Differences in Post-mRNA Vaccination SARS-CoV-2 IgG Concentrations and Surrogate Virus Neutralization Test Response by HIV Status and Type of Vaccine: a Matched Case-Control Observational Study

Following SARS-CoV-2 mRNA vaccination, people living with HIV (PLWH) had lower surrogate virus neutralization test response (p=0.03) and a trend towards lower IgG response (p=0.08), particularly among those with lower CD4+T-cell counts and who received the BNT162b2 vaccine. Study of the impact of supplemental vaccine doses among PLWH is needed.

Patients with reflex syncope have a higher prevalence of atrial fibrillation than general population which is predicted by the type of the tilt table test response

Introduction Reflex syncope is the result of an imbalance between the sympathetic and parasympathetic nervous system. The autonomic nervous system has been associated to some forms of atrial fibrillation (AF). Objective The aim of this study was to assess the prevalence of AF in patients with reflex syncope and a positive tilt table test and to identify the type of tilt test response in patients with AF in comparison to patients without AF. Methods We retrospectively studied consecutive patients that underwent a tilt table test at our institution between 2016 and 2019. We selected those patients with a positive test. Patients with an implanted pacemaker at the time of the tilt test and patients followed in a different institution were excluded. Previous diagnoses of AF episodes were assessed. We analysed the clinical characteristics and the tilt table test results according to previous history of AF. Results We studied 49 patients with a positive tilt test. Seven (14.3%) patients had previously diagnosed paroxysmal AF at the time of the tilt table test. Patients with AF were older, had more frequently hypertension, and the tilt test response was more frequently a vasodepressor than mixed or cardioinhibitory response (71.4% vs. 28.6%) (Table). In univariate analysis, age and hypertension were associated with AF, respectively, OR 1.08 (95% CI 1.01–1.17), p=0.034 and OR 10.80 (95% CI 1.19–98.36), p=0.035. A vasodepressor response was also associated with AF (OR 6.25, 95% CI 1.06–36.74, p=0.043). Conclusions Patients with reflex syncope and a positive tilt table test had a higher prevalence of AF than the general population. A vasodepressor response was associated with AF as were age and hypertension, demonstrating the possible impact of the autonomic nervous system and the multifactorial nature of AF. FUNDunding Acknowledgement Type of funding sources: None.

Knowledge, Attitude and Practice of Pharmacovigilance Among Nursing Staff in BGS GIMS Hospital

Background:To assess the knowledge, attitude andpractice (KAP) of pharmacovigilance (PV) and adverse drug reaction (ADR) reporting among nurses and to evaluate the impact of an educational intervention for improving awareness of pharmacovigilance among nurses in a tertiary care teaching hospital. Methods:A predesigned structured KAP survey questionnaire was adapted from the previous studies,modified and validated internally in the department.Nursing staff working in all the departments of BGS GIMS College were included in the study. The KAP questionnaire was used to collect the data before and after an educational intervention. Results:A total of 77 nursing staffs were involved in pre-KAP and post- KAP survey questionnaire.The pre-test response rate was 25.3% for knowledge based questions, 55% for attitude and 24.67% for practice based questions. After educational intervention, the post-test response rate was 96.6% knowledge based questions, 84.4% for attitude and 78.24 % for practice based questions. The overall scores observed between pre-test and post-test were found to be statistically significant proving the effectiveness of educational intervention and improving the knowledge of pharma covigilance among nursing staff.Post educational intervention, nursing staff strongly agreed that pharmacovigilance (PV) should be trained in detail to all health care professionals and understood with the necessity of ADR reporting to the adverse drug monitoring centre (AMC) in our hospital run by department of pharmacology. Conclusions:This study proves that knowledge, attitude and practice of pharma covigilance and adverse drug reporting in routine practice can be improved by proper orientation and medical interventions.