Introduction: Nepal started the first phase of COVID-19 vaccination for frontline healthcare workers in January 2021 with the ChAdOx1 nCoV-19 (COVISHIELD) vaccine. We conducted active surveillance of Adverse Effect Following Immunization (AEFI) after the first dose of the vaccine administered at one of the sentinel sites for vaccination, Patan Academy of Health Sciences (PAHS). Method:  All the 5591 first dose ‘COVISHIELD’ vaccine recipients between 27 Jan -5 Feb 2021 at PAHS, were approached through phone calls to collect data on AEFI.  Incidence of common AEFIs in different age groups, gender and those with previous history of COVID-19 were analyzed. Presence of any Adverse Events of Special Interest (AESI) were evaluated. Result: Out of 5591 vaccines recipient, 3991 (71.3%) responded to the phone call and AEFI was noted in 3394 (85.04%) of them. Minor AEFI was seen in 3391 (84.9%), severe Minor AEFI in 1 (0.02%) and Serious AEFI in 2 (0.05%). Out of 807 vaccine recipients with previous history of COVID-19, 709 (87.9%) had AEFI while of the 3184 with no past history of COVID-19, 2685 (84.3%) had AEFI. However, some of the systemic AEFIs were noted more frequently in those with past COVID-19 infection. A total of 1886 (55.6%) took self-medication for symptom relief, 278 (8.2%) took leave from work while 26 (0.76%) visited health facility for the AEFIs. Conclusion:  Most AEFIs following the first dose of COVISHIELD vaccine were mild and resolved within a few days. Except for one case of anaphylaxis, no other AESI were encountered.

Introduction: Various types of COVID 19 vaccine are being used globally to control the current pandemic. Post-licensure surveillance of vaccine is essential to ensure the safety. This study aimed to determine Adverse Events Following Immunization (AEFIs) of China Sinopharm (Vero cell), the inactivated COVID-19 vaccine. Method: This is a cross sectional observational study conducted at Patan hospital, Patan Academy of Health Sciences (PAHS) after the approval from IRC. Vaccine recipient between April 7 to April 13 and May 16 to May 25 were contacted through a phone call after 72 h of vaccination to record the AEFIs. Pattern and distribution of AEFIs were analyzed. Ethical approval was taken from PAHS IRC. Result: A total of 6142 individual got the first dose of the vaccine and out of them we were able to contact 4574 through phone calls. Of the 4574, only 941 were included for the follow up phone call after the second dose of the vaccine. A total of 1336 AEFIs were reported in 868(19%) first dose vaccine recipients while 147 AFEIs were reported in 105(11.2%) second dose vaccine recipients.  The frequently reported AEFIs were pain at injection site, lethargy, headache, muscle ache and fever. All the AEFIs were mild to moderate in severity. Most of the AEFIs started within 24 h and resolved within 72 h. Conclusion: The Sinopharm (Vero cell) vaccine was found to have mild to moderate AEFIs in our study cohort and no case of severe AEFI was identified.

Introduction: Pfizer-BioNTec vaccine was started in Nepal for the age group of more than 12 y. This study was conducted to find out the adverse event following immunization with Pfizer-BioNTech vaccine against COVID-19 at Patan Academy of Health Sciences (PAHS). Method: This is a descriptive study conducted at PAHS from November to December 2021. The vaccine recipients were called over the phone after 72 h of receiving the vaccine to find out adverse events following immunization (AEFI). They were inquired about the list of pre-defined AEFI. Ethical approval was obtained. Result: A total of 1377(27.4%) individuals among 5014 receiving the first dose and 983(71.4%) of 1377 receiving the second dose were enrolled in the study. Vaccine recipients who had minor AEFI in the first dose were 462(33.6%) and in the second dose were 205(20.9%). Reported AEFI in both first and second dose was pain 377(27.4%) and 97(9.9%) respectively, followed by fever in 65(4.8%) and 91(9.3%) respectively. There were no severe AEFI reported in both doses of vaccination. The AEFI started within 24 h and subsided within 72 h. Conclusion: Minor AEFI of pain and fever was reported with the first and second dose of the Pfizer-BioNTech vaccine. There were no severe and serious AEFI reported in this study population.

Introduction: During COVID-19 pandemic, live online lectures were offered for the first time to the undergraduate students. Due to its novelty, it was important to identify the effectiveness. Thus, the aim of this study was to compare the perception of students and faculty regarding the attributes of lectures delivered via live online versus classroom platform. Method: In this descriptive study, after approval from the ethical committee, link to the validated questionnaire was sent via email to all participants. Quantitative data were expressed as numbers and percentage while thematic analysis was done for qualitative data. Result: In this study 22 faculty members and 176 students participated. Twenty-one (95%) faculty and 159 (90.3%) students agreed that it was a good initiative to start live online lectures during the pandemic, and 18 (81.8%) faculty and 160 (91%) students were satisfied or partially satisfied with online mode. Limitations identified were technical issues and lack of physical interaction. Both faculty members 18 (81.8%) and students 116 (65.9%) agreed or strongly agreed that online lectures were less interactive, and suggested ways to improve online lectures by making sessions more interactive, proper lecture scheduling and using different online media. Conclusion: Participants identified various strengths of live online mode which is encouraging to use during adverse situations or even continue as a standard platform but it is not without limitations. Thus, for successful implementation, proper planning and designing of lectures are required.

Background: Several generations of antidepressant medication which act by distinct pharmacological mechanisms have been introduced for the treatment of depression; tricyclic antidepressants (TCAs) were first line of treatment for many years. However, over the last decade, selective serotonin reuptake inhibitors (SSRIs) have displaced TCAs, mainly because of better side effect profile. There are no references in literature on comparison of efficacy of TCAs and SSRIs in Nepalese population. This study attempted to compare the efficacy of amitriptyline, a reference standard TCA with escitalopram, a newer SSRI in Nepalese population.Methods: An open level, randomised, prospective study was conducted for one year duration. Eighty outpatients suffering from major depression who met inclusion and exclusion criteria were randomly assigned to either amitriptyline or escitalopram group for four week study. Seventy one patients (amitriptyline N: 36, escitalopram N: 35) completed the study. Hamilton Depression Rating Scale (HDRS) was used to measure the antidepressant effect. Antidepressant efficacy was evaluated on reduction of HDRS score before and after therapy (End of four weeks).Results: In amitriptyline group, mean percentage reduction in HDRS score was 58.29% (13.5 points), while in escitalopram group was 60.78% (14.03 points). Both the drugs significantly improved the HDRS score at the end of the study (p<0.05). On intergroup comparison, antidepressant efficacy of amitriptyline and escitalopram did not differ significantly from each other (p>0.05).Conclusions: This study suggests that escitalopram is effective in the treatment of depression and its efficacy appears to be comparable to amitriptyline at the end of four weeks.