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Background: In India, the majority of construction workers are engaged in the informal sector, often working under unsafe and unhygienic conditions with minimal occupational safety. Limited access to healthcare, poor sanitation, malnutrition driven by poverty, and menstrual irregularities among female workers further exacerbate their health risks. These factors collectively contribute to a high burden of anemia among this vulnerable labor force. Understanding the prevalence and determinants of anemia among them is crucial for targeted interventions and improved worker well-being. Materials and Methods: A cross-sectional study was conducted to estimate the prevalence of anemia among reproductive-age women engaged as laborers of 18–49 years in construction sites. The sample size considered for the study was 147. Hemoglobin levels were measured using a portable hemoglobinometer (HemoCue). Anemia was defined as hemoglobin <12 g/dL. The data were analyzed using the Statistical Package for the Social Sciences statistical software. Results: The prevalence of anemia was 82.99% (122/147). The majority, 73 (49.7%), had mild anemia, while 36 (24.5%) had moderate anemia, and 13 (8.8%) had severe anemia. Younger individuals (<30 years) were more likely to have anemia (adjusted odds ratio [AOR]: 2.14, P < 0.001). Married individuals also showed a higher risk (AOR: 4.85, P < 0.001). Educational status was not associated with increased anemia (AOR: 1.16, P = 0.51). Menstrual irregularities significantly elevated the risk (odds ratio: 3.56, P < 0.001). Fatigue (AOR: 0.71, P = 0.03) and shortness of breath (AOR: 1.76, P = 0.01) were also linked to anemia. Lack of deworming treatment strongly correlates with anemia (OR: 3.38, P < 0.001). Conclusion: Anemia is highly prevalent among reproductive-age women laborers in construction sites, highlighting the need for targeted interventions to address this issue and improve their overall health and productivity.
Background:Pneumococcal conjugate vaccines (PCVs) have markedly reduced childhood pneumococcal diseases, yet serotype replacement and regional heterogeneity remain important challenges. The World Health Organization recommends either a 3p + 0 or 2p + 1 schedule for PCV immunization programmes. BE-PCV14, a 14-valent vaccine, has previously been shown to be non-inferior to PCV13 in a 3p + 0 regimen. In this Phase III trial, we aimed to descriptively compare the immunogenicity and safety of BE-PCV14 and PCV13 in a 2p + 1 schedule in Indian infants. Methods:In this randomized, single-blind, multicenter trial, 400 PCV-naïve infants (6-8 weeks old) were randomized 1:1 to receive either BE-PCV14 or PCV13; at 6 and 14 weeks, with a booster at 9 months. Serum IgG against 14 vaccine serotypes plus cross-protective 6 A were measured at post primary (28 days post dose 2), pre booster (at 9 months) and post booster (30 days post dose 3) time points. The primary endpoint was the proportion achieving IgG ≥0.35 μg/mL (seroresponse rate) for the 12 serotypes common to both vaccines at post primary, pre booster and post booster time points. Solicited local and systemic reactions were recorded for 7 days after each dose; unsolicited, and serious adverse events (SAEs) were captured throughout. Findings:Between May 2023 and July 2024, 400 participants were enrolled of which 380 (95%) completed the study. Post primary seroresponse rates in the BE-PCV14 arm for common serotypes ranged from 72.6% (95% CI: 65.8, 78.5) (serotype 3) to 100% (95% CI: 98.0, 100.0) (14, 19 F); PCV13 rates ranged from 71.6% (95% CI: 64.9, 77.5) to 100% (95% CI: 98.1, 100.0) (14, 19 F, 19 A). Post booster rates were 87.6% (95% CI: 82.1, 91.6) to 100% (95% CI: 98.0, 100.0) for BE-PCV14 and 85.0% (95% CI: 79.4, 89.4) to 100% (95% CI: 98.1, 100.0) for PCV13. BE-PCV14 elicited high responses against the two additional serotypes, i.e., 22 F: 96.8% (95% CI: 93.1, 98.5), 33 F: 92.5% (95% CI: 87.8, 95.5), and cross-protective 6 A: 93.0% (95% CI: 88.4, 95.9). Of the participants that received BE-PCV14 or PCV13, 33.5% (95% CI: 27.3, 40.3) and 38% (95% CI: 31.6, 44.9) had mild AEs and 11.5% (95% CI: 7.8, 16.7) and 10.5% (95% CI: 7.0, 15.5) had moderate AEs, respectively. Two unrelated SAEs occurred in the BE-PCV14 arm. Interpretation:Administered in a 2p + 1 schedule, BE-PCV14 was highly immunogenic, well tolerated, and comparable to PCV13 while broadening serotype coverage. These findings support consideration of BE-PCV14 for routine infant immunization programmes using a 2p + 1 schedule, particularly in settings where the additional serotypes contribute to ongoing pneumococcal disease. Funding:This clinical research was exclusively funded by Biological E. Limited, Hyderabad, India.
Objectives: We assess the impact including safety, efficacy, and complications of a new emergency primary ureteroscopy service to improve pathways for patients with acute ureteric colic. Patients and methods: A retrospective review of patients with confirmed ureteric stones presenting to accident and emergency (A&E) department between May 2022 and May 2024 was performed. Patients were categorised on the management approach to conservative, emergency stent insertion or primary ureteroscopy. Data on demographics, outcomes, complications, waiting times, and procedures performed was collected. Results: A total of 618 patients were studied. A total of 128 patients underwent emergency ureteroscopy. A total of 124 (97%) were rendered stone free. There was one readmission with sepsis. A total of 343 patients were managed conservatively with 236 (69%) stone free at follow-up with 22 readmissions, and 82 patients were still awaiting follow-up. A total of 147 patients had temporary stents inserted, with a mean wait for ureteroscopy of 3 months. A total of 29 patients were awaiting ureteroscopy. Discussion/conclusion: Primary ureteroscopy as an emergency procedure allows immediate definitive treatment and is safe and effective, with a very low rate of complications and readmissions. We have reduced the number of stented patients added to our waiting list from the emergency pathway by 46.5%. Implementing ureteroscopy as standard practice in acute settings will align hospitals with the National Institute for Health and Care Excellence (NICE) and Getting It Right First Time (GIRFT) guidance on the acute management of ureteric stones and lead to better outcomes, less complications, improved training opportunities for residents, and reduced complaints. Level of evidence: Level IV
Childhood cancer poses a growing global health burden. This study aimed to assess incidence patterns, temporal trends and five-year survival probabilities of childhood cancers in Iran using national cancer registry data from 2005 to 2014. A retrospective analysis was conducted using data from the Iran National Cancer Registry. After quality control procedures, 20,624 validated cases of childhood cancer (ages 0–14 years) were included. Age-standardized incidence rates (ASIRs) were calculated per million person-years using the new World Health Organization standard population. Trends over time were examined, and five-year observed survival probabilities were estimated for major diagnostic categories according to the International Classification of Childhood Cancer, Third Edition. The overall ASIR for childhood cancers in Iran was 116.2 per million person-years, higher in males (128.1) than in females (103.6). The most common cancer groups were leukemia (ASIR: 31.7), lymphomas (ASIR: 13.2), and central nervous system neoplasms (ASIR: 12.6). Lymphoid leukemia was the most frequent subtype (ASIR: 26.6 in males, 20.0 in females). Joinpoint analysis indicated a modest but significant increase in overall ASIRs in both sexes (average annual percent change ≈ 3.5
