Case report on meningoenceplapathy in an Indian patient post CoViD vaccination.

The SARS-COV-2 infection-related severe illness is prevented by vaccinations. Therefore, it is relevant to report a case of post vaccine meningoencephalitis in a 30 year old male Indian patient, who presented with weakness in all the extremities, episodes of loose stool, fever, vomiting, tachypnea and loss of consciousness immediately following the 2nd dose of the COVID vaccination (COVAXIN).

COVID-19 Vaccination and Gaps in India.

INTRODUCTION: The important variables that influence how many people are vaccinated against coronavirus disease (COVID-19) in India include vaccine skepticism, socioeconomic status, and multi-dimensional deprivation. Our preliminary research suggests that uncertainty about the safety of the COVID-19 vaccine has a large and detrimental effect on immunization rates. MATERIALS AND METHODS: The Crucial Subsets Survey (CSS) is performed daily on Facebook to recruit participants for cross-section surveys by academic institutions, the Delphi Research Center, and the University of Maryland's Joint Program in Survey Methodology. Facebook will notify a portion of its daily users to take a vote. CSS adds behavior, attitude toward policy and preventive measures, economic consequences, and critical indicators to official reporting data. RESULTS: It has been estimated that a 30% drop in vaccination coverage may be attributed to a 1% rise in vaccine skepticism. Similarly, higher rates of multidimensional poverty are associated with lower rates of COVID-19 vaccine coverage. When the multidimensional poverty index (MPI), or the percentage of persons living in extreme poverty, rises by one unit, immunization rates fall by around half. It suggests that higher rates of socioeconomic hardship have unfavorable effects on health outcomes like vaccination rates. We also showed that gender is a major factor in influencing how internet availability affects vaccination rates and hesitation. We discovered that male vaccination rates went up in tandem with male internet use. This might be because of the digital divide and India's reliance on digital technologies like the COVID Vaccine Intelligence Network (COWIN), AAROGYA SETU, and Imphal, India, to assign and register for COVID-19 vaccinations, while males have greater digital excess than females. While male internet access is significantly and positively correlated with coverage, female internet access is significantly and negatively correlated with coverage. Women are less likely to seek medical care and have more vaccination reluctance than men, both of which contribute to this trend. CONCLUSION: The government's strategy for disseminating information about the COVID-19 vaccination should prioritize reaching out to women. In order to recruit more women to vaccination clinics, it is important to raise public awareness about the need for immunization among women via the media and community outreach.

Assessment of Kidney Involvement in COVID-19 Patient.

BACKGROUND AND AIM: Physicians need to be aware of the difficulties that SARS-CoV-2 infection brings to other regions of the body, such as the kidneys, even though the key emphasis is on pulmonary characteristics. The most frequent kidney complication among COVID-19 hospitalized patients is considered acute kidney injury (AKI). This study aimed to describe overall different aspects of acute kidney injury (AKI) in COVID-19 patients admitted to JLNMCH during the COVID-19 pandemic and to determine the prevalence of AKI among COVID-19 hospitalized patients. METHODS AND MATERIALS: All adult patients (over the age of 18 years) who screened positive for COVID-19 in a swab specimen from areas of nasopharyngeal by reverse transcriptase polymerase chain reaction and then hospitalized were included in the study. Information was gathered on the patient's demographics, general medical history, and drugs prescribed. From past medical information, associated comorbidities and home pharmaceuticals were identified. We gathered hospitalization information, such as duration of stay in ICU, details about the application of mechanical ventilation, information regarding extracorporeal membrane aeration, details of the use of vasopressor administration, and baseline results of laboratory test along with baseline clinical information during 48 hours of hospitalization. RESULTS: The percentage of patients with no history of AKI requiring traumatic mechanical ventilation was 79.4%, while the percentage of patients with no history of AKI not requiring traumatic mechanical ventilation was 11.5%. The difference was relevant statistically (p<0.001). The percentage of patients with AKI of any stage requiring traumatic mechanical ventilation was 22.8%, while the percentage of patients with no history of AKI not requiring traumatic mechanical ventilation was 76.8%. The difference was relevant statistically (p<0.022). CONCLUSION: We discovered that AKI was a rather typical finding among hospitalized COVID-19 patients. Patients hospitalized for COVID-19 had a poor prognosis if they developed AKI.

Effectiveness and Safety of Pirfenidone and Nintedanib for Pulmonary Fibrosis in COVID-19-Induced Severe Pneumonia: An Interventional Study.

Background After a diagnosis of two to five years, the survival length for pulmonary fibrosis (PF) is considered to be medium. The primary objective of PF treatment is to stabilize or minimize the pace of progression of the illness. The treatment of PF by nintedanib and pirfenidone was a breakthrough. In a group of coronavirus disease 2019 (COVID-19)-induced PF patients, we examined the efficacy of pirfenidone and nintedanib. Methodology From May 2021 to April 2022, 5,000 patients receiving antifibrotic treatment with pirfenidone or nintedanib (mean age of 78.3 ± 23.8) for PF were identified. Their clinical and functional information was retrospectively examined at zero, six, and twelve months of therapy. Results The average age of patients receiving nintedanib was greater than the average age of the pirfenidone group (p < 0.0001). Exertional dyspnea and dry cough, with no distinction between the two groups, were the most prevalent symptoms of the illness (p < 0.05). No significant changes between patients on pirfenidone and nintedanib were seen in forced vital capacity, forced expiratory volume in one second, total lung capacity, and diffusing capacity for carbon monoxide at zero or six months (p > 0.05). After one year, lung function measures were similar to the baseline in individuals treated with pirfenidone and nintedanib. This study highlights the appearance of both antifibrotic medicines as promising treatment options for functional stability in COVID-19-induced PF patients. Conclusions The patients affected by COVID-19 and undergoing fibrinolytic therapy may be well treated by any of the drugs with a significant improvement.

A study of bone turnover markers in gestational diabetes mellitus.

INTRODUCTION: Gestational diabetes is defined as carbohydrate intolerance resulting in hyperglycemia of variable severity with the first recognition during pregnancy. Established risk factors for gestational diabetes mellitus (GDM) are maternal age, obesity, family history of diabetes, etc. Vitamin D, parathyroid hormone (PTH), and various other hormones are known for their function in maintaining calcium and phosphorous homeostatic. Furthermore, Vitamin D, PTH serum ionized calcium, and alkaline phosphatase (ALP) have been reported to be altered with glucose homeostasis. The present study compares the bone markers in pregnant women with and without gestational diabetes. MATERIALS AND METHODS: This cross-sectional study was conducted at outpatient antenatal check-up clinic and outpatient diabetic clinics at J. N. Medical College and Hospital, Aligarh. One hundred pregnant females, of which fifty with GDM and fifty without GDM, were included in the study from January 2014 to November 2015. Detailed history, physical examination, and anthropometric measurement were done. Bone turnover markers in the form of Vitamin D, parathyroid hormone, serum ionized calcium, and serum ALP were measured in pregnant women who had gestational diabetes which was compared with normal pregnant women. RESULTS: In our study, the mean age of participate of GDM group was 28.2 ± 3 years, while the mean age group in non-GDM group was 25.44 ± 2.78 years. Ionized calcium in GDM was found to be 4.606 ± 0.354 mEq/L, while in non-GDM, it was 4.548 ± 0.384 mEq/L, P = 0.430. Vitamin D came out to be 21.80 ± 9.48 ng/ml, while it was 32.346 ± 8.37 ng/ml in non-GDM group. Serum PTH in GDM group was 71.436 ± 36.189 pg/ml and 37.168 ± 8.128 pg/ml in nondiabetic gestational group. Serum ALP in GDM group was 9.1 ± 4.56 KA U/dl and 6.98 ± 2.2 KA U/dl in nondiabetic gestational group, P - 0.0038. In GDM group, there was a significant negative linear correlation between PTH and 25-hydroxyvitamin D with research correlation coefficient r = -0.9073, P = 0; there was a significant positive linear correlation coefficient between PTH and ALP with Persian correlation coefficient r = 0.6597, P = 0; there was no statistically significant correlation between PTH and ionized calcium r = 0.1416, P = 0.3267. CONCLUSION: All GDM subjects should ideally be screened for serum calcium, vitamin D, PTH, ALP. If found impaired should immediately be corrected in order to prevent its adverse effects on maternal and fetal outcome. Vitamin D supplementation should ideally be initiated in all GDM females even if the above parameters are not investigated in Indian setup.

Correlation of Waist-to-hip Ratio (WHR) and Oxidative Stress in Patients of Acute Myocardial Infarction (AMI).

BACKGROUND: Obesity is associated with increased oxidative stress and lipid peroxidation is thought to play a crucial role in the generation of atherosclerotic lesions of Acute Myocardial Infarction (AMI). METHODS: The case-control study contained 120 subjects divided in two groups, 60 patients with AMI and equal number of age- and sex-matched healthy subjects as controls. Ratio of Waist Circumference (WC) to Hip Circumference (HC) (waist-to-hip ratio) of all the subjects was recorded. Antioxidant status of the individuals was determined by measuring the serum levels of Glutathione Peroxidase (GPx) and Superoxide Dismutase (SOD). Estimation of Malondialdehyde (MDA), a marker of lipid peroxidation was used as a surrogate marker of free radical activity. RESULTS: WHR was found to be significantly higher in patients of AMI as compared to controls. MDA levels were significantly high and antioxidants molecules GPx and SOD were significantly decreased in AMI patients as compared with control (p<0.001). WHR correlated positively to serum level of MDA and inversely to the serum level of antioxidant enzymes. CONCLUSION: High Waist-to-hip ratio is associated with high concentrations of malondialdehyde level and low concentration of antioxidant's enzyme. This results in increased oxidative stress, a major causative factor of AMI.