Background: Eventration of diaphragm associated with gastric volvulus is an uncommon condition.

Background. Little information is available from India regarding prognostic factors in patients with community acquired pneumonia (CAP). Methods.Hospital-based prospective study to test the validity of pneumonia severity index (PSI) and the confusion, urea, respiratory rate, blood pressure, age over 65 years (CURB-65) risk scoring systems in patients with CAP (n=150).Results. Although both CURB-65 class ≥III and PSI class ≥IV were 100% sensitive in predicting death, CURB-65 class ≥III had a higher specificity (74.6%) than PSI class ≥IV (52.2%) when used to predict death. In both PSI and CURB-65 risk scoring systems, mortality rate, need for intensive care unit (ICU) admission, prolonged need for intravenous (I.V.) antibiotics, prolonged duration of hospital stay and need for admission to ICU increased progressively with increasing scores. The PSI class ≥IV was more sensitive in predicting ICU admission than CURB-65. The duration of hospital stay was found to have a weak but significant correlation with PSI and CURB-65 criteria. Defervescence time also had a very weak but significant correlation with PSI and CURB-65 criteria. Duration of I.V. antibiotics had a moderately strong correlation with CURB-65 criteria but a weak correlation with PSI criteria. Conclusions.Both PSI and CURB-65 were found to have equal sensitivity to predict death from CAP. Specificity of CURB-65 was higher than that of PSI. However, PSI was more sensitive in predicting ICU admission than CURB-65.

Background: Chest trauma comprises about 10-15% of all traumas and 25% of all deaths from traumatic injury. Chest injuries are cause by blunt mechanisms such as road traffic accidents or penetrating mechanisms such as stab and missile injuries. Traumatic chest injuries are the most common cause of preventive mortality and morbidity.Methods: A retrospective study of all patients with chest injury presenting to Emergency Department of SKIMS Medical College, Srinagar was done.  Records of all the patients were retrieved. A complete data regarding age, gender, mode/type of injury, extra thoracic injuries, mode of management and outcome was gathered.Results: A total number of 1429 trauma patients presented to AE of which 160 patients (11.2%) had chest trauma. Majority of the patients (51.87%, n=83) were of age group of 21-40 years. A male preponderance was observed. Road traffic accidents were major causes of blunt chest injury, while gunshot injury was the major causes of penetrating chest injuries. Head and neck injuries were the most common associated injuries. Tube thoracostomy was the commonest modality of management (65%) and (28%) patients were managed conservatively.  Severity of chest trauma and associated injuries coupled with prompt diagnosis and treatment were important factors in efficient management of chest injuries.Conclusions: Chest trauma resulting from road traffic accidents remains the major mechanism of injury. Preventive measures aimed at educating the common masses about traffic rules and strictly implementing them is indispensable to reduce the incidence of chest injuries.

BACKGROUND: The World Health Organization declared vaccine hesitancy as one of the planet's top 10 global health threats in 2019. With the rollout of the coronavirus disease-19 (COVID-19) vaccines, a survey was conducted to find out the hesitancy and the apprehensions that come along with taking COVID-19 vaccines among health-care workers (HCWs). MATERIALS AND METHODS: This was an online cross-sectional survey which was developed and shared through social media platforms among the HCWs of Kashmir. The survey captured demographic data and used a validated hesitancy measurement tool from January 2021 to February 2021. The data were analyzed by descriptive statistics and multivariable logistic regression using Stata 15 (Stata Corp. 2017. Stata Statistical Software: Release 15. College Station, TX: Stata Corp LLC). RESULTS: Willingness to take the COVID-19 vaccine when available was seen in 67.7% of the HCWs. Overall, 9.59% of respondents reported unwillingness to receive a vaccine for COVID-19, while 22.7% were unsure. The most commonly cited reason for willingness to get vaccinated was an understanding of the disease and vaccination, as reported by 81.5%. Being single was significantly related to an increased risk of vaccine hesitancy (adjusted odds ratio = 5.27, 95% confidence interval: 2.07–13.40). Among vaccine attitudes, concerns about the safety of the vaccine, unforeseen problems in children, and possible unknown future adverse effects of the vaccine were the most important determinants of unwillingness. CONCLUSIONS: A significant proportion of the HCWs showed vaccine hesitancy to the COVID-19 vaccine. Hesitancy attitudes were almost always driven by concern around the vaccine safety. States and health-care authorities need to recognize the massive trust deficit around the Covid-19 vaccine and use the popular media used by people to share credible and reliable information.

The treatment and outcome of respiratory virus infections differ. SARS-CoV-2, as well as other respiratory viruses such as influenza virus (A and B) and respiratory syncytial virus (RSV), require simultaneous, cost-effective, and rapid differential detection. We used a gold standard five-target single-step RT-PCR to detect influenza viruses, RSV, and SARS-CoV-2, and this method can be extended to detect influenza virus subtypes. As a result, this five-target single-step RT-PCR method is ideal for differentiating respiratory viruses. The 5’ nuclease activity of Taq DNA polymerase is used in the real-time reverse transcription PCR assay. The Taq man fast viral 1-step enzyme is a 4× Master mix and five-target primer probe mix that detects influenza A, influenza B, SARS-CoV-2 ORF1ab, respiratory syncytial viruses A/B and actin. When compared with TaqMan TM and Invitrogen superscript TM III Platinum and the Meril Kit for SARS-CoV-2, the assay demonstrated 100% sensitivity, specificity, and amplification efficiency of 90.1% for target genes. In conclusion, our one-tube multiplex RT-PCR assay offers a rapid and reliable method for the simultaneous detection of influenza A/B, RSV, and SARS-CoV-2 from nasopharyngeal swabs. This assay has the potential to enhance diagnostic capabilities and improve public health responses during respiratory outbreaks, enabling timely interventions and informed decision making.