Status of poliomyelitis--1996 after "pulse polio immunization programme" sentinel center experience.
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Biomedical subjects
Publications and source records attributed to B Ahuja.
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OBJECTIVE: To study the trends of paralytic poliomyelitis in pre Pulse Polio Immunization period. SETTING: Hospital based sentinel surveillance. METHODS: Analysis of 6704 line-listed poliomyelitis cases from January 1989 to December 1994 attending the Department of Physical Medicine and Rehabilitation. RESULTS: 85% of all cases reported in Delhi were from this center. A decline in alternate year peaks was observed from 1621 cases in 1990 to 1062 cases in 1994. There was an increase in proportion of cases with poliomyelitis in fully vaccinated children from 14% to 22.9%. Polio type I virus was the commonest isolated virus in all the years except 1993, when type II was isolated in 38.7% of cases. CONCLUSION: Despite improvement in immunization coverage, the study reveals that a large number of children (67.2%) who suffer from poliomyelitis are unvaccinated. This stresses need to intensify and sustain high level of immunization coverage with effective vaccine.
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Kalawati Saran Children's Hospital, New Delhi, is the Sentinel Centre for poliomyelitis in the Northern region and 52-76% of cases of acute poliomyelitis from the Union Territory of Delhi are registered here. In this paper, data from this hospital for the last 13 years is presented. A detailed analysis of 1874 cases seen during the year 1987 is also presented. Inspite of large scale vaccination being carried out, the total number of cases have not shown a corresponding decline. The incidence of acute polio in Delhi has not declined over the years: it was 14.7/100,000 population in 1976 and 15.25 100,000 in 1988. There has been no change in the epidemiology of the disease over the years, except that the disease among the fully vaccinated children has increased from 1.3% in 1979 to 13.9% in 1988. Inspite of a decade of use of the oral polio vaccine there has been no significant reduction in the incidence of the disease, and urgent alternative strategies are needed.
Seven cases of benign form of spinal muscular atrophy were studied to evaluate the importance of detecting hand tremors, muscle fasciculation, evertion of foot and ECG tremors to distinguish these cases from muscular dystrophy. Taken in combination, diagnosis of all the seven cases was possible without the need for application of more sophisticated and invasive investigations, e.g., EMG, nerve conduction study, CPK levels and muscle biopsy.
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