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To evaluate the impact of ICDS on maternal nutrition and birth weight.28 ICDS and 21 non-ICDS villages in two adjoining blocks of Varanasi.5289 pregnancies were registered during 1987-1993 in these two blocks. In the ICDS block 916 and 1453 nutrition supplemented and unsupplemented, respectively and 1748 of the non-ICDS live births with weight recorded within 48 h formed the study subjects.The ICDS supplemented mothers gained 100g more in pregnancy and birth weight was higher by 58 g (p0.05) as compared to unsupplemented ICDS mothers. Birth weight in unsupplemented ICDS areas was 25g higher as compared to non ICDS area. ICDS supplemented women had a significantly smaller proportion of low birth weight babies (14.4%) compared to ICDS unsupplemented (20.4%) and non-ICDS women (26.3%). The corresponding prevalence of preterm births was 2.0, 2.4 and 4.3%, respectively (P0.001). Multiple regression analysis showed that increased wight gain in pregnancy, length of gestation, caloric intake and term hemoglobin were significantly associated with birth weight. However, the length of gestation was not influenced by factors improving the birth weight.Undernourished pregnant women are benefitted by late pregnancy nutrition supplement

To evaluate the effectiveness of early administration of intravenous Magnesium sulfate (i.v. MgSO4) in children with acute severe asthma not responding to conventional therapy.Randomized double-blind, placebo-controlled trial.Pediatric emergency service of a large teaching hospital.47 children aged between 1-12 years with acute severe asthma showing inadequate or poor response to 3 doses of nebulized salbutamol given at an interval of 20 min each.The MgSO4 group received 0.2 ml/kg of 50% MgSO4 as intravenous (i.v.) infusion over 35 minutes and the placebo group received normal saline infusion in the same dose and at the same rate. MgSO4 solution and normal saline were coded and dispensed in identical containers. Decoding was done at the completion of the study. All the patients received oxygen, nebulized salbutamol, i.v. aminophylline and corticosteroids.MgSO4 group showed early and significant improvement as compared to placebo group in PEFR and SaO2 at 30 min and 1, 2, 3 and 7 hours after stopping the infusion (p ranging from0.05 to0.01). The clinical asthma score also showed significant improvement in the MgSO4 group 1, 2, 3 and 11 hours after stopping the infusion (p0.01).Addition of MgSO4 to conventional therapy helps in achieving earlier improvement in clinical signs and symptoms of asthma and PEFR in patients not responding to conventional therapy alone.

In March 1992, an outbreak of measles, in the tribal population of Vavar village, Mokhada Taluk, Thane district, Maharashtra, was investigated. Two hamlets of Vavar village namely Sagpanipada (epidemic in October, November 1991) and Behedpada (epidemic in January, February 1992) were affected. In both hamlets, measles cases were confined to children below 10 yrs and 96% of the cases occurred in children below 6 yrs. Attack rates were 52.7% and 51.4% and case fatality rates were 31.2% and 15.6% at Sagpanipada and Behedpada, respectively. All the convalescent patients' sera possessed IgM antibodies against measles. A clear drop in IgM and a rise in IgG antibodies against measles was observed in 35 paired samples from convalescent patients. Fifty four per cent of sera from controls, possessed IgM antibodies. Migrating population appeared to have imported measles which flared up in an epidemic among the susceptibles. Priority immunization of the children of remote isolated populations may prevent such epidemics.

An epidemic of encephalitis occurred in the eastern, paddy growing districts of Haryana state between July and November 1990. One hundred and eighty-two patients with encephalitis were admitted to different hospitals in Haryana and 118 of them expired (mortality rate 64.8%); 88% of the patients were children. The male to female ratio was 2. 3. 1. IgM class of antibodies to Japanese Encephalitis (JE) Virus could be demonstrated in the CSF and/or sera of 3 surviving and 2 fatal patients of the 19 patients studied. This is the first detailed report on an epidemic of encephalitis in North-Western part of India. Serologically proven cases of JE are being reported, for the first time, from this region.

The present study was conducted to construct standards for midarm circumference and midarm/head circumference ratio to identify neonates at risk for metabolic complications and to assess the anthropometric variable which could be used to substitute weight to identify low birth weight neonates. A study of 2925 consecutive live births showed significant correlation (p less than or equal to 0.001) between different anthropometric variables studied. Since midarm circumference (MAC), midarm circumference/head circumference ratio (MAC/HC) and ponderal index (PI) had the least correlation with gestation, these were used as independent markers for gestation. Among these three, MAC had the best correlation with birth weight (r = 0.808). A midarm circumference of less than or equal to 8.6 cm and less than or equal to 7.4 cm had the best sensitivity and specificity for identifying neonates with a birth weight of less than or equal to 2500 and less than or equal to 2000 g, respectively. All the anthropometric variable studied can rule out low birth weight with great accuracy (high negative predictive value greater than 90%).

Intrauterine growth (weight, length, head circumference, Ponderal index) was studied in 2875 consecutive live born babies. Weight, length and head circumference growth curves did not show any significant difference when compared to previous growth curves made 20 years back from this centre. Norms and curves for ponderal index are provided for the Indian babies and were comparable with figures from Western studies. However, the 90th centile values were found to be low between 32-38 weeks of gestation.

Two hundred and eight alive newborns examined within 2 hours of birth showed 37.50% incidence of retinal hemorrhage (RH). Out of these, 38.59% were full term and 29.17% were preterm. Head circumference had a significant correlation (p less than 0.05) with retinal hemorrhage, while sex of the newborn, birth weight, gestational age and fetal distress showed no significant correlation. Birth injuries especially ocular and periocular injuries showed a significantly higher incidence of retinal hemorrhage (83.33%).

Clinico-bacteriological profile of 106 leprosy patients below 15 years of age was studied. Majority of the patients were males and fell in the 10-15 years age group (p less than 0.01). Nearly 89% had not received any prior treatment because of financial constraints. Seventy per cent gave a positive history of contact with adult patients who were mainly of the lepromatous variety (p less than 0.01). Skin lesions were present in 103 cases, mainly on the exposed areas and their number was found to increase significantly with advancing age (p less than 0.01). These lesions were hypopigmented patches in 71% of the children and erythematous in the rest. Cutaneous sensations were affected in most of the patients while nerve thickening was observed in 45. Positivity of the skin smears increased significantly as the number of skin lesions per patient increased (p less than 0.05). With advancing age, the disease moved from the tuberculoid end of the spectrum towards the lepromatous end (p less than 0.01).