Impact of hepatitis B immunization among the Nicobarese tribe - antibody titres & seroprotection five years after vaccination.

Background & objectives: A total of 237 Nicobarese subjects who had received hepatitis B vaccination as part of mass vaccination project during 2000-2001 were screened for anti-HBsAg titres by quantitative ELISA five years after vaccination. Methods: Anti-HBsAg antibody was estimated using quantitative ELISA. Proportion of the subjects with protective levels of antibody and geometric mean antibody titres were calculated. Results: Among the 237 study subjects, 213 had received three doses of vaccine, 17 had received two doses and seven had received one dose. The geometric mean titres of anti-HBs antibodies were 201.7, 31.9 and 23.1 mIU/ml among those who received three, two and one dose of vaccine, respectively. Among those who received three doses of vaccination, 85.9 per cent had anti-HBs antibody levels of 10 mIU/ml or more, indicating seroprotection. The difference in the seroprotection rates among those who received three doses of vaccination (85.9%) and those who received less than three doses (58.3%) was significant. Seroprotection rates one month after the first, second and third dose of vaccination were 49.1, 86.9 and 96.7 per cent, respectively. It then declined to 89 per cent by the end of the second year and to 85.5 per cent by the end of the third year, but there was no decline thereafter. Interpretation & conclusions: Seroprotection rate reached at the maximum one month after the third dose of HBV vaccine. Although about 15 per cent of the vaccinated persons lost seroprotection by the end of the third year, no further loss in seroprotection was observed between the third year and the fifth year.

Correlation of radiological and pathological assessment of tumour volume with lymph node involvement in cancer cervix.

The present study was carried out in 18 patients with carcinoma cervix stage IB through early IIB-Preoperative computerised tomography (C.T.) was done within seven days before surgery. Volume of tumour was determined from the C. T. films. Radical hysterectomy Type-III was performed in all 18 patients and specimens of cervix, parametrium and lymph nodes subjected to histopathological examination. Each specimen of cervix was cut into 4 to 12 equal sections depending on the size of the tumour mass. Cervical tumour volume was measured. Correlation of radiological with pathological tumour volume and of tumour volume with lymph node involvement was done. C. T. Scan was able to detect tumour mass accurately only four patients (Sensitivity 40%, Specificity 28.5%). In the Indian setting the conventional surgical approach appears to be the more appropriate.

Incidence of primary bone tumours and tumour like lesions in and around Dakshina Kannada district of Karnataka.

A total of 523 cases of primary bone tumours and tumour like lesions in and around Dakshina Kannada district of Karnataka were diagnosed over a period of 36 years. About 39% of these tumours were malignant and the remaining benign. Among the malignant tumours the highest incidence was of osteosarcoma (45.7%) followed by Ewing's sarcoma (19.4%). Osteochondroma was the most frequent in the benign tumour category (30.3%). Peak incidence of tumour was in the 2nd and 3rd decade of life with a male preponderance. The most commonly affected bones were femur, tibia and humerus in that order. Results indicate a significantly higher incidence of primary bone tumours in this part of India.

Carcinoma bladder: comparative evaluation of urinary cytology, excretory urography and ultrasonography.

A total of 63 patients with 85 bladder tumors were evaluated with excretory urography (IVU), ultrasonography and urine cytology, before being subjected to cystosocopy and biopsy. An attempt was made to evaluate accuracy of detection by different modalities, individually and combined together. Untrasonography and IVU detected 90 percent and 75 percent of tumors respectively while cytology was positive in 63 percent patients. Ultrasonography was superior to IVU, and, Urinary cytology, despite its low catch, could detect few cases where both the previous mentioned modalities had failed. Larger tumors situated on posterior and lateral walls were consistently detected by ultrasonography. Tumor staging by ultrasonography correlated well with final staging in infiltrating tumors. Thus it is concluded that the two non-invasive procedures, sonography and urine cytology must be routinely used for evaluation of fresh cases and in follow up of bladder tumors.