Comparative assessment of SARS CoV2-associated mortalities in 3 COVID waves and related risk factors: The South Kashmir's experience.

Introduction: Severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) pandemic have spurted in three major waves in India at different times and had different levels of severity in different waves. The objective of our study was to determine the comparative mortality rate in three COVID-19 waves and determine the factors associated with mortality. Methods: We identified a cohort of 1,132 COVID-19 patients who were admitted between April 14, 2020 and February 08, 2022 at our center. All the admitted patients with positive COVID-polymerase chain reaction were included in the study. Sample characteristics were determined by screening age, sex, socio-economic status, occupation, symptomatology of COVID, patient status on admission, baseline investigations, comorbidities, medical history, oxygen dosage needed during admission, the span of hospital stay, diagnosis, and vitals such as blood pressure, pulse, and oxygen saturation. All the data were procured from an institutional database. Results: In total, 1,132 patients included in the study, the mean age was 65.08 ± 12.29 and 56% were males. The affliction rate was 42.13% in >60 years, 29.5% in 46-60 years, 20.8% in 31-45 years, and 7.4% in 30 years' group. In the first, second, and third waves of COVID-19, the mortality rates were 13.21%, 23.53%, and 11.39%, respectively. Among the comorbidities, mortality rates were proportionately higher in those with hypertension (6.7%), and diabetes (5.5%), than those with chronic obstructive pulmonary disease (3.3%), chronic kidney disease (CKD) (1.5%), heart disease (1.6%), and malignancy (0.2%). Conclusion: We identify the peaked mortalities in the second encounter which was predicted by age, comorbidities such as hypertension, and diabetes.

High frequency abrupt shifts in the Indian summer monsoon since Younger Dryas in the Himalaya.

In order to quantify the Indian summer monsoon (ISM) variability for a monsoon dominated agrarian based Indian socio-economy, we used combined high resolution δ13C, total organic carbon (TOC), sediment texture and environmental magnetic data of the samples from a ~3 m deep glacial outwash sedimentary profile from the Sikkim Himalaya. Our decadal to centennial scale records identified five positive and three negative excursions of the ISM since last ~13 ka. The most prominent abrupt negative ISM shift was observed during the termination of the Younger Dryas (YD) between ~11.7 and 11.4 ka. While, ISM was stable between ~11 and 6 ka, and declined prominently between 6 and 3 ka. Surprisingly, during both the Medieval Warm Period (MWP) and Little Ice age (LIA) spans, ISM was strong in this part of the Himalaya. These regional changes in ISM were coupled to southward shifting in mean position of the Intertropical Convergence Zone (ITCZ) and variations in East Asian monsoon (EAM). Our rainfall reconstructions are broadly in agreement with local, regional reconstructions and PMIP3, CSIRO-MK3L model simulations.

Complete ophthalmoplegia: A rare presentation of idiopathic intracranial hypertension.

Idiopathic intracranial hypertension (IIH) is a disorder defined by clinical criteria that include signs and symptoms isolated to those produced by increased intracranial pressure (ICP; e. g., headache, papilledema, and vision loss), elevated ICP with normal cerebrospinal fluid (CSF) composition, and no other cause of intracranial hypertension evident on neuroimaging or other evaluations. The most common signs in IIH are papilledema, visual field loss, and unilateral or bilateral sixth cranial nerve palsy. Here we report a case of IIH presenting as headache with vision loss, papilledema, complete ophthalmoplegia with proptosis in one eye, and sixth cranial nerve palsy in the other eye. Patient was managed with acetazolamide, topiramate, and diuretics. Symptoms remained static and she was planned for urgent CSF diversion procedure.