The aim of the study was to assess the status of routine immunization status and reasons for drop-outs in five districts in Bihar India. A community based cross sectional rapid survey in five districts in Bihar was undertaken from 11th January to 5th February 2013. Of the 38 districts in Bihar, 5 districts prioritized by the state government for intensive routine immunization support were selected purposively for the rapid assessment. Samples of primary health centres, Health sub centres, villages were chosen for the study using geographic and performance criteria. Twenty households having babies 0 to 36 months old from each village were randomly selected. A total of 7,500 households were taken from the 5 study districts. Apart from household survey, cold chain points where vaccines are stored and vaccination session sites were also assessed for service delivery and community participation. The assessment findings revealed high access resulted in good coverage of the initial vaccination such as BCG and DPT1, while low utilization due to drop out of children from DPT1 to DPT3 (15%) and BCG –measles dropout (27%). The coverage was inequitable, with 12% difference in full immunization among children below poverty line and scheduled caste and tribe children. The reasons for low vaccination coverage were both related to demand and supply side. Lack of awareness on immunization, lack of correct information about the place and time of immunization, illness of the child at the time of immunization session, irregular session timing and fear of adverse effects were found to be the major causes for almost 60% of households. The health staff ascribed it mainly to erratic supply of vaccines and logistics, poor planning, insignificant role of media or past experience of Adverse Effect Following Immunization (AEFI) as major causes. Based on the assessment of cold chain and vaccination session facility and key informant interviews, it was recommended that special emphasis should be given to due list preparation and tracking of beneficiaries using local volunteers, self-help groups and mobilizers especially in hard to reach areas. In addition, to ensure regular vaccine and logistic availability, Microplanning to include disadvantaged communities like Scheduled Caste (SC)/Scheduled Tribe (ST) & Below Poverty Line (BPL) households and intensive monitoring using both internal and external supervisors for regular monitoring of the routine immunization activities

AIMTo study the occurrence of Y chromosome microdeletions in azoospermic patients with Klinefelter's syndrome (KFS).

METHODSBlood and semen samples were collected from azoospermic patients with KFS (n = 14) and a control group of men of proven fertility (n = 13). Semen analysis was done according to World Health Organization (WHO) guidelines. Blood samples were processed for karyotyping, fluorescent in situ hybridization (FISH) and measurement of plasma follicle stimulating hormone (FSH) by radioimmunoassay. To determine Y chromosome microdeletions, polymerase chain reaction (PCR) of 16 sequence tagged sites (STS) and three genes (DFFRY, XKRY and RBM1Y) was performed on isolated genomic DNA. Testicular fine needle aspiration cytology (FNAC) was done in selected cases.

RESULTSY chromosome microdeletions spanning the azoospermia factor (AZF)a and AZFb loci were found in four of the 14 azoospermic patients with KFS. Karyotype and FISH analysis revealed that, of the four cases showing Y chromosome microdeletion, three cases had a 47,XXY/46,XY chromosomal pattern and one case had a 46,XY/47,XXY/48,XXXY/48,XXYY chromosomal pattern. The testicular FNAC of one sample with Y chromosome microdeletion revealed Sertoli cell-only type of morphology. However, no Y chromosome microdeletions were observed in any of the 13 fertile men. All patients with KFS had elevated plasma FSH levels.

CONCLUSIONPatients with KFS may harbor Y chromosome microdeletions and screening for these should be a part of their diagnostic work-up, particularly in those considering assisted reproductive techniques.

Adolescent ; Adult ; Chromosome Deletion ; Chromosomes, Human, Y ; Electrophoresis, Gel, Two-Dimensional ; Genetic Loci ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Klinefelter Syndrome ; complications ; genetics ; Male ; Mosaicism ; Oligospermia ; etiology ; genetics ; Seminal Plasma Proteins ; genetics ; Sequence Tagged Sites

AIMTo determine if Yq microdeletion frequency and loci of deletion are similar in two tissues (blood and sperm) of different embryological origin.

METHODSThe present study included 52 infertile oligozoospermic cases. In each case, DNA was isolated from blood and sperms and polymerase chain reaction (PCR) microdeletion analysis was done from genomic DNA isolated from both the tissues. The PCR products were analyzed on a 1.8% agarose gel. PCR amplifications found to be negative were repeated at least three times to confirm the deletion of a given marker.

RESULTSOnly 1 case harbored microdeletion in blood DNA, whereas 4 cases harbored microdeletion in sperm DNA.

CONCLUSIONThe frequency of Yq microdeletions is higher in germ cells as compared to blood. As the majority of infertile couples opt for assisted reproduction procreation techniques (ART), Yq microdeletion screening from germ cells is important to understand the genetic basis of infertility, to provide comprehensive counseling and most adapted therapeutics to the infertile couple.

Chromosomes, Human, Y ; genetics ; DNA ; blood ; genetics ; isolation & purification ; Humans ; Male ; Repetitive Sequences, Nucleic Acid ; Sequence Deletion ; Spermatozoa ; physiology

PURPOSEBoth cannulated cancellous screw (CCS) and sliding hip screw (SHS) are used in femoral neck fracture fixations, but which is superior is yet to be determined. This study was aimed to compare the clinicoradiological outcome of femoral neck fracture treated with SHS or CCS in young adults.

METHODSAdults (16e60 years) with femoral neck fracture were divided into Group 1 fixed with SHS and Group 2 fixed with three CCS after closed reduction. Pain relief, functional recovery and postoperative radiographs at 6 weeks, 3 months, 6 months and then yearly for upto 4 years were analyzed.

RESULTSGroup 1 (n=40) achieved radiological union at mean of 7.6 months, with the union rate of 87.5% (n=35), avascular necrosis (AVN) rate of 7.5% (n=3) and mean Harris Hip Score (HHS) of 86.15 at the end of 4 years. In Group 2 (n=45) these parameters were union at 7.1 months, union rate of 82.22% (n=37), AVN rate of 6.67% (n=3) and HHS of 88.65. Comparative results were statistically insignificant.

CONCLUSIONThere is no significant difference in clinicoradiological outcome between the two implants.

Adolescent ; Adult ; Bone Screws ; Female ; Femoral Neck Fractures ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Osteonecrosis ; epidemiology ; Postoperative Complications ; epidemiology ; Prospective Studies ; Recovery of Function ; Young Adult