Background: The objective of this study was to assess the awareness and acceptance of anticipated COVID-19 pediatric vaccination among parents in rural south India.Methods: Objective questionnaire based online cross-sectional study in out-patient department, school WhatsApp groups and the community between 01 July 2021 to 15 July 2021. Sample size 873. Parents of children less than 18 years of age willing to participate in the study were included. Parents not willing to participate in the study were excluded.Results: 64.6% parents accepted pediatric COVID-19 vaccination; 96.4% felt it beneficial to vaccinate children prior to re-opening of school. 96.68% were positive that vaccination in children shall play a pivotal role in the projected third wave. 35.39% were hesitant and wanted to delay vaccinating their children and 14.14% do not believe in vaccine efficacy. 14.53% parents were weary of giving vaccine to their children due to personal experience of adverse effects they had suffered, and 22.45% parents refused vaccination due to hearsay adverse effects. 17.6% parents felt that post COVID-19 infection, children don’t need vaccination. 38.95% of parents were concerned about interaction of COVID-19 vaccine with other vaccines of immunisation schedule, 19.36% felt that children don’t need specific COVID-19 vaccine since the regular immunisation schedule prevents COVID-19 infection.Conclusions: Parents of rural India are aware of the pandemic and its lasting impact in our society but its effect on children is still beyond their comprehension. Most parents are willing and accept pediatric COVID-19 vaccination, however vaccine hesitancy and misconceptions are significant entities that can derail full coverage of children.

Background: The objectives of study were to analyse and compare the methods for detection of fetal malnutrition and to study the maternal factors associated with fetal malnutrition in babies born in rural hospitals.Methods: Periodic prospective cross-sectional case-control questionnaire-based study. Nursing home and Hospital based in rural population from January 2017-March 2018. There were 350 term newborns born in Shrinivasa Nursing Home, and Crawford General Hospital, Sakleshpur, were selected consecutively. Inclusion criteria: live, singleton term neonates. Exclusion criteria: Preterms, post-terms, those with congenital malformation, multiple gestations, cephalhematoma, subgaleal bleed. Anthropometry, fetal malnutrition assessed using clinical assessment of nutrition (CAN) score, Ponderal and Kanawati indices between 24–48 hours of birth. Newborns with fetal malnutrition (cases), and well-nourished babies (controls) assessed for maternal risk factors using standardised questionnaire from mothers.Results: CAN score identified 185 (52.9%) as malnourished and 165 (47.1%) as normal; Ponderal index classified 170(48.6%) as malnourished and 180 (51.4%) normal. Kanawati index grouped 151 (43.1%) as malnourished. Maternal factors:  age (91.7% among <20 yr mothers-malnourished, 25% among >35 yrs), socioeconomic status (status 3, 4 had 57.2%, 66.7% malnourishment), improper antenatal care(80.7% irregulars; 38.5% among regulars), primiparity (60%;against  38.3% among multipara), pre-eclampsia (78.7%; 41.3% in normotensives), anemia (55.4%), weight gain (83.2% in <10 kg; 33.33% in >10 kg), stature (73.5% in <145 cm; 39.7% in >145 cm), medical illness (55.81%).Conclusions: CAN score is simple, systematic, clinical method of identifying malnutrition; statistically superior as screening tool. Maternal factors: improper antenatal checkups, primiparity, pre-eclampsia, medical illness, inadequate weight gain, short stature had significant association with fetal malnutrition. Maternal age, socioeconomic status, anemia not statistically significant.

The aim of this case report is to discuss issues related to management of one eyed pregnant female. A 26-year-old female (Patient A) and 28-year-old female (Patient B) both in second trimester and one eyed presented to our outpatient department with diminution of vision due to rhegmatogenous retinal detachment (RRD). Retina was attached in Patient A following scleral buckling surgery but Patient B required pars plana vitrectomy with silicon oil tamponade. Best corrected visual acuity in both patients did improve from 1/60 to 6/24 and 6/18, respectively at 6 months follow-up. Exudative RDs are known to occur in pregnancy as a complication of preeclampsia, but RRD in pregnancy although co-incidental poses certain challenge with regard to management of such cases especially if the patient is one-eyed. Things to consider for management include (1) type of anesthesia (2) surgical positioning (3) positioning after surgery (4) anti-glaucoma medication if required (5) corticosteroid treatment in pregnancy (6) to provide them ambulatory vision as early as possible. With proper management and monitoring it is possible to provide them with early ambulatory vision without offering any harm to her pregnancy and fetus.

The noble coronavirus SARS-CoV-2 results in a devastating, multisystem disease among which COVID-19 pneumonia creates serious complications and most of COVID-19 related deaths. COVID-19 patients develop a systemic inflammatory response through interleukin (IL) and tumor necrosis factors. In COVID-19 patients, cytokine storm controlling is the key step for treatment because cytokine attacks own body cells instead of fighting with the virus. We reviewed several literatures to summarize the safety and efficacy of LD-RT in COVID-19 patients. Low dose chest radiation may reduce the inflammation in the lungs in severely ill patients. The radiation offset an immune system called AS a cytokine storm. Several randomized/non-randomized, single/multi-centered, open/close clinical trials are underway in U.S, India, Iran and around the globe. Early studies showed LD-RT reduces the inflammatory cytokines, time of hospitalization, duration of ventilation, and a number of deaths. However, some researchers warned for radiation-induced cancer (lung, breast, and esophageal) and cardiovascular diseases. So, further extensive preclinical studies should be conducted to identify the risk-benefit ratio in COVID-19 patients.

Background: Breastfeeding is the most crucial intervention with exponential positive impact on the maternal and infant health, that can change the community health outcome. Although a general awareness regarding breastfeeding cannot be undermined, there is significant gap in its optimal understanding, and practice in the rural community.Methods: Questionnaire-based cross-sectional study conducted in a rural nursing home and clinic. Mothers aged 15-45 years who were actively breast feeding or have breastfed in the past, visiting for various reasons.Results: Out of 300 mothers included in the study, most mothers were aged 20-30 years (66%), stay-at-home (77%), below-poverty-line (81%) with school-level education (43%). 77% mothers knew about breastfeeding initiation within 1 hour of life, 75% knew exclusive breastfeeding must be practiced for 6 months. 74% knew that breastmilk reduces risk of allergies in baby, 58% were aware of its thermoregulatory benefits in neonates, 41% knew about its contraceptive benefits. 17% mothers felt embarrassed to breastfeed in public, 28% felt breastfeeding is a hindrance to occupation. 51% mothers fed by partial emptying of both breasts in each feed, 28% practiced burping of children for 20 minutes, 5% stored expressed breastmilk at room temperature, none knew about storage of breastmilk in fridge.Conclusions: Mothers lack awareness about thermoregulatory benefits, reduced allergy risks and lactational contraceptive benefits of breastfeeding. They lag significantly, regarding complete emptying of each breast during feeds, adequate burping of baby, expression and storage of breastmilk. Significant gap between knowledge and practice of successful breastfeeding noted.