Routine primary immunization: status in two district of West Bengal

The study was conducted at Birbhum and Purba Medinipur districts of West Bengal to assess the routine primary immunization coverage following 40 cluster sampling technique was used to study 320 children in each of the districts. BCG coverage was found to be 79.69% at Birbhum and 84.38% at Purba Medinipur. Only 62.81% children at Birbhum and 67.81% children at Purba Medinipur received all the three primary doses of DPT. Regarding OPV, coverage with three primary doses were only 65% and 66.88% at Birbhum and Purba Medinipur respectively. Measles vaccine coverage was very poor at both the districts, 55.94% at Birbhum and 62.5% at Purba Medinipur. Full primary immunization was observed 53.13% and 61.56% in Birbhum and Purba Medinipur respectively. High drop-out rate was identified as a major deficiency in both the districts. Of the children who received at least one routine vaccine, more than 1/3rd at Birbhum and more than 1/4 th at Purba Medinipur did not turn up later for completion of their primary vaccine doses. It is evident that routine immunization coverage was poor in both the districts and it seems there has been no improvement in situation for last few years. It will influence not only the child morbidity and mortality situation but also will jeopardize the paralytic polio eradication programme. Urgent intervention should be undertaken to address the large number of non-immunized children as well as high proportion of drop-outs.     

Electro-clinical phenotypes of chromosome disorders associated with epilepsy in the absence of dysmorphism

Chromosome imbalances are associated with epilepsy but electro-clinical phenotypes are lacking for all but the best-known syndromes. Scanty information is contained in older case reports published in genetics journals that describe children with severe patterns of malformation and dysmorphism. From a larger series of children with chromosome abnormalities and epilepsy, we identified 10 patients with associated dysmorphism without malformation. Electro-clinical features are described for each patient. We found that these patients are at greater risk of delayed diagnosis, particularly when there are no learning difficulties at the onset of epilepsy, as in ring chromosome 20 syndrome. Chromosome studies should be ordered on all children with learning difficulties and epilepsy, and on children with atypical non-lesional epilepsy, even in the absence of learning difficulties or dysmorphism.     

A case of subcutaneous dirofilariasis of the eyelid in the South Indian state of Kerala

This report describes a case of dirofilariasis of the upper eyelid of a young female patient from Kerala. This is probably the first reported case from India in which a live dirofilarial worm was recovered from the subcutaneous tissues of the eyelid.     

Outcomes of thrombolytic therapy for acute myocardial infarction in women

Coronary artery disease is the leading cause of mortality in women older than 50 years of age. Thrombolytic therapy substantially reduces mortality in both women and men with ST-elevation acute myocardial infarction. However, the mortality risk reduction is somewhat lower in women, in spite of similar rates of successful coronary reperfusion after thrombolytic therapy in women and men. Hemorrhagic complications including stroke and other major bleeding appear to be more common in women, particularly elderly women. The risk of reinfarction after thrombolytic therapy also is greater in women compared with men. Because of the higher complication rates, women should be monitored closely after thrombolytic therapy. However, this lifesaving treatment should not be withheld or delayed in women when indicated.     

CT angiography of renal artery anatomy for evaluating embolic protection devices

PURPOSE: To determine which commercially available embolic protection devices are suitable for use in renal arteries. MATERIAL AND METHODS: A retrospective study was conducted of 97 patients who underwent three-dimensional computed tomographic (CT) angiography with either 16- or 64-detector row helical CT of the renal arteries for the evaluation of renal artery stenosis. Nine anatomic measurements were obtained of the renal artery from each reformatted CT angiogram. These data were used to evaluate seven commercially available embolic protection devices (SpideRX, BSC FilterWire EZ, GuardWire, Angioguard, Accunet, Emboshield, TriActiv FX) to determine suitability for use in conjunction with renal artery stent placement. The authors evaluated the reference vessel diameter (diameter to which the stent would be expanded) and length of device. RESULTS: The mean length (+/- standard deviation) of the main renal artery on the left (39.9 mm +/- 6.7) was significantly less than that on the right (44.9 mm +/- 7.4, P < .001). The mean distal diameter of the main renal artery was significantly larger on the left (6.0 mm +/- 0.5) than on the right (5.6 mm +/- 0.6, P = .02). For a reference vessel diameter of 4-7 mm necessitating a 12-mm-long stent, only three of the seven devices tested (SpideRx, Angioguard, and Accunet) could be used. CONCLUSION: Three of the seven devices tested could be used for reference vessel diameters of 4-7 mm necessitating a 12-mm-long stent.     

Association of ApoE genetic variants with obstructive sleep apnea in children

BACKGROUND AND PURPOSE: Although several studies have reported an association between obstructive sleep apnea (OSA) and the chromosomal region containing the Apolipoprotein E (ApoE) gene, findings about the exact location in the ApoE gene have been inconsistent. The objective of our study was thus to determine the allele, genotype, and haplotype frequencies at several single nucleotide polymorphisms (SNPs) in the region of ApoE and test their association with OSA status in children. PATIENTS AND METHODS: Caucasian children, ranging in age from 2 to 21 years, with polysomnographic evidence of OSA (>1 obstructive apnea or obstructive hypopnea episodes per hour of sleep) were recruited in the case group. Our race- and gender-matched control group was recruited from a population-based cohort of children enrolled in the Princeton School District Study. RESULTS: Comparison of allele and genotype frequencies between cases (n=92) and controls (n=92) revealed significant differences for SNPs rs405509 and rs7412. Multivariate logistic regression analysis with age and body mass index (BMI) as covariates revealed a significant association between OSA status and SNPs rs157580, rs405509, rs769455 and rs7412. The sliding window haplotype trend regression test revealed that SNP rs405509 was included in all haplotypes that are significantly associated with OSA status. CONCLUSIONS: We conclude that polymorphisms involving more than one locus in the ApoE gene and its regulatory region are associated with OSA in children. Further studies replicating these findings in different populations are needed as are studies involving fine mapping of this region.