Publications by authors named "Khadilkar A"

Background: Coronavirus disease 2019 (COVID-19), resulting from the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), affects various bodily systems, including the heart, central nervous system, muscles, and bones, all of which harbor angiotensin-converting enzyme 2 (ACE-2) receptors similar to those in the respiratory system. However, research on the inflammatory response and its impact on systems such as the musculoskeletal one is relatively scarce. Our study aimed to investigate bone and muscle metrics as well as handgrip strength in individuals who recuperated from COVID-19 infection.

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Objectives: Exocrine pancreatic insufficiency has been demonstrated in type 1 diabetes (T1D); lower concentrations of pancreatic enzymes have been associated with metabolic risk (MR). Influence of puberty and MR factors on serum concentrations of amylase and lipase remain unexplored in Indian youth with T1D. 1) To characterize and predict determinants of serum amylase and lipase concentrations in adolescents/youth with T1D.

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Introduction: Energy metabolism in type 1 diabetes (T1D) is known to be different. Resting metabolic rate (RMR) accounts for the largest portion of total energy needs. The objective of our study was to assess resting metabolic rate and its determinants in adolescents and young adults with T1D in comparison with age- and gender-matched healthy controls.

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Objectives: Geographic Information System (GIS) mapping, is a novel way to provide insights into spatial distribution of type 1 diabetes (T1D) and associations between T1D outcomes and potential predictors. We aimed to explore GIS in children with T1D, and identify predictors of poor glycemic control.

Methods: Design: Cross-sectional; Participants: 402 children and youth (187 boys) with T1D.

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Introduction: An understanding of the influence of family relationship on vitamin D concentrations could be useful in designing community-based strategies to improve vitamin D status. Hence, the aim of this study was to explore if family relationship had an impact on total serum 25-hydroxyvitamin D (25OHD) concentrations of individuals living in Pune, India.

Methods: This cross-sectional study included 104 families.

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Article Synopsis
  • - Blastomycosis is caused by fungi that can change from mold to yeast, primarily spread through inhalation of spores, often found in warm, wet soils, especially near forests and waterways.
  • - It is mostly found in Canada, particularly in Ontario and Manitoba, with Northwestern Ontario seeing high case rates; however, diagnosis can be delayed because symptoms resemble those of pneumonia or tuberculosis.
  • - Climate change might increase cases of blastomycosis due to shifts in temperature and rainfall, emphasizing the need for more research to predict its effects and improve prevention strategies.
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Background: The physical inactivity pandemic not only has a negative impact on the physical and mental health of children and youth, but it is also a key contributor to the non-communicable disease (NCD) burden, particularly among low- and middle-income countries. The widespread effects of climate change, ranging from extreme weather events to worsening air quality, are exacerbating the physical inactivity pandemic, highlighting the need to undertake holistic interventions to address environmental barriers while promoting physical activity. Despite the potential benefits of active school transportation (AST) on physical activity and the environment, no study has examined the intersection between perceptions of AST, environmental perceptions, and moderate-to-vigorous physical activity (MVPA) among children and youth in India from a child and youth perspective.

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  • BoneXpert (BX) is useful for evaluating bone age (BA) and metacarpal index (MCI) in Indian children and youth with type-1 diabetes (T1D), but its application in this group had not been previously studied.
  • A study of 1,272 T1D subjects revealed that BX can accurately assess BA, with minimal errors compared to established methods, and MCI showed a significant correlation with bone density measurements.
  • Findings indicated that over 50% of subjects exhibited decreased MCI, highlighting the importance of monitoring factors like height and vitamin D levels, as well as the negative impact of HbA1c and T1D duration on bone health.
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  • The study explored how early pregnancy affects psychological well-being and sleep quality among 325 pregnant women in urban and rural areas of Pune, India, noting a significant prevalence of distress and poor sleep.
  • Results showed that 37.5% of women experienced prenatal distress, with a higher prevalence (40%) in rural areas and a strong link between high distress and poor sleep quality.
  • Factors like rural living, low BMI, vomiting episodes, and overall poor sleep were identified as contributors to higher prenatal distress, highlighting the need for early intervention strategies to improve outcomes for mothers and infants.
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Introduction: Adolescence is a critical period for the accrual of bone mass. However, few studies have assessed the bone geometry in slum-dwelling girls/young women. We thus conducted this study: (1) to assess bone health in Indian adolescent girls and young women residing in slum vs nonslum (NS) areas and (2) to identify factors associated with poor bone health.

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Introduction: Recent evidence suggests that vitamin D deficiency and type-1 diabetes (T1D) have a bidirectional cause-effect relationship. The objective of this study is to estimate the prevalence and determinants of vitamin D deficiency in Indian children and young adults with T1D and assess the relationship between vitamin D status and their bone health.

Methods: It was a single-centre, cross-sectional study.

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Article Synopsis
  • Sarcopenia is the age-related loss of muscle mass and function, with a significant prevalence among the elderly population in India, expected to rise from 8.6% to 20% by 2050, particularly affecting those in rural areas.
  • A study assessing 745 adults (400 women) aged 40 and older in urban and rural Pune found an overall sarcopenia prevalence of 10%, higher in rural (14.8%) compared to urban (6.8%) settings, and more prevalent in men (12.5%) than women (8%).
  • Factors like older age, rural living, inadequate protein intake, and lower socioeconomic status were linked to sarcopenia, highlighting the urgent need
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Unlabelled: The double burden of malnutrition (DBM) is a significant public health issue in South and Southeast Asia (SA and SEA). This study aimed to assess the impact of using local and regional ethnicity-specific anthropometric references versus international references on the prevalence of DBM in these regions.A narrative review of DBM prevalence using local versus international standards was conducted.

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  • The study aimed to investigate the prevalence of diabetic retinopathy (DR) in Indian children and youth with type-1 diabetes (T1D) and assess the effectiveness of screening recommendations.
  • In a sample of 882 participants, the study found a DR prevalence of 6.4%, with all cases being early non-proliferative, and identified hypertension and older age as significant predictors.
  • The results indicate a need for early screening of DR in T1D patients, as the condition is present even in younger individuals, emphasizing the importance of monitoring their health closely.
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Objective: To establish age and gender-specific paediatric and adult reference data for muscle function parameters assessed using Jumping Mechanography in the Indian population.

Methods: 2056 healthy individuals (1068 males), aged 5 to 60 years, performed 2 tests on a force platform (Leonardo Mechanograph, Novotec). Maximum power (Pmax) was assessed by single two legged jump and maximum force (Fmax) by multiple one legged hopping.

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Objective: To design a specific advanced life support (ALS) tape based on recent Indian multicenter height/length and weight data to accurately estimate the weight from the recumbent length.

Methods: We designed the new ALS tape by matching the median weights to median heights/lengths from the recently published Indian multicenter growth data, maintaining the same color codes as the Broselow tape. The accuracy of weight estimation for the newly designed ALS tape was validated and compared with the Broselow estimated weights at a tertiary care hospital.

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Background: Increasing dietary diversity is a sustainable solution to combat micronutrient deficiencies. Given the large slum population in urban India, double burden of malnutrition, nutritional transition among slum-dwellers, and limited studies focusing on dietary intake and diversity among pregnant slum-dwellers, this study aimed to 1) describe macro- and micronutrient intakes and compare them with guidelines, 2) describe dietary diversity and intake of unhealthy foods and, 3) investigate the sociodemographic and lifestyle determinants of adequate dietary diversity among pregnant slum-dwellers in Pune, Maharashtra, India.

Methods: This study presents cross-sectional data of 454 pregnant slum-dwelling women completing mid-pregnancy visit collected from a larger cohort study.

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Introduction: Global surveillance of physical activity (PA) of children and adolescents with questionnaires is limited by the use of instruments developed in high-income countries (HICs) lacking sociocultural adaptation, especially in low- and middle-income countries (LMICs); under-representation of some PA domains; and omission of active play, an important source of PA. Addressing these limitations would help improve international comparisons, and facilitate the cross-fertilisation of ideas to promote PA. We aim to develop and assess the reliability and validity of the app-based Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) among 8-17 years old in 14 LMICs and HICs representing all continents; and generate the 'first available data' on active play in most participating countries.

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Introduction: A good screening tool, such as a growth chart, should distinguish between children with normal growth and those with perturbed growth. Suitability of synthetic Indian growth references for diagnosing growth-related disorders for under-five children has not been evaluated. To assess the validity of World Health Organization (WHO) 2006 standards vs synthetic Indian references (2019) (by comparing weight, height, body mass index (BMI), standard deviation scores (SDS) and the composite index of anthropometric failure (CIAF)) in differentiating normal children and children with growth-related disorders.

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Introduction: Recent evidence reveals that type 1 diabetes mellitus (T1DM) impairs muscle function (MF) in adolescents. However, despite its importance in physical well-being, data on dynamic MF in Indian children and adolescents (C and Y) with T1DM are scarce. We assessed MF using Jumping Mechanography (JM, a measurement method for motion analysis and assessment of muscle power and force).

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Introduction: Bone age (BA) assessment is important in evaluating disorders of growth and puberty; the Greulich and Pyle atlas method (GP) is most used. We aimed to determine the weightage to be attributed by raters to various segments of the hand x-ray, namely, distal end of radius-ulna (RU), carpals, and short bones for rating bone age using the GP atlas method.

Methods: 692 deidentified x-rays from a previous study (PUNE-dataset) and 400 from the Radiological Society of North America (RSNA-dataset) were included in the study.

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Introduction: Insulin resistance (IR) and obesity are common presentations of double diabetes (DD) in subjects with type-1 diabetes (T1D). There is evidence that dietary composition has an impact on developing IR. Objectives were to assess the impact of macronutrient and fibre intake on glycaemic control and the role of macronutrient composition of diet in the development of DD in subjects with T1D.

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Physical inactivity is one of the four key preventable risk factors, along with unhealthy diet, tobacco use, and alcohol consumption, underlying most noncommunicable diseases. Promoting physical activity is particularly important among children and youth, whose active living behaviours often track into adulthood. Incorporating yoga, an ancient practice that originated in India, can be a culturally-appropriate strategy to promote physical activity in India.

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Article Synopsis
  • The study investigates the effectiveness of waist-to-height ratio (WHtR) compared to waist circumference (WC) and body mass index (BMI) in identifying youths at risk for cardiometabolic issues.
  • Data from over 34,000 children and adolescents from multiple countries was analyzed, focusing on those with cardiometabolic risk factors, carotid intima-media thickness (cIMT), and arterial stiffness.
  • Results showed that WHtR, WC, and BMI performed similarly in identifying at-risk youths, with WHtR being highlighted as a simple and effective screening tool for clinical use.
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