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For many years, proper biomedical waste (BMW) management in line with the rules was among the overlooked components of health care. Biomedical waste presents a series of environmental contamination. As a result, it must be treated using extreme caution and disposed of properly. There are a few gaps in the handling of biological generated waste, and the coronavirus epidemic has made it very hard. The virus's quick breakout resulted in a massive increase in the amount of biohazardous matter. The COVID-19 epidemic's devastation has altered global waste generation trends, needing special attention. Sudden variations in trash generation and volume need a dynamic response from authorities. This study highlights the problems that the collection and recycling business faces even after a pandemic, as well as the basic possibility to eliminate current framework faults. The study covers specific situations for handling medical waste, polymeric garbage, and recycling bins, which were all major causes of concerns all through this time period. We also go over successful stakeholder involvement and teamwork.The existence of illness sewage treatment in regular effluent created offers significant dangers and liabilities to hygiene workers. Small metal usage is predicted to recover as a result of rising hygiene concerns, particularly from items used for safety precautions and medication. The research further underlines the significance of creating localized, streamlined supply channels to deal with these kinds of situations in the case of unanticipated devastating catastrophes. Despite presenting unique solutions to existing recycling challenges, the paper also presents numerous crucial recommendations to regulators to enable them to cope with any potential outbreaks in a holistic way. © 2023 Author(s).
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The Coronaviridae family's severe acute respiratory syndrome corona virus 2 (SARS-Co V-2) outbreak has infected a large number of the population during the COVID- 19 pandemic. The most prominent mode of virus transmission is considered through respiratory droplets of the infected person. Virus-mediated respiratory infection depends upon the binding between spike protein and the Angiotensinconverting enzyme 2 (ACE2) receptor expressed in lung alveolar type 2 cells. But some studies reported that gastrointestinal infection is also one of the prominent symptoms of COVID-19 because of the high expression of the ACE2 receptor in absorptive enterocytes of the small intestine. In a country like India, with high population density and due to unhygienic sanitation, it is crucial to understand the potential fecal-oral transmission route of SARS-CoV-2 during infection because of presence of ACE2 in small intestine. Therefore in our study, we aim to trace the potential fecal-oral transmission route of SARS-Co V-2 by examining human stool (collected from hospital settings) and nearby sewage water systems, followed by molecular characterization and viral load kinetics evaluation of SARSCOV- 2. qRT-PCR and NGS sequencing methods were used. The presence of SARS-COV-2 was reported in around 70% of samples (both clinical and environmental), this will help us to establish the epidemiological link between clinical and environmental samples after genomic analysis to alter the circulation of silent SARS Co V2 in the community.
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The concept of the resilient supply chain has appeared to be one of the essential tools to survive, compete and grow during disturbances and uncertainties. During the current pandemic and the Suez Canal blockage, this concept has once again proven its utility. In this research work, we explore the resilient supply chain's concept, capabilities, and practices. In addition, an attempt is made to quantify the resilient performance of an Indian manufacturing organisation. For this research, we have used a quality function deployment integrated with the weighted sum method approach. This research brings about new insights into the concept of risk management through the resilient supply chain. It also suggests the portfolios of the resilient practices that enable the organisations to be prepared and recover from the major disruptions. Copyright © 2022 Inderscience Enterprises Ltd.
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To combat the COVID-19 pandemic, the scientific community has progressed from discovering antivirals to the large-scale production of vaccines. Mass vaccination programs to curb the COVID-19 pandemic started in many parts of the world at the beginning of 2021. Mass vaccination aims to exit from health emergencies by vaccinating all the population with the required dose in the shortest possible time. The production rate has been boosted, and many new production facilities have been opened to fulfill worldwide demand. The objective of the vaccination program is to maximize the medical benefit with the lowest cost and equitable distribution of vaccines worldwide. However, the environmental impact of this long-run immunization program has received very little attention. This study explores the environmental impact of the vaccine supply chain (VSC) and analyzes the mitigation strategies to minimize it without affecting the medical, economic, and social benefits of vaccination. The fuzzy DEMATEL technique has been used to prioritize the mitigation techniques and find cause and effect relations among them. The finding of studies shows that the "optimal vial design” is most important, and "vaccine awareness and education” is the most impactful strategy to tackle the environmental impact of VSC. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Background: India is facing a pandemic of 'Coronavirus disease-2019' (COVID-19). In the absence of proper medicine and vaccine for the treatment of COVID-19, the Government of India has imposed the country lockdown from 25 March 2020 to avoid chain/community transmission of coronavirus in humans. Consequently, the educational institutes were also closed during the lockdown period and traditional classroom teaching switched to online teaching in India to compensate for the educational losses. Aim(s): This article aims to measure the impact of online teaching on education as well as the health of the students. Methodology: The online survey was conducted on the students to measure the impact of online teaching on their education and health. There are 792 valid responses obtained from the survey. Result(s): According to the survey, online teaching was equally important in all segments of education during the period of a pandemic, but about 30 % of students are not satisfied with the delivery of content through online teaching. The students below 14 years were getting addicted to mobiles and laptops and consequently, they suffered from mental sickness and eye problems due to the screen effect. Conclusion(s): Online teaching has played a vital role during the pandemic, but its consequences can not be ignored. The online classes can not be accessed by each student due to the unavailability of smart-phones, laptops and mobiles network to especially poor families and remote areas. This creates dis-crimination among the students of poor and rich or urban and rural. The students below 14 years are not aware of the screen effect and get addicted to mobile that causes mental and eye problems. Thus, online teaching can not take the position of traditional classroom teaching for a long time and we will need to get back to traditional teaching after a pandemic ends.Copyright © 2021 Bentham Science Publishers.
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A more focused approach is needed to understand the SARS-CoV-2 virulence, structure, and genomics to devise more effective diagnostic and treatment interventions as this virus can evade the immune attack and causes life-threatening complications such as cytokine storm. The spread of the virus is still amplifying and causing thousands of new cases worldwide. It is essential to review current diagnostics and treatment approaches to pave the way to correct or modify our current practices to make more effective interventions against COVID-19. COVID-19 vaccine development has moved at a breakneck pace since the outbreak began, utilizing practically all possible platforms or tactics to ensure the success of vaccines. A total of 42 vaccine candidates have already entered clinical trials, including promising results from numerous vaccine candidates in phase 1 or phase 2 trials. Further, many existing drugs are being explored on broad-spectrum antiviral medications for their use in clinical recovery against COVID-19. The present review attempts to re-examine the SARS-CoV-2 structure, its viral life cycle, clinical symptoms and pathogenesis, mode of transmission, diagnostics, and treatment strategies that may be useful for resorting to more effective approaches for controlling COVID-19. Various antiviral drugs and vaccination strategies with their strengths and weaknesses are also discussed in the paper to augment our understanding of COVID-19 management.Copyright © 2022 Bentham Science Publishers.
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There seems to be a growing curiosity for utilizing MIPs to recognize molecules that can be applied in numerous fields, such as biomimetic antibodies, detection of viruses and bacteria, the broad range of sensing devices, etc., owing to its scalability and economic viability. MIPs have higher thermal and chemical stability, delivering a promising potential for recognizing bacteria and viruses. The bacteria and virus imprinted polymer exhibit elongated product life-time, reproducible fabrication, robustness, reusability, sensitivity, and high target selectivity. Moreover, the MIPs could give consistent screening along with negligible false positive/negative outcomes, which is vital for the control and prevention of viral and bacterial infections. In the viral and bacterial imprinting process, critical aspects, such as compositional complexity, fragility, solubility, and target size, should be systematically evaluated and analytically considered. Although, the application of MIPs has a number of drawbacks and challenges that require solving to develop sensing platforms with high specificity and sensitivity for clinical application. In the present review, current progress and advancement regarding the reasoning and applications of MIPs as recognition molecules in various biosensors for detecting bacteria and viruses and its existing noteworthy challenges along with future perspectives are also reflected.
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The vaccine distribution system, being a bio-pharmaceutical cold chain, is a complicated and sensitive system that must be effectively managed and maintained due to its direct impact on public health. However, vaccine supply chains continue to be affected by concerns, including vaccine expiry, inclusion of counterfeit vaccines, and vaccine record fraud. The blockchain technology integrated with the Internet of Things (IoT) can create a solution for global vaccine distributions with improved trust, transparency, traceability, and data management, which will help monitor the cold chain, tackle counterfeit drugs, surveillance, and waste management. Several theoretical models for vaccine management with blockchain have recently been published, and a few pilot studies for COVID-19 vaccine management using blockchain have been started in India. Still, full-scale adoption of blockchain technology in vaccine distribution and management has yet to be achieved due to underlying barriers. This study explores the adoption barriers utilizing Technology-Organization-Environment (TOE) framework with the help of extant literature and inputs from administrators, academics, immunization, and blockchain experts and then analyzed using the Delphi and fuzzy Decision-Making Trial and Evaluation Laboratory (DEMATEL) techniques. The finding shows that the requirement of change in organizational structure and policies is the most prominent barrier, and the barrier related to requirement of large-scale IoT infrastructure and lack of technical expertise are the most impactful barriers. The theoretical contribution of this study lies in the identification and analysis of barriers that should be addressed to achieve blockchain technology adoption in the vaccine supply chain. © 2022 Elsevier B.V.
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Rhino-orbital mucormycosis is a rare life threatening invasive fungal infection that has recently shown a very high mortality rate in India during COVID-19 pandemic. We have designed the present study to find out associations between COVID-19 induced rhino-orbital mucormycosis and concentrations of inflammatory markers, i.e. D-dimer, Ferritin, IL-6, CRP and PCT, in blood serum of Indian population. There were four groups in the study, viz. control group with healthy subjects, treatment group-1 with patients suffering from SARS-COV-2 infection, treatment group-2 with patients suffering from both SARS-COV-2 infection and rhino-orbital mucormycosis, and treatment group-3 with patients suffering from rhino-orbital mucormycosis after SARS-COV-2 infection recovery. Inflammatory markers were quantified with standard protocols, and recorded data were subjected to statistical analyses. We found that patients suffering from SARS-COV-2 infection were more susceptible to rhino-orbital mucormycosis, as they had higher concentrations of inflammatory markers in their blood than the other subjects. Diabetes mellitus, hypertension, cardiovascular diseases and renal disorders were the associated comorbidities with the patients. We also found higher concentrations of inflammatory markers in males than the females, indicating towards their higher susceptibility in developing rhino-orbital mucormycosis than females. Present study therefore suggests that the frequent occurrence of rhino-orbital mucormycosis in India during second wave of COVID-19 was possibly due to indiscriminate use of corticosteroids by COVID-19 patients. Subjects with previous history of comorbidities like diabetes mellitus, hypertension, cardiovascular disorders and renal diseases are the most susceptible population groups for developing infection. Moreover, males are at higher risk of developing mucormycosis than the females. © 2022 Innovative Publication, All rights reserved.
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Background: The COVID-19 pandemic has affected almost 100 million people worldwide. Although the disease spectrum has still not been fully understood, there have been the reports of the persistence of symptoms well beyond the acute stage or after discharge from the hospital. Therefore, there is a need to document the persistence of symptoms to identify and provide physical as well as psychosocial support for ensuring the complete recovery of COVID-19 survivors. The present study examines the postacute stage persistence of symptoms in severe acute respiratory syndrome-coronavirus-2 patients. Materials and Methods: A longitudinal follow-up study was conducted on 1170 patients discharged from COVID hospital. All the study participants were contacted after discharge and at 7-day intervals for 42 days, and details of the persistence of symptoms were sought from them. Results: It was found that 43.8% of patients had persistence of symptoms, and 12.4% had symptoms even after 30 days of discharge from the hospital. Among symptoms, the most common persisting symptom was found to be fatigue (26%) followed by respiratory difficulty. The presence of comorbidity (odds ratio 1.61, 95% confidence interval 1.56-2.25, P < 0.01) and moderate/severe disease were found to be independent risk factors for the persistence of COVID-related symptoms. Conclusion: The findings of the study indicate that a large number of COVID-19 survivors continue to suffer from COVID-19 symptoms well after the recovery from the acute stage (discharge from hospital). Therefore, there is a genuine need for instituting measures for the monitoring of patients postdischarge and if required providing treatment to those having persistent symptoms of COVID-19. © 2022 by the Author(s).
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Background: On March 30, 2020, coronavirus disease 19 was declared pandemic and many countries of the world started working on the development of vaccine soon after China released the genetic structure of severe acute respiratory syndrome coronavirus 2. Drugs Controller General of India on January 3, 2021, accorded emergency use authorization to Oxford-AstraZeneca's ChAdOx1 nCoV-19 vaccine and vaccination drive commenced in India on January 16, 2021. The present study was conducted to determine the incidence adverse event following immunization (AEFI) among recipients of the first and second dose of the vaccine. Materials and Methods: A longitudinal descriptive study was conducted among 2529 vaccine beneficiaries who were asked about the side effects at 24 and 72 h after the first dose and second dose of vaccination with ChAdOx1 nCoV-19 vaccine. Passive surveillance was also done for 4 months. Results: AEFI was reported in 27.59%, 38.4%, and 19.96% of vaccines after both doses, first dose, and second dose, respectively. 14% did not report any AEFI with either dose of vaccine. Younger people had higher rates of AEFIs with both the doses. Pain at injection site and fever <102°F were the most common symptoms. Only three patients required admission after first dose and nil required admission after second dose, all three were discharged after 24 h observation without any complication or sequelae. Conclusion: The results of our study indicate that the vaccine has good safety profile and is recommended for use among 18-60 years. However, since majority of individuals in our study were young, studies may be undertaken in more than 60 years of age, persons with a history of allergy, and comorbidities to further evaluate safety profile of the vaccine among these groups of people. © 2022 Medical Journal of Dr. D.Y. Patil Vidyapeeth ;Published by Wolters Kluwer - Medknow.
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Purpose: The present study analyzed the existing literature related to COVID 19 and Mental Health by using the technique of bibliometric analysis which may serve as guide-map for future researchers and policy makers. Method: Bibliometric analysis is conducted in the present study by using various techniques like citation analysis, co-citation analysis, co-occurrence of keywords, thematic mapping by using visualization of similarities (VOS) viewer open-source software and R-based bibliometrix. Results: The study highlighted the most significant journals, authors, co-cited authors, institutions, keywords co-occurrence, and most cited articles in the area of COVID-19 and Mental Health on the basis of bibliometric analysis of 149 studies taken from the database of Scopus for the past three years (2020– first quarter of 2022). Also, authors identified few relevant themes such as Economic Effects of COVID-19, COVID-19 and its Impact on Healthcare workers, COVID-19 and its Impact on Patients and General Population as important emerging key areas for further research. Conclusion: We have highlighted significant citations, co-citations and keywords co-occurrence to summarize the literature. The present bibliometric study convincingly confirms the effect of COVID 19 pandemic on mental health and provides enough evidence to advocate formulation of strategies to tackle mental health issues. © 2022, MedSci Publications. All rights reserved.
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Aim: The aim of the study was to correlate environmental changes with coronavirus disease 2019 (COVID-19) cases in four metropolitan cities. Methodology: Data on monthly cumulative new cases, monthly average temperatures, humidity, precipitation, and average monthly air quality index (AQI) levels for the four Indian cities - Chennai, New Delhi, Mumbai, and Kolkata, and biomedical waste (BMW) quantity at national level were ed for the period from March 2020 to December 2020. Results: An inverse correlation was observed between temperature and transmission of the disease in New Delhi and Kolkata which was of fair degree for New Delhi (r = 0.299, P = 0.402) and poor for Kolkata (r = 0.200, P value = 0.579). Positive correlation of fair and poor degrees was observed between temperature and transmission of the disease in Mumbai (r = 0.272, P = 0.448) and Chennai (r = 0.196, P = 0.588), respectively. A positive correlation was observed between the transmission of the disease and humidity in New Delhi, Mumbai, and Kolkata, which was of moderate-to-good degree for Mumbai (r = 0.729, P = 0.017) and poor for New Delhi (r = 0.242, P = 0.501) and Kolkata (r = 0.123, P = 0.735). A significant positive correlation was observed between the rise in COVID-19 cases and the quantity of BMW generated (r = 0.88, P = 0.009). Furthermore, significant improvement in air quality AQI in four metros and water quality biological oxygen demand/chemical oxygen demand of Yamuna river was observed. Conclusions: Understanding of the interplay of environmental meteorological factors on COVID-19 disease transmission and vice versa is necessary for better informed policy framing and future research. © Medical Journal of Dr. D.Y. Patil Vidyapeeth 2022.
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Introduction: The present study was conducted for vaccine effectiveness in the prevention of mortality among moderate to severe COVID-19 cases. Methods: The study was conducted in a dedicated COVID-19 hospital in Northern India from April 2021 to June 2021. Only moderate and severe COVID-19 cases were admitted to the hospital. All patients with the outcome (recovery or mortality) till 30 June 2021 constitute the study population for the study. The study is designed as a case-control study. The outcome was mortality due to COVID-19. The control group was cases who have recovered. The exposure was vaccination status. The data about the age, sex, and vaccination status including the type of vaccine was collected from the case sheets. Results: A total of 735 participants were recruited, out of which 409 patients survived and 326 patients died due to COVID-19 in the hospital. The mean age was 52.80 years (SD = 14.1 years) in the cases group and 60.92 years (SD = 14.97 years) in control group (P = 0.001). 137 (33.50%) were female and 272 (66.50%) were male in the control group while in cases 134 (41.10%) were female and 192 (58.90%) were male (P = 0.03). A total of 473 (64.35%) patients were unvaccinated, 199 (27.07%) were partially vaccinated, and 63 (8.57%) were fully vaccinated. Among the patients who survived, 101 (24.69%) were partially vaccinated and 28 (6.85%) were fully vaccinated;in the cases group, 98 (30.06%) people were partially vaccinated and 35 (10.74%) were fully vaccinated. On multiple regression analysis, there was no association between vaccination status and mortality among moderate and severe cases. Conclusion: The present study brought out that there is no association between vaccination and mortality among moderate to severe COVID-19 cases admitted to the makeshift hospital in Delhi. © Medical Journal of Dr. D.Y. Patil Vidyapeeth 2022.
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Introduction: The world is enveloped with the coronavirus disease 2019 (COVID-19) Pandemic with modern medicine and public health facing their most significant challenges ever posed. As the number of COVID-19 cases increased worldwide, an important issue of concern was the continuation of routine immunization services for children. This study has been conceptualized to assess the effect of the COVID-19 pandemic on infant Immunization. Materials and Methods: This study was a descriptive study conducted in an urban community amongst healthy children < 1-year-old from January 2018 to September 2021. Immunization records of infants were obtained from data generated during each immunization session and strength, weakness, opportunity, and threat analysis was done using a questionnaire. Results: During the study, a total of 3518 vaccinations were done, a total of 3010 vaccinations (85.5%) were done on time, and the total delayed vaccinations were 508 (14.5%). The difference among the years was statistically significant, with the highest delay in the year 2020 (P < 0.001). However, in the year 2021, the number of vaccinations carried out from April to September was 568, with delayed vaccination of only 10.9%. Conclusion: The Armed Forces childhood immunization program could be sustained during the COVID-19 pandemic due to a multitude of contributing factors such as adherence to national guidelines that prioritized vaccination, infrastructure, and availability of trained workforce and most importantly commitment to strict COVID appropriate behavior.
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Background: The coronavirus disease-2019 (COVID-19) pandemic has introduced new ethical challenges in the care of patients and people who may have been exposed to severe acute respiratory syndrome coronavirus-2 or have mild to moderate COVID-19. Refusal to get tested for COVID-19 and having poor adherence to infection prevention protocols are the areas of concern for the ongoing pandemic. Such situations increase the risk of infection to other patients and staff. The factors affecting testing refusal were studied with the help of the Google questionnaire. Methodology: The cross-sectional survey tool was developed and distributed after pilot testing. The study population was selected using mix sampling method, snowball, and random sampling using the mobile number of the participants. All the participants were informed about the purpose of the study and included after taking consent. Results: Of the 176 study participants, the majority were male (112, 63.6%), with a mean age of 37.2 years (standard deviation 10.4). Forty-one (23.3%) were health-care workers and 74 (42.1%) were private company employees. Seventy-one (40.3%) refused to get tested for COVID-19 when asked whether they will get tested in the presence of any COVID-19 symptoms and 81 (46.8%) refused to get tested in the absence of any symptoms. Conclusion: Health policy-makers should utilize the study results to formulate the policy regarding any future pandemic to reduce the level of stigma associated with an unknown disease. These clarifications and excuses asked to the study participants are meant to provide a deeper understanding to address the pandemic better.
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Objectives: The study aimed at evaluating orthodontics and dental emergencies during the COVID-19 pandemic. Materials and methods: An online-questionnaire survey was developed using google form and sent to orthodontists and dental surgeons in Nepal, practicing during the pandemic. Responses were collected and statistical analysis was done using SPSS version 16.0. Result: It was seen that the most frequently encountered orthodontic emergencies were due to, loose brackets (60%) and poking wires (47.6%) followed by loose bands (31.4%) and debonded loose buccal tubes (30.5%). Most frequently reported dental emergencies were broken or loose removable prosthesis and broken or loose crowns and/or bridges (13.3%) followed by bleeding while brushing (41.9%), swelling due to periodontal origin (33.1%), and severe pain due to tooth decay (44.8%). Conclusion: Loosening of brackets and poking wires were the most frequently reported orthodontic emergencies while, broken or loose prosthesis were reported commonly during the pandemic. © 2022 Nova Science Publishers, Inc.
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Purpose: Each individual needs to be vaccinated to control the spread of the COVID-19 pandemic in the shortest possible time. However, the vaccine distribution with an already strained supply chain in low- and middle-income countries (LMICs) will not be effective enough to vaccinate all the population in stipulated time. The purpose of this paper is to show that there is a need to revolutionize the vaccine supply chain (VSC) by overcoming the challenges of sustainable vaccine distribution. Design/methodology/approach: An integrated lean, agile and green (LAG) framework is proposed to overcome the challenges of the sustainable vaccine supply chain (SVSC). A hybrid best worst method (BWM)–Measurement of Alternatives and Ranking According to COmpromise Solution (MARCOS) methodology is designed to analyze the challenges and solutions. Findings: The analysis shows that vaccine wastage is the most critical challenge for SVSC, and the coordination among stakeholders is the most significant solution followed by effective management support. Social implications: The result of the analysis can help the health care organizations (HCOs) to manage the VSC. The effective vaccination in stipulated time will help control the further spread of the virus, which will result in the normalcy of business and availability of livelihood for millions of people. Originality/value: To the best of the author's knowledge, this is the first study to explore sustainability in VSC by considering the environmental and social impact of vaccination. The LAG-based framework is also a new approach in VSC to find the solution for existing challenges. © 2022, Emerald Publishing Limited.
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Purpose: The already-strained vaccine supply chain (VSC) of the expanded program for immunization (EPI) require a more robust and structured distribution network for pandemic/outbreak vaccination due to huge volume demand and time constraint. In this paper, a lean-agile-green (LAG) practices approach is proposed to improve the operational, economic and environmental efficiency of the VSC. Design/methodology/approach: A fuzzy decision framework of importance performance analysis (IPA)–analytical hierarchy process (AHP)–technique for order for preference by similarity in ideal solution (TOPSIS) has been presented in this paper to prioritize the LAG practices on the basis of the influence on performance indicators. Sensitivity analysis is carried out to check the robustness of the presented model. Findings: The derived result indicates that sustainable packaging, coordination among supply chain stakeholders and cold chain technology improvement are among the top practices affecting most of the performance parameters of VSC. The sensitivity analysis reveals that the priority of practices is highly dependent on the weightage of performance indicators. Practical implications: This study's finding will help policymakers reframe strategies for sustainable VSC (SVSC) by including new management practices that can handle regular immunization programs as well as emergency mass vaccination. Originality/value: To the best of the authors' knowledge, this is the first study that proposes the LAG framework for SVSC. The IPA–Fuzzy AHP (FAHP)–Fuzyy TOPSIS (FTOPSIS) is also a novel combination in decision-making. © 2022, Emerald Publishing Limited.
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Introduction: Studies have linked lower vitamin D levels with cardiovascular disease (CVD) and mortality in general population and chronic kidney disease (CKD). The preliminary evidence of vitamin D supplementation is encouraging but there is a huge void with respect to good quality long term data supporting the use of this promising intervention for translation into better outcomes for CVD in CKD. This study is exploring the effect of cholecalciferol supplementation on cardiovascular disease, markers of inflammation and bone metabolism in CKD. We present the baseline characteristics of feasibility phase of the trial. Methods: The study is a multicentric, prospective, randomized, placebo controlled, double blind trial in two parallel groups and feasibility phase is being done at Postgraduate Institute of Medical Education and Research, Chandigarh, India. The trial is registered at Clinical Trials Registry of India (CTRI/2019/05/019211). After a run-in period of 2 weeks, the enrolled subjects are randomized in 1:1 to receive either 60,000 IU/2 weeks of cholecalciferol or matching placebo. The subjects will be then followed up every three month till 3 years. The primary outcome of the study is a composite of major adverse cardiac events (MACE). Secondary outcome measures include all-cause mortality, need of RRT, change in hsCRP, IL-6, iPTH, FGF-23, bone specific alkaline phosphatase, and CTX-1. Results: A total of 720 subjects have been screened till date. Out of 119 enrolled, 86 subjects have been randomized over 24 months period. 76% subjects have completed annual follow up at 12 months, 66% subjects - 15thmonths follow up, 40%- 18 months follow up, 26% subjects - 21 months follow up, 6% subjects – 24 months follow up. Baseline characteristics and serum biomarkers levels has been analysed in 80 subjects. Mean age of the subjects were 51.3 ± 12.2 years and 58.8 % were males. Serum haemoglobin levels were 11.6 ±1.7 g/dl. Mean eGFR was 26.3 (17.4, 35.1) ml/min/1.73m2. Outcome events were;MACE: 1 (due to CVD), death other than due to MACE: 1 (due to COVID 19), subjects with composite of all-cause death and non-fatal MACE: 2, subject with need of RRT:1 and subjects with composite of 50% decline in GFR or need of RRT: 3. 2 serious adverse events unrelated to study drug were reported during the course of study. Table: Baseline levels of various serum biomarkers [Formula presented] Conclusions: Despite COVID 19 related restrictions being in place for most of the last 18 months, the study has been able to screen and enrol participants. The follow ups have been ensured either through physical or remote (mobile/telephonic) means. Once in the multi-centric phase, the study will be able to test a relatively inexpensive intervention in the form of vitamin D supplementation for CVD in CKD. No conflict of interest