ABSTRACT
Background: Measles surveillance serves as the means of monitoring program success. The quintessential purpose of measles surveillance is to identify gaps and garner effective public health responses to achieve measles elimination. Objectives: There were two key objectives: (i) to conduct an in-depth review of the existing measles surveillance system in Kashmir and highlight its strengths and weaknesses and (ii) to assess the pattern of measles?containing vaccine (MCV1) coverage and MCV2 coverage among under?5 years children and describe the health-seeking patterns of suspected cases of measles. Methods: The mixed methods study was conducted in the Kashmir valley from March 2018 to March 2019. An explorative qualitative design was followed using individual face?to?face interviews with thirty-two (n = 32) different stakeholders from the state, district, medical block, and primary health center (PHC) levels. To complement the qualitative study, a quantitative survey was done in two districts, Srinagar and Ganderbal, which consist of 5 and 4 medical blocks, respectively. Results: Among the suspected cases of measles, 52% had visited PHCs. Sixty?four suspected cases of measles (64) were immunized with two doses of MCV. None of the clinically suspected cases of measles were further investigated. In the qualitative analysis, five themes were generated viz, “measles surveillance description of Kashmir valley;” “factors affecting measles surveillance, perceptions, and experiences of stakeholders;” “barriers to measles surveillance;” “measles surveillance activities need to be intensified;” and “respondent recommendations for building an effective and sensitive measles surveillance system.” Conclusion: The current measles surveillance system in Kashmir was not effectively functioning; case-based measles surveillance is not being done as per the WHO guidelines. There is a lack of planning, advocacy, awareness, and communication of measles surveillance among the stakeholders. The visible barriers in measles surveillance included lack of training, logistics, incentives, and monitoring by internal and external agencies.
ABSTRACT
Background: Over the last two decades, there has been increased awareness that hypertension in children may be a part of the spectrum of essential hypertension mainly linked to obesity epidemic. An increasing number of children and adolescents are being diagnosed with hypertension. Objectives of this study was to determine the prevalence of hypertension among apparently healthy school children residing in the valley of Kashmir.Methods: It was a community based cross sectional study was done over a period of one year in School going children aged 11 to 16 years from both urban and rural areas of Kashmir valley.Results: Thus, prevalence of hypertension was 5.1% and prevalence of prehypertension was 9.3%. Out of total 1600 children 1464 (91.5%) had a normal BMI, 72 (4.5%) were overweight and 64 (4%) were obese. In the prehypertensive group 114 (77%) had normal BMI, 18 (12.16%) were overweight and 16 (10.8%) were obese. In the hypertensive group 30 (36.6%) had normal BMI, 26 (31.7%) were overweight and 26 (31.7%) were obese.Conclusions: Our study reveals that hypertension is not uncommon in Kashmiri children. With globalization bringing more lifestyle modifications, children are exposed to multiple risk factors including obesity and family history of hypertension. We need to make people aware of these facts so that blood pressure measurement could be a part of routine health care check-up in children to detect it early and do necessary interventions.
ABSTRACT
Background: Blood cultures form a critical part of evaluation of patients with suspected sepsis. The present study was undertaken to study the risk factors, duration of incubation for obtaining positive cultures, and the clinical impact of the culture report. Methods: A total of 224 samples from 110 critically sick pediatric patients presenting with suspected bacteraemia were processed aerobically. Results: Cultures were positive in 25.45% of the Patients. Most of the positive cultures were obtained after 24 hours of incubation of the broth and no isolates were obtained beyond day 4 of incubation. Therapy was modified in 52.73% of the patients after receipt of culture report. Conclusions: Incubation beyond four days (unless with specific indication like enteric fever) may be unnecessary for issuing a negative culture report. Repeated isolation of doubtful pathogens confirms true bacteraemia. Early culture report increases therapeutic compliance.
ABSTRACT
Primary extrahepatic hydatid cysts are rare, and primary splenic hydatid cysts even more so, constituting 2% to 3.5% of all hydatid cysts. We report here a case series of isolated splenic hydatid cysts. Case records of 382 adult patients of abdominal hydatid cysts were analyzed; eight of them (2%; aged 23 to 45 years, 5 women and 3 men) had primary splenic hydatid cysts. Seven patients presented with dull dragging pain in the left hypochondrium. Four patients had splenomegaly. Diagnosis was made at ultrasonography and/or contrast-enhanced computed tomography. Enzyme linked immunosorbent assay for hydatid antibodies tested positive in all patients. One patient presented with hemoperitoneum. All patients underwent splenectomy. Primary splenic hydatid cyst is rare but should be considered in patients with cystic lesions of the spleen.