Management of SAM Children in India: Current Strategies

Management of children with Severe Acute Malnutrition (SAM) is being given a high priority in India. This intervention is being implemented for bringing reduction in under five mortality. Children with SAM are 9 times higher risk of mortality as compared to optimally nourished children. There are two strategies for management of Children with SAM namely i) Facility based and ii) Community Based. More than 90% of children can be treated through community based management. The progress of facility based management has been satisfactory in India. However, the programme of community based intervention is slow due to lack of scientific data on impact of indeginous RUTF available in the country. The scientific evidence is being generated through sponsored research studies so that evidence based management of SAM children can be developed

Trend in Infant and Young Child Feeding practices during 2005 – 2015 in India

Background: Optimal infant and young child feeding (IYCF) practices during first 2 years of life is the key to ensuring optimal growth and development of the infant. Improving IYCF practices have an important role in reducing morbidity and mortality amongst under 5 children in India. Material & Methods: The secondary data from National Family Health Survey (NFHS)-3 and NFHS- 4 was analyzed. Objective: To assess the trend in IYCF practices during 2005 – 2015 for 13 selected states of India. Results: It was found that over a decade, there has been an improvement in early initiation of breast feeding and exclusive breastfeeding for 6 months amongst infant in 11 out of 13 states. However, a reduction in the timely initiation of complementary feeding amongst children in the age group of 6-8 months has been observed in 9 out of 13 states. Conclusion: There is a need to strengthen the efforts to further improve the IYCF practices in India for reducing high rates of undernutrition in the country

Double Burden of Nutritional Disorders amongst Adolescents and Strategies required for combating it

Adolescents are the future generation of any country and their nutritional needs are critical for the well being of the society. In India, approximately 20% of the population consists of adolescents (1). Presently, the dietary inadequacy exists due to poverty and it is the main cause of under-nutrition. However simultaneously, we have affluent population groups, which have high consumption of foods rich in fats and calories, leading to over-nutrition and obesity. Thus, India is facing double burden of Nutritional disorders amongst adolescent in which we have under-nutrition at one end of the socio-economic spectrum and over-nutrition at the other (1)

Effects of Secondary Electron Emission on the Plasma Sheath and Local Electron Energy Distribution with Application to Hall Thrusters.

The nature of plasma transport across the magnetic field in crossed-field (CF) devices such as Hall effect thrusters (HETs) remains largely an unsolved problem. This can be further complicated by the presence of secondary electrons derived from the thrusters channel wall due to the impact of photons and electrons. The role of these secondary electrons in the operation of HETs has been a subject of investigation in recent years. Under normal operating conditions of a HET, several physical phenomena occur simultaneously and the interaction of the plasma with the channel walls of the thruster play an important role in its effective operation. These plasma wall interactions produce secondary electrons that have a non-linear coupling effect with the bulk plasma and affect the performance of crossed field devices by changing the sheath potential as well as the electron energy distribution. This influence is not yet fully understood in the community and thus the computational models are based on assumptions that are not highly accurate. Experimentally, there is little available data on the SEE yield in plasma and its effects to environments similar to that of a Hall thruster, which could be used to validate existing numerical models. A test-bed apparatus is needed to understand these effects that could serve as a tool to validate and improve existing numerical models by providing the appropriate boundary conditions, secondary yield coefficients and variation of plasma parameters to aid the future design of HETs. In this work, a bench-top apparatus is developed to elucidate the role that secondary electrons play in regards to crossed field transport and energy flow to the walls. An electron beam which simulates energetic electrons in Hall channel is used to generate a secondary electron plume at the surface of various targets (Cu, C, BN) which simulates channel wall. The response of the plasma to these secondary electrons is assessed by measuring changes to the potential distribution in the sheath of the irradiated target and the measured electron energy distribution. An attempt is made to relate phenomena and trends observed in this work with those in Hall thrusters.PhDNuclear Engineering and Radiological SciencesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/111614/1/sawlanik_1.pd

Implementation of Double Fortified Salt in India is based on Low Scientific Evidence

Micronutrient malnutrition (MNM) can affect all age groups, but young children and women of reproductive age are most at risk of developing micronutrient deficiencies. Iodine Deficiency Disorders (IDD) and Iron Deficiency Anaemia (IDA) are two important Public Health problems. Out of 342 districts surveyed, so far IDD is a major public health problem in 286 districts. No state in India is free from iodine deficiency (1). Iron Deficiency Anaemia is reported in about 70% of the population across all age groups (2). The magnitude of Vitamin B12 deficiency is documented to be about 73.5% in the adolescents (3) and Zinc deficiency is reported in about 49.4% amongst children (4). In addition, there are deficiencies of other micronutrients and minerals like Folic Acid, Vitamin D which are of public health concern. Fortification of food is one of three primary strategies to combat micronutrient deficiencies. Fortification is defined by the World Health Organization (WHO) and Food and Agricultural Organization (FAO) as "the practice of deliberately increasing the content of an essential micronutrient, i.e. Vitamins and minerals (including trace elements) in a food irrespective of whether the nutrients were originally present in the food before processing or not, so as to improve the nutritional quality of the food supply and to provide a public health benefit with minimal risk to health”. Food fortification is one of the most cost effective ways to make up for the deficient vitamins and minerals in low quality diets. The edible salt is the most widely used food vehicle for fortification with micronutrients (5). Fortification of salt with iodine, to prevent IDD, under the National Iodine Deficiency Disorders Control Programme, is in operation since 1962 (1). This intervention has led to significant prevention and control of IDD (6). Recently, the technology has been developed for fortification of salt with iron and iodine commonly known as DFS, to simultaneously combat IDD and IDA (7-9).&nbsp

Integration of Non Alcoholic Fatty Liver Diseases (NAFLD) into NPCDCS programme: A recent initiative in India

Non-alcoholic fatty liver disease (NAFLD) is an emerging public health problem globally. NAFLD is one of the most common liver diseases worldwide and is the most common cause of abnormal liver enzymes in many developed countries. NAFLD is estimated to afflict approximately 1 billion individuals worldwide. An estimated 20-30 % of general population is afflicted from it globally. In India NAFLD could be a silent epidemic with its prevalence ranging from 9-32%. Studies have shown, strong association of NAFLD with major Non Communicable diseases (NCD) like Diabetes, Obesity, CVD, Chronic Kidney diseases, Cancers, etc. Perceiving the threat of NAFLD and the central role of hepatic accumulation of fat in the pathogenesis of other NCD, the Government of India (GoI) has taken steps to include NAFLD in the public health agenda. It has included it in the national NCD programme, i.e., National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in 2021. India has become the first country in the world to start a national programme for preventive efforts for NAFLD. The present review describes public health relevance of NAFLD and the process of integration of Non Alcoholic Fatty Liver Diseases (NAFLD) into NPCDCS programme in India

Assessment of nutritional status of elderly population living at high altitude regions of India utilizing Mini Nutritional Assessment (MNA) methodology

Background: Malnutrition is associated with increased risk of morbidity and mortality amongst elderly population. There is lack of scientific evidence on the staus of malnutrition amongst elderly population residing at high altitude regions of Uttarakhand, India. Background: Malnutrition is associated with increased risk of morbidity and mortality amongst elderly population. Lack of scientific evidence exists on the status of malnutrition amongst elderly population residing at high altitude regions of Uttarakhand, India. Materials and methods: A community based cross-sectional study was conducted in high altitude regions of District Nainital. A total of 980 elderly subjects were selected from 30 clusters identified using population proportionate to size sampling method. Nutritional status of the elderly population was assessed using Mini Nutritional Assessment (MNA) tool. Data was entered in MS Excel 2007 and analyzed using SPSS version 20.0. Results: The results of MNA revealed that 14.3% of the elderly subjects were malnourished. High prevalence of malnutrition was found among subjects who were illiterate (74.5%), financially dependent (75.2%), belonged to low monthly income (43.3%) had poor appetite (71.6%) and chewing problems (63.1%); (p<0.0001). Conclusions: High prevalence of malnutrition was present amongst the elderly population in India. There is a need for timely assessment of malnutrition for maintenance of nutritional status and prevention of chronic diseases. Materials and methods: A community based cross-sectional study was conducted in high altitude regions of District Nainital. A total of 980 elderly subjects were selected from 30 clusters identified using population proportionate to size sampling method. Nutritional status of the elderly population was assessed using Mini Nutritional Assessment (MNA) tool. Data was entered in MS Excel 2007 and analyzed using SPSS version 20.0.   Results: The results of MNA revealed that 14.3% of the elderly subjects were malnourished. High prevalence of malnutrition was found among subjects who were illiterate (74.5%), financially dependent (75.2%), belonged to low monthly income (43.3%) had poor appetite (71.6%) and chewing problems (63.1%); (p<0.0001).   Conclusions: High prevalence of malnutrition was present amongst the elderly population in India. There is a need for timely assessment of malnutrition for maintenance of nutritional status and prevention of chronic diseases

Status of Dietary Intake of Calcium in Women of Reproductive Age in Delhi, India

Background: Calcium (Ca) plays an important role in bone formation. Attaining optimal bone mass and peak bone densities is essential to prevent osteoporotic fractures in future life. In conditions of Ca deficiency, Ca from the bones maintains the blood levels of Ca leading to its depletion in bones. Calcium depletion leads to poor bone density and a higher risk of osteoporosis particularly in women who have repeated episodes of pregnancy and lactation. Aim & Objective: To assess the dietary intake of calcium. Material Methods: the study was conducted among 200 healthy women of reproductive age group of 20-49 years. Result: The dietary intake of calcium was less than the Recommended Dietary Allowances of 600mg/day. Women from upper socioeconomic class had a higher intake of dietary calcium 435±268 mg/day as compared to women from low socioeconomic class with a dietary intake of 295±163 mg/day. Conclusion: The dietary intake of calcium improved with an increase in socioeconomic class

Organoleptic Study of Deacidified and Deodourised Palm Oil

Deficiency of vitamin A has long been identified as a serious and preventable nutritional disorder, associated with increased risk of mortality and morbidity amongst children. The present study was conducted with the objectives (i) to perform organoleptic testing of food products cooked in Deacidified and Deodourised Palm oil (DDPO), by sensory evaluation method and (ii) to compare the characteristics of these food products with the same products cooled in routinely used oil. Eleven commonly used weaning food items were prepared with routinely used oil (Group a). The same recipes were also prepared with DDPO (Group B). A food testing panel conducted with sensory evaluation for assessing the acceptability of the various food items. It was observed that with respect to all characteristics there was no significant difference in the recipes made with the two types of oil. Results indicated that DDPO can be used in India for preparation of weaning foods which are routinely given to young children