Children In Delhi Research Articles

A Study On Growth Parameters And Prevalence Of Overweight And Obesity Among School Going Children (5 – 10 Years) In Tirunelveli District

Recent data indicate a rise in obesity in children in developing countries. A study in India revealed that among school going children 9.9% of boys and 12% of girls were overweight and 6.3% of the girls were obese. This study highlights the theories of prevalence, assessment dietary significance, clinical effects and inter relation between low socio economic and upper socio economic status of childhood for overweight and obesity. This paper outlined current tools used to assess and identify those who are at risk for overweight and obesity. The current gold standard for assessing and diagnosing overweight and obesity is the Body Mass Index (BMI). This study was designed to know the prevalence of childhood obesity in school children from rural and urban areas in Tirunelveli district. Data on the prevalence of obesity in children were collected and analyzed from two schools from urban and rural areas of Tirunelveli district respectively. The prevalence of childhood obesity in Tirunelveli is not very high as compared to other reports from different regions of the country. However, it is an important multi factorial condition which needs immediate medical attention to stop the march of healthy children towards chronic disorders. I. Introduction Obesity is one of the most prevalent nutritional diseases of children and adolescents in many developed and developing countries. The World Health Organization (WHO) has declared overweight as one of the top ten health risks in the world and one of the top five in developed nations. The term overweight refers to an excess of body weight 10 percent greater than the standard, whereas obesity is used to describe an excess body weight 20 percent or more than the standard. Childhood obesity is a condition where excess body fat negatively affects a child's health or wellbeing. As methods to determine body fat directly are difficult, the diagnosis of Obesity is often based on BMI. The prevalence of overweight and obesity in urban children in Delhi has shown an increase from 16% in 2002 to about 24% in 2006. According to our recent data, the prevalence among adolescent children (14 - 17 years) was 29% in private schools and 11.3% in government funded schools in 2006 - 2007. Globally an estimated 10% of school-aged children between 5 to 17 years of age are overweight or obese. Prevalence of childhood and adolescent obesity and overweight from different parts of India (Punjab, Maharashtra, Delhi and South India) that range from 3% to 29% and also indicate that the prevalence is higher in urban than in rural areas. One half of obese school children become obese adults. However, whether or not obesity persists into adulthood, obesity in childhood appears to increase the risk of subsequent morbidity. The proportion of school-age children affected will almost double by 2010 compared with the most recently available surveys from the late 1990s up to 2003. Children were categorized into three groups: Obese (> 95 th percentile), Overweight (85 th percentile) and normal ( 5 th percentile) using age - and sex - specific percentiles of BMI. World Health Organization (WHO) has recommended various indices based on anthropometry to evaluate the nutritional status of children (WHO, 1995). Weight, height and BMI for age are parameters for assessment of nutritional status in children. The BMI is expressed as BMI= Weight in kg / (Height) in m 2

Blood Lead Levels among School Children after Phasing-Out of Leaded Petrol in Delhi, India

The use of leaded petrol was prohibited in the Delhi city by the end of 1998. To determine the impact of use of unleaded petrol, this cross-sectional study was conducted to determine blood lead levels in primary school children. Blood lead levels were estimated in 300 school children aged 6 to 10 y. The data regarding clinical features and putative risk factors for high blood lead levels was also collected. Of the 300 children, 36 (12 %) had high blood lead levels. Of the 36 children, 32 had blood lead levels between 10 and 19 μg/dl, 4 had 20-44 μg/dl and none had levels >45 μg/dl. Factors such as exposure to peeling paint, recent renovation of housing and near-distance of house to main road were significantly associated with high blood lead levels. There is significant prevalence of high blood lead levels in school children in Delhi, even after with prohibition of use of leaded petrol.

Children’s Choice of Influence Strategies in Family Purchase Decisions and the Impact of Demographics

The existing literature has shown that children have an influence in family purchase decisions and recognized different influence strategies children use to influence their parents. The present study is based on survey approach and intends to understand children’s choice of influence strategies and the impact of various demographic factors. A sample of 180 children in Delhi was studied by using structured questionnaire from June 2011 to March 2012. The findings of the study reveal that children basically use four major types of influence strategies in family purchases and the choice of a particular influence strategy depends on children, parent and family characteristics.

Environmental and occupational respiratory diseases – 1057. Correlation between air pollution and respiratory health of school children in Delhi

Background Urban air pollution (indoor and outdoor) poses a major health hazard for city dwellers. Exposure to ambient air pollution may result in respiratory health disorders. The aim of this study was to correlate air pollutant levels to the respiratory health of school children in Delhi. Methods The questionnaire was designed based on the internationally valid questionnaires for respiratory illness. The respiratory health survey was approved by the Directorate of Education – Delhi and schools were selected based on land usage pattern i.e. commercial (Chandni Chowk), industrial (Mayapuri) and residential (Sarojini Nagar) areas. Approximately 1800 students (600 / zone) of age 10 – 14 years participated in the survey which included spirometry tests also. Indoor and outdoor levels of SO2 ,N O2 and PM were also measured in the school premises. Results The questionnaire data showed that the students having respiratory disorder symptoms was maximum in Chandni Chowk (66%) followed by Mayapuri (59%) and Sarojini Nagar (46%). Spirometry test results demonstrated that a significant population of subjects in Chandni Chowk (19%) had mild to severe pulmonary obstruction. However the percentage of subjects with such conditions was comparatively less in Maypuri (17%) and Sarojini Nagar (14%) area. Indoor and outdoor PM10 concentration at schools located in Chandni Chowk, a commercial zone, was observed to be 815±354.45 µg/m 3 & 337±85 µg/m 3 respectively, which is ten times above the permissible limits. The PM10 concentration was lower in Mayapuri (694.6±322.9 µg/m 3 & 274±78 µg/m 3 ), an industrial zone, and was least in Sarojini Nagar (534.3±94.22µg/m 3 & 197±48 µg/m 3 ) which is a residential zone. However, levels of SO2 and NO2were under the permissible limits in all three areas. Conclusions

Perception of Causes, Consequences and Solutions to Global Warming among School Children in Delhi

Background: Global warming has emerged as one of the most important environmental issues ever to confront humanity having wide health & environmental implications. Awareness especially among children and youth is necessary to combat this challenge. Objectives: To study the perceptions of school students with regard to climate change, its potential health & environmental impacts and their behaviour towards tackling the issue. Setting and Design: This observational study was conducted in a government boys school in rural Delhi. Material and Method: All students of classes 9th, 10th and 11th who were willing to participate were included in the study. A self-administered, semi-structured questionnaire was used and responses were evaluated. Statistical Analysis Used: Proportions, percentages and chi-square test. Results: In all, 290 students participated in the study. Majority (78.9%) had heard about global warming and most students correctly attributed it to decreasing green cover (57.6%) and rising pollution (53.1%). Majority were aware of the increased chances of epistaxis but only some knew of its other health implications. Majority (96.5%) felt the need to take action and suggested increasing the green cover as a possible solution (85.1%). However, there were gaps in knowledge of students and some misconceptions were also observed. Further, knowledge did not necessarily translate into students' actions. Eleventh graders were better informed regarding global warming than lower two grades. Conclusion: It is imperative to include the issue of global warming at all levels in school curriculum with emphasis on its health impacts and focusing on early years of schooling.

A comparison of two pain scales in the assessment of dental pain in East delhi children.

Pain is the most common symptom of oral diseases. Pain perception in children is highly variable and unreliable due to poor communication. Therefore we designed a study to compare pain measurement techniques, that is, visual analogue scale (VAS) and Wong-Baker faces pain rating scale (WBFPS) among Delhi children aged 3 to 14 years undergoing dental extraction. Method. A cross-sectional study was conducted on 180 patients aged 3 to 14 years who had undergone dental extraction. Children were assessed for their pain sensitivity using visual analogue scale (VAS) and Wong-Baker faces pain rating scale (WBFPS ). Result and Conclusion. Pain threshold tends to decline, and the self-management of pain becomes more effective with increasing age. Genderwise result shows that communication ability of boys and girls is similar in all age groups.

Association between indoor fungi in Delhi homes and sensitization in children with respiratory allergy

Indoor fungi are potential sensitizing agents in children and their detection and quantification in indoor air are important in the diagnosis and environmental management of fungal allergies. The objective of this investigation was to assess the prevalence of fungal allergies in children in Delhi and to study the association between mold counts in the homes of children and their sensitization to respective fungal extracts. Fungal concentrations and seasonality were studied at two-week intervals for one year using Andersen Volumetric and Burkard Slide samplers. Sensitization to fungi frequently encountered in patients' homes was assessed by Skin Prick Tests (SPTs). Total fungal specific IgE was measured by ELISA in the sera of patients positive to fungal extracts. Skin Prick Tests revealed that 39.3% (33/84) of patients were markedly positive (2 + and above) to one or the other fungal allergens. Raised serum IgE to predominant indoor fungal species was observed in patients with marked SPT results. Highest marked skin reactivity (2 + and above) was obtained with Alternaria alternata allergens in 17.9% of the children, which was followed by the response to fungal antigens of Aspergillus fumigatus and Penicillium citrinum (15.5%). Exposure to high fungal counts of some dominant fungi (Penicillium, A. nidulans and A. fumigatus) was found associated with increased fungal sensitization in the patients. Total serum IgE level was revealed to be significantly linked with the intensity of skin reactions, as well as with skin index (r(2) = 0.052; P < 0.05). We concluded that children in Delhi are exposed to high concentrations of fungi in the indoor environment and that respiratory allergies were connected with higher prevalence of skin sensitization.

Children’s Construction of Society in Mizo and Delhi Cultures

Mizo and Delhi children between the ages of 3 and 8 years responded to queries that emerged from six contexts, three of which were real contexts and three other pretense contexts. The study tested if young children from different cultures understand pretense and reality situations and know the use of children's reference to self, others, significant others and self with others in their narratives of reality and pretense contexts. Content analysis of the children's narratives revealed that children from both cultures were similar in their reference to self, others, significant others and self with other. However, the reference to self and others differed in the reality and pretense contexts of both groups of children. Findings indicate processes in children that differ in the pretense and reality situations. Furthermore, developmental differences indicate that this ability improves with age and sustains the effects of peer culture that has similarly influenced both groups of children.

Indoor Fungal Concentration in the Homes of Allergic/Asthmatic Children in Delhi, India

Allergy to fungi has been linked to a wide range of illnesses, including rhinitis and asthma. Therefore, exposure to fungi in home environment is an important factor for fungal allergy. The present study was aimed to investigate types of airborne fungi inside and outside the homes of asthmatic children and control subjects (nonasthmatic children). The dominant fungi were evaluated for their quantitative distribution and seasonal variation. The air samples were collected from indoors and immediate outdoors of 77 selected homes of children suffering from bronchial asthma/allergic rhinitis using Andersen volumetric air sampler. The isolated fungal genera/species were identified using reference literature, and statistical analysis of the dominant fungi was performed to study the difference in fungal concentration between indoor and immediate outdoor sites as well as in between different seasons. A total of 4423 air samples were collected from two indoor and immediate outdoor sites in a 1-year survey of 77 homes. This resulted in the isolation of an average of 110,091 and 107,070 fungal colonies per metric cube of air from indoor and outdoor sites, respectively. A total of 68 different molds were identified. Different species of Aspergillus, Alternaria, Cladosporium, and Penicillium were found to be the most prevalent fungi in Delhi homes, which constituted 88.6% of the total colonies indoors. Highest concentration was registered in autumn and winter months. Total as well as dominant fungi displayed statistically significant differences among the four seasons (p < 0.001). The largest number of isolations were the species of Aspergillus (>40% to total colony-forming units in indoors as well as outdoors) followed by Cladosporium spp. Annual concentration of Aspergillus spp. was significantly higher (p < 0.05) inside the homes when compared with outdoors. Most of the fungi also occurred at a significantly higher (p < 0.001) rate inside the homes when compared with immediate outdoors. Asthmatic children in Delhi are exposed to a substantial concentration of mold inside their homes as well as immediate outdoor air. The considerable seasonal distributions of fungi provide valuable data for investigation of the role of fungal exposure as a risk for respiratory disorders among patients suffering from allergy or asthma in Delhi.

Our lives, our say: Street and working children talk about their rights in Delhi

Recently a “new sociology of childhood” has been proposed arguing that childhood must be seen as a social construct and considered like race, class and gender as an important analytical variable. It is asserted that children and their life worlds are topics worthy of study and that children must be seen as active agents in creating their own social worlds and society at large. The main implication of such a conceptualization is that childhood takes a multiplicity of forms over time and across cultures. Essentially these approaches privilege the perspectives of children and reject the representation of them as passive vessels into which the rules of society are poured as merely adults in training. This paper examines this new discourse by drawing upon the experiences of Butterflies, a non-government organization working for the empowerment of street and working children in Delhi. In particular the paper will explore Butterflies’ rights-based approach to working with street and working children and give space to children’s own experiences and perceptions in regards to this approach. The article focuses on four key areas: the right to participation; the right to freedom of assembly; the right to protection from economic exploitation and the right to work. Keywords: children, work, rights, poverty, marginalisation, participation

Effects of air pollution on the respiratory health of children: a study in the capital city of India.

Urban air pollutants cause a wide range of acute and chronic effects on the respiratory system of children that can be devastating. In this study, the respiratory health of children was assessed in the capital city of India where the level of air pollution is much above the National Ambient Air Quality Standards. The study was carried out in Delhi, and the findings were compared with those of rural West Bengal and Uttaranchal. The prevalence of respiratory symptoms was determined through a structured respiratory symptomlogy questionnaire and personal interviews. Air quality data were collected from Central and State Pollution Control Boards and also obtained by direct measurements using a portable aerosol monitor. Based on the data collected on the cohort of children participating in this study, 32.1% of children in Delhi suffered from respiratory problems in contrast to 18.2% of rural children (control). The respiratory symptoms were more prevalent in girls than in boys. A strong, statistically significant positive association was observed between PM10 level in Delhi’s air and the prevalence of lower respiratory tract symptoms.

Validation of "Signs of Inflammation in Children that Kill" (SICK) score for immediate non-invasive assessment of severity of illness

ObjectiveTo validate the SICK scoring system's ability to differentiate between individuals with higher and lower probabilities of deathMethodWe performed a one year two-centre prospective evaluation of all children aged between one month and 12 years referred to the Paediatric team at St Stephens Hospital in Delhi and admitted to the Paediatric Department at West Middlesex University Hospital in London. We calculated SICK scores at presentation and correlated them with subsequent in-hospital mortality. We used discrimination by areas under receiver operating characteristic (ROC) curves to measure performance.ResultsWe prospectively evaluated 3895 children in Delhi and 1473 children in London. The areas under the ROC curves were 84.8% in Delhi, 81.0% in London and 84.1% (95% CI 77.4 - 90.8%) for combined data. Hosmer-Lemeshow goodness of fit for the combined data was good (Hosmer-Lemeshow Chi-square = 2.13 (p = 0.345).ConclusionsWe propose the SICK score as a useful triage tool at initial presentation and highlight its particular suitability for resource poor settings.

Air Pollution and its Impact on Lung Function of Children in Delhi, the Capital City of India

Air pollution is a major contributor to several respiratory problems, it affects the whole population in general but children are more susceptible. Exposure to automobile exhaust is associated with increased respiratory symptoms and may impair lung function in children. In view of this, the study was conducted among the children of Delhi, the capital city of India, where ambient air quality was much above the National Ambient Air Quality Standards. The study was conducted in children aged 9–17 years. Pulmonary function test was carried out following the guideline of American Thoracic Society using a portable, electronic spirometer. Air quality data was collected from Central and State Pollution Control Boards. In addition, the level of particulate matter in indoor air was measured by portable laser photometer. Lung function was reduced in 43.5% schoolchildren of the urban area compared with 25.7% of control group. The urban children had increased prevalence of restrictive, obstructive, as well as combined type of lung functions deficits. Besides higher prevalence, the magnitude of lung function deficits was also much more in them. After controlling potential confounders like season, socioeconomic conditions and ETS, PM10 level in ambient air was found to be associated with restrictive (OR = 1.35, 95% CI 1.07–1.58), obstructive (OR = 1.45, 95% CI 1.16–1.82), and combined type of lung function deficits (OR = 1.74, 95% CI 1.37–2.71) in children. Spearman's rank correlation test reaffirmed the association. The study confirms that the level of air pollution is affecting the children.

Prevalence of Thyroid Disorders in School Children In Delhi - Post Iodization Scenario: An epidemiological survey conducted under the first phase of EMR project on "Effects of Homoeopathic treatment on natural history of autoimmune thyroiditis"

Screening of 4543 children between 6-18 years of age from different schools of Delhi was done during the first phase of research study under EMR project by AYUSH, for thyroid function status-clinically, serologically & ultrasonographically. Data of 4506 children has been analyzed & it has been found that goiter is prevalent at mild endemic level in children (17%) even after two decades of iodization. Significant increase in anti TPO ab positivity (6.39%) and thyroid dysfunction (11.92%) raises suspicion about the role of environmental goitrogens and prolonged iodine supplementation

Lead loadings in household dust in Delhi, India

Lead in household dust is dangerous to children who ingest lead from playing close to the ground, and having frequent hand-to-mouth contact. Although there have been several investigations of lead levels in India in air, blood and new paint, the literature is sparse on the levels of lead in household dust. This study analyzed 99 samples of dust taken from bare floors and 49 samples of dust taken from windowsills in a cross-section of Delhi, India houses for lead loadings. The arithmetic mean of lead loading for floor samples and windowsill dust samples was found to be 36.24 microg/ft(2) and 129.5 microg/ft(2), respectively. The geometric mean of dust lead loading for floor and interior windowsill samples was found to be 19.7 microg/ft(2) and 75.5 microg/ft(2), respectively. Comparing the results with US geometric mean dust lead levels from a national cross-section of US housing, which in 2000 were 1.1 microg/ft(2) and 9.4 microg/ft(2) on floors and windowsills, respectively as reported by Jacobs et al. (2002) suggests that the lead content of the dust in Delhi homes is much higher than that in the national data in the US and that the levels pose a hazard to children. Practical Implications The present study is first of its kind in this part of the world. In the context of ongoing efforts to eliminate lead from paints worldwide this research will help the scientists and policy makers in assessing the Children's exposure to lead in developing country as well. Since more than one half of the housing units tested had at least one dust lead sample exceeding US health-based standards, health care providers and public health officials need to give attention to possible lead poisoning in Delhi children. Routine blood lead screening of children should follow recommended public health practice for children at risk. Additional larger-scale studies are needed in Delhi and elsewhere to determine how representative these findings are and to attempt to delineate the sources of the high dust lead which are expected to vary depending on the location. Knowledge of the sources is needed to appropriately allocate resources. From other studies performed in India it is likely that lead-based paint is one of the sources and its continued use should be discontinued.

Iodine nutrition in upper socioeconomic school children of Delhi

We assessed the iodine nutrition of upper socioeconomic strata school children from Delhi to identify its association with goiter, thyroid autoimmunity or thyroid function. After informed consent of parents, all assenting students (n=997) from one randomly selected section of each class from five private schools representing all the zones of Delhi) were evaluated for goiter, urinary iodine excretion, thyroid function and antibody status. Median urinary iodine was 35.28 microg/dL. Goiter was present in 123 (12.3%) and positive anti-TPO antibodies in 17 (2.6%). Increased urinary iodine was associated with thyroid dysfunction, though not with goiter.

Prevalence of overweight and obesity amongst school children in Delhi, India.

Obesity has emerged as an epidemic worldwide. The present study was conducted to assess the prevalence of overweight and obesity amongst children in the age group of 5-18 years belonging to low, middle and high income group in National Capital Territory NCT of Delhi. A total of 16,595 children (LIG 5087, MIG 5134 and HIG 6368) were covered in the present study. Overweight and obesity were assessed using Body Mass Index (BMI) and Triceps Skin Fold Thickness (TSFT) utilizing age and sex specific cut off points. Considering the BMI cut off points, the prevalence of obesity and overweight in Low Income Group (LIG) school children was 0.1 and 2.7 percent respectively, amongst Middle Income Group (MIG) school children it was 0.6 and 6.5 percent and in High Income Group (HIG) school children was 6.8 and 15.3 percent respectively (p<0001). With regard to the TSFT criteria, the prevalence of obesity and overweight in LIG school children was 1.2 and 2.4 percent, amongst MIG school children it was 2.5 and 4.9 percent and in children belonging to HIG schools was 9.3 and 13.1 percent respectively (p<0.001). The present study documented that the prevalence of overweight and obesity was higher in the HIG children as compared to the MIG and the LIG for all age groups, highlighting the possible role of change in the dietary pattern and physical activities with increase in income levels.

Assessment of Mental Health Status of Senior Secondary School Children in Delhi

Schoolchildren undergo rapid mental, emotional, and social changes and are susceptible to psychiatric disorders. This study aimed to assess the mental health status and some determinants in senior secondary school children in Delhi. A cross-sectional study was carried out on a sample of 458 children, selected by 2-stage sampling. Goldberg's General Health Questionnaire containing 60 items (GHQ-60) was used for assessment of mental health. GHQ was administered to 239 boys and 219 girls in the age group of 15 to 20 years. Of 458 students, 113 (24.7%) had a score>or=16, the cutoff score, indicating mental morbidity among them. Among boys and girls, 28.5% and 20.5%, respectively, had some component of mental morbidity. Morbidity was significantly higher in children hailing from nuclear families and among children who had either failed or those who had scored highest in the class. Mental health needs of schoolchildren need to be addressed by the school health services.

Prenatal Diagnosis

Feminists in India have been concerned about the declining sex ratio in the country. The Prenatal Diagnostic Techniques (Regulation and Prevention of Misuse) Act 1994 or PNDT Act, which outlaws sex-selective abortions, has been welcomed by feminists, even though they remain concerned with bottlenecks in its implementation. A relatively unnoticed but critical issue, however, is the possibly unwitting legitimisation of the abortion of potentially disabled children. This article endeavours to question the ideology that regards abortion as the only option when prenatal testing reveals a birth abnormality, an option sanctioned by the PNDT Act. We contend that disability is, to a great extent, socially constructed: its conceptualisation reflects societal attitudes that view the lives of disabled people as tragic, worthless and a burden. The article recognises the tension between the feminist and disability activists around the issue of women's choice. These issues are discussed through the voices of the mothers of both non-disabled and disabled children in Delhi. We contend that: (a) the concept of individual choice, which is reified through the PNDT Act, is socially constructed and contextually located, and (b) while a pro-choice perspective is important to feminists, the thoughtless use of prenatal testing could reduce, rather than expand, women's choices.

Clinical and biochemical profile of dengue haemorrhagic fever in children in Delhi

The clinical and biochemical profile of dengue haemorrhagic fever (DHF) varies from epidemic to epidemic. We studied children hospitalized with DHF from September 2003 to December 2003. All were diagnosed, managed and monitored according to a standard protocol. Of the 34 who fulfilled the World Health Organization criteria of DHF, 22 (64.6%) were male. All patients presented with fever and hepatomegaly. Examination also revealed splenomegaly in 11 (32.4%), ascites in 6 (17.6%) and pleural effusion in 3 (8.8%). Common bleeding manifestations were positive tourniquet test in 22 (64.7%) and epistaxis in eight (23.5%). Most children had a platelet count of between 20,000/mm(3) and 50,000/mm(3) (56%). Bleeding manifestations were not related to platelet count (P > 0.05). Serum glutamic pyruvic transaminase (SGPT) >40 IU/L was seen in 22 (64.6%) patients, alkaline phosphate (ALP) >400 IU/L in 12 (35.3%) and serum bilirubin >1 mg% in 3 (8.8%). IgM dengue serology was positive in 68.5% cases. There was no significant difference in liver function tests with age or sex (P > 0.05). Clinical features of DHF varied from the previous epidemic. Hepatic dysfunction with increased levels of serum enzymes was common in DHF.