BackgroundThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is continuously evolving and many mutant variants of the virus are circulating in the world. Recurrent waves of COVID-19 have caused enormous mortality all over the world. It is of utmost importance for a health expert to understand the demographic and clinical attributes between the first and second waves of COVID-19 induced deaths.MethodThis was a hospital record based comparative study of baseline demographic, clinical and laboratory parameters of the first and second wave of COVID-19 in a tertiary care hospital in Uttarakhand, India. The study included all deceased patients admitted to the hospital during the first and second wave of COVID-19, i.e., between March 2020 to January 2021 and between March 2021 to June 2021, respectively.ResultThe study showed that there were more casualties in the second wave compared to the first, 475 (19.8%) and 424 (24.1%) respectively. There was no significant difference in terms of age. A male preponderance of mortality was evident in both the waves. The median duration of hospital stay was 5 (3-10) days in the second wave, which is significantly different from the corresponding duration in first wave (p<o.ooo). The most common clinical manifestation among the deceased were dyspnoea in both the waves, followed by fever and cough, the difference was statistically significant for cough (p< 0.000) The most prevalent comorbidity was diabetes mellitus (DM), followed by hypertension (HTN), with significant difference for HTN (p<0.003). The most frequently deranged lab parameter was lymphopenia with a significant difference across both the waves (p<0.000).ConclusionIn both the first and second COVID-19 waves, older males (>45 years) with comorbidities like HTN and DM were most susceptible for COVID-19 related mortality. The study also demonstrated that most of the baseline demographic and clinical characteristics which are attributed to the mortality were more common during the second wave of COVID-19.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is continuously evolving, and many mutant variants of the virus are circulating in the world. Recurrent waves of COVID-19 have caused enormous mortality all across the globe. Considering the novelty of the virus, it becomes crucial for healthcare experts and policymakers to understand the demographic and clinical attributes of inpatient deaths in the first and second waves of COVID-19. MethodsThis hospital record-based comparative study was conducted at a tertiary care hospital in Uttarakhand, India. The study included all COVID-19 RT PCR-positive patients admitted to the hospital during the first wave, from 1 st April 2020 to 31 st January 2021, and the second wave from 1 st March 2021 to 30 th June 2021. Comparisons were made with respect to demographic, clinical, laboratory parameters, and course of hospital stay. ResultsThe study exhibited 11.34% more casualties in the second wave, with the number of deaths being 424 and 475 for the first and second waves, respectively. A male preponderance of mortality was evident in both waves with significant differences (p=0.004). There was no significant difference in age between the two waves (p=0.809). The significantly different comorbidities were hypertension (p=0.003) and coronary artery disease (p=0.014). The clinical manifestations demonstrating a significant difference were cough (p=0.000), sore throat (p=0.002), altered mental status (p=0.002), headache (p=0.025), loss of taste and smell (p=0.001), and tachypnea (p=0.000). The lab parameters with a significant difference across both waves were lymphopenia (p=0.000), elevated aspartate aminotransferase (p=0.004), leukocytosis (p=0.008), and thrombocytopenia (p=0.004). During the hospital course of the second wave, in terms of intensive care unit stay, the need for non-invasive ventilation and inotrope support was higher. The complications manifesting in the form of acute respiratory distress syndrome and sepsis were observed more in the second wave. A significant difference was discerned in the median duration of hospital stay in both waves (p=0.000). ConclusionDespite being of shorter duration, the second wave of COVID-19 culminated in more deaths. The study demonstrated that most of the baseline demographic and clinical characteristics attributed to mortality were more common during the second wave of COVID-19, including lab parameters, complications, and duration of hospital stays. The unpredictable nature of COVID-19 waves calls for instituting a well-planned surveillance mechanism in place to identify the surge in cases at the earliest possible time and prompt response, along with developing infrastructure and capacity to manage complications.

Background and aims: COVID19 vaccines are now accessible to all Indian citizens. Infection with COVID19, on the other hand, continues to spread continuously. Our study aimed to determine the number of persons who had COVID-19 infections despite receiving the recommended number of doses of the COVID 19 vaccination at AIIMS Rishikesh, a tertiary care facility in Uttarakhand, India. Methods: We analysed meticulously preserved data regarding COVID-19 vaccination, COVID-19 infection, Clinical symptoms, and RT-PCR testing among all HCWs in our healthcare institution during period from 16 January 2021 to 30th June 2021.. Results: During this period, 5273 (90.3%) HCWs received two doses of COVID-19 vaccine, while 566 (9.7%) received only one dose. 628 HCWs (10.8%) were BBV152 recipients and 5211(89.2%) AZD1222 (ChAdOx1-S) recipients. 423 HCWs (7.2%,confidence interval of 95% - 13.8, 22.0) reported COVID-19 infections.274(5.19% of total vaccinated HCWs ) breakthrough infections and 149 non-breakthrough COVID-19 infections reported in HCWs who had previously received a single dose of the COVID-19 vaccination. . Conclusion: Viral infections sepecially breakthrough infections following adequate vaccination are a cause for concern, but there is a lack of data on these infections in the actual world. Therefore, the primary focus of research should be on the emergence of illness in India following the completion of a full vaccine course.

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The article provides a comprehensive review of the current situation of micronutrient deficiencies (MND) among children in India. It provides information of common MND with its prevalence and geographical distribution. The review includes a nationally representative survey, nutritional reports and studies conducted in the different regions of India. Iron deficiency anaemia, Vitamin A deficiency (VAD) and iodine deficiency disorder are found to be the most prevalent MND among children. The prevalence of anaemia ranging from 21% to 59.2%, VAD reported as a maximum of 10.2% in one of the recent Indian studies while the total goitre rate of highest as 21.9%. With the implementation of various nutritional programs for children, these deficiencies are found to be significant mainly among pre-school children. The recommendation on strengthening existing nutritional health programmes with some new intervention strategies to improve the micronutrient status among children and to reduce the economic burden to MND in the coming years.