Association of Adiposity with Pulse Pressure Amongst Gujarati Indian Adolescents

Background and Aim:

The current study was conducted to determine the effect of adiposity on vascular distensibility in Gujarati Indian adolescents as research indicating the pathogenesis of hypertension among overweight and/or obese Indian adolescents is scant and ethnic differences exist in the pathogenesis of hypertension

Materials and Methods:

A cross-sectional study was conducted on 488 Gujarati Indian adolescents of 16-19 years age group. Adiposity was assessed in terms of BMI, Body Fat %, Fat Mass, Fat Mass Index and Waist Circumference. Arterial blood pressure was recorded and pulse pressure (PP) was calculated using the standard equation based on the difference between systolic blood pressure (SBP) and diastolic blood pressure (DBP). Pearson’s correlation coefficient was determined to find the association between the markers of adiposity and SBP, DBP and PP.

Result:

A significant positive correlationship was found between adiposity and PP in boys. However, no significant correlationship was found between adiposity and PP in girls.

Conclusion:

An increase in total as well as visceral adiposity is probably associated with a decrease in vascular distensibility in the Gujarati Indian adolescent boys but not in girls, thus indicating a protective role of female sex hormone estrogen which has been shown earlier to protect the vasculature from atherosclerosis, endothelial dysfunction which occurs with increase in adiposity.     

SWOT Analysis of Total Sanitation Campaign in Yavatmal District of Maharashtra

Aims:

To study the strengths, weaknesses, opportunities, and threats of the Total Sanitation Campaign (TSC) in the Yavatmal district of Maharashtra.

Methodology:

Data was collected in December 2006 through interviews with stakeholders, house-to-house surveys, focus group discussions, and transect walks. Information in each category was finalized in a meeting after brainstorming and discussion with the TSC cell members.

Results:

The strengths of the campaign were innovations in Information Education and Communication, motivation through incentives, competitive spirit, active participation and partnerships, involvement of women, and universal coverage. The main weaknesses of the program were the absence of Rural Sanitary Marts/Production Centers, poor maintenance of Women Sanitary Complexes, lack of facilities for monitoring/ follow-up and a temporary focus of the campaign approach. There is an opportunity to tap additional resources, learn from other experiences, and institute back-up agencies to support and guide the community in the post-TSC phase. A change in administration and local leadership and loss of priority and interest needed to sustain the momentum while scaling up the interventions are possible threats for the program.     

Does cross-cultural communication training for physicians improve pediatric asthma outcomes? A randomized trial

Objective: Adverse cross-cultural interactions are a persistent problem within medicine impacting minority patients' use of services and health outcomes. To test whether 1) enhancing the evidence-based Physician Asthma Care Education (PACE), a continuing medical education program, with cross cultural communication training (PACE Plus) would improve the asthma outcomes of African American and Latino/Hispanic children; and 2) whether PACE is effective in diverse groups of children. Methods: A three-arm randomized control trial was used to compare PACE Plus, PACE, and usual care. Participants were primary care physicians (n = 112) and their African American or Latino/Hispanic pediatric patients with persistent asthma (n = 867). The primary outcome of interest included changes in emergency department visits for asthma overtime, measured at baseline, and 9 and 21 months following the intervention. Other outcomes included hospitalizations, asthma symptom experience, caregiver asthma-related quality of life, and patient-provider communication measures. Results: Over the long term, PACE Plus physicians reported significant improvements in confidence and use of patient-centered communication and counseling techniques (p < 0.01) compared to PACE physicians. No other significant benefit in primary and secondary outcomes was observed in this trial. Conclusion: PACE Plus did not show significant benefit in asthma-specific clinical outcomes. More trials and multi-component strategies continue to be needed to address complex risk factors and reduce disparities in asthma care.

Trial registration: ClinicalTrials.gov: NCT01251523 December 1, 2010.     

Hair loss in infancy and childhood

Hair problems can cause considerable anxiety to both children and their parents. This article discusses hair growth and cycling, the common presentations of hair loss in infancy and childhood and an approach to diagnosis. This information will help equip the reader to manage common types of hair loss in the paediatric setting.