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BACKGROUND According to UNDCP World Drug Report, the problem of substance abuse in adolescence is fast assuming alarming proportions in both developed and developing nations. Kullu District of Himachal Pradesh has regularly been in media headlines for extensive cannabis cultivation and abuse of other substances. The study was conducted to provide an essential source of information about substance abuse and its correlates in this Himalayan region. MATERIALS AND METHODS This was a descriptive school-based cross-sectional study conducted among students (13-19 years) studying in classes 7 th to 12 th. Multi-stage cluster random design and PPS sampling methodology was adopted. A sample of 3000 students both from rural and urban areas studying in 20 government and private senior secondary schools was selected. An anonymous, pretested, self-administered questionnaire adapted from WHO and ESPAD questionnaires was used to collect relevant information. Statistical analysis was done by entering the data in SPSS. RESULTS The ultimate response rate was 98.5%. Out of the total of 2864 participants, 785 (27.4%; 95%, CI 25.8% to 29.1%) had indulged in substance abuse at least once in their lifetime. Prevalence of current and regular users was 13.8% (95%, CI 12.5% to 15.1%) and 4.1% (95%, CI 3.4% to 4.9%), respectively. Alcohol was the most commonly abused substance among ever users at 18.1% followed by tobacco (17.6%) and cannabis (6.2%). Around 85% of the students perceived indulgence in substance abuse to be harmful for health. The logistic regression model revealed that substance abuse among friends (AOR 5.32), family members (AOR 2.04), inability to spend quality time with parents (AOR 2.44), gender (AOR 1.68) and older age group of 16-19 years (AOR 1.51) were the factors found to be positively associated with substance abuse. CONCLUSION The study has brought out a high prevalence of substance abuse among the students. The participants' high knowledge about deleterious effects of substance abuse did not translate into any beneficial behavioural change. Hence, scaling up of IEC activities and life skill education focussed on school going adolescents is imperative. Further, the negative influence of family abuse practices and inability to spend quality time with their wards highlights the necessity to include parents in any awareness campaign being planned.

Introduction:IDRS is based on four simple parameters derived from known risk factors for diabetes; two modifiable risk factors (waist circumference and physical inactivity) and two non-modifiable risk factors (age and family history of diabetes), which may be amenable to intervention. The present study has been planned as the region specific validation is important before it can be used for screening in this part of the country.Aims:The aim of the present study was to validate MDRF-IDRS for screening of diabetes mellitus among adult population of urban field practice area, IGMC, Shimla, Himachal Pradesh, India.Methods:The present community based cross sectional study was conducted among 417 adults fulfilling the eligibility criteria using a two stage sampling design.Results:In the present study IDRS value ≥70 had an optimum sensitivity of 61.33% and specificity of 56.14% for detecting undiagnosed type 2 diabetes in the community. At an IDRS score of ≥70, the PPV was 23.47%, NPV as 86.88%, the diagnostic accuracy as 57.07%, LR for positive test as 1.398, LR for negative test as 0.69 and Youden's index as 0.17. However Youden's index was 0.19 at a cut of ≥60 i.e. higher than what was at ≥70. Higher IDRS scores increased the specificity but the sensitivity dramatically decreased. Conversely, lower IDRS values increased the sensitivity but the specificity drastically decreased. Area under the curve = 0.630 and a P value < 0.001.Conclusions:MDRF IDRS is user friendly screening tool but the criteria of including the parameter of physical activity for the calculation of the risk score needs to be clearly defined. In the present study the maximum sensitivity of 100% was seen at a cut off of ≥30. Hence we would recommend that all those in the medium and high risk group should be screened for type 2 Diabetes.