Introduction: There is limited information on the effectiveness of COVID-19 vaccination in patients with autoimmune rheumatic diseases (AIRD). Methods: 136 consecutive patients with rheumatic diseases who never had a diagnosis of COVID-19 previously, and had completed vaccination with either the ChAdOx1 or BBV152 vaccines were recruited. Their IgG antibody titres to the Spike protein were estimated 1 month after the second dose. Results: 102 patients had AIRD while the 34 had non-AIRD. Lesser patients with AIRD (92/102) had positive antibodies titres than ones with non-AIRD(33/34) [p<0.001]. Amongst patients who received the ChAdOX1 vaccine, the AIRD group had lower antibody titres. Although the AIRD patients receiving BBV152 had similarly lower titres numerically, this did not attain statistical significance probably due to lesser numbers. Comparing the two vaccines, 114(95%) of those who received ChAdOx1 (n=120) and 11(68.7%) of those who received BBV152(n=16) had detectable antibodies [p=0.004] . Antibody titres also were higher in ChAdOx1 recipients when compared to BBV152. To validate the findings, we estimated antibody titres in 30 healthy people each who had received either vaccine. All 30 who had received ChAdOX1 and only 23/30 of those who had received BBV152 had positive antibodies (p=0.011). Conclusion: In this preliminary analysis, patients with AIRD had lower seroconversion rates as well as lower antibody titres as compared to patients with non-AIRD. Also,the humoral immunogenicity of the BBV152 vaccine appears to be less than that of the ChAdOX1 vaccine. Validation using larger numbers and testing of cellular immunity is urgently required.

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Aims:Evaluation of supportive care management of cancer patients experiencing drug-related problems (DRPs) is a challenge because it might increase the cost due to additional therapy. The main objectives of this study were to estimate chemotherapy-associated drug-related hospital admissions in the department of medical oncology and to estimate the cost of managing chemotherapy-associated DRPs.Settings and Design:This study is a prospective observational study.Subjects and Methods:Patients with chemotherapy-related DRPs were prospectively identified from the patient's medical records. The contribution of DRPs and cost incurred due to each hospitalization was assessed.Statistical Analysis Used:Data were analyzed using SPSS® 20.0 version.Results:Out of 55 patients analyzed for DRPs, 25 (45.5%) patients in the age group of 51–60 years experienced DRPs most frequently. Most commonly occurring DRP was adverse drug reactions 42 (76.4%), which were more frequent in females. DRPs were maximum with alkylating agents 15 (27.3%) and the least with hormonal agents 1 (1.8%). The mean length of hospitalization was 9.6 ± 6.5 days. The total direct medical cost was Rs. 31,540 ± 42,476, of which medicine cost accounted for Rs. 16,550 ± 25,404, constituting a major share of the total medical costs.Conclusions:Pharmacists can provide better patient care by identifying and preventing DRPs and reducing drug-related morbidity and mortality.

N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune neurological disorder arising from the generation of antibodies which binds to the synaptic proteins. Here we present a case series of 3 cases where the different aspects of treating NMDAR encephalitis are dealt with. The association of ovarian teratoma and the importance of its removal before treating the encephalitis have been discussed in the second case. Apart from the first line and second line agents used in the therapy of NMDAR encephalitis, the importance of managing infections especially urinary tract infection and lower respiratory tract infection with antibiotics have also been discussed. The article also aims to throw light into the treatment of extrapyramidal side effects induced by antipsychotics. At the end, the significance of putting the patient on a ketogenic diet to manage refractory seizures associated with anti-NMDA receptor encephalitis has also been discussed based on reviewing literature.

Universities are responsible for the disseminating and transferring of knowledge, as well as for providing specialized human resources. Furthermore, they continually required to analyze and update their services, and to identify problems and challenges to allow them to optimize educational quality. The ongoing educational assessment of different scientific disciplines is critical, particularly for medical sciences. Educational assessment helps to identify constraints and obstacles, and to solve problems and identify strengths and weaknesses. The results of such assessments allow positive aspects to be upheld and effective solutions for potential problems to be implemented. [1] Many studies have indicated a need for the nursing education system to keep pace with continuous changes in nursing practice. The literature suggests that the results of apprenticeship are not satisfactory, which is indicated the need for more attention to this aspect. [2] Although new nursing graduates possess a strong theoretical background and knowledge, they do not have the necessary skills and dexterity which are required to solve problems that arise in clinical settings. Some studies have also indicated the existence of a vast gap between classical nursing and obstetric education and clinical care performance, suggesting that the present clinical education system does not provide students with the