Seroconversion and Side Effects After COVID Vaccination Among Persons with Type 2 Diabetes in Urban, Rural, and Tribal Areas in Kerala, India

Background: Persons with type 2 diabetes mellitus (T2DM) are at high?risk for COVID?19 infection and are a priority group for vaccination. Objectives: The objective of this study is to estimate the seroconversion and determine the side effects after COVID?19 vaccination among persons with T2DM in urban, rural, and tribal areas in Kerala. Methods: A cross-sectional study was conducted in urban, rural, and tribal field practice areas of a medical college in Central Kerala, among 396 persons with T2DM. The participants were selected by simple random sampling from the 200–250 diabetic patients visiting each health center. Qualitative and quantitative estimation of antibodies were done by WANTAI Ab enzyme?linked immunosorbent assay kit and Abbott SARS COV?2 IgG Quantitative assay, respectively. Results: The mean age of the respondents was 59.40 ± 12.25 years. A majority (65.5%) had received both doses of vaccine. About half (51.5%) experienced side effects after vaccination. Antibodies (IgG or IgM) were detected in 93.2% (95% confidence interval [CI] 90.2, 95.5) of participants. Those with a duration of diabetes ?5 years, with a single dose of vaccine, were five times (adjusted odds ratio [aOR] – 5.23,95% CI 1.86, 14.66) and four times (aOR – 4.11, 95% CI 1.66, 10.13) more likely, respectively, to be seronegative. Those who took medication for diabetes were protected against a no antibody (aOR – 0.05, 95% CI 0.02, 0.148) response. The median antibody titer in a subset (150) of participants was 365.2 (90–1587) AU/ml. Past COVID infection was an independent determinant of high IgG titers (aOR – 4.95, 95% CI 1.50, 16.36). Conclusion: Reinforcing the importance of vaccination particularly among those with longer duration of diabetes is imperative.

ViVan Ratio for Maxillomandibular Tooth Material Discrepancy.

According to the guidelines of the American and Indian Boards of Orthodontics, it is essential to include second molars, while managing an orthodontic case. Therefore, the present study was planned to determine maxilla-mandibular tooth material discrepancy.METHODSThe study sample consisted of study casts of 300 subjects in the age range of 18-30 years. Samples having a full complement of teeth with Angle’s Class I molar and canine relationships, good intercuspation, normal overjet and overbite and minimal crowding and spacing were included in the study. Tooth dimensions were measured using digital vernier caliper (accurate to 0.01 mm) and overall ratio was calculated. The data was statistically analysed for range, mean, standard deviation and coefficient of variation.RESULTSViVan ratio was found to be 90.79 with standard deviation of 3.13, variance of 9.81 and range was 83.55 - 95.82.CONCLUSIONSIdeal tooth proportions play an important role in achieving good occlusion at the end of orthodontic treatment. The ViVan ratio obtained in the study included second molars and this would benefit the orthodontist in proper treatment planning. This ratio will add importance for improved results at the finish of orthodontic treatment.

Etiological agents of acute poliomyelitis in south India.

This study was done to identify the specific etiological agents that cause acute poliomyelitis (APM). All the children newly diagnosed clinically as APM at the Institute of Child Health, Madras, during the period May 1988 to May 1989 were recruited. Stool specimen collection, transportation and identification of viruses by culture were done by standard procedures. The total number of children recruited was 312. Specimens were contaminated/insufficient in 10. Analysis was done for 302 cases. Polio virus type II was identified in 25.5% children, type I in 18.5%, type III in 15.9%, multiple polioviruses in 6.3% and non-polio enteroviruses (NPEV) in 20.2% cases. No virus was identified in 13.6%. Among the APM cases clinically diagnosed, the proportion of NPEV has increased considerably from 5% in 1984 to 20.2% in 1988-89. The age distribution was not significantly different between polio viruses and NPEV. The distribution of polio viruses and NPEV did not differ significantly in relation to immunization status, source of water supply, method of excreta disposal and the clinical types. For surveillance and control/eradication program of poliomyelitis, laboratory confirmation is essential.

Potency of oral polio vaccine stored at distribution centers in Madras.

This study was done with the objective to measure, monitor, and document the potency of oral polio vaccine and the storage conditions in the city of Madras for a period of one year from May 88. The Corporation of Madras which takes care of indenting and supplying the vaccine has 87 centers for storage and distribution. We took 12 samples a month from these centers by stratified random sampling technique adopting proportionate sampling. The samples were coded and sent to the laboratory. The investigator noted the storage conditions in a specially designed data card. Results were notified to the managers concerned. 122 samples were tested out of which 28 (23%) showed loss of potency (less than log 10(5.84]. The loss of potency is statistically significant in centers not having dial thermometer and where inappropriate carrier was used for transport of vaccine. It was least in Maternity and Child Health Centers probably due to the orientation of the personnel. The frequency of loss of potency was more in the beginning of the study and decreased as the study progressed. Monitoring of storage conditions and potency of vaccine along with periodic training and reorientation of health personnel are stressed.

Prevalence of placentally transmitted antibodies for measles in infants 3 to 11 months old in an urban slum community.

Upto 35% of infants aged between 6 and 11 months are infected with measles in India with its associated high morbidity and mortality. The objective of the study is to know the waning pattern of placentally transmitted antibodies (PTA) for measles so that the age at which children are likely to become susceptible to measles infection could be identified. A cross-sectional serological survey of children aged 3 to 11 months in one of the Integrated Child Development Service (ICDS) area in Madras city slums was done. Venous blood from 376 children was collected and was tested for Hemagglutination Inhibition (HI) antibodies by standard microtitration technique. Titre greater than or equal to 1:8 has been considered as protective. The proportion of children with immune level and the Geometric Mean Titre (GMT), declined to the least by 5 months which denotes that most of the infants become susceptible to measles infection from as early as 5 months of age. There is no significant difference in the waning pattern between different age groups, sex and nutritional status. A community study for effectiveness of measles vaccine at 6-8 months of age is needed to know the feasibility of immunization earlier than 9 months of age.