Background: Patients undergoing elective cardiac surgery often experience pre-operative anxiety. Preoperative anxiety influences surgical outcome. There are very few studies which have assessed the impact of clonidine and Gabapentin in the treatment of anxiety especially in Indian populations and its implications on major adverse cardiac events (MACE) and 30 days mortality. Materials and Methods: Adult patients aged 18 to 80 years old who were scheduled to have an elective coronary artery by-pass graft (CABG) were included in the study. Those who satisfied the inclusion criteria were given either Gabapentin (800 mg) or Clonidine (300 mcg) 90-120 minutes before the induction. State trait anxiety inventory (STAI) was used to assess anxiety in baseline and taking just before operating room. The primary endpoint was a reduction in the STAI associated with the study drug, while the secondary endpoint was the incidence of MACE in the perioperative period (30 days), which included composite episodes of non-fatal cardiac arrest, chaotic rhythm, acute myocardial infarction, congestive heart failure, cardiac arrhythmia, angina, and death. Results: A total of 75 patients were considered for the statistical analysis. The demographic and clinical features of the study participants were similar in both groups. Nearly 75-80% of participants had severe anxiety in the preoperative period while 10-20% had moderate anxiety. While both the drugs showed a reduction in the anxiety levels, the clonidine group fared better (statistically insignificant). The incidence of MACE was similar in both groups. Conclusion: The preoperative anxiety levels were high among cardiac surgery patients. Both clonidine and gabapentin were equally effective in reducing the levels of preoperative anxiety. Preoperative STAI scores in the range of 32-53 is not associated with MACE and 30-day mortality among cardiac surgery patients.

Introduction: Ibutilide is a class 3 antiarrythmic agent that is used infrequently. There are few studies on its usage, especially among Indians. Materials & Methods: A retrospective study was conducted on patients in a tertiary care unit who had recently developed atrial fibrillation and were given the normal dose of ibutilide. During the study period, data was gathered from medical records. Results: During the study period, ibutilide was given to a total of 40 patients who met the inclusion criteria. The majority of the participants were under 60 years old and had only been in atrial fibrillation for less than 24 hours. In 70% of cases, atrial fibrillation could be successfully terminated with only a small risk of adverse events. Conclusion: Ibutilide is a safe and effective treatment for people who have recent onset atrial fibrillation.

The global struggle against corona virus disease 2019(COVID19) is now in its 8th month since the pandemic virus SARS –COV2 has first emerged.The severe economic,personal and psychological adverse effects of shutdowns and social distancing make these effective preventive measures challenging to sustain long term.Safe and effective COVID-19 vaccine could lead to a level of global immunity that stops the pandemic.This is the anti COVID-19 intervention most public health leaders and many people long for the most. As of August 2020,there were 231 vaccine candidatesin development although no vaccine has completed clinical trials to prove its safety and efficacy.1 26 vaccine candidates are in clinical trials with 20 still in phase l-ll and 6 beginning phase lIl2 among which three are Chinese COVID-19 vaccines (inactivated virus based) from Sinovac/Institute Butantan, Wuhan institute of biological products/sinopharm and beijing institute of biological products/sinopharm,the other three leading candidates are developed by oxford/astrazeneca(modified adenovirus vector),moderna/NIAID(mRNA based) and Bio-N tech/Fosun pharma/Pfizer (mRNA based) WHO however warned “entering phase lll doesn’t mean nearly there” as there is no guarantee that any of these six will give us the answer. Sputnik 5 Russian based COVID-19 vaccine (adeno based) is a medical coup,a propaganda coup,a political and marketing coup.Phase l/ll trials are inadequate to prove it’s efficacy and safety because of three reasons 1) it was tested only on 76 people 2 it is a two dose vaccine but in phase l/ll only one dose was given 3 it’s phase l/ll results were not published therefore not peer reviewed.3 India based Bharath biotech(inactivated virus based)/ zydus cadila( DNA based) vaccine trials demonstrated an encouraging safety profile in phase l and moved to phase ll

A 22 yr old postpartum female after a twin vaginal delivery presented with shortness of breath grade 2-4 NYHA, grade 3 pedal edema and basal crepitations is diagnosed to have Takotsubo cardiomyopathy. A young age of 22 years is uncommon for this disease and stressor might be twin vaginal delivery in this case. However patient showed significant improvement within a week and showed complete recovery within 2 months.

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