Drugs Controller General of India (DCGI) in April 2022 approved the emergency use authorisation of Corbevax and Covaxin COVID 19 vaccines in children. Corbevax is a protein subunit COVID 19 vaccine developed by Texas Children's Hospital.  Third nerve palsy is rarely reported following protein sub- unit COVID vaccines. We report a case of a 13-year-old male who presented to a tertiary care hospital with complaints of   giddiness, headache, diplopia and drooping of left eye within one hour of receiving Corbevax vaccine in school. He was subsequently diagnosed with third nerve palsy and treated with corticosteroids and lubricant eye drops. He recovered fully and was discharged after four days. Causality assessment as per World Health Organization (WHO) guidelines for the causality assessment of Adverse Events Following Immunization (AEFI) was consistent. Protein sub unit vaccines can rarely cause third nerve palsy.

Several formulations of vaccines against novel coronavirus have been launched. Thereby, increasing the plausibility of having one or more successful vaccines. India put in place the world’, s largest Covid-19 vaccination drive in January 2021. However, the side effects of these vaccines are slowly unfolding. Each new vaccine has potential adverse events of special interest (AESI) that warrant a focused evaluation. We report a very rare neurological complication Guillain-Barré,syndrome, immediately following the first dose of COVID vaccination in a young female. An apparently healthy 35 years old female presented with acute onset lower backache, weakness of bilateral lower limbs 11 days after receiving the first dose of Covishield vaccine, which rapidly ascended to upper limbs over 5 days with symmetric motor weakness, power 1/5 in bilateral lower limbs, 3/5 in bilateral upper limbs, with absent deep tendon reflexes. Mild sensory involvement was seen. Evolving dysphagia and hoarseness of voice. Bladder/bowel function, respiratory pattern, and hemodynamics were unaffected. A provisional diagnosis of Guillain-Barre Syndrome was made on basis of clinical presentation, neurological examination, and nerve conduction studies suggesting axonal polyneuropathy. Gradual improvement of the muscle power over the next 2 weeks following Human Intravenous immunoglobulin was seen. The risk-benefit analysis for an individual should be considered prior to Covid-19 vaccination, including the implementation of a pre-vaccination screening checklist to ensure vaccine safety for every vaccine recipient. The vaccine continues to be far more beneficial than detrimental for the public at large. Nonetheless, increased awareness amongst healthcare professionals and the public regarding the potential adverse effects of the vaccine is warranted.

Introduction: Medical errors threaten health and welfare of patients in health systems. Root cause analysis is an important way to identify errors and causes. This technique is a systematic analysis of cause and effect which tries to determine how patients’ issues, staff, policies, environments and processes are involved in occurrence of medical errors. The present study has analyzed root causes of an adverse event (death of a 21 year old patient who was admitted to hospital with abdominal pain) in Mashhad, 2011.Methods: This was a descriptive study conducted with qualitative approach within six steps. These steps included: defining the event, collecting the data, drawing causal factors, analyzing data and identifying root causes, and implementing recommendation. Root cause analysis was performed using tools such as brain storming and cause and effect diagram from August 2011 until October 2011.Results: Lack of immediate access to professionals and experts in different medical fields, unavailability of up-to-date guidelines, unawareness about CPR rules and insufficient number of ICU beds, inadequate personnel in push time, and lack of standard equipments for identifying and preventing risks were identified as causes of this medical error.Conclusion: Due to the usefulness of root cause analysis in patients' safety, this technique should be used systematically in health care providing unites for critical events management. Reporting and analyzing medical errors needs structural and cultural changes.

Objective: Psychiatric disorders are chronic in nature which require medications for a long duration. These medications have been associated with many adverse events. Failure to recognize an adverse drug reaction (ADR) exposes the patient to continuing risk of ADR, leading to a significant impact on patient’, s quality of life. Thus, the present study carried out to identify the pattern of ADRs reported due to psychotropic medication. Methods: This was a cross‑, sectional study conducted to analyze ADRs reported from the psychiatry department of a tertiary care teaching hospital from October 2021 to March 2022. Findings: A total of 137 ADRs were identified from 102 patients. Majority of the ADRs were reported from antidepressants, with paroxetine being the leading offending drug. The central nervous system was most commonly affected, and dizziness (13. 13%) was the most common ADR noted. On causality assessment, 97 ADRs (70. 8%) were of “, possible”,type. Almost half of the patients with ADRs (47. 5%) recovered spontaneously. No ADR encountered turned out to be fatal. Conclusion: The present study revealed that the majority of ADRs reported from psychiatry OPD were mild in nature. We reinforce the identification of ADR is crucial in the hospital setting process as it gives an insight into the risk‑, benefit ratio for rational use of the drug.