Background: COVID-19 vaccines were made available to the public by the end of 2020. However, little is known about COVID-19 booster dose (CBD) vaccine perception among healthcare workers (HCW) worldwide. The present study aims to assess the perception of CBD vaccines among healthcare workers in India and Saudi Arabia (SA). Methods: A cross-sectional study was conducted among HCWs in two countries, India and SA. Data were gathered through the use of a self-administered questionnaire. A convenience sampling technique was utilized to collect the data. Results: A total of 833 HCW responses were collected from the two countries, with 530 participants from India and 303 participants from SA responding to the questionnaire. Among them, 16% from India and 33% from SA were unwilling to take a CBD (p < 0.005). The primary reasons for not being willing were concerns about whether the vaccine would be effective (32%) and concerns about probable long-term side effects (31%). Concerns about not knowing enough about the vaccination (30%) and the possibility of long-term side effects (28%) were the primary concerns in SA. Regression analysis showed that males, urban residents, and post-graduates were more willing to take the CBD. Conclusion: There is a good perception of CBD and some hesitancy in receiving the booster dose among HCWs in both countries. The introduction of personalized education, risk communication, and deliberate policy could help to reduce the number of people who are unwilling to take a booster shot.

Background and Purpose Autoimmune encephalitis (AIE) following coronavirus disease 2019 (COVID-19) is an underexplored condition. This study aims to systematically review the clinico-investigational and pathophysiologic aspects of COVID-19 and its vaccines in association with AIE, and identify the factors predicting neurological severity and outcomes. Methods Relevant data sources were searched using appropriate search terms on January 15, 2022. Studies meeting the criteria for AIE having a temporal association with COVID-19 or its vaccines were included. Results Out of 1,894 citations, we included 61 articles comprising 88 cases: 71 of COVID-19-associated AIE, 3 of possible Bickerstaff encephalitis, and 14 of vaccine-associated AIE.There were 23 definite and 48 possible seronegative AIE cases. Anti-NMDAR (N-methyl-D-aspartate receptor; n =12, 16.9%) was the most common definite AIE. Males were more commonly affected (sex ratio=1.63) in the AIE subgroup. The neurological symptoms included alteredmental state ( n =53, 74.6%), movement disorders ( n =28, 39.4%), seizures ( n =24, 33.8%), behavioural ( n =25, 35.2%), and speech disturbances ( n =17, 23.9%). The median latency to AIE diagnosis was 14 days (interquartile range=4–22 days). Female sex and ICU admission had higherrisks of sequelae, with odds ratio (OR) of 2.925 (95% confidence interval [CI]=1.005–8.516)and 3.515 (95% CI=1.160–10.650), respectively. Good immunotherapy response was seen in42/48 (87.5%) and 13/13 (100%) of COVID-19-associated and vaccine-associated AIE patients, respectively. Sequelae were reported in 22/60 (36.7%) COVID-19 associated and 10/13 (76.9%) vaccine-associated cases. Conclusions The study has revealed diagnostic, therapeutic, and pathophysiological aspects of AIE associated with COVID-19 and its vaccines, and its differences from postinfectious AIE. Systematic review registration PROSPERO registration number CRD42021299215

A BSTRACT MTHFR enzyme deficiency is an autosomal-recessive inborn error of folate metabolism. The deficiency cause defect in the remethylation of homocysteine to methionine leading to increased blood levels of homocysteine. Hyperhomocysteinemia in infants cause seizures, hypotonia, apnoea, microcephaly, progressing to coma and death if untreated whereas in childhood onset it causes developmental delay, seizures, psychiatric disturbances, spastic gait, and ataxia. We report a 10-year-old girl with rapidly progressive spastic paraplegia requiring wheelchair ambulation within 3 months of symptom onset with behavioral disturbances. Plasma homocysteine and plasma lactate were high with normal vitamin B12 levels. Clinical exome sequencing showed homozygous missense mutation in MTHFR gene which was likely pathogenic variant. Respiratory chain complex assay from muscle sample showed reduced complex 1 deficiency (<20%).

Biomaterials have occupied a prominent place in regenerative procedures to restore human health. Moreover, there is a greater need in understanding, analyzing and establishing their toxicity profile. These, when made into nano-sized constructions called nanostructured biomaterials, their regenerative potential is enhanced, which could influence their toxicity nature. This chapter intends to give comprehensive information on their nanotoxicology pathways at the cellular level, their entry pathways into the human body, and their potential consequences on human health. It clearly explains the cytocompatibility and biocompatibility of various nanostructured biomaterials for potential human health applications like drug delivery and tissue engineering. A detailed overview of various in vitro and in vivo evaluation methods of biocompatibility of nanomaterials are outlined in this chapter that researchers should address as they move forward in developing new systems for the field of regeneration.

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