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Introduction: Body mass index (BMI) has been used for a long period as a surrogative measure for obesity. But BMI does not differentiate between fat and nonfat tissue (blood, bone, and muscle) due to which it is not considered accurate anymore. But since BMI is easier to estimate and used widely for assessment of obesity, it is better if it is re-standardized according to the body fat percentage (BFP) of a specific population, community, and their ethnicity. Objective: To estimate and propose the BMI cut-off values in young Indian population especially MBBS students taking BFP as a standard. Design: This is a cross-sectional study. Anthropometric data (age, gender, height, weight, waist circumference, and hip circumference) were collected from the participants after taking consent. BMI was calculated using Quetelet’s Rule. BFP was estimated using Omron Body fat Monitor (HBF 385). It measures the BFP by the bioelectrical impedance (BI) method. Data were analyzed with appropriate statistical tests and receiver operating curve (ROC) curves were drawn to find the cut-off values of BMI to determine obesity. Setting: The present study is a multi-centric study conducted in four medical colleges (two in each state; Odisha and Andhra Pradesh, India). Participants: Apparently healthy MBBS students aged 18-24 years were included in this study. Students having any chronic or acute illnesses were excluded from the study. Out of 904 students contacted from four medical colleges, 863 (430 males and 433 females) consented and participated. Results: Some 863 MBBS students have participated in this study. After adjusting for age, BMI was found to be higher in males. BMI was found to be 29.33 for males and in females it was 29.06. BFP was higher in females (34.23) as compared to males (20.77). Waist hip ratio was found to be higher in females (0.92) than in males (0.84). Whereas, fat free mass (FFM) and fat free mass index (FFMI) are higher in males, i.e., 56.24 and 18.48 respectively. Most appropriate cut-off value for obesity on ROC curve was found to be 22.09 (sensitivity 84.5%, specificity 83.46%) in males and that of females was 23.73 (sensitivity 85.26, specificity 81.23). Whereas, the conventional cut-off of 25 for males had sensitivity of only 46% and that of females was 70.5%. For total population BMI cut-off value was found to be 22.2 with 81% sensitivity and 74% specificity. Conclusion: We propose the cut-off value for overweight/obesity in males to be 22.09 kg/m 2 and for females to be 23.73 kg/m 2 in young adult Indian population. These values were found to have more sensitivity and specificity than current BMI cut-off value.

Background: -To enhance child health, Indian Child Development Scheme (ICDS) and National Health Mission (NHM) strategized that reinforcement of Infant and Young Child Feeding (IYCF) practices would be a good take off. Anganwadis, where 78% of mothers of children below 6 receive services, can serve as an effective platform for mothers to receive counseling on appropriate breast feeding and complementary foods, in a priority state like Odisha.  Aim: -As a prelude to a detailed intervention, a rapid baseline situational analysis was planned in 4 intervention districts to know about the district specific variations and also the overall IYCF practices in the area. Objective: Assess the IYCF indicators in the districts with focus on feeding practices above 6 months of age. Assess the factors responsible for breast feeding and complementary feeding in the sample Materials and Methods: - Final sample of 600 was chosen using 30 cluster sampling based on proportions of less than 2 years children in the study districts (districts named A-D, as the interventions are in progress and state refrains the identity of districts), 30 clusters to be divided in the ratio of 10:8:5:7. From each cluster-mothers of 20 children, nearly equal proportions of children in 0-6months and 7-23 months, were interviewed for sociodemographic, health seeking and prevailing IYCF practices. BMI (Body Mass Index) and MUAC (Mid Upper arm Circumference) were used to corroborate the nutritional status of child. Results: - 606 interviews were conducted. Age groups ratio was 2:1.5. Exclusive breast feeding was noted at 68% and under nutrition was 59.2%. Advanced maternal age  were positively associated with declining breast-feeding practice; however good spacing and male child was protective for good IYCF practices. The complementary feeding practices, measured with 2 major indicators i.e. Minimum Food Diversity and Minimum Meal Frequency, were calculated as 40.7% and 20.6% respectively. Gender representation for both indicators was positively skewed for females, which was reasoned in FGDs as purely by chance and did not mean a preference for boys. Both service provider and the mothers’ knowledge was compromised regarding complementary feeding indicators, in spite of the fact that former had been trained on this aspect. Conclusion: - Targeted interventions are envisaged as scope for improvement in the IYCF indicators in the mixed mileu of a state, wherein some districts indicators markedly affect the overall state indicators. In Odisha, this study may give guidelines to the intervening districts to overhaul the load of under nutrition which is now more district and select population specific.

BACKGROUNDTetanus toxoid vaccine has always been an indelible constituent of the Universal Immunization Programme in India. Besides being given to pregnant women in two doses, it used to be given in children at the ages of ten and sixteen. Gradually with the coming down of the burden of communicable diseases, the vaccine is now even recommended in five years age besides as a prophylactic vaccine for any injury of moderate to severe degree in the tropical situations. With India achieving Neonatal Tetanus Elimination in 2015, the pressures to ensure the availability of cost-effective vaccine has gone up. To cope with the increased demand of this vaccine in India, a bio similar tetanus vaccine vial for the Indian market is proposed and hence the Phase 1 study to validate the dose and the safety of the interventional product was planned at Kalinga Institute of Medical Sciences, Bhubaneswar in the eastern part of India under stringent regulatory guidelines of Central Drug Standards Control Organization (CDSCO), and adhering to the good clinical practice guidelines. MATERIALS AND METHODS24 recruits (healthy adults aged 18-45 years) were taken up for the study with lab screening for blood parameters both preand seven days post vaccination. 23 subjects completed the study as per the protocol and were included in the Efficacy Analysis. Only solicited local adverse events were reported in the trial. Total number of solicited adverse events reported in the trial was 15 (62.5%) The maximal incidence of any local reaction after immunizations within 7 days of vaccination was 58.3% (Pain/Tenderness) followed by swelling/induration in 1 (4.2) subject. RESULTSIgG antibody response after single dose of vaccine was optimal in study population. There is a statistically significant difference between pre-vaccination and post-vaccination values for IgG response against Tetanus antibodies, after single dose. Prevaccination GMT of study changed from 2.24 IU/ml to 12.81 IU/ml, indicating significant results. CONCLUSIONIn our study, in a mixed age and gender group, the seroconversion was nearly 76% and the AEs were 62.5% all of which subsided on their own without medication, which suggests that the vaccine is effective and can proceed onto Phase 2 and 3 trials for further in-depth assessments of the safety and primarily immunogenicity of the vaccine.