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QTc prolongation is a common black box warning within medication labeling. However, it is unclear if QTc prolonging drugs carry the same risk for torsade de pointes as primary or congenital prolongation. The majority of previous studies regarding antipsychotics are limited by a variety of factors. This was a retrospective, cohort study amongst 114 patients at the FHCC to examine the risk of developing QTc prolongation and torsade de pointes in relation to antipsychotic dosing. The primary objective is to determine the incidence rate and mean of QTc prolongation stratified to dose of five antipsychotics. The secondary objective is to determine the incidence of QTc of ≥ 500 msecs and torsades de pointes stratified to dose. The frequency of QTc prolongation was analyzed using chi-square and Fischer's exact test as appropriate with a p < 0.05 being labeled as significant. The average length of QTc prolongation stratified to the dose of antipsychotic was analyzed using linear regression analysis. Dose dependency of QTc prolongation with the five antipsychotic drugs of interest (haloperidol, ziprasidone, olanzapine, risperidone, and ziprasidone) was not supported in this study based on the non-significant linear regression analyses.However, the frequency of torsade de pointes and changes of > 60 msec in the QTc were relatively rare. Thus frequent monitoring is likely unnecessary unless the patient has a prolonged QT at baseline or other risk factors.

The COVID-19 pandemic has led to many drug delivery systems and vaccine developments globally. Implementation of immunization programs has been done through emergency approvals and has also raised concerns regarding side effects and adverse events following immunization. The side effects are fever, injection site pain, arthralgia, redness, swelling, induration, pruritus, myalgia, induration, chills, headache, vomiting, and fatigue. The adverse events are anaphylaxis, thrombotic thrombocytopenic purpura, intracranial venous sinus thrombosis, Guillain–Barre syndrome, seizures, Steven–Johnson Syndrome, pulmonary embolism, acute myocardial infarction, myocarditis, and pericarditis associated with different vaccines. The factsheet of many vaccines does not convey sufficient details to alert the beneficiaries. These need to be updated timely and beneficiaries need to be made aware of the same. In some countries, authorized portals have captured these data on a real time basis. Similar portals need to be in place in India also so that data generated can be used for further timely recognition, reporting, and management of AEFI. The reporting of the same should be made mandatory for all and guidance should be provided regarding levels of management, home based, or hospital based.

A neglected tropical disease, declared by the WHO in 2016, mycetoma, is a chronic granulomatous, mutilating and debilitating disease. Apart from affecting the lower limbs, it also affects the cervico-facial region, chest and abdomen. In the cervico-facial region, mycetoma of the paranasal sinuses, scalp, ear, and tongue have atypical presentation. Sinus mycetoma can be sequelae to allergic fungal sinusitis due to the raised intracranial pressure effects of mycotoxins whereas mycetoma of the scalp may present without discharging granules. Neglect of fungal sinusitis, chronic pain in the scalp can be detrimental in the long run. In the oral cavity, minor trauma and bad oral hygiene can contribute to mycetoma of the tongue or oral cavity, the latter being rare. Dental surgeons can also help in the early detection of mycetoma of the oral cavity and para-nasal sinuses, during dental examination. This article aims to review mycetoma of the cervico-facial region with the objective of addressing ways for early diagnosis.