This study examined the prevalence of vitamin A deficiency (VAD) among 1,000 primary school children aged 5-15 years in urban slums of Ahmedabad, India. The overall prevalence of VAD was found to be 2.9%, with a higher prevalence among girls (4.1%) compared to boys (1.9%). Specific manifestations of VAD found included 0.5% with night blindness, 1.4% with conjunctival xerosis, and 2.1% with Bitot’s spots. Lower social class, poor intake of green vegetables, and nuclear family type were found to be significantly associated with higher rates of VAD. The results suggest that VAD remains a public health issue among
“Morbidity profile of children [6-11 years] attending Municipal Corporation P...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Malnutrition affects human performance, health and survival, including physical growth, morbidity, mortality, cognitive development, reproduction, physical work capacity and risks for several chronic diseases. In Madhya Pradesh state there are 1.3 million severely malnourished children. Nutrition rehabilitation centers (NRCs) were started in the state to control severe malnutrition and decrease the prevalence of severe malnourished children to less than 1% among children aged 1-5 year. Objective of the present survey was i) to make aware people about nutritional and other preventive measures for protein energy malnutrition and severity of complications of PEM. ii) To investigate Prevalence of Malnutrition in Rural areas of Indore. Protein Energy Malnutrition among children below the age of 3-6 years as indicated by anthropometrical measurements (weight-for-age, weight-for- height, height-for-age), had been identified as a major public health problem in children of slum areas. The total number of surveyed children was 500 and they surveyed for appearance and status of hair, lips, teeth, and bones. Percentage of surveyed children having good, fair, poor, very poor appearance were 44.8%, 21%, 31%, 7.40% respectively. Percentage of surveyed children having normal hair, loss and luster hair, discolored & dry hair were 40.60%, 27.80%, 31.44% respectively. Percentage of surveyed children having normal lips and angular stomatitis lips were 51%, 49%, respectively. Percentage of surveyed children having normal teeth, chalky of teeth, pitting of teeth, discolored teeth were 60.80%, 11.40%, 9.40% 18.40% respectively. Percentages of surveyed children having normal skin, dry & rough skin were 71%, 29% respectively. Percentages of surveyed children having normal bones and rickets bones were 99.40%, 0.40%, respectively. Malnutrition among children in slum areas is a public health problem which requires active interventions to improve child and maternal nutrition. Breastfeeding and complementary feeding programs as well as early screening, active case management of PEM and public education should be considered as a national public health priority.
This study examined 100 under-5 children with protein-energy malnutrition (PEM) admitted to a hospital in Nigeria to determine the prevalence of HIV infection. The researchers found that 27% of the children with PEM were HIV positive. The highest prevalence of HIV infection was among those with the subtype of PEM known as marasmus (65% prevalence). All of the HIV-positive children were younger than 3 years old and acquired HIV infection from their mothers via mother-to-child transmission. The study highlights the need for increased HIV screening among under-5 children presenting with PEM, especially marasmus, given the high prevalence found.
Effect of Nutrition Education on Anemic Rural Adolescent Girls in OdishaYogeshIJTSRD
Adolescence is considered as the nutritionally vulnerable period due to an increased demand for nutrients due to growth spurt. It has a far reaching implication on their reproductive health in their later years. In Odisha, the prevalence of anemia among adolescent girls in general, has not been well documented. Hence, the present study investigated the prevalence of anemia and effect of nutrition education on anemic adolescent girls in a selected population of Odisha. Adolescent girls 12 17 years who were studying in schools and colleges and residing in the study area for a minimum of six months were included in this study. Total numbers of 508 adolescent girls 12 17years were screened for anemia. Considering its association with the lack of right knowledge, attitude, and practice KAP , it could be preventable. The objectives of the study were 1 to assess the Knowledge, Attitude and Practice KAP of the adolescent girls about Anemia, 2 To determine the association between the selected demographic variables and the level of KAP among the adolescent girls, 3 to analyse the effectiveness of the planned nutrition education of Anemia programme on knowledge, attitude and practice. Dr. Sandhya Rani Mohanty "Effect of Nutrition Education on Anemic Rural Adolescent Girls in Odisha" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45002.pdf Paper URL: https://www.ijtsrd.com/home-science/extension-education/45002/effect-of-nutrition-education-on-anemic-rural-adolescent-girls-in-odisha/dr-sandhya-rani-mohanty
This study assessed awareness levels about immunization programs among low socioeconomic families in rural West Bengal. A survey was conducted covering 590 children aged 1-5 years. The results showed that mothers had higher awareness than other family members. Factors like education level, caste, occupation, family size and distance from health centers influenced immunization rates. Full immunization was higher for males (56%) compared to females (23%). Children supported by integrated child development services had significantly higher full immunization (75%) than non-supported children (30%). The study concluded immunization awareness among rural families needs to be improved, especially for females and disadvantaged groups.
10 coast and jungle peruvian malnutritionJuan R Farro
This document discusses malnutrition in Peru. It begins by introducing a human medical school class and its members. It then defines malnutrition and describes its prevalence and causes in Peru. Chronic malnutrition affects over 20% of Peruvian children under 5, with the highest rates in the Sierra and jungle regions. Causes of malnutrition in Peru include maternal malnutrition, lack of healthcare and nutrition information, economic hardship, and water/sanitation issues. The document outlines consequences of childhood malnutrition like increased disease risk, lower educational and economic attainment. It concludes by proposing policies to address malnutrition in Peru like nutrition education programs, kitchens, health campaigns, and food security projects.
“Morbidity profile of children [6-11 years] attending Municipal Corporation P...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Malnutrition affects human performance, health and survival, including physical growth, morbidity, mortality, cognitive development, reproduction, physical work capacity and risks for several chronic diseases. In Madhya Pradesh state there are 1.3 million severely malnourished children. Nutrition rehabilitation centers (NRCs) were started in the state to control severe malnutrition and decrease the prevalence of severe malnourished children to less than 1% among children aged 1-5 year. Objective of the present survey was i) to make aware people about nutritional and other preventive measures for protein energy malnutrition and severity of complications of PEM. ii) To investigate Prevalence of Malnutrition in Rural areas of Indore. Protein Energy Malnutrition among children below the age of 3-6 years as indicated by anthropometrical measurements (weight-for-age, weight-for- height, height-for-age), had been identified as a major public health problem in children of slum areas. The total number of surveyed children was 500 and they surveyed for appearance and status of hair, lips, teeth, and bones. Percentage of surveyed children having good, fair, poor, very poor appearance were 44.8%, 21%, 31%, 7.40% respectively. Percentage of surveyed children having normal hair, loss and luster hair, discolored & dry hair were 40.60%, 27.80%, 31.44% respectively. Percentage of surveyed children having normal lips and angular stomatitis lips were 51%, 49%, respectively. Percentage of surveyed children having normal teeth, chalky of teeth, pitting of teeth, discolored teeth were 60.80%, 11.40%, 9.40% 18.40% respectively. Percentages of surveyed children having normal skin, dry & rough skin were 71%, 29% respectively. Percentages of surveyed children having normal bones and rickets bones were 99.40%, 0.40%, respectively. Malnutrition among children in slum areas is a public health problem which requires active interventions to improve child and maternal nutrition. Breastfeeding and complementary feeding programs as well as early screening, active case management of PEM and public education should be considered as a national public health priority.
This study examined 100 under-5 children with protein-energy malnutrition (PEM) admitted to a hospital in Nigeria to determine the prevalence of HIV infection. The researchers found that 27% of the children with PEM were HIV positive. The highest prevalence of HIV infection was among those with the subtype of PEM known as marasmus (65% prevalence). All of the HIV-positive children were younger than 3 years old and acquired HIV infection from their mothers via mother-to-child transmission. The study highlights the need for increased HIV screening among under-5 children presenting with PEM, especially marasmus, given the high prevalence found.
Effect of Nutrition Education on Anemic Rural Adolescent Girls in OdishaYogeshIJTSRD
Adolescence is considered as the nutritionally vulnerable period due to an increased demand for nutrients due to growth spurt. It has a far reaching implication on their reproductive health in their later years. In Odisha, the prevalence of anemia among adolescent girls in general, has not been well documented. Hence, the present study investigated the prevalence of anemia and effect of nutrition education on anemic adolescent girls in a selected population of Odisha. Adolescent girls 12 17 years who were studying in schools and colleges and residing in the study area for a minimum of six months were included in this study. Total numbers of 508 adolescent girls 12 17years were screened for anemia. Considering its association with the lack of right knowledge, attitude, and practice KAP , it could be preventable. The objectives of the study were 1 to assess the Knowledge, Attitude and Practice KAP of the adolescent girls about Anemia, 2 To determine the association between the selected demographic variables and the level of KAP among the adolescent girls, 3 to analyse the effectiveness of the planned nutrition education of Anemia programme on knowledge, attitude and practice. Dr. Sandhya Rani Mohanty "Effect of Nutrition Education on Anemic Rural Adolescent Girls in Odisha" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45002.pdf Paper URL: https://www.ijtsrd.com/home-science/extension-education/45002/effect-of-nutrition-education-on-anemic-rural-adolescent-girls-in-odisha/dr-sandhya-rani-mohanty
This study assessed awareness levels about immunization programs among low socioeconomic families in rural West Bengal. A survey was conducted covering 590 children aged 1-5 years. The results showed that mothers had higher awareness than other family members. Factors like education level, caste, occupation, family size and distance from health centers influenced immunization rates. Full immunization was higher for males (56%) compared to females (23%). Children supported by integrated child development services had significantly higher full immunization (75%) than non-supported children (30%). The study concluded immunization awareness among rural families needs to be improved, especially for females and disadvantaged groups.
10 coast and jungle peruvian malnutritionJuan R Farro
This document discusses malnutrition in Peru. It begins by introducing a human medical school class and its members. It then defines malnutrition and describes its prevalence and causes in Peru. Chronic malnutrition affects over 20% of Peruvian children under 5, with the highest rates in the Sierra and jungle regions. Causes of malnutrition in Peru include maternal malnutrition, lack of healthcare and nutrition information, economic hardship, and water/sanitation issues. The document outlines consequences of childhood malnutrition like increased disease risk, lower educational and economic attainment. It concludes by proposing policies to address malnutrition in Peru like nutrition education programs, kitchens, health campaigns, and food security projects.
This document reports on a study examining factors associated with uptake of the measles, mumps, and rubella (MMR) vaccine and use of single antigen vaccines in the UK. The study analyzed data on over 14,500 children from the Millennium Cohort Study. It found that 88.6% of children were immunized with the MMR vaccine, while 5.2% received at least one single antigen vaccine. Children were more likely to be unimmunized if they lived in households with more children or a lone parent, or if their mother was under 20 or over 34 years old. Parents who chose single vaccines over MMR tended to have higher incomes and education levels. Nearly three-quarters of parents
This document summarizes a study on childhood vaccination rates in Athens, Greece. The study assessed vaccination coverage of 304 preschool and primary school children, identified weaknesses in vaccination programs, and examined the impact of parental socioeconomic factors and attitudes. The results showed vaccination rates were higher than other Greek studies, with 94.8% fully vaccinated for DTP, 99.2% for polio, and 63.3% for MMR. Socioeconomic factors like low parental education and poorly organized family schedules were associated with lower vaccination rates. The study aimed to evaluate vaccination programs and factors influencing coverage in an urban Greek population.
This study aimed to assess the quality of life of children and adolescents with hemophilia in Kabul, Afghanistan. The study included 65 patients ages 8-16 with hemophilia who were randomly selected from a registry of 350 patients. Patients completed a questionnaire on quality of life. The results showed patients had an average age of 12.9 years and average quality of life score of 75.9. Most patients had severe hemophilia A and came from low-income families with high illiteracy. Quality of life scores did not significantly differ based on hemophilia severity, family income, or parents' education. The domains most impaired were family and sports. This study provides the first reliable data on quality of life and characteristics of
This document discusses a study on uptake of measles vaccination services and associated factors among children under five in Temeke District, Tanzania. The study aimed to investigate factors associated with low uptake of vaccination in the district. A cross-sectional survey was conducted between November 2011-January 2012 where 295 caretakers of children aged 12-23 months were interviewed. The findings showed that 27.8% of children had low uptake of vaccination services. Factors significantly associated with low uptake included younger age of the child, low education level of the caretaker, lack of knowledge on vaccination purposes and schedules, residing in high measles incidence wards, and residing in wards established less than 2 years. The study concluded that household and child
Measuring Poverty through Child Malnutrition A Study With Special Referance T...iosrjce
This study examines child malnutrition in Arumbavur Village, Perambalur District, India. It finds that 81.74% of children in the village are malnourished based on body mass index (BMI) measurements, which is higher than the national average of 43%. Through interviews with 115 households, it identifies several socioeconomic factors contributing to malnutrition, including low family incomes below the national average, lack of sanitation facilities, and limited access to nutritious foods. While most children are breastfed, the average duration is only 6.7 months. The study concludes that despite families' efforts to provide nutrition, children in the village remain underweight and stunted due to their socioeconomic conditions.
Iodine supplementation into drinking water improved intelligence of preschool...Alexander Decker
This randomized controlled trial tested the effects of iodine supplementation through drinking water on 67 preschool children aged 25-59 months in an iodine-deficient area of Central Java, Indonesia. Children received either 100 μg of iodine per day or a placebo for 12 weeks. Urinary iodine levels and intelligence scores were measured before and after the intervention. The results showed that urinary iodine levels significantly increased and intelligence scores significantly improved in the treatment group compared to the control group, demonstrating that iodine supplementation through drinking water can effectively increase urinary iodine and intelligence in preschool children living in iodine-deficient areas.
A Quasi Experimental Study Comparing Knowledge Regarding Child Abuse among Pa...YogeshIJTSRD
Introduction The future of nation can become bright only if the children are healthy. They need full protection by their full development. Jujhar Singh Maan | Sobana M | Abhishek Yadav "A Quasi-Experimental Study: Comparing Knowledge Regarding Child Abuse among Parents of Children of Experimental and Control Group" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45008.pdf Paper URL: https://www.ijtsrd.com/biological-science/other/45008/a-quasiexperimental-study-comparing-knowledge-regarding-child-abuse-among-parents-of-children-of-experimental-and-control-group/jujhar-singh-maan
The most common cause of bleeding from gums is inflammation of the gums, otherwise called as gingivitis which leads to periodontitis if left untreated.
Read More:https://www.icliniq.com/qa/bleeding-gums/what-is-the-cause-and-solution-for-bleeding-gums
The document defines 20 vocabulary words related to the medical field, including pernicious, meaning having a harmful effect in a gradual way; insurrection, meaning a violent uprising against authority; and quagmire, meaning a soft boggy area of land or an awkward situation. It also defines words like stupor, timorous, repulsive, ignominy, profound, and denouement.
The document outlines a transition plan for the US Coast Guard Auxiliary Fourteenth District. It will form an ad hoc transition team representing diverse members to address potential problems and opportunities. District staff officers will be selected based on their expertise and ability to work cooperatively. A technology team will be established to improve communication challenges and implement new technologies. The plan also details strategies to address recruitment and retention issues like attracting younger members and making the onboarding process quick. A communication plan is outlined to keep members informed through meetings, videos, surveys and public media. The program will focus on core missions while introducing new ones like paddle craft and commercial vessel inspections. Gantt charts and organization charts will be attached.
A 2 bedroom apartment located in the Naama View Resort in Sharm El Sheikh is available for short term rental. The fully furnished 108 sqm apartment includes 2 bathrooms, private parking, swimming pools, and 24hr security. It rents for 450 Egyptian pounds per night, which includes water and electricity. The sales manager, Cheryl Wilson, can be contacted for more information.
The document provides guidelines for safe bicycling. It emphasizes the importance of wearing a properly fitted helmet that meets safety standards. It also outlines rules for riding bikes on roads, including riding with traffic, obeying traffic laws, signaling turns, and yielding appropriately. Additional tips include staying alert, avoiding parked cars, and wearing bright/reflective clothing so others can see the rider.
The document discusses how hotels need to adapt to changing market conditions and increasing use of technology. It summarizes that:
1) Hotels cannot assume they will follow the same recovery path as before and must seize new opportunities from shifting to online/direct distribution.
2) By 2010, 50% of leisure bookings worldwide are expected to be made online, so hotels need their websites and mobile access to be optimized to attract customers.
3) Hotels should focus on having an effective internet strategy, driving traffic to their websites, optimizing conversion rates, and ensuring their sites and booking capabilities are up-to-date.
This document provides recommendations for a company seeking to elicit joy and do good through its products and services. It outlines the company's purpose and ideal customers, and recommends positioning, branding, and strategies for product, service, delivery channels, pricing, promotion, lead generation, and lead conversion. Appendices provide introduction, survey, SWOT, brand, generation, sample survey, benchmark, country, and index analyses to support the recommendations.
C.Lal Realtors is a real estate consulting firm based in Noida, India that has been in business since 1974. They are developing a new mixed-use community called 3C Ozone Boulevard on Expressway NoidaGolf View. The community will be located next to a golf course and offer modern residential, commercial, leisure, hospitality, and business facilities. C.Lal Realtors has experience executing various real estate projects and provides services across retail, commercial, residential, and leisure verticals. They can be contacted at their Noida office for advisory, agency, management, and financial services related to real estate.
This document reports on a study examining factors associated with uptake of the measles, mumps, and rubella (MMR) vaccine and use of single antigen vaccines in the UK. The study analyzed data on over 14,500 children from the Millennium Cohort Study. It found that 88.6% of children were immunized with the MMR vaccine, while 5.2% received at least one single antigen vaccine. Children were more likely to be unimmunized if they lived in households with more children or a lone parent, or if their mother was under 20 or over 34 years old. Parents who chose single vaccines over MMR tended to have higher incomes and education levels. Nearly three-quarters of parents
This document summarizes a study on childhood vaccination rates in Athens, Greece. The study assessed vaccination coverage of 304 preschool and primary school children, identified weaknesses in vaccination programs, and examined the impact of parental socioeconomic factors and attitudes. The results showed vaccination rates were higher than other Greek studies, with 94.8% fully vaccinated for DTP, 99.2% for polio, and 63.3% for MMR. Socioeconomic factors like low parental education and poorly organized family schedules were associated with lower vaccination rates. The study aimed to evaluate vaccination programs and factors influencing coverage in an urban Greek population.
This study aimed to assess the quality of life of children and adolescents with hemophilia in Kabul, Afghanistan. The study included 65 patients ages 8-16 with hemophilia who were randomly selected from a registry of 350 patients. Patients completed a questionnaire on quality of life. The results showed patients had an average age of 12.9 years and average quality of life score of 75.9. Most patients had severe hemophilia A and came from low-income families with high illiteracy. Quality of life scores did not significantly differ based on hemophilia severity, family income, or parents' education. The domains most impaired were family and sports. This study provides the first reliable data on quality of life and characteristics of
This document discusses a study on uptake of measles vaccination services and associated factors among children under five in Temeke District, Tanzania. The study aimed to investigate factors associated with low uptake of vaccination in the district. A cross-sectional survey was conducted between November 2011-January 2012 where 295 caretakers of children aged 12-23 months were interviewed. The findings showed that 27.8% of children had low uptake of vaccination services. Factors significantly associated with low uptake included younger age of the child, low education level of the caretaker, lack of knowledge on vaccination purposes and schedules, residing in high measles incidence wards, and residing in wards established less than 2 years. The study concluded that household and child
Measuring Poverty through Child Malnutrition A Study With Special Referance T...iosrjce
This study examines child malnutrition in Arumbavur Village, Perambalur District, India. It finds that 81.74% of children in the village are malnourished based on body mass index (BMI) measurements, which is higher than the national average of 43%. Through interviews with 115 households, it identifies several socioeconomic factors contributing to malnutrition, including low family incomes below the national average, lack of sanitation facilities, and limited access to nutritious foods. While most children are breastfed, the average duration is only 6.7 months. The study concludes that despite families' efforts to provide nutrition, children in the village remain underweight and stunted due to their socioeconomic conditions.
Iodine supplementation into drinking water improved intelligence of preschool...Alexander Decker
This randomized controlled trial tested the effects of iodine supplementation through drinking water on 67 preschool children aged 25-59 months in an iodine-deficient area of Central Java, Indonesia. Children received either 100 μg of iodine per day or a placebo for 12 weeks. Urinary iodine levels and intelligence scores were measured before and after the intervention. The results showed that urinary iodine levels significantly increased and intelligence scores significantly improved in the treatment group compared to the control group, demonstrating that iodine supplementation through drinking water can effectively increase urinary iodine and intelligence in preschool children living in iodine-deficient areas.
A Quasi Experimental Study Comparing Knowledge Regarding Child Abuse among Pa...YogeshIJTSRD
Introduction The future of nation can become bright only if the children are healthy. They need full protection by their full development. Jujhar Singh Maan | Sobana M | Abhishek Yadav "A Quasi-Experimental Study: Comparing Knowledge Regarding Child Abuse among Parents of Children of Experimental and Control Group" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45008.pdf Paper URL: https://www.ijtsrd.com/biological-science/other/45008/a-quasiexperimental-study-comparing-knowledge-regarding-child-abuse-among-parents-of-children-of-experimental-and-control-group/jujhar-singh-maan
The most common cause of bleeding from gums is inflammation of the gums, otherwise called as gingivitis which leads to periodontitis if left untreated.
Read More:https://www.icliniq.com/qa/bleeding-gums/what-is-the-cause-and-solution-for-bleeding-gums
The document defines 20 vocabulary words related to the medical field, including pernicious, meaning having a harmful effect in a gradual way; insurrection, meaning a violent uprising against authority; and quagmire, meaning a soft boggy area of land or an awkward situation. It also defines words like stupor, timorous, repulsive, ignominy, profound, and denouement.
The document outlines a transition plan for the US Coast Guard Auxiliary Fourteenth District. It will form an ad hoc transition team representing diverse members to address potential problems and opportunities. District staff officers will be selected based on their expertise and ability to work cooperatively. A technology team will be established to improve communication challenges and implement new technologies. The plan also details strategies to address recruitment and retention issues like attracting younger members and making the onboarding process quick. A communication plan is outlined to keep members informed through meetings, videos, surveys and public media. The program will focus on core missions while introducing new ones like paddle craft and commercial vessel inspections. Gantt charts and organization charts will be attached.
A 2 bedroom apartment located in the Naama View Resort in Sharm El Sheikh is available for short term rental. The fully furnished 108 sqm apartment includes 2 bathrooms, private parking, swimming pools, and 24hr security. It rents for 450 Egyptian pounds per night, which includes water and electricity. The sales manager, Cheryl Wilson, can be contacted for more information.
The document provides guidelines for safe bicycling. It emphasizes the importance of wearing a properly fitted helmet that meets safety standards. It also outlines rules for riding bikes on roads, including riding with traffic, obeying traffic laws, signaling turns, and yielding appropriately. Additional tips include staying alert, avoiding parked cars, and wearing bright/reflective clothing so others can see the rider.
The document discusses how hotels need to adapt to changing market conditions and increasing use of technology. It summarizes that:
1) Hotels cannot assume they will follow the same recovery path as before and must seize new opportunities from shifting to online/direct distribution.
2) By 2010, 50% of leisure bookings worldwide are expected to be made online, so hotels need their websites and mobile access to be optimized to attract customers.
3) Hotels should focus on having an effective internet strategy, driving traffic to their websites, optimizing conversion rates, and ensuring their sites and booking capabilities are up-to-date.
This document provides recommendations for a company seeking to elicit joy and do good through its products and services. It outlines the company's purpose and ideal customers, and recommends positioning, branding, and strategies for product, service, delivery channels, pricing, promotion, lead generation, and lead conversion. Appendices provide introduction, survey, SWOT, brand, generation, sample survey, benchmark, country, and index analyses to support the recommendations.
C.Lal Realtors is a real estate consulting firm based in Noida, India that has been in business since 1974. They are developing a new mixed-use community called 3C Ozone Boulevard on Expressway NoidaGolf View. The community will be located next to a golf course and offer modern residential, commercial, leisure, hospitality, and business facilities. C.Lal Realtors has experience executing various real estate projects and provides services across retail, commercial, residential, and leisure verticals. They can be contacted at their Noida office for advisory, agency, management, and financial services related to real estate.
The document advertises a business park launched by Stellar Group in Greater Noida on 11 acres opposite Gautam Budha University. It offers a 12% assured rental return and guaranteed leasing with a minimum investment of 16.3 lacs. Stellar Group has established over 2 million square feet of commercial and residential projects in NCR and this new business park continues their work developing quality real estate with an experienced team.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help alleviate symptoms of mental illness and boost overall mental well-being.
This document describes several residential projects developed by Stellar, a real estate developer, including Stellar Park, Stellar Greens, and Stellar Kings Court. It also outlines two ongoing projects, Stellar Jeevan Apts and Stellar Sigma IV Apt. Additionally, it provides information on C.Lal Realtors, a real estate consulting firm offering various services such as agency, advisory, and financial services across commercial, residential, and other sectors.
This study assessed the prevalence of vitamin A deficiency (VAD) among rural preschool children in West Bengal, India. The researchers conducted clinical examinations on 9,228 children and blood tests on 590 children. They found that the prevalence of Bitot's spots, a sign of clinical VAD, was 0.6%. The proportion of children with subclinical VAD (blood vitamin A <20μg/dL) was 61%. Prevalence was significantly higher in boys and among children from lower socioeconomic communities and scheduled tribes. This study indicates that VAD is a major public health problem among rural preschool children in West Bengal.
- The study assessed the prevalence of vitamin-A deficiency and its determinants among 681 preschool children in Dembia District, Ethiopia.
- The overall prevalence of xerophthalmia (a clinical sign of vitamin-A deficiency) was found to be 8.6%.
- Factors significantly associated with vitamin-A deficiency included non-attendance at antenatal care clinics, being male, and being between 49-59 months of age.
Prevalence of Malaria Infection and Malaria Anaemia among Children Attending ...theijes
Malaria associated anaemia represent a major public health problem. Thestudy considered Out-Patient children at Emergency Paediatric Unit, Federal Medical Centre, Yola aged 6 months-15 years from June to November 2015. Questionnaires were used to collect information relating to gender, age and parents/guardians sociodemographic characteristics. Microscopic examination of Thick and Thin blood films a technique was employed, Pack Cell Volumewas used to screen for anaemia. Of the 168 children sampled, the prevalence of malaria infection and malaria anaemia was 29.2% and 26.2% respectively and it was associated with P. falciparum. Malaria infection in relation to anaemia, children with mild anaemia (47.6%) had the highest infection rate. It was observed that malaria infection was higher among males (32.2%) than the females (25.6%), age group 5-9 years (34.2%) had the highest malaria infection and least was ≥15 years (20.0%) but these were statistically insignificant within gender and age of the children and malaria infection (p˃0.05). Higher malaria infection among children whose parents/guardians were unemployed (38.5%), attended primary education (52.6%) and reside in village setting (31.4%). Malaria anaemia in relation to children epidemiological data, males (31.6%), 5-9 years (31.6%) recorded with high prevalence rate while sociodemographic characteristics of parents/guardians, children whose parents/guardians were civil servant (18.9%), attended tertiary education (13.8%) and live in quarters (11.1%) had the least prevalence rate of malaria anaemia. Children gender, parents/guardians occupation and educational qualification were significantly associated with malaria anaemia (p˂0.05). Therefore, parents/guardians sociodemographic factors such as better occupation, higher educational qualification and well layout and refined area of residence reduces the prevalence of malaria infection and malaria anaemia in children. There is need to sensitized public on the importance of management of malaria and the possible effects of malaria anaemia on children in order to circumvent the menace.
Prevalence of diarrhea among severely malnourished children admitted in Gover...Open Access Research Paper
Mortality rate of children under the age of five has reduced worldwide, but still the probability of a child dying before the age of five is greatest in underdeveloped countries. Pakistan reports child mortality rates in same bracket as other South Asian countries due to malnutrition and diarrhea. To determine the prevalence and factors associated in children less than five years of age a cross sectional study was conducted with mothers whose children were admitted in pediatric government Hospital, Lahore. A convenient sample of 101 children (6-59 months, 53 males and 48 females) suffering from malnutrition and diarrhea were selected from hospital. Data about socio demographic, anthropometric, clinical and dietary variables were collected and analyzed by using SPSS version 16. The results showed that mean age of patients was 19.36 ± 10.5 months. The illiteracy rate among mother and father of patients was 94.1% and 69.3% respectively. 94.1% of the patients were breastfed while 47.5% of the patients were on bottle feed with breast milk. 66.3% patients families has very low-income rate while 33.7% were satisfactory. 40.6% patients were not vaccinated against immunization. Out of 101 patients, 39.6% of the patients had diarrhea while 6.9% of the patients had chronic diarrhea. The prevalence rate of diarrhea (39%) was less among children who were younger than 18 months as compared to those who were above 18 months (40.5%). The most significant factors that caused the incidence of diarrhea in children was form of water storage system, complementary feeding practices, and hand wash cleaning materials. This study concluded that government, nongovernmental organizations and families living with children and mothers could cooperate on strategies to minimize the risks of the diarrhea among children less than five years of age.
Knowledge, Attitude and Practices of School Children on Prevention and Contro...Premier Publishers
Superficial fungal infections are common among school-going children due to their involvement in practices that promote the spread at school or home. However, practices, knowledge and attitude of these children on prevention and control of fungal infection are poorly understood. This study assessed the practices, knowledge and attitude on the prevention and control of fungal infections among 163 children aged 5-12 years in western Kenya. A cross-sectional study design and systematic sampling method were adopted. Information on knowledge, attitude and practices on fungal prevention and control was collected using a structured questionnaire. Results showed that over 50% of the pupils had adequate knowledge on prevention and control of superficial fungal infections. On attitude, 58.9%of the children believed that those with fungal infection should not be allowed to play with others or go to school. Furthermore, 70.6% and 54.6% of the pupils agreed that sharing of toys and hairbrushes respectively leads in promoting the infections. These findings show that pupils demonstrate a good knowledge of superficial fungal with marked limited infection and control measures. Therefore, there is a need for stakeholders in health and education sectors to develop a policy framework involving learners in prevention and control of fungal infections.
Effectiveness of Video Teaching Program on Knowledge Regarding 5Fs Of Disease...ijtsrd
Introduction Infectious diseases are caused by pathogenic microorganisms, such as bacteria, viruses, parasites or fungi the diseases can be spread, directly or indirectly, from one person to another.1 These infectious diseases often spread through direct contact that means from person to person. Coming with the contact of body fluids, or any secretions or even the fomites used by the infected person. The feaco oral route can be summarized into 5fs finger, food, fluid, feaces, flies. The main diseases that are caused by feaco oral route are diarrhoea, cholera, polio, hepatitis.2 The objectives of the study were to assess the knowledge regarding the prevention of 5f’s finger, food, fluid, flies and feaces disease transmission among children. Materials and methods Research approach was quantitative and research design was descriptive research design. 30 samples who fulfilled the inclusion criteria were selected by non probability convenient sampling technique. The tool used for the collection comprises of 2 sections section A demographic variables section B to assess the effectiveness of structured teaching programme on knowledge regarding 5Fs of disease transmission food, finger, fluid, fomite, faces among children Data collected were analyzed by using descriptive and inferential statistics. Results The study findings reveals that, the pre test mean value is 11.3 with SD of 66 and post test value is 18.3 with SD of 97, it shows that there is a significance difference between pre test post test knowledge regarding 5Fs disease transmission among mothers of school children and there is a significant association between the level of post test knowledge regarding 5Fs disease transmission with mother’s age group, educational status and at 5 level of significance respectively. Mrs P. Umalakshmi "Effectiveness of Video Teaching Program on Knowledge Regarding 5F's Of Disease Transmission (Food, Finger, Fluid, Fomite, Faces) among Children at Selected Setting, Chennai" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd63422.pdf Paper Url: https://www.ijtsrd.com/medicine/other/63422/effectiveness-of-video-teaching-program-on-knowledge-regarding-5fs-of-disease-transmission-food-finger-fluid-fomite-faces-among-children-at-selected-setting-chennai/mrs-p-umalakshmi
Prevalence of malnutrition among under five children of RukaminiNagar, BelgaumSawan Kumar
synopsis of prevalence of malnutrition among under five years children in Rukmini Nagar, Belgaum
Reaserche:- Mr. Sawan Kumar Yadav
Guide:- Dr. Mubashir Angolkar,
Coordinator and Assistant Professor
Department of Public Health,
J.N. Medical college, Belgaum, Karnataka, India
A Study on Knowledge, Attitude and Practice KAP on Anemia and Socio Economic ...YogeshIJTSRD
This study examined the knowledge, attitudes, and practices (KAP) related to anemia among 508 rural adolescent girls in Odisha, India before and after a planned nutrition education program. The study found that 55% of participants had mild anemia at baseline. Scores for knowledge, attitudes, and practices all improved significantly after the education program, indicating it was effective at positively changing KAP related to anemia. Certain demographic variables like age, family income, and mother's education were also found to influence KAP levels. The results suggest planned nutrition education can help address anemia issues among adolescent girls.
Assess the Knowledge on Hazards of Junk Foods among Adolescentsijtsrd
INTRODUCTIONFood is important for survival. It provides necessary nutrition for the body of the human being. Fast food, which is available readymade and easy to eat is now a day’s an important item of food. It often termed as food away from home FAFH Jahan, et al., 2020 . Junk food was first popularized in 1950s in the United States. The first Junk food restaurants were established in the United States with White Castle in 1916. Now a days McDonald’s, KFC and Pizza Hut are multinational corporations with outlets across the globe. At present fast food restaurants are one of the largest segments of the food industry with over 200,000 restaurants and 120 billion in sales in the U.S. alone10. International chains including McDonald’s and Yum Brands have 65 percent and 50 percent of their sales overseas respectively which indicates that fast food has a great demand all over the worldSTATEMENT OF THE PROBLEMA study to assess the knowledge on hazards of junk food among adolescents.OBJECTIVESTo assess the level of knowledge regarding hazards of junk food among adolescents.To associate the level of knowledge regarding hazards of junk food among adolescents with their selected demographic variables.RESEARCH METHODOLOGYA descriptive design with simple random research design was used to assess the assess the knowledge on hazards of junk food among adolescents at rural areas After obtaining permission from the Department of Community Heath Nursing, the investigator selected 30 samples by using purposive sampling technique. The samples who met the inclusion criteria were selected by convenience sampling technique. The purposes of the study to the samples and obtained the written informed consent. The nature and purpose of the study was explained to the women. Questionnaire was used to collect the demographic variables of adolescents.MAJOR FINDING OF THE STUDY The study shows that 15 50 had moderate level of knowledge, 8 26.67 had inadequate knowledge and 7 23.33 had adequate knowledge regarding health hazards of the fast food consumption among adolescents. The mean score of knowledge score was 8.50±2.86. The median score was 9.0 with minimum score of 4.0 and maximum score 13.0The demographic variable pocket money per month 2=10.243, p=0.037 had shown statistically significant association with level of knowledge regarding health hazards of the fast food consumption among adolescents at p 0.05 level and the other demographic variables had not shown statistically significant association with level of knowledge regarding health hazards of the fast food consumption among adolescents.CONCLUSIONThe findings of the study conclude that the adolescents had moderate to inadequate level of knowledge on health hazards of the junk food consumption. The study suggest that health education on consumption of fast food should be imparted to the adolescents at the community and school level. Meena. P | Francis Nath | F. J. David "Assess the Knowledge on Hazards of Junk Foods am
This study examined the prevalence of eye disorders in 5918 children aged 5-16 in Dehradun, India. The highest rates of ocular morbidity were found in children under 10 years of age (6.48%), decreasing to 4.4% in older children. No significant relationship was found between sex and eye disorders. The most common cause of visual impairment was refractive errors. The study concludes effective vision screening in schools can help detect correctable issues like refractive errors and minimize long-term visual disability.
The document discusses a study on the prevalence of anemia among under-five children attending Muhimbili National Hospital in Tanzania. The study found:
1) The overall prevalence of anemia was 77.2%, with mild, moderate and severe cases being 16.5%, 33% and 27.7% respectively.
2) Factors associated with severe anemia included unemployment of parents, malaria parasitemia, and the presence of sickle hemoglobin.
3) The study recommends that the government and health organizations increase efforts to detect, treat and prevent anemia in under-five children through expanding healthcare resources and providing health education.
Background: Adolescent is one of the most rapid phases of human development. Anemia is a deficiency in the number of RBC in your body. RBC carry oxygen around your body using a particular protein called hemoglobin. Normal hemoglobin level in adolescent girls 13-15 g/dl. According to WHO, the hemoglobin level 10- 11.9 g/dl is considered mild anemia, 7-9 g/dl is considered moderate, and less than 7 g/dl is called severe anemia. Methods: The present study is pre-experimental among 60 adolescent girls, using a disproportional stratified random technique. One experimental group of clients was selected without randomization and no control group was used. The data was collected by using the structured close-ended knowledge questionnaire. The data was analyzed using descriptive and inferential statistics regarding mean, frequency distribution, percentage, paired table t-test and chi-square test. Results: The overall findings reveal that the post-test knowledge mean score 26.24% with SD±5.94, which was 72% of the total score was more when compared to the pre-test knowledge mean score 12.98 with SD 5.94, which was 36.83% of total score. The calculated t-value of 24.91 was much higher than the table t-value 1.96 for the hypothesis. Conclusion: The study provides that VATP on knowledge regarding the preparation and use of moringa juice in managing anemia among adolescent girls was the scientific, logical and cost-effective strategy.
Key-words: Adolescent girls, Knowledge, VATP, Effectiveness, Socio-demographic variables.
Indian j communitymed463550-2090863_054828DRTEJASWINIHK
This study explored the prevalence of anemia and poor menstrual hygiene management (MHM) practices among 393 adolescent girls in an urban slum in Bhopal, India. The study found that 38.7% of participants were anemic, with 65.1% having mild anemia. Poor MHM practices, defined as unsatisfactory in 5 or more of 6 assessed parameters, were found in 87.3% of participants. Logistic regression analysis revealed significant associations between anemia and poor MHM practices, excessive menstrual bleeding, religion, education level, and nutritional status. The study concluded that concerted efforts are needed to improve awareness of MHM and access to sanitary facilities to help reduce the burden of anemia.
The document summarizes a study on the nutritional status of pre-school children (ages 3-6) in urban and rural areas served by the Integrated Child Development Services (ICDS) program in Jammu district, India. A sample of 300 children was selected and their weight and height were measured. Malnutrition levels were calculated using WHO standards. The study found high levels of malnutrition among children in both urban and rural areas, with girls found to be more malnourished than boys. It concluded that child feeding and care practices need improvement and that nutrition education for mothers should be strengthened to promote unbiased childcare.
The document discusses newborn screening in India, arguing that it is needed to prevent health issues. It outlines the components of newborn screening programs and principles from Wilson and Jungner. Internationally, most Western countries screen for various treatable genetic disorders. In India, pilot studies found higher rates of congenital hypothyroidism than the West. The document recommends starting screening for congenital hypothyroidism, congenital adrenal hyperplasia, and G6PD deficiency in urban Indian hospitals. It stresses the need for diagnostic confirmation, treatment facilities, and quality assurance before a national newborn screening program is implemented.
The document is a survey report on HIV awareness among male and female students at Taylor's University Lakeside Campus. A group of six students conducted a survey using a 15 question form distributed to 150 male and 150 female students over three days. The collected data was compiled and statistically analyzed to identify the level of HIV awareness between genders. The analysis found that male students displayed a higher level of awareness compared to females, such as knowing HIV cannot be cured and is not transmitted through casual contact or mosquito bites.
This survey report summarizes the results of a survey conducted among 150 male and female students at Taylor's University to assess their level of awareness of HIV (Human Immunodeficiency Virus). The survey was conducted over three days using a questionnaire consisting of 15 multiple-choice questions. The collected data was compiled and analyzed statistically based on gender. Overall, the analysis found that male students displayed a higher level of awareness of HIV than female students, with many more males correctly answering questions related to transmission methods, prevention, and treatment of HIV/AIDS.
Similar to Prevalence of Clinical Vitamin A Deficiency Among Primary School Children in Urban Slums of Ahmedabad: A Cross Sectional Study (20)
This document discusses different types of epidemiological studies, with a focus on experimental studies and randomized controlled trials (RCTs). It describes the key features of RCTs, including that they: (1) involve randomly allocating subjects into study and control groups to receive or not receive an intervention, (2) aim to control for confounding factors through randomization, and (3) are considered the gold standard for evaluating interventions due to their ability to minimize bias. The document outlines the basic steps in conducting an RCT, from developing a protocol to randomization, intervention, follow-up, assessment and analysis. It also discusses types of RCTs and their importance in evaluating treatments, prevention, risk factors and more.
1) Geriatrics is the branch of medicine focused on the health and medical issues of older adults. It aims to prevent disease, promote health, and manage illnesses in elderly populations.
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3) A multidisciplinary team approach is often used in geriatrics, involving geriatricians, nurses, physiotherapists, and social workers to address medical, physical, social, and emotional needs of older patients. The goals are to maintain health, detect and manage illnesses early, and provide supportive care during
A 20-year-old Spanish man traveling in Thailand for a martial arts competition was admitted to a local hospital in Koh Samui, Thailand with fever, headache, and decreased consciousness. His condition worsened over 48 hours, developing seizures, paralysis, and decreased responsiveness. Testing revealed positive IgM antibodies for Japanese encephalitis virus (JEV) in his serum. JEV is a mosquito-borne virus that causes viral encephalitis, with high incidence in parts of Asia. Personal protection from mosquito bites and vaccination are recommended for travelers to endemic areas.
This document discusses objective evaluation methods, specifically multiple choice questions (MCQs). It outlines the advantages and limitations of MCQs, including that they allow for objective, large-scale evaluation but can be time-consuming to create and may test trivial details. The document describes different types of MCQs and provides guidelines for writing high-quality questions at various cognitive levels. It also covers using item analysis to evaluate questions based on difficulty, discrimination, and distractor effectiveness to improve assessments over time.
This document discusses different methods of assessment used in education. It defines evaluation as determining if educational objectives have been achieved. The aims of evaluation are selection of top students, assessing learner needs, providing feedback, and determining competence. Evaluation tools should be relevant, valid, objective, and feasible. Types of evaluation include essays, short answer questions, multiple choice questions, and practical exams. Guidelines are provided for writing effective essay questions, short answer questions, and multiple choice questions as assessment tools. The document emphasizes the importance of involving learners in the evaluation process to enhance learning.
This document summarizes an investigation of a hepatitis outbreak in Girdharnagar, Ahmedabad, India in 2008. A total of 233 cases were identified, with an attack rate of 10.9 per 1000 people. Laboratory testing found that 16 of 17 patients were positive for hepatitis E virus. The outbreak was likely caused by contamination of the municipal water supply from leaking pipes and overflowing drains, as those exposed to the contaminated water had a relative risk of 2.3 compared to unexposed individuals. Recommendations included temporary alternative water supply, repairing leaks, and water quality surveillance to prevent future outbreaks.
The document discusses the global HIV/AIDS epidemic and its impact. It notes that as of 2008, there were an estimated 33.4 million people living with HIV/AIDS globally. Women accounted for half of new infections that year. The epidemic disproportionately impacts those in sub-Saharan Africa, where 22.4 million people were estimated to be living with HIV/AIDS in 2008. The epidemic has had vast social and economic impacts, including orphaning millions of children and slowing economic growth.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
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“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
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- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
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Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
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Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
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Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Prevalence of Clinical Vitamin A Deficiency Among Primary School Children in Urban Slums of Ahmedabad: A Cross Sectional Study
1. original Article
Prevalence of Clinical Vitamin A Deficiency
Community Medicine section
Among Primary School Children in Urban Slums
of Ahmedabad: A Cross Sectional Study
NAresh T. ChAuhAN, TriVedi ATul V., KhAN iqBAl M., TAlsANiA NiTi J.
ABSTRACT selected from standard I-VII. Xerophthalmia was diagnosed if
Background: Although there is a substantial documentation there was a history of night blindness, or on examination, there
of prevalence, severity and health consequences of vitamin A were signs of conjunctival xerosis, Bitot’s spots, corneal xerosis
deficiency (VAD) in preschool-aged children, very few studies or keratomalacia.
have been done to find out the extent of VAD in primary school Statistical Analysis: The collected information was analysed by
children. Present study was carried out in school children using the Microsoft Excel and the Epi info 3.4 software. Chi-
(5-15 years age) from slum areas of Ahmedabad city to see the square test was used for analysis.
prevalence of xerophthalmia. Results: In this study prevalence of VAD was found to be 2.9%.
Aims: To clinically asses the prevalence of xerophthalmia among Prevalence of VAD among girls (4.1%) was significantly high than
school going children in urban slums of Ahmedabad. To study boys (1.9%). In present study 0.5% cases of night blindness,
the socio-demographic factors associated with VAD in urban 1.4% cases of conjunctival xerosis and 2.1% cases of Bitot’s
slums spot were found. Types of family, lower social class (class IV
Settings and Design: The present study was designed as a & V) and poor intakes of green vegetables were significantly
cross sectional study conducted in primary schools of urban associated with the vitamin A deficiency.
slums in Ahmedabad from October 2007 to July 2008. Conclusion: The observation of this study underlines the
Methods and Materials: 1000 children were randomly selected magnitude and severity of vitamin A deficiency in an age group
from 10 schools and examined with predesigned and pretested that policy makers do not usually consider to be at risk in this
Performa. From each school 100 children were randomly respect.
Key Words: Ahmedabad, Vitamin A deficiency, Xerophthalmia, Night blindness, Bitot’s spot
KEY MESSAGE
n Prevalence of vitamin A deficiency in older children (5-15 years) is high and it demands systemic evaluation of the extent of VAD
in this age group.
InTRoDuCTIon children in India is far away from being satisfactory. Lack of basic
Deficiency of vitamin A has long been identified as a serious and amenities like safe drinking water, proper housing, drainage and
preventable nutritional disease. It also contributes significantly, excreta disposal make this population more vulnerable to infection
even at sub-clinical levels, to morbidity and mortality from common which further compromise the nutrition of those living in the slums.
childhood infection. Studies suggest that ill health and risk of death Children living in slum are more prone to nutritional deficiency
from some infection are also increased even in children who are disorders [6].
not clinically deficient but, whose vitamin A body stores is depleted Present study was a small effort to assess the prevalence of VAD
[1-2]. Though one of the main causes of xerophthalmia is poor among school children of 5-15 years in urban slums of Ahmedabad,
intake of vitamin A rich foods, it is also associated with poverty, India.
ignorance, faulty feeding habits among the entire population but
young children in particular [3]. At least 45 countries are now known
MATERIALS AnD METHoD
to have serious vitamin A deficiency (VAD) [3-4]. Corneal scarring
selection of study population &sample size: A cross sectional
results from deficiency of vitamin A is responsible for about 19% of
study was conducted among primary school children in the age
all causes of childhood blindness [5].
group 5-15 years. The study was conducted from October 2007
Surveys indicate that the intake of Vitamin A is, on an average, to July 2008. Total sample size was calculated of 1000 children
about half the recommended dietary intake. It is important that the considering 30 % prevalence of ocular morbidity in the pilot
dietary practices are improved and intake of Vitamin A rich foods study. Sample size of 933.33 was calculated by considering 30%
be actively promoted. The diet and nutritional status of urban slum prevalence of ocular morbidity in the pilot study with the help of
Journal of Clinical and Diagnostic Research. 2011 December, Vol-5(8): 1627-1630 1627
2. Naresh T. Chauhan et al., Prevalence of Vitamin a Deficiency among Primary School Children www.jcdr.net
formula 4pq/l2 where (l= 10% of p). For practical reason and feasibility Variables No (n=1000) Percentage
of survey, sample size of 1000 was decided for the study.
Sex
sampling Method: Population of Ahmedabad city was 35, 20, Boys 536 53.6
850 distributed in five zones (Census 2001). List of primary schools Girls 464 46.4
running in slums in each zone was obtained from Ahmedabad
Type of family
Municipal Corporation. From 531 schools, 10 schools were
Nuclear 886 88.6
selected by the simple random sampling method. Two schools
selected from each zone and 100 children from each school Joint 114 11.4
were examined to achieve desired sample size. First standard No. of siblings
wise cumulative frequency was prepared according to roll no ≤3 550 55.0
and class interval was calculated for the selection of 100 children >3 450 45.0
proportionate representation from each class. Paternal Education (n=988)
Training and survey technique: Training for identification of various Illiterate 344 34.8
stages of vitamin A deficiency (xerophthalmia) was conducted at Primary 404 40.9
a local institute. Prior permission for the study was taken from Secondary 236 23.9
the school authorities. The investigator filled a predesigned and
Higher secondary and more 4 0.4
pretested proforma after explaining the purpose of the study. The
Maternal Education (n=996)
first child was selected randomly by lottery method. If selected child
was absent, next child was selected. The questionnaire dealt with Illiterate 492 49.4
information regarding the child like age, sex, residential address, Primary 384 38.6
class in which the student is studying, education, occupation Secondary 120 12.0
and income of parents and dietary intake of dark green leafy Parents occupational Status (n=978)
vegetables/yellowish fruits. All the children were examined in day
Both parents working 825 82.5
light for vitamin A deficiency. Xerophthalmia was diagnosed if there
Father only working 153 15.3
was history of night blindness, or there were signs of conjunctival
xerosis, Bitot’s spots, corneal xerosis and keratomalacia on clinical Socio-economic status
examination [7]. Anthropometric measurements were recorded Class I 29 2.9
as per the standard WHO guidelines. Dietary intake of dark green Class II 221 22.1
leafy vegetables/yellowish fruits noted in terms of frequency of Class III 385 38.5
consumption per week [1]. BMI percentiles were calculated for Class IV 331 33.1
each respective age group. The BMI percentile between the 5th
Class V 34 3.4
percentile to less than the 85th percentile was taken as normal, the
85th to less than the 95th percentile was taken as overweight and [Table/Fig-1]: Socio-demographic characteristics of school going
children aged 5-15 years in urban slums of Ahmedabad, India
that which was equal to or above the 95th percentile was taken
as obese. Socio-economic classification of children was done by
modified Prasad classification method. Children diagnosed having Age groups
(years) No VAd (%) X2 test P-value
xerophthalmia were given two lakh IU of vitamin A solution on the
5-6 250 5 (2)
spot and referred to local health institute.
7-8 253 7 (2.7)
data analysis: All the data were analyzed by Epi-info 3.4.3. The chi-
9-10 184 11 (5.9)
square test was used to test difference in proportions. Differences 8.78 0.11
11-12 146 4 (2.7)
were considered statistically significant at 5% level.
13-14 113 1 (0.8)
oBSERvATIon AnD RESuLTS 14-15 54 1 (1.8)
The present study was conducted among primary school children Boys 536 10 (1.9)
4.39 0.03
aged 5-15 years in urban slums of Ahmedabad. In total, 1000 Girls 464 19 (4.1)
examined including 53.6% boys and 46.4% girls [Table/Fig-1]. All [Table/Fig-2]: Age and sex wise distribution of Xerophthalmia among
the children examined were from age 5-15 years of age and mean school going children in urban slums of Ahmedabad, India
age was 9 years. Among study participants, 88.6% belong to
nuclear family and 45% had more than three siblings. 34.8% father reported VAD in various forms of xerophthalmia. As per WHO
and 34.8% mother were illiterate. Majority of children had their both standards of prevalence of night blindness >1% and Bitot’s spot,
parents (82.5%) working as unskilled/semi-skilled/skilled work. As >0.5% considered as public health problem among preschool and
per modified Prasad classification, 36.5% family belongs to lower school children. The prevalence of night blindness 0.5%, Bitot’s
(IV &V) social class. Body mass index was measured and 73.3% spot 2.1% and of conjunctival xerosis 1.4% was found in present
children found underweight and 16.6% overweight/obese. study [Table/Fig-3].
[Table/Fig-2] shows age and sex wise distribution of VAD. Highest Various factors like type of family-nuclear or joint, number of siblings,
no of cases observed in age group 9 to 10 yrs (5.9%) and lowest paternal education, maternal education, parent’s occupational
in age group 13 to 14 years (0.8%). Higher prevalence in girls status-weather both parents working or father only working, social
was statistically significant (p=0.03) but no significant association class as upper and middle(I,II &III) or lower (IV &V), nutritional
between age and VAD (p=0.11). [Table/Fig-3] shows various status-normal weight or malnourished (underweight, overweight,
manifestation of vitamin A deficiency. Almost 3% of boys and girls or obese), and consumption of dark green leafy vegetables were
1628 Journal of Clinical and Diagnostic Research. 2011 December, Vol-5(8): 1627-1630
3. www.jcdr.net Chauhan Naresh T. et al., Prevalence of Vitamin a Deficiency among Primary School Children
Prevalence Prevalence (p=0.00). Nutritional status of children was not found to be
Ocular (%) observed (%) as per associated (p=0.45) with occurrence of VAD but the consumption
manifestation Total no in present WhO of dark green leafy vegetables < 3times per week significantly
of VAd (n=29) study standard*
associated with occurrence of VAD (p=0.01).
Night blindness (XN) 5 0.5 >1.0
Bitot’s spot (X1B) 21 2.1 >0.5
DISCuSSIon
Conjunctival Xerosis 14 1.4 - Although there is a substantial documentation of prevalence,
(X1A)
severity and health consequences of vitamin A deficiency in
Corneal Xerosis 0 0 0
preschool-aged children, extent of VAD in older children has not
(X2), Keratomalacia
(X3A,X3B) & Corneal given much attention. Present study was carried out in primary
Scaring (XS) school children (5-15 years age) from slum areas of Ahmedabad
[Table/Fig-3]: Prevalence of Xerophthalmia among school going city to see the prevalence of VAD.
children in urban slums of Ahmedabad and its comparison with WHO
standard [7] In present study prevalence of vitamin A deficiency was observed
* Prevalence more than WHO standards will be considered as public to be 2.9% which was similar to finding of a comprehensive study
health problem of morbidity in Tamilnadu [8]. Cross-sectional survey with multi-
stage sampling of 3 of 19 districts (Baroda, Ahmedabad and
Yes (%) Total Rajkot) in Gujarat state showed 6.30 % to 13.5 % prevalence in
Variables (n=29) (n=1000) X2 test P value
same age group [9]. Studies done on school children in other part
Type of family
of country show prevalence of xerophthalmia ranging from 1.8 % to
Nuclear 21 (72.4) 886 10.6% [10-14]. Evidence from various countries of South-eastern
7.74 0.00
Joint 8 (27.6) 114 Asia had shown VAD ranging from 0.2 % to 15 % in school aged
Paternal Education (n=988) children [15]. In present study, highest no of cases were observed
Illiterate 13 (44.8) 340 in age group 9 to 10 years (5.9%) and lowest in age group 13
Primary 9 (31.0) 404 to 14 years (0.8%). The prevalence of xerophthalmia among boys
Secondary 7 (24.2) 240 1.43 0.23 was 1.9% and in girls it was 4.1% and the difference observed
was statistically significant, p=0.03. These observations were
Higher secondary 0 (0) 4
and more correlated with the Ethiopian study conducted by Tarik Kassaaye
Maternal Education (n=996)
et al. [16], but not to the Lucknow study conducted by D. Kumar
et al [10]. The prevalence of night blindness (0.5%) in the present
Illiterate 14 (48.3) 492
study comparable to the Gupta et al., study [14]. Wedner et al.,
Primary 11 (37.9) 384 0.02 0.90
reported the higher prevalence (5.3%) of night blindness among
Secondary 4 (13.8) 120 school children (7-19years) but the study conducted in rural area
Parents occupational Status(n=978) of Tanzania [17]. Prevalence of vitamin A deficiency was higher in
Both parents working 21 (72.4) 825 social class IV and V, than in social class I, II and III. This difference
3.23 0.07
Father only working 8 (27.6) 153 was statistically significant, p=0.00. Similar observation was found
Socio-economic status in the study done by Pal R et al [18].
Class I,II and III 11 (37.9) 635 Dietary deficiency of vitamin A leads to development of xerophthalmia
8.42 0.00
Class IV and V 18 (62.1) 365 in those children taking insufficient green leafy vegetables. This
Body Mass Index (BMI) was also observed by Tarik Kassaaye et al and Faruk Ahmed et
Underweight 23 (79.3) 733 0.55 0.45 al [16,19].
Normal weight 1 (3.5) 101 This study suffers from two limitation, first is that we included
Overweight 3 (10.3) 103 children who were present at the time of data collection, if the
Obese 2 (6.9) 63 selected child was absent next child selected. This could have
Dark green leafy vegetables an effect on prevalence of VAD. Second was we had collected
the data regarding consumption of green leafy vegetables but not
< 3 times/wk 26 (89.7) 681 6.39 0.01
about other rich sources of vitamin A which could be significantly
≥ 3 times/wk 3 (10.3) 319
associated with prevalence of xerophthalmia.
[Table/Fig-4]: Factors affecting vitamin A deficiency among school going
children in urban slums of Ahmedabad, India The observation of this study underlines the magnitude and
severity of vitamin A deficiency in an age group that policy makers
assessed to determine any association with VAD among school do not usually consider to be at risk in this respect. It is important
children [Table/Fig-4]. to educate the community about the important morbidity in school
Occurrence of VAD was significantly high among children resid- age children, their aetiology and prevention. Provision of rich food
ing in joint family than nuclear family (p=0.00). No statistical in vitamin A must be supplied regularly in Mid Day Meal. Increase
significance was found for children having number of sibling three awareness of school children and parents about importance of
or more than three (p=0.06). Similarly, no association was found taking dark green leafy vegetables, yellow fruits and dairy products
between education status of father (p=0.23) and mother (p=0.90) by respective Public Health people in the district. Identify high-
and occurrence of VAD. No association was found for parents risk children who are prone to develop vitamin A deficiency and
working status and VAD (p=0.07). Significant number of cases of intervene with appropriate strategy to prevent xerophthalmia
VAD reported among lower socio-economic children (class IV & V) amongst those children. If space is available than school kitchen
Journal of Clinical and Diagnostic Research. 2011 December, Vol-5(8): 1627-1630 1629
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to Dr. V. S. Rawal, then professor and head of Community Medicine Ocular morbidity prevalence among school children in Shimla,
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AuThOr(s): NAMe, Address, TelePhONe, e-MAil id OF The
1. Dr. Naresh T. Chauhan COrresPONdiNG AuThOr:
2. Dr. Trivedi Atul V. Dr. Naresh T. Chauhan,
3. Dr. Khan Iqbal M. Flat No 1, Shivganga Flats, Oppo. Bavlia Hanuman Temple,
4. Dr. Talsania Niti J. Bhayanini wadi, Bhavnagar, Gujarat, India - 364003.
Phone: +919904266004; Fax: +912782431866
PArTiCulArs OF CONTriBuTOrs
E-mail: drnareshchauhan@rediffmail.com.
1. Assistant Professor, Community Medicine Department,
Government Medical College, Bhavnagar, India deClArATiON ON COMPeTiNG iNTeresTs:
2. Assistant Professor, Community Medicine Department, No competing Interests.
B. J. Medical College, Ahmedabad, India
3. Assistant professor, Deptt. of community medicine,
Geetanjali medical college & Hospital Manwa Kheda,
NH-8 Byepass Udaipur, Rajasthan
Date of Submission: Jun 17, 2011
4. Professor, Community Medicine Department, Date of peer review: sep 19, 2011
B. J. Medical College, Ahmedabad, India. Date of acceptance: dec 10, 2011
Date of Publishing: dec 25, 2011
1630 Journal of Clinical and Diagnostic Research. 2011 December, Vol-5(8): 1627-1630