Impact of Real-time Assessment on the Training of Trainers for the Introduction of Rotavirus Vaccine in India

Background and aim: The introduction of rotavirus vaccine (RVV) in the universal immunization program of India is a big feat as it became the first nation in the World Health Organization (WHO) Southeast Asia region to do so. The involvement of huge numbers of frontline workers in introducing new vaccines in India and the underlined deficits in skills and knowledge require efficient capacity building programs. In view of this, limited research is available on the effectiveness of capacity-building interventions for healthcare workers. There is a dearth of studies from India measuring the “on-spot” impact of immunization trainings on healthcare workers. This study aims to assess the effectiveness of training in RVV introduction in enhancing the knowledge of the participants. Methods: The study was conducted among the participants attending two training workshops for the introduction of RVV: a state workshop in Pune and a regional workshop in Guwahati. The participants who attended the workshops and participated in both the pre- and post-test were included in the study. Real-time data was collected via Google forms pre- and post-training sessions. Results: In both workshops, a comparison of pre- and post-test scores of all questions taken together showed a significant increase in the knowledge level of the participants (p < 0.05). In Guwahati, the knowledge of the participants regarding doses of RVV, inadequate dosing, vaccine vial monitor (VVM), open vial policy, operationalization of RVV and monetary incentive increased significantly. In Pune, the knowledge of the participants regarding doses of RVV, bundling approach, schedule and dose, storage temperature for RVV, VVM, open vial policy, vaccine delivery and operationalization of RVV increased significantly after the training. Conclusion: A pre-planned and well-designed knowledge assessment tool can be used to understand the impact of training workshops in enhancing the knowledge and practical skills of the participants prior to the introduction of a new vaccine.

Rare Site Of Presentation Of A Rare Manifestation Of Graves’ Disease

Infiltrative dermopathy is an uncommon manifestation of Graves’ disease frequently involving the lower extremities. The pretibial area is most commonly involved. Rarely the fingers, hands, elbows, arms, or face are affected. Skin thickening is the characteristic abnormality. Localized myxedema is an autoimmune manifestation of Graves’ disease. Here, we report the case of a 45-year-old who presented with thyroid-associated orbitopathy and localized myxoedema over both the shoulders. In a patient who has long-standing hyperthyroidism, the diagnosis of infiltrative dermopathy is usually confirmed by the location, non-pitting nature, and distinct borders of the lesions. As most of these lesions are asymptomatic, no specific therapy is required

Down Syndrome With Ambiguous Genitalia: A Rare Association

Down syndrome (DS) is one of the most common chromosomal disorders. Although genitourinary anomalies, such as a cryptorchidism, micropenis, posterior urethral valves, and hypospadias, have been recognized as complications, the association of ambiguous genitalia with DS has been rarely reported. We report the case of a 1-year-old baby; assigned male sex at birth who was the first child born of a non-consanguineous marriage, by vaginal delivery at term with a birth weight of 2.2 kg. The baby had clinical features suggestive of DS with a micropenis, penoscrotal hypospadias, and incompletely fused labial-scrotal folds with palpable gonads. The external masculinization score was 3/12. The child was reared as a male and hormonal investigations were suggestive of androgen insensitivity. Karyotype was 47, XY, +21.