Stage 2: Scrotum slightly
enlarged, with skin reddened and changed in texture.
Stage 3: Penis slightly
enlarged, mainly in length and a smaller increase in breadth.
Scrotum further enlarged than in Stage 2.
Stage4: Penis further enlarged
with growth in length and breadth and development of glans.
Scrotum further enlarged than in Stage 3: scrotal skin darker
than n earlier Stages
Stage 5: Genitalia adult
in size and shape.
Breast development Stage in girls was rated as follows 2
Stage 1: Infantile Stage
Stage 2: Breast bud Stage, elevation of breast and
papilla as small mound. Diameter of areola is increased.
Stage 3: Breast and areola
both enlarged with a continuous rounded contour.
Stage 4: The areola and
papilla are further enlarged and form a secondary mound projecting
above the corpus of the breast.
Stage 5: Adult Stage with
smooth rounded contour, the secondary mound present in Stage
4 having disappeared.
This component of the study was cross-sectional and was
carried out by 3 centres viz. Vellore, Jabalpur and Delhi.
The Tanner TW -2 method 3 was used for rating of skeletal
maturity. X-ray of the left hand of the child was taken in
such a manner that each child was exposed only once during
the study period. For each child a total skeletal maturity
score for the left hand and wrist was assigned by a radiologist
as (1) RUS bone score (2) Carpal bone score and (3) TW -20
The anthropometry of somatic growth involves the subject,
instrument and observer in an interactive situation that needs
to be standardized. The individual is dynamic, constantly
changing and cannot be remeasured after six months to check
old measurements. All efforts were made to observe the children
at pre-scheduled age points. All instruments were standardized.
Adequate measures were taken to maintain uniformity in information
generation and data collection. Data was recorded on uniform
pre coded proformae at all centres, All research workers were
given training at the same time at one place. Before initiating
the actual data collection workshops were organized at Jabalpur