Background: A missed opportunity of immunization is one of the important contributing factors for poor immunization status of western desert part of India. The present study is aimed to know the prevalence of MOI in children visiting the Health facility.Methods: Immunization status was assessed via interview method using standard protocols recommended by the WHO, in a total of 600 children aged less than two years (200 indoor and 400 outdoor patients) enrolled randomly. The children who had missed an immunization opportunity were compared with those who had not, for socio-demographic variables and reasons for same were determined.Results: 45.64% of children had missed an opportunity for immunization in health care visit Illiteracy, higher birth order, rural residence; poor socioeconomic status emerged as the risk factors. Failure to assess Immunization during health visit was found in 82.39%, lack of knowledge of the parents regarding immunization schedule in 79.40% and false contraindications (mild acute illness in 21%, current antimicrobial therapy in 8.22%, convalescent phase of illness in 7.86%, recent exposure to infectious disease in 5.24%, fever precipitating seizures in 1.12%, pre-maturity 0.74% in that order) were the main causes.Conclusions: Immunization is an important but yet neglected part of child health visits. Each child’s immunization status should be assessed at every health care visit to avoid missed opportunities.

INTRODUCTIONCerebral palsy (CP) is one of the leading causes of disability in children. Incidence of cerebral palsy varies from one to six per thousand live births. Besides handicapping a child, it causes considerable psychological and social trauma to the parents and financial burden to family and community. A cure for cerebral palsy (CP) has not yet been discovered, hence, a ABSTRACT Background: Cerebral palsy (CP) is one of the leading causes of disability in children. Incidence of cerebral palsy varies from one to six per thousand live births. Besides handicapping a child, it causes considerable psychological and social trauma to the parents and financial burden to family and community. A cure for cerebral palsy (CP) has not yet been discovered, hence, a need for primary prevention of disease. But unfortunately, the etiology of cerebral palsy is poorly understood thereby eluding a definitive prevention strategy. Methods: All cases of non-progressive neurological disorder in the age group of 0-9 years were enrolled in the present study. Thorough and complete Obstetric history including antenatal, natal and post-natal were recorded. Woodside scale is used for assessment of neurodevelopment and a complete anthropometric measurement, physical examination including detailed Central Nervous System and all neuroimaging and EEG were recorded. Severity of cerebral palsy was assessed according to Minear's classification. Statistical analysis was done by standard statistical methods. Results: Majority of patients were males (78.26%) as compared to females. The mean age of male patients was 2.04±1.53 years and females was 3.67±3.14 years. Spastic type of CP was most common (93.47%), followed by mixed (4.34%) and atonic (2.17%) type. Quadriplegic CP was the most common (76.75%), followed by diplegia (11.62%) amongst the spastic variety. Risk factors found are maternal pyrexia (17.39%), home vaginal delivery (58.70%), birth asphyxia (67.39%), Neonatal seizures (39.13%) other factors being icterus neonatorum (13.04%) and meconium aspiration syndrome (13.04%), ICH (10.86%), septicemia (8.69%) and renal failure (4.34%). Majority of the patients (78.26%) had class III and IV functional impairment. Cortical atrophy was the most commonly (71.73%) seen abnormality on neuroimaging with CT-scan. Epilepsy was present in 47.82% patients. Conclusions: Cerebral palsy along with its associated dysfunctions definitely disturbs the routine of children's life as well as family life. We have to go a long way before something definitive can be done for these children and their families.

Background: Intrauterine growth restriction accounts for a significant increase in perinatal mortality rate as well as immediate neonatal morbidity and continuing long term disability in some of the survivors. A different clinical problem develops in infants of same weight but different gestational age therefore identification of high risk newborns based on gestational age and weight. Hence without an accurate knowledge of gestational age, the clinician is significant hampered in an attempt to differentiate truly growth restricted fetus from a patient with incorrect gestational parameters. TCD is emerging as a new sonografic parameter and least affected by fetal growth restriction while liver is most affected organ.Methods: The patients were sonographically examined for TCD/AC ratio. The best cut-off value of TCD/AC ratio in predicting IUGR was determined by a receiver operating characteristic (ROC) curve. The fetus with a TCD/AC ratio greater than the cut-off value would be antenatally diagnosed as IUGR for every gestational week. Standard definition of IUGR was a low birth weight, less than the 10th percentile.Results: Eighty pregnancies with suspected IUGR were analyzed. The prevalence of IUGR among the study group was 51.5%. The best cut-off value of the TCD/AC ratio for predicting IUGR was 15.87%, giving the sensitivity, specificity, positive predictive value and negative predictive value of 81.25%, 62.25%, 89.65%, and 45.45%, respectively.Conclusions: The sonographic fetal TCD/AC ratio as a gestational age-independent, useful, feasible and sensitive method for antenatal diagnosis of IUGR, especially in pregnancy with uncertain gestational age. Routine TCD/AC ratio should be performed to diagnose IUGR.

Background: Assessment of fetal gestational age (GA) is an essential part of obstetric USG. Accurate knowledge of fetal GA is important to facilitate the best possible prenatal care and successful pregnancy outcome.  For the estimation of GA the commonly used parameters in third trimester are:- BPD, HC, AC and FL. As all these parameters are affected by fetal growth disorders and fetal position. TCD can be used as another parameter for the estimation of GA in growth restricted fetuses.Methods: This study was conducted at Mahila Chikitsalaya Sanganeri Gate; SMS Medical College Jaipur from July 2005 to September 2006. A total of 80 pregnant women in third trimester with singleton pregnancy including 40 pregnant women with known cases of IUGR and 40 AGA fetuses were studied for TCD measure.Results: Correlation coefficient between TCD and gestational age was highly significant and no significant difference was found in TCD of AGA and IUGR fetuses.Conclusions: TCD measurement can be used as more reliable parameter for accurate estimation of gestational age in IUGR fetuses in third trimester.

Background: Assessment of clinico demographic characteristics of HIV infected children in western Rajasthan.Methods:All the children who were attending Antiretroviral treatment (ART) center for one year period were enrolled for study as pre-ART and ART group. All the data pertaining to clinical and demographic characteristics were recorded. They were further classified into clinical staging as per WHO guideline and immunological staging based on CD4 count in accordance with CDC classification of immunodeficiency.Results: Perinatal transmission is the most common mode of acquiring HIV in Pediatric age, who most commonly presented with Fever and diarrhoea along with failure to thrive. Tuberculosis and oral candidiasis were the commonest opportunistic infections in this geographic area.  Conclusions: A proper history, detailed clinical examination and high index of suspicion would therefore help in making early diagnosis to institute an appropriate management plan.