To develop and validate a culturally appropriate measure for the diagnosis of ASD among children between 2 and 6 y of age in Kerala. This qualitative study was conducted among 200 children who were consecutively recruited over a period of 18 mo. The development of the new measure was based on the Consensus based Standards for the selection of health Measurement Instruments (COSMIN) protocol. The face and content validity were already established while developing the measure. The convergent and divergent validity of CAT-T were measured against Childhood Autism Rating Scale (CARS) and Vineland Social Maturity Scale (VSMS) respectively. The construct validity of CAT-T was evaluated using exploratory factor analysis. A 39-item measure was developed by using the 8 steps recommended for psychosocial measure development. The 39 items of the tool were subjected to factor analysis and finally a tool having 24 items was developed (CAT-T). Convergent validity of the measure with CARS (r = 0.67, p = 0.0001) and divergent validity with VSMS (r = -0.50, p = 0.0001) were moderate. The tool has good test retest reliability (ICC = 0.86), inter rater reliability (ICC = 0.89), and internal consistency of 24-item CAT-T was very high (Cronbach’s alpha = 0.86). The construct validity of CAT-T demonstrated a 7- factor structure that explained 66.22

Background: Physical inactivity is now identified as the fourth leading risk factor for global mortality. Worldwide, 80% of adolescents do not meet the recommended levels of physical activity, and a significant number spend more than two hours each day on recreational screen activities. Methods: The study was conducted among 1844 class eleven students recruited from fifteen Government/Government-aided Higher Secondary schools in Thiruvananthapuram district of Kerala, through a multistage cluster sampling. Socio-demographic information, frequency and duration of different types of physical activity, and screen-based recreational activities, as well as the participant’s awareness and perception on physical activity and screen usage was collected through a pre-validated structured self-administered questionnaire in the local language. Results: In the study about 34.1% students reported never engaging in at least ten minutes of continuous vigorous physical activity. Around 46.2% engage in vigorous activity less than three times a week. More than half (55.2%) of participants use social media for one to three hours per day. About 46.2% of participants watch television for one to three hours a day. A higher percentage of females (46.4%) reported never engaging in vigorous physical activity compared to males (10.4%). About 67% reported facing obstacles when trying to engage in physical activity. Also, even though more than half of the students were aware of many benefits of physical activity, only a third of them were aware of lifestyle diseases. Conclusion: Engagement in physical activity was low, and screen-based sedentary behaviour was high among the students. Measures to improve awareness of physical activity for lifestyle disease prevention, improve engagement in physical activity and to limit screen-based sedentary behaviour need to be implemented in schools in the state. Key words: Adolescents, Physical Activity, Screen use

Background: In the background of rising prevalence of non-communicable diseases (NCDs), the health system needಸ್ to implement preventive strategies particularly at early stages of disease development. Addressing these issues should commence in childhood, as unhealthy lifestyle practices play a significant role in influencing health outcomes from an early age. Methods: This cross sectional study was conducted among1852 class eleven students in 15 Higher Secondary Schools in Thiruvananthapuram district selected through multistage cluster sampling. Dietary practices, physical activity and screen use patterns, substance abuse, and perceived stress levels were assessed using a prevalidated questionnaire. Blood Pressure, Anthropometric measurements, and Acanthosis nigricans neck severity grading were also recorded. Results: About 25% of the students had Grade I Hypertension and 8.3% had Grade II Hypertension. Around 19% of the students were overweight, while 6.4% were obese. Around 62% of the participants reported engaging in moderate or vigorous physical activities less than three days a week. Consumption of junk foods was highly frequent among the students, with 61% reporting consumption of oil-fried snacks three or more days a week and 53.5% consuming sugary snacks three or more days a week. Fruit and vegetable consumption was low. Acanthosis nigricans (neck) was found in 26% of the students. Nearly 33% of the students had recreational screen time greater than three hours per day. Conclusion: The study results show that a major proportion of middle-late adolescents have behavioural, and physiological risk factors for NCDs, warranting strong preventive measures to be adopted at school level itself. Strategies aimed at awareness generation, increasing availability of and accessibility to healthy food and physical activity habits, as well as regular anthropometric and blood pressure screenings with follow up provisions in the schools need to be implemented.

Background and Objective: Hypertension is one of the major risk factors for Non-Communicable disease related morbidity and premature mortality worldwide. Rising levels of Non-Communicable diseases necessitate adoption of early detection of premorbid conditions and risk factors and preventive strategies in vulnerable population. The current study was aimed at assessing the prevalence and associated factors of hypertension among adolescents in Southern Kerala. Methods: For this cross-sectional study, 1852 class eleven students from fifteen selected schools in the capital district, recruited using multistage cluster sampling procedure were examined by trained medical personnel. Blood pressure, anthropometry, and lifestyle parameters were assessed. Hypertension was determined based on the latest American Academy of Pediatrics recommendations. Adjusted Odds Ratios were calculated using binary logistic regression. Results: Grade 1 Hypertension was found in 24.68% (CI: 22.7%-26.6%) and Grade 2 in 8.31% (CI: 7%-9.5%). The odds of Hypertension were higher in boys (adjusted Odds Ratio- aOR 1.62, CI:1.3-2.0), overweight students (aOR 3.45, CI: 2.71-4.39), students with lower fruit intake (aOR 1.44, CI 1.06-1.95), lower daily physical activity (aOR 1.42, CI 1.08-1.86), and those who were currently using smokeless tobacco products (aOR 3.71, CI: 1.1-12.5). Conclusion: High levels of hypertension among the students warrant concern and adoption of early screening measures in the school-level itself, with appropriate interventions including behavioral-change communication, and follow-ups. Keywords: Adolescents, Determinants, Hypertension, Kerala, Prevalence

Background: Early intervention strategies significantly improve developmental outcomes for children with autism spectrum disorders. In this background, this study was conducted to translate and validate Malayalam version of Modified Checklist for Autism in Toddlers (M-CHAT-R/F). Methods: This cross-sectional study was conducted in four steps. The original version of MCHAT-R/F was translated into Malayalam, and back translated by bilingual experts followed by pilot testing. Finally, the translated tool was administered to 100 children for evaluation of psychometric properties which included reliability and validity assessment. The statistical analysis was conducted using IBM SPSS version 25. Results: The internal consistency of the items as per parent confirmed stage of screening and flow chart interview stage of screening was 0.539 and 0.731 respectively. The level of agreement in categorizing the children according to the risk of ASD by two raters during first and second screening stage was 0.647 and 0.432 respectively. The test-retest reliability analysis showed that all the items had a moderate level of agreement between test and retest. All the items had an I-CVI more than 0.90. There was strong positive correlation between the score obtained during first stage (r: 0.562) and second stage (r: 0.529) with CARS score which indicates high convergent validity. Conclusions: The newly translated tool with high reliability and validity could enable in screening symptoms of autism among children belonging to lower age group, which would facilitate in providing appropriate intervention as early as possible.

Background: Acanthosis nigricans (AN) is a dermatologic condition that may be associated with various underlying medical conditions and is increasingly seen in obese children and adolescents. Assessing AN in adolescents is crucial as it can serve as an early indicator of underlying insulin resistance and metabolic disorders. Methods: This cross sectional study was conducted among class eleven higher secondary students in public and aided sector in Thiruvananthapuram district of Kerala. A total of 1832 students were recruited using multistage cluster sampling procedure. The participants were examined and neck grading for acanthosis was recorded. Anthropometric readings along with blood pressure, perceived stress levels, family history of diseases as well as life style habits were also evaluated. The female participants were examined for symptoms of anovulation and hyperandrogenism. Results: A total of 1832 students participated in the study of which 66% were girls and 34% were boys. About 26% were found to have AN. Prevalence of Acanthosis was higher in girls (30.3%) compared to boys (18%). Hypertension (OR: 2.83, 95% CI: 2.25-3.55), overweight or obesity (OR: 10.67, 95% CI: 8.26-13.78) and high levels of perceived stress (OR: 1.55, 95% CI: 1.05-2.30) were found to be significantly associated with acanthosis. Conclusions: The findings suggest that AN neck grading can serve as a useful tool for non-communicable disease screening in schools, enabling the identification of students who may require further evaluation and intervention.

ObjectivesBringing up a youngster with Autism Spectrum Disorders (ASD) is a multifaceted issue with major changes in family dynamics. Parents experience great distress and feel anxious or sad throughout the diagnostic process and the time after the diagnosis. There are very few studies on the aspect of grief in parents of children with ASD. Hence an attempt was made to do a systematic review of the available literature to assess the prevalence and pattern of grief among parents of children with autism spectrum disorder.MethodsA systematic review of available literature was done up to November 2021. The data was extracted from the literature by two independent observers and any conflict was resolved by a third person.ResultsThe two predominant disorders seen in these parents are grief and distress. The emotions usually described are the sense of loss leading to pain, parental expectations being put into peril, shock, turmoil, and a feeling of helplessness in family members after hearing the diagnosis.ConclusionsA literature search has revealed a huge lacuna in studies related to the feelings of grief experienced by the caregivers of autistic children. Emotional stability and coping of the parents are highly essential not only for the rehabilitation of the child but also to make an improvement in the quality of life of the parents. The primary caregivers of children in the spectrum suffer very powerful and incessant emotions of sadness and grief. The feelings of mothers and fathers of children with autism from recent studies include an unexpected sense of losing a child along with shock, denial, fearfulness, guilt, rage, and/or sorrow. Two most common affective reactions of these parents were grief ("chronic sorrow" or "nonfinite grief") and distress. The maternal experience of grief was found to be more especially in children with recent diagnoses of autism.

Justification Neurodevelopmental disorders, as per DSM-V, are described as a group of conditions with onset in the development period of childhood. There is a need to distinguish the process of habilitation and rehabilitation, especially in a developing country like India, and define the roles of all stakeholders to reduce the burden of neurodevelopmental disorders. Process Subject experts and members of Indian Academy of Pediatrics (IAP) Chapter of Neurodevelopmental Pediatrics, who reviewed the literature on the topic, developed key questions and prepared the first draft on guidelines. The guidelines were then discussed by the whole group through online meetings, and the contentious issues were discussed until a general consensus was arrived at. Following this, the final guidelines were drafted by the writing group and approved by all contributors. Objectives These guidelines aim to provide practical clinical guidelines for pediatricians on the prevention, early diagnosis and management of neurodevelopmental disorders (NDDs) in the Indian settings. It also defines the roles of developmental pediatricians and development nurse counselor. Statement There is a need for nationwide studies with representative sampling on epidemiology of babies with early NDD in the first 1000 days in India. Specific learning disability (SLD) has been documented as the most common NDD after 6 years in India, and special efforts should be made to establish the epidemiology of infants and toddlers at risk for SLD, where ever measures are available. Preconception counseling as part of focusing on first 1000 days; Promoting efforts to organize systematic training programs in Newborn Resuscitation Program (NRP); Lactation management; Developmental follow-up and Early stimulation for SNCU/NICU graduates; Risk stratification of NICU graduates, Newborn Screening; Counseling parents; Screening for developmental delay by trained professionals using simple validated Indian screening tools at 4, 8, 12, 18 and 24 months; Holistic assessment of 10 NDDs at child developmental clinics (CDCs)/district early intervention centre (DEICs) by multidisciplinary team members; Confirmation of diagnosis by developmental pediatrician/developmental neurologist/child psychiatrist using clinical/diagnostic tools; Providing parent guided low intensity multimodal therapies before 3 years age as a center-based or home-based or community-based rehabilitation; Developmental pediatrician to seek guidance of pediatric neurologist, geneticist, child psychiatrist, physiatrist, and other specialists, when necessary; and Need to promote ongoing academic programs in clinical child development for capacity building of community based therapies, are the chief recommendations.

Background: Specific learning disorders (SLD) comprise varied conditions with ongoing problems in one of the three areas of educational skills-reading, writing, and arithmetic-which are essential for the learning process. There is a dearth of systematic reviews focused exclusively on the prevalence of SLD in India. Hence, this study was done to estimate the prevalence of SLD in Indian children. Methods: A systematic search of electronic databases of MEDLINE, Embase, PsycINFO, and CINAHL was conducted. Two authors independently assessed the eligibility of the full-text articles. The third author reassessed all selected studies. A standardized data extraction form was developed and piloted. The pooled prevalence of SLDs was estimated from the reported prevalence of eligible studies, using the random-effects model. Results: Six studies of the systematic review included the diagnostic screening of 8133 children. The random-effects meta-analysis showed that the overall pooled prevalence of SLD in India was 8% (95% CI = 4-11). The tools used to diagnose SLD in the studies were the National Institute of Mental Health and Neurosciences (NIMHANS)-SLD index and the Grade Level Assessment Device (GLAD). Conclusions: Nearly 8% of children up to 19 years have SLD. There are only a few high-quality, methodologically sound, population-based epidemiological studies on this topic. There is a pressing need to have large population-based surveys in India, using appropriate screening and diagnostic tools. Constructing standardized assessment tools, keeping in view the diversity of Indian culture, is also necessary.

Objectives To develop a tool to assess pre-writing skills of 2-5 y old children in India. Methods The tool development process followed the recommendations by Fitzpatrick et al. and the Consensus based Standards for the selection of health Measurement Instruments (COSMIN), and included 4 phases. In Phase I, an initial 35-item draft tool was developed by an expert panel for the tool-development. In Phase II, the 35-item draft tool was prevalidated through peer and expert reviews, pilot-study to assess the tool-comprehensibility, and assessment of test-retest and inter-rater reliability. In Phase III, the 35-item draft tool was administered on the 575 typically developing children aged 2-5 y, recruited from rural, urban, slum, and coastal areas through stratified random sampling. In Phase IV, the normative age-range for development of each item was generated by calculating the age-percentiles (10 th , 25 th , 50 th , 75 th , 90 th ). Factor analysis and item reduction was done for items in 2-3, 3-4, and 4-5 y age-groups. The final tool was converted to graphic format with 10 th -90 th age-percentile bars. Results The final tool had 26 items with a three-factor structure. Cronbach’s alpha was within acceptable limits for all three age-groups (0.723, 0.778, and 0.823 in 2-3 y, 3-4 y, and 4-5 y respectively). Kappa coefficients of the items ranged from 0.6-1 in interrater reliability and 0.64-1 test-retest reliability analysis reflecting substantial agreement between ratings. Conclusions A 26-item screening tool “Prewriting skills Assessment Tool” (PAT) to assess writing readiness of 2-5 y old children was developed. Tool reliability and construct validity have been established.

Introduction: Language is a fundamental skill and a foundation stone for multiple cognitive and socio-emotional aspects of development. Considering that well-developed language abilities enable children to negotiate the social-relational demands of school life and provide the foundational knowledge upon which academic skills are built, there is a higher chance of scholastic difficulties, social and, behavioural and emotional maladjustments resulting in poor mental health in those who have language delay. Methods: An ambispective study conducted at a tertiary centre after taking ethical approval from the institutional review board. Children with isolated early language delay were reassessed at school age for intelligence quotient, language development, adaptive behaviours and behavioural issues. Results: out of 57 children, persistence of poor language skills was seen in 65%, mean IQ score was 90 ( ± 17. 067) and mean VABS score was 94 ( ± 15). 61.4% children had significant behavioural issues. On interview, most worrisome issue reported by children was ‘being teased by friends’ due to poor language skills. Additionally, lower social competence level was noted in children who had poor language skills. Conclusions: persistence of language, cognitive and behavioural dysfunctions in children with seemingly benign ‘speech and language delay’ at an early age, emphasizes the importance of comprehensive reassessment of these children at school age for early recognition and management.

Background Low birth weight (LBW) is susceptible to neonatal complications, chronic medical conditions, and neurodevelopmental disabilities. We aim to describe the determinants of very low birth weight (VLBW) in India and compare it with the determinants of LBW based on the National Family Health Survey – 4 (NHFS-4) Methods Data from the NFHS-4 on birthweight and other socio-demographic characteristics for the youngest child born in the family during the five years preceding the survey were used. Data of 147,762 infant–mother pairs were included. Multiple logistic regression models were employed to delineate the independent predictors of VLBW (birth weight<1500 g) or LBW (birth weight: 1500-2499 g). Results Of the 147,762 children included in the study, VLBW and LBW were observed in 1.2% and 15.8% of children, respectively. The odds of VLBW were higher in female children (aOR: 1.36, 95% CI: 1.15–1.60), among mothers aged 13–19 years (aOR: 1.58, 95% CI: 1.22–2.07), mothers with severe or moderate anaemia (aOR: 1.61, 95% CI: 1.34–1.94), mothers without recommended antenatal care (aOR: 1.47, 95% CI: 1.31–1.90), maternal height less than 150 cm (aOR: 1.54, 95% CI: 1.29–1.85) and among mothers with multiple pregnancy (aOR: 21.34, 95% CI: 14.70–30.96) in comparison to their corresponding counterparts. In addition to the variables associated with VLBW, educational status of mothers (no education; aOR: 1.08, 95% CI: 1.02–1.15 and primary education; aOR: 1.16, 95% CI: 1.08–1.25), caste of the children (scheduled tribe; aOR: 1.13, 95% CI: 1.03–1.24), and wealthiness of the family (poorest wealth quintiles; aOR: 1.11, 95% CI: 1.03–1.19) were associated with LBW. Conclusions Interventions targeting improvements in antenatal care access, maternal health, and nutritional status may reduce the number of VLBW infants. Social determinants of LBW require further detailed study to understand the high propensity of low birth-weight phenotypes in the disadvantaged communities in India.

There is a dearth of validated red flags measures for early identification of autism spectrum disorder (ASD) among toddlers. Hence, a new screening measure was developed. Item generation was done through literature search. Content validity (CVI) assessment was done. Criterion validity was done using Diagnostic and Statistical Manual 5 (DSM-5) as reference standard, data were collected from the case records of children with ASD diagnosis at 2 y, and evaluated for developmental milestones between 12 and 18 mo in a tertiary care setting. Item reduction of the measure from 18 to 9 was done. The area under the curve in the receiver operating characteristic (ROC) curve for new measure was 0.81 (95% CI = 0.73, 0.87); z = 7.874; p < 0.001 against DSM-5 score of ≥ 2 in the new measure; achieved sensitivity of 93.42% (95% CI = 85.3, 97.8) and specificity of 60% (95% CI = 45.9, 73.0). Thus, new validated red flag sign card (Concern-9) can be used effectively for early screening and identification of ASD among children aged 12–18 mo.

: This study has been undertaken to investigate postpartum depression among the postnatal mothers in selected hospital at Jabalpur. Postpartum depression (PPD) ,also called postnatal depression ,is a type of mood disorder associated with child birth which can affect both sex, symptom may include extreme sadness , low energy anxiety ,changes in sleeping or eating pattern ,crying episodes and irritability

Background Low birth weight (LBW) is susceptible to neonatal complications, chronic medical conditions, and neurodevelopmental disabilities. We aim to describe the determinants of very low birth weight (VLBW) in India and compare it with the determinants of LBW based on the National Family Health Survey – 4 (NHFS-4) Methods Data from the NFHS-4 on birthweight and other socio-demographic characteristics for the youngest child born in the family during the five years preceding the survey were used. Data of 147,762 infant–mother pairs were included. Multiple logistic regression models were employed to delineate the independent predictors of VLBW (birth weight<1500 g) or LBW (birth weight: 1500-2499 g). Results Of the 147,762 children included in the study, VLBW and LBW were observed in 1.2% and 15.8% of children, respectively. The odds of VLBW were higher in female children (aOR: 1.36, 95% CI: 1.15–1.60), among mothers aged 13–19 years (aOR: 1.58, 95% CI: 1.22–2.07), mothers with severe or moderate anaemia (aOR: 1.61, 95% CI: 1.34–1.94), mothers without recommended antenatal care (aOR: 1.47, 95% CI: 1.31–1.90), maternal height less than 150 cm (aOR: 1.54, 95% CI: 1.29–1.85) and among mothers with multiple pregnancy (aOR: 21.34, 95% CI: 14.70–30.96) in comparison to their corresponding counterparts. In addition to the variables associated with VLBW, educational status of mothers (no education; aOR: 1.08, 95% CI: 1.02–1.15 and primary education; aOR: 1.16, 95% CI: 1.08–1.25), caste of the children (scheduled tribe; aOR: 1.13, 95% CI: 1.03–1.24), and wealthiness of the family (poorest wealth quintiles; aOR: 1.11, 95% CI: 1.03–1.19) were associated with LBW. Conclusions Interventions targeting improvements in antenatal care access, maternal health, and nutritional status may reduce the number of VLBW infants. Social determinants of LBW require further detailed study to understand the high propensity of low birth-weight phenotypes in the disadvantaged communities in India.

OBJECTIVE We aimed to determine a possible association between motor and mental development in infants of women with epilepsy and antenatal exposure to antiseizure medication (ASM). METHODS Developmental paediatricians who were blinded to antenatal ASM exposure evaluated motor and mental development of infants (>12 months) using the Developmental Assessment Scale for Indian Infants (an Indian adaptation of the Bayley Scale of Infant Development). Motor (MODQ) and mental development quotients (MEDQ) were computed as ratios of respective developmental age to the chronological age of the child. We employed linear mixed models to study the relationship between antenatal exposure to ASM and the development quotients after adjustment for malformation status and age of the baby, maternal education and seizure type. RESULTS We studied 1,357 infants with mean age of 15.3±4.0 months (71.2% of all eligible infants). Infants were classified as having monotherapy or polytherapy, or unexposed in 840, 407 and 110 participants, respectively. The MEDQ of the polytherapy (92.9±14.9) and monotherapy (96.9±13.9) groups was lower than that of unexposed infants (99.8±12.5). Similarly, the MODQ of polytherapy (91.1±19.3) and monotherapy (96.6±17.5) groups was lower than that of unexposed infants (97.6±16.6). The differences in adjusted mean MEDQ were -7.4 (-11.4 to -4.3, p=0.001), -9.6 (-11.3 to -6.0, p=0.001) and -6.4 (-9.2 to -3.7, p=0.001) for valproate monotherapy, polytherapy with valproate and polytherapy without valproate, respectively. The adjusted mean MODQ also showed a similar trend. Those exposed to levetiracetam (n=62) had higher or similar adjusted MODQ (110.4±14.3; p=0.001) and MEDQ (104.3±9.1; p=0.09), compared to unexposed infants. A dose-dependent decrease in developmental indicators was observed for valproate and phenobarbitone. SIGNIFICANCE Antenatal exposure to ASM, especially valproate and phenobarbitone, adversely affects motor and mental development of exposed infants. Early developmental screening of high-risk infants is desirable.

Background: Menstrual problems are common among adolescent girls which can affect their daily routine and quality of life. Early detection and intervention for the menstrual problems can improve future reproductive health. Aims: To nd the prevalence and type of menstrual disorders, premenstrual syndrome and premenstrual dysphoric disorder among adolescents in the primary care setting. This was a community based cross sectional survey done covering Materials and methods: the whole of Thiruvananthapuram district, Kerala..Anganwadis were the primary data collecting units, selected by systematic random sampling. Data was collected using pretested structured questionnaire and validated premenstrual symptoms screening tool. Mean, standard deviation and simple percentage were used. Chi square test was used for nding associations and signicance level. P value <0.05 was taken as signicant. The most common reported Results: problems during menstruation were dysmenorrhoea (73.6%), moderate to severe premenstrual syndrome (13.5%), oligomenorrhoea (12.5%), menorrhagia (8.4%) and premenstrual dysphoric disorder (6.2%).The prevalence of menstrual problems increased as the age increased Conclusions: Majority of adolescents suffer from one or other menstrual problem which can affect their academic and social life. It can also affect their future reproductive health. So school health programs should give emphasis on adolescent menstrual health for a healthy future generation.

Background: Polycystic Ovary Syndrome is a common endocrine problem with a heterogenous clinical picture. Early identication is essential to prevent metabolic problems and infertility. To estimate the prevalence of Objective: Polycystic Ovary Syndrome and depict the clinical prole of young adults (18-24 years) with Polycystic Ovary syndrome. A cross- Methods: sectional study of all the nursing students aged 18-24 years in Thiruvananthapuram District was conducted to self-screen for Polycystic Ovary Syndrome and Rotterdam criteria were applied. The study group comprised 529 subjects who were diagnosed to have the syndrome. The clinical and ultrasonographic characteristics and anthropometric variables of the study group were estimated and compared with 399 young adults without Polycystic Ovary Syndrome. Variables were expressed in terms of frequenci Statistical Analyses: es for categorical and mean (± SD) for continuous variables. Chi-square test was used for categorical and t- test for continuous variables. The prevalence of Polycystic Ovary Results: Syndrome was 13.1%. Irregular periods was seen in 74.7%, hirsutism in 57.1%, acne in 37.1%, acanthosis nigricans in 51% and alopecia in 2.5%. Overweight and obesity were found in 30.8%, increased waist circumference in 16.1% and hypertension in 27.8%. Polycystic Conclusion: Ovary Syndrome is a clinically heterogenous condition with an increased prevalence of irregular periods, hirsutism, acne and acanthosis. Overweight and obesity are signicantly increased. A younger age group of late adolescents or young adults is ideal to screen for the syndrome and institute lifestyle intervention to prevent metabolic problems.

Background: Overweight and obesity among adolescents and children are associated with early onset of non-communicable diseases and greater risk of complications in adulthood. The study was conceived in the background of the high burden on adult non-communicable diseases in the state, to assess the prevalence and determinants of overweight and obesity among higher secondary students in one of its fourteen districts, with a view to explore the areas to be focused in preventive activities.Methods: Anthropometric, blood pressure, and physical examination of 1846 class plus one students were conducted in Thiruvananthapuram. Lifestyle assessment of the children was also conducted using a self-administered prevalidated questionnaire. Prevalence of overweight and obesity was calculated based on Indian academy of pediatrics body mass index cut-offs. Logistic regression analysis was done to discover factors associated with overweight conditions.Results: Among the students, 14.19% were overweight; 6.45% were obese. Boys, rural residents, and those from low socioeconomic background had lower odds of being overweight. Students who had main meal (s) from outside on three or more days a week (adjusted odds ratio 1.99; CI: 1.17-3.386), and with history of hypercholesterolemia (adjusted odds ratios (aOR) 1.8; CI: 1.19-2.63), obesity (aOR 1.6; CI: 1.11-2.23), or diabetes (aOR 1.5; CI: 1.17-1.95) in the immediate-family had higher odds of being overweight. Hypertension and acanthosis were significantly higher among overweight students (p=0.001).Conclusions: The results warrant the adoption of screening and timely intervention for non-communicable disease risk factors from school level itself to reduce future morbidity and the risk of complications.