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Biomedical subjects

T Gopaldas

Publications and source records attributed to T Gopaldas.

At least 19 recordsLinked to original sources
PubMed1996

More nutrients, fewer parasites, better learning.

By 1997 it is intended that all of India's 160 million primary-school children will be given a free daily midday meal. Since 1994 almost 3 million such children in Gujarat, already benefiting from this initiative, have been receiving, in addition, supplements of iron, iodine and vitamin A, and deworming treatment with albendazole. As a consequence there have been significant, highly cost-effective and sustainable improvements in growth rates and haemoglobin levels, and decreases in the prevalence of ocular signs of vitamin A deficiency and in intestinal parasitic infections.

Adolescent↗
PubMed1995

Risk factors of nutritional blindness and determinants of a successful vitamin A prophylaxis programme.

Data on 7668 children (0-72 months) and their 4621 mothers and 81 Anganwadi Workers (AWWs) collected for the USAID Assisted ICDS Evaluation Surveys were analysed. The results indicated that the major risk factors of nutritional blindness were lack of nutrition and health knowledge among mothers; presence of iron deficiency anemia in the children; and history of the child having had measles in the past one year. Mother's health and nutrition, knowledge and maternal literacy status were the determinants of the success of a vitamin A prophylaxis programme. Factors that determined AWW's performance in vitamin A supplementation were her nutrition and health knowledge, her literacy status and the amount of supervisory assistance she received from Auxillary Nurse Midwife (ANM).

Adult↗
PubMed1993

Evaluation of the impact on growth of a controlled 6-month feeding trial on children (6-24 months) fed a complementary feed of a high energy-low bulk gruel versus a high energy-high bulk gruel in addition to their habitual home diet.

Twenty-one pairs of slum children (6-24 months) were pair-matched for age and weight. The experimental group consumed a complementary feed of a high energy (1.63 Kcal/ml), but low bulk wheat gruel providing a mean 199 Kcal/child/day v. the control group which consumed an identical (1.63 Kcal/ml), but high bulk gruel providing a mean 50 Kcal/child/day for a period of 180 days. The home diet (breastmilk+family diet) provided about 470 Kcal/child/day in both groups. A comparative evaluation of growth at commencement and end of study demonstrated that: 1. weight, height, and velocity of growth in weight were significantly better in the experimental group; 2. a comparison by nutritional classifications (Indian Academy of Pediatrics and Waterlow) showed a greater benefit to the experimental group; 3. the energy intake per kg body weight was 73 and 62 Kcal, respectively, in the experimental and control groups at end of study. It is concluded that the much higher intake of the amylase-rich food (ARF) treated gruel in the experimental group was responsible for the substantially better growth.

Case-Control Studies↗
PubMed1993

Xerophthalmia, vitamin A supplementation and morbidity in children.

The relationship between ocular manifestation of vitamin A deficiency and children's anaemic/morbidity status as well as the efficacy of vitamin A prophylaxis in preventing these conditions was determined. The prevalence of xerophthalmia in morbid children with anaemia and history of worm infestation, measles, and diarrhoea was higher as compared to their non-morbid counterparts. The relative risk (RR) of anaemic children with eye signs was significantly higher (1.5), but the chances of having anaemia were similar in both vitamin A receivers and non-receivers. The RR of history of worm infestation, measles, and severe diarrhoea was 1.4, 1.0, and 1.2, respectively, in children with eye signs and 1.2, 0.8, and 1.3, respectively in children who did not receive vitamin A prophylaxis. The RR for occurrence of diarrhoea along with vitamin A deficiency was as high as 1.9. It appears xerophthalmia and anaemia co-exist and vitamin A supplementation helps in curbing these conditions among 1-6-year-old children.

Child↗
PubMed1993

Prevalence of xerophthalmia and efficacy of vitamin A prophylaxis in preventing xerophthalmia co-existing with malnutrition in rural Indian children.

Data of 4302 children, 0-6 years old were analysed to study the prevalence of vitamin A deficiency and the efficacy of vitamin A prophylaxis in preventing xerophthalmia co-existing with malnutrition. Manifestation of ocular signs of vitamin A deficiency were seen in 10 per cent children. The prevalence of xerophthalmia was higher in the normal and mild to moderately malnourished children, and lowest in the severely malnourished ones. The ability of vitamin A prophylaxis to curb xerophthalmia was greatest at the extreme ends of the nutritional grade spectrum. These findings have important implications for the existing national Vitamin A Prophylaxis Programme, and suggest that: (a) normal and mild to moderately malnourished children less than 6 years old, should be preferably considered for vitamin A mega dosing; (b) in the management of protein energy malnutrition, vitamin A status of the children should be monitored; and (c) the coverage should be improved as most children are in the mild and moderate degrees of malnutrition.

Age Factors↗
PubMed1992

Evaluation of a controlled 6 months feeding trial on intake by infants and toddlers fed a high energy-low bulk gruel versus a high energy-high bulk gruel in addition to their habitual home diet.

The aim of this study was to determine the intake of 68 slum children (6-24 months old) pair matched for age and nutritional status who were fed an experimental energy dense (1.63 Kcal/ml) wheat flour gruel rendered low-viscosity with catalytic amounts of germinated wheat flour (Amylase-Rich Food, ARF) v. an identical high viscosity control gruel without ARF for a once-a-day ad lib feed in addition to the habitual home diet for a period of 180 days. The mean intake in the experimental group was 124 ml and 199 Kcal v. 31 ml and 50 Kcal in the control gruel group per child/day. The gruel feeds were well accepted and were complementary to the home diet (breastmilk plus some family diet which provided only 420-461 Kcal/day). The experimental and control gruels provided about 20 and 5 per cent of the food energy RDA, respectively. The protein RDA was nearly met by the home diet in both groups. The study demonstrated a simple means to greatly increase the food energy intake in this age group by offering high energy yet low bulk gruels with the help of the ARF technology.

Age Factors↗
PubMed1990

Does growth monitoring work as it ought to in countries of low literacy?

The paper examines various aspects of the growth monitoring (GM) component of the Integrated Child Development Services (ICDS) programme of India. Data of 3704 rural children, 0-6 years of age revealed that growth of almost half of the children had never been monitored, and monitored inadequately in another 25 per cent of cases. While very few mothers (1 per cent) could interpret growth charts (GC) correctly, 87 per cent of the ICDS functionaries could do this. There was a significant and positive relationship between maternal knowledge and functionary knowledge of the growth chart (GC), and coverage of children for GM. Impact of mothers' GC knowledge on nutritional status of children was determined largely by their literacy status; however, only 17 per cent were literate. Analysis of covariance of the effect of GM on weight-for-age and morbidity controlling for socio-economic status and other programme services showed that GM did not have an impact on the nutritional or health status of children. It is therefore concluded that very high levels of illiteracy amongst mothers may be a major determinant to the success of GM programmes in India.

Child↗
PubMed1990

Agreement between arm circumference, weight for age, and weight for height measures of malnutrition in children.

Agewise agreement between mid-upper arm circumference (AC), weight for age and weight for height assessment of nutritional status was analyzed for 5,509 Indian children 1 to 5 years of age. Sensitivity specificity and positive predictive value of AC are presented. The sensitivity of AC for detecting moderate malnutrition by weight for age or weight for height was found to be low, except in children 13-24 months of age. From 25-58% of the severely malnourished children by weight for age in the age group 25-60 months were misclassified as normal by AC. Specificity of AC was high across the age range indicating that most of the children identified as not malnourished by weight for age or weight for height also had normal AC. The positive predictive value of AC was low for severe malnutrition but high for moderate to mild malnutrition compared to weight for age and weight for height. The findings indicate that AC is not constant over the age range 1 to 5 years, and use of fixed cut-off points for assessing malnutrition from 1 to 5 years is inappropriate. Sensitivity of AC using a fixed-cut-off point clearly decreases with age, and specificity increases with age. Where possible, weight of children is preferable to AC for nutritional status assessment, due to large number of moderately or severely malnourished children likely to be wrongly classified as normal by AC.

Age Factors↗
PubMed1989

Impact of iron supplementation on cognitive functions in preschool and school-aged children: the Indian experience.

Four studies examined impacts of iron supplementation on school children of various ages and both sexes. The first study investigated impact of iron-folic acid supplements for 60 d on cognition in 94 boys and girls aged 5-8 y. Improvement in total scores of the anemics was significantly higher than the nonanemics in 7-8-y-old children only. The second study assessed impacts of supplementation on cognition in 14 pairs of 5-6-y-old anemic boys, with clear beneficial effects on cognitive function. The third study investigated effects of varying dosages of elemental iron on cognitive function in 48 boys aged 8-15 y, with different levels of improvement. The fourth study investigated impacts of iron supplementation on 163 anemic girls aged 8-15 y with treatment and evaluations at 4 and 8 mo, with significantly improved scores in cognitive function after the eighth month.

Adolescent↗
PubMed1989

Relationship between maternal and infant nutritional status.

Relationship between maternal anthropometry, age, parity, education, work status, and food practices and nutritional status of children 0-6 months post-partum was determined using a cross-sectional design in a univariate situation. Whereas mothers' weight, height, weight for height, and months of lactation were significantly related to the weight for age of the infants, only weight, height, and work status seemed to affect their height for age. In the second stage where stepwise multiple regression analyses were done, maternal height, months of lactation, and weight for height in that order showed a significant relationship (R2 = 0.08) with infants weight for age while mothers' height and working status were the only two factors that affected the height for age of the infants (R2 = 0.04). The findings suggest that there exists a significant relationship between maternal and child anthropometry.

Adolescent↗
PubMed1989

Agreement between haemoglobin estimation and anaemia recognition card in assessment of anaemia in pregnant women.

Sensitivity and specificity of pallor signs were compared to haemoglobin determination for identifying nutritional anaemia in pregnant women. A total of 211 pregnant women were examined for signs of pallor using the anaemia recognition card, and their haemoglobin was determined by the cyanmethaemoglobin filter paper technique. The sensitivity of pallor signs in identifying severe nutritional anaemia in the population was fair, as 67 per cent of the pregnant women identified as anaemic by haemoglobin levels less than 8 g/dl were detected as anaemic by the presence of pallor signs. However, the specificity of the measure indicated that almost half of the pregnant women with haemoglobin level above 8 g/dl were misclassified as anaemic by presence of signs of pallor. Since the sensitivity and specificity of the pallor signs test are fairly low, the anaemia recognition card is an inefficient tool to be used to screen for severe cases of nutritional anaemia.

Anemia, Hypochromic↗