Ratio Of Girls Research Articles

Evaluation of outcome of titanium elastic nailing (TEN) versus hip spica cast in the treatment of femoral shaft fractures in children

Femoral shaft fractures are among the most common pediatric injury and treatment of them carries a lot of controversies. The aim of this study was to compare the outcome of titanium elastic nailing versus hip spica cast in femoral shaft fractures in children. This prospective study was conducted on 40 children of 5 to 15 years of age treated with titanium elastic nail or early hip spica cast for the fracture shaft of femur during July 2016 to October 2017 in the Department of Orthopaedics, R.I.M.S., Ranchi, Jharkhand. Majority of patients in both treatment group were male child with overall boy to girl ratio was 1.85:1. Mean age in titanium elastic nailing group was 9.82 ± 2.99 years and in spica group was 8.35 ± 2.53 years. RTA was most common mechanism of injury and right limb was more commonly involved in both groups. Union time was less in titanium elastic nailing group (8.80 1.76 week) than spica group (10.20 2.33 week) (p = 0.039). Patients in titanium elastic nailing group walked with and without support earlier than the spica cast group (p = 0.000). Most common complication in titanium elastic nailing group was limb lengthening (50%) followed by mal alignment (40%) while in spica group it was limb shortening (65%) followed by mal alignment (55%). Overall complication was higher in spica group. At final analysis, Flynn score was better in titanium elastic nailing group than in hip spica group (p = 0.365). Titanium elastic nailing is better method for the management of femoral shaft fractures in children as it results in higher rate of excellent functional outcome with lower incidence of complications.

SEX & AGE-WISE DISTRIBUTION AND CAUSES OF DYSPHONIA IN CHILDREN

Background: Dysphonia is common in children due to which they suffer adversely both at home and at school. The objectives of this study were to determine the sex & age-wise distribution and causes of dysphonia in children. Materials & Methods: This descriptive cross-sectional study was conducted at the Department of ENT and Head & Neck surgery, Hayatabad Medical Complex, Peshawar, Pakistan from January 1, 2017 to December 31, 2018. Sample size consisted of 72 patients presenting with chronic dysphonia, selected using the non-probability consecutive sampling technique Inclusion criteria were children presenting with dysphonia for more than 4 weeks. Exclusion criteria were children with stammering, puberphonia, acute respiratory distress, deaf mutism, speech articulation and increased or decreased nasal twang in voice. The demographic variables were sex and age groups and research variables were causes of dysphonia. All variables except age being categorical were analyzed by frequency and percentages carried out using SPSS 16.0 for windows. Results: Mean age of the sample of patients was 8.78+3.6 with range of 12 years (3-15). Out of 72 patients, 44(61.11%) were boys and 28(38.89%) girls with boy to girl ratio of 1.57:1. Chronic nonspecific laryngitis was the commonest etiology followed by reflux laryngitis. Functional dysphonia was noted only in girls and vocal nodules, vocal hematoma and post traumatic laryngeal stenosis were noted only in boys. Conclusion: Chronic nonspecific laryngitis and reflux laryngitis were the commonest causes especially in males less than 9 years of age. Vocal nodules, vocal hematoma and post traumatic laryngeal stenosis were found only in boys and functional dysphonia was noted only in adolescent girls.

Prevalence of caregiver burden, depressive and anxiety symptoms in caregivers of children with psychiatric disorders in Durban, South Africa

BackgroundThere is increased caregiver burden, depressive and anxiety symptoms associated with the care of mentally ill children. This may be influenced by child or caregiver factors such as socio-demographic and clinical factors and has not been explored in the South African context.AimTo describe the prevalence of depression, anxiety symptoms and caregiver burden in caregivers of children treated at psychiatric outpatient services at two public sector hospitals.MethodsA cross-sectional questionnaire study of 121 adult primary caregivers of children aged 1–17 years with mental illness using a socio-demographic questionnaire, Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder-7 Questionnaire (GAD-7), and the Child and Adolescent Impact Assessment (CAIA) to assess caregiver burden.ResultsThe caregivers were predominantly female (n = 96, 79.5%) and married (n = 72, 59.5%), with a mean age of¬34.99 years (SD 10.38), and 74% were mothers. Among the children, there was a predominance of boys with a 1:4 ratio of girls to boys. The most common diagnoses in the children were attention deficit hyperactivity disorder (ADHD) (n = 56, 59.6%) and autism spectrum disorder (n = 22, 23.4%). Fifty-four (44%) caregivers were depressed with a mean PHQ9 score of 5.75 (SD 5.98), and 65 (54 %) reported anxiety symptoms with a mean GAD7 score of 5.71 (SD 5.03). Mothers reported significantly higher levels of anxiety (p = 0.045) and experienced higher impact on feelings of personal well-being on the CAIA (p = 0.004) in comparison with fathers. Caregiver burden was predominantly reported in the domains of restrictions in activities (n = 40, 32.8%), feelings of personal well-being (n = 37, 30.7%) and economic impact (n = 21, 17.4%).The caregivers of children with ADHD reported higher anxiety levels (p = 0.023) than for autistic children. A diagnosis of autistic spectrum disorder was associated with higher income impact (p = 0.004) and restrictions impact (p = 0.001) than for children with ADHD diagnosis in terms of caregiver burden.ConclusionThe high prevalence of depression and anxiety symptoms reported amongst caregivers suggests the need for improved mental health screening and psycho-social support programmes for caregivers, particularly mothers. Programmes should consider the impact of caregiving, particularly on mental health, income and social restrictions of caregivers.

Evidence for a Change in the Sex Ratio of Children Referred for Gender Dysphoria: Data From the Gender Identity Development Service in London (2000–2017)

IntroductionThe prevalence of gender dysphoria in children is not known; however, there are some data on the sex ratio of children referred to specialized gender identity clinics. AimWe sought to examine the sex ratio of children, and some associated factors (age at referral and year of referral), referred to the Gender Identity Development Service in the United Kingdom, the largest such clinic in the world. MethodsThe sex ratio of children (N = 1,215) referred to the Gender Identity Development Service between 2000–2017 was examined, along with year of referral, age-related patterns, and age at referral. Main Outcome MeasureSex ratio of birth-assigned boys vs birth-assigned girls. ResultsThe sex ratio significantly favored birth-assigned boys over birth-assigned girls (1.27:1), but there were also age and year of referral effects. The sex ratio favored birth-assigned boys at younger ages (3–9 years), but favored birth-assigned girls at older ages (10–12 years). The percentage of referred birth-assigned boys significantly decreased when 2 cohorts were compared (2000–2006 vs 2007–2017). On average, birth-assigned boys were referred at a younger age than birth-assigned girls. Clinical ImplicationsThe evidence for a change in the sex ratio of children referred for gender dysphoria, particularly in recent years, matches a similar change in the sex ratio of adolescents referred for gender dysphoria. The reasons for this remain understudied. Strength & LimitationsThe United Kingdom data showed both similarities and differences when compared to data from 2 other gender identity clinics for children (Toronto, Ontario, Canada, and Amsterdam, The Netherlands). Such data need to be studied in more gender identity clinics for children, perhaps with the establishment of an international registry. ConclusionFurther study of the correlates of the sex ratio for children referred for gender dysphoria will be useful in clinical care and management.de Graaf NM, Carmichael P, Steensma TD, et al. Evidence for a Change in the Sex Ratio of Children Referred for Gender Dysphoria: Data From the Gender Identity Development Service in London (2000–2017). J Sex Med 2018;15:1381–1383.

WOMEN PROPOSITION IN THE INDIAN JUDICIARY

There have been innumerable debates about gender in India over the years. Much of it includes women’s positing in society, their education, health, economic position, gender equality etc. What one can conclude from such discussions is that women have always held a certain paradoxical position in our developing country.
 The women position in Indian Judiciary has again been a debatable, topic which has henceforth never been into exact numerical representation. The women clan involved into the legal network of benches has been notably less. The women position has been the highest in the Supreme Court of India with ‘Nine’ Judges.
 The research work includes statistical data with the research of Vidhi legal policy. “The District Courts and the courts below them comprise the ‘lower’ or ‘subordinate’ judiciary. These courts lie under the administrative control of High Courts. Each judicial district in India has one District Court, below which lie civil and criminal courts of original jurisdiction,” the study notes, and finds that 71% judges in the subordinate judiciary across India are male.
 Motivation/Background: The women position has been the highest in the Supreme Court of India with ‘Nine’ Judges. The women clan involved into the legal network of benches has been notably less.
 Method: The fundamental protestant of the research are ‘women’, their count in the benches of Indian Judiciary, specifically over the High Courts and the Supreme Court. So what has been the reason behind such a low count of women?
 What has been the numerical denomination of women benches in High Courts and Supreme Courts over the past years?
 Results: Women were relegated to the household, and made to submit to the male-dominated patriarchal society, as has always been prevalent in our country. Indian women, who fought as equals with men in the nationalist struggle, were not given that free public space anymore. They became homemakers, and were mainly meant to build a strong home to support their men who were to build the newly independent country.
 Conclusions: Women were reduced to being second class citizens. The national female literacy rate was an alarmingly low 8.6%. The Gross Enrolment Ratio (GER) for girls was 24.8% at primary level and 4.6% at the upper primary level (in the 11-14 years age group). There existed insoluble social and cultural barriers to education of women and access to organized schooling.

No gender differences in growth patterns in a cohort of children with cystic fibrosis born between 1986 and 1995

A higher mortality rate at young ages has been reported in cystic fibrosis (CF) girls compared to boys. The reasons of this gap remain unclear but may be related to a different evolution of the disease, in terms of growth and lung function throughout childhood and adolescence. This study aimed at investigating gender differences in growth patterns in a cohort of children with CF through a longitudinal study, and as secondary objectives, to evaluate gender differences in forced expiratory volume in one second (FEV1) trend and transplant-free survival. We performed an historical cohort study of 203 CF patients born between 1986 and 1995. Weight and height were recorded from the time of CF diagnosis to the age of 18 years. Generalized estimated equations were used to evaluate the effect of gender on changes in z-score of BMI-for-age and z-score of height-for-age and FEV1. Transplant-free survival to age 18 was computed by the Kaplan-Meier estimator. Girls did not show a worse growth pattern as compared to boys. The odds of being underweight [Odds Ratio (OR) for girls: 0.85, 95% CI: 0.51; 1.39] or stunted [OR for girls: 0.79, 95% CI: 0.42; 1.49] were not significantly different between genders. FEV1 trend was also similar in boys and girls, as well as the probability of surviving to age 18 without receiving lung transplantation (boys: 0.88, 95% CI: 0.82-0.95, girls: 0.92, 0.87-0.98, P=0.26). In a cohort of children with CF born between 1986 and 1995, no gender differences in growth patterns were observed. This finding suggests that CF girls and boys have benefited equally from the advances in treatments that have occurred over the last three decades.

Incidence of childhood Type 1 diabetes mellitus in Crete.

To investigate the epidemiology of childhood Type 1 diabetes mellitus in Crete over the last 25 years and to evaluate incidence trends over time. The study included all children aged 0-14 years who live in Crete and were diagnosed during the 25-year period from 1 January 1992 to 31 December 2016. A total of 271 children were diagnosed with Type 1 diabetes during the 25-year period: 148 boys and 123 girls (boy:girl ratio 1.2). The median (interquartile range) age at diagnosis was 8.3 (5.0-12.0) years for boys and 8.0 (5.3-11.3) years for girls. The standardized annual incidence rate was 10.5 per 100 000 children (95% CI 9.2 to 11.8). Incidence rates were higher in children aged 5-9 years. During the 25-year study period an average 4.4% annual increase in incidence was documented and was most prominent in the age group 5-14 years. Incidence seemed to remain relatively stable for the age group 0-4 years in the last decade. No seasonality of the clinical onset of Type 1 diabetes was observed. The recent increase in Type 1 diabetes incidence places Crete among regions with high incidence as per the World Health Organization DiaMond project classification. The rising trends in incidence confirmed by this study are in accordance with the reported global trends in Type 1 diabetes incidence.

Children with autism spectrum disorders and selective mutism.

BackgroundIt has been suggested that autism spectrum disorder (ASD) might be a “comorbid” condition in selective mutism (SM).MethodsIn this retrospective study, we examined medical records of children with SM diagnosis (n=97) at a medical center specializing in assessment of ASD.ResultsMean age for onset of SM symptoms was 4.5 years and mean age at SM diagnosis was 8.8 years. SM was more common among girls (boy:girl ratio=2.7:1). We found that 63% of the study group had an ASD (no gender difference). The SM group with combined ASD had later onset of symptoms, higher age at diagnosis, more often a history of speech delay, and a higher proportion of borderline IQ or intellectual disability.ConclusionThe results highlight the risk of overlap between ASD and SM.

Prevalence Estimates for Hidradenitis Suppurativa among Children and Adolescents in the United States: A Gender- and Age-Adjusted Population Analysis.

The prevalence of hidradenitis suppurativa (HS) in the pediatric population is unknown. We sought to establish standardized overall as well as gender-, age-, and race-specific prevalence estimates of HS among children and adolescents in the United States. We performed a cross-sectional analysis in a heterogeneous sample of 55 million patients across all census regions. We identified 1,240 patients with HS in whom the ratio of girls to boys was 3.8:1. Almost all (96.8%) patients with HS were ≥10 years of age. Overall, HS prevalence was 0.028%, or 28.1 (95% confidence interval [CI] 26.5-29.7) per 100,000 children and adolescents. Standardized prevalence was higher in girls (44.6 [95% CI 41.8-47.5] per 100,000), in patients aged 15-17 years (113.7 [95% CI 106.4-121.4] per 100,000), and among African Americans (78.7 [95% CI 71.0-86.9] per 100,000). Highest prevalence of HS was observed among female adolescents aged 15-17 years who were African Americans (525.1 [95% CI 459.4-597.5] per 100,000) and biracial (253.2 [95% CI 121.4-465.6] per 100,000). Patients with HS who went undiagnosed were not captured, and as such prevalence estimates may be underestimated. HS appears to be a postpubertal disease that disproportionately afflicts girls and African Americans in the pediatric population.

Clinical Features, Surgical Treatment, and Long-Term Outcome in Children with Hemorrhagic Moyamoya Disease

The objective of this study was to elucidate the clinical features, surgical treatment, and long-term outcome in pediatric patients with moyamoya disease (MMD). We retrospectively reviewed 46 pediatric patients with hemorrhagic MMD at Beijing Tiantan Hospital. Clinical features, radiological findings, and outcomes were analyzed. The mean age at diagnosis was 13.6 ± 3.6 years. The ratio of girls to boys was 1.0:1.1. Familial occurrence was 4.3%. The primary symptoms at initial presentation were intraventricular hemorrhage (IVH) (47.8%), intracerebral hemorrhage (ICH) (37.0%), ICH with IVH (13.0%), and subarachnoid hemorrhage (2.2%). Most patients presented with Suzuki stage 3 or 4 MMD. Posterior cerebral artery involvement was observed in 22 (18.4%) patients. During the average follow-up of 126.1 ± 96.0 months, 11 of 53 (20.8%) conservatively treated hemispheres and 1 of 36 (2.8%) surgically treated hemispheres experienced a stroke event (P < .05). There was a difference in the Kaplan-Meier curve of stroke between the 2 groups (log rank test, P < .05). What is more, the rate of perfusion improvement in surgically treated patients was higher than in those conservatively treated patients 3 months after discharge (P < .05). Revascularization surgery has a role in the prevention of recurrent strokes and can improve cerebral perfusion in pediatric patients with hemorrhagic MMD. Further study is needed to determine which bypass surgery is more beneficial for pediatric patients with hemorrhagic MMD.

Are Boys at Risk of Low Immune Response to Recombinant Hepatitis B Virus Vaccine in Steroid Sensitive Nephrotic Syndrome

Introduction: This study was conducted to evaluate the immune response following vaccination with different doses and to compare the antigen specific antibody response to Hepatitis B Vaccine (HBVac) in Steroid Sensitive Nephrotic Syndrome (SSNS) patients between boys and girls. Materials and Methods : This prospective study was conducted in 30 SSNS children at Bangladesh Institute of Child Health, Dhaka, Bangladesh from July 2012 to June 2013.Thirty patients who had all features of Minimal Change Nephrotic Syndrome (MCNS) according to International Study for Kidney Diseases for Children (ISKDC) and received oral prednisolone every alternate day and were HBsAg negative were enrolled in the study. The patients were randomly assigned to one of the two treatment group to receive either 0.5 ml (10μg) or double dose 1ml (20μg) of HB vaccine in a 0-1-2month schedule. After excluding hepatitis B virus infection, the vaccine was administered at a standard dose in group-A (0.5 ml or 10 microgram) and at a double dose (1 ml or 20 microgram) in group-B. After one month of the last dose, the seroprotection rate was measured and compared among sexes. Results: The mean age of the participants in group-A was 5.81 ± 1.73 years with a boy to girl ratio of 9:6 and the mean age of the subjects in group-B was 5.65 ± 1.68 years with a boy to girl ratio of 8:7. The mean vaccine titer was 25.60 ±19.97 mIU/ml in group-A and 617.47 ±292.11 mIU/mlin group-B, with a significant difference (p<0.05) between the two groups. Irrespective of the dose, the mean vaccine titer was higher in girls (37.33 ± 19.45 mIU/ml) compared to boys (16.22 ± 14.81mIU/ml) and the difference was statistically significant in group-A. It was also observed that the mean vaccine titer was significantly higher in girls (743.00±252.34mIU/ml) compared to boys (394.88±246.63 mIU/ml) in group-B (p<0.05,t-test). Conclusions: The results of our study showed a reduced response to HB Vaccine boys with SSNS in comparison to girls. As the study size was small, single center study and time limited follow-up, we cannot draw any valid conclusions. Keywords : Immune deficiency; Sex differences; Steroid Sensitive Nephrotic Syndrome; Seroconversion.

Contribution of Microfinance in Achieving Millennium Development Goals

Evidences world over largely acknowledge the contribution of empowered women on education and health of the family. Since all over the world microfinance (MF) is mainly intervened through women, their economic empowerment should have a salubrious impact on poverty and social variables. The linkage of MF with Millennium Development Goals (MDGs) accepted by United Nations in 2010 further boosted this belief. However, literature on MF linkage with social transformations does not provide concrete evidence. In this article, with the help of a set of 92 cross-country pooled data for 9 years (2007–15), a linkage assessment of MF and MDGs related to poverty, that is, poverty headcount ratio and school enrolment at primary level of female and ratio of girls to boys in primary education, that is, Gender Parity Index, is attempted. With the help of pooled ordinary least square regression, three models were separately developed for the selected MDGs. While the findings do provide evidence about the participation of poor in MF and poverty reduction linkage, the education-related MDGs were less influenced by the MF programme. This prompts to suggest that overall capacity-building interventions at grass-roots level are also required along with MF for achieving MDGs.

Influence factors of extubation failure following surgical repair of congenital heart defects in infants

Objective To investigate the risk factors of extubation failure following surgical repair of congenital heart defects (CHD) in infants. Methods Infantile patients who underwent surgical repair of CHD under cardio-pulmonary bypass (CPB) in the First Affiliated Hospital of Sun Yat-Sen University from January 2015 to October 2016 were included.According to results of extubation, the patients were divided into the extubation failure group and extubation success group.Clinical and laboratory data were collected and analyzed, including age, gender, body mass, the types of congenital heart disease, extracorporeal circulation time and the use of vasoactive drug, et al. Results Sixty cases were enrolled in this study.Among them 12 cases (7 males, 5 females with the boy to girl ratio of 1.4∶1.0, and average age was 0.56 years old) were in the extubation failure group, in which 3 cases (25.0%) aged 5-10 kg.Forty-eight cases(27 males, 21 females; the boy to girl ratio was 1.2∶1.0 and average age was 1.15 years old) were in the extubation success group.The distribution of age and body weight were significantly lower in the extubation failure group than those in the extubation success group[0.42 (0.37) years old vs.1.00 (1.08) years old, Z=-3.22, P 0.05). Multiple Logistic regression showed that the duration of CPB was an independent risk factor of extubation failure[odds ratio (OR)=0.967, 95% CI: 0.956-0.997, P=0.024]. Conclusions The risk factors of extubation failure include young age, low body weight, and prolonged CPB and mechanical ventilation.CPB time is an independent risk factor of extubation failure following cardiac surgery in infants. Key words: Infant; Congenital heart disease; Postoperative; Extubation failure; Risk factor

Current status and change trend of violence against children in China from 2006 to 2015, an analysis on data from National Injury Surveillance System

Objective: To understand the current status and change trend of violence against children in China and provide evidence for the risk factor and intervention priority identifications and intervention strategy development. Methods: The data of National Injury Surveillance System (NISS) from 2006 to 2015 were used to analyze the change in outpatient visit due to violence against children, injury cases'demographic characteristics, incidence of injury and clinical outcomes of injury cases. Results: A total of 44 319 injury cases caused by violence against children were reported through NISS during this period. The proportion of violence related child injury cases in total child injury cases decreased year by year. In child violence cases reported in 2015, boys accounted for 81.31%, the boy to girl ratio was 2.22∶1. Violence related injuries caused by blunt strike accounted for 65.69%. The incidences of child violence were low in February and during July-August and 48.87% of violence related injuries occurred in schools and public places, bruise accounted for 63.52%. The main injured body part caused by child violence was head (51.18%), and most violence caused injuries (82.66%) were mild, while 83.21% of the injury cases went home after treatment. Conclusions: Violence against children should not be ignored. Male students of middle/high schools are at high risk. Schools are the places where violence against children is prone to occur. Health and safety education should be strengthened to prevent the occurrence of campus violence and improve the child's awareness of self-protection and reduce the incidence of serious violence.

Thyroid Disease and Type 1 Diabetes in Dutch Children: A Nationwide Study (Young Dudes-3)

To investigate the prevalence of overt thyroid disease in children in The Netherlands with and without type 1 diabetes mellitus (T1DM). Nationwide, retrospective cohort study in The Netherlands. Using the national registry of both healthcare reimbursement and pharmaceutical care, data of all Dutch children (aged 0-14 years) with a diagnosis of T1DM, or a diagnosis of hypothyroidism or hyperthyroidism in the period 2009-2011. The prevalence of thyroid disease was 0.15% in children without T1DM, and 3.43% in children with T1DM (rate ratio 23.59; 95% CI 19.92-27.93; P < .001). Both hyperthyroidism and hypothyroidism were 24 times more likely in children with T1DM than in those without. Thyroid disease was more common in girls than in boys, both in children with T1DM (rate ratio of girls vs boys 3.07; 95% CI 2.10-4.49) and in children without T1DM (rate ratio 1.59; 95% CI 1.49-1.69). This sex difference was more pronounced for hypothyroidism than for hyperthyroidism. Children with T1DM in The Netherlands are 24 times more likely to develop thyroid disease than their peers without diabetes. Girls with T1DM were more prone to thyroid disease, particularly hypothyroidism.

Epidemiological survey of anterior cruciate ligament injury in Japanese junior high school and high school athletes: cross-sectional study

ABSTRACTWe investigated the incidence of anterior cruciate ligament (ACL) injuries among athletes in junior high school and high school by retrospectively reviewing Japan Sports Council notification data registered over a period of 10 years. The total number of ACL injuries during the 10-year period was 30,458, with an incidence of 0.81 per 1000 athlete-years. Among those with ACL injuries, the ratio of girls to boys was 2.8, and incidence of injury was significantly greater among girls than boys (1.36 as against 0.48). Athletes in the 11th grade demonstrated the highest incidence of ACL injuries. We also found that the greatest incidence of ACL injuries was among female high school basketball players; the second highest being among female high school Judo athletes. For sports with a greater number of ACL injuries and a higher injury rate, it is necessary to obtain more detailed data and analysis to determine an effective prevention programme.

Effect of Weight Loss on Puberty Onset in Overweight Children

To assess the impact of weight changes on the onset of puberty in overweight children. We evaluated the timing of puberty onset in 160 prepubertal overweight children (aged 11.2 ± 1.0 years) depending on the changes of their weight status in a 1-year lifestyle intervention. We determined body mass index (BMI), pubertal stage, luteinizing hormone (LH), follicle-stimulating hormone, insulin-like growth factor (IGF)-1, insulin-like growth factor binding protein-3, insulin resistance index homeostatic model assessment, and serum gonadotropins at baseline and 1 year later. Puberty onset during the 1-year follow-up was significantly (P = .014) more frequent in girls without BMI-SDS reduction (75.0%) compared with girls with BMI-SDS reduction (45.7%). The start of puberty was significantly (P = .024) more frequent in boys with BMI-SDS reduction (76.9%) compared with boys without BMI-SDS reduction (53.6%). In logistic regression analyses adjusted for baseline age and BMI-SDS, BMI-SDS reduction was associated with a decreased likelihood for puberty onset in girls (OR 0.24; 95% CI 0.07-0.85) and an increased likelihood in boys (OR 3.77; 95% CI 1.34-10.52). Central onset of puberty was confirmed by an increase of LH concentration and LH/follicle-stimulating hormone ratio in both boys and girls. Homeostatic model assessment, IGF-1, and IGF-1/insulin-like growth factor binding protein-3 ratio as marker for free IGF-1 at baseline or their changes were not associated with the onset of puberty. BMI-SDS reduction in overweight children was associated with earlier gonadotropin-dependent onset of puberty in boys and later onset of puberty in girls, suggesting earlier puberty in obese girls and later puberty in obese boys. We found no evidence that insulin resistance or IGF-1 have an impact on the start of puberty in obese children. ClinicalTrials.gov: NCT00435734.

Neck circumference measurement as a screening tool for obesity in children

Background: Childhood obesity is a rising epidemic and a major public health problem with the risk for type 2 diabetes mellitus, hypertension and cardiovascular disorders in later life. Neck circumference (NC), a marker of upper body subcutaneous adipose tissue distribution can predict higher metabolic risk. The aim of the present study was to evaluate the association between neck circumference (NC) and obesity.Methods: This cross-sectional prospective observational study was conducted in Bangalore in the month of October 2016. 172 male and 161 female students, aged 13-17 years were screened. Anthropometric markers of obesity measured included body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and compared with neck circumference (NC) of the same subjects. Pearson’s correlation coefficient was calculated between neck circumference and other obesity indices, and receiver operating characteristic curve analysis was used to determine the best cutoff value of neck circumference in predicting high BMI. Results: Overall, 13.2% boys and 9.9% girls were found overweight/obese. The mean BMI was 25.27±2.09kg/m2 and25.17±2.23kg/m2, mean neck circumference was 33.43±2.3cm and 31.50±1.4 in overweight/obese boys and girl respectively. All of the anthropometric parameters were found to be significantly higher in overweight/obese children than with their normal weight peers and higher in boys compared to girls. The neck circumference in boys was significantly greater than girls and higher in overweight/obese with P&lt;0.001. The best cut-off value of neck circumference by ROC to identify boys with a high BMI was 32cm with sensitivity of (81.82%), specificity (89.06%), and for girls was 30cm with sensitivity of (84.85%), specificity (87.5%). Neck circumference had a strong positive correlation with other anthropometric measures BMI, WC, waist hip ratio in both boys and girls (p &lt;0.001).Conclusions: Neck circumference significantly correlated with other indices of obesity. It can be used with great reliability to screen overweight and obesity in children. NC can be considered as a simple, time saving and inexpensive clinical tool for detection of obesity in large population-based studies in children and adolescents.

Reports of child sexual abuse of boys and girls: Longitudinal trends over a 20-year period in Victoria, Australia

Although prevalence studies show girls are more frequently sexually abused than boys, a significant proportion of boys also experience child sexual abuse (CSA). The challenges for public policy are amplified for boys due to less developed public and professional sensitisation to boys’ experiences, conceptions of masculinity, and less research on boys including into reporting trends and outcomes. We conducted a 20-year longitudinal time-trend analysis of government data to identify reporting trends and report outcomes for CSA in Victoria, Australia from 1993 to 2012. We stratified by child gender and reporter status. Results indicate a new sensitisation to CSA, especially for boys, although this trend was not stable. Marked change occurred in the last five years, likely influenced by major social and political events. Comparison over time revealed that from 1993 to 2012, the rate of reporting of boys increased 2.6-fold whereas there was a 1.5-fold increase for girls. Comparing genders, with regards to rate of reporting, in 1993, the sex ratio of girls to boys was 2:1, while by 2012 this ratio changed to 1.14:1. Reports by police and other mandated reporters accounted for the majority of the increase in reports over the 20-year period, suggesting unequal sensitisation. Positive report outcomes (i.e. substantiations, findings of harm, and referral to services) increased twelve-fold for boys, and nearly five-fold for girls, indicating the increased levels of reports were based in actual clinical need. Most of this increase occurred from 2009 to 2012, influenced by a compound of social, political and agency-related factors.

The clinico-epidemiological profile of atopic dermatitis in residential schoolchildren: A study from South Chhattisgarh, India

Introduction: Atopic dermatitis is a chronic, inflammatory, relapsing skin disorder with early age of onset in infancy and early childhood. Objective: The present study was conducted to study the clinico-epidemiological profile of atopic dermatitis among children of residential schools of naxal-infested South Chhattisgarh. Materials and Methods: Ninety children (4.6%) of atopic dermatitis were pooled out from a previous study by the same authors on 1943 children of eight residential schools. The various clinico-epidemiological factors were studied and analyzed using relevant statistical tools. Results: Out of ninety children having atopic dermatitis, boys:girls ratio was 1:1.73. The mean age of onset was 2.14 ± 0.52 years, and the mean duration of illness was 1.71 ± 0.38 years. The personal history of atopy was present in 34 (37.8%) children whereas a family history of atopy was seen in 47 (52.2%) children. Among clinical presentation, chronic type (n = 56, 62.2%) was most common, followed by subacute (n = 24, 26.2%) and acute (n = 10. 11.1%). Flexor (n = 42, 46.7%) was the most common site affected followed by extensor and face (n = 24, 26.7%) each. Mild severity was seen in 76 (84.4%) children followed by moderate severity (n = 12, 13.4%) and severe (n = 2, 2.2%) children. Sweating (n = 53, 58.9%) was the most common aggravating factor followed by seasonal (n = 51, 56.7%), wool (n = 24, 26.7%), stress (n = 15, 16.7%), dust (n = 10, 11.1%), physical exercise (n = 8, 8.9%), and food (n = 2, 2.2%). Conclusions: Atopic dermatitis of chronic type with mild in severity is more common in community.