Sputnik V vaccine perception and hesitancy in a tertiary health care centre transformed to Covid-19 vaccine centre: A case study

BACKGROUND

Sputnik V vaccine was approved in India in April 2021 to tackle the pandemic situation. However, there was lack of information on the effects, side effects, and peoples' perception toward it. The present case study aims to evaluate the vaccine coverage, the awareness, and perception toward it and compare the adverse effects after each dose.

MATERIALS AND METHODS

A unique case study was conducted in a sample of 200 participants comparing 2 groups of population who took first and second dose of Sputnik V vaccine during June to November 2021. The data were collected by a prevalidated questionnaire, follow-up telephonic interviews focused on knowledge, awareness, side effects of vaccine, and analyzed using descriptive statistics such as frequency, percentages, mean, and standard deviation.

RESULTS

The vaccine coverage for first and second doses were 98.3% and 96.5%, respectively. The mean age of the participant was 29 + 9.5 years and majority 68.5% were males. Seventeen percent experienced the S/E for the vaccine with 9.5% from second dose. There were usual side effects; however, it was more after second dose of vaccination. Friends and healthcare workers were the main source of information (33.5%) and motivation (43%). Majority (73.5%) were aware of the side effects. Forty three point five percent took vaccine attributed to its protective role, availability, and peer pressure. There was no significant association between type of doses and side effects of the respective doses of vaccine.

CONCLUSION

The vaccine coverage was >90%. Participants were well aware of the vaccine and side effects which were more in second dose. However, there was no significant difference between the two doses of vaccine.

Potential biomarkers uncovered by bioinformatics analysis in sotorasib resistant-pancreatic ductal adenocarcinoma

Background

Mutant KRAS-induced tumorigenesis is prevalent in lung, colon, and pancreatic ductal adenocarcinomas. For the past 3 decades, KRAS mutants seem undruggable due to their high-affinity GTP-binding pocket and smooth surface. Structure-based drug design helped in the design and development of first-in-class KRAS G12C inhibitor sotorasib (AMG 510) which was then approved by the FDA. Recent reports state that AMG 510 is becoming resistant in non-small-cell lung cancer (NSCLC), pancreatic ductal adenocarcinoma (PDAC), and lung adenocarcinoma patients, and the crucial drivers involved in this resistance mechanism are unknown.

Methods

In recent years, RNA-sequencing (RNA-seq) data analysis has become a functional tool for profiling gene expression. The present study was designed to find the crucial biomarkers involved in the sotorasib (AMG 510) resistance in KRAS G12C-mutant MIA-PaCa2 cell pancreatic ductal adenocarcinoma cells. Initially, the GSE dataset was retrieved from NCBI GEO, pre-processed, and then subjected to differentially expressed gene (DEG) analysis using the limma package. Then the identified DEGs were subjected to protein-protein interaction (PPI) using the STRING database, followed by cluster analysis and hub gene analysis, which resulted in the identification of probable markers.

Results

Furthermore, the enrichment and survival analysis revealed that the small unit ribosomal protein (RP) RPS3 is the crucial biomarker of the AMG 510 resistance in KRAS G12C-mutant MIA-PaCa2 cell pancreatic ductal adenocarcinoma cells.

Conclusion

Finally, we conclude that RPS3 is a crucial biomarker in sotorasib resistance which evades apoptosis by MDM2/4 interaction. We also suggest that the combinatorial treatment of sotorasib and RNA polymerase I machinery inhibitors could be a possible strategy to overcome resistance and should be studied in in vitro and in vivo settings in near future.

Investigating the binding affinity of andrographolide against human SARS-CoV-2 spike receptor-binding domain through docking and molecular dynamics simulations

SARS-CoV-2 is a positive-sense single-stranded RNA virus that causes a deadly coronavirus disease (COVID-19) in humans. The infection of SARS-CoV-2 in humans involves a viral surface spike glycoprotein containing the receptor-binding domain (RBD). The interactions of SARS-CoV-2 with the host angiotensin-converting enzyme 2 (ACE2) receptor are mediated by RBD. It binds to the host ACE2 and influences viral replication and disease pathogenesis. Therefore, targeting the RBD to prevent SARS-CoV-2 infections is of utmost importance. In this study, we used docking and molecular dynamics simulations to understand the binding effect of andrographolide on the SARS-CoV-2 spike protein. During docking, a strong binding affinity was observed between the ligand and the target receptor protein. MD results demonstrated higher conformational fluctuations in the ligand-free protein compared to the bound form. Several residues in the active sites make conformational rearrangements for the S protein to interact with the ligand. While RBD experiences conformational transition to gain more stability upon binding with the ligand. This binding is strengthened via several non-covalent interactions that make the complex structure more stable with higher binding affinity. Overall findings of the study may shed some valuable insights concerning the development of potential therapeutics in the strategies for COVID-19 prevention.

"Proximal to distal" sequence of the release of the upper extremity post-burn contracture: Rule or case-based approach?

Post-burn contractures are common entities seen in developing countries. There are multiple reasons for the development of contractures, most are preventable. In extensive contractures, a strategic plan is necessary to release all contractures and yet not antagonize post-operative positions. It is also necessary to be cost-effective and minimize the number of surgeries needed. Conventionally the release sequence in extensive burn contractures is proximal to distal. In this case report, we discuss an unusual sequence where we released distal contractures before the proximal to achieve optimum results. A 3-year-old child with post-burn contracture of hand, wrist, elbow, and axilla was treated in 2 stages, with the release of wrist contracture and cover with pedicled abdominal flap in the first stage and division of pedicled flap with the release of axilla and elbow contracture in the second stage. Thus, the release of all contractures was achieved without antagonizing post-operative positions and minimized the number of surgeries. A case-based approach may be crucial in making a strategic surgical plan to minimize the rehabilitation phase, rather than following known dictums.

A new systematic model for analysis and a hybrid fuzzy multimodality model for lung tumor prediction

Lung cancer is one of the most commonly occurring diseases that ranked in the top of the present survey. Advancements in the medical field enable non-invasive methods of computerised diagnosis procedures and detection processes. Deep learning methods are already in evaluation by keeping the deep analysis on improving segmentation accuracy and prediction accuracy etc. The classification of tumour type depends on the quality of segmentation work and feature mappings. In this paper, we developed a robust model that classifies the types of tumours with improved accuracy but is also capable of detecting the early stages of cancer by detecting the unique hidden points of the image intensity in the lung images, etc. The system is comprised of a novel relative convergence technique for feature extraction technique to extract the infected area and its characteristic pixels to evaluate a unique feature mapping vector. The MSB feature mapping vectors are analysed with Hybrid Regress Fuzzy Net. The final result on whether a tumour is present in the CT image or normal depends on the three individual decisions made by the three algorithms mentioned. The accuracy of each algorithm is also considered for the probable decision-making. The performance measure of the entire proposed Hybrid Regress Net is evaluated through Accuracy, Precision, Recall and F1Score etc.

A Retrospective Drug Utilization Study on Psychiatric Illness in a Tertiary Care Teaching Hospital

Psychiatric disorders are now widely recognized as a major contributor to the global burden of disease. It has been described that there is an increased risk of adverse effects when more than one psychotropic drug is prescribed. Knowledge of the pattern of utilization of drugs in the general population can be achieved through the conduct of drug utilization studies. The present study has therefore been conducted to observe the pattern of drug use in psychiatry patients in a tertiary care hospital. Aim and Objective: To assess the epidemiology of various psychiatric illnesses among the study population To assess the Prescribing Pattern of drugs in Psychiatric Illness. To assess the drug-drug interactions in the prescription using MICROMEDEX. Methodology: A retrospective descriptive observational study was performed in a tertiary care hospital. A total of 100 prescriptions were collected from MRD.  Results: The study reported that 66% of patients were males and 34% were females. The average number of drugs and psychotropic drugs per prescription is six and four respectively. Around 61.98% of drugs in the prescription are psychotropic drugs, among that 40.17% of benzodiazepines are majorly used, followed by 34.27% of antipsychotics. Almost 95 prescriptions had a minimum of one drug-drug interaction.  The average number of psychotropics per prescription was higher than in studies. The average number of drugs per prescription was 5.84, which lead to polypharmacy. Conclusion: Using WHO indicators prescription analysis was done and it showed some deviation from the standard value which can be improved. Polypharmacy was noted in this study. Most of the drug is prescribed in the brand name which should be avoided.

“VAN DER WOUDE SYNDROME: REPORT OF TWO CASES”

Van Der Woude syndrome is a rare autosomal dominant condition which is associated with developmental malformations involving lips, palate. This syndrome can be a genetic origin due to Microdeletion of chromosome bands 1q32-q41 and also mutation of Interferon regulatory factor 6 (IRF-6) can be a pathogenic cause. We report two interesting cases of Van Der Woude syndrome with lip pits and orofacial features.

Effect of Transcutaneous Electrical Nerve Stimulation on Parotid Saliva Flow in Patients with Hyposalivation

Context:

In recent days, we have come across an increase incidence of dry mouth as a side effects of drugs and in order to bring an awareness about a simple non- invasive method to increase the salivary flow, we have used TENS which in many way is beneficial to patients with metabolic disorders.

Aims and Objectives:

The aim is to assess the effectiveness of transcutaneous electrical nerve stimulation on salivary gland function in patients with hyposalivation.

Subjects and Methods:

The present study included total of 25 subjects with complaint of hyposalivation. Written informed consent was obtained from all the participants. Subjects with pacemakers, autoimmune diseases, pregnancy, and history of salivary gland pathology were excluded from the study. Subjects were asked to refrain from eating, drinking, chewing gum, smoking, and oral hygiene procedures for at least 1 h before the appointment. Unstimulated saliva was collected using modified Carlson Crittenden cup placed over the Stenson's duct bilaterally for 5 min and measured. TENS pads were placed over the parotid region and were activated. The intensity control switch was adjusted for patient's comfort. The intensity was turned up 1 increment at a time at 5 s intervals until the optimal intensity level was reached and stimulated saliva was then collected for 5 min using the modified Carlson Crittenden cup and measured. Any increase in parotid salivary flow (SF) with electrostimulation was considered a positive finding.

Statistical Analysis Used:

A paired t-test, evaluating mean changes in stimulated versus unstimulated SF rates, was applied to look for statistically significant differences using PASW 18.0 for Windows. An independent sample t-test was performed to note difference between genders.

Results:

There was significant increase in parotid SF in 19 of 25 patients after transcutaneous electrical nerve stimulation. Males showed more salivary secretion when compared to females.

Conclusions:

From the results of the study and within limitations of the study, it can be concluded that TENS was effective in increasing the SF rate in hyposalivatory patients with residual saliva. TENS was less effective in patients who are under xerogenic drugs. Thus, TENS may be an ever-growing armamentarium in the management of salivary gland hypofunction when other therapies have failed or are contraindicated.