Assessment of nutritional status and health challenges among female garment workers: a cross-sectional study

Background: The economic status of women is now accepted as an indicator of a society’s development in Bangladesh. Women workers like the majority in the informal sector have been exposed to rigorous work, discipline, fixed working hours, specific production norms etc. The aim of the study was to perform cross-sectional study was conducted to assess nutritional status of female garment workers in Chattogram, Bangladesh. Methods: The study was conducted with the help of a semi-structured questionnaire to collect data from the respondents by face-to-face interview. Informed written consent was obtained from the respondents. A checklist containing height and weight (measured using measuring tape and digital weight machine respectively) of the respondents included in the questionnaire. Results: According to the study, gastrointestinal problem was reported by 49.7% and the rest reported problem were respiratory problem (35.3%), skin problem (27.3%), urinary problem (18%), eye problem (15%). Age, marital status, number of children, family member, monthly income, job section, working hours and overtime were significantly associated with various types of health problem. Respondents were categorized into underweight (?18.5 kg/m2), normal (18.6-24.9 kg/m2) and overweight and above (?25.0 kg/m2) using BMI. Prevalence of underweight, normal and overweight and above were 3.3%, 61.3% and 35.3% respectively. Conclusions: Female worker’s age, marital status, number of children, monthly income, job duration, job section and overtime showed significant association with their nutritional status (BMI). Findings of this study may play an important role to develop a policy and in commercial sector of our country to reduce health problem of the female garment workers for better productive and healthy lifestyle.

Examining the relationship between chronic kidney disease, dyslipidaemia, and dysglycemia: a prospective study

Background: Chronic kidney disease (CKD) results in profound lipid disorders, which stem largely from dysregulation of high-density lipoproteins (HDL) and triglyceride-rich lipoprotein metabolism. Objectives were to evaluate the correlation between chronic kidney disease, dyslipidaemia and dysglycemia. Methods: In-patient and outpatient department (OPD) of department of medicine, COM and JNM Hospital, Kalyani. Cases are defined as patients (>20 years of age) with a diagnosis of CKD (non-oedematous). The controls are defined as age and gender-matched patients (>20 years) attending medicine OPD/indoor without diagnosis of CKD. Results: Among the CKD cases, 30 individuals were diagnosed as overtly diabetic, whereas in the control group, 22 participants had fasting blood sugar (FBS) levels equal to or exceeding 126 mg/dl. The mean FBS was 111 mg/dl (standard deviation (SD) 44 mg/dl) in the CKD group and 91 mg/dl (SD 31 mg/dl) in the control group. The difference in FBS levels between the CKD patients' group and the control group was statistically significant (p value=0.001). Conclusions: Hyperglycaemia is also significantly associated with CKD in form of increased fasting blood sugar (47% among cases as compared to 30% in control) and increased post-prandial blood sugar (49% in cases as compared to 36% in controls). Dyslipidaemia occurs in CKD cases (39% among CKD cases and in 24% of controls) in the form of increased triglycerides (TG), LDL and low HDL.

Pattern of Capsule and Seed Development in Sesame (Sesamum indicum L.) as Influenced by Seed Priming

Aim: To study the influence of seed priming on the pattern of capsule and seed development in sesame. Place and Duration of Study: The field experiment was conducted during the pre kharif seasons of 2017-2018 and 2018-2019 in sesame variety Savitri at AB Block farm, Bidhan Chandra Krishi Viswavidyalaya, Kalyani, Nadia, West Bengal, India. Methodology: Experiment was laid out in split plot design with 3 replications. Ten schedules of seed priming viz T1 (KNO3 @ 10 mM), T2 (KNO3 @ 20 mM), T3 (KNO3 @ 50 mM), T4 (KH2PO4 @ 50 mM), T5 (KH2PO4 @ 100 mM),T6 (KH2PO4 @ 200 mM), T7 [Polyethylene glycol (PEG) 6000 @ -0.4 MPa], T8 [Polyethylene glycol (PEG) 6000 @ -0.3 MPa], T9 [Polyethylene glycol (PEG) 6000 @ -0.2 MPa], T10 Distilled water (Hydro priming) along with control T11 (Dry seed) were taken as main plot treatment and stage of harvest was considered as sub plot treatment. The pattern of capsule and seed development was studied at 10 days after anthesis (DAA), 20 days after anthesis (DAA), 30 days after anthesis (DAA), 40 days after anthesis (DAA) and 50 days after anthesis (DAA) interval. Ten plants from each replication and in each treatment were selected at random to record data on morphological and physiological characters. Results: Fresh capsule length, fresh capsule breadth, fresh capsule weight, fresh seed weight and dry seed weight showed a steady increase up to 40 days after anthesis (DAA) then decreased slowly up to maturity. Conclusion: Considering seed yield and quality parameters, T7 [Polyethylene glycol (PEG) 6000 @ -0.4 MPa] and T9 [Polyethylene glycol (PEG) 6000 @ -0.2 MPa] appears to be ideal among the treatments for quality seed production in sesame.

Growth, Yield, Seed and Seedling Quality Parameters of Rapeseed-mustard Varieties under Different Seed Priming Options

Rationale: Crop production and quality of produce get affected by drought, stand establishment and low availability of nutrients. Apart from various prevailing methods, seed treatment through priming now-a-days has been found to noticeably improve crop establishment for increasing seed yield and quality. Aim: To study the effect of various seed priming options on rapeseed-mustard varieties. Place of Study: A field experiment was conducted at AB Block Farm, Bidhan Chandra Krishi Viswavidyalaya, Kalyani, Nadia, West Bengal, India during winter season of 2017-2018. Methodology: Experiment comprised six rapeseed-mustard varieties (Anushka, Sanchita, TBM-143,TBM-204, Kranti and Pusa Bold) in main plot and five seed priming options (KH2PO4 @ 0.15 mol 100 ml water-1 5 g seeds-1, KNO3 @ 0.1 mol 100 ml water-1 5 g seeds-1, PEG 6000 @ -0.3 MPa 100 ml water-1 5 g seeds-1, hydro priming @ 100 ml 5 g seeds-1 and control) in subplot, replicated thrice in a split plot design. Observations on growth and yield contributing parameters were recorded from the field. Further, various quality parameters of seed and seedlings were evaluated in the laboratory. Data on all the parameters were finally statistically analyzed. Results: Among the varieties, Pusa Bold performed better in terms of growth, yield contributing parameters and seed yield under seed priming through either KH2PO4 @ 0.15 mol 100 ml water-1 5 g seeds-1 or PEG 6000 @ -0.3 MPa 100 ml water-1 5 g seeds-1. Seed and seedling quality parameters such as root and shoot lengths, seedling fresh and dry weights, germination % and vigour index were also improved under the same. Conclusion: Cultivation of mustard variety, Pusa Bold by seed priming through any of those two chemicals (KH2PO4 or PEG 6000) can be recommended for New alluvial zone of West Bengal, India.

Solar elastosis in conjunctival squamous cell neoplasm.

Aim: To study the role of solar elastosis in the patient's with Conjunctival Squamous Cell Neoplasia (CSCN). Materials and Methods: Paraffin embedded 30 Conjunctival Squamous Cell Neoplasia tissues were studied for the presence of solar elastosis by Verhoeff's stain. Nineteen Squamous Cell Carcinoma (SCC), 6 Carcinoma In Situ (CIS) and 5 Conjunctival Intraepithelial Neoplasia (CIN) specimens were included in the study. Disease free conjunctiva and pterygium tissues were used as negative and positive control respectively. Results: Solar elastosis was found to be present in 19 of 30 (63.3%) Conjunctival Squamous Cell neoplasia specimens. Conclusion: Our study showed the presence of solar elastosis in conjunctival squamous cell neoplasia. Poor socioeconomic condition is an important factor as most of the elastosis positive patients were farmers.

Clinical Profile and Outcome of Chronic Pancreatitis in Children.

Objective: To evaluate the etiology, presentation, complications and management of chronic pancreatitis in children. Design: Retrospective chart review. Setting: Gastroenterology department at Christian Medical College and Hospital, Vellore, India between January 2005 and December 2010. Participants: 99 Children (<18 yrs) diagnosed with chronic pancreatitis based on clinical and imaging features. Main outcome measures: Etiology, clinical presentation, complications and management of chronic pancreatitis in children. Results: Of 3887 children who attended the Gastroenterology department, 99(2.5%) had chronic pancreatitis, of which 60 (60.6%) were males. In 95(95.9%) patients no definite cause was detected and they were labeled as Idiopathic chronic pancreatitis. All patients had abdominal pain, while 9(9.1%) had diabetes mellitus. Of the 22 children tested for stool fat, 10(45.5%) had steatorrhea. Pancreatic calcification was seen in 69 (69.7%). 68 (71.6%) patients with idiopathic chronic pancreatitis had calcification. Calcific idiopathic chronic pancreatitis was more frequent in males (67.6% vs. 48.1%, P=0.07), and was more commonly associated with diabetes mellitus (13.2% vs. none, P=0.047) and steatorrhea (61.5% vs. 16.7%, P=0.069). Pseudocyst (17.1%) and ascites (9.1%) were the most common complications. All children were treated with pancreatic enzyme supplements for pain relief. 57 patients were followed up. With enzyme supplementation, pain relief was present in 32 (56.1%) patients. Of those who did not improve, 10 underwent endotherapy and 15 underwent surgery. Follow up of 8 patients who underwent endotherapy, showed that 5 (62.5%) had relief. Follow up of 11 patients who underwent surgery showed that only 3 (27 %) had pain relief. There was no death.

Ecology of Two Riverine Wetlands of Goalpara District, Assam in Relation to Plankton Productivity.

Ecological investigation of two riverine wetlands of Goalpara district, Assam, India was carried out in relation to planktonic productivity from 2006 to 2008. The physico chemical parameters were found fluctuating with the growth of both phytoplankton and zooplankton. Both the beel was dominated by Chlorophyceae throughout the year amongst which Ulothrix and Spirogyra were found as dominating species. Among the Copepods, Cyclops was over all dominating species and amongst the Cladoceran groups; Daphnia, Bosmina and Moina were found in the wetlands throughout the studied period. Phytoplankton community of Urpod beel constituted 58.82% to 65.52%, while zooplankton community constituted 34.48% to 41.18% of the total plankton hauled throughout the studied period. Chlorophyceae fluctuates between the range of 47% to 58%, Bacillariophyceae 20% to 27% and Myxophyceae fluctuates between the ranges of 20% to 30%. Mean value of GPP in Hasila beel was estimated between the range of 2.88 gC/ m2/day and 4.66 gC/ m2/day, while in Urpod beel it was between 2.75g Cm-2day-1 and 4.27g Cm-2day-1.

Immunogenicity and Safety of a DTaP-IPV//PRP~T Vaccine (Pentaxim) Booster Dose During the Second Year of Life in Indian Children Primed with the Same Vaccine.

Objective: To evaluate the immunogenicity and safety of a pentavalent (diphtheria, tetanus, acellular pertussis, inactivated poliovirus, Hib polysaccharide-conjugate) combination vaccine booster dose. Design: Multicenter, open, Phase III clinical study. Setting: Two tertiary-care hospitals in Delhi and Vellore, India. Participants/patients: 207 healthy Indian children. Intervention: The DTaP-IPV//PR~NT vaccine (Pentaxim) was given at 18-19 months of age to children who had been primed with the same vaccine at 6,10,14 weeks of age. Main outcome measures: Immunogenicity was assessed before and 1 month after the booster. Safety was evaluated from parental reports, and investigator assessments. Results: At 18-19 months of age, before boosting, the SP rates against diphtheria, tetanus, poliovirus and PRP were 82.3-100%; 90.0% of participants had anti-PRP ≥0.15 μg/mL. Anti-poliovirus titers were ≥1:8 dilution in 97.9-98.4% of participants. Anti-PT and FHA titers (≥5 EU/mL) were detectable in 82.5% and 90.8% of participants, respectively. One month after the booster dose, SP rates were 99.5% for PRP (≥1.0 μg/mL), 100% for diphtheria, tetanus (≥0.1 IU/mL) and polioviruses (≥8:1/dilution). Seroconversion (4 fold post-booster increase in anti-PT and -FHA concentration) occurred in 96.8% and 91.7%, respectively. Geometric mean concentrations (GMC) increased from 11.7 to 353.1 EU/mL and from 18.2 to 363.4 EU/mL for anti-PT and anti- FHA, respectively. Anti-PRP GMC increased from 1.75 to 70.5 μg/ mL. Vaccine reactogenicity was low; severe solicited reactions were reported by <1.4% of participants. Conclusion: The DTaP-IPV//PRP-T vaccine booster at 18-19 months of age was well tolerated and induced strong antibody responses.

Length-weight relationship and condition factor of Aorichthys aor (Hamilton-Buchanan) in Lower Reaches of River Brahmaputra.

The studies were conducted during 2008–2010 to evaluate length-weight relationship and condition factor of Aorichthys aor in lower reaches of River Brahmaputra. 750 nos of fishes having weight of 20g to 1250 g and total length of 10 cm to 55 cm were recorded. The Cube law or Length–weight relationship was calculated as W = 0.00352 L3.246. The coefficient of correlation (r) between observed length & weight and calculated length & weight was 0.96 and 0.93 respectively, which indicated highly significant relationship between length and weight. The exponent (b) value obtained indicating the positive allometric growth pattern. The relative condition factor (Kn) value was found higher in fishes of above 650 g weight groups.

Fishery status of undivided Goalpara District, Assam with reference to socio -economic conditions of fishers.

The studies were conducted during 2008–2010 to evaluate Fishery status and its bearing on socio-economic condition of Fishers Community of undivided Goalpara district of Assam. A total of 97 species belongs to 56 genera of 26 families were recorded from various fish landing centers of the region during study period. Fishers catch fish in the river throughout the year. However, fishing intensity decreased during winter season due to decreasing water level. Fish catching ratio were also found in decreasing trend day by day due to increase in the level of fishing intensity as well as due to increasing numbers of fishers. The results of the co-efficient of correlation calculated from socio-economic data clearly exhibited that incomefamily size; expenditure - family size is highly related to each other in all the fishers groups.

Ichthyofaunal diversity of lower reaches of the Brahmaputra River, Assam.

An investigation was carried out from February 2009 to January 2010 in the core fish landing centres of Goalpara district, Assam to evaluate the present status of ichthyofaunal diversity of the lower reaches of Brahmaputra River. A total of 97 species including exotic species belonging to 56 genera of 26 families were recorded from all the fish landing centres. Among these, according to IUCN status, 5 species are endangered, 21 species vulnerable, 29 species lower risk-near threatened, 7 species lower risk-less concern and other 29 species are not evaluated. The families recorded were Notopteridae, Clupeidae, Engraulidae, Cyprinidae, Psilorhynchidae, Balitoridae, Cobitidae, Bagridae, Siluridae, Schilbeidae, Sisoridae, Clariidae, Heteropneustidae, Chacidae, Mugilidae, Beloniidae, Synbranchidae, Mastacembelidae, Chandidae, Nandidae, Cichlidae, Gobiidae, Anabantidae, Belontidae, Channidae and Tetradontidae. Seasonal variations of the fishes were also noticed remarkably. The taxonomic composition of the fish fauna suggests, Cyprinidae were the most dominant family with 39 representative species (42.8%) followed by Bagridae having 7 species (7.7%). The study reveals that lower reaches of River Brahmaputra is very rich in ichthyofaunal diversity. However, strategies such as controlled harvest, checks on growth of exotic species, controlling water pollution etc. are suggested for conservation of the native and endemic fish species of the region.

Validation of IMNCI Algorithm for Young Infants (0-2 months) in India.

Objective: To check the validity of Integrated Management of Neonatal and Childhood Illness (IMNCI) algorithm for young infants (0-2 months). Design: Prospective observational study. Setting: The outpatient department and emergency room of a medical college attached hospital. Methods: 419 infants (176 between 0-7 days, 243 between 7 days–2 months) underwent a detailed diagnostic assessment and treatment as per the standard protocol of treating unit. These infants also underwent assessment, classification and identification of treatment as per IMNCI algorithm. The diagnostic and therapeutic agreement between standard protocol and IMNCI was computed to assess the validity of IMNCI algorithm. Results: The IMNCI algorithm performed well in identifying sick young infants with sensitivity of 97%, 94% and 95%, and specificity of 85%, 87% and 87% in 0-7 days, 7 days–2 months and 0-2 months age groups, respectively. The algorithm covered majority (80%) of recorded diagnoses, and could identify bacterial infection with 88.5% sensitivity and 57.4% specificity. Complete diagnostic agreement with gold standard was seen in 50%; overdiagnosis and under diagnosis was seen in 13% and 19%, respectively. Low birthweight and upper respiratory infection were the main reasons for overdiagnosis whereas surgical conditions resulted in under diagnoses in majority. Conclusion: IMNCI algorithm for evaluation and management of young infants has good sensitivity and specificity for referring cases with severe illness.

Dyslipidemia and Superoxide Dismutase Activity in Children with Down Syndrome.

Introduction: Down Syndrome (trisomy 21) provides an interesting natural model to study atherosclerosis, since these individuals appear to be protected from plaque formation. Methodology: We assessed the lipid levels, and superoxide dismutase (SOD) activity in 32 clinically diagnosed children of Down syndrome and 34 children matched for age and sex as controls. Results: SOD activity was found to be significantly higher (p=0.004) in children with Down Syndrome (mean=313.7 IU/ml) than in controls (mean140.2 IU/ ml). Significantly higher levels of serum triglyceride (154.7 mg/dl) and VLDL (33.9 mg/dl) were observed in Down Syndrome as compared to healthy controls (119.6 mg/dl and 23.9 mg/dl respectively; p<0.05 for each). However, the two groups did not show any significant difference in levels of serum HDL-C, LDL-C. Conclusion: The raised antioxidant activity of SOD, because of over expression of genes situated non chromosome 21, probably offers some protection against the development of atherosclerosis despite the occurrence of dyslipidemia.

Assessment of dietary compliance to gluten free diet and psychosocial problems in indian children with celiac disease.

Objective. To assess dietary compliance to Gluten Free Diet (GFD), to identify barriers to compliance and to study the impact of diet on the psychosocial behavior of children with celiac disease. Methods. Children diagnosed with celiac disease and followed up for more than 6 months, were assessed for dietary compliance. After this assessment, patients were subjected to an interview, consisting of self administered questionnaire, by the investigator who was blinded to initial results of initial assessment. Psychosocial parameters were assessed by standard Pediatric Symptom Checklist (PSC) containing 35 items. Dietary compliant and non-compliant groups were compared for assessed factors affecting the dietary compliance. Cases were also compared to healthy controls for psychosocial parameters. Results. A total of 70 patients were assessed for dietary compliance: 53(75%) were found to be dietary compliant, 13(18%) dietary non-compliant while 4 had doubtful dietary compliance. Final analysis was done for 64 patients who had complete assessment; 4 patients with doubtful dietary compliance and 2 patients who had incomplete assessment, were excluded. Dietary compliance was higher in younger children (>80%) compared to adolescents (44%); in children with higher maternal education; in parents having better knowledge and understanding of disease. Compliance was better in nuclear families; with less number of siblings (68.3% of compliant had <2 siblings compared to 23% in non- compliant); in families with higher per capita income. Dietary compliance was also better in children who presented with typical symptoms of celiac disease (72% of dietary compliant presented with loose motion as presenting symptom compared to only 15% in non-compliant). Celiac children had problems related to adjustment such as difficulty in maintaining diet at school, restaurants, trips, etc.45% patients complained that their teachers don’t understand the nature of their disease. Pediatric Symptom Checklist (PSC) score was above cut-off in 4 children of dietary non-compliant group. Few individual PSC items such as complaints of aches and pains; is irritable, angry; does not listen to the rules, blames other for mistakes; teases others; refuses to share, were more common in celiac children than control. Conclusions. Noncompliance to gluten free dietary regimen is seen in18 % of cases. Dietary noncompliance is more common in the adolescent age group, in joint families and those who have more number of siblings. Dietary restrictions have impact on child’s social activities and thus psychosocial parameters (PSC score) are better in the dietary compliant group.

Cytokine gene polymorphisms in Irritable bowel syndrome in Indian population - A pilot case control study.

Aim: This study aimed at evaluating the single nucleotide polymorphisms (SNPs) in five cytokine genes regulating inflammation at altogether 8 different loci and compared their frequencies in patients with Irritable bowel syndrome (IBS) versus healthy age and sex matched controls. Methods: Peripheral blood was collected for DNA cytokine analysis from 23 patients with IBS and 20 healthy controls. The cytokine SNPs studied include TNF-á (-308G/A), TGF-â1 (codon10T/C, codon25G/C), IL-10 promoter (-1082A/G; -819T/C; -592A/C), IL-6 promoter (-174G/C), and IFN-ã (+874T/A). Results: There was a significant difference between a SNP in IL-10 (-592A/C) among cases and controls. There was also a trend to significance as regards to IL-6 promoter (-174G/C). Frequencies of other SNPs were not significantly different between the two groups. Conclusion: This pilot study shows that there are polymorphism differences in cytokine genes between patients with IBS and healthy controls from India.

Profile of tuberculous meningitis with or without HIV infection and the predicators of adverse outcome / Perfil de la meningitis tuberculosa con o sin infección por VIH y predictores de la evolución clínica adversa

OBJECTIVES: To compare the clinical, radiological and cerebrospinal fluid (CSF) findings, at hospital admission, among adult patients with tuberculous meningitis (TBM) with or without HIV infection and to identify the factors that predict adverse outcome at six months. METHODS: A total of 82 adult patients with TBM were included (40 HIV-positive and 42 HIV-negative). Several clinical (duration of illness, Glasgow Coma Scale score, presence of high temperature, headache, cranial nerve or sphincter abnormality, seizures and endocrine dysfunction), radiological (presence of hydrocephalus, cerebral infarction and oedema, meningeal enhancement, granuloma) and cerebrospinal fluid parameters (glucose, protein, lactate, lymphocytes, neutrophils and adenosine deaminase values) were recorded along with CD4 count in the peripheral blood. Statistical analysis was performed using the chi-square test. Individual variables were evaluated as prognostic factors for adverse outcome in both groups by calculating the relative risk of association for each. RESULTS: Temperature more than 38.33ºC was more common in the HIV-negative group while seizures, hydrocephalus, cerebral infarction and low CD4 count occurred significantly more commonly in the HIV-positive group. Hydrocephalus had strong association with severe neurological deficit and seizure with death in both the groups. CONCLUSION: Several clinical and laboratory features of TBM in patients who are HIV-positive are distinctly different from those without HIV infection; some of these have an association with the probability of adverse outcome.

OBJETIVOS: Comparar los hallazgos clínicos, radiológicos y del líquido cefalorraquídeo (LCR) entre pacientes adultos con meningitis tuberculosa (MTB) con o sin infección de VIH en su ingreso al hospital, e identificar los factores que predicen la evolución clínica adversa en seis meses. MÉTODOS: Un total de 82 pacientes adultos con MTB fueron incluidos (40 VIH positivos y 42 VIH negativos). Se registraron varios parámetros: clínicos (duración de la enfermedad, puntuación de la Escala de Coma de Glasgow, presencia de alta temperatura, dolor de cabeza, anormalidad del esfínter o nervio craneal, o anormalidad del esfínter, convulsiones y disfunción endocrina); radiológicos (la presencia de hidrocefalia, infarto cerebral, edema, realce meníngeo, granuloma); y del líquido (glucosa, proteína, lactato, linfocitos, neutrófilos, y valores de adenosina deaminasa), junto con un conteo de CD4 en la sangre periférica. Se realizó un análisis estadístico usando la prueba de chi-cuadrado. La variable individual se evaluó como factor pronóstico de la evolución clínica en ambos, calculando el riesgo relativo de asociación para cada uno. RESULTADOS: Una temperatura de más de 38.33ºC fue más común en el grupo VIH negativo, mientras que convulsiones, hidrocefalia, infarto cerebral, y bajo conteo de CD4 ocurrieron significativamente más normalmente en el grupo VIH positivo. La hidrocefalia estuvo fuertemente asociada con un déficit neurológico severo y la convulsión con la muerte en ambos grupos. CONCLUSIÓN: Varias características clínicas y de laboratorio del MTB en pacientes que son VIH positivos, difieren claramente de aquellos con infección por VIH. Algunas de estas características se hallan asociadas con la probabilidad de una evolución clínica adversa.

Immunogenicity and safety of a pentavalent diphtheria, tetanus, acellular pertussis, inactivated poliovirus, haemophilus influenzae type b conjugate combination vaccine (pentaxim™) with hepatitis B vaccine.

Objective: To obtain immunogenicity and safety data for a pentavalent combination vaccine (diphtheria, tetanus, acellular pertussis, inactivated poliovirus, Hib polysaccharide-conjugate). Design: Multicenter, open, Phase III clinical study. A DTaP-IPV//PRP~T vaccine (PentaximTM) was given at 6,10,14 weeks of age; and Hepatitis B vaccine at 0,6,14 or at 6,10,14 weeks of age. Immunogenicity assessed 1 month post-3rd dose; safety assessed for 30 minutes by the investigator, then by parents and investigators to 8 days and 30 days post-vaccination. Setting: Tertiary-care hospitals. Participants/patients: 226 healthy Indian infants (6 weeks of age). Main outcome measures: Immunogenicity and safety. Results: Immunogenicity was high for each vaccine antigen, and similar to a historical control study (France) following a 2,3,4 month of age administration schedule. Post-3rd dose, 98.6% of subjects had anti-PRP ³0.15 mg/mL and 90.0% had titers ³1.0 mg/mL; the anti-PRP GMT was 4.1 µg/mL. Seroprotection rates for diphtheria and tetanus (³0.01 IU/mL) were 99.1% and 100%; and 100%,99.1% and 100%, for polio types 1,2 and 3 (³8 [1/dil]) respectively. Anti-polio GMTs were 440.5,458.9, and 1510.7 (1/dil) for types 1,2 and 3 respectively. The vaccine response rates to pertussis antigens (4-fold increase in antibody concentration) were 93.7% for PT and 85.7% for FHA; the 2-fold increase was 97.1% and 92.4%. Vaccine reactogenicity was low with adverse reaction incidence not increasing with subsequent doses. Conclusion: The DTaP-IPV//PRP~T vaccine, given concomitantly with monovalent hepatitis B vaccine, was highly immunogenic at 6, 10 and 14 weeks of age in infants in India. The vaccine was well tolerated.

Pediatric inflammatory bowel disease in south India.

Among 34 children diagnosed to have inflammatory bowel disease (IBD) over past 8 years, 23 had Crohn’s disease and 11 had ulcerative colitis. Pediatric patients accounted for 7% of new cases of IBD seen annually. Median delay in diagnosis was 15 months. Nutritional impairment was significantly more common in Crohn’s disease.

Splenic metastasis and bleeding manifestations--an unusual association with gastric malignancy.

Splenic metastasis is a rare clinical entity--incidence being 0.6% at autopsy and 1.1% at splenectomy. We report the case of a 30 year old female who presented with purpura and melena and who was later diagnosed to have a mucinous adenocarcinoma of stomach with disseminated intravascular coagulation and splenic metastasis.