With rapid urbanization and large-scale development activities going on in Indian cities, a large population is displaced, which need to be resettled. Although shelter is provided, but the Project Affected People (PAP) are often neglected, they don't have access to promotive and preventive health services such as immunization, family planning services and general health checkup. This is the cost of development; such displaced groups have to pay. Immunization is often cited as being one of the greatest public health achievements of the 20 th century which has resulted in dramatic decrease in morbidity and mortality due to vaccine preventable diseases. 1 However, effective protection against these diseases requires 90-95% immunization coverage. 2 Immunization coverage refers to information on the proportion of children who have received specific vaccines or are up to date with the recommended vaccine schedule. This information is essential for planning immunization programs, identifying the vulnerable groups that require ABSTRACT Background: With the rapid urbanization and numerous infrastructure projects going on in cities, large number populations are affected by these development projects. Such Projects Affected People (PAP) is resettled in colonies where critical health services are often lacking. Immunization is one such preventive and promotive health services, which is often cited as one of the greatest public health achievement of 20 th century and has resulted in dramatic decrease in morbidity and mortality due to vaccine preventable diseases. However, effective protection against these vaccine preventable diseases requires 90-95% immunization coverage. This study was conducted to assess the immunization coverage in PAP resettlement area of urban slum in Mumbai and associated responsible factors. Methods: Immunization coverage was assessed with the help of the WHO's 30cluster sampling method with a sample size of 210 children in the 12-23 months age group. Results: 90% children were completely immunized. The immunization coverage was highest for BCG (98.1%) and least for measles (90%). The most common reason for noncompliance was child's illness at the time of scheduled vaccine dose. Conclusions: The Universal Immunization Programme (UIP) goal of 85% immunization coverage can be achieved by community based awareness activities, supplemented by patient friendly immunization services at the health centre.
Aims and Objectives:
To evaluate the outcome of preoperative portal vein embolization (PVE) using N-butyl cyanoacrylate (NBCA) for change in future liver remnant (FLR) volume, biochemical changes, and procedure-related complications. The factors affecting FLR hypertrophy and the rate of resection was also evaluated for this cohort.
Materials and Methods:
From 2012 to 2017, PVE utilizing NBCA mixed with lipiodol (1:4) was performed using percutaneous approach in 28 patients with hepatobiliary malignancies with low FLR. All patients underwent volumetric computed tomography (CT) assessment before and at 3–5 weeks after PVE and total liver volume (TLV), FLR volume, and FLR/TLV ratio, changes in portal vein diameter and factors affecting FLR were evaluated. Complications and the resectability rate were recorded and analyzed.
Result:
PVE was successful in all 28 patients. The mean FLR increased by 52% ± 32% after PVE (
P
< 0.0001). The FLR/TLV ratio was increased by 14.2% ± 2.8% (
P
< 0.001). Two major complications were encountered without any impact on surgery. There was no significant change seen in liver function test and complete blood counts after PVE. Eighteen patients (64.28%) underwent hepatic resection without any liver failure, and only three patients developed major complication after surgery. Remaining ten patients did not undergo surgery because of extrahepatic metastasis detected either on follow-up imaging or staging laparotomy. Patients with diabetes showed a lower rate of hypertrophy (
P
< 0.05).
Conclusion:
Preoperative PVE with NBCA is safe and effective for increasing FLR volume in patients of all age group and even in patients with an underlying liver parenchymal disease with hepatobiliary malignancy. Lesser hypertrophy was noted in patients with diabetes. A reasonable resectability was achieved despite having a high rejection in gall bladder cancer subgroup due to rapid disease progression.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.