Study Design: Comparison of diagnostic tests; methodological validation. Objectives: Primary: to investigate the precision and reliability of a knee bone mineral density (BMD) assessment protocol that uses an existing dual energy X-ray absorptiometry (DXA) forearm acquisition algorithm in individuals with spinal cord injury (SCI). Secondary: to correlate DXA-based knee areal BMD with volumetric BMD assessments derived from quantitative computed tomography (QCT). Setting: Academic medical center, Chicago, IL, USA. Methods: Participants: a convenience sample of 12 individuals with acute SCI recruited for an observational study of bone loss and 34 individuals with chronic SCI who were screened for a longitudinal study evaluating interventions to increase BMD. Main outcome measures: root-mean-square standard deviation (RMS-SD) and intra/inter-rater reliability of areal BMD acquired at three knee regions using an existing DXA forearm acquisition algorithm; correlation of DXA-based areal BMD with QCT-derived volumetric BMD. Results: The RMS-SD of areal BMD at the distal femoral epiphysis, distal femoral metaphysis and proximal tibial epiphysis averaged 0.021, 0.012 and 0.016 g cm À2 , respectively, in acute SCI and 0.018, 0.02 and 0.016 g cm À2 in chronic SCI. All estimates of intra/ inter-rater reliability exceeded 97% and DXA-based areal BMD was significantly correlated with QCT-derived volumetric BMD at all knee regions analyzed. Conclusions: Existing DXA forearm acquisition algorithms are sufficiently precise and reliable for short-term assessments of knee BMD in individuals with SCI. Future work is necessary to quantify the reliability of this approach in longitudinal investigations and to determine its ability to predict fractures and recovery potential.

In India the prevalence of asthma has increased over the last two decades, especially in children. There is scarcity of data on prevalence of asthma in school children. The aim of the study was to estimate the prevalence of asthma in school going children aged 9-14 years in the town of Kakinada, East Godavari district, Andhra Pradesh and determine the risk factors associated with it. METHODSFrom the listed many schools of urban and rural areas of Kakinada, 4 schools (i.e. 2 urban schools, 2 rural schools) were selected randomly. Total of 1117 students were thus selected from the four schools and the questionnaires were distributed to all of them, among them parents of 997 children responded. The questionnaire included the validated ISAAC screening questions and some other questions related to risk factors of asthma. RESULTSOverall, prevalence of bronchial asthma in this study was 15%. The prevalence of asthma in urban and rural areas was 16.8% and 13.4% respectively. The prevalence of asthma in boys and girls was 17.7% and 12.6% respectively. The prevalence of bronchial asthma in age group 9-11 years was 21.1% and in age group 12-14 years was 9%. The risk factors significantly associated with asthma were family history of asthma and tobacco smoking, personal history of allergic rhinitis, atopic dermatitis. CONCLUSIONSUrban areas had higher prevalence compared to rural areas. Boys (17.7%) had higher prevalence compared to girls (12.6%). Significant inverse linear association was found with increasing age as prevalence of asthma in age group 9-11 years (21.1%) was higher than 12-14 years' age group (9%). KEYWORDSAsthma, Prevalence, Risk Factors. HOW TO CITE THIS ARTICLE:Rambabu B, Chandran CNM, Prasad AK, et al. Study of prevalence and risk factors of bronchial asthma in school children in urban and rural areas of Kakinada.

BACKGROUNDAcute Lower Respiratory Infection (ALRI) is a leading cause of morbidity and mortality in under five children in developing countries. There is a need to explore the association between easily modifiable risk factors and occurrence of ALRI in developing countries to bring down the incidence of ALRI. This study is taken up to identify the various risk factors for acute lower respiratory tract infection and their effect on severity and outcome in under five children.

Original Research ArticleVaccination has saved more lives worldwide than any other medical products or procedures. To accelerate immunization coverage, Mission Indradhanush was launched by Ministry of Health and Family Welfare in 2014. Under Mission Indradhanush, the immunization programme was strengthened and also newer vaccines like pentavalent, rotavirus and f-IPV vaccines were sequentially introduced. Mission Indradhanush was intensified in 2017 to further accelerate full immunization coverage. The present study was done for a period of 2 months in 2 urban areas, 2 rural areas and 2 tribal areas of East Godavari district of Andhra Pradesh with the objective to know the immunization coverage in children aged 1-2 years after launching Mission Indradhanush with the aim to evaluate the primary immunization coverage, coverage of newer vaccines after launching MI , assess the knowledge of mothers on routine vaccination with a special focus on newer vaccines and the reasons for delay or dropouts in vaccination. In the present study, the overall coverage of primary immunization was 94.8%. Overall immunization coverage is less in urban areas compared to rural and tribal areas. Literacy of mother, parity and place of delivery had significant association with complete immunization coverage. The main reason for high dropout rate of newer vaccines was nonavailability of vaccine. This study showed that Mission Indradhanush was successful in accelerating the overall primary immunization coverage in this area to a significant extent.