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Journal of Family Medicine and Primary... May 2024Sickle cell disease (SCD) is a disorder marked by a single-point mutation in the beta-globin gene. Hydroxyurea is a globally accepted disease-modifying agent that sounds...
BACKGROUND
Sickle cell disease (SCD) is a disorder marked by a single-point mutation in the beta-globin gene. Hydroxyurea is a globally accepted disease-modifying agent that sounds to be effective in managing clinically and probably preventing complications of SCD. The current study aims to document the morbidity pattern and impact of Hydroxyurea therapy in the Outpatient Department of Sickle Cell Institute, Raipur.
MATERIALS AND METHODS
This cross-sectional study was conducted among randomly selected sixty-five patients (adults and children above six years). After obtaining informed consent, relevant data were collected in a predesigned pretested questionnaire. The appropriate statistical exercise was applied for the interpretation of results and inferences.
RESULTS
Acute febrile illness 54 (83%) and 53 (81.5%) reported pain crisis observed to have the most common morbidity among the study subjects, followed by 55.4% (36), 33 (50.8%) jaundice and difficulty breathing, respectively. Joint pain was the most commonly observed complaint, particularly at the knee joint (76.9%). Other complaints such as hand-foot syndrome (24.6%), epistaxis (27.7%), and acute chest syndrome (21.5%). Vaso-occlusive crisis (72.4%), difficulty in walking (60.0%) and eyesight (35.4%), leg ulcers (9.2%), and dactylitis (3.1%) were also documented as clinical manifestations among study participants. Less than half (44.46%) had an awareness about SCD. Hydroxyurea therapy was highly significant in improving the patient's clinical picture ( < 0.01), especially following the frequency of hospitalization and the requirement for blood transfusion.
CONCLUSION
Pain crisis is the most common morbidity among study participants with a low level of knowledge about SCD with febrile illness. Hydroxyurea therapy was found to be quite effective as a disease-modifying therapy, especially for reducing the frequency of blood transfusion and lowering hospitalization rates among SCD patients.
PubMed: 38948632
DOI: 10.4103/jfmpc.jfmpc_1490_23 -
Journal of Family Medicine and Primary... May 2024COVID-19 is a disease caused by the severe acute respiratory syndrome coronavirus 2 that has appeared as a global pandemic in recent times. Currently, the transmission...
INTRODUCTION
COVID-19 is a disease caused by the severe acute respiratory syndrome coronavirus 2 that has appeared as a global pandemic in recent times. Currently, the transmission rate has slowed down significantly, but the definite pathological reason behind this is still unknown. Therefore, the prevalence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody must be studied to establish the relation between the rate of transmission and antibody presence.
MATERIALS AND METHODS
A clinical assessment was performed to evaluate the seroprevalence of SARS-CoV-2 Immunoglobulin G (IgG) antibodies among 299 healthy volunteers in the period of February to May 2021. Serum samples were analyzed using chemiluminescent microparticle immunoassay (CMIA) technology to detect the presence of IgG antibodies.
RESULT
It was observed that 21% of the participants were seropositive, and 78% of the population was seronegative across the different genders. This confirmed that the generation of antibodies is independent of gender. Simultaneously, a -test was performed that further suggested no statistical correlation between gender and seroprevalence. Moreover, a comprehensive analysis was performed to establish the relation between age and blood group with the seroprevalence. However, there was no statistical relationship found among these parameters.
CONCLUSION
This study assisted in examining the underlying causes of high or low seroprevalence among healthy volunteers.
PubMed: 38948624
DOI: 10.4103/jfmpc.jfmpc_780_23 -
Journal of Family Medicine and Primary... May 2024Symptoms for severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) appear 2-3 days after exposure to the virus. Being a virus, detection is primarily by...
BACKGROUND
Symptoms for severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) appear 2-3 days after exposure to the virus. Being a virus, detection is primarily by polymerase chain reaction as this offers superior sensitivity and specificity. There was a misconception that patients with low cycle threshold (Ct) have severe coronavirus disease (COVID), and for individuals with higher Ct, it is the other way around. The prognosis for COVID was derived from various biomarkers and physicians heavily relied on them.
MATERIALS AND METHODS
A cross-sectional study spanning a duration of 2 years was conducted at a tertiary care centre in western India. A total of 201 individuals were included and the correlation between Ct, clinical features and biomarkers was studied.
RESULTS
In the E-gene, 43.28% had lower Ct values and 40.79% had low Ct values in the RdRp gene. 50% of all patients had diabetes, with 60% being between the ages of 61 and 80. 54.1% of hypertension patients belonged to ages between 61 and 80. 90.54% of COVID-positive individuals had lactose dehydrogenase levels ranging from 440 to 760. 79% of patients had a procalcitonin value of more than one but less than six. 79.1% of patients had an erythrocyte sedimentation rate between 36 and 90.
CONCLUSION
Ct value though has a research value; it is a poor prognostic marker when compared to the various biomarkers that have been studied earlier. We cannot conclusively state that all our findings are accurate due to a lack of data but further research into the prognostic value of Ct should be conducted which will help in the ongoing scenario.
PubMed: 38948616
DOI: 10.4103/jfmpc.jfmpc_967_23 -
Journal of Family Medicine and Primary... May 2024The Coronavirus disease 2019 (COVID-19) pandemic has been the biggest threat to humankind during the last 3 years. It has caused the loss of more than 6.9 million...
INTRODUCTION
The Coronavirus disease 2019 (COVID-19) pandemic has been the biggest threat to humankind during the last 3 years. It has caused the loss of more than 6.9 million precious lives across the world. The only method by which the massacre could be stopped was by mass vaccination or mass immunization. The patients suffering from autoimmune rheumatic disorders (AIRDs) and treated with immunosuppressants were the high-priority candidates for vaccination. However, the data regarding the efficacy of COVID-19 vaccines in this group of patients are very less. Hence, this study was planned to study the immunogenicity of Covishield in patients with AIRDs attending the rheumatology OPD at DMCH, Ludhiana.
MATERIALS AND METHODS
It was a prospective cohort study and was planned by the Department of Biochemistry and Department of Clinical Immunology and Rheumatology at Dayanand Medical College and Hospital, Ludhiana. Fifty patients with AIRDs attending the DMCH rheumatology OPD and 52 age and sex-matched healthy controls who had received two doses of Covishield vaccine were included in this study. Patients having any other immunosuppressive conditions like uncontrolled diabetes, hepatitis, malignancy or HIV were excluded. Patients who had suffered from previous laboratory-confirmed COVID-19 infection (by RT-PCR) were also excluded. Blood samples were collected following all aseptic precautions from patients and controls on the 28 day after administration of a second dose of Covishield vaccine and total antibodies to the severe acute respiratory syndrome coronavirus 2 spike (S) protein receptor binding domain was measured using Elecsys Anti-SARS-CoV-2 S kit from Roche.
RESULTS
It was observed that no significant difference was there in antibody titre between cases and controls (6213 ± 4418 vs. 8331 ± 7979, = 0.1022). It was also observed that no statistically significant difference in antibody titre in cases without prednisolone and those taking treatment with prednisolone was found ( = 0.7058). A similar observation was found in terms of methotrexate also ( = 0.457). No significant difference in antibody titres was there when compared with controls (for prednisolone, = 0.169, for methotrexate, = 0.078). We found that only the patients receiving mycophenolate mofetil showed a statistically significant decrease in antibody titre in comparison to healthy controls ( = 0.03). Our study showed no statistically significant difference in antibody titres between patients suffering from different AIRDs.
CONCLUSION
Our study supplements the fact that patients with AIRDs in India can receive Covishield as the primary vaccine against COVID-19 without concerns regarding decreased immunogenicity or increased adverse effects.
PubMed: 38948615
DOI: 10.4103/jfmpc.jfmpc_1021_23 -
Journal of Family Medicine and Primary... May 2024Since beginning of the coronavirus disease (COVID-19) it became clear that severe forms of this infection have primarily affected patients with chronic conditions.
Clinical and epidemiological risk factors associated with hospitalization and mortality rate of COVID-19 patients in Banja Luka County: A retrospective observational cohort study on 40,000 patients.
CONTEXT
Since beginning of the coronavirus disease (COVID-19) it became clear that severe forms of this infection have primarily affected patients with chronic conditions.
AIMS
The aim of the study was to explore clinical and epidemiological characteristics associated with COVID 19 outcomes.
SETTINGS AND DESIGN
The retrospective observational study included 40,692 citizens of Banja Luka County, Bosnia and Herzegovina, who were confirmed as reverse transcriptase polymerase chain reaction (RT-PCR) positive on COVID-19 at a primary healthcare centre from March 2020 to September 2022.
METHODS AND MATERIALS
Epidemiological data were obtained from Web-Medic medical records of patients. The COVID-19 data were obtained from COVID-19 data sheets comprised of patients' RT-PCR testing forms, surveillance forms for severe acute respiratory syndrome coronavirus-2 status, and a map of their positive and isolated contacts.
STATISTICAL ANALYSIS USED
Differences regarding the distributions of patients between groups were analysed using the Pearson chi-square test and Mantel-Haenszel chi-square test for trends, while differences in mean values were compared using an independent sample -test.
RESULTS
The average age of hospitalised patients was significantly higher compared to the age of non-hospitalised patients ( < 0.001). The average age of patients with lethal outcomes was nearly twice as high in comparison to patients with non-lethal outcomes ( < 0.001). Male patients had a higher hospitalization and mortality rate ( < 0.001). The highest hospitalization rate was in patients with chronic renal failure (CRF), diabetes and cardiovascular diseases (CVDs), while the death rate was the highest among patients with CRF and hearth comorbidities. Patients with fatigue and appetite loss had a higher percentage of lethal outcomes. Vaccinated patients had a significantly lower rate of lethal outcome.
CONCLUSIONS
Clinical symptoms, signs and outcomes, are posing as predictive parameters for further management of COVID-19. Vaccination has an important role in the clinical outcomes of COVID-19.
PubMed: 38948596
DOI: 10.4103/jfmpc.jfmpc_1641_23 -
Journal of Family Medicine and Primary... May 2024The rapid spread and mutation rate of severe acute respiratory syndrome corona virus (SARS-CoV2) demands continuous monitoring in terms of genomic and serosurvival. The...
INTRODUCTION
The rapid spread and mutation rate of severe acute respiratory syndrome corona virus (SARS-CoV2) demands continuous monitoring in terms of genomic and serosurvival. The current study is designed to track the seroprevalence of health care workers (HCWs) postvaccination, as they may be more susceptible to contracting the SARS-CoV-2 infection compared to the general population.
OBJECTIVE
The objective was to identify the seroprevalence rate for SARS-CoV-2 immunoglobulin G (IgG) antibody (N, S1, S2) amongst HCWs of various levels of exposure working in a tertiary care teaching hospital in Puducherry.
MATERIALS AND METHODS
The present study followed a nonprobability consecutive sampling technique, which involved 216 study participants HCWs from the hospital. IgG antibody levels were measured using EUROIMMUNE Anti SARS-COV-2 ELISA KIT (IG g) ELISA at two points: firstly, 2 weeks after the second dose of vaccination, followed by 2 weeks after the booster dose.
RESULTS
Out of the total 216 participants enrolled in the survey, there were 140 males and 76 females, and the maximum number of candidates studied were in the 41-50 age group. Almost 46.7% of the HCWs who participated in the study were seropositive for SARS-CoV-2 in the case of those who were high-risk exposed, while only 30.4% were amongst those who were low-risk exposed. The proportion of study participants who became seropositive increased considerably after the booster dose (65.7%), from 38.0% when tested three months after infection.
CONCLUSION
A significant increase in antibody titres amongst high-risk HCWs postboost vaccination demands continuous monitoring of soluble IgG levels for recommendations of vaccination schedules.
PubMed: 38948592
DOI: 10.4103/jfmpc.jfmpc_1488_23 -
Journal of Family Medicine and Primary... May 2024The World Health Organization (WHO) declared Coronavirus disease-19 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) a pandemic on March...
BACKGROUND
The World Health Organization (WHO) declared Coronavirus disease-19 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) a pandemic on March 11, 2020. On 16 January 2021, India began its vaccination programme using two COVID-19 vaccines (Covishield and Covaxin). Precautionary dose (booster shots) was administered to health and front-line workers in the beginning and then to all eligible populations.
MATERIAL AND METHODS
This was a descriptive observational study conducted in the COVID-19 vaccination centres of Karnal district and the ADR monitoring centre, KCGMC, Karnal. During the visits to vaccination centres, all beneficiaries of the precautionary third dose of COVID-19 vaccines as well as healthcare workers were sensitized to report in case of any adverse event following vaccination as part of the policy of the vaccination programme run by the government and Pharmacovigilance Programme of India. The data were collected in suspected adverse drug reaction (ADR) reporting form version 1.4, and causality assessment was done as per the WHO-UMC scale. The data were analysed as simple proportions and percentages.
RESULTS
The booster dose was administered to 72,853 individuals, while the 1 dose and 2 dose were given to 13,30,042 and 10,73,050, respectively. Only three ADRs were reported with the booster dose in 34 vaccination centres in the Karnal district. These three ADRs were classified as unlikely on causality assessment and hence not included in the analysis.
CONCLUSION
The booster dose administered for the prevention of COVID-19 has been found to be reasonably safe. The population who received COVID-19 booster doses was significantly less than the populations who received the first and second doses, which suggests a low acceptance rate.
PubMed: 38948581
DOI: 10.4103/jfmpc.jfmpc_973_23 -
Journal of Family Medicine and Primary... May 2024The coronavirus disease 2019 (COVID-19) is a viral infection characterized by respiratory and gastrointestinal symptoms. The causative agent of this infection is the...
INTRODUCTION
The coronavirus disease 2019 (COVID-19) is a viral infection characterized by respiratory and gastrointestinal symptoms. The causative agent of this infection is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The genomic study helps in understanding the pathogenesis, epidemiology, and the development of therapeutic and preventive strategies in the combat against COVID-19.
MATERIALS AND METHODS
Nasopharyngeal and oropharyngeal swab samples were collected from asymptomatic and symptomatic patients during the time period of 2021-2022 for the detection of SARS-CoV-2 by employing real-time reverse transcriptase, cDNA synthesis, whole-genome sequencing by next-genome sequencing, analysis of SARS-CoV-2 sequence data and lineage and variant of concern assignment along with phylogenetic analysis.
RESULTS
Lineages BA.2.10 and BA.4.1.1 clustered with genomes from Senegal suggested the spread of infections. Similarly, high clustering among delta samples during the second wave showed possible importation and subsequent spread via local transmission.
CONCLUSIONS
Studies like these are important to understand the characteristics and origins of locally circulating SARS-CoV-2 diversity in order to prevent further spread.
PubMed: 38948575
DOI: 10.4103/jfmpc.jfmpc_1698_23 -
Journal of Family Medicine and Primary... May 2024Corona virus disease (COVID-19) initially appeared to be an exclusively respiratory ailment. While that is true in a vast majority of the cases, its evolution and later...
Corona virus disease (COVID-19) initially appeared to be an exclusively respiratory ailment. While that is true in a vast majority of the cases, its evolution and later evidence have shown that it can afflict virtually any organ system in the human body after first gaining entry through the respiratory tract. The COVID-19 vaccines were one of the turning points in the campaign to control the COVID-19 pandemic. However, after their extensive use all over the world, it has emerged that they can cause some dangerous collateral damage. We, herein, report the case of a 58-year-old woman who presented to us with signs and symptoms of acute intestinal obstruction 4 months after receiving her first dose of Covishield vaccination for COVID-19. Her blood tests showed a high D-dimer and normal platelet count. She was previously admitted to the hospital with an acute abdomen 3 months back. A contrast-enhanced computed tomography (CECT) scan of the abdomen done then had revealed thrombi in the aorta and inferior mesenteric and splenic arteries. She was started on low-molecular-weight heparin and discharged on tablet Warfarin after clinical improvement. CECT abdomen done during her present admission revealed a proximal small bowel stricture with dilated proximal and collapsed distal loops. She underwent a laparoscopic jejuno-ileal resection anastomosis. During the post-operative period, a repeat CECT abdomen done to evaluate multiple episodes of vomiting revealed pulmonary embolism in the lower chest cuts. A venous Doppler revealed extensive deep venous thrombosis of the left lower limb. A thrombophilia profile diagnosed anti-phospholipid antibody syndrome, an exacerbation of which was likely precipitated by the COVID-19 vaccine.
PubMed: 38948557
DOI: 10.4103/jfmpc.jfmpc_1006_23 -
Cancer Innovation Feb 2024Since RNA sequencing has shown that induced pluripotent stem cells (iPSCs) share a common antigen profile with tumor cells, cancer vaccines that focus on iPSCs have made...
BACKGROUND
Since RNA sequencing has shown that induced pluripotent stem cells (iPSCs) share a common antigen profile with tumor cells, cancer vaccines that focus on iPSCs have made promising progress in recent years. Previously, we showed that iPSCs derived from leukemic cells of patients with primary T cell acute lymphoblastic leukemia (T-ALL) have a gene expression profile similar to that of T-ALL cell lines.
METHODS
Mice with T-ALL were treated with dendritic and T (DC-T) cells loaded with intact and complete antigens from T-ALL-derived iPSCs (T-ALL-iPSCs). We evaluated the safety and antitumor efficiency of autologous tumor-derived iPSC antigens by flow cytometry, cytokine release assay, acute toxicity experiments, long-term toxicity experiments, and other methods.
RESULTS
Our results indicate that complete tumor antigens from T-ALL-iPSCs could inhibit the growth of inoculated tumors in immunocompromised mice without causing acute and long-term toxicity.
CONCLUSION
T-ALL-iPSC-based treatment is safe and can be used as a potential strategy for leukemia immunotherapy.
PubMed: 38948536
DOI: 10.1002/cai2.95