Introduction: Nepal started the first phase of COVID-19 vaccination for frontline healthcare workers in January 2021 with the ChAdOx1 nCoV-19 (COVISHIELD) vaccine. We conducted active surveillance of Adverse Effect Following Immunization (AEFI) after the first dose of the vaccine administered at one of the sentinel sites for vaccination, Patan Academy of Health Sciences (PAHS). Method:  All the 5591 first dose ‘COVISHIELD’ vaccine recipients between 27 Jan -5 Feb 2021 at PAHS, were approached through phone calls to collect data on AEFI.  Incidence of common AEFIs in different age groups, gender and those with previous history of COVID-19 were analyzed. Presence of any Adverse Events of Special Interest (AESI) were evaluated. Result: Out of 5591 vaccines recipient, 3991 (71.3%) responded to the phone call and AEFI was noted in 3394 (85.04%) of them. Minor AEFI was seen in 3391 (84.9%), severe Minor AEFI in 1 (0.02%) and Serious AEFI in 2 (0.05%). Out of 807 vaccine recipients with previous history of COVID-19, 709 (87.9%) had AEFI while of the 3184 with no past history of COVID-19, 2685 (84.3%) had AEFI. However, some of the systemic AEFIs were noted more frequently in those with past COVID-19 infection. A total of 1886 (55.6%) took self-medication for symptom relief, 278 (8.2%) took leave from work while 26 (0.76%) visited health facility for the AEFIs. Conclusion:  Most AEFIs following the first dose of COVISHIELD vaccine were mild and resolved within a few days. Except for one case of anaphylaxis, no other AESI were encountered.

Background: Prehypertension in adolescents is an important risk for developing hypertension in later years of life. Hypertension is one of the major cardiovascular problems in urban and suburban areas of Nepal and is increasing among the young population. There are not many studies reported in Nepal which estimates the prevalence of hypertension among medical students. Hence, this study aimed to assess the prevalence of prehypertension and its association with body mass index so that it would assist in developing strategies for control of hypertension and cardiovascular diseases in later years of life Methods: This cross-sectional study included 250 medical students. Anthropometric variables of the subjects were recorded. Height and weight were measured on calibrated scales and body mass index was calculated. Waist and hip measurements were obtained and waist-hip ratio was calculated. Blood pressure was measured with a mercury sphygmomanometer. The data obtained was divided into different groups according to blood pressure and BMI. Descriptive statistics, chi-square test was used for presenting data and testing the significance and P<0.05 was considered as statistically significant. Results: The prevalence of normotensive, prehypertensive and hypertensive students was found to be 75.2%, 20.8% and 4% respectively. Mean BMI was found to be 21.59±3.39. In general, 75.2% of the students had ideal waist hip ratio, 15.2% were underweight, 70 % had normal weight, 12 % were overweight, and 2.8% were found to be obese. Moreover, 51.4% of prehypertensives had BMI more than 25. Prehypertension was significantly higher among males (χ2=16.385, p<0.001) and among the obese medical students (χ2=16.416,p<0.001). Conclusions: Prehypertension is prevalent in about a third of medical students and BMI is found to be significantly associated with pre-hypertension.

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Introduction: Pfizer-BioNTec vaccine was started in Nepal for the age group of more than 12 y. This study was conducted to find out the adverse event following immunization with Pfizer-BioNTech vaccine against COVID-19 at Patan Academy of Health Sciences (PAHS). Method: This is a descriptive study conducted at PAHS from November to December 2021. The vaccine recipients were called over the phone after 72 h of receiving the vaccine to find out adverse events following immunization (AEFI). They were inquired about the list of pre-defined AEFI. Ethical approval was obtained. Result: A total of 1377(27.4%) individuals among 5014 receiving the first dose and 983(71.4%) of 1377 receiving the second dose were enrolled in the study. Vaccine recipients who had minor AEFI in the first dose were 462(33.6%) and in the second dose were 205(20.9%). Reported AEFI in both first and second dose was pain 377(27.4%) and 97(9.9%) respectively, followed by fever in 65(4.8%) and 91(9.3%) respectively. There were no severe AEFI reported in both doses of vaccination. The AEFI started within 24 h and subsided within 72 h. Conclusion: Minor AEFI of pain and fever was reported with the first and second dose of the Pfizer-BioNTech vaccine. There were no severe and serious AEFI reported in this study population.

Introduction: Type 2 diabetes mellitus (T2DM) is a heterogeneous polygenic metabolic disease condition that is caused by insulin resistance leading to hyperglycemia. Since, T2DM is genetically inherited and autonomic dysfunction is its major complications, healthy offsprings of diabetic parents are highly vulnerable to manifest dysautonomia leading to insulin resistance. Objectives: We aimed to assess cardiac autonomic function using heart rate variability (HRV) parameters in healthy offsprings having parental history of T2DM. Methodology: A comparative cross-sectional study was carried out in the laboratory of department of Physiology enrolling 30 healthy offsprings of non-diabetic parents (Group 1) and 30 healthy offsprings of diabetic parents (Group 2). Anthropometric, biochemical and cardiovascular variables were assessed using standard procedures. Time domain and frequency domain parameters of HRV spectrum were assessed using photoplethysmography principle. Results: HRV findings revealed that markers of sympathetic regulation were significantly higher and those of parasympathetic function were significantly reduced in subject group having parental history of T2DM. LF/HF ratio was significantly increased suggesting sympatho-vagal imbalance in offspring of diabetic parents even in their euglycemic state. Conclusion:  Alteration of cardiovascular autonomic function is found in healthy offspring of diabetic parents, characterized by reduced vagal activity and pronounced sympathetic regulation. Assessment of cardiac autonomic function would help in timely detection of such dysautonomia and reducing the life-threatening effects on offspring having parental history of T2DM.