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Background: We compared the mortality rate of patients with moderate to severe COVID-19 who were vaccinated and who were not. Material And Methods: In this retrospective observational study, we collected data of patients who were admitted with moderate to severe COVID-19.The vaccination status and co morbidities of the patients were documented. The incidence and in-hospital mortality of COVID-19 patients was assessed. Univariate analysis was performed to determine the risk factors of in-hospital mortality. Result: Of 294 patients, 5.1% (n=15) received Covaxin™ and 26.5% (n=78) received Covishield™; 68.4%(n=201) patients were un vaccinated. Of patients who were vaccinated and contracted COVID-19, 24.8%(n=73) had taken the first dose and 6.8%(n=20) had taken the second dose of either vaccine. The inhospital mortality rate was 13.6% (n=40). No significant association was found with the type of vaccine and the in-hospital mortality (p=0.23). Significant associations with in-hospital mortality were found with the interval before COVID-19 disease and vaccination (OR, 3.02; p=0.01); and the presence of diabetes mellitus (OR, 2.13; p=0.02), cardiovascular diseases (OR, 2.11; p<0.001), and malignancy (OR: 2.33; p=0.0325). Conclusion: The mortality rate of unvaccinated patients with moderate to severe COVID-19 was high. There was no significant difference in the effectiveness of Covaxin™ and Covishield™ in terms of the incidence of COVID-19 and in-hospital mortality. Diabetes mellitus, cardiovascular diseases, and malignancies had a significant association with in-hospital mortality in patients with moderate to severe COVID-19. [ABSTRACT FROM AUTHOR]

Vitamin D toxicity also known as hypervitaminosis D was previously believed to be rare. But with an increase in vitamin D supplementation several cases have been reported in literature. Fat soluble vitamins like Vitamin D, due to their ability to accumulate in the body, have a higher potential for toxicity than water soluble vitamins. The main clinical consequence of vitamin D toxicity is hypercalcemia. In this report we describe an adult female patient who developed very high serum Vitamin D levels (746 ng/mL, RI: 20 to 50) as a result of medication error. Inspite of such high serum concentrations the patient was without any clinical symptoms and had normal serum calcium. We critically discuss the mechanism of toxicity and hypothesize the possible molecular/metabolic factors which might have been responsible for this nontoxic presentation. This case study highlights the fact that physicians need to consider the risk of medication errors while prescribing Vitamin D therapy. Clinical trials to study Vitamin D toxicity in humans is not possible ethically. Thus the evidence base regarding the safety profile of Vitamin D supplementation in humans has been build through case reports. This review of the paradoxical clinico-laboratory manifestation of hypervitaminosis D could possibly contribute to existing literature. [ABSTRACT FROM AUTHOR]

1 T2-weighted axial MRI images (A, B) showing hyperintense well-demarcated lesions in bilateral erector spinae muscles (green arrows) with normal architecture of surrounding muscles; T1-weighted axial MRI (C) showing the lesion is hypointense (orange arrow); coronal T2-weighted image (D) showing the lesions (green arrows); parasagittal T2-weighted image (E) showing the longitudinal extent of the lesion (green arrow); axial T1 MRI (F) and axial CT scans (G) showing the lesions (with open and closed orange arrows, respectively) but in the CT the center is more hypodense than the periphery and (H) twinkling artifact seen on Doppler ultrasound of the lesion. 1) of her lumbar spine showed well-demarcated bilateral T1 hypointense and T2 hyperintense lesions inside the erector spinae muscles, extending from D12 to L2 levels. The characteristic MRI and CT imaging features of a well-demarcated lesion with no muscle involvement and twinkling artifact on Doppler USG (due to the keratinaceous semisolid debris of the cyst [5]) can clinch the diagnosis. [Extracted from the article]