Background: Adolescence period is very crucial in the life of an individual, when major physical, psychological and behavioral changes take place. Tobacco and areca nut use among school going adolescent is becoming a major public health problem. The aim was to determine the prevalence and pattern of smokeless tobacco and betel nut use among school going adolescents.Methods: The study was a cross sectional study. After taking the permission of principal of Government high school and consent of the parents of adolescents, 546 adolescents were interviewed during February-March 2016. A self-administered questionnaire was used for data collection. Thus collected data was analyzed using SPSS 17 (Trial Version). Results: Age of the study students (total 546) ranged from 10-19 years. (Mean age=14.60 ± 2.84 years). Out of 546 children 166 (30.4%) children had addiction. Prevalence of any type of addiction in girls and boys was 13.4% and 17.0% respectively. Tobacco prevalence was 12.3% and betel nut prevalence was 18.1%. Type of addiction and its association with gender was highly significant. All children addicted to tobacco using chewing form (gutkha) of tobacco. The mean age group of children who consume tobacco and betel nut was 16.14±1.33 years and 16.13±1.51 years respectively. Most common reasons among adolescents for starting addiction of tobacco and betel nut was to look mature (88.0%) followed by to look good (73.5%) and to refresh breathe (56.0%).Conclusions: High prevalence of tobacco and betel nut use among adolescents needs attention of parents, teachers and health officials.

Background: Immunization is one of the most cost effective methods of preventing childhood diseases and needs to be sustained with higher coverage for desired benefits. Objective of the study was to assess immunization coverage in children of 24-35 months of age group in urban slums of Ahmedabad city, India.Methods: Using the purposive sampling method, a cross sectional community based study was conducted in urban slum area (Vadaj area) of Ahmedabad city during July-November 2014. All 214 children of 24-35 months age group of the area were included after taking verbal informed consent of their parents or guardians. Vaccination status of the children was verified using the Immunization card. In conditions where the Immunization card was not available, the mother/parents were asked about the site of vaccinations to confirm the vaccines being given. Analysis of study was done by using appropriate statistical software. Results: Total 936 households were surveyed. There were 214 children in the 24-35 months age group. Mamta card or immunization record was available with 145 (73.6%) mothers of 24-35 months age group of children. Vaccination coverage in the age group of 24-35 months old children was maximum for BCG and OPV first dose (96.7%) followed by Pentavalent first dose (95.8%) and OPV second dose (95.3%). Overall, 75.7% of the children in the 24-35 months age group were completely immunized while only 6 children were unimmunized. Dropout rate percentage for Pentavalent 1st dose to pentavalent 3rd dose was 3.44% while for BCG to second dose of measles was 19.75%.Conclusions: Complete immunization coverage was 75.7% which was better than the national surveys still the causes for no/ partial vaccinations need to be addressed.

Background: Sickle cell disease is commonly seen in rural population of south part of Gujarat in India. It is one of the common causes of recurrent hospitalization, morbidity and mortality in pediatric population. This study was therefore undertaken to evaluate the clinical profile of sickle cell disease in a tertiary care hospital.Methods: This was the prospective observational study done from November 2015 to October 2016. All the hospitalized diagnosed case of sickle cell disease and trait in age group of 6 months to 14 years were taken in this study. Sickle cell disease with some genetic or metabolic disease and sickle-beta-thalassemia patients were not included in this study.Results: Total 61 patients were admitted over a one year of study period, out of which 47 were sickle cell disease and 14 sickle cell trait patients. Morbidity events were commonly observed in 5-12 years of age groups (68.85%). Seasonal variation also observed, 47.54% of total cases are seen in winter season. Pain (60.65%) was the most common presenting symptom. Severe pallor (39.34%) and splenomegaly (24.59%) was the most common sign in both groups. Vaso-occlusive crisis (59.01%) was the most common morbidity event observed, of which abdominal pain was the most common site of pain involvement. On laboratory analysis, there was statistically significant difference observed in disease and trait. In patients with sickle cell disease acute painful crisis (59.57%) was the common morbidity event observed while in sickle cell trait patients acute febrile illness (71.42%) observed.Conclusions: Vaso-occlusive crisis is the commonest manifestation in pediatric age group. Comprehensive medical care and management is required to decrease the morbidity and mortality.

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