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The COVID-19 Pandemic has disrupted life and changed what we knew as normal, for the past 9 months. Although the first case of COVID-19 was identified in Wuhan, China in mid-December 2019, it was coined as a Pandemic by WHO in March 2020. The COVID-19 Pandemic has impacted each and everyone and caused a ripple effect in all areas of life, the healthcare is no exception. With its novel nature, limited information, lack of resources, risky working conditions, and high spikes in cases, it has caused a massive overload on the healthcare systems. It has caused mental health disturbances not just in the frontline workers and COVID-19 survivors but also in the general public owing to uncertainty, isolation, fear, anxiety, andmisinformation. In addition to this, there has also been an increase in the prescription of antibiotics which stems from the inability to examine the patient physically and obtain samples for cultures as consultations are scheduled through telemedicine. Antimicrobial resistance(AMR) is considered to be further potentiated during the Pandemic as Antimicrobial stewardship programs (ASP) have been disrupted and there is an increase in hospital admissions and intubations of patients. Measures like lockdown and travel restrictions placed to curb the spread of the virus have negatively impacted individuals with addictions and substance use disorders (SUD’s) due to inability to access de-addiction centers, increased isolation, and inability to obtain toxicants which lead to the use of adulterated substances and in some cases withdrawal symptoms. The lockdown has also caused delays in the treatment of chronic and co-morbid diseases like Diabetes, Cardiovascular diseases, Cancer, Dialysis leading to poor disease management and progression of the disease. It has also impacted regular vaccination schedules and periodic health checkups leading to late diagnosis of diseases.

Idiopathic Intracranial hypertension (IIH) is a condition characterized by elevated Intra cranial pressure (ICP) due to no definite cause. It is a rare disorder and mostly occurs in females of reproductive age and obese individuals. Obesity and anemia are associated with elevated ICP, and contribute to the disease. If not managed at right time prolonged ICP can lead to papilledema and other visual abnormalities. The diagnosis is made with MRI, CT scan, lumbar puncture. The treatment focuses on reducing the elevated ICP and preserving the optic nerve function. Treatment is done with pressure reducing agents like Acetazolamide and supportive treatment may be given to reduce headache. This disease is prone to recurrence, thus management of weight and lifestyle modifications are necessary to prevent the relapse of disease.

Introduction: Gastroesophageal reflux disease (GERD) is a digestive disorder that affects the lower esophageal sphincter (LES). Functional dyspepsia (FD) is characterized by troublesome early satiety, epigastralgia or heart burn. It is often overlooked as the symptoms overlap with GERD. This study aims to compare the effectiveness of Acotiamide+Rabeprazole vs. a double dose of Rabeprazole in Indian population. Method: In this study 60 patients diagnosed with PPI refractory GERD (taking PPI>8weeks) and FD with no gastric or duodenal organic abnormalities were randomly allocated in two groups. Group 1 received a combination of Acotiamide (200mg/day) +Rabeprazole (20mg/day) and group 2 received a double dose of Rabeprazole (40mg/day). Follow ups were done every month for 3 consecutive months. The frequency and severity of symptoms were assessed using standard Izumo scale and FSSG scale. Results: The total score and GERD score from the baseline were significantly reduced in group 1 however the reduction in FD score from baseline did not differ significantly in the two treatment groups according to F-scale. The proportion of patients with ≥ 50% reduction in the total score for three upper gastrointestinal symptoms (heart burn, epigastralgia, and epigastric fullness) in the izumo scale was 96.7% in group 1 and 33.3% in group 2. Significant difference were noticed between the two groups. No serious adverse events were observed. Conclusion: The combination group of Acotiamide+Rabeprazole was found to be more effective than double dose of Rabeprazole in reducing the overlapping symptoms of PPI refractory GERD and FD.