Background: The equitable COVID-19 vaccination is an effective tool to end the pandemic globally. Many studies have reported, namely, in the western population, vaccination protected against the severe form of COVID-19 infection. Aims and Patients: To estimate the prevalence of COVID-19 infection amongst health-care professional's post vaccination at a Tertiary Care Centre in Kodagu, Karnataka. Methods: A cross-sectional study was conducted amongst 336 health-care workers in a Tertiary Care Centre Kodagu from November 2021 to January 2022. A convenient sampling technique was used to collect the data using a semi structured questionnaire. Data were entered into Excel and analysed using Epi-info version 7.2. Results: Of 336 study participants, females were 195 (58.04%), and males were 141 (41.96%). The mean (standard deviation) age of the participants was 25.80 (4.67) years. The total prevalence of infection was 83 (24.4%); after the first dose of the vaccine was 22 (6.52%), and after the second dose was 61 (21.73%). The total number of hospital admissions after the first and second dose was 1 and 9, respectively. None of them required intensive care in the hospital. Conclusions: The COVID-19 infection reported after vaccination amongst health care workers was minimal. None of them required intensive care in the hospital.

Background: Chronic kidney disease (CKD) is a global health problem, with a worldwide prevalence of around 9.1 per cent (as of 2017). In India, its prevalence was found to be around 17.2%. There are several risk factors of CKD, out of which the presence of underlying longstanding uncontrolled diabetes mellitus (DM) and hypertension are common. Certain previous studies have tried to assess the level of knowledge, attitudes and practices of such a 'high risk' group for developing CKD but there is a paucity of literature on it. Hence, this study was undertaken to assess these domains in individuals at risk for developing CKD. Patients and Methods: It is an observational cross-sectional study conducted from October 2020 to December 2021 at a tertiary care teaching and referral hospital in India. A total of 215 patients who were at risk of developing CKD, were enrolled and were given a CKD Screening Index questionnaire to fill and scoring was done for all three components-knowledge, attitudes and practices. Results: The mean age was found to be 49.21 ± 13.49 years with a male: female ratio of 1.4:1. Nearly three-a fourth of the patients were having DM while one-fourth of the participants had a previous history of hypertension. The mean scores on the knowledge, attitude and practices scales were found to be 11.80 ± 5.31, 50.18 ± 8.23 and 30.83 ± 7.53 respectively. The study results revealed that the majority of patients had 'low' levels of knowledge scores but 'average' levels of attitude and practice scores. A significant correlation was found amongst knowledge and attitude scores (r = 0.226, P = 0.001), knowledge and practice scores (r = 0.153, P = 0.025) and practice and attitude scores (r = 0.295, P = 0.000) of our patients. Conclusion: There is a need of improving awareness at least amongst the population at risk of getting CKD. Improving knowledge would help in inculcating positive attitudes and healthier practices amongst these, thus delaying the onset of this disease.

Background: Ensuring high immunisation coverage and its acceptance among the beneficiaries are crucial for a healthy society. Hence, this study aimed to estimate vaccine coverage and barriers of immunisation among children of age 12–23 months in urban areas of Rishikesh, Uttarakhand. Aims: To estimate the immunization coverage rate among children of age 12-23 months in urban area of Rishikesh. Objectives: To identify the barriers towards immunization in children of age 12-23 months in urban area of Rishikesh. Materials and Methods: A community-based cross-sectional study was done in urban areas of Rishikesh for 1 year, including 210 children, using the WHO's 30 × 7 cluster sampling technique to collect data on immunisation status. Results: About 92% of the children were fully immunised. Bacillus Calmette–Guérin has the highest coverage rate (99.5%), whereas the coverage was the lowest for the measles vaccine (93.8%). Full immunisation coverage was found to be statistically significant with the education of the respondent, socio-economic status (SES) of the family and birth order of the child. Additional vaccines uptake showed a significant association between SES of the family and the place of vaccination. Conclusion: There were significant variations in childhood immunisation coverage across socio-economic and demographic factors. These findings emphasize on the need for regular monitoring and evaluation of immunisation coverage to achieve the benefits of vaccination in all strata of society.

Introduction: In this era of epidemiological transition where noncommunicable diseases are on a significant rise, cancer is a major public health problem globally. Out of all cancers, breast cancer is the most common female cancer worldwide. Aim: To determine the knowledge of breast cancer and its risk factors and breast self-examination (BSE) practice amongst urban women of North India. Patients and Methods: A cross-sectional study was carried out amongst 370 women aged between 20 and 60 years of age using pretested self-administered questionnaire. The collected information was entered into Microsoft Excel sheet and analysed using SPSS. Results: Mean age of the study participants was 40.3 ± 12.1 years and majority of the study participants (87%) were married. It was seen that the proportion of women who were aware increased as their literacy status increased, and this was statistically significant (P = 0.00). About 18.4% of the participants were aware regarding BSE. The most mentioned reason for not practicing BSE amongst those who were aware was that they considered themselves healthy (63.2%). Conclusions: In the current study, half of the women were aware of breast cancer and few were aware of BSE and very few were practicing BSE. It was seen that women with a higher level of education had better knowledge regarding breast cancer than women with low educational status. For the prevention of breast cancer, women are the most important stakeholder. There is a need to sensitise women regarding risk factors of breast cancer and preventive practices like BSE.

Background: Coronavirus disease 2019 (COVID-19) has caused unprecedented harm to humanity and economies worldwide. A study of economic impact of COVID-19 patients in urban slums is limited. Aims: Hence, this study was undertaken to estimate the out-of-pocket expenditure (OOPE), and compare amongst admissions in public and private hospitals and home isolation of COVID-19 patients. Patients and Methods: A community-based cross-sectional study was conducted in urban slums under the urban field practice area of a medical college between September 2021 and November 2021. Data from 108 COVID-19 patients were collected by a pre-tested semi-structured questionnaire by interview method. Results: The mean age of respondents was 41.99 ± 10.49. The most common symptom was fever 91.6%, followed by cough 69.4%. History of travel was present in 64% and contact with family member was 69%. The mean OOPE for COVID-19 disease was 36756 INR per patient. Overall, the mean direct cost for COVID-19 admission was 29143 INR and mean indirect cost was 7529.62 INR. On applying Krushkal Wallis test, OOPE for direct cost on COVID-19 patient hospital admission, lab investigations, medications was H=65.85, 53.52, 28.98 with P value< 0.05 respectively and was found statististically significant. Similarly for Indirect cost , Loss of wages, travel expenses of the patient and attenders was H=10.45, 31.23 respectively and was found to be statistically significant at P <0.05. Overall the mean direct cost with government, private, home isolation COVID-19 patients was highly significant χ² = 33.92, P = 0.000, and mean indirect cost χ² = 9.48, P = 0.002. Conclusions: The OOPE for COVID-19 disease was high. The direct and indirect cost in government facility was minimal. The government's timely response to the pandemic was able to reduce the costs to the patients or else the economic burden would be higher.

Background: The nursing process is an important tool that has transformed the standards of nursing practices. Application of the nursing process required proper training, guidelines and resources to be used by the nurses. Aim: The objective of this study was to assess the knowledge and practice of nursing process among nurses and explore factors influencing its applications by nurses. Methods: An exploratory, descriptive study was conducted among 210 nurses using a simple random sampling technique. A pre-designed, self-structured questionnaire on knowledge and practice of nurses regarding nursing process and factors influencing its application were used to collect data. The data were analysed using descriptive and inferential statistics. Results: Most of the nurses were female (60.5%), had General Nursing and Midwifery (76.2%) as professional education, working in general medicine units (52.5%) and had more than 5 years of professional experience. The mean knowledge and practice score regarding nursing process were 13.93 ± 5.204 and 6.51 ± 0.96, respectively. Major hindering factors were the absence of a format for recording nursing process, poor nurse–patient ratio and excessive workload and never attended in-service education on the nursing process. Many nurses reported working in a stressful environment and were dissatisfied due to excessive clerical paperwork. Conclusion: The majority of nurses had average knowledge of nursing process, but they were not practicing. Certain factors such as no format, in-service education and equipment supplies affected the nursing process application in clinical areas. Hence, it is recommended to modify the above factors for proper application of nursing process.

Background: Newborn screening (NBS) to identify various disorders has been running successfully across the world. But the public in many developing countries do not have access to this program. Aims: To assess the awareness of NBS in patients and clinicians. Patients and Methods: We assessed the awareness of NBS by oral questionnaire. Results: We found that, in the community the awareness regarding NBS was low [47.2%] and the knowledge of the availability of the test was less both in the community [65%] and amongst clinicians [11/28]. But all the subjects opined that the tests will have a high rate of acceptance if they are offered free of cost. Conclusions: The awareness regarding NBS is low but has potential for acceptance.

Zoonotic infection, severe acute respiratory syndrome coronavirus 2 causes several million deaths worldwide from its pandemic origin in China to date due to lack of proper diagnosis and treatment. Clinical laboratory investigations in biochemistry and pathology can be markers for sepsis, cardiovascular and hepatorenal impairment and genetic variations in angiotensin-converting enzyme as well as in ABO blood group play a vital role in predicting severity and prognosis in patients with comorbidities. In this minireview, the article will discuss the beneficial role of clinical laboratory markers in the management of coronavirus diseases 2019 and the possible factors which contribute to variations in laboratory results that may require attention during clinical management.

Gene therapy is the treatment of abnormal or mutated genes present in cells through the addition of healthy genes or replacement/deletion/site-specific modification of faulty genes. Deoxyribonucleic acid, messenger ribonucleic acid (RNA), small interference RNA, microsomal RNA and antisense oligonucleotides are the genetic materials implicated in gene therapy. They are inserted into the diseased cells using viral or non-viral vectors through an in vivo or ex vivo transduction. Gamma retrovirus, lentivirus, herpesvirus, adenovirus and adeno-associated virus are common viral vectors, while transposons, cationic polymers, dendrimers and cell-penetrating peptides or liposomes are common non-viral vectors. Allologous or autologous T cells, haematopoietic stem cells and chimeric antigen receptor T cells are used for ex vivo gene transduction. Conventional gene therapy of inserting new genetic material shows toxicity such as off-target effects, altered immune responses, inflammatory reactions and possible oncogenic transformation in the recipient. Newer gene editing techniques such as zinc-finger nuclease, transcription activator-like effector nucleases and clustered regularly interspaced short palindromic repeats allow the site-specific correction or control of expression of mutated genes present in cells. Until August 2020, 23 gene-based medicines received approval from drug regulatory agencies in various countries and 362 were in development. Single-gene disorders have shown encouraging results, but evidence of using gene therapy in polygenic and common age-related diseases is still required. Recently, the horizon of gene therapy widened to include COVID vaccines and as an adjunct to chemotherapy. If we could overcome its limitations such as immunogenicity, mutagenicity and high costs, gene therapy can be the medicine of the next generation.