Adverse reactions to intravenous iodinated contrast media: a prospective study

Background: Adverse reactions to intravenous iodinated contrast media may be classified as general and organ-specific, such as contrast-induced nephrotoxicity. General adverse reactions may be sub classified into acute and delayed types. Acute general adverse reactions can range from transient minor reactions to life-threatening severe reactions. This study was done to determine clinical adverse effects of the iodinated contrast media.Methods: Data of 899 consecutive patients at C.U. Shah Medical College and Hospital, Surendranagar, who received sodium meglumine diatrizoate intravenous iodinated contrast media during the period of May 2011 to April 2012, were collected for any adverse drug reactions.Results: Out of 899, 189 patients developed adverse contrast reactions. The incidences of mild, moderate and severe adverse reactions were 19.47%, 1.33% and 0.28%, respectively. There were no differences in the incidence of adverse reactions according to gender (males 21.1%; females 20.7%; p= >0.05) or age (p= >0.05). The incidence of adverse reactions was significantly higher in patients with a history of previous reactions (50%) than in those with no history (21.25%; p= <0.05).Conclusions: The skin was the most commonly affected site of reactions. In reactions, mild forms were more common compared to moderate and severe

Evaluation of immunization coverage among children aged 12-23 months in Surendranagar city

Background: Infectious diseases are a major cause of morbidity & mortality in children. One of the most cost effective & easy methods for child survival is immunization. In May 1974, the World Health Organization (WHO) officially launched a global immunization programme known as Expanded Programme of immunization (EPI) to protect all the children of the world against 6 Vaccine Preventable Diseases by the year 2000. It was later redesignated as Universal Immunization Programme (UIP) since 1985. The objectives of this study were to assess the dropout rate and primary immunization coverage of children aged 12-23 months in Surendranagar city and to know the various reasons for partially or not immunizing the child.Methods: A community-based cross-sectional study. Thirty clusters were selected out of a total of 282 blocks of Surendranagar using the cluster sampling method. Cluster sampling method was used for sample selection and the proforma designed by UNICEF was used as a study tool. Sample size was 210 children (7 Children from each cluster) of aged 12-23 months. The obtained data were analyzed using appropriate statistical tests like Z test and X2 test. Results: Out Of the 210 surveyed children, 121(57.62%) were males and 89(42.38%) were females. Immunization card was available for 69.52% of children and fully immunized were 70.47%. Coverage was highest for BCG (95.71%) followed by OPV3 (82.85%), DPT3 (79.52%) and lowest for measles (75.23%). As far as the dropout rate is concerned, it was 21.39%, 10.21%, and 9.37% for BCG to measles, DPT1 to DPT3, and OPV1 to OPV3, respectively. Amongst the various reasons main reasons for dropout or unimmunization of children were ignorance in about 64% and lack of information regarding time, place and schedule (21%).Conclusions: Improvement should focus on reducing the dropout rate from DPT2/OPV2 to DPT3/OPV3 and improving coverage of measles and also Vitamin A

Estimation of tuberculosis incidence at subnational level using three methods to monitor progress towards ending TB in India, 2015–2020

Objectives We verified subnational (state/union territory (UT)/district) claims of achievements in reducing tuberculosis (TB) incidence in 2020 compared with 2015, in India.Design A community-based survey, analysis of programme data and anti-TB drug sales and utilisation data.Setting National TB Elimination Program and private TB treatment settings in 73 districts that had filed a claim to the Central TB Division of India for progress towards TB-free status.Participants Each district was divided into survey units (SU) and one village/ward was randomly selected from each SU. All household members in the selected village were interviewed. Sputum from participants with a history of anti-TB therapy (ATT), those currently experiencing chest symptoms or on ATT were tested using Xpert/Rif/TrueNat. The survey continued until 30 Mycobacterium tuberculosis cases were identified in a district.Outcome measures We calculated a direct estimate of TB incidence based on incident cases identified in the survey. We calculated an under-reporting factor by matching these cases within the TB notification system. The TB notification adjusted for this factor was the estimate by the indirect method. We also calculated TB incidence from drug sale data in the private sector and drug utilisation data in the public sector. We compared the three estimates of TB incidence in 2020 with TB incidence in 2015.Results The estimated direct incidence ranged from 19 (Purba Medinipur, West Bengal) to 1457 (Jaintia Hills, Meghalaya) per 100 000 population. Indirect estimates of incidence ranged between 19 (Diu, Dadra and Nagar Haveli) and 788 (Dumka, Jharkhand) per 100 000 population. The incidence using drug sale data ranged from 19 per 100 000 population in Diu, Dadra and Nagar Haveli to 651 per 100 000 population in Centenary, Maharashtra.Conclusion TB incidence in 1 state, 2 UTs and 35 districts had declined by at least 20% since 2015. Two districts in India were declared TB free in 2020