Introduction: Congenital malformations are important contributors for neonatal and infant mortality after prematurity, intrapartum complications and infections. Aim: To find out the prevalence and ...pattern of congenital malformations among the live born neonates in study area as well as to identify the associated risk factors. Materials and Methods: This descriptive hospital based cross- sectional study was carried out in 305 cases at Midnapore Medical College, Medinipur, West Bengal, from July 2016 to June 2017. All live inborn neonates were assessed for the presence of any malformation(s). The still born or out born babies were excluded. Congenital malformations were diagnosed by clinical examination as well as imaging studies. Data regarding risk factors were collected from the history and the case records. Chi-square test was done to find out the significance of the risk factors. Results: During the study period, there were 14240 live births, out of which 305 cases of congenital malformations were noted. Prevalence of congenital malformations was 214.1 per 10,000 live births or 2.14%. Out of 305 cases, 165 (54.10%) were males, 137 (44.92%) were females, and 3 (0.98%) had ambiguous genitalia. Prevalence of malformations was not significantly different between primi and multipara mothers, and for the different socio-economic backgrounds. A higher prevalence of congenital malformations in mothers above 30 years, consanguinity, low birth weight and prematurity were observed. History of abortion and still birth were associated with higher prevalence. Polyhydramnios, pregnancy induced hypertension and previous abortion and still birth were also associated with higher prevalence of malformations. Musculoskeletal system was majorly involved in 92 (30.16%) cases, followed by central nervous system 48 (15.74%). Conclusion: Prevalence of congenital malformations was found to be 214.1 per 10,000 live births or 2.14%. Maternal age >30, consanguinity, prematurity and low birth weight were associated with increased prevalence of congenital malformations. Musculoskeletal system was the most commonly involved system.
Vaccination being the only way to reduce mortality from the dreaded COVID-19 disease, the vaccine was introduced in India as per the advice of the National Expert Group on January 16, 2021. Duration ...of immune response elicited by the vaccines has always been a matter of content. With new variants emerging every other day, the study was done to look for the antibody response in vaccine recipients post second dose of vaccination.
A longitudinal observational study was conducted from August 2021 to February 2022 in fully vaccinated individuals who took either Covishield (AZD1222) or Covaxin (BBV-152). Blood was collected from the individuals at 12-16 weeks post-vaccination to look for IgG antibody response against S1 spike protein of SARS-CoV2 by ELISA. Follow-up was done at 32 weeks post the second dose in individuals who had received Covishield.
Among 176 individuals, IgG antibody against S1 spike protein was found to be positive in 89.7% (158). Covishield recipients showed higher antibody response (99.1%) as compared to Covaxin recipients (71%). Antibody response was higher in males, individuals less than 50 years, and non-comorbid individuals. Of 38 Covishield recipients, IgG antibody response was positive in 28 (73.6%) individuals when followed up at 32 weeks post the second vaccination dose.
The study gives us input with regard to the long-term antibody kinetics of both vaccines. The study has a follow-up plan to co-relate the antibody response to the neutralization test.
We describe a rare haematological complication of pulmonary thromboembolism in a scrub typhus infection. There are very few case reports on scrub typhus infection causing deep venous thrombosis. ...Vasculitis and perivasculitis with endothelial dysfunction could be considered as the main pathologic mechanism causing this complication.
Artemisinin and partner-drug resistance in Plasmodium falciparum are major threats to malaria control and elimination. Triple artemisinin-based combination therapies (TACTs), which combine existing ...co-formulated ACTs with a second partner drug that is slowly eliminated, might provide effective treatment and delay emergence of antimalarial drug resistance.
In this multicentre, open-label, randomised trial, we recruited patients with uncomplicated P falciparum malaria at 18 hospitals and health clinics in eight countries. Eligible patients were aged 2–65 years, with acute, uncomplicated P falciparum malaria alone or mixed with non-falciparum species, and a temperature of 37·5°C or higher, or a history of fever in the past 24 h. Patients were randomly assigned (1:1) to one of two treatments using block randomisation, depending on their location: in Thailand, Cambodia, Vietnam, and Myanmar patients were assigned to either dihydroartemisinin–piperaquine or dihydroartemisinin–piperaquine plus mefloquine; at three sites in Cambodia they were assigned to either artesunate–mefloquine or dihydroartemisinin–piperaquine plus mefloquine; and in Laos, Myanmar, Bangladesh, India, and the Democratic Republic of the Congo they were assigned to either artemether–lumefantrine or artemether–lumefantrine plus amodiaquine. All drugs were administered orally and doses varied by drug combination and site. Patients were followed-up weekly for 42 days. The primary endpoint was efficacy, defined by 42-day PCR-corrected adequate clinical and parasitological response. Primary analysis was by intention to treat. A detailed assessment of safety and tolerability of the study drugs was done in all patients randomly assigned to treatment. This study is registered at ClinicalTrials.gov, NCT02453308, and is complete.
Between Aug 7, 2015, and Feb 8, 2018, 1100 patients were given either dihydroartemisinin–piperaquine (183 17%), dihydroartemisinin–piperaquine plus mefloquine (269 24%), artesunate–mefloquine (73 7%), artemether–lumefantrine (289 26%), or artemether–lumefantrine plus amodiaquine (286 26%). The median age was 23 years (IQR 13 to 34) and 854 (78%) of 1100 patients were male. In Cambodia, Thailand, and Vietnam the 42-day PCR-corrected efficacy after dihydroartemisinin–piperaquine plus mefloquine was 98% (149 of 152; 95% CI 94 to 100) and after dihydroartemisinin–piperaquine was 48% (67 of 141; 95% CI 39 to 56; risk difference 51%, 95% CI 42 to 59; p<0·0001). Efficacy of dihydroartemisinin–piperaquine plus mefloquine in the three sites in Myanmar was 91% (42 of 46; 95% CI 79 to 98) versus 100% (42 of 42; 95% CI 92 to 100) after dihydroartemisinin–piperaquine (risk difference 9%, 95% CI 1 to 17; p=0·12). The 42-day PCR corrected efficacy of dihydroartemisinin–piperaquine plus mefloquine (96% 68 of 71; 95% CI 88 to 99) was non-inferior to that of artesunate–mefloquine (95% 69 of 73; 95% CI 87 to 99) in three sites in Cambodia (risk difference 1%; 95% CI −6 to 8; p=1·00). The overall 42-day PCR-corrected efficacy of artemether–lumefantrine plus amodiaquine (98% 281 of 286; 95% CI 97 to 99) was similar to that of artemether–lumefantrine (97% 279 of 289; 95% CI 94 to 98; risk difference 2%, 95% CI −1 to 4; p=0·30). Both TACTs were well tolerated, although early vomiting (within 1 h) was more frequent after dihydroartemisinin–piperaquine plus mefloquine (30 3·8% of 794) than after dihydroartemisinin–piperaquine (eight 1·5% of 543; p=0·012). Vomiting after artemether–lumefantrine plus amodiaquine (22 1·3% of 1703) and artemether–lumefantrine (11 0·6% of 1721) was infrequent. Adding amodiaquine to artemether–lumefantrine extended the electrocardiogram corrected QT interval (mean increase at 52 h compared with baseline of 8·8 ms SD 18·6 vs 0·9 ms 16·1; p<0·01) but adding mefloquine to dihydroartemisinin–piperaquine did not (mean increase of 22·1 ms SD 19·2 for dihydroartemisinin–piperaquine vs 20·8 ms SD 17·8 for dihydroartemisinin–piperaquine plus mefloquine; p=0·50).
Dihydroartemisinin–piperaquine plus mefloquine and artemether–lumefantrine plus amodiaquine TACTs are efficacious, well tolerated, and safe treatments of uncomplicated P falciparum malaria, including in areas with artemisinin and ACT partner-drug resistance.
UK Department for International Development, Wellcome Trust, Bill & Melinda Gates Foundation, UK Medical Research Council, and US National Institutes of Health.
Objectives: Accidental poisoning is one of the major medical emergencies in paediatric population, specially among under five children. However, there is still lack of clinicodemographic data mostly ...due to under-reporting of events. In this study, we analyzed the clinicoepidemiological profile as well as awareness of parents in respect to childhood poisoning cases admitted in our institute.
Methods: Children aged up to 12 years admitted in our hospital with accidental poisoning between January 2020 to June 2021 were included in this study. We collected their demographic, epidemiological and clinical data, analyzed, and compared these with data from other parts of India as well as world.
Results: About 87% of children were under 5 years of age with a male dominance (male: female was 1.3:1). Majority of children (65%) were from lower socioeconomic class and 66% of parents had no knowledge or ignorant about the poisonous substance. Hydrocarbons like-kerosene oil (44.5%) followed by drugs were the most common substance related to poisoning. Cough (23.7%) followed by vomiting (21%) was the most common presenting symptom and cardiorespiratory abnormalities were most common (49%) finding on clinical examination. About 5% of children died due to poisoning or its related effects.
Conclusion: It can be said that negligence and ignorance from the side of caregivers play the most important role in such calamities. Community-based childhood poisoning prevention program and simple preventive measures like education to the parents, proper storage of household items, and proper placement of drugs could be helpful in preventing mortality and morbidity in children with poisoning.
Background: Wasting, a form of malnutrition is a major public health burden in developing countries including India. Since, food and diet diversity have direct impact on nutritional status of ...children. The aim of the study was to assess the dietary consumption pattern and malnutrition based on mid upper arm circumference (MUAC) of Lodha tribal children of Paschim Medinipur and Jhargram districts of West Bengal, India.Methods: A total of 1043 Lodha preschool children (1-5 years) was selected for the present study. MUAC of the children was made and recorded by standard method. A questionnaire for 24-hour dietary recall method was applied to collect dietary information. Dietary diversity was calculated by standard techniques. All statistical analyses were performed by using Statistical package for social sciences (SPSS) software.Results: The mean±SD of MUAC was 129.7±11.3 mm. The results showed that the mean MUAC increased steadily with the advancement of age in both genders. Prevalence of wasting based on MUAC in age-sex combined among Lodha children was 28.9%, of which 24.9% and 4.0% found to be moderate and severe acute malnutrition. The dietary intake of children was insufficient than recommended dietary allowance (RDA). The dietary diversity score (DDS) and Dietary serving score (DSS) of the children were very low. Pearson correlation analysis showed Mean adequacy ratio (MAR) had significant correlation with DDS (r=0.26, p<0.001), DSS (r=0.81, p<0.001), calorie intake (r=0.52, p<0.001) and protein intake (r=0.38, p<0.001).Conclusions: The dietary consumption of Lodha children was inadequate. This effort should be given to improve their nutritional status by nutrition education and nutrient sensitive farming including kitchen garden.
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