Rotavirus Infections in Children Vaccinated Against Rotavirus in Pune, Western India.

Objective: To characterize rotavirus infections detected in rotavirus vaccinated children hospitalized for acute gastroenteritis. Design: Observational, hospital-based study. Setting: Three hospitals in Pune, Western India. Participants: Children aged <5 years hospitalized for acute gastroenteritis during 2013-14. Methods: Rotavirus capture ELISA was performed on all stool samples that were collected from patients following informed consent from parents. VP7 and VP4 genes of rotavirus strains were genotyped by multiplex RT-PCR. Stool samples from vaccinated children were tested for other enteric viruses. Results: Among the 529 children, 53 were vaccinated with at least one dose of the rotavirus vaccine. There was no difference in the mean (SD) (months) age of vaccinated [14.8 (10.6)] and unvaccinated [14.4 (10.5)] children. Rotavirus positivity was significantly higher (47%) in unvaccinated than in vaccinated (28.3%) children (P=0.01). Mean Vesikari score and severe cases were significantly more in rotavirus positive than in negative children within unvaccinated group (P<0.001), while these did not differ within the vaccinated group. Rotavirus strain G1P[8] was identified as the most prevalent strain in both, vaccinated (60%) and unvaccinated (72.8%) groups. No association was found between mean Vesikari score and viral coinfections. Conclusions: This study suggests decline in rotavirus positivity in rotavirus-vaccinated children hospitalized for acute gastroenteritis and high prevalence of G1P[8] and non-rotaviral co-infections in Pune, Western India.

Study of blood pressure and blood sugar levels in adolescence and comparison with body mass index.

Background: Worldwide prevalence of overweight and obesity is increasing and its consequences prompted the WHO to designate obesity as a global epidemic in 2002. Being overweight is a risk factor for significant illness, especially diabetes and hypertension in adult life. Objectives : To study the blood pressure and blood sugar levels and lifestyle parameters in adolescence and comparison with body mass index. Materials and Methods: In a prospective case control study, out of the 1000 screened, a total of 200 adolescents were considered out of which 100 were with high body mass index (BMI) and the other 100 were with normal BMI. Height, weight, BMI, waist hip ratio (WHR), blood pressure (BP), BSL, and associated risk factors like physical activity, fast food consumption, and computer/television watching were measured and screened. Results and Observations: 109 (54.5%) males and 91 (45.5%) females were included. Maximum number [90 (45%)] of adolescents screened were in the age group of 17-19 years, while 54 (27%) and 56 (28%) adolescents were in the age group of 10-13 years and 14-16 years, respectively. According to CDC charts 2000, prevalence of overweight was 24% which was double when compared to WHO charts 2007. There was significant difference in prevalence of obesity; according to CDC chart it was 26%, whereas according to WHO chart it was 39%. The difference in blood pressures between cases and controls as per both CDC and WHO charts was found to be statistically significant (P < 0.0001). Positive family history of hypertension has a highly significant correlation (P < 0.001) with BMI. Blood sugar level (BSL) was significantly higher in cases (high BMI) when compared to controls (normal BMI). The comparison of WHR in the study group showed highly significant correlation ( P < 0.0001) between cases and controls. The present study shows highly significant correlation of physical activity ( P < 0.0001) and fast food ( P < 0.05) between cases and controls, whereas there was no significant correlation of computer/television watching ( P > 0.05) with BMI. Conclusion: The adolescents seem to have become heavier owing to environmental influences on growth patterns. So, a consideration should be given to shift the cut-offs for overweight and obesity to higher BMI percentiles if recent growth charts are to be followed. Adolescents with a BMI above the 95 th percentile (obese) are most likely to have obesity-related health risks.

Guillain-Barré syndrome in child with prolong intubation.

Guillain-Barré syndrome (GBS) is an acute demyelinating disorder of the peripheral nervous system that results from an aberrant immune response directed at peripheral nerves. A typical GBS patient presents with rapidly ascending symmetrical weakness, which may progress to respiratory failure in 30% of patients. There are no definite criteria exists in GBS in children regarding prolonged ventilation. Here we report a child of GBS requiring prolonged intubation and ventilation for 60 days who afterward had a complete recovery. We present this case to highlight the importance that even in children prolonged intubation and ventilation of GBS case prognosis can be good.

Characteristics of rotavirus gastroenteritis in hospitalized children in Pune.

Background : Diarrheal diseases affect millions of people around the world and have the greatest impact on children, especially those in developing countries. Rotavirus is now known to contribute significantly to the etiology of diarrheal diseases in both developing and developed countries. Objective : To study demographic, clinical, and laboratory characteristics of rotavirus infection in cases of acute diarrhea admitted in the hospital who were below the age 5 years. Materials and methods : It was a prospective study conducted from June 2009 to June 2011 to determine characteristics, clinical profile, and antigenemia of rotavirus. The study group included patients up to 5 years of age hospitalized with a diagnosis of acute gastroenteritis. Statistical analysis was done using the chi-square test. Data were analyzed using SPSS (Statistical Package for Social Sciences) version 17.0. Results : From the 246 cases studied in the hospitalized patients of acute gastroenteritis, 88 cases (35.77%) were found to be positive for rotavirus infection. The occurrence of infection was found to be most common in the age group of 11-20 months (38.63%) followed by the age group of 0-10 months (23.86%). There was no association with the sex of the child. In rotavirus-positive patients, associated features were fever in 48.86%, vomiting in 29.54%, and pain in abdomen in 53.4% of cases. Seasonal variation of rotavirus infection was observed in the present study with peak in the winter season. It was found that 5.68% cases which were positive for rotavirus in their stool samples were positive for rotavirus present in their urine sample, suggesting extraintestinal manifestation of rotavirus. Conclusion : It is concluded that in spite of clean hygienic condition and vaccination rotavirus is still an important cause of infantile diarrhea in urban area like Pune. There is association between the occurrence of rotavirus and degree of dehydration, fever, vomiting, and pain in abdomen. Peak incidence was found in the months of December and January. There is association between the occurrence of rotavirus in stool and rotavirus in blood.