Immunization coverage of infants--rural-urban difference in Kerala.

A study on the Immunization Coverage relating to the six vaccine preventable diseases was carried out in an urban, semi urban and rural area in Kerala and the results from the three areas were compared and discussed. The percentage of fully immunized children was similar in all the three areas and it was quite high. Coverage of measles vaccine was high in the Health Unit, Pangappara where health education activities were carried out by the interns. The awareness about vaccine preventable diseases was more in the urban and semiurban areas. The drop out rate for DPT and OPV was also less in urban and semiurban than in the rural areas. More than 50% of the households in urban, semiurban and rural areas were unaware of the diseases prevented by DPT vaccine. Intense Health Education Campaign can definitely improve the immunization coverage further in a state which has already attained total literacy.

Two-dimensional and Doppler echocardiographic study of coronary arteriovenous fistulas.

Sixteen patients with coronary arteriovenous fistula (CAVF) were studied by two-dimensional echocardiography (2DE). Of these 12 had Doppler studies. In all, the diagnosis of CAVF was confirmed by aortic root or selective coronary angiography. In 8 patients, the 2DE findings suggested CAVF. Five patients had dilated main coronary arteries and in 4 patients abnormal fistulous channels were identified. Two had diastolic flutter of the tricuspid valve and one had spontaneous contrast in the right atrium. In 11 out of 12 patients, Doppler analysis picked up a continuous flow (to the right atrium in 5, right ventricle in 4 and to both ventricles in 2 patients) prior to the cardiac catheterisation. We conclude that noninvasive diagnosis of CAVF can be made with the combined use of two-dimensional and Doppler echocardiography in most of the patients.