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Aims: To assess the serum zinc levels in children aged 2 months to 5 years admitted with Lower Respiratory Tract Infections and to study the association between low zinc levels and other known risk factors LRTI. Material and Method: This prospective, observational study enrolled 200 children in age group of 2 months to 5 years admitted with acute LRTI. Serum Zinc level were measured and its association was seen with other risk factors of LRTI. Results: Mean serum zinc level of study population was 57.9±29.2 microgram/dL. There was significant difference in zinc level depending on severity of pneumonia, nutritional status, anemia, clinical vitamin A deficiency, breast feed infants and birth weight (p<0.05). Conclusion: Low serum level of zinc were seen in severe pneumonia cases. Serum zinc levels were found to be lower in risk factors of LRTI like poor nutritional status, anemia, vitamin A deficiency, low birth weight and formula fed patients. Zinc supplementation is required in LRTI patients especially those with the above mentioned risk factors.

Aims Gestational trophoblastic neoplasia (GTN) comprise a spectrum of interrelated conditions originating from the placenta. With sensitive assays for human chorionic gonadotropin (b-hCG) and current approaches to chemotherapy, most women with GTN can be cured with preservation of reproductive potential. The purpose of this analysis was to address the outcome of GTN in patients from a tertiary care center of India. Materials and MethodsWe undertook a retrospective and prospective review of GTN cases treated at our center over a period of 7 years from 2008 to 2014. Patients of GTN were assigned to low-risk or high-risk categories as per the FIGO scoring system. The low-risk group was treated with combination of actinomycin-D and methotrexate and the high-risk group received the Etoposide, Methotrexate, Actinomycin-D/ Cyclophosphamide, Vincristine (EMA/ CO) regimen. Salvage therapy was Etoposide, Paclitaxel / Paclitaxel, Cisplatin (EP/TP). Treatment was continued for three cycles after normalization of b-hCG level, after which the patients were followed up regularly. Results In total, 41 GTN patients were treated at our institution during the above period; 17 were in the low-risk and 24 were in the high-risk category. The lung was the most common site of metastasis. All low-risk patients achieved complete remission. Among high-risk patients, one patient died while receiving first cycle chemotherapy, one patient relapsed, and 22 patients achieved complete Conclusion Risk-stratified treatment of GTN was associated with acceptable toxicity and resulted in outcome that was comparable with international standards. The use of two-drug combination in low-risk patients is a better option especially in developing countries.

Aims:The purpose of this analysis was to address the outcome of GTN from a tertiary care centre of India.Materials and Methods:We undertook a retrospective and prospective review of GTN cases treated at our centre from 2006 to 2014. Patients of GTN were assigned to low-risk or high-risk categories as per the FIGO scoring system. The low-risk group was treated with combination of actinomycin-D and methotrexate (MTX) and the high-risk group received the EMA/CO regimen. Salvage therapy was EP/TP. Treatment was continued for 3 cycles after normalization of β-hCG level, after which the patients were kept on follow-up.Results:In total, 52 GTN patients were treated at our institution during this period; 21 were low-risk and 31 were in the high-risk category. The lung was the most common site of metastasis. All low risk patients achieved complete remission. Among high risk patients one patient died while receiving first cycle chemotherapy, one patient relapsed and 29 patients achieved complete remission. The single relapsed patient also achieved remission with 2nd line chemotherapy.Conclusion:1. Two drug combination of Actinomycin-D and Methotrexate is a better alternative to single drug chemotherapy especially in developing countries were proper risk stratification is not always possible. 2. Patients with high disease burden should initially be treated with low dose chemotherapy to avoid life threatening visceral haemorrhage.

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