relics of the Buddha after the parinirvana. (Kern, 1989: 46) The emperors, kings, traders and commoners extended patronage and built monuments, kept relics, offered gifts to pay ovation to the Master Teacher. This historical phenomenon is known from various forms of Buddhist monuments built across India. Odisha, a geographical orbit of South Eastern India, is fortunate to have received a good deal of Buddhist monuments and relics. This paper is intended to present an account of different forms of Buddhist monuments that have been discovered so far, such as Stupas, Chaitys, Monasteries under the possible patronage of Buddhism in this part of India from third century BCE to sixth-seventh century CE. [ABSTRACT FROM AUTHOR]

Background: The role of common variants in leptin promoter has already been established to play a major role in obesity and diabetes in humans. The study was accordingly focused on leptin promoter variants and their potential association with diabetes and obesity in ethnic population from Kashmir, India. Methods: Allele frequencies of 620 Kashmiri subjects with diabetes (200), obese subjects (200), and ethnically matched healthy controls (200) were tested for the Hardy–Weinberg disequilibrium. Among 200 obese subjects, a total of 50 persons were with diabetes. The genotype and allele frequencies were evaluated using the Chi-square or Fisher's exact tests. Results: Sequence analysis revealed two reported variations i.e., rs72563764C>T and rs7799039G>A in promoter region. Both variants show homozygous as well as heterozygous genotypes. These variations indicated significant difference with respect to allelic and genotypic frequencies in all groups i.e., persons with diabetes, obese, and obese persons with diabetes (P < 0.05). We also analyzed the association of these variations with biochemical characteristics and found significant association of rs72563764C>T with triglycerides (TG) in obese patients and fasting plasma glucose (FPG) and random blood sugar (RBS) in obese/persons with diabetes. Also rs7799039G>A showed association with postprandial plasma sugar (PPPS) in obese patients and FPG and resting plasma glucose (RPG) in obese persons with diabetes. Conclusions: Our results are suggestive of the association of leptin promoter gene variations i.e., rs72563764C>T and rs7799039G>A with both diabetes and obesity. [ABSTRACT FROM AUTHOR]

Background: Obesity is a global epidemic. Bariatric surgery is being considered as the treatment of choice in morbid obesity. Psychiatric comorbidity affects outcomes in this population. There is a dearth of data on psychiatric profile of the morbidly obese from Indian subcontinent. We studied people with morbid obesity to estimate the psychiatric burden among them and to identify factors associated for developing psychiatric disorders. Methodology: This is a cross-sectional study done in a bariatric clinic of a tertiary care teaching hospital in South India. Sixty morbidly obese patients were evaluated by psychiatrists and data from medical records were collected and analyzed. Prevalence of psychiatric disorders was estimated. They were compared with patients without psychiatric disorders using appropriate statistical tests. Results: Nearly 33.33% of the patients had a psychiatric disorder. Depression and dysthymia accounted for about half of those cases. The variables that were associated with psychiatric disorders were current suicidal ideation, past self-injurious behavior, perceived poor social support, and past psychiatric history. Conclusion: One-third of the morbidly obese patients having psychiatric disorder is suggestive of high comorbidity. Considering this active involvement of psychiatrists in bariatric clinic would be useful. [ABSTRACT FROM AUTHOR]

Context: Hypothyroidism is one of the most common thyroid disorders in India, affecting one in ten adults. Although the diagnosis and treatment of hypothyroidism are often considered simple, there are large number of people with this condition who are suboptimally treated. Due to wide spectrum of the disease and high prevalence in the society, the current issue was opted for study and its management by means of Ayurvedic principles. Materials and Methods: Fifteen eligible hypothyroid patients with serum thyroid-stimulating hormone >4.5 μIU/ml and serum T3and T4 lower than their respective normal range were selected and treated with Triphladya Guggulu pills and Punarnavadi Kashayam (decoction) for 45 days. Patients were advised to discontinue any medicine they might be taking for the management of hypothyroidism to assess the unbiased effect of therapies. Results: Significant improvement was observed on subjective parameters, but the results on objective parameters were statistically insignificant (P > 0.05). Of the 15 enrolled patients, excellent improvement was observed in 33.33% of the patients, while marked improvement was reported by 53.33% of the patients, moderate improvement was found in 6.66% of the patients and same number of patients, that is, 6.66% showed mild improvement. Moreover, few interesting observations were noted 4 months after completion of the trial. Out of 15 patients registered, 86.66% had positive drug history for levothyroxine. After clinical trial, 6.66% of the patients continued their previous dosage of levothyroxine, while 80% of the patients had withdrawn their hormone replacement therapy. Conclusion: Triphladya Guggulu and Punarnavadi decoction are effective in the management of hypothyroidism. [ABSTRACT FROM AUTHOR]

Introduction: Risk of metabolic syndrome is 2-3 times more in persons with high visceral fat. Increased accumulation of visceral fat is associated with hypertension in adults, children and adolescents. Aims: The present study was undertaken to check association of visceral fat with blood pressure in Indian adolescents of 18-19 years of age group. Methodology: Our study was conducted on 120 healthy Indian adolescents (60 males and 60 females) of 18-19 years of age group from various colleges in vicinity of Shree Krishna Hospital, Karamsad, Gujarat, India after their voluntary consent. Body visceral fat was recorded by bioelectrical impedance technique using Omron HBF-302 body fat analyzer. Systolic blood pressure (SBP) and Diastolic blood pressure (DBP) were measured by Omron T8 (HEM757A4-C1) Automatic Blood Pressure instrument by following all standard precautions. Results: All participants were divided into two groups on the basis of their visceral fat. Participants with visceral fat 0 to 9 were categorized as normal visceral fat group and participants with visceral fat ≥ 10 were categorized as high visceral fat group. In high visceral fat Indian adolescents, systolic blood pressure (SBP), diastolic blood pressure (DBP) & mean arterial pressure (MAP) were more and statistically significant than low visceral fat Indian adolescents. Conclusion: Visceral adiposity correlated with MAP, SBP and DBP in both gender with better correlation in females. [ABSTRACT FROM AUTHOR]

Sports goods, we all know, do not fall under the category of necessary items for a large population, especially in a society which is a part of developing economy. Sellers of the commodities like sports goods, in the countries like India, are to manage on many fronts when it comes to increase the sale profitably. On the one hand they have to understand the changing needs and requirements of the existing customers of sports goods while partly they need to undertake all such measures which, if possible, can help in turning the non-customers into customers. In other words they have not only to concentrate to offer the brands of choice to the customers of sports goods on the conditions they want but also, through show casing, for example, lure the ones who till the other day were not interested in engaging themselves in sports activities. Promoting a brand, we know, is not that much a difficult task as promoting a product and that too for such items which are not considered necessary by a large section of the people in the society, specially the one which is in the stage of only a developing economy. Thus being able to sell such items which are not much in demand, as pointed out above, will certainly require a seller to be extra skillful. This paper dwells on the isses as mentioned above and covers factors and their relative importance in the area of sports marketing in emerging sports centres of India. [ABSTRACT FROM AUTHOR]

This article analyses a nationally representative household dataset-the National Family Health Survey (NFHS-3) conducted in 2005 to 2006-to examine factors influencing the prevalence of overweight/obesity in India. The dataset was disaggregated into four sub-population groups-urban and rural females and males-and multi-level logit regression models were used to estimate the impact of particular covariates on the likelihood of overweight/obesity. The multi-level modelling approach aimed to identify individual and macro-level contextual factors influencing this health outcome. In contrast to most studies on low-income developing countries, the findings reveal that education for females beyond a particular level of educational attainment exhibits a negative relationship with the likelihood of overweight/obesity. This relationship was not observed for males. Muslim females and all Sikh sub-populations have a higher likelihood of overweight/obesity suggesting the importance of socio-cultural influences. The results also show that the relationship between wealth and the probability of overweight/obesity is stronger for males than females highlighting the differential impact of increasing socio-economic status on gender. Multi-level analysis reveals that states exerted an independent influence on the likelihood of overweight/obesity beyond individual-level covariates, reflecting the importance of spatially related contextual factors on overweight/obesity. While this study does not disentangle macro-level 'obesogenic' environmental factors from socio-cultural network influences, the results highlight the need to refrain from adopting a 'one size fits all' policy approach in addressing the overweight/obesity epidemic facing India. Instead, policy implementation requires a more nuanced and targeted approach to incorporate the growing recognition of socio-cultural and spatial contextual factors impacting on healthy behaviours. [ABSTRACT FROM AUTHOR]

Objective: To assess trends in nutrient intakes and nutritional status of rural adult women (≥18-60 years) and the association of sociodemographic characteristics with overweight/obesity.Design: Community-based cross-sectional studies carried out during 1975-79 to 2011-12 by the National Nutrition Monitoring Bureau (NNMB) were used. Anthropometric measurements such as height, weight and waist circumference, carried out during the surveys, were used. Association and logistic regression analyses between sociodemographic characteristics and overweight/obesity and abdominal obesity were conducted using a complex samples procedure.Setting: Ten NNMB states of India.Subjects: Non-pregnant and non-lactating rural women aged ≥18-60 years covered during the above periods from ten states in India.Results: The prevalence of chronic energy deficiency has declined from 52 % during 1975-79 to 34 % during 2011-12, while that of overweight/obesity has increased from 7 % to 24 % during the same period. Median intakes of most of the nutrients have increased over the same period, although they were below recommended levels. The chance of overweight/obesity and abdominal obesity was significantly (P<0·01) higher among women aged 40-60 years, those belonging to Christian religion and other backward communities, women living in pucca houses, literate women, women engaged in service and business, and those having higher per capita income.Conclusions: Prevalence of chronic energy deficiency has declined significantly; however, overweight/obesity has increased during the same period. This increase in overweight/obesity may be attributed to increased consumption of fatty foods, sedentary lifestyle and improved socio-economic status. There is a need to educate the community about regular physical exercise, low intakes of fats and oils, and a balanced diet. [ABSTRACT FROM AUTHOR]

Background: Numerous studies worldwide have identified a high prevalence of non-alcoholic fatty liver disease (NAFLD) among morbidly obese subjects. Several predictors have been found to be associated with NAFLD and its histological high-risk components. Similar data from India is lacking. We aimed to determine the prevalence and the predictors of NAFLD and its histological high-risk components in a cohort of Indians with morbid obesity undergoing bariatric surgery. Safety of a routine intraoperative liver biopsy was also assessed. Methods: There were 134 morbidly obese patients who underwent bariatric surgery with concomitant liver biopsy. These were assessed for NAFLD and its histological high-risk components. Clinical, biochemical, and histological features were evaluated, and predictors of NAFLD, non-alcoholic steatohepatitis (NASH), fibrosis, and advanced fibrosis were identified. Results: Mean BMI was 44.66 ± 9.81. Eighty-eight (65.7 %) showed NAFLD. Forty-five (33.6 %) showed NASH and 42 (31.3 %) showed fibrosis both not mutually exclusive. Nineteen (14.1 %) showed advanced fibrosis. Higher alanine aminotransferase (ALT) independently predicted NAFLD and was significantly associated with NASH and fibrosis. Type 2 diabetes mellitus (T2DM) and the metabolic syndrome were significantly associated with fibrosis. Systemic hypertension (HT) independently predicted NASH and fibrosis. There were no intraoperative or postoperative complications related to the liver biopsy. Conclusions: NAFLD has a high prevalence among morbidly obese patients. Elevated ALT, HT, T2DM, and the metabolic syndrome are predictors for NAFLD and its high-risk histological components. Routine intraoperative liver biopsy is safe in morbidly obese undergoing bariatric surgery for diagnosing NAFLD. [ABSTRACT FROM AUTHOR]

Aim: To describe recruitment challenges in a randomized controlled translational trial (RCTT) of diabetes prevention in India.Methods: The Diabetes Community Lifestyle Improvement Program (D-CLIP) is a RCTT, comparing standard of care to a step-wise model of diabetes prevention. Overweight adults with prediabetes were identified through a two-step screening process (1) field-based screening: minimal testing with a random capillary glucose measurement and (2) clinic-based screening including an Oral Glucose Tolerance Test (OGTT).Results: Individuals from the community (n=19377) were screened at residential locations, offices, educational institutions, places of worship, parks and beaches. Of these, 3535 (18.2%) 'high-risk' participants based on capillary glucose values were eligible for step 2 screening with OGTT. However, only 21.5% participated. An additional 521 participants directly entered step 2 via direct referrals from our clinical/research databases, study participant referrals and targeted advertisements. Of the 1285 individuals who underwent an OGTT, 710 (55.3%) were eligible for randomization, and 602 (84.8%) were randomized into the trial. The ratio of participants entering from step 1 to step 2 was 25:1 (3.9%) and from step 2 to randomization 2:1 (47%). Average staff time for recruitment was 350 h per week for an 11-person team.Conclusions: Nearly 55 people needed to be screened with a questionnaire plus capillary glucose test to randomize one participant with prediabetes. Using a 2-step strategy requires additional staff time, but considerably reduces the need for OGTT's, thereby minimizing participant burden and study costs. [ABSTRACT FROM AUTHOR]

We studied the morbidity pattern of inpatient adolescents over a period of 17 months. Of 32115 admissions in this period, 2742 were adolescents (39.7% females). 93.9% were partially immunized, 37.3% were malnourished, 2.8% were overweight and 56% were anemic. Dengue and dengue-like illness (528) were the most common illness. [ABSTRACT FROM AUTHOR]

Background: For better perception of adolescent overweight and obesity as a global public health problem, systematic collection of baseline data is urgently needed in India. Objective: A community-based study was undertaken for better perception of the prevalence and correlates of obesity in an adolescent urban community in Katihar, Bihar. Materials and Methods: A cross-sectional study was conducted among urban adolescents in the eastern part of India to find out prevalence of overweight and obesity and sociodemographic correlates by interview technique followed by clinical examination with ethical consideration. Results: Out of 400 adolescent study participants, 21% were overweight or obese. The study showed that there was a significant association between less consumption of vegetable foods, fruits, meals cooked outside the home, alcohol consumption, yoga practice, socioeconomic status, and the occurrence of overweight/obesity in the adolescents. Conclusions: We attempted to find out the prevalence and risk correlates of overweight and obesity among adolescents and found it quite alarming compared to developed countries. The urban underserved population in India has difficulty to access quality healthcare and not conscious enough to seek healthcare until critically ill. Community-based studies are required to highlight the problem of obesity among urban adolescents by a comprehensive approach. [ABSTRACT FROM AUTHOR]

Background Urban migration is associated with an increased risk of hypertension, obesity and diabetes in Indian migrants. This study assessed the relationship between internal migration and renal function in the Hyderabad arm of the Indian Migration Study. Methods We assessed 841 subjects; urban non-migrants (n = 158), urban migrants (n = 424) and rural non-migrants (n = 259). Muscle mass was ascertained from DXA scanning. We derived urban life years for urban migrants and rural non-migrants. Multivariable linear regression was used to examine the association between tertiles of urban life years and 4-variable MDRD eGFR using Stata 11. Results Mean eGFR was lower in urban non-migrants and urban migrants compared to rural nonmigrants. The prevalence of CKD 3-5 was higher in the rural non-migrant population (5.0%) than in the urban non-migrant populations (2.5%) due to a negatively skewed distribution of eGFR in rural non-migrants. As urban life years increased, eGFR declined (p = 0.008) though there was no obvious dose response effect. After adjustment for muscle mass, the association was attenuated and the trend was consistent with chance (p = 0.08). Further adjustment for vascular risk factors weakened the association to a small degree (p = 0.11). Conclusions The high prevalence of reduced eGFR in rural areas requires further research. Urbanization was associated with reduced eGFR. This association appears mostly to be due to higher muscle mass with a small contribution from adverse vascular disease risk factors. [ABSTRACT FROM AUTHOR]

If some research indicates that bodies are becoming central to the life projects of 'new liberal Indian' women, public debates simultaneously reveal that their bodies are entangled in satisfying traditional and modern ideals of womanhood. There are few studies, though, that have looked into how women reconcile and make use of contradictory cultural signals surrounding their bodies that arise out of a rapidly changing gender and class structure. We draw upon both followers and critics of Bourdieu to show that bodily concerns and undertakings of 48 urban Indian women, and the ways in which they resist and embrace cultural demands on their bodies, vary by social class locations. The women in the study who were most keenly aware of 'options' embedded in thin or fit bodies were the ones who could take advantage of new careers and styles of living that the global economy was bringing to their doorsteps. In contrast, women who saw limited prospects for social mobility were unconvinced of the symbolic value of a thin body and rejected appearance concerns on the ground that it interfered with their mothering responsibilities. We conclude that while the fit body has indeed emerged as an important site of self-making for the modern Indian woman, the degree to which she sees costs and benefits involved in the bodywork of losing weight depends on her class location. [ABSTRACT FROM AUTHOR]

Objective: To share our clinical experience with exenatide in obese North Indian subjects with type 2 diabetes. Materials and Methods: We share our experience with use of exenatide in 74 patients treated at Indraprastha Apollo Hospital, a tertiary care centre in New Delhi, India Subjects included obese / overweight subjects (mean weight and BMI; 97.67 ± 5.6 kg and 34.56 kg/m²) with known history of type 2 DM (Mean: 9 ± 5.6 years) and maintaining suboptimal glycemic control (HbA1c >7%) on oral antidiabetic agents, with or without basal insulin. Metformin and sulphonylureas were continued (with dose adjustment if indicated), as was basal insulin (glargine / detemir). TZDs and DPP4 inhibitors were discontinued. The dose of exenatide was increased to 10 mcg twice a day after 4-12 weeks. 56 patients completed minimum 3 month therapy. 42 patients completed 6 months, 32, 9 months and 25 completed 12 months. Data of patients who had completed at-least 3 months of therapy was included for analysis. Results and Discussion: 69.77, 67.44, and 13.95% of the patients were receiving metformin, secretagogues or thiazolidinediones alone or in combination; 17.76% of the patients were on basal insulin. The change in fasting and post-prandial blood glucose levels were significant at 3, 6, 9 and 12 months with P-value <0.05. The mean weight loss at one, three, and six months and one year was 1.7 ± 1.3, 3.8 ± 2.5, 6.3 ± 3.4, and 8.3 ± 4.3 kg, respectively (P <0.05). The mean HbA1c (baseline: 8.8 ± 1.3%) at 3, 6 months and at one year was 7.8 ± 0.9, 7.7 ± 0.8 and 7.2 ± 0.8 (P <0.05). Thirty-five percent of the patients had a 'good' A1c value (< 7%) at the end of 12 months. 13 patients discontinued exenatide (three due to lack of response, six due to cost of therapy and four due to severe nausea). Nausea was the most common side effect, occurring in 95% patients within 1 month, although the incidence declined with passage of time. Conclusions: Clinical use of Exenatide is associated with significant improvement in glycemic control and major weight loss (8.3±4.3 kg at 1 year) in obese subjects with type 2 diabetes. Nausea is the most common side effect. In conclusion, exenatide is a effective and useful option for treatment of type 2 diabetes in obese Indian subjects. [ABSTRACT FROM AUTHOR]

Background: The incidence of obesity and related metabolic disorders in India and that of stomach carcinoma is one of the highest in the world. Hence, one requires a procedure that allows postoperative surveillance of the stomach with the best outcomes in terms of weight control and resolution of co-morbidities. Here, we compare one such procedure, duodenojejunal bypass with sleeve against the standard Roux-en Y gastric bypass. Methods: Fifty-seven patients who were selected for a bypass procedure were randomized into two groups of laparoscopic duodenojejunal bypass with sleeve (DJB) and laparoscopic Roux en Y gastric bypass. The limb lengths were similar in both the groups, and the sleeve was done over a 36F bougie. Results: The mean body mass index and percent excess weight loss at the end of 3, 6, and 12 months between the groups were not statistically significant. The operating times were higher in the DJB group. The rate of resolution of diabetes, hypertension, and dyslipidemias were also similar with no statistical significance. There was 100% resolution of dyslipidemias in both groups. There was one patient in the DJB group who presented with internal herniation 1 month post-op and was managed surgically. There was no mortality in both the groups. Conclusion: Laparoscopic duodenojejunal with sleeve gastrectomy, a procedure which combines the principles and advantages of sleeve gastrectomy and foregut hypothesis, is a safe and effective alternative to gastric bypass in weight reduction and resolution of co-morbidities especially for Asian countries. But, long-term follow-up is required. [ABSTRACT FROM AUTHOR]

Objective: To develop age and sex specific cut-offs for BMI to screen for overweight and obesity in Indian children linked to an adult BMI of 23 and 28 kg/m respectively, using contemporary Indian data. Design: Cross-sectional. Setting: Multicentric, School based. Participants: 19834 children were measured from 11 affluent schools from five major geographical regions of India. Data were analyzed using the LMS method, which constructs growth reference percentiles adjusted for skewness. Results: Compared to the cut-offs suggested for European populations and those by the Indian Academy of Pediatrics 2007 Guidelines, the age and sex specific cut off points for body mass index for overweight and obesity for Indian children suggested by this study are lower. Conclusions: Contemporary cross-sectional age and sex specific BMI cut-offs for Indian children linked to Asian cutoffs of 23 and 28 kg/m for the assessment of risk of overweight and obesity, respectively are presented. [ABSTRACT FROM AUTHOR]

Objective: To compare three growth references that can be used to assess the weight status of school-aged youth living in India, with a particular focus on identifying overweight and obese youth. Study Design: Cross-sectional study. Kappa scores were used to measure agreement between growth references. Regression models were used to test for differences in weight status by grade level, gender, and school type, using each growth reference. Setting: Private (n=4) and Government schools (n=4) in Delhi, India. Participants: Students (n=1818) in eighth and tenth grade attending the schools. Main outcome measures: Weight status was derived using age- and gender-specific cut-points provided by: (a) a national growth reference specific to India; (b) an international reference recommended by the International Obesity Task Force (IOTF); and (c) a new international reference recommended by the World Health Organization (WHO). Results: The IOTF reference consistently classified participants in a lower weight status category, compared with the national reference (?=0.57) and the WHO reference (?=0.69). The agreement between the WHO and the national references was higher (?=0.84). Conclusions: To date, all published studies of childhood obesity in India have used the IOTF reference, the national reference, or an old WHO reference to measure weight status among school-going youth. The new WHO reference may be a better choice. Compared to the IOTF reference, it does not appear to underestimate obesity and can still be used to compare trends, globally. [ABSTRACT FROM AUTHOR]

The article presents a cross sectional study to examine whether waist-to-hip (W/H) ratio is a better indicator of obesity over body mass index (BMI) among older people in an urban area of Jaipur, India. The study employed 270 individuals in the age group 60 and above. It was found that W/H ratio is a better indicator of obesity for development of hypertension.

The present study was conducted in the Urban Health centre, Muthialpet, Pondicherry covering a population of 40000 from July to October 2007 by using a predesigned and pretested proforma to find out the risk of diabetes in general population by using Indian Diabetes Risk Score. A total of 616 respondents were studied comprising 325(53%) females and 290(47%) males. Majority 518(85%) were Hindus. Of them, 380 (62 %) had studied up to higher secondary and above, 539 (87%) belonged to upper middle and upper socioeconomic class. A large number of the subjects 422(68%) were above 35 years of age. Most of the respondents 558(90.50%) indulged in mild to moderate physical activity. Again, 422 (68.50%) had no family history of diabetes mellitus, 315 (51%) individuals were in the overweight category (>25 BMI), and 261 (83%) of high Diabetic Risk Score individuals were overweight. It is observed that chances of high diabetic score increase with the increase in BMI. Prevalence of diabetes in the studied population were 51 (8.27%), out of that 39 (76%) had high (>60) IDRS score. The relationship between BMI and IDRS shows that if BMI increases from under weight (<18.50) to obesity (>30) chances of risk for diabetes also increases significantly. [ABSTRACT FROM AUTHOR]

Background: Obesity has become a major chronic disorder affecting the larger population more than any other disease in the world. Objectives: 1) To determine the prevalence of obesity in both sexes in persons aged 30 years and above. 2) To determine the relationship of epidemiological determinants on the obesity status in the study subjects. Materials and Methods: The present study had been undertaken in literate high income group colonies of Gwalior city in which persons aged 30 years and above, in a family, were interviewed. A house-to-house survey method on a pre-designed, pre- tested structured questionnaire was used. Information regarding socio-demographic profile, eating habits and current health status were recorded. Anthropometric data regarding height, weight and blood pressure was also taken. The data was collected and analyzed using statistical software and chi square and proportional statistical test were applied. Results: The study showed that 34.4% of males and 31.3 % of females, both aged 30 years and above were either obese or over weight. There was a statistically significant difference noted in the likening of fried food and fast food between obese and overweight persons and persons with normal body mass index. Conclusions: It can be concluded from the present study that obesity is a chronic illness. Early detection of it can prevent various complications associated with it. BMI plays a crucial role in its early detection as it is simple to calculate and can even detect the pre-obesity stage in time. [ABSTRACT FROM AUTHOR]

Context • Ayurveda, the traditional Indian medical system, is receiving increasing attention worldwide. Objective • A retrospective study was conducted to determine the effectiveness of Ayurvedic constitution-based diets on weight loss patterns of obese adults. Design, setting subjects, and intervention • Records of 200 obese adults, both male and female, who had completed 3 months of the diet therapy at Ayurvedic clinics, were examined and data collated. Techniques used included a checklist of Personality traits. physical signs, and food likes and dislikes to determine the dosha. Based on the predominant doshas, diets were prescribed and closely monitored for a period of 3 mouths. Outcome measures • Records of height and weight and chest, abdominal, waist, arm, and thigh circumferences noted initially and after each month for the period of 3 months were obtained. Results • Among the 200 subjects, 55 (27.5%) were vatta-, 83 (41.5%) were pitta-, and 62 (31.0%) were kapha-predominant. At the beginning, kapha and pitta people were heavier than vatta people. After the 3 months of therapy, the pitta group lost the most weight (9.84%). The decrease in all the anthropometric measurements was higher inpitla and kapha people than in vatta individuals. Hence, diets based on Ayurvedic constitution may prove useful in promoting weight loss. Though these promising findings support traditional Indian Ayurvedic scriptures, more closely controlled trials are needed to substantiate these findings. [ABSTRACT FROM AUTHOR]

The article discusses a study regarding the prevalence of overweight among adolescents in the urban area of Hyderabad, India, and identifies its factors. A cross-sectional and institutional study was administered in 2003 on adolescents 12 to 17 years of age. The study revealed that 6.1 percent of the boys and 8.2 of the girls were overweight, and 1.6 percent and 1.0 percent were obese respectively. It was stated that physical activities and healthy eating could help reduce obesity.

The article focuses on the study emphasizing on the high level of overweight and obesity in a sample of older Asian Indians living in urban areas of New Zealand and India. Findings show that the group in Auckland had a higher pervasiveness of being obese than the ones living in New Delhi. Moreover, it shows that exercise or physical activity was a more popular and recommended weight management strategy than diet.

In the present cross-sectional study, an attempt has been made to report the prevalence of overweight and obesity in school-going children of the affluent families of Punjab. A total of 1000 children (490 boys and 510 girls) were measured for height and weight. Overweight and obesity were assessed using age and sex-specific body mass index (BMI) cut-off points. In the present study, 12.24% boys and 14.31% girls were overweight, and 5.92% boys and 6.27% girls were obese. The prevalence of overweight and obesity among the affluent school children of Punjab was as high or higher as in some developed countries. [ABSTRACT FROM AUTHOR]

Copyright of Collegium Antropologicum is the property of Croatian Anthropological Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The author comments on a study published within the issue which examined the prevalence of generalized obesity (GO), abdominal obesity (AO) and combined obesity (CO) in India. Topics discussed include the implication of the increasing obesity in rural India on the delivery of health care, the reduced high density lipoprotein observed in majority of the subjects and the cases of hypertension and good glycaemic control found in the study.

Appendicectomy is the most common abdominal operation performed on an emergency basis in most parts of the world. The laparoscopic technique has many advantages over conventional open surgery especially in women and obese patients. A further improved version introduced recently is using a single-incision (SILS). Inducing a pneumoperitoneum, as a necessary precondition of laparoscopic procedures, represents a restriction of the surgeon’s freedom of movement and can lead to typical though rare complications. Gasless laparoscopic surgery has most of the advantages of laparoscopic surgery without many of the disadvantages. It is also less expensive, and can be combined with regional anaesthesia. Furthermore, fewer disposable materials are necessary. We describe a series of single umbilical incision gasless laparoscopic appendicectomies performed in rural areas of India. [ABSTRACT FROM PUBLISHER]

The authors reflects on the efforts to prevent obesity in India. They describe the prevalence of obesity in India, along with the factors that influence the increasing number of obese people in India. They suggest innovative and low-cost ways to prevent obesity, such as promoting yoga and Indian folk dancing. The authors also note that not all aspects of traditional India are healthy.

The author reflects on the role of weight regulation in hypertension prevention in India as countries observe the World Hypertension Day on May 17, 2010. He says that the new obesity guidelines proposed by the Ministry of Health and Family Welfare means that 15% of the population are obese versus 3% of western countries such as Canada. He suggests addressing the socio-psycho-biology complex of obesity as eating less and moving more are not always effective. Rather than weight loss, he recommends the prevention of weight gain regardless of current weight.

Copyright of Collegium Antropologicum is the property of Croatian Anthropological Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)