Background Efficacy of vaccines studied in clinical trial settings are likely to be different from their effectiveness in a real-world scenario. Indian Armed Forces launched its vaccine drive against COVID-19 on 16 Jan 2021. This study evaluated the effect of vaccination on mortality amongst hospitalized COVID patients. Methods A cross sectional study was done on all admitted moderate to severe COVID-19 patients at a designated COVID hospital in New Delhi. The primary outcome assessed the association of being fully vaccinated with mortality. Unadjusted odds ratios (OR) (with 95% CI) was performed for each predictor. Logistic regression was used for multivariable analysis and adjusted odds ratios obtained. Results The 1168 patients included in the study had a male preponderance with a mean age of 54.6 (± 17.51) years. A total of 266 (23%) patients were partially vaccinated with COVISHIELD® and 184 (16%) were fully vaccinated. Overall, 518 (44.3%) patients had comorbidities and 332 (28.4%) died. Among those fully vaccinated, there was 12.5% (23/184) mortality while it was 31.45 % (309/984) among the unvaccinated (OR 0.3, 95% CI 0.2 to 0.5, p<0.0001). In a logistic regression model, complete vaccination status and younger age were found to be associated with survival. Conclusions Vaccination with two doses of COVISHIELD® was associated with lower odds of mortality among hospitalized patients with moderate to severe COVID.

Platelet indices are inexpensive, easily accessible parameters and potentially useful prognostic indicators in sepsis. In this study we explore the differences in platelet indices and their kinetics between sepsis survivors and non-survivors. A retrospective cohort-study of 97 cases of culture-positive sepsis at a tertiary-care center in North India. Demographics, clinical and laboratory parameters at admission were assessed. Platelet count (PLT), mean-platelet-volume (MPV), platelet-distribution-width (PDW) and plateletcrit (PCT) on admission, and third, fifth and last days of hospitalization were analyzed. Fractional change in platelet indices (ΔMPV 72h, ΔPDW 72h , ΔPCT 72h , and ΔPLT 72h ) by day-3 were calculated. Unpaired and paired t-tests were used to compare survivors with non-survivors, and to study the change in platelet indices with time. Logistic regression was used for multivariate analysis. ROC-curves and optimum cut-offs to predict mortality were obtained. There were 64 survivors. Non-survivors had significantly higher ΔMPV 72h, ΔPDW 72h, day-1 MPV and PDW, and lower ΔPLT 72h . MPV and PDW increased, and PLT decreased with time among non-survivors. Trends were reversed in survivors. Only MPV and PDW showed significant change by day-3. Both were independent predictors of mortality on multivariate analysis, alongside ΔMPV 72h and ΔPLT 72h . On ROC analysis, MPV, PDW, ΔMPV 72h, ΔPDW 72h and ΔPLT 72h effectively predicted mortality. Cut-off for MPV was 10.25 fL (sensitivity = 93.9%, specificity = 60.9%), and PDW, 12.6% (sensitivity = 84.8%, specificity = 51.6%). A rise in MPV and a fall in PLT was associated with mortality in this study. MPV and PDW values at admission are effective predictors of mortality and may be used in conjunction with traditional parameters.

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Objective: Breast Cancer is the leading cause of mortality and morbidity amongst Indian females. Breast self-examination (BSE) as an early detection modularity can have a profound effect on lowering mortality, if it is practiced regularly. The aim of this study was to assess the knowledge, attitude, and practice of Breast Self-examination amongst Indian women, aged 30 years and above. Methods: A validated questionnaire, consisting 35 questions measuring ‘Knowledge, Attitudes and Practice of Breast Self-Examination’ was widely circulated amongst 1000 females throughout India and responses were collected for a duration of 3 weeks, from 2nd, September 2020 to 23rd,September 2020. Results: Despite having knowledge about the technique of performing BSE, the respondents did not have a positive attitude towards it and were reluctant to practice BSE. A total of 54.4%, 15.1%, 21.3% and 9.2% of respondents were from the Northern, Southern, Western and Eastern regions of India, respectively. The overall median (IQR) KAP score was 70.0 (16.0) out of a maximum of 110. The knowledge, attitude and practice domain scores were 22.0 (5.0), 36.0 (7.0), and 13.0 (8.0) out of a maximum of 30, 52 and, 28, respectively. All three individual score domains were significantly correlated with each other and the total score.Conclusion: Despite having knowledge about the technique of performing BSE, the respondents did not have a positive attitude towards it and were reluctant to practice BSE.

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