Recent advancements in vaccinology and the introduction of new vaccines warrant a revision of the existing immunization guidelines. To review and revise the IAP recommendations (2023) on immunization of children aged 0 to 18 years and issue recommendations on existing and new vaccines. The Advisory Committee on Vaccines and Immunization Practices (ACVIP) of the Indian Academy of Pediatrics (IAP) discussed the updates and drafted evidence-based consensus recommendations after several rounds of meetings convened both in-person and virtually. The contents were finalized during the meeting held at the IAP Office, Navi Mumbai, on November 23, 2025. The major changes include recommendation of replacing the quadrivalent (A/H1N1, A/H3N2, B/Victoria, B/Yamagata) influenza vaccines with trivalent (A/H1N1, A/H3N2, B/Victoria) influenza vaccines. The use of nirsevimab for respiratory syncytial virus is recommended for high-risk cases, after consultation with the parents. Immunocompetent girls aged 9 to 15 years may receive a single dose of the human papilloma virus (HPV) vaccine. A 5-dose intramuscular rabies vaccination schedule administered on days 0, 3, 7, 14, and 28 is recommended for post-exposure prophylaxis (PEP), along with rabies immunoglobulin (RIG) or rabies monoclonal antibody (RMAb) based on the category of exposure.
CONTEXT:Triglyceride (TG) accumulation and insulin resistance (IR) are the hallmarks of nonalcoholic fatty liver disease (NAFLD). The triglyceride glucose (TyG) index may serve as an important risk factor for both hepatic steatosis and liver fibrosis in individuals with NAFLD. AIMS:This study was undertaken to assess the TyG index in patients with NAFLD and to study its correlation with the disease severity. SETTINGS AND DESIGN:This cross-sectional study spanning over 18 months was conducted in the department of Medicine at a tertiary care teaching hospital. MATERIALS AND METHODS:The study enrolled 105 adult NAFLD patients in whom the TyG index was calculated and correlated with serum transaminases and liver elastography measurements. STATISTICAL ANALYSIS USED:Descriptive statistics were calculated for all variables, including mean and standard deviation for continuous variables, and frequency and percentage for categorical variables. Pearson or Spearman correlation coefficients were computed to evaluate the relationships between the TyG index and continuous variables such as liver elastography and transaminases. RESULTS:The mean TyG index was 9.34 ± 0.41. A significant and positive correlation was observed between TyG and liver transaminases (aspartate transaminase: r = 0.53 and alanine transaminase: r = 0.46). The mean liver stiffness measurement (LSM) on liver elastography was 6.04 ± 2.54 kPa. A significant positive correlation was observed between TyG and LSM ( r = 0.71). CONCLUSIONS:TyG is an inexpensive, simple, and easily available surrogate marker of IR, which has statistically significant positive correlation with both serum transaminases and LSM. Thus, TyG may serve as a novel biomarker for predicting disease severity in NAFLD patients.
A paradoxical reaction (PR) in tuberculosis (TB) is defined as clinical and/or radiological worsening of pre-existing tuberculous lesions or the appearance of new lesions during appropriate anti-tubercular therapy (ATT), despite initial improvement and in the absence of treatment failure, drug resistance, poor adherence, or superinfection. Although more commonly described in HIV-infected or disseminated TB cases, PR can also occur in immunocompetent individuals and may be misinterpreted as disease progression. We report a case of a 19-year-old immunocompetent female receiving standard first-line ATT for sputum-positive pulmonary TB who developed progressive, painless right cervical lymphadenopathy two months after initiation of therapy. Ultrasonography revealed a large necrotic cervical mass suggestive of a tubercular abscess. Repeated ultrasound-guided fine needle aspiration cytology was inconclusive. Given the absence of systemic symptoms, treatment adherence, and lack of evidence of drug resistance, a diagnosis of PR was considered. In conclusion, recognition of PR is essential to prevent unnecessary modification of ATT, escalation to second-line therapy, or invasive procedures. Clinicians should maintain a high index of suspicion for PR in compliant patients presenting with new or enlarging lesions during the early months of treatment.
We meta-analyzed randomized trials to assess efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) after bariatric surgery. We searched PubMed, Embase, and Cochrane Central for randomized trials comparing GLP-1 RAs with placebo after bariatric surgery. Primary outcomes were change in body weight (kg) and HbA1c (
