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Background and aims: Diarrhoea is one of the deadliest diseases and causing death among children in India, but no systematic attempt is made to understand it especially its control using oral rehydration salts (ORS). It is well known that use of ORS and Zinc have been effective in containing diarrhoea among children. An attempt is made using large scale national data set in India to understand use of ORS and Zinc to control diarrhoea and their associated factors among diarrhoeal children under five in India. Methods: Publicly available most recent cross-sectional National Family Health Survey data in India was used for the study. The multi-stage cluster sampling design was used with 2011 Census of India as a sampling frame. Households were selected using a Systematic Random Sampling design from selected primary sampling units in rural and urban clusters. From the selected households, the eligible children were those who suffered from diarrhoea in the two weeks preceding the survey and were less than 5 years old. Using this criterion, out of 232,920 children in the survey of less than five years, 16,213 sample diarrheal children found to be available for the study. Both descriptive and inferential statistical techniques were used to analyse the data. Results: Across India, 61% and 31% of the children were given ORS and Zinc respectively. However, combined ORS + Zinc treatment was only around 24%. The treatment of ORS, Zinc, and combined ORS + Zinc supplementations were significantly higher among younger children, children of 24–35 age group mothers, children from rich wealth index groups, belong to Hindu religion and general caste compared to their counterparts. The logistic regression results showed that consumption of ORS among diarrhoeal children under five years of age depends upon size of a child at birth. For instance, diarrheal children who were very small size at birth compared to very large at birth, had 39% lower odds of consuming ORS (AOR = 0.61; CI 0.48, 0.78; p<0.001). Another important variable is place of first treatment sought for diarrheal children. That is children who first sought treatment in private hospital compared to government hospital had 52% lower odds of ORS consumption. The logistic regression adjusted AORs are similar with Zinc and ORS + Zinc supplementations. Conclusions: To improve the coverage and management of childhood diarrhoea in India, planning activities should focus not only on distribution, and increasing knowledge of ORS preparation especially for urban slum residents and rural disadvantaged groups through demonstration. There should be also proper focus on providing ongoing pathways to ensure proper supply chains. [ABSTRACT FROM AUTHOR]

Most of the women who use alcohol and tobacco before pregnancy likely to use alcohol and tobacco during pregnancy. The objectives of this study was to describe alcohol and tobacco use, and to identify associated characteristics during preconception period. The Indian National Family Health Survey-4 was used. A total of 65,238 preconception, young, married women were included and analysed usingbivariate and multivariate analyses statistical techniques. The data revealed that 4.3% of preconception women in India were using alcohol and tobacco. The prevalence of alcohol and tobacco use was higher among older women (5.6%), Scheduled Tribes (14.2%), living in rural areas (5.0%), non-educated (8.9%), poorest households (9.1%), northeast region (25.0%) and with a low body mass index (BMI) (6.2%). The adjusted odds ratios shown that after controlling for important background factors, being Hindu, from scheduled tribes, already having children, being underweight, from poorest households and Northeast region had higher odds of alcohol and tobacco use compared to with their corresponding reference groups. Findings suggest that preconception women of reproductive age who use alcohol and tobacco should be strongly encouraged and supported to quit alcohol and tobacco use before pregnancy for preventing adverse birth outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of the study was to explore the variations in body mass index (BMI) trajectories during the 20 years before diagnosis of type 2 diabetes mellitus (T2DM) over four decades between 1968 and 2007. METHODS: Longitudinal measurements of BMI from 437 men, all with a diagnosis of T2DM, were used in the analysis. A mixed method approach was used to fit individual patterns of BMI measurements during the 20 years before diagnosis of T2DM. RESULTS: The mean BMI at diagnosis was 26.7 kg/[m.sup.2] (95% confidence interval, 26.4-27.1). Compared with men whose condition was diagnosed between 1968 and 1977, for men with a diagnosis between 1978 and 2007 the mean BMI about 10 years before diagnosis significantly increased by 0.92 to 1.54 BMI units. Decades also varied in how long there was a persistent increase in BMI during the 20 years before diagnosis. The rate of change in mean BMI among men whose T2DM was diagnosed in the most recent two decades increased by 8.8% to 22.6% during the 10-year interval before diagnosis, but there was no significant difference among men given a diagnosis between 1978 and 1987. The quadratic trend of BMI prior to diagnosis was also significantly affected by age at diagnosis. CONCLUSION: The BMI trajectories during the 20 years leading up to T2DM varied by decade of diagnosis. The increase in BMI persisted for much longer among relatively younger men with a diagnosis in more recent decades. Strategies to prevent T2DM, informed by the pattern of BMI trajectories, should be customized to consider a potential age-period effect. KEY WORDS: Diabetes mellitus; body mass index trajectories; men; longitudinal study; Canada OBJECTIF: Le but de l'etude etait d'analyser les ecarts dans les trajectoires de l'indice de masse corporelle (IMC) au cours des 20 annees anterieures a un diagnostic de diabete sucre de type 2 (DST2) sur une periode de quatre decennies (1968 a 2007). METHODE: Les mesures longitudinales de l'IMC de 437 hommes ayant tous un diagnostic de DST2 ont ete analysees. Nous avons employe une approche a methodes mixtes pour integrer les trajectoires individuelles des mesures de l'IMC au cours des 20 annees anterieures au diagnostic de DST2. RESULTATS: L'IMC moyen au diagnostic etait de 26,7 kg/[m.sup.2] (intervalle de confiance de 95%, 26,4-27,1). Comparativement aux hommes chez qui la maladie a ete diagnostiquee entre 1968 et 1977, pour les hommes ayant recu leur diagnostic entre 1978 et 2007, l'IMC moyen environ 10 ans avant le diagnostic presentait une hausse significative de 0,92 a 1,54 unite d'IMC. La duree de la periode pendant laquelle il y avait eu une hausse persistante de l'IMC au cours des 20 annees anterieures au diagnostic variait egalement selon la decennie. Le taux de changement de l'IMC moyen chez les hommes dont le DST2 avait ete diagnostique au cours des deux decennies les plus recentes a augmente de 8,8% a 22,6% au cours de l'intervalle de 10 ans precedant le diagnostic, mais il n'y avait aucun ecart significatif chez les hommes ayant recu un diagnostic entre 1978 et 1987. La tendance quadratique de l'IMC avant le diagnostic etait aussi significativement affectee par l'age au diagnostic. CONCLUSION: Les trajectoires de l'IMC au cours des 20 annees anterieures au DST2 variaient selon la decennie du diagnostic. L'augmentation de l'IMC persistait beaucoup plus longtemps chez les hommes relativement plus jeunes diagnostiques au cours des decennies plus recentes. Les strategies de prevention du DST2, eclairees par les trajectoires de l'IMC, devraient etre individualisees pour tenir compte d'un eventuel effet selon l'age et la periode. MOTS CLES: diabete sucre; trajectoires de l'indice de masse corporelle; hommes; etude longitudinale; Canada La traduction du resume se trouve a la fin de l'article. Can J Public Health 2015;106(3):e95-e100 doi: 10.17269/CJPH.106.4641, The type 2 diabetes mellitus (T2DM) epidemic, along with the rapid increase in the epidemic of overweight and obesity, has become a major public health concern in Canada, (1) and [...]

Uttar Pradesh (UP), with more than 220 million people, is the most populous state in India. Despite a high unmet need for modern family planning methods, the state has experienced a substantial decline in fertility. India has also seen a decline during this period which can be attributed to the increased prevalence of modern methods of family planning, particularly female sterilisation, but in UP, the corresponding increase was marginal. At the same time, Traditional Family Planning Methods (TMs) increased significantly in UP in contrast to India, where it was marginal. The trends in UP raise questions about the drivers in fertility decline and question the conventional wisdom that fertility declines are driven by modern methods, and the paper aims to understand this paradox. Fertility trends and family planning practices in UP were analysed using data from different rounds of National Family Health Surveys (NFHS) and the two UP Family Planning Surveys conducted by the UP Technical Support Unit to understand whether the use of TMs played a role in the fertility decline. As per NFHS-4, the prevalence of TM in India (6%) was less than half that of UP (13%). The UP Family Planning Survey in 25 High Priority Districts estimated that 22% of women used TMs. The analysis also suggested that availability and accessibiility of modern contraceptives might have played a role in the increased use of TMs in UP. If there are still couples who make a choice in favour of TMs, they should be well informed about the risks associated with the use of traditional methods as higher failure rate is observed among TMs users. [ABSTRACT FROM AUTHOR]