Attitude and perception versus reality of COVID-19 vaccination among healthcare professional: a survey

Background: The pandemic of COVID-19 infection has almost paralyzed the world since the first infection was reported in December 2019. We have seen 3 waves of infection in the country, out of which the second wave caused by the delta variant was the most severe. Along with the preventive measures of masking, maintaining social distance, and handwashing, the vaccines seemed to be the most logical next step. Many vaccines received emergency use approvals with hardly any efficacy and adverse effects data available with the process inducing a significant amount of anxiety among the public. This survey was aimed at understanding the attitude and perception of our hospital employees towards COVID-19 vaccination. Methods: This is a cross-sectional study conducted among health care workers (HCW) at CMC, Vellore between March 2021 to July 2021. The HCWs who are willing to participate in this study were recruited and collected the quantitative data on their attitude and perception towards COVID vaccine. In-depth interviews were conducted among those who did not take vaccine to understand the reasons for not taking vaccine. The data were analyzed using statistical package for the social sciences (SPSS). Results: The survey results were analyzed on 435 HCWs. 58.4 percent of the HCWs trust the institutional protocols as the trusted source of information about vaccine. Most of the HCWs agreed that vaccines are the only protective way, and they are safe and effective. Conclusions: Sensitization and awareness programs with transparency of vaccine development processes, safety and efficacy will help remove barriers.

Disseminated histoplasmosis: A comparative study of the clinical features and outcome among immunocompromised and immunocompetent patients.

Background. Disseminated histoplasmosis is a chronic granulomatous disease caused by the dimorphic fungus, Histoplasma capsulatum. Clinical presentation can vary from the acute pulmonary to the chronic disseminated form. In India, disseminated histoplasmosis often presents with pyrexia of unknown origin with a presentation similar to ‘disseminated tuberculosis’ involving the adrenal glands and bone marrow. Due to rarity of the disease, data are lacking regarding its clinical presentation and outcome among immunocompromised and immunocompetent patients. Methods. During January 2000 to December 2010, we identified 37 patients of disseminated histoplasmosis and attempted to characterize the differences between immunocompromised and immunocompetent patients. Demographic characteristics, clinical presentation, risk factors, laboratory findings, diagnostic yield, treatment received and prognosis were noted and compared between the two groups. Results. Eleven of 37 patients with disseminated histoplasmosis were immunocompromised and 26 were immunocompetent. Comparison of their clinical features showed a higher frequency of skin lesions in the immunocompromised compared to the immunocompetent group (54.5% v. 11.5%). Pancytopenia and anaemia were more common among the immunocompromised (81.8%) compared to the immunocompetent (46.2%) group. In the immunocompromised patients, the diagnosis was made most often by bone marrow aspirate and culture (72.7%) compared to the immunocompromised group where the diagnosis was most often obtained by adrenal gland biopsy and fungal cultures (57.7%). The cure rate was significantly higher in the immunocompetent group (73% v. 45%). Conclusion. The clinical presentation and outcome of patients with disseminated histoplasmosis differs among immunocompromised and immunocompetent patients.

Leptospirosis: Experience at a tertiary care hospital in northern India.

Background. Leptospirosis is primarily a disease of wild and domestic mammals. Man is infected either directly through contact with an infected animal or indirectly by water or soil contaminated with the urine of an infected animal. We studied the incidence of leptospirosis in patients presenting with an acute febrile illness of more than 7 days to a tertiary care hospital in northern India. Methods. This study was done over a period of 1 year and included 647 patients who presented with an acute febrile illness for more than 7 days. These patients were screened for leptospirosis using the Dri-Dot test and ELISA. Results. Using the Dri-Dot screening test, 244 of 647 patients (37.7%) were positive for leptospirosis. Of these 244 patients, 200 (82%) were positive by ELISA. Conclusion. Leptospirosis is common in northern India and should be considered as a possible differential diagnosis in patients with an acute febrile illness of more than 7 days’ duration.