RESUMO
Background: Congenital anomalies (CAs) are a major cause of stillbirths and neonatal mortality in India. Its magnitude and pattern reportedly vary over time and across geographical locations. Objectives: The objective of the study is to estimate the incidence of CAs in community development block RS Pura of District Jammu. Methods: The present study is a community-based prospective study. The field workers were trained with the help of “Birth Defect Surveillance” Atlas issued by WHO and ICBDMS (International Clearinghouse for Birth Defects Monitoring Systems) 2014. Pregnant women (registered or unregistered) with all health institutions in RS Pura Block on or after April 1, 2014, were followed till September 2015 for the ascertainment of CAs. All CAs detected during antenatal period (by ultrasonography), after delivery and abortion at any site were counted as events and classified by organ system according to the 10th version of the WHO International Classification of Diseases-10. Results: A total of 1670 mothers were followed till their pregnancy outcome was recorded. Among 1600 live births recorded, 54 babies had CAs resulting in the incidence rate of 33.7/1000 live births. The incidence rate was comparatively higher among women aged <20 years (71.4/1000 live births) and with Para 4 (43.5/1000 live births) as compared to other women. Digestive system was the most common system involved (35%) followed by the Central nervous system (26.6%). The U-shaped pattern in the incidence of CAs with regards to parity and maternal age was observed. Conclusion: The study demonstrated that the CAs continue to occur in Jammu at a similar magnitude as reported from other parts of the country.
RESUMO
Background: Rabies continue to be a major public health challenge in India. It can certainly be prevented by timely and appropriate administration of WHO recommended pre and post exposure prophylaxis. Intradermal regimen is running successfully and beneficial both in monetary as well as non-monetary terms. Aim& Objective:To evaluate the reduction in direct cost incurred with the use of intradermal regimen as compared to intramuscular regimen. Settings and Design: The present cross-sectional study was conducted in Government Medical College Jammu, a tertiary care centre. Methods and Material: A total of 17535 patients attending Anti Rabies Section of GMC Jammu were studied from Jan 2015 to September 2017.The patients belonging to Category II and III received 0.1 ml 2 site ID purified vero cell culture vaccine (PVCCV) on days 0, 3, 7 and 28 (2-2-2-0-2) and Rabies Immunoglobulin (RIG)(Category III only). Cost borne per patient receiving intradermal regimen was calculated and compared with cost borne in case Intramuscular regimen would have been used. Statistical analysis: Results were presented in descriptive manner using percentages and proportions. Conclusions: Intradermal regimen reduces the direct cost as compared to intramuscular regimen.
RESUMO
OBJECTIVE: To determine the utility of certain clinical and hematological parameters as diagnostic markers of dengue hemorrhagic fever (DHF), namely, (i) tourniquet test, (ii) association of bleeding manifestations with the platelet count, and (iii) "cut off" value of hematocrit diagnostic of DHF in Indian population. DESIGN: Prospective study. SETTING: Tertiary care hospital. SUBJECT: 304 children of DHF presenting between September 1996 to December 1996. RESULTS: The tourniquet test had a low sensitivity and was positive only in 61/239 (25.5%) cases. There was no statistical difference in the incidence of bleeding manifestations between thrombocytopenic and non-thrombocytopenic individuals highlighting poor association of thrombocytopenia with bleeding manifestations. A "cut off" hematocrit value of 36.3% diagnostic of DHF was estimated by discriminant analysis in Indian population. CONCLUSION: The study highlights tourniquet test as a less sensitive diagnostic marker of DHF, poor association of thrombocytopenia with bleeding manifestations and also defines the hematocrit value diagnostic of DHF in Indian population.