A Study on COVID-19 Vaccine Hesitancy in Bhopal

Background: The coronavirus has become a global pandemic and to overcome the pandemic crisis vaccine were launched in India. COVID-19 mass immunisation has emerged as a crucial preventive technique. COVID-19 vaccine hesitancy may become a distinctive element of the pandemic's next stage. The loss of public trust in vaccines around the world is a source of concern and a serious problem for public health professionals. A study was therefore planned in Bhopal to determine whether hesitancy is present in a population and to distinguish hesitancy from other reasons why adults do not get vaccinated. The study was conducted with the objective as to assess the vaccine hesitancy in Bhopal. Methodology: This is a cross-sectional study conducted among the general population of Bhopal during the time period between 2oth Jan to Feb 2021. 381 participants were administered with a predesigned pretested questionnaire. Results: The mean age of the participants was 33.8 years. Majority was unskilled workers, Hindu by religion and most of them were married. 57.3 % showed hesitancy for COVID vaccination. Majority had the knowledge of vaccine. Television was the major source of information. Almost 80% responded as they would continue practicing personal protective measures even after vaccination. The major reasons for hesitancy were lack of information, safety about vaccination, and side effects from the same. The public demands the proper information about the vaccine and educate the general public and communicate the important information regarding vaccinations. Conclusion: Routine monitoring of vaccine hesitancy plays a valuable role in identifying early vaccine concerns. And adopt the strategies to address these concerns, through in-depth understanding of the nature of hesitancy, as well as who is hesitating. Given the dynamic and changing nature of vaccine hesitancy, the importance of ongoing monitoring cannot be overstated. Key words: COVID-19, COVID-19 Vaccine, SARS-COV2 vaccine, Vaccine hesitancy, Vaccine resistance, Vaccine opposition.

Immunogenicity of the COVID-19 Two-Vaccination Series Among Hematologic Malignancies: Report of Three Cases of Breakthrough Infection

Data is limited on the immunogenicity of the COVID-19 two-vaccination series among patients with hematologic malignancies and current guidelines do not recommend routine monitoring for post-vaccine antibodies. However, we describe three patients who developed severe or critical COVID-19 infections six months after vaccination. This highlights the importance of routine testing of COVID-19 IgG Spike, semi-quantitative antibodies post-vaccination, particularly among immunocompromised patients.

Anti-inflammatory and immunomodulatory effects of rosuvastatin in patients with low-to-moderate cardiovascular risk

Statins have shown anti-inflammatory pleiotropic effects in subjects with/at risk of cardiovascular disease. The aim of this study was to evaluate the inflammatory/immunomodulatory properties of rosuvastatin in subjects at low-to-moderate cardiovascular risk. Data was collected from patients’ records, physical examination and blood sampling. Subjects were assigned to rosuvastatin 20 mg per day. Rosuvastatin significantly decreased C-reactive protein (p = 0.045), and increased vascular endothelial growth factor (p = 0.004) and epidermal growth factor (p = 0.009). A multivariate analysis identified total cholesterol (p = 0.027) and vascular endothelial growth factor (p = 0.011) to be independently associated with rosuvastatin treatment. Given beneficial/harmful role of growth factors, vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF), in cardiovascular disease, one would suggest the need for routine monitoring of growth factor levels, especially in patients on long-term statin therapy.

A comparison of Lidocaine and Ketamine for prevention withdrawal from injection of Rocuronium.

Aim : To make comparison of the effects of lidocaine and ketamine in preventing withdrawal moments linked with IV injection of rocuronium . Methods: About sixty candidates (ASA I & II) were chosen for this case research and categorized into two groups via aid of random number table in such a manner that each group contained 30 individuals. Candidates belonging to group A were administered ketamine in the dosage of 0.5mg/kg that was diluted in 2ml whereas group B candidates were administered 2ml of 1% lidocaine. On the dorsum of the hand, 20 gauge cannula will be inserted intravenously and candidate will be administered midazolamin doage of 0.02mg/kg intravenously for five minutes before coming into in the Operation theatre. After arrival of candidate , non-invasive routine monitoring of the candidates will be carried out and free fluid flow fluid via cannula will be assured by gravity with aid of IV fluid as normal saline. At room temperature, the syringes will be placed. Administration of drugs will be carried out via the injection port of intravenously cannula with a free fluid flow intravenously. Results: In case of ketamine , the prevalence withdrawal movements was recorded as 43.3% and lidocaine as 40%. In case of both research groups, the mean withdrawal scores were similar (P value two tailed = 1.0 (>0.05). Two candidates among these individuals i-e one from each groups depicted generalized response (3.3%). No noteworthy difference was recorded in case of lidocaine and ketamine for preventing withdrawal moments after administration of injection of rocuronium. Conclusion: Equal effectiveness of lidocaine 1% and Ketamine 0.5mg/kg 2ml (20mg) was recorded in deducing withdrawal moments after administration of injection of rocuronium intravenously . Keywords: Lidocaine, ketamine, withdrawal movements

Will Mass Spectrometry Replace Current Techniques for Both Routine Monitoring and MRD Detection in Multiple Myeloma?

In recent years, mass spectrometry has been increasingly used for the detection of monoclonal proteins in serum. Mass spectrometry is more analytically sensitive than serum protein electrophoresis and immunofixation, can help distinguish therapeutic monoclonal antibodies from M-proteins, and can detect the presence of post-translational modifications. Mass spectrometry also shows promise as a less-invasive, peripheral-blood-based test for detecting minimal residual disease in multiple myeloma. Studies comparing the clinical utility of mass spectrometry to current blood- and bone-marrow-based techniques have been conducted. Although still primarily limited to research settings, clinical laboratories are starting to adopt this technique for patient care. This review will discuss the current status of mass spectrometry testing for multiple myeloma, the benefits and challenges of this technique, and how it may be incorporated into clinical practice in the future.

Valproic Acid Concentrations in Mothers, Colostrum and Breastfed Infants during the Early Postpartum Period: Comparison with Concentrations Determined during Delivery and in the Mature Milk Period

To obtain information on the transport of valproic acid from mothers to colostrum and breastfed infants, in this cohort study, valproic acid concentrations in maternal serum (90 subjects), colostrum and the serum of breastfed infants were analyzed in years 1993–2018, between the 2nd and 5th postnatal days. Valproic acid concentrations ranged from 4.3 to 66.5 mg/L (mean 31.2 ± 13.6 mg/L) in maternal serum, from 0.5 to 5.9 mg/L (mean 1.1 ± 1.2 mg/L) in milk, and from 0.5 to 42.9 mg/L (mean 15.4 ± 9.4 mg/L) in infant serum. The milk/maternal serum concentration ratio ranged from 0.01 to 0.22 (mean 0.04 ± 0.04), and the infant/maternal serum concentration ratio ranged from 0.01 to 1.61 (mean 0.51 ± 0.28). A significant correlation was found between serum concentrations of breastfed infants and milk concentrations, maternal serum concentrations, maternal daily dose, and dose related to maternal body weight. Valproic acid concentrations in milk and infant serum did not reach the lower limit of the reference range used for the general epileptic population, and three-quarters of the concentrations in milk were lower than the lower limit of quantification. Routine monitoring of serum concentrations of breastfed infants is not necessary. If signs of potential adverse reactions are noted, serum concentrations of the infants should be measured.

Solar Monitoring of the NEXRAD WSR-88D Network using Operational Scan Data

Solar monitoring is a method in which solar interferences, recorded during operational scanning of a radar, are used to monitor antenna pointing, identify signal processor issues, track receiver chain stability, and check the balance between horizontal and vertical polarization receive channels. The method is used by Eumetnet to monitor more than 100 radars in twenty European countries and it has been adopted by many national weather services across the world. NEXRAD is a network of 160 similar S-band weather radars (WSR-88Ds), which makes it most suitable for assessing the capability of the solar monitoring method on a continental scale. The NEXRAD Level-II data contain radial-by-radial noise power estimates. An increase in this estimate is observed when the antenna points close to the sun. Our decoding software extracts these noise power estimates for the horizontal and vertical receive channels (converted to solar flux units) and other relevant metadata, including azimuth, elevation, observation time and radar location. Here we present results of analyzing one year of solar-monitoring data generated by 142 radars from the contiguous United States. We show monitoring results, geographical maps, and statistical outcomes on antenna pointing, solar fluxes, and differential reflectivity biases. We also assess the quality of the radars by defining a Figure of Merit, which is calculated from the solar monitoring results. The results demonstrate that the solar method provides great benefit for routine monitoring and harmonization of national and transnational operational radar networks.

Systemic Treatments in Pediatric Psoriasis: A Retrospective Single-Center Study

Background: Systemic therapies commonly used in adult psoriasis are mostly used only off-label in children and little is known about the efficacy and tolerability of these drugs in this population. In this study, we aimed to evaluate the efficacy and safety of systemic treatments in pediatric patients with psoriasis. Methods: Data were obtained retrospectively from the Department of Dermatology, Ondokuz Mayis University, School of Medicine between 2010–2019. Our study consisted of 742 pediatric patients (age ≤18 years) with psoriasis. Demographic data, adverse events of systemic treatments and healing periods were considered. Results: A total of 195 patients received systemic treatment. The mean age of onset of disease and the initiation of systemic therapy were 9.68±4.62 and 11.33±4.38 years, respectively. Patients received methotrexate (n=52, 26.67%), cyclosporine (n=18, 9.24%), acitretin (n=106, 54.35%) and others (biologics and/or one of conventional treatments) (n=19, 9.74%) as systemic therapy. Adverse events occurred in 12 patients (incidence of 6.15%, and its related 95% confidence interval of 2.75%, 9.56%) and nine of them had to discontinue the medication due to those adverse events. Healing periods calculated in the remaining 186 patients were 13.25±5.87, 10.85±5.67, 11.05±7.00, and 9.41±4.16 (mean±SD) weeks for acitretin, methotrexate, cyclosporine, and others, respectively. No statistically significant differences were noted between the treatments regarding the healing periods. Conclusion: All treatments were effective and none of them was superior in terms of the healing period. Systemic treatments used in adults can also be used in pediatric patients with psoriasis with similar efficacy and safety rates as long as routine monitoring is provided.

Validated Simple HPLC-UV Method for Mycophenolic Acid (MPA) Monitoring in Human Plasma. Internal Standardization: Is It Necessary?

The aim of the work was to prepare a simple but reliable HPLC-UV method for the routine monitoring of mycophenolic acid (MPA). Sample preparation was based on plasma protein precipitation with acetonitrile. The isocratic separation of MPA and internal standard (IS) fenbufen was made on Supelcosil LC-CN column (150 × 4.6 mm, 5 µm) using a mobile phase: CH3CN:H2O:0.5M KH2PO4:H3PO4 (260:700:40:0.4, v/v). UV detection was set at 305 nm. The calibration covered the MPA concentration range: 0.1–40 µg/mL. The precision was satisfactory with RSD of 0.97–7.06% for intra-assay and of 1.92–5.15% for inter-assay. The inaccuracy was found between −5.72% and +2.96% (+15.40% at LLOQ) and between −8.82% and +5.31% (+19.00% at LLOQ) for intra- and inter-assay, respectively, fulfilling acceptance criteria. After a two-year period of successful application, the presented method has been retrospectively calibrated using the raw data disregarding the IS in the calculations. The validation and stability parameters were similar for both calculation methods. MPA concentrations were recalculated and compared in 1187 consecutive routine therapeutic drug monitoring (TDM) trough plasma samples from mycophenolate-treated patients. A high agreement (r2 = 0.9931, p < 0.0001) of the results was found. A Bland–Altman test revealed a mean bias of −0.011 μg/mL (95% CI: −0.017; −0.005) comprising −0.14% (95% Cl: −0.39; +0.11), whereas the Passing–Bablok regression was y = 0.986x + 0.014. The presented method can be recommended as an attractive analytical tool for medical (hospital) laboratories equipped with solely basic HPLC apparatus. The procedure can be further simplified by disapplying an internal standard while maintaining appropriate precision and accuracy of measurements.