Lymphatic osteopathic manipulative treatment reduces duration of deltoid soreness after Pfizer/BioNTech COVID-19 vaccine

Pfizer-BioNTech BNT162b2 is one of the three U.S. Food and Drug Administration (FDA)-approved vaccines for the prevention of COVID-19. Its most common side effect, injection site pain, occurs because of locally recruited inflammatory mediators and is mitigated by the lymphatic system. Side effects may discourage individuals from receiving vaccines; therefore, reducing the duration of injection site pain can promote vaccination compliance. Osteopathic manipulative treatments (OMT) can directly affect the physiology underlying muscle soreness; however, there is currently no literature that supports the use of OMT in this scenario. In this case report, an otherwise healthy male presented with acute left deltoid soreness after receiving the Pfizer COVID-19 vaccine. The pain began 5 h prior to the visit. Three hours after being treated with lymphatic OMT, the severity of the pain was significantly reduced and was alleviated 8h after onset in comparison to the median duration of 24–48 h. He received his second dose 3 weeks later. This case report can provide future studies with the groundwork for further investigating the role of OMT in treating postvaccination muscle soreness, which can improve patient satisfaction and potentially promote vaccination compliance.

Chewing gum reduces visually induced motion sickness

Visually induced motion sickness (VIMS) is a common side-effect of exposure to virtual reality (VR). Its unpleasant symptoms may limit the acceptance of VR technologies for training or clinical purposes. Mechanical stimulation of the mastoid and diverting attention to pleasant stimuli-like odors or music have been found to ameliorate VIMS. Chewing gum combines both in an easy-to-administer fashion and should thus be an effective countermeasure against VIMS. Our study investigated whether gustatory-motor stimulation by chewing gum leads to a reduction of VIMS symptoms. 77 subjects were assigned to three experimental groups (control, peppermint gum, and ginger gum) and completed a 15-min virtual helicopter flight, using a VR head-mounted display. Before and after VR exposure, we assessed VIMS with the Simulator Sickness Questionnaire (SSQ), and during the virtual flight once every minute with the Fast Motion Sickness Scale (FMS). Chewing gum (peppermint gum: M = 2.44, SD = 2.67; ginger gum: M = 2.57, SD = 3.30) reduced the peak FMS scores by 2.05 (SE = 0.76) points as compared with the control group (M = 4.56, SD = 3.52), p < 0.01, d = 0.65. Additionally, taste ratings correlated slightly negatively with both the SSQ and the peak FMS scores, suggesting that pleasant taste of the chewing gum is associated with less VIMS. Thus, chewing gum may be useful as an affordable, accepted, and easy-to-access way to mitigate VIMS in numerous applications like education or training. Possible mechanisms behind the effect are discussed.

The Status of Healthcare Professionals’ Having COVID-19 Vaccine and Evaluation of Its Side Effects: A Pandemic Hospital Experience

Aim: Vaccination is one of the most effective and safest preventive health services in the fight against COVID-19. Many people in society have hesitations about the COVID-19 vaccines. We evaluated the vaccination participation rates of healthcare workers to be a positive role model for society. Methods: Between 14 January 2021 and 15 April 2021, 2637 healthcare workers who received 2 doses of 0.5 ml CoronaVac vaccine with 4 weeks intervals were classified as occupation, unit, marital status, age, and gender. Registered side effects were evaluated. Results: It was observed that 65.6% of the healthcare workers were vaccinated and 2.4% (n=62) of the vaccinated workers developed side effects. The mean age of the vaccinated personnel was 34.37±10.04 years. 59.8% (n=1577) of the vaccinated personnel were male and 53.6% (n=1413) were single. The occupational group with the highest vaccination rate was doctors with 78% (n=658). The most common side effect was myalgia in 45.2% (n=28), followed by headache with 38.7% (n=24). About half of those who developed side effects had only one side effect. Conclusion: It was concluded that COVID-19 vaccination differs according to age, gender, and role in the hospital, with the highest vaccination rate among physicians. The vaccination status of healthcare workers who are heavily affected by COVID-19 will positively affect society. Keywords: health personnel, COVID-19, vaccination

Disturbance of Vancomycin Infusion Flow during Multidrug Infusion: Influence on Endothelial Cell Toxicity

Background: Phlebitis is a common side effect of vancomycin peripheral intravenous (PIV) infusion. As only one PIV catheter is frequently used to deliver several drugs to hospitalized patients through the same Y-site, perturbation of the infusion flow by hydration or other IV medication may influence vancomycin exposure to endothelial cells and modulate toxicity. Methods: We assessed the toxicity of variations in vancomycin concentration induced by drug mass flow variations in human umbilical vein endothelial cells (HUVECs), simulating a 24 h multi-infusion therapy on the same line. Results were expressed as the percentage of viable cells compared with a 100% control, and the Kruskal–Wallis test was used to assess the toxicity of vancomycin. Results: Our results showed that variations in vancomycin concentration did not significantly influence local toxicity compared to a fixed concentration of vancomycin. Nevertheless, the loss of cell viability induced by mechanical trauma mimicking multidrug infusion could increase the risk of phlebitis. Conclusion: To ensure that vancomycin-induced phlebitis must have other causes than variation in drug mass flow, further in vitro experiments should be performed to limit mechanical stress to frequent culture medium change.

Management of Chemotherapy Induced Mucositis

Oral mucositis is a severe ailment that causes erythema, edema, and ulceration of the oral mucosa, as well as pain and oral intake restrictions. Chemotherapy and radiation therapy are the most often utilized cancer treatment options. Despite the fact that these treatments are used to improve a patient's quality of life, they are linked to a number of negative side effects. Oral mucositis is a common side effect in patients undergoing head and neck radiation therapy. While some chemotherapy-related side effects are being better managed, mucositis is becoming more common. Reducing patient risk factors, adopt proven preventative measures, and optimize supportive care practices targeted to the patients' needs and symptoms are all recommendations that can be made. In clinical practice and research, a variety of measures have been used to record the amount and severity of oral mucositis. The World Health Organization (WHO) scale is a simple, easy-to-use scale that can be used in clinical practice on a regular basis. There are multiple approaches for management of Mucositis. Cryotherapy, palifermin, and sucralfate are among the three therapies that showed statistically significant effect in avoiding or lowering the severity of mucositis according to reports. In this article we’ll be looking at Chemotherapy induced mucositis, its etiology, epidemiology, evaluation. And most importantly management.

Safety of Weekly Primaquine in Glucose 6 Phosphatase Dehydrogenase (G6PD) Deficient Children

Aim: To assess the Safety of weekly Primaquine in Glucose 6 Phosphatase Dehydrogenase (G6PD) deficient children, for radical treatment of Plasmodium vivax malaria Study Design: cross sectional study Place and Duration: Pediatrics Out Patient Department, Liaquat University of Medical and Health Sciences Hyderabad from 11 January 2018 to 31st August 2019 (total 20 months’ duration) Methodology: A sample of 40 patients was studied during study period. Male children between 4 years to 12 years of age having confirmed vivax malaria were included in the study. If G6PD result showed decreased level of G6PD level then, they were enrolled for study. MP was checked by thick and thin slide method. 5 ml blood was taken in anticoagulant bottle for G6PD, liver function test, creatinine, complete blood count, and reticulocyte count tests. Haemoglobin < 7 g/dL, reticulocyte count > 4, SGPT > 80, G6PD Level < 60% of normal and creatinine > 1.2 was considered significant. Treatment was given with Artemether and Lumefantrine for 3 days while Primaquine, 0 .75 mg base/kg body weights once a week was given for 8 weeks. Patients were followed at OPD initially on 3rd day of therapy then every week for 8 weeks for any hemolysis. Results: There was no hemolysis during the first week and 8 weeks after therapy. Most common side effect was abdominal pain 4 (10%). Mean hemoglobin was 11.8mg/dl. Plasmodium vivax was negative on 3rd day of therapy, it was also negative on 8 week of therapy. Reticulocyte count, Liver function test, creatinine were also normal on 8 weeks of therapy. Conclusion: Primaquine 0.75mg//kg/week for total eight weeks is highly effective for the radical cure of Plasmodium vivax in G6PD deficient children. There is no recurrence of Plasmodium vivax after 8 weeks of therapy. We found this regimen safe as there was no hemolysis demonstrated in children.

A CROSS-SECTIONAL STUDY ON ACCEPTANCE AND POST-VACCINATION SYMPTOMS OF COVID-19 VACCINATION IN INDIA

Objectives: The fastidious development of the COVID-19 vaccine is a vital achievement for the country and early data suggest that it is both safe and efficacious, however, the acceptance of the COVID-19 vaccine is still a major concern as it depends on the individual decision and sociodemographic characteristics. The main objective of our study is to assess the vaccine acceptance among Indians and study about post-vaccination symptoms to identify potential concerns to be addressed to ensure vaccine safety. Methods: An online cross-sectional study was conducted using Google Forms over a period of 1 week on the general population. Data were collected which included the questions regarding participant demographics, vaccination details, and their health status. Microsoft Excel was used for recording and analyzing the collected data. Results: Out of 1016 respondents, 52% were male and 47.6% were female. Most of the respondents perfectly accept the vaccine, 35.5% are neutral and 5.9% are unacceptable toward vaccination. Post the vaccination of both doses, the occurrence of fever and chills is more common in the case of the first dose, whereas rashes are more common in the second dose, muscle pain and joint pain are common in both doses. Conclusion: This community-based project on acceptance and post-vaccination symptoms of vaccination among Indians reveals that the majority of participants showed a positive acceptance rate toward the vaccination but most of them are worried about the risk of side effects. In regard to post-vaccination symptoms, mild fever and chills are the most common side effect in the case of the first dose of vaccination, whereas muscle/joint pain was seen commonly in both the first and second doses of vaccination.