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Even after the enforcement of the lockdown, the government was unable to control the spread of the COVID-19 infection. Vaccination is the only remaining hope for preventing and controlling COVID-19 infections. The knowledge and attitude of the recipients can influence vaccine acceptance. In this study, we aim to assess the knowledge and attitude toward the COVID-19 vaccine among the general rural population of India.A community-based, prospective, cross-sectional study was conducted from May 2021 to October 2021 in the rural part of the Mandya district of Karnataka, India. Individuals over the age of 18 who met the Ministry of Health and Family Welfare's vaccination eligibility criteria were included in the study. Demographic details of participants and assessment of knowledge and attitude towards the COVID-19 vaccine were done in a designed and validated data collection form.The study included 596 participants, with females dominating males by 54.9 % (327). The average age of the participants was 31 years. Among them, 81.71% (487) had adequate knowledge, and 81.5% (486) had a positive attitude towards the COVID-19 vaccine. Females (85.3%, 279) tend to have a more positive attitude than males (77%, 207). Positive attitude participants (86.86 %, 423) have a higher level of knowledge about the COVID-19 vaccine than negative attitude participants (57.79 %, 63).In the study, we found that 81.71% had adequate knowledge and 81.5% had a positive attitude toward the COVID-19 vaccine.

Antiepileptic drugs (AEDs) are extensively used to manage epilepsy and other comorbidities associated with seizures. Human Leukocyte Antigen (HLA) has a strong association with AED-induced severe cutaneous adverse drug reactions.We aimed to perform a systematic review and meta-analysis to identify, critically evaluate, and synthesize the best possible evidence on HLA-associated AED-induced Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN).MEDLINE/PubMed, Scopus, and the Cochrane Library were searched for literature from inception up to July 2022. We included case control studies analyzing association between HLA and AED-induced SJS/TEN. We assessed the studies' risk of bias in using Quality of genetic studies (Q-genie) tool. Outcomes focused on association (risk) between HLA and AED-induced SJS/TEN. The estimated risk was presented in the form of odds ratio (OR).We included 37 studies (51,422 participants; 7027 cases and 44,395 controls). There was a significantly higher risk of Carbamazepine-induced SJS/TEN with HLA-A (OR: 1.50; 95% CI: 1.03 to 2.17), HLA-B (OR: 1.94; 95% CI: 1.45 to 2.58), HLA-C (OR: 7.83; 95% CI: 4.72 to 12.98), and HLA-DRB1 (OR: 2.82; 95% CI: 1.94 to 4.12). Lamotrigine-induced SJS/TEN posed a higher risk with HLA-A (OR: 2.38; 95% CI: 1.26 to 4.46) and HLA-B (OR: 2.79; 95% CI: 1.75 to 4.46). Phenytoin-induced SJS/TEN showed a higher risk with HLA-A (OR: 3.47; 95% CI: 2.17 to 5.56), HLA-B (OR: 1.72; 95% CI: 1.38 to 2.15), and HLA-C (OR: 2.92; 95% CI: 1.77 to 4.83). Phenobarbital-induced SJS/TEN had a higher risk with HLA-A (OR: 6.98; 95% CI: 1.81 to 26.84), HLA-B (OR: 2.40; 95% CI: 1.39 to 4.17), and HLA-C (OR: 3.37; 95% CI: 1.03 to 11.01). Zonisamide-induced SJS/TEN was significantly associated with HLA-A*02:07 (OR: 9.77; 95% CI: 3.07 to 31.1), HLA-B*46:01 (OR: 6.73; 95% CI: 2.12 to 21.36), and HLA-DRB1×08:03 (OR: 3.78; 95% CI: 1.20 to 11.97). All other alleles of HLA were observed to have a non-significant association with AED-induced SJS/TEN. All included studies were of good quality, with a score of50 and a mean score of 54.96 out of 77.Our study showed a significant association between few variants of HLA alleles and AED-induced SJS/TEN. Evidences from our study could help in population-based studies and in implementation of individualized treatment regimens. These findings could be part of translational research helping in precision therapy.

COVID-19 vaccinations are intended to help produce neutralizing antibodies which target surface spike protein to combat the SARS-Cov-2 virus. Similarly, COVID-19 recovered patients exhibit high levels of SARS-CoV-2 neutralizing antibodies, which predominantly target the surface spike protein and are associated with the occurrence of health consequences in survivors.The aim of the study is to explore the long-term health consequences of the COVID-19 vaccines.A prospective, exploratory observational study conducted both online and offline using various questionnaires with all immunized individuals who had been inoculated for at least a month following their last COVID-19 vaccine either AZD1222® or BBV152® vaccines.We evaluated 258 individuals who had taken the COVID vaccine and found that females made up the majority (54.3%) and that the mean age was 24 years. Post-vaccination long-term health issues were reported by 36.05% (93) of the participants, with 37.86% (53) of females and 33.9% (40) of males (p = 0.292). Myalgia was reported by 20.15% (52), fatigue was 13.95% (36), paresthesia was 1.16% (3), ageusia was 0.77% (2), sadness/irritability was 2.31% (6), and lack of concentration/excessive worry was 3.1% (8).Myalgia, fatigue, paresthesia, ageusia, coughs and colds, dyspnea, sadness/irritability, and lack of concentration/excessive worry are health consequences related to the COVID-19 vaccination which follow a similar pattern of post-COVID syndrome.El objetivo de las vacunas frente a la COVID-19 es el de ayudar a producir anticuerpos neutralizantes dirigidos a la proteína de la espícula para combatir el virus SARS-Cov-2. De igual modo, los pacientes que se recuperan de la COVID-19 exhiben grandes niveles de anticuerpos neutralizantes de SARS-CoV-2, que se dirigen predominantemente a la superficie de la proteína de la espícula, y están asociados a la incidencia de consecuencias para la salud de los sobrevivientes.El objetivo del estudio es explorar las consecuencias para la salud a largo plazo de las vacunas frente a la COVID-19.Estudio prospectivo, exploratorio y observacional realizado tanto online como offline, utilizando diversos cuestionarios con todos los individuos vacunados a quienes se había inoculado en el plazo de al menos un mes, tras la última vacuna frente a la COVID-19, bien fueran las vacunas AZD1222® o BBV152®.Evaluamos a 258 individuos que habían recibido la vacuna frente a la COVID, y encontramos que la mayoría eran mujeres (54,3%) con una edad media de 24 años. Las cuestiones de salud a largo plazo, tras la vacuna, fueron reportadas por un 36,05% (93) de los participantes, con un 37,86% (53) de mujeres y un 33.9% (40) de varones (p = 0,292). Se reportó mialgia en el 20,15% (52) de los casos, fatiga en el 13,95% (36), parestesia en el 1,16% (3), ageusia en el 0,77% (2), tristeza/irritabilidad en el 2,31% (6), y falta de concentración/preocupación excesiva en el 3,1% (8).Mialgia, fatiga, parestesia, ageusia, tos y resfriado, disnea, tristeza/irritabilidad, y falta de concentración/preocupación excesiva son las consecuencias de salud relacionadas con la vacuna frente a la COVID-19, y siguen un patrón similar al del síndrome post-COVID.

Background: Pregnancy is a wonderful physiological period to be in. Maternal sustenance and wellbeing are significant variables that influence embryonic development. Maternal malnutrition has a significant, serious and long-term impact on the mother and children which plays an important role in premature birth, still birth condition and also affects their fetus. Consequently, it is important to assess the nourishing status of pregnant women to stay away from complications Objective: To determine the nutritional health of pregnant women who are at risk of malnutrition. Materials and methods: An observational study was directed to evaluate healthful status of pregnant ladies. The wholesome state of 150 pregnant ladies going to ANC in tertiary consideration medical care was evaluated. A fundamental arbitrary system was utilized to pick the subjects. Educated assent and moral endorsement were acquired. Information was acquired by utilizing information assortment structures which included patient demographics, income anthropometric measurements and 24 hr dietary history. The information was analyzed with SPSS programming and genuinely classified utilizing recurrence and rate, just as the chi-square test was utilized. Results: A sum of 150 pregnant ladies were included in the study , of which larger part 67.3% of them were in the age gathering of 20-25 years and few of them 4.0% were

The Background of this study is Malnutrition is a main reason for the changes of the child mortality and morbidity. Several socioeconomic factors may influence the malnutrition in children. In children nutritional deficiency may cause diarrhea, recurrent illness and other chronic diseases. Therefore, it is necessary to assess malnutrition in children. The objective of this study is to assess the malnutrition in children by using anthropometric measurement. An observational prospective study was conducted to assess malnutrition of children. Data was obtained by using data collection forms which included information about anthropometric measures such as height, weight, BMI and MUAC of children of age 6 months to 7 years. A total of 160 children were included in the study, of which 55% were male and 45% were female. 35.6% of them were 3 to 5 years old and 41.9% of them were 6months to 2 years and 22.5% children were 6 to 7years. 47.5% of parent’s annual income was less than 1lakh and 31.8% had 1 lakh to 2.5lakh and 20.6% had above 2.5lakh. 39.3%% of the children were severely underweight, 10.6% were moderately underweight and 2.5% children were mild underweight, while 88.7% of children had normal MUAC and 11.25% of them had low MUAC. From the above data 52.5% were malnourished and 47.5% were well nourished. This study concluded children’s underweight measures acute and chronic malnutrition and wasting represents a failure to receive adequate nutrition. Likewise, children`s gender, age, size at birth, height, weight and low MUAC also predicts wasting among children.

Arterial invasive monitoring is the most common method in the USA for hemodynamic monitoring during atrial fibrillation (AF) ablation. Although studies have shown favorable comparison between non-invasive and invasive hemodynamic monitoring (IHM) in non-cardiac procedures under general anesthesia, limited data is available for complex cardiac procedures such as AF ablation in the USA. With progressive improvement in AF ablation procedural safety, particularly with routine use of intracardiac echocardiography (ICE) to monitor for pericardial effusion, it is unclear if invasive hemodynamic monitoring provides any advantage over non-invasive methods. Therefore, the purpose of this study is to determine whether noninvasive hemodynamic monitoring is non-inferior to invasive hemodynamic monitoring during AF ablation under general anesthesia in patients without major cardiac structural abnormality.A multi-center retrospective data of AF ablation from July 2019 to December 2020 was extracted. A total of three hundred and sixty-two patients (362) were included, which were divided into group A (non-invasive hemodynamic monitoring) and group B (invasive hemodynamic monitoring). The primary outcome was to compare procedural safety between the two groups.Out of 362 patients, 184 (51%) received non-invasive and 178 (49%) received invasive hemodynamic monitoring with similar baseline characteristics. There was no significant difference between the two groups in complication rates (groin hematoma, pericardial effusion, cardiac tamponade). Mean procedure time was longer in group B with 3.35% arterial site discomfort. Urgent arterial access was required in only 1 patient in group A.This retrospective multicenter study strongly suggests that catheter ablation for atrial fibrillation under general anesthesia can be safely performed with noninvasive hemodynamic monitoring without requiring arterial access, with potential benefit in procedural duration and cost.

Background: Many variants detected after Wuhan-Hu-1 reference which were able to develop the resistance against the neutralizing antibodies induced by vaccine and may cause false negative results in diagnostic test. Novel variant B1.617 was detected in India and the Covid-19 cases hiked to its maximum; forcing the government towards approving a new vaccine for restricted use in emergency situation to cover a maximum population. Aims: This review looks at the efficacy, safety, and economical aspects of vaccines that have been authorized in India. Materials and methods: Wide-ranging assessment and analysis of accessible resources on online database. Results: The rAd26-s & rAd5-s demonstrate high efficacy as well as safety, followed by BBV152 and AZD1222. Various combinations of the vaccines with different platforms or vectors may induce wide range of immunity than a specific one. As per economical aspect, AZD1222 is more economical than the other two currently approved in India. Conclusion: There is a lack of clear end point to measure efficacy of the vaccine so the epidemiological studies with huge number of populations is required which may predict the perfect endpoint for efficacy measurement. Until then, inoculation with locally accessible vaccines and self-awareness about disease transmission prevention are the main options for reducing fatalities, protecting the health-care system, and eventually disease control.

For many years, the Government of India has worked hard to offer health services to people all around the country, and it remains dedicated to doing so. It has formed numerous programmes to achieve the goal of “Health for All.” As a result, in 2005, The Hon’ble Prime Minister formed the The National Rural Health Mission will provide the countries’ network with well-being administrations. The National Rural Health Mission, which went into effect in April 2005, is considered the backbone of the rural sector. They have been instilled with the belief that, as a result of their efforts, something special has appeared to assist the country dwellers in re-establishing their well-being. The National Rural Health Mission (NRHM) aims to provide rural populations, especially disadvantaged groups, with comprehensive, low-cost, and high-quality health care. Material & Method: We reviewed all of the articles published on PubMed, Scopus, BMJ, Google scholar, Nature, Web of science that were focusing on, National rural health mission services, to achieving universal health coverage (UHC). Conclusion: This study compiles a list of all social need interventions that have been described in the literature to date. National health systems around the world are reforming to meet health goals, with a focus on cost containment, universal coverage, equity in access and quality, and resource efficiency and effectiveness. The primary purpose of the mission is to establish a fully operational, community-owned, decentralised health-care delivery system with cross-sectoral integration at all levels, enabling for simultaneous action on a wide variety of health determinants such as poverty and social equity.

Introduction: Despite the fact that just a few researchers have examined the prenatal and postpartum periods, the findings from those few studies suggest an increase in prevalence through out pregnancy and the first six months after delivery. Pregnancy is a pivotal period in a woman’s life, as she experiences significant emotional, physical, hormonal, and social changes. Pregnancy and the first six months after delivery (perinatal phase) can be taxing, leading in sleep deprivation, relationship difficulties, and feelings of isolation. Materials & Methods: Quality of care, perinatal care, India, hospital, intrapartum care, implementation, and still birth for period were searched in the PubMed database using MeSH terms. A narrative summary of the goals and outcomes was completed. Conclusions: This study compiles a list of all prenatal social needs interventions that have been described in the literature to date. The majority of therapies have been for IPV, according to the findings of this study, and interventions that combine counselling or ongoing support have the best likelihood of lowering social risk factors and improving clinical outcomes.

Objectives Recently, there is an increased number of reports being published on Methotrexate (MTX) related cutaneous manifestations. We aimed to identify and critically appraise descriptive studies describing the MTX related skin manifestations, treatment approach, and their outcomes. Methodology An extensive literature search was performed in the PubMed, Embase, and Scopus databases from inception to April 2021 without any restrictions along with the bibliographic search of included studies, grey literature search, and a snowball search was performed in Google and Google Scholar to identify the relevant literature. Descriptive studies reporting MTX related cutaneous manifestations were considered for the review. The study selection, data extraction, and quality assessment were conducted by two independent reviewers and any disagreements were settled by consensus with the third reviewer. Results 31 out of 8,365 descriptive studies including 38 patients (22 females and 16 males) aged between 12 and 78 years prescribed for the management of rheumatoid arthritis, ankylosing spondylitis, and psoriasis were included in this review. Toxic epidermal necrolysis (TEN), papular eruption, vasculitis, erosions of psoriasis, ulcerated psoriatic plaques, local reactions, keratinocyte dystrophy, erythema multiforme, drug rash with eosinophilia and systemic symptoms, Steven Johnson syndrome and photosensitive dermatitis were the majority of MTX induced cutaneous reactions. Immediate withdrawal of MTX, providing appropriate care with anti-inflammatory, topical steroids, and supplementation with folic acid were reported to be effective for the management of the MTX related cutaneous manifestations. Conclusions Clinicians and healthcare professionals should be aware of possible acute cutaneous drug reactions induced by MTX to avoid further consequences and fatal conditions. Immediate withdrawal of MTX and supportive care were reported as an efficacious therapeutic management of acute cutaneous drug reactions. PROSPERO Registration number CRD42020220038.

In the present double-blind randomised study, the efficacy of combination of Bacillus coagulans Unique IS2 and lactulose was evaluated in the treatment of functional constipation in adults. One-fifty participants diagnosed with functional constipation (Rome III criteria) were randomised (1:1:1) and supplemented daily with 15 mL suspension of probiotic (B. coagulans Unique IS2, 2 × 109 spores) with lactulose (10 g) (group 1) or lactulose (10 g) (group 2) or placebo (water) (group 3) for 4 weeks. The primary (stool frequency) and secondary outome measures (stool consistency, sensation of incomplete evacuation, defecation- and abdominal-pain) were recorded weekly for up to 4 weeks. Bacillus coagulans Unique IS2 with lactulose showed significant changes in stool frequency as compared to lactulose treatment; however, at the end of the trial, it was found insignificant due to the gradual increase of stool frequency score of lactulose treatment. The changes observed in stool consistency were early (2nd week) and remained consistent up to end of the trial. The significant reduction of sensation of incomplete evacuation, defecation-, and abdominal-pain correlated with the strains ability to produce short-chain fatty acids. No adverse events were observed in any of the groups, and all the vital parameters were normal during the course of the study. Overall, results indicated that B. coagulans Unique IS2 addition to lactulose reduced time required to relieve constipation as compared to lactulose alone. In conclusion, B. coagulans Unique IS2 with lactulose is more effective than lactulose alone to relieve symptoms of constipation in a shorter period. Trial registration: CTRI/2018/11/016399, dated 22/11/2018.

When a child has a fever and rashes, the diagnosis can frequently be determined with only one look, but it can also be difficult to make even after days of clinical observation and comprehensive laboratory testing. Cefixime has antibacterial properties because it inhibits the production of mucopeptides in the bacterial cell wall. Rickettsia is a category of vector-borne bacteria that causes acute fever diseases all around the world. While Rickettsial illness has a similar clinical presentation across the country, the causative species and epidemiology differ by region.

Narcolepsy is a rare chronic, debilitating sleep disease that is currently categorized as different types of CNS hypersomnia in narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). Narcolepsy type 1 (NT1) is narcolepsy with cataplexy caused by a selective loss of hypothalamic neurons that produce hypocretin, while NT2 is narcolepsy without cataplexy and normal hypocretin levels. Hypocretin is a neurotransmitter that regulates sleep, body homeostasis, emotions, and behavior and has extensive projections to a variety of brain locations, including the locus coeruleus (norepinephrine neurons), tuberomammillary nucleus, raphe nucleus (serotonergic neurons), and dopaminergic neurons (ventral tegmental areas). Hypocretin is a neurotransmitter that not only excites the central nervous system, but also affects serotonin and histamine levels. Hypocretin is a neurotransmitter that regulates the activity of serotonin, histamine, dopamine, acetylcholine, GABA, and glutamate in the central nervous system. It is now understood to be a separate condition with its own pathogenesis and neurochemical abnormalities. Narcolepsy affects men and women equally and has a prevalence of 20–60 cases per 100,000. The highest rate is found in Japan, while the lowest is found in Israel. There is no cure for narcolepsy, despite a reliable pathophysiological hypothesis linking NT1 to an autoimmune process that damages hypocretin-producing cells. Because current symptomatic pharmaceutical treatments are not 100% effective for all symptoms, behavioral therapies play a synergistic role in the disease treatment. We examine the narcolepsy diagnostic and treatment options, including symptomatic pharmacological treatments as well as behavioral and psychological measures that may help doctors to improve narcoleptic patients' quality of life.

COVID-19 pandemic presents countries with major political, scientific, and public health challenges. The onset of the pandemic resulted in both positive and negative impacts on people's physical, mental and emotional wellbeing. The aim of this study is to assess the impact of the covid-19 pandemic imposed lockdown on happiness and depression. A cross-sectional study was conducted using two standard Questionnaires «Oxford Happiness Index» and «Montgomery and Asberg Depression Rating Scale». The Questionnaire was employed through Google form, and circulated via social platforms. All the collected data were analyzed using the SPSS version 22 statistical method. A total of 494 out of 515 participants gave consent, the majority of them belonging to the age group 18- 25(74.7%). Our study noticed that during the COVID-19 lockdown, the majority of the participants were very happy as they got quality time to spend with their family and friends. Only a few experienced severe depression mainly due to pandemic situations or missing their beloved ones. The lockdown imposed by the COVID-19 pandemic was correlated with an impact on both happiness and depression. The COVID-19 pandemic resulted in increased happiness and very few people suffered depression during a lockdown situation. There will always be an important need to track population habits and well-being and to collect research data to establish evidence-driven strategies to minimize the impact of the introduction of lockdowns and the consequences induced by these unprecedented changes in the everyday lives of people.

In this placebo-controlled, double-blind clinical trial, we have investigated the effect of multi-strain probiotic (Bacillus coagulans Unique IS2, Lactobacillus rhamnosus UBLR58, Bifidobacterium lactis UBBLa70, Lactobacillus plantarum UBLP40 (each of 2 billion CFU); Bifidobacterium breve UBBr01, Bifidobacterium infantis UBBI01 (each of 1 billion CFU)) capsule with glutamine (250 mg) on students facing examination stress. A total of 80 students (18-24 years) were enrolled and randomised to receive multi-strain probiotic or placebo capsules twice a day for 28 days (i.e. pre- and during examination). The stress was analysed at the baseline and the end of the treatment by using the perceived stress scale (PSS), depression anxiety stress scale (DASS), and state-trait anxiety inventory (STAI) questionnaire. The serum cortisol levels were also determined. As a result, at the end of the trial, a total of 74 students completed the study, and those who consumed probiotic capsules showed a significant reduction in PSS, DASS, and STAI scores, and serum cortisol levels from the baseline as compared with placebo. No adverse events were reported during the study. In conclusion, the multi-strain probiotic is effective in reducing stress associated with examination. CTRI/2019/03/018178.

Rationale and Objective: Proton pump inhibitor (PPI) is one of the most widely prescribed medicines and commonly used in gastric related disorders and there is a huge need to analyze the irrational use of PPI in a country like India. The present study was designed to describe the rational drug use and cost comparison analysis of PPI in a rural tertiary care hospital. Methodology: A prospective observational study was performed among 253 inpatients for a period of 9 months after getting ethical approval. Those who received the PPIs for any of its indications were included in the study without any gender or age restriction. US FDA guidelines were used to analyse the appropriateness of the drug use and cost comparison analysis of the branded versus generic PPIs was also performed. Findings: Among the 253 inpatients, the majority (62%) were male and the mean age was 46±19 years. Mean hospital stay and the number of drugs in prescription were found to be 4.0 ± 1days 4.39 ±1.16 items, respectively. Pantoprazole (76%) was the most prescribed PPI even though the majority (57%) of the patients treated outside the FDA approved indication. Drug interaction has been reported in 14% and ADR in 9% of the population. The average cost of hospital stay estimated as 207.96+149.57 INR, and potential cost saving of INR 41582 was observed with generic replacement. Conclusion: The study inferred irrational drug use of PPI still prevalent, that too without considering the economic impact of it on general populations. Healthcare practitioners should be aware and cautious while prescribing the PPI to identify the actual need and to choose the most cost-effective alternative 1.

CAUTIs (catheter-associated urinary tract infections) continue to be one of the most common health-care-related illnesses in the entire globe. CAUTIs are the cause of 40% of all hospital-acquired infections and 80% of all nosocomial urinary tract infections (UTIs). A urine catheter is implanted into a high percentage of inpatients at some point during their hospitalization, and indwelling urinary catheter adoption likely to be on the rise. Urinary catheters, made of plastic materials, inhibit the urinary tract’s natural defence mechanisms and enhance the bacterial colonization or biofilm formation on the catheter surface, which may cause CAUTIs. It is associated with increased burden of disease, mortality, hospital bills and length of hospital stay. Therefore, to prevent these infections, technological innovations in catheter materials that limit biofilm formation will be required. Unfortunately, many health-care practitioners are unclear of the precise indications for bladder catheterization and accurate CAUTI criteria, which can lead to unnecessary catheterization, antibiotic overuse for asymptomatic bacteriuria and the spread of resistant organisms. As a result, we discuss CAUTIs in general, including definitions, pathophysiology, causation, indications for catheterization and a variety of effective CAUTI-fighting strategies.

Objective: The objective of this study was to investigate whether psychotropic has any effect on neutrophils and lymphocyte ratio (NLR) in psychiatric patients. Methods: In this hospital-based prospective quasi-randomized follow-up study, we analyzed every 10 patients with newly diagnosed with depression, schizophrenia, and bipolar disorder for complete blood count before and after treatment with the selected psychotropic. Results: There was a significant increase in NLR of patients with depression after treatment with psychotropic (p=0.001), also in schizophrenia, there was a slight increase in NLR of patients after treatment with psychotropic (p=0.005), but in bipolar disorder, there was a significant decrease in NLR of patients after treatment with psychotropic (p=0.002). Conclusion: The present study confirmed that psychotropics have a statistically significant effect on the increase in NLR in patients with depression, a slight increase in patients with schizophrenia, and a decrease in patients with bipolar disorder. Further studies are needed for a better understanding of the mechanism of psychotropic drug effect on NLR.

Background: Many variants detected after Wuhan-Hu-1 reference which were able to develop the resistance against the neutralizing antibodies induced by vaccine and may cause false negative results in diagnostic tests targeting the S gene. The Covid-19 cases are increasing rapidly in India and the government authorized a new vaccine for restricted use in emergency situation. Aims: This review discusses about the efficacy, safety, and economical aspects of vaccines authorized in India. Materials and methods: Wide-ranging assessment and analysis of accessible resources on online database. Results: The rAd26-s & rAd5-s (Gamaleya Research Institute of Epidemiology and Microbiology) demonstrate high efficacy as well as safety, followed by BBV152 (Bharat Biotech) and AZD1222 (Oxford AstraZeneca); AZD1222 is more economical than other two. Conclusion: The main goal of vaccination is to reduce deaths, protect the health care system and finally disease control, this is only be possible if more population is vaccinated with locally available Covid-19 vaccine and self-awareness about the prevention of disease transmission. Key Words: Covid-19, SARS-CoV-2, Immunization, Vaccine, Efficacy.

Funding Acknowledgements Type of funding sources: None. Introduction The clinical benefit of multielectrode high-density (HD) mapping during catheter ablation has been an area of active research. One advantage of HD mapping is improved sensitivity which can lead to better visualization and substrate delineation during the procedure. In addition to the advantages offered by the multielectrode grid mapping catheter (HD Grid), a novel software enable the display of beat-to-beat, dynamic regional mapping data from the current location of HD Grid in real-time (LiveView). The optimal settings and workflows to incorporate the dynamic data into routine ablation procedures have not been explored. Purpose To examine the common settings and workflow patterns among operators from different geographies when using dynamic mapping. Methods Observational procedural data including procedure time, total RF time, workflow preference, and fluoroscopy time, were prospectively collected from operators across Europe, the U.S., and Asia Pacific countries from May to September 2020. Cases from both catheter ablation of atrial and ventricular arrhythmias were included in the analysis. Results A total of 754 cases were collected (428, 133, and 193 cases from Europe, the U.S., and the Asia Pacific region, respectively). The most commonly reported indication across all three geographies was de novo paroxysmal atrial fibrillation (223/754, 30.0%). A steerable sheath was more frequently used with the mapping catheter in Europe and U.S. compared to Asia Pacific countries. Contrary to cases from the U.S. and Asia Pacific countries where the double transseptal approach was the preferred technique for left atrial procedures (78.8% and 55.3%, respectively), the single transseptal approach was more commonly observed in European cases (233/428, 54.4%). Visualization of real-time mapping data after creation of traditional full-chamber maps were commonly observed in all three geographies. Regardless of geography, the CS catheter was commonly used a reference electrode; and the most common map appearance settings for interior projection, exterior projection, and interpolation was 7, 7, and 7 respectively. Voltage cutoff of 0.1 mV, range from 0.01 to 1.5 mV, was most frequently observed for delineating scar in atrial arrhythmia cases analyzed in this dataset. Conclusions While there is a geographical difference in ablation workflow, common settings and patterns can be observed in all three regions. This data suggests that minimal workflow changes are required to incorporate the use of dynamic data into routine procedures. Adaptation of LiveView can help improve procedure efficiency and efficacy by reducing the need for full chamber maps, identifying areas that were under ablated, and confirming ablation endpoints. Further control study examining procedure efficiency and efficacy associated with dynamic mapping may be warranted.

BACKGROUND Background: The novel Coronavirus disease (COVID-19) is being considered as the most serious health threat that the world has never witnessed in the recent times and significantly affecting the daily routine of mankind by emerging as a global pandemic. As there is no treatment nor a vaccine that was approved so far, universal safety precautions (USPs) and mitigating strategies are the only way to deal with this emergency crisis. However, studies on knowledge and beliefs towards USPs among the general public in countries such as India with a large population are lacking. OBJECTIVE Objective: The goal of this study is to assess the knowledge and beliefs towards universal safety precautions during COVID-19 pandemic among the general public in India. METHODS Methods: A cross-sectional, web-based online survey was conducted among the general public in India during March 2020. A 20-item validated, a self-administered survey questionnaire was developed and randomly distributed among the public using Google Forms through social media networks. Descriptive statistics were used in representing the study characteristics, and the Chi-square test was used in assessing the associations among the study variables with a p-value of < 0.05 was considered as statistically significant. RESULTS Results: Of 1287 participants, 1117 have given their consent of willingness and completed the questionnaire with a response rate of 86.8%. The mean age of the study participants was 28.8 ± 10.9 years, and based upon the socio-demographic information, the majority were post-graduates (32.9%), professional job holders (45%) and belonged to the upper-middle (40%) economic class. Overall, the average correct responses of knowledge (~63%) and beliefs (~83%) towards USPs and mitigating strategies among participants varied between moderate to high, with statistically significant associations with their socio-demographic characteristics. CONCLUSIONS Conclusions: Although the knowledge and beliefs of the general public in India towards USPs are encouraging, there is a need for long-term educational interventions as the dynamics and severity of COVID-19 have been changing day-by-day rapidly. The findings of this study could guide the public health authorities in making and implementing decisions to combat this pandemic. CLINICALTRIAL N/A

BackgroundThe novel Coronavirus disease (COVID-19) is being considered as the most serious health threat that the world has never witnessed in the recent times and significantly affecting the daily routine of mankind by emerging as a global pandemic. Yet, as there is no treatment nor a vaccine that was approved so far, universal safety precautions (USPs) and mitigating strategies are the only way to deal with this emergency crisis. However, knowledge and beliefs towards USPs among the general public in countries such as India with a large population are lacking.MethodsA prospective, cross-sectional, web-based online survey was conducted among the general public in India during March 2020. A 20-item self-administered survey questionnaire was developed and randomly distributed among the public using google document forms through social media networks. Descriptive statistics were used in representing the study characteristics, and the Chi-square test was used in assessing the associations among the study variables with a p-value of < 0.05 was considered as statistically significant.ResultsOf 1287 participants, 1117 have given their consent of willingness and completed the questionnaire with a response rate of 86.8%. The mean age of the study participants was 28.8 ± 10.9 years, where the majority of them belong to the age category ConclusionsAlthough the knowledge and beliefs of the general public in India towards USPs are encouraging, there is a need for long-term educational interventions as the dynamics and severity of COVID-19 have been changing day-by-day rapidly. The findings of this study could guide the public health authorities in making and implementing decisions to combat this pandemic.

Purpose There is an increased number of reports being published on rasburicase-induced methemoglobinemia recently. We aimed to identify and critically evaluate all the descriptive studies that described the rasburicase-induced methemoglobinemia, its treatment approach, and their outcomes. Methodology PubMed, Scopus and grey literature databases were searched from inception to January 2022 using search terms “rasburicase” and “methemoglobinemia” without any language and date restriction. A bibliographic search was also done to find additional studies. Only descriptive studies on Rasburicase-induced methemoglobinemia were included for our review. Two contributors worked independently on study selection, data abstraction, and quality assessment, and any disagreements were resolved by consensus or discussion with a third reviewer. Result A total of 24 reports including 27 patients (23 male, 3 female patients, and 1 study did not specify the gender of the patient) aged from 5 to 75 years were included in the review. Immediate withdrawal of the drug and administering methylene blue, ascorbic acid, blood transfusion, and supportive oxygen therapy are the cornerstone in the management of rasburicase-induced methemoglobinemia. Conclusion Rasburicase administration should be followed by careful monitoring of patients for any severe complication and treat it as early as possible appropriately. In a patient who presents with rasburicase-induced haemolysis or methemoglobinemia, it is often important to expect a diagnosis of G6PD deficiency unless otherwise confirmed and to avoid administering methylene blue, even though the patient is from a low-risk ethnicity for G6PDD.