Background During ongoing COVID-19 pandemic, researchers worked enormously to develop effective vaccines against COVID-19 infection. Two Indian-made vaccines [Covishield (ChAdOx1 nCoV-19) and Covaxin] were granted Emergency Use Authorization. India launched its COVID-19 vaccination drive starting with healthcare workers (HCW). Aim of the study was to evaluate adverse events following immunization (AEFI) amongst the HCW with two doses of Covishield vaccine. We also evaluated association of AEFI according to sex, profession and age groups. Methods A prospective observational study was conducted in a tertiary care COVID dedicated hospital of Southern India from 16 Jan - 15 Apr 2021. Nine hundred and eighty one HCW who received 2 doses (4 weeks apart) were enrolled. Active and passive surveillance was conducted after 48 hours, and at days 8,15, 22 and 28 for both doses. The rate of AEFI for each dose was determined. Incidence and association of AEFI with various demographic variables was determined. Results 1020 non-serious and two serious AEFI (altered sensorium) were reported within 48 hours of first dose. Two hundred and twenty non-serious AEFI were reported within 48 hours of second dose. No AEFI was reported after 15 days for both the doses. We found no association of AEFI with sex and profession ( p >0.5). Significant association of AEFI was found with age ( p <0.01) Conclusion Short-term AEFI were predominantly observed in first 48 hours. Incidence decreased in subsequent weeks with no occurrence after 15 days in both doses. Symptoms were mild in severity and short-lived. No serious AEFI attributable to vaccines were reported.

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Background: The prevalence of chronic otitis media in the Armed Forces is high. Moreover, management of high-risk perforation and atelectatic ear is an even greater challenge. It is necessary to assess the most viable management approach to achieve an optimal outcome. Aims and Objectives: We aimed to compare anatomical and audiological results in tympanoplasty for high-risk perforation and atelectasis using perichondrium-cartilage island (PCI) graft with temporalis fascia (TF) graft. Materials and Methods: A retrospective study was carried on 110 patients. Fifty-four patients and 56 patients underwent PCI graft and TF tympanoplasty, respectively. Postoperative graft integration rates and hearing outcomes were compared. Chi-square test was carried out to compare postoperative graft uptake. Postoperative audiological outcomes were compared using t-tests. Results: At 2-year follow-up, the graft take-up rate for PCI graft and TF graft was 96.29% and 82.14%, respectively (statistically significant). In the TF group, 17.86% had reperforation and recurrence of retraction pockets. In the PCI group, 3.71% had recurrent perforation. Furthermore, there was a statistically significant in the postoperative long-term improvement in pure-tone average air-bone gap in the cartilage island graft group (15.01 ± 3.53 db vs. 21.96 ± 4.09 db, P < 0.05). Conclusion: PCI graft achieves better morphological and audiological results in comparison to TF graft in high-risk perforation and atelectatic ears. It has a higher graft integration rate and better long-term audiological outcomes.

Introduction: Ossicular chain reconstruction (OCR) augments the hearing mechanism in various ossicular pathologies. Titanium allograft with superior properties was evaluated in the study. Materials and Methods: To assess the audiological and anatomical outcomes following titanium OCR, a retrospective review was performed for 47 cases who underwent OCR from January 2015 to December 2018 at a tertiary care center. The ossiculoplasty was carried out in a single stage tympanoplasty. The partial ossicular replacement prostheses (PORP) and total ossicular replacement prostheses (TORP) were used in 28 and 19 patients, respectively, with a follow up for 12 months. The pre and postoperative air conduction pure tone averages and air bone gaps(ABG) were analyzed. The operative success was defined as a postoperative ABG of ≤20 dB. Fisher's test, analysis of variance (ANOVA), and t test were used depending on data compared. Results: Postoperatively, the mean ABG was 15.4 ± 2.8 dB; about 80. 85% of cases achieved operative success. ABG values showed significant improvement compared with preoperative values (P = 0.001, t test). Successful OCR was achieved 85.7% of PORP and 73.6% TORP cases. Discussion: The mean postoperative ABG was 13.75 ± 5.4 dB for the PORP group and 17.84 ± 2.5 dB for the TORP group. No variation in audiological outcomes was observed when comparing PORPs to TORPs. There was no significant difference in postoperative ABG on comparison of different etiologies (P = 0.508, ANOVA), procedures undertaken (P = 0.226, ANOVA), and primary/ revision surgery (P = 0.172, t test). The extrusion and displacement rates were 2% each. These findings highlight that Titanium OCR gives stable hearing gains with low extrusion rates.

Small bowel evisceration from dehiscent vaginal cuff is unusual subsequent to laparoscopic hysterectomy. This complication is seldom cited in studies and reviews. We present an uncommon case of evisceration of small bowel from vaginal cuff dehiscence (VCD). The event occurred approximately 2 hours subsequent to the first act of coitus performed 3 months after the laparoscopic hysterectomy. Patient was brought to the emergency department for primary treatment. Urgent surgical intervention was planned. Small intestine was reposed after saline wash. Repairing of the vault was done with continuous suture by polyglactin-910 braided synthetic absorbable suture no.1. Patient was sent to home after 5 days of surgery. The strength of vaginal vault in laparoscopic hysterectomy depends on technique of vaginal cuff closure and types of suture materials used during surgery. Postoperative counseling of patients for recommencing physical activity and sexual intercourse is also of utmost significance.