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Basnet A, Tamang B, Pokhrel N, Khadka S, Shrestha MR, Ghimire S, Prajapati R, Thapa S, Duwal Shrestha SK, Chand AB, Amatya I, Rai SK. First-Generation SARS-CoV-2 Vaccines: A Comparative Analysis between Vaccinated and Unvaccinated Hospitalized Patients Infected with SARS-CoV-2. Kathmandu Univ Med J (KUMJ) 2022; 20:316-322. [PMID: 37042373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Background Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) variants, which have emerged due to several mutations in spike protein, have a potential to escape immune protection provided by the first-generation vaccines, thereby resulting in breakthrough infections. Objective To identify the socio-demographic factors, clinical features, and outcomes in both vaccinated and unvaccinated hospitalized patients infected with SARS-CoV-2. Method Socio-demographic details, clinical features, and the outcomes among fully vaccinated (double for Covishield/AstraZeneca and BBIBP-CorV and single for Janssen), partially vaccinated, and unvaccinated hospitalized patients with coronavirus disease of 2019 (COVID-19) were collected and analyzed using SPSS version 17. Result Among the hospitalized COVID-19 patients (n=299), 175 (58.5%) patients received a single-dose, 82 (27.4%) double-dose, and 124 (41.5%) did not receive any dose of the COVID-19 vaccines. The risk of SARS-CoV-2 infection when compared between vaccinated and unvaccinated patients was found to be associated among professional degree holders (23.4% versus 9.7%) (p<0.05), professional workers (43.4% vs. 25.0%) (p<0.05), hospitalization to general ward (76.6% vs. 72.6%) (p<0.05), and presence of multiple symptoms (> or equel 3) (86.8% vs. 75.0%) (p>0.05) and comorbidities (> or equal 2) (15.5% vs. 13.7%) (p>0.05). Despite such approximate incidences, the risk of in-hospital mortality among the vaccinated patients was reduced (0.6% vs. 3.2%) (p>0.05), when compared to the unvaccinated patients. The risk of in-hospital mortality was associated with the older age and the presence of multiple comorbidities including bronchial asthma, diabetes, and hypertension. Conclusion Full or partial vaccination against the SARS-CoV-2 variants of concerns might be effective in preventing in-hospital mortality among COVID-19 patients.
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Affiliation(s)
- A Basnet
- Department of Medical Microbiology, Shi-Gan International College of Science and Technology, Tribhuvan University, Shankha marg, Kathmandu, Nepal. and Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - B Tamang
- Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - N Pokhrel
- Research Section, Nepal Health Research Council, Kathmandu, Ramshah path, Kathmandu, Nepal
| | - S Khadka
- Department of Immunology, Mayo Clinic, Rochester, Minnesota, United States. and Department of Microbiology and Immunology, Stanford University, Palo Alto, California, United States
| | - M R Shrestha
- Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - S Ghimire
- Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - R Prajapati
- Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - S Thapa
- Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - S K Duwal Shrestha
- Department of Orthopedic, Nepal Armed Police Force Hospital, Balambu, Kathmandu, Nepal
| | - A B Chand
- Department of Clinical Laboratory, KIST Medical College and Teaching Hospital, Gwarko, Lalitpur, Nepal
| | - I Amatya
- Research Section, Nepal Health Research Council, Kathmandu, Ramshah path, Kathmandu, Nepal
| | - S K Rai
- Research Division, Nepal Medical College and Teaching Hospital, Gokarneswor-08, Kathmandu, Nepal
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Singh N, Pandey CR, Tamang B, Singh R. Scranton Type V Osteochondral Defects of Talus: Does one-stage Arthroscopic Debridement, Microfracture and Plasma Rich in Growth Factor cause the Healing of Cyst and Cessation of Progression to Osteoarthritis? Malays Orthop J 2020; 14:64-71. [PMID: 32983379 PMCID: PMC7513663 DOI: 10.5704/moj.2007.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: The study was conducted to evaluate the efficacy of arthroscopic debridement, microfracture and plasma rich in growth factor (PRGF) injection in the management of type V (Scranton) osteochondral lesions of talus and its role in healing the subchondral cyst and cessation of progression of ankle osteoarthritis. Material and Methods: This is a prospective case series conducted on patients who were diagnosed with type V osteochondral lesions of talus. All the cases were treated with arthroscopic debridement, microfracture, and PRGF injections. The patients were evaluated for the healing of subchondral cysts and progression of osteoarthritis with radiography (plain radiographs and computerised tomography Scan). Also, the patients’ outcome was evaluated with Quadruple Visual Analogue Scale, Ankle Range of Motion, Foot and Ankle Disability Index, Foot and Ankle Outcome Instrument and a Satisfaction Questionnaire. Results: Five male patients underwent arthroscopic debridement, microfracture and PRGF injection for type V osteochondral lesion of talus. The mean age of patients was 27.4 years (19-47 years). All the patients gave history of minor twisting injury. Subchondral cyst healing was achieved in all patients by six months post-surgery. However, four out of five patients had developed early osteoarthritic changes of the ankle by their last follow-up [mean follow-up 29 months (ranged 15-36 months)]. Despite arthritic changes, all the patients reported ‘Good’ to ‘Excellent’ results on satisfaction questionnaire and Foot and Ankle Disability Index and could perform their day to day activities including sports. Conclusion: Arthroscopic debridement, microfracture, and PRGF causes healing of the subchondral cyst but does not cause cessation of progression to osteoarthritis of ankle in type V osteochondral defects of talus. However, despite progress to osteoarthritis, patient satisfaction post-procedure is good to excellent at short-term follow-up.
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Affiliation(s)
- N Singh
- Department of Orthopaedics and Traumatology, Grande International Hospital, Kathmandu, Nepal
| | - C R Pandey
- Department of Orthopaedics and Traumatology, Grande International Hospital, Kathmandu, Nepal
| | - B Tamang
- Department of Orthopaedics and Traumatology, Grande International Hospital, Kathmandu, Nepal
| | - R Singh
- Department of Physiotherapy and Rehabilitation, Grande International Hospital, Kathmandu, Nepal
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Abstract
INTRODUCTION Diagnosis of subungual glomus tumour is mostly based on detailed history and clinical examination. Recently, Magnetic Resonance Imaging (MRI) and Ultrasound have been proposed as the imaging modality to confirm the clinical diagnosis and in planning the surgical management of these tumours. However, these imaging modalities are not routinely available in rural setting and also are expensive. Due to these limitations, we set out to establish that diagnosis and management of these rare tumours can be based solely on a battery of clinical tests and history taking. MATERIALS AND METHODS Retrospectively, we reviewed nine cases of glomus tumour. A clinical evaluation proforma was developed on the basis of clinical history and specific clinical test for diagnosis of these tumours. All the cases were evaluated and treated surgically by a single surgeon with a specific technique. Post-operatively, diagnosis was confirmed by histopathological examination. RESULTS Females (77.78%) were predominantly affected in this series and the tumours commonly occurred in the right hand (66.66%). Spontaneous pain, cold sensitivity test and Love's Pin test was positive in all cases (100%). Hildreth's test was positive in 88.89%. In none of the cases the tumours recurred during minimum follow-up of one year. In all cases, histopathological examination confirmed the preoperative diagnosis of glomus tumours. CONCLUSION Diagnosis of glomus tumours can be made clinically based on history taking and clinical examination. Magnetic Resonance Imaging and Ultrasound are not necessary for diagnosis and management of typical subungual tumours.
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Affiliation(s)
- C R Pandey
- Department of Orthopaedics, Grande International Hospital Kathmandu, Nepal
| | - N Singh
- Department of Orthopaedics, Grande International Hospital Kathmandu, Nepal
| | - B Tamang
- Department of Orthopaedics, Grande International Hospital Kathmandu, Nepal
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