Vaccination and associated factors among tribal children of 1 year age in nine Indian districts: A cross-sectional study.

OBJECTIVE: To report on vaccination status by 12 months of age among tribal children from nine districts of India. METHODS: Cross-sectional study of 2631 tribal women having a child aged 12 months or below from nine Indian districts with a considerable proportion of the tribal population. Socio-demographic details, reception of various vaccines by 12 months of age, mother's antenatal care utilisation and health system-related details were collected through a pre-tested, interviewer-administered questionnaire from mothers. Multiple logistic regression analysis was used to identify the factors associated with complete vaccination by 12 months of age. RESULTS: Only 52% of children were fully vaccinated by the age of 12 months among the tribal populations; 11% did not receive any vaccine, and 37% of the tribal children received some vaccines. The age-appropriate vaccination was unsatisfactory as only 75% of the infants received all birth dose vaccines, and only 60.5% received all doses by 14 weeks. Only 73% were vaccinated against measles. Illness of the child, home births and communication gaps concerning vaccination were the main reasons for an infant not being vaccinated appropriately. Frequency of health worker's visits to the village, hospital birth, reception of advice on vaccination and educational status of the head of the households were significantly associated with full vaccination status. CONCLUSION: A relatively low proportion of children were fully vaccinated among the tribal populations. Health systems factors, mainly the outreach services and advice by the health workers, were positively and significantly associated with a child being fully vaccinated by 12 months of age. Improving outreach services is crucial to improve vaccination coverage in tribal areas, and there is a need to address the social determinants in the long run.

Impact of Bariatric Surgery on Clinical, Biochemical, and Hormonal Parameters in Women with Polycystic Ovary Syndrome (PCOS).

There is limited data on the impact of bariatric surgery on polycystic ovarian syndrome (PCOS) especially in the Indian population. BACKGROUND: To study the impact of bariatric surgery in women with PCOS in terms of clinical, hormonal, and radiological aspects of polycystic ovarian syndrome. METHODS: A prospective observational study of 50 women who underwent bariatric surgery at our tertiary care center. Evaluation of anthropometric data and menstrual cyclicity as well as markers of hyperandrogenism was done preoperatively and at 3- and 6-month and 1-year follow-up. RESULTS: Eighteen (36%) women were diagnosed to have PCOS. % EWL at 3-months (n = 14), 6-month (n = 14), and 1-year (n = 11) follow-up was 31%, 49%, and 63% respectively among women with PCOS. All females regained their normal menstrual cycle at 3 months of follow-up. Hirsutism resolved completely among 44% (5/11) with a decline in median hirsutism score from 11 to 9 at 1-year follow-up. Mean serum testosterone decreased from 0.83 ± 0.38 ng/ml preoperatively to 0.421 ± 0.25 ng/ml at 1-year follow-up (p Ë‚ 0.01), whereas changes in levels of serum LH and FSH were not significant. Seventy-seven percent of females (14/18) had polycystic ovaries preoperatively on USG; out of which, 55% (i.e., 4/7) showed complete resolution at 1-year follow-up. Metabolic syndrome resolved completely at 1-year follow-up in both PCOS and non PCOS group. CONCLUSIONS: Bariatric surgery results in an effective and sustained weight loss with improvement in clinical, hormonal, and radiological parameters associated with PCOS.

Prevalence of hypothyroidism in pregnancy: An epidemiological study from 11 cities in 9 states of India.

BACKGROUND: A previous hospital based study from Delhi revealed a high prevalence of hypothyroidism in pregnant women. Several other studies with small sample size also indicate a rising trend of prevalence of hypothyroidism during pregnancy in India. OBJECTIVE: To assess prevalence of hypothyroidism in pregnant women from various states/cities across India. MATERIALS AND METHODS: This was a cross-sectional multicenter study conducted at Allahabad (Uttar Pradesh), Bengaluru (Karnataka), Chennai (Tamil Nadu), Kolkata (West Bengal), Hyderabad (Telangana), Nasik (Maharashtra), Rohtak (Haryana), Pune (Maharashtra), New Delhi (Delhi), Srinagar (Kashmir), and Vizag (Andhra Pradesh) enrolling 2599 pregnant women. Estimation of thyroid stimulating hormone (TSH), free T4, and antithyroid peroxidase (TPO) antibodies was carried out using Roche modular kit using ECLIA technology in a central laboratory. RESULTS: We found in our study population that 13.13% of pregnant women have hypothyroidism (n = 388), using a cutoff TSH level of 4.5 µIU/ml. This prevalence was much higher using the American Thyroid Association criteria. Anti-TPO antibodies were positive in 20.74% of all pregnant women (n = 613), whereas 40% (n = 155) of hypothyroid pregnant women were positive for anti-TPO antibodies. CONCLUSION: This study concludes that there is a high prevalence of hypothyroidism (13.13%), majority being subclinical in pregnant women during the first trimester from India and universal screening of hypothyroidism may be desirable in our country.