Socioeconomic Inequalities in Childhood Undernutrition in India: Analyzing Trends between 1992 and 2005

India experienced a rapid economic boom between 1991 and 2007. However, this economic growth has not translated into improved nutritional status among young Indian children. Additionally, no study has assessed the trends in social disparities in childhood undernutrition in the Indian context. We examined the trends in social disparities in underweight and stunting among Indian children aged less than three years using nationally representative data.We analyzed data from the three cross-sectional rounds of National Family Health Survey of India from 1992, 1998 and 2005. The social factors of interest were: household wealth, maternal education, caste, and urban residence. Using multilevel modeling to account for the nested structure and clustering of data, we fit multivariable logistic regression models to quantify the association between the social factors and the binary outcome variables. The final models additionally included age, gender, birth order of child, religion, and age of mother. We analyzed the trend by testing for interaction of the social factor and survey year in a dataset pooled from all three surveys.While the overall prevalence rates of undernutrition among Indian children less than three decreased over the 1992-2005 period, social disparities in undernutrition over these 14 years either widened or stayed the same. The absolute rates of undernutrition decreased for everyone regardless of their social status. The disparities by household wealth were greater than the disparities by maternal education. There were no disparities in undernutrition by caste, gender or rural residence.There was a steady decrease in the rates of stunting in the 1992-2005 period, while the decline in underweight was greater between 1992 and 1998 than between 1998 and 2005. Social disparities in childhood undernutrition in India either widened or stayed the same during a time of major economic growth. While the advantages of economic growth might be reaching everyone, children from better-off households, with better educated mothers appear to have benefited to a greater extent than less privileged children. The high rates of undernutrition (even among the socially advantaged groups) and the persistent social disparities need to be addressed in an urgent and comprehensive manner

Large vessel vasculitis

Takayasu arteritis is a chronic granulomatous disease of the aorta and its major branches that usually affects women during the second and third decades of life, but it has been reported in young children. This review details the clinical, pathological and radiological features, differential diagnoses and management of the condition, focusing chiefly on the disease in children. The recent definition of Takayasu arteritis is discussed. The condition should be considered in patients with unexplained arterial hypertension or unexplained inflammatory syndromes without signs of localization. Since the disease may be life-threatening and progressive, early recognition is necessary to initiate appropriate therapy. Patients with persistent ischaemic symptoms including hypertension might benefit from revascularization procedures

Multimodality Management of Two Pairs of Pyopagus Twins

Background and Aim: Conjoined twins, due to their rarity and complex anatomy, pose not only a technical, but also a physiological challenge for their separation, with each case being uniquely distinct. The aim of the present article is to describe the surgical approach and management strategy for two cases of pyopagus conjoined twins operated at our center. Case Report: Case 1: Antenatally detected conjoined twin girls presented postnatally to our centre. They were found to have a common vestibule with single anal opening facing partially away from each other. On evaluation they were found to have a single sacrum and fused conus and filum terminale. They were taken up for separation at 2years of age & the 24hour long surgery, culminated in successful separation. The children had good post-operative outcome at 10months post separation. Case 2: Conjoined pyopagus twin girls presented postnatally, and were found to have fused cords, having a terminal syrinx and partially separate sacrum. They were separated at 2.5 years of age, with a multi-departmental effort and coordination. They are doing well 2 months post-operatively. Conclusion: A multidisciplinary team support with thorough preoperative planning significantly aids in improving the outcome of surgical separation. This has been possible by using modern technology. Each reported case contributes significantly to literature