Short-term adverse effects of COVID-19 vaccines after the first, second, and booster doses: a cross-sectional survey from Punjab, Pakistan, and the implications

ABSTRACT Background: Safety and efficacy concerns regarding coronavirus disease 2019 (COVID-19) vaccines are common among the public and have a negative impact on their uptake. We aimed to report the adverse effects currently associated with the vaccine in Pakistan to build confidence among the population for its adoption. Methods: A cross-sectional study was conducted in five districts of the Punjab province of Pakistan between January and March 2022. The participants were recruited using convenience sampling. All data were analyzed using SPSS 22. Results: We recruited 1622 people with the majority aged between 25-45 years. Of these, 51% were female, including 27 pregnant women and 42 lactating mothers. Most participants had received the Sinopharm (62.6%) or Sinovac (17.8%) vaccines. The incidences of at least one side effect after the first (N = 1622), second (N = 1484), and booster doses (N = 219) of the COVID-19 vaccine were 16.5%, 20.1%, and 32%, respectively. Inflammation/erythema at the injection site, pain at the injection site, fever, and bone/muscle pain were common side effects of vaccination. No significant differences were observed in the adverse effect scores between all demographic variables except for pregnancy (P = 0.012) after the initial dose. No significant association was observed between any variable and the side effect scores of the second and booster doses of the vaccine. Conclusions: Our study showed a 16-32% prevalence of self-reported side effects after the first, second, and booster COVID-19 vaccinations. Most adverse effects were mild and transient, indicating the safety of different COVID-19 vaccines.

Anti-Snake Venom Properties of Medicinal Plants: A Comprehensive Systematic Review of Literature

Abstract Snakebite is one of the major health issues posing considerable morbidity and mortality. According to an estimate of World Health Organization (WHO) (World health organization, 2021) approximately 5 million people are bitten by several species of snakes resulting in up to 2.5 million envenomation cases annually. The mainstay of treatment for envenomation is intravenous administration of anti-snake venom. Although antivenom neutralizes the systemic effects but it does not relieve the symptoms such as venom-induced hemorrhage, necrosis and nephrotoxicity. Moreover, the use of antivenoms is associated with hypersensitivity reactions including urticaria, anaphylaxis, or serum sickness due to their heterologous property. Furthermore, stringent storage conditions and narrow specificity of antivenoms limit their use in both developed as well as developing countries. In this context, researchers have been searching for natural products and plant extracts to explore their antivenom activity along with anti-myotoxic, anti-hemorrhagic and anti-inflammatory properties. Plant remedies may prove to be an effective alternate for antivenom sera with less adverse events and better tolerability. To the best of our knowledge, this is the first comprehensive review of medicinal plants possessing anti-snake venom activities against certain species of snakes. The current review highlights the investigated plants with their phytochemical analysis to integrate the available information for future research and development of antivenom sera.

Determination of phytoconstituents of n-hexane extract of leaves of Morus nigra and evaluation of their effects on biochemical and histopathological parameters in paracetamol intoxicated mice liver

In-vitro investigation of Morus nigra L. (Moraceae) has demonstrated the evidence of several antioxidant compounds. Current study was aimed to determine the phytoconstituents and hepatoprotective potential of n-hexane extract of Morus nigra. Swiss albino mice were divided into five groups: normal control, paracetamol control, silymarin control, 250 mg/kg p.o. extract for 7 days plus paracetamol 3 h later, 500 mg/kg p.o. extract for 7 days plus paracetamol 3 h later. Serum levels of liver enzymes and total bilirubin were assessed and compared between the groups by using one-way ANOVA to confirm hepatoprotective activity. HPLC analysis revealed the presence quercetin, oleanolic acid, luteolin, apigenin, vitamin C and kuwanon C. n-hexane extract of Morus nigra at dose of 250 mg/kg reduced elevated ALT by 54.3% (p<0.001), AST by 55.1% (p<0.01), ALP by 28.5% (p<0.01) and TBR by 56.4% (p<0.01) as compared to paracetamol control. The dose of 500 mg/kg of the extract reduced the ALT levels by 62.9% (p<0.001), AST by 56.7% (p<0.01), ALP by 33.6% (p<0.01) and TBR by 54.5% (p<0.01), as compared to paracetamol group. However, the reduction of liver enzymes and total bilirubin after administration of extract was comparable to the silymarin. Current study demonstrated potential hepatoprotective activity of n-hexane extract of Morus nigra

Analgesic Nephropathy: A neglected cause of Chronic Kidney Disease.

Introduction: Analgesic nephropathy is a preventable cause of chronic renal failure that occurs due to excessive use of over the counter (OTC) analgesics. Misuse or long term use of OTCs’ without prior consultation from any healthcare professional leads to serious health problems. Case presentation: Current is the case of a 48 years old woman who was presented to hospital complaining of high blood pressure and breathlessness. Patient was neither diabetic nor hypertensive. Upon examination, it was revealed that she is suffering from analgesic nephropathy due to long term use of Ibuprofen for her knee pain. Patient was diagnosed with chronic renal failure with associated hypertension. Conclusion: Long term use of OTCs’ without prior consultation of healthcare providers may lead to serious unwanted side effects and complications. Misuse of such medications should be strictly discouraged and such patients should be encouraged to undergo renal screening tests as early as possible.