Reporting adverse events of ChAdOx1 nCoV-19 coronavirus vaccine (Recombinant) among the vaccinated healthcare professionals: A cross-sectional survey

Background & objectives: The safety of the ChAdOx1 nCoV-19 vaccine is a cause of concern for many who have been vaccinated. The people have multiple concerns and fear regarding the adverse events of the vaccine. Thus, this study was undertaken to establish the safety profile of ChAdOx1 nCoV-19 Corona Virus Vaccine (Recombinant) among the healthcare professionals. Methods: This was a descriptive cross-sectional survey. After taking clearance from the institutional ethics committee 1500 healthcare professionals, who had their vaccination in the past two weeks were selected. They were provided with an online survey proforma regarding adverse events following immunization (AEFIs) of COVID-19 vaccine developed using google forms with an informed consent form affixed to it. Results: A total of 1036 individuals participated in the study. The mean and median (inter quartile range) age of the participants was 37.7 ±11.25 and 35 (29-46) yr, respectively. Of these, 52.1 per cent were female, 29.3 per cent were doctors, 33.4 per cent were nurses and 9.5 per cent were paramedical staff. Forty six per cent participants experienced one or more minor AEFIs such as pain, tenderness, redness, etc. at the injection site. Fatigue (31.75%), generalized feeling of unwell (28.57%), muscle pain (23.16%) and fever (21.71%) were the most commonly reported systemic AEFIs followed by headache (20.07%), dizziness (10.03%) and joint pains (15.25%). Most of them experienced these AEFIs within 24 h of the first dose of administration. About 42 per cent of the participants took oral antipyretics/analgesics for managing the AEFIs. Interpretation & conclusions: ChAdOx1 nCoV-19 Corona Virus Vaccine was found to be associated with mild local and systemic AEFIs that were more common after the first dose as compared to the second dose. There adverse events could be dealt with oral over-the-counter medications, with no requirement of hospitalization

Ophthalmomyiasis: Three cases from North India.

Three cases of external ophthalmomyiasis are reported here. The larvae were identified to be Oestrus ovis in two cases and Cochliomyia hominivorax in one. Two of the patients were immunocompetent while one was undergoing treatment for squamous cell carcinoma of eyelid. In the latter myiasis led to complete destruction of the eye.

Neuroprotection in glaucoma.

Currently, glaucoma is recognised as an optic neuropathy. Selective death of retinal ganglion cells (RGC) is the hallmark of glaucoma, which is also associated with structural changes in the optic nerve head. The process of RGC death is thought to be biphasic: a primary injury responsible for initiation of damage that is followed by a slower secondary degeneration related to noxious environment surrounding the degenerating cells. For example, retinal ishaemia may establish a cascade of changes that ultimately result in cell death: hypoxia leads to excitotoxic levels of glutamate, which cause a rise in intra-cellular calcium, which in turn, leads to neuronal death due to apoptosis or necrosis. Neuroprotection is a process that attempts to preserve the cells that were spared during the initial insult, but are still vulnerable to damage. Although not yet available, a neuroprotective agent would be of great use in arresting the progression of glaucoma. There is evidence that neuroprotection can be achieved both pharmacologically and immunologically. Pharmacological intervention aims at neutralising some of the effects of the nerve-derived toxic factors, thereby increasing the ability of the spared neurons to cope with stressful conditions. On the other hand, immunological interventions boost the body's own repair mechanisms for counteracting the toxic effects of various chemicals generated during the cascade. This review, based on a literature search using MEDLINE, focuses on diverse cellular events associated with glaucomatous neurodegeneration, and discusses some pharmacological agents believed to have a neuroprotective role in glaucoma.

Vogt-Koyanagi-Harada syndrome following injury-induced progressive vitiligo.

We report a case of Vogt-Koyanagi-Harada (VKH), Syndrome wherein the patient developed ocular symptoms following injury-induced progressive vitiligo with immunologic evidence from the skin biopsy specimen of the vitiligo. This case supports the hypothesis that the cell-mediated immune process against a common melanocyte antigen plays an important role in the development and progression of the disease.

Using government schools to monitor iodine content of salt at household level in Delhi.

The Government had banned the sale of un-iodized salt in Delhi in 1989 as a step towards elimination of iodine deficiency disorders. The present study was done to detect the presence of iodine in salt samples every month from households of the students of government middle schools in Delhi using spot testing kits. One section each, from the classes six to eight of the thirty selected middle schools was chosen randomly. The children were asked to bring salt from their homes on a prefixed day. The salt samples were examined for the presence of iodine by a spot testing kit. This was repeated every month during the study (August '94 to February '95) among the same students in each school. A total of 16,596 salt samples were collected. Of this 12,736 (76.7%) tested positive for iodine and the rest (23.3%) of the salt samples did not contain iodine. The proportion of children who brought the salt samples varied between 53% to 72% in different months. As the study progressed, the trend showed more samples being tested positive for iodine. The differences in districts were not significant. Un-iodized salt thus still continues to be available in the households of the government school children of the National Capital Territory of Delhi. The use of rapid testing kits in schools is a practical and feasible way to enhance the monitoring activities of the government.

Prevalence of iodine deficiency disorders among school children of Delhi.

BACKGROUND: Iodine deficiency disorders (IDDs) are an important cause of mental handicap and poor educability of children. Though Delhi does not lie in the classical Himalayan goitre belt, it has been shown that IDD was endemic in Delhi. Studies of school children in Delhi reported a total goitre rate of 55% which indicates severe endemicity. The sale of uniodized salt has been banned in Delhi since July 1989. This study was done five years later to assess the impact of this measure on IDD prevalence in Delhi. METHODS: A cross-sectional study was done among class VI students studying in government schools of Delhi. A complete list of government middle schools in Delhi was obtained and 30 were selected on the basis of 'probability proportion to size'. A sample size of 1200 was decided based on an expected prevalence of 50% with 5% error and design effect of three. All children in class VI of each school were clinically examined by a trained doctor for the presence of goitre and casual urine samples were collected in capped plastic tubes. The urinary iodine estimation was done by the wet ashing method. RESULTS: The total goitre rate was 20.5%. If the results were limited to children in the age group of 10-12 years it was 19.7%. The urinary iodine was less than the recommended 100 micrograms/L of urine in 23.6% of the children; 7.6% had no iodine in the urine. It is possible that some children could have substituted water in place of urine. The median urinary iodine level was 198 micrograms/L of urine. CONCLUSION: The study showed that IDD continues to be prevalent in mild endemic proportions. Compared to the results of previous surveys, the IDD rates have declined in the last few years. However, it continues to be an important public health problem in Delhi. It is essential to monitor the iodine content of salt on a regular basis. IDD control activities should be strengthened in Delhi and repeat surveys should be done every 3-5 years to monitor the progress achieved in eliminating IDD.

Risk factors influencing the treatment outcome in diabetic macular oedema.

A multivariate analysis was done on 96 eyes to evaluate the effect of various risk factors on the final visual outcome after laser photocoagulation for clinically significant macular oedema (CSME) in diabetic retinopathy. Advanced age of the patient, large size of CSME and poor baseline visual acuity were found to be significantly associated with poorer outcome (p < 0.05). The association of nephropathy and hypertension with poorer visual outcome was of boderline significance (p = 0.054 and 0.07, respectively). Wavelength of the laser (argon or krypton) used for treatment did not significantly influence the outcome.

Metastatic tumour of the iris: a rare presentation.

Metastasis to the iris is less frequent than that to the ciliary body and choroid. This might be the presenting feature. We report a 40 years male patient, a chronic smoker, who presented with pain, redenss and photophobia in the right eye. On detailed examination and investigations it turned out to be a case of primary squamous cell carcinoma of the bronchus metastasising to the iris. The presentation, difficulty in the diagnosis and management is discussed with review of the relavent literature.