Objectives: To determine the efficacy of cell culture based influenza vaccines in children. Methods: Embase, PubMed, Cochrane and clinical trials were searched.14 randomised controlled trials in children were selected. The current systematic review was done as per the PRISMA guidelines. The pooled estimate of seroconversion and GMT rate was calculated as mean difference. Data was analysed using the Cochrane Collaboration Review Manager Version software. Risk of bias was done as per Cochrane risk of bias tool. The quality of evidence was adjudged using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) using the Grade pro software. Results: Significant results for efficacy were reported for half dose MF59 influenza vaccine control group for GMT at day 1 with a mean difference of 0.78, 95%CI, 0.50 to 1.07, p<0.00001 as compared to full dose MF59 influenza vaccine experimental group .No significant results were reported in half dose MF59 influenza vaccine for GMT at Day 43(mean difference 151.57,95% CI,-29.36 to 332.50 ,p=0.10). Significant results were reported for seroconversion rate for half dose MF59 influenza vaccine control group at day 22 with a mean difference of 17.92,95%CI,10.08 to 25.75,p<0.00001 as compared to half dose MF59 influenza vaccine group at day 43 with a mean difference of 5.00,95%CI,-4.80 to 14.80,p=0.32 . Conclusion: The current systematic review demonstrated that half dose cell derived influenza vaccines was well tolerated and more immunogenic and resulted in high seroconversion rate and Geometric Mean Titres rate in paediatric population.

Objective: To conduct an umbrella review collating the existing evidence to determine whether there is an association between exposure of paracetamol in utero or in infancy, and the development of childhood asthma. Methods: In this review, systematic reviews with or without meta-analysis that reported the association between paracetamol and asthma in children were included. To identify relevant reviews, a search was performed in the electronic databases PubMed, the Cochrane Central Register of Controlled Trials Library, and Ovid. Results: The search strategy in various databases identified 1913 conceivably significant studies for inclusion. After removal of 493 duplicates ,1420 studies were screened for titles and abstracts against a standard eligibility criterion. Full text screening yielded four systematic reviews to be included in this review. Prenatal paracetamol exposure is associated with an increased risk of Asthma in the offspring. Of the four systematic reviews, 2 have an unclear risk of bias, one has a high risk and one has a low risk of bias. Association does not imply causation and we recommend further research to answer this very important question. In the absence of any other alternative, paracetamol will have to continue to be the safest and the most widely prescribed analgesic and antipyretic in pregnancy. Conclusions: We recommend further research to answer this very important question. In the absence of any other alternative, paracetamol will have to continue to be the safest and the most widely prescribed analgesic and antipyretic in pregnancy.

Introduction: Tuberculosis is still a leading cause of morbidity and mortality in the world, especially the low and middle income countries. While a lot is being done on the programmatic level, the burden of the disease is still underestimated owing to problems in diagnostics and infrastructure. Objective: The objective of this study was to estimate the prevalence of Latent Tuberculosis infections in the pediatric household contacts of patients of pulmonary tuberculosis in India. Methods: We searched electronic databases PubMed, EMBASE and Ovid for relevant articles. Search of grey literature and unpublished data was also done.The protocol of the study was registered in the PROSPERO. The quality of included studies was assessed using the Hoy et, al. checklist. The data extraction from relevant studies and subsequent data synthesis and analysis was done. The calculation of the pooled prevalence of LTBI, and the construction of galbraith plot for heterogeneity was done using STATA software. Result: The searches yielded 600 studies out of which 19 were included in the review. The pooled prevalence of LTBI among household contacts was 39.27[26.05-52.49]. On subgroup analysis, the prevalence of LTBI from studies with only pediatric contacts included was 26.73[17.70-35.76].There was significant heterogeneity amongst the various studies with overall I2=99.7%. A Galbraith Plot was constructed which also shows significant heterogeneity among the different studies. All studies had a low risk of bias with a score of 3 or less, except one, which had a moderate risk of bias with a total score of 4.