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Objective: The objective of the study was to assess the levels of neutralizing antibody after COVID vaccination in the elderly and compare it with that of the younger persons. The study also aimed at determining the association between the age, sex, and comorbidities and levels of neutralizing antibodies in the young and the old. Subjects and Methods: This was a single-center, cross-sectional, analytical study, conducted in the General Medicine Unit of ACS Medical College, Chennai, from August 2021 to October 2021. Forty?five elderly persons aged 60 years and above and 103 young adults aged 18 years and above and <60 years who were vaccinated with either COVISHIELD or COVAXIN were randomly selected to participate in this study. A detailed history regarding vaccination status, vaccination type, comorbidities, and breakthrough infection was obtained. Blood samples were collected from the participants to analyze the levels of neutralizing antibodies developed after COVID vaccination. Results: The mean age of the older participants was 66.13 ± 5.3 years and the mean age of the younger participants was 36.48 ± 10.9 years. The median level of neutralizing antibody in the younger participants was 97.4% (interquartile range [IQR]: 96.4%–98.0%) and in the older participants was 97.1% (IQR: 93.1%–97.6%). There was a significant difference in the neutralizing antibody level between the younger and the older participants (P = 0.033). There was no significant difference in the neutralizing antibody levels after two doses of either of the two vaccines among both the groups of participants. There was no significant association between the neutralizing antibody titer and sex and comorbidities in both the groups of participants. Five young and two old participants had breakthrough infections after vaccination. The antibody level was higher in persons with breakthrough infection than in those with no breakthrough infection in both the study groups. Conclusion: There was a significant difference in the neutralizing antibody level between the younger and the older participants after COVID vaccination. No significant difference existed in neutralizing antibody response with respect to the type of vaccine in both the study groups. There was no significant association between sex, comorbid status, and neutralizing antibody levels in both the groups.
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BACKGROUND: The epidemiological aspects and diagnostic problems encountered in a rural set up are largely unknown. The present study on cutaneous tuberculosis encompassing clinical, pathological and epidemiological aspects was undertaken at Rajah Muthiah Medical college and Hospital (RMMC&H), a teaching hospital mainly catering to the health needs of a predominantly rural population from villages and hamlets around Chidambaram, a taluq headquarters, located in Cuddalore district ofTamil Nadu. MATERIAL AND METHODS: During the period of study, 5744 cases (82%) of pulmonary tuberculosis and 1261 (18%) of extra-pulmonary tuberculosis were encountered. Cutaneous tuberculosis accounted for 117 (1.67%) of tuberculosis cases. RESULTS: Of the seventy-one patients with cutaneous tuberculosis, 39 had lupus vulgaris and 32 with TBVC. Lupus vulgaris was more prevalent with male pre-ponderance. The maximum incidence was seen in the second decade of life. Both LV and TBVC showed a male pre-ponderance, M:F ratio being 3:2 and 2:1 in LV and TBVC respectively. A majority of patients with LV (27 cases; 69.2%) and TBVC (31 cases; 96.8%) manifested with a single site of involvement. Lower extremities were more commonly involved among patients hailing from poor economic strata who were not habituated to the use of footwear while working out doors. Over crowding was also a contributing factor. The relationships between BCG vaccination and Mantoux test with cutaneous tuberculosis, association with pulmonary tuberculosis in addition to the underlying predisposing socio-economic factors are discussed.
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Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , India , Male , Middle Aged , Rural Health/statistics & numerical data , Sex Factors , Tuberculosis, Cutaneous/diagnosis , Young AdultABSTRACT
Background: Lymph node involvement in cutaneous tuberculosis is primarily seen in patients with Scrofuloderma. However, patients with lupus vulgaris and TBVC sometimes present with regional lymphadenopathy. Demonstration of organism in skin biopsies by ZN stain and culture is time consuming and often unrewarding when bacillary load is considerably low. Fine needle aspiration cytology (FNAC) is an economical, dependable, quick and cost effective tool for an early diagnosis compared to biopsy studies. Aim: The present study was undertaken to assess the utility of FNAC of lymphnodes in diagnosis of cutaneous tuberculosis. Method: FNAC of affected lymph nodes in Scrofuloderma and lymph nodes draining the lesions in TBVC and lupus vulgaris was carried out followed by skin biopsy in 26 patients of clinically suspected cases of cutaneous tuberculosis. Observations: Smears revealed epithelioid cell granulomas over a necrotic background. AFB could not be demonstrated by ZN stain. Histopathological studies of skin biopsies revealed epithelioid cell granulomas and Langhans’ giant cells. Biopsies were also negative for AFB by ZN stain and culture. All the patients responded well to standard antituberculous regimen. Conclusions: FNAC of lymph nodes in cases of cutaneous tuberculosis is a useful procedure that helps in arriving at diagnosis within a reasonable time frame.
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AIM: To estimate bone mineral density and fracture threshold in South Indian elderly and to correlate BMD with risk factors. MATERIAL AND METHODS: A prospective study of estimating bone mineral density (BMD) was done in 116 elderly patients from the out-patient Department of Geriatric Medicine, Government General Hospital, Chennai. Bone density was estimated using dual X-ray absorptiometry scan. (Dexa Scan-Model Hologic QDR 1000). The BMD, 'T' score and 'Z' score were estimated. RESULTS: Of 116 patients (53 males, 63 females) 38 had sustained fractures. BMD in 61-70 years age group was 0.765 and 71-80 years age group was 0.735 and 81-90 years was 0.821. BMD in fractures cases was 0.720 and non-fracture cases was 0.80. The average BMD in female patients were 0.78, 0.76, 0.74, 0.575 after 10, 20, 30, 40 years of menopause, respectively. CONCLUSION: This study suggests a BMD value of 0.72 as a fracture threshold in South Indian elderly. Increasing age and post-menopausal state negatively correlates with BMD as in Western studies.