Background Vitamin-D is an immune-modulator which might be linked to disease severity by SARS-CoV-2. Methods Meta-analysis of RCTs and quasi-experimental studies, evaluating the role of vitamin-D supplementation in COVID patients was done. Results Total 5 studies (3 RCTs and 2 Quasi-experimental) including n = 467 patients were included. Vitamin D didn't reduce mortality (RR 0.55, 95%CI 0.22 to 1.39, p = 0.21), ICU admission rates (RR 0.20, 95% CI 0.01–4.26, p = 0.3) and need for invasive ventilation (RR 0.24, 95% CI 0.01–7.89, p = 0.42). Conclusion No significant difference with vitamin-D supplementation on major health related outcomes in COVID-19. Well-designed RCTs are required addressing this topic.

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Background Sedation and analgesia are the integral components of modern-day upper gastrointestinal (GI) endoscopic procedures. Irrespective of the sedative agent, hypoxia is the most commonly encountered unwarranted event with sedation. The current study intends to scrutinize whether high-flow nasal oxygen (HFNO) is advantageous for providing respiratory support during upper GI endoscopic procedures over other conventional low-flow oxygen delivery modalities, e.g. nasal cannula, facemask, etc. Methods An extensive screening of electronic databases was done till July 31, 2022, after enlisting in International prospective register of systematic reviews (PROSPERO) (CRD42021245409). Randomized controlled trials (RCT), comparative cohort studies, case series, cross-sectional studies and case–control studies evaluating the utility of HFNO during upper GI endoscopy under sedation were included in this meta-analysis. Results We retrieved eight randomized control studies and one longitudinal study with 3294 patients. The application of HFNO during endoscopy led to lesser incidence of desaturation spells (odds ratio [OR] = 0.23; 95% CI 0.11–0.48; I 2 = 71%), reduced procedural interruption (OR = 0.11; 95% CI 0.02–0.60; I 2 = 88%), better nadir SpO 2 level during procedure (mean difference [MD] = 3.16; 95% CI 0.54–5.78; I 2 = 73%), overall lesser incidence of sedation-related adverse events (OR = 0.63; 95% CI 0.42–0.93; I 2 = 25%), with no significant impact on the duration of endoscopy (MD = 0.15; 95% CI − 0.02 to 0.31, I 2 = 0%). Conclusion HFNO is a novel option for upper GI endoscopy under sedation. Clinical trial number and registry URL CRD42021245409 ( https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021245409 ). Supplementary Information The online version contains supplementary material available at 10.1007/s12664-022-01308-6.

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Prone position ventilation has been shown to decrease mortality and improve oxygenation in ARDS patients. With best of our knowledge, no study reported physiological effect of prone position in SARS- CoV-2 infected ARDS patients. In this prospective observational study, data of n=20 consecutive laboratory confirmed SARS- CoV-2 patients with severe ARDS as per Berlin definition was included. Data of 20 patients analyzed with a median (Interquartile range, IQR) age of 56 (45.5- 67) y and median (IQR) P/F ratio of 56 (54- 66) with a median (IQR) PEEP of 12 (12- 14) before initiation of prone position. Seventy-five percentage (95% CI 53.1- 88.8) patients were prone responders at 16h prone session and 50 (95% CI 29.9- 70.1) % patients were sustained responders. There was a significant decrease in plateau airway pressure (p<0.0001), peak airway pressure (p<0.0001) and driving pressure(p<0.0001) and increase in static compliance (p=0.001), P/F ratio (p<0.0001), PaO2 (p=0.0002)and SpO2 (p=0.0004) at 4h and 16h since initiation of prone session and also after return of supine position. Prone position in SARS- CoV-2 infected severe ARDS patients is associated with improvement in lung compliance and oxygenation in two- third of the patients and persisted in half of the patients.

Introduction: In space, cephalad shift of body fluid equalizes the blood pressure throughout the body leading to various cardiovascular disturbances. Effects of microgravity have been perfectly simulated in the rat hindlimb unloading (HU) model. This study was planned to assess the structure-function relationship of the carotid artery before and after HU of 14 days. Material and methods: This study was done in Department of Physiology, AIIMS, New Delhi. 18 male Wistar rats weighing 250-300 gm were randomly divided into control and hindlimb unloaded groups and housed in separate cages for 14 days. Body weight, food, and water intake were measured every day. The pelvic suspension method was used to simulate microgravity. Blood pressure was recorded directly from the carotid artery.ECG was recorded in lead II configuration. A graph was plotted of MAP v RRI and the slope was taken. Linear regression of mean arterial pressure and RR intervals were used to derive the Baroreflex sensitivity. Vessel wall thickness, intimal thickness, smooth muscle cell layer thickness & luminal diameter were observed after H&E staining. Ultrathin sectioning and counter-staining were done for electron microscopy and changes in endothelial thickness, elastic lamina, and deeper artery structures were observed. Statistical analysis was done using Graphpad Prism (version 9.0). Unpaired t-test was applied. Results: We found significant differences were observed Food intake(p <0.001) Body weight(p <0.001), Heart rate (p=0.031), BRS (p=0.026), HRV:R-R interval (p=0.0246 ), SDSD (p=0.0001), RMSD (p=0.0001), VLF(p=0.001), HF (p=0.0054), LF/HF Ratio (p=0.0001 ). We did not found significant changes in Water intake, MAP, SBP, DBP, LFT, RFT, Vessel wall thickness (micron meter), Luminal Diameter (micron meter), Intimal thickness (micron meter), Smooth muscle thickness (micron meter), in H&E staining and in electron microscopy. Conclusion: Chronic microgravity simulation using pelvic suspension showed a decrease in BRS, however 15 days are not insufficient to produce any structural changes in the carotid artery. BRS changes are accompanied by changes in vascular vasoconstriction and vasodilation properties due to alterations in the sympathetic and parasympathetic outflow.