Thyroid gland is located in the neck and synthesize thyroid hormones, which have an indispensable role in the metabolic functions of the body. Iodine is an essential compound for the synthesis of thyroid hormones and is mostly derived from the environment. Other important nutrients for the thyroid function include selenium, iron, Zinc and vitamin A. Dietary alterations of the micronutrients lead to structural and functional alterations in thyroid function. The alternative medical practitioners and nutritionists advocate plenty of dietary modifications without a scientific rationale. In this article, we review the role of dietary micronutrients in thyroid physiology and dispel few myths surrounding the same topic.

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Among cations of biologic importance, Magnesium (Mg) is the forgotten member, often labeled as "fifth electrolyte" and sometimes even as the body's 'orphan ion', because of an apparent lack of a specific endocrine control. Magnesium is an important co-factor in many enzymatic reactions involving energy metabolism, protein and nucleic acid synthesis. Ionized Mg is the physiologically active form of the element. It has been mentioned in various epidemiological and correlation studies that low Magnesium status is widely prevalent. Data from many studies indicate that in about 60% of adults the Magnesium intakes from food do not meet the estimated average requirement. Recommended dietary allowance especially for Indians are still undefined.

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There have been many nutritional aspects in diagnostic radiology, which have always been of interest to the clinicians as well as to the patients. Some of the important nutrition-related aspects in radiological investigations are discussed here.

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Background: Infant feeding and complementary feeding practices are the determinants of growth and development. Inadequate nutrition contributes substantially to childhood death and disease. Restriction of diet during common childhood illnesses further compromises the nutritional status of the child. Objectives: The present study aims to determine the beliefs and practices among rural caregivers regarding diet during common childhood illnesses. Materials and Methods: A cross-sectional study was conducted at pediatrics department of Pravara Rural Hospital, Loni from April to June 2012 by interviewing 200 caregivers of ill children. A pre-designed and pre-tested questionnaire, which based on the beliefs and practices regarding dietary pattern in common childhood illnesses, was used to collect the data. Results were analyzed in the form of percentage and proportions whenever appropriate. Results: In this study, caregivers believed that a child must be fed less during illness. Majority (89%) believed that curd should be restricted during measles, and 69% and 72% believed that oily foods should be restricted during jaundice and fever, respectively. Feeding the child with khichadi (81.5%) was most preferred during measles, while banana (95%) was preferred food during diarrhea. About 32% preferred thinner consistency of food, and 21% believed that the breastfeeding should be decreased during illness. Conclusion: There is scope of improving feeding practices and to remove misbelieves among few caregivers. Health workers should educate elderly caregivers and mothers about the same.

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Hypoglycemia is most commonly caused by drugs used to treat diabetes mellitus or by exposure to other drugs, including alcohol. Diverse neurologic manifestations of hypoglycemia have been reported frequently. These neurologic symptoms range from focal neurologic deficits to permanent dysfunction or death. Here, we report a case of prolonged hypoglycemia in an alcoholic who was unconscious and in whom there were reversible changes on magnetic resonance imaging.

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Context: Conjunctival Imprint cytology is widely used to detect vitamin A deficiency in field studies. Vitamin A deficiency is known to be associated with malignancies. Aims: To assess the vitamin-A status in cancer patients using conjunctival impression cytology technique (CICT) and to correlate the results with serum levels of the vitamin. Settings and Design: To study CICT in freshly detected cancer patients. To compare with normal controls, and to correlate the results obtained by the cytology technique with a serum retinol by HPLC method. Materials and Methods: Patients and their family members accompanying the patients were taken as subjects for the study and after an informed consent. Conjunctival imprint cytology samples and venous blood for serum retinol were collected from both groups. Statistical Analysis Used: Odds ratio, Pearson Chi-square test, Fisher exact test, analysis of variable, independent and dependent sample t test, mean and standard deviation. Data: Of 1551 subjects analyzed, vitamin A level < 20 mcg/dl was observed in 395 subjects; 322 (81.5%) were patients and 73 (19.5%) were controls (P < 0.001). CICT grades ≥ 2 was found in 357 subjects including 285 (79.8%) patients and 72 (20.2%) controls (P < 0.001). CICT had sensitivity 93.0%, specificity of 95.6%, positive predictive value 86.1%, negative predictive value 92.9%, Cohen's kappa value 0.74, and P < 0.001. Conclusions: CICT is a reliable technique to detect vitamin A deficiency in cancer patients.

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Background: In Pakistan, poor infant and young child feeding practices are contributing to the burden of infectious diseases and malnutrition. Objective: This study aimed to estimate the determinants of selected feeding practices and key indicators of breastfeeding in Pakistan. Materials and Methods: Total 5718 children aged 0 to 23 months from the Pakistan Demographic and Health Survey of 2006-2007 were included. WHO recommended infant and young child feeding indicators were estimated, and selected feeding indicators were examined against a set of individual-, household-, and community-level variables using univariate and multivariate analyses. Results: Only 26.3% of mothers initiated breastfeeding within the first hour after birth, 97.6% had ever breastfed, 92.5% were currently breastfeeding, and 62.7% were currently bottle feeding. Bottle feeding rates were higher among infants whose mothers partner had worked (OR = 1.66), had ever been employed (OR = 1.17), birth order > 5 (OR = 1.25) and in the Richest wealth quintiles (OR for the richest = 2.34). The likelihood of not initiating breastfeeding within first hour after birth was higher for mothers those who were not visited to the antenatal clinic (OR = 1.54), no post natal visits (OR = 1.45), working mother (OR = 1.76), delivery at facility based centre (OR = 1.95), richer households (OR = 1.77), birth order > 5 (OR = 1.67), and formally married women (OR = 2.31). Conclusions: Breastfeeding practice indicators suggest that there is need for promotion of correct/recommended breastfeeding practices in the community. Breast feeding promotion should targeted those women who have younger age and working in the urban areas.

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Background: With the advent of highly active antiretroviral therapy (HAART) metabolic abnormalities such as dyslipidaemia, changes in fat distribution and insulin resistance have been observed with increasing frequency in patients with Human Immunodeficiency Virus (HIV) infection. Aims: This study was undertaken to (i) assess body composition and the metabolic effects of HAART in HIV infected patients and (ii) compare the above variables between different 1 ^st and 2 ^nd ART regimens of National AIDS Control Organization of India. Methods and Material: 201 HIV patients receiving HAART for more than 3 months were studied. Body mass composition was measured using TANITA segmental body composition monitor. The metabolic parameters measured included blood glucose, serum cholesterol and serum triglycerides. Results: Lipodystrophy was observed in 21.40% patients. The mean body mass index (BMI) was 18.24 ± 3.18 and mean visceral fat mass was 4.16 kg. Altered lipid profile was observed in 26.86% patients (25.55% on 1 ^st line and 38.09% on 2 ^nd line) and impaired glucose tolerance was seen in 7.96% (6.66% on 1 ^st line and 19.04% on 2 ^nd line). Conclusions: HAART has significant effect on the body mass composition and metabolic parameters.

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This review forms part of a series on Eponyms in Medical Nutrition and Nutraceuticals. The Ketogenic Diet (KD), a therapeutic diet for seizure control in intractable epilepsy, works on the principle of producing ketones as the body's main energy source as opposed to glucose by means of a high fat diet with limited protein and minimal carbohydrate (CHO). A >90% reduction in seizure frequency ranging from 31% to 86% has been recorded in patients following the KD for 3 months and >6 years respectively. Short- and long-term side effects include dehydration, kidney stones, and restricted growth with 82% of children following the KD for >6 years being under the 10 ^th centile for height and weight. Side effects of the KD must be weighed up against benefits in terms of quality of life gained through reduction in seizures.

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Context: Adolescence is a period of transition and is associated with the risk of many nutrition and health-related problems. Teachers and grass root level health service providers i.e., multi-purpose health workers, being the key stakeholders, are expected to provide them nutrition and health guidance. Aims: To assess nutrition and health guidance to adolescents by their school teachers and multipurpose health workers. Settings and Design: It was a cross-sectional study conducted in rural block in the field practice area attached to Department of Community Medicine, Pt BD Sharma PGIMS Rohtak (India). Materials and Methods: All the multipurpose health workers (males and females) [i.e., MPHW (M and F)] who were working in the study area i.e., those posted at the sub-centers, Primary Health Centers, or Community Health Centers for more than 6 months were included in the study. For selecting the teachers, 4 large schools with strength of more than 250 students (2 Girls and 2 Boys Senior Secondary Schools) were randomly selected by simple random sampling. All the teachers who were teaching the standards 9 to 12 in those schools were also enrolled in the study. Thus, the study population comprised of 49 and 94 such workers and teachers, respectively. Data were collected with the help of predesigned, pre-tested, and semi-structured schedules by interviewing the study subjects. Statistical Analysis Used: Proportions, chi square test, Fisher exact test Results and Conclusion: Only 58/94 (61.7%) and 40/94 (42.6%) teachers stated to have provided guidance on "substance abuse" and "HIV/AIDS/STDs/RTIs/Menstrual hygiene," respectively. Surprisingly, 35/49 (71.4%) workers provided guidance on nutrition and anemia to the adolescents, whereas only 10/49 (20.4%) and 11/49 (22.4%) workers provided the guidance on substance abuse and HIV/AIDS/STDs/RTIs/Menstrual hygiene, respectively.

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This review forms part of a series on Eponyms in Medical Nutrition and Nutraceuticals. The Atkins Diet (AD) commercial weight loss program works on the principle of producing ketones as the body's main energy source as opposed to glucose by means of a diet high in protein and fat and very low in carbohydrate (CHO). In terms of weight loss, the AD has proved more effective than a high CHO/low fat diet in the short term with both diets demonstrating similar weight loss at 12 months. Habitual concerns regarding the effect of the AD on bone and cardiovascular health appear to be unfounded although high-quality randomized-controlled trials (RCTs) are limited. The AD is contraindicated in patients with chronic kidney disease (CKD) although evidence does not indicate a negative effect on kidney function in healthy populations.

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