Pulmonary renal syndrome (PRS) is characterized by both diffuse alveolar haemorrhage and glomerulonephritis as pathological features. Several immunologic and non-immunologic mechanisms including antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis, anti-glomerular basement membrane disease, and systemic lupus erythematosus are commonly involved in the pathogenesis of the syndrome. We herein present a 60-year-old woman, non-smoker, who presented with fever, polyarthralgia, and the spreading of generalized purpuric rashes. The patient displayed rapid deterioration over the following two weeks marked by progressive declining renal function followed by haemoptysis. The patient was subsequently diagnosed with PRS, which was confirmed by the radiological evidence of alveolar haemorrhage and the histopathological evidence of pauci-immune glomerulonephritis. All immune markers including ANCA were negative. The patient was successfully treated with hemodialysis and immunosuppressive therapy. ANCA-negative vasculitis is a rare entity and even more rare as an etiology of PRS. An early diagnosis of this disease and its timely intervention is crucial.

The first case of SARS-CoV2 admitted on 26th December 2019 in Central Hospital, Wuhan, China. Broncho-alveolar lavage and Polymerase chain reaction of the aspirate showed high abundance of a viral RNA which has 89.1 % nucleotide identity with bat coronavirus previously isolated in China. Soon human to human transmission was observed and the outbreak started spreading. World Health Organisation on 11th March 2020 declared it as pandemic. COVID 19, caused by SARS-CoV-2, a disease we are still struggling to contain. With vaccination drive throughout the world, though the severity in re-infection has come down, but there is still threat by the various variants which are arising from time to time in various countries. The most effective way of preventing the spread of the virus is to keep physical distance from others of at least 1 meter, wearing a well fitted mask, keep hands clean and use hand sanitizer frequently, stay in well ventilated place, avoid crowded place and cough into bent elbow or tissue paper and get vaccinated when once’s turn comes. Therefore, we urge people to follow COVID appropriate behaviour properly. Keywords: COVID 19, SARS-CoV2, COVID appropriate behaviour, Social Distancing

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COVID 19 caused by severe acute respiratory syndrome corona virus 2 (SARS CoV2). Initial infection started from China in December 2019. It became pandemic and till date it has infected 399 million people all over the world. First wave was associated with more panic situation and it has impacted mental health globally. As time passed and with subsequent waves, we have learnt to deal with the stress caused by COVID 19. I am presenting my case of suffering from COVID 19 twice despite vaccinated and its psychological impact on mental status.

Background: Telemedicine service was historically started for ambulatory and hospice care patients. Since 2020, we have been in the midst of the COVID-19 pandemic. The availability of healthcare facilities became limited due to repeated locked down during the COVID-19 pandemic. Thus, telemedicine service has gained tremendous popularity among healthcare services. Telemedicine service was started at All India Institute of Medical Sciences (AIIMS), Deoghar, as a COVID Helpline facility to provide guidance and care to the home isolated COVID-19 patients during the second wave of COVID-19. But we observed that more than 40% of calls were due to non-COVID-19-related problems, but we managed the non-COVID-19-related calls by discussing with a specialist in conference calls or WhatsApp consultation. Therefore, we planned to compare individual satisfaction with telemedicine services in patients with COVID-19 and non-COVID-19-related problems.Methods and materials: This study was a cross-sectional retrospective analysis of the register of telemedicine maintained in AIIMS, Deoghar, callers were grouped into two-COVID-19 and non-COVID-19related problems. We obtained feedback from the patients and recorded it in a google form, collected data were analyzed in both groups. Telephonic consent was taken for participating in the study. The sample size was calculated to be 252, the COVID-19 group: 126, and the non-COVID-19 group: 126, and simple random sampling was used to choose the participants from the 730 total callers of the first month of telemedicine service. Their response was graded on 4 points Likert scale (1=Poor, 2=fair, 3=Good, 4=Excellent) and outcomes were analyzed by IBM SPSS (version 20.0) software. A p-value of <0.05 was considered statistically significant.Objective: The primary objective is to estimate the level of satisfaction in both groups and compare their level of satisfaction. The secondary objective is to determine the department-specific telemedicine services requirement for people in need.Results: Out of a total of 252 patients, most (54%) callers were 18-45 years old, and 44% were above 45 years old. 64% of patients were male. 90% of callers were from urban or semi-urban districts. 90% of callers had a 10th-grade or more education. 89% of patients were willing to use telemedicine services in the future. An Independent sample t-test was used to compare the means of both the groups showed a significant difference (p < 0.05) in the level of satisfaction in the COVID-19 group to the non-COVID-19 group. It showed that satisfaction in the COVID-19 group was higher than the group with non-COVID-19-related problems.Conclusion: COVID-19 has changed the whole spectrum of healthcare needs of the community. Our study findings showed that there is a need for separate department-wise telemedicine services to provide satisfactory service for attending to problems related to that department. For example, problems with diabetes should be attended to by an endocrinologist or an internal medicine specialist. This study ...