Browsing by Author "Kapil, Umesh"
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Item Assessment of energy expenditure among obese and non-obese children in national capital territory of Delhi.(2013-04) Kapil, Umesh; Bhadoria, Ajeet SinghItem Assessment of iodine deficiency disorders in district Bharatpur, Rajasthan.(2003-02-11) Kapil, Umesh; Singh, Preeti; Pathak, Priyali; Singh, CharanIodine deficiency disorders (IDD) is a public health problem in India. A ban on the sale of uniodised salt for household consumption has been introduced in Rajasthan State since 1992. The present study was conducted in the district of Bharatpur, Rajasthan with the objective to assess the prevalence of iodine disorders in school children as no data is available on this aspect. A total of 3072 children in the age group of 6-12 years were included in the study and were clinically examined. On the spot urine samples were collected randomly from 450 children. A total of 1064 salt samples were collected randomly from the families of the children. The total goiter prevalence was found to be 7.2% in the subjects studied. It was found that the percentage of children with urinary iodine excretion <20.0; 20.0-49.9, 50.0-99.9 and 100 mcg/L and above was 1.1, 1.1, 7.8 and 90.0% respectively. The assessment of iodine content of salt revealed that 56% of the families were consuming iodised salt. The findings of the present study indicated that the population is in a transition phase from iodine deficient (as revealed by the TGR) to iodine sufficient (as revealed by the medium UIE of 200.0 mcg/L) nutriture.Item Assessment of risk factors in laryngeal cancer in India: a case-control study.(2005-04-17) Kapil, Umesh; Singh, Preeti; Bahadur, Sudhir; Dwivedi, Sada Nand; Singh, Rajvir; Shukla, NkCancer of the larynx is fourteenth most common cancer in the world. Limited data are available from India on associations with risk factors and hence the present hospital based matched case-control study was conducted. Three hundred and five laryngeal cancer patients and an equal number of healthy controls matched for their age within 2 years, sex and place of residence constituted the study population. A pre-tested, semi-structured questionnaire was administered to each individual to elicit information on their socio-demographic profile, food habits and risk factors and dietary consumption patterns. Univariate logistic regression analysis and multivariate forward stepwise conditional logistic analysis were performed. In the univariate analysis a lower consumption of roots and tubers green leaf vegetable other vegetables and fruits, and higher consumption of milk, eggs, meat, tea, alcohol , smoking, consumption of betel leaf with tobacco as well as a preference for spicy and fried foods emerged as significant positive variables. After adjusting for education, years of use of alcohol, smoking, chewing of betel leaf with tobacco in the model, low green leafy vegetables and preference for spicy foods were found to be positively related to the risk of laryngeal cancer. There was a significant difference in the dietary consumption patterns of laryngeal cancer patients and controls, indicating a role for nutritional factors in the etiology of laryngeal cancer in the Indian population.Item Association between breast cancer and vitamin C, vitamin E and selenium levels: results of a case-control study in India.(2005-04-17) Singh, Preeti; Kapil, Umesh; Shukla, Nutan Kumar; Deo, Svs; Dwivedi, Sada NandIn women, cancer of the breast is generally the most prevalent neoplasm and cause of cancer death. Though a large number of women are affected with breast cancer, very few studies have been undertaken in India on the association between micronutrients and the risk of breast cancer. We conducted a hospital based case- control study to examine the associations of vitamin C, vitamin E and selenium with breast cancer. One hundred and sixty breast cancer patients and an equal number of normal healthy individuals constituted the study population. Venous blood was collected from the cases and controls for estimation of vitamin C, vitamin E and selenium utilizing standard procedures. Univariate logistic regression analysis was carried out to calculate odds ratios and confidence intervals. The mean vitamin C, vitamin E and selenium levels were lower in patients as compared to the controls. There was a 84% and 77% lower risk of breast cancer if the levels of vitamin C and vitamin E were increased by 1 unit, respectively. Similarly, there was a 7% lower risk of breast cancer if the level of selenium was increased by 1 unit. The results of the present study thus indicated a strong association of vitamin C, vitamin E and selenium with breast cancer in the Indian population.Item Association of Vitamin A Status With Under-Five Mortality in India(Indian Academy of Pediatrics, 2022-03) Thomas, Tinku; Sachdev, Harshpal S; Ghosh, Santu; Kapil, Umesh; Kurpad, Anura VObjective: To re-estimate the survival benefit from Vitamin A supplementation (VAS) in India using meta-analysis and to correlate mortality and vitamin A deficiency (VAD) in children aged 6 month to 5 year. Methods: Pooled risk ratio (fixed effects model) for mortality reduction with VAS was calculated from available Indian studies. Computed mortality rates in 6 months to 5 years children in Indian states were regressed on VAD prevalence estimates of the states. Results: There was no reduction in risk of all-cause mortality with VAS (RR=0.96; 95% CI: 0.89, 1.03). When regressing mortality on VAD in high or low VAD prevalence states, the regression coefficients were discordant. Conclusion: No survival benefit was observed for VAS in India from the available literature. The targeting of VAS programs should be given serious consideration.Item Authors’ response.(2014-02) Sachdev, H P S; Kapil, UmeshItem Comparison of HemoCue method with cyanmethemoglobin method for estimation of hemoglobin.(2002-08-28) Kapoor, S K; Kapil, Umesh; Dwivedi, Sada Nand; Anand, K; Pathak, Priyali; Singh, PreetiItem Consensus Statement of the Indian Academy of Pediatrics on Integrated Management of Severe Acute Malnutrition.(2013-04) Dalwai, Samir; Choudhury, Panna; Bavdekar, Sandeep B; Dalal, Rupal; Kapil, Umesh; Dubey, A P; Ugra, Deepak; Agnani, Manohar; Sachdev H P SJustification: Severe acute malnutrition (SAM) is a major public health issue. It afflicts an estimated 8.1 million under-five children in India causing nearly 0.6 million deaths. The improved understanding of pathophysiology of SAM as well as new internationally accepted growth charts and newer modalities of integrated intervention have necessitated a relook at IAP recommendations. Process: A National Consultative Meeting on Integrated Management of Severe Acute Malnutrition was held in Mumbai on 16th and 17th October, 2010. It was attended by the invited experts in the field. Extensive discussions were held as per the program. The participants were then divided into six groups for detailed discussions. The groups deliberated on various issues pertaining to the task assigned and presented recommendations of the groups in a plenary session. The participants made a list of recommendations after extensive discussions. A Writing Committee was formed and was entrusted with the task of drawing a Consensus Statement on the basis of these Recommendations. After multiple deliberations, the following Consensus Statement was adopted. Objectives: To critically evaluate the current global evidence to formulate a consensus among stakeholders regarding diagnosis and management of SAM. Recommendations: An integrated management of malnutrition is likely to yield more dividends. Thus, management of SAM should constitute an important component of Integrated Management of Neonatal and Childhood Illnesses (IMNCI) program. Determination of SAM on the basis of Z-scores using WHO Growth charts is considered statistically more appropriate than cut-offs based on percentage weight deficit of the median. Considering the fact that many children with SAM can be successfully managed on outpatient basis and even in the community, it is no more considered necessary to advise admission of all children with SAM to a healthcare facility. Management of SAM should not be a stand-alone program. It should integrate with community management therapeutic programs and linkages with child treatment center, district hospitals and tertiary level centers offering inpatient management for SAM and include judicious use of ready-to-use-therapeutic Food (RUTF). All sections of healthcare providers need to be trained in the integrated management of SAM.Item Consensus Statement: National Consensus Workshop on Management of SAM Children through Medical Nutrition Therapy.(2010-08) Sachdev, H P S; Kapil, Umesh; Vir, SheilaJustification: Severe acute malnutrition (SAM) is an important preventable and treatable cause of morbidity and mortality in children below five years of age in India. The concerned stakeholders are not in agreement about the role of product based medical nutrition therapy in the management of this condition. Process: In November 2009, a National Consensus Workshop was organized by the Department of Human Nutrition, All India Institute of Medical Sciences, New Delhi in collaboration with the Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, and the Sub-specialty Chapter on Nutrition, Indian Academy of Pediatrics. Presentations by eminent national and international scientists, the ensuing discussions, and opinions expressed by the participants provided the basic framework for drafting the consensus statement. The draft of the consensus statement was circulated to all the participants; it underwent two revisions after consideration of their comments. Objectives: (i) Critically appraise the current global evidence on the utility of “Medical Nutrition Therapy” (MNT) for the management of SAM in under five children; (ii) Formulate a consensus amongst stakeholders regarding the need to introduce product based MNT for the management of SAM in under five children in India; (iii) Identify research priorities for MNT for the management of SAM in under five children in India; and (iv) Ascertain potential challenges for introducing product based MNT in India, if consensus opinion identifies such a need. Recommendations: Guidelines related to the role of MNT in management of children suffering from SAM are presented. Global and regional data document the effectiveness of MNT using ready-to-use therapeutic foods (RUTF) and locally formulated products. Adequate caution should be exercised to ensure that MNT for SAM does not interfere with measures for the holistic prevention of childhood undernutrition. Indian manufacture of RUTF is feasible, and can be scaled up. Product-based nutrition therapy including RUTF can be introduced on a pilot basis when a delivery design and plan of action is developed and is in place as a part of the larger system to deal with childhood undernutrition. RUTF should be used only as therapeutic and not supplementary feeding, above six months of age, and for a limited time period (4-8 weeks) until the child recovers from SAM, which should be defined in explicit treatment protocols. An urgent research issue is comparison of RUTF with home-based and locally-formulated products.Item Consumption of tobacco, alcohol and betel leaf amongst school children in Delhi.(2005-11-05) Kapil, Umesh; Goindi, Geetanjali; Singh, Vinita; Kaur, Supreet; Singh, PreetiItem Continuation of High Goiter Prevalence in Regions with Successful Salt Iodization Program.(2011-06) Kapil, UmeshItem Correspondence.(2015-01) Bhadoria, Ajeet Singh; Kapil, UmeshItem Cost of syrup versus capsule form of vitamin A.(2004-08-07) Kapil, Umesh; Prakash, RajatItem Current status of iodine nutriture and iodine content of salt in Andhra Pradesh.(2004-02-09) Kapil, Umesh; Singh, Preeti; Pathak, PriyaliA cross sectional survey was conducted in the year 2001, to establish the current status of iodine nutriture and level of salt iodisation in the state of Andhra Pradesh, India. All the 23 districts were included. The data was collected in each district through school approach. A total of 3706 salt samples and 1952 casual urine samples were collected. Nearly 45% of the population was found to be consuming iodised salt. All the districts had adequate iodine nutriture except Rangareddy and Cuddapah. The districts which were earlier found endemic to iodine deficiency namely Srikakulam, Vizianagaram, Visakhapatnam, Godavari, Khammam, Adilabad and Warrangal were found with adequate iodine nutriture as reflected by median UIE level of more than 100 microg/L. The study revealed success of salt iodisation program in the state.Item Do we need campaign approach of vitamin A administration in non vitamin A deficient areas?(2002-01-06) Kapil, UmeshItem Elimination of iodine deficiency disorders in Delhi.(2004-03-15) Kapil, Umesh; Sethi, Vani; Goindi, Geetanjali; Pathak, Priyali; Singh, PreetiOBJECTIVE: The present study was conducted in year 2002 in NCT of Delhi with the objective to re-assess the prevalence of iodine deficiency disorders. METHODS: A total of 7009 children in the age group of 6-11 years were clinically examined for presence of goiter. A total of 991 salt samples were also collected randomly. On the spot casual urine samples were collected from 1395 children. RESULTS: The total goiter prevalence was found to be 6.2%. The percentage of children with urinary iodine excretion (UIE) of < 20.0, 20.0- < 50.0, 50.0-99.9 and 100.0 microg/l and above was 0.8, 1.8, 8.7 and 88.7%, respectively. The median UIE level was 200 microg/L. The assessment of iodine content of salt revealed that only 16% of the families were consuming salt with iodine content less than 5 ppm. CONCLUSION: The findings of the present study indicated that the population is in a transition phase from iodine deficient (as revealed by Total Goiter Prevalence) to iodine sufficient nutriture (as revealed by median UIE 200 microg/l). A significant progress has been achieved towards elimination of IDD from NCT of Delhi.Item Evaluation of vitamin A status during pregnancy.(2003-03-08) Kapil, UmeshItem Excess Iodine Nutrition in Delhi.(2010-10) Kapil, UmeshItem Impact of single /multiple micronutrient supplementation on child health.(2004-11-02) Kapil, Umesh