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Depression is characterized by symptoms like sad mood, loss of interest and pleasure, low energy, worthlessness, guilt, psychomotor retardation or agitation, change in appetite and/or sleep and suicidal thoughts, etc. It may be a unipolar or a bipolar cyclic disorder in which cycles of mood swings from mania to depression occur over time. Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Citalopram and Escitalopram are the various SSRIs( Selective Serotonin Reuptake Inhibitors) preferred as first line of drug in such conditions. Among the SSRIs, Escitalopram exerts a highly selective, potent, and dose-dependent inhibitory effect on the human serotonin transport. By inhibiting the reuptake of serotonin into presynaptic nerve endings, this drug enhances the activity of serotonin in the central nervous system. Herein we report a case of a 82 year old male who presented with altered sensorium, tachycardia, hypertension and restlessness to emergency department of our hospital. Patient was known case of Adjustment disorder with Depressed mood and was on treatment with Tablet Escitalopram 10 mg OD and Tablet Zolpidem 10 mg OD since 1 month. Patient overdosed himself with 4 Escitalopram tablets of 10 mg. He presented with features similar to serotonin syndrome.

Introduction: WHO declared COVID-19 a pandemic on 11thMarch,2020. It was recommended to use standard Q COVID-19 Ag detection test as a point of care diagnostic assay for testing in the containment zones as well as hospitals in combination with the RT-PCR test.Medical students had been involved to carry out the Rapid Antigen Testing (R.A.T) Program.Objective: To evaluate perception of medical and paramedical students towards rapid antigen testing program (R.A.T.). Method: This was a cross sectional study conducted among Medical/Paramedical students of Ahmedabad, Gujarat participating in R.A.T. This program involved testing of people by standard Q COVID-19 Ag detection test. Patients who tested positive were isolated and counselled for further management. Feedback responses from the students were elicited regarding program effectiveness, utility and students’ satisfaction. Results: A total of 513 responses were recorded. 72.8% of the students perceived their communication skills to improve with patients. It helped 62.9% students to allay fear and apprehension regarding COVID.About77.8% of the students were extremely satisfied with the transport facility provided by the authorities. About 53% students were extremely satisfied with personal protective equipment. 36.6% students were extremely satisfied with remuneration. R.A.T. program invited intermediate rating with 34.8% students rating it as 7 or 8 on a scale of 0-10. Conclusion: Students reacted positively for the program and reported improvement in their communication skills. Most of the students were satisfied working at the community level during this pandemic and this program provided them unique chance to work at grassroots level. Undergraduate students for the first time were given individual responsibility as a health care worker in society. Hence, eliciting their perception and feedback was useful for all stakeholders.

Background: Autoimmune skin disorders (ASDs) are complex diseases triggered by autoantibodies action against epidermal antigens or the dermo epidermal junction. Although rare, they present high morbidity, affecting the quality of life (QoL) of patients and financial status of patient.Methods: This prospective, observational study was carried out in department of dermatology for 2-3 months after ethical approval. Drug usage pattern, heath related QoL (HRQOL) by using DLQI (Dermatology life quality index) and cost were evaluated in patients with ASDs. Statistical analysis was done using Microsoft excel office 2019 and rechecked with SPSS (version 23.0). P<0.001 was considered as statistically significant.Results: Out of 73 patients enrolled, 32 were male and 41 were female with the mean age was 48.27±14.93 years; 55% patients had autoimmune blistering skin disorders (AIBDs) and 45% having other ASDs (OADs). Pemphigus vulgaris (PV) (35%) being the most common among all ASDs. Systemic steroid (60.27%), topical steroid (79.45%), levocetirizine (63%) were most commonly prescribed drugs. Mean DLQI score at baseline and after treatment was 11.64±2.49 and 6.8±2.75 respectively. It was highly significant statistically (p<0.0001). Total cost of illness per month was 813.64±481.21 INR. Maximum percentage variation in cost was seen with prednisolone (1706.28%).Conclusions: ASDs have a female bias and inflict severe impairment to the QoL of patients. Appropriate drug therapy with corticosteroids and other adjuvant drug lead to positive impact on QoL. There was very wide price variation of different brands of the same generic most commonly prednisolone and levocetirizine.