Safety, immunogenicity & effectiveness of the COVID-19 vaccine among healthcare workers in a tertiary care hospital

Background & objectives: The COVID-19 pandemic has caused significant global morbidity and mortality. As the vaccination was rolled out with prioritization on healthcare workers (HCWs), it was desirable to generate evidence on effectiveness of vaccine in prevailing real-life situation for policy planning. The objective of the study was to evaluate the safety, effectiveness and immunogenicity of COVID-19 vaccination among HCWs in a tertiary care hospital. Methods: This prospective observational study was undertaken on the safety, immunogenicity and effectiveness of the ChAdOx1 nCoV- 19 coronavirus vaccine (Recombinant) during the national vaccine roll out in January-March 2021, in a tertiary care hospital, New Delhi, India. Results: The vaccine was found to be safe, with local pain, fever and headache as the most common adverse events of milder nature which generally lasted for two days. The adverse events following vaccination were lower in the second dose as compared to the first dose. The vaccine was immunogenic, with seropositivity, which was 51 per cent before vaccination, increasing to 77 per cent after single dose and 98 per cent after two doses. Subgroup analysis indicated that those with the past history of COVID-19 attained seropositivity of 98 per cent even with single dose. The incidence of reverse transcription (RT)-PCR positive COVID-19 was significantly lower among vaccinated (11.7%) as compared to unvaccinated (22.2%). Seven cases of moderate COVID-19 needing hospitalization were seen in the unvaccinated and only one such in the vaccinated group. The difference was significant between the fully vaccinated (10.8%) and the partially vaccinated (12.7%). The hazard of COVID-19 infection was higher among male, age >50 yr and clinical role in the hospital. After adjustment for these factors, the hazard of COVID-19 infection among unvaccinated was 2.09 as compared to fully vaccinated. Vaccine effectiveness was 52.2 per cent in HCWs. Interpretation & conclusions: ChAdOx1 nCoV-19 coronavirus vaccine (Recombinant) was safe, immunogenic as well as showed effectiveness against the COVID-19 disease (CTRI/2021/01/030582).

De novo Philadelphia chromosome positive myelodysplastic syndrome: Report of two cases with brief literature review

Myelodysplastic syndromes (MDSs) are characteristically defined by the presence of specific karyotypic abnormalities, based on which they have been prognosticated. Translocation t(9;22)(q34;q11.2) (Philadelphia positive [Ph +ve]) and corresponding BCR-ABL fusion transcript is the defining parameter of chronic myeloid leukemia. It is also seen in a fair proportion of adult acute lymphoblastic leukemia. Occurrence of a Ph +ve MDS is very uncommon, and that too is seen mostly on progression to higher stage/acute leukemia. Even rarer is the de novo presence of Ph positivity in an MDS. A literature search through PubMed has shown only about forty cases of Ph +ve MDS among which less than half had shown Ph positivity at the time of initial diagnosis. Due to its rarity, this entity has not yet found its space in current WHO 2008 classification and is still under “yet to be validated phase” in current practice of hematological malignancies. The benefit of using a tyrosine kinase inhibitor in such a situation is also debatable. We report here two such cases of de novo Ph +ve MDS, diagnosed in last 1½ year at our institute along with brief literature review

Medicinal Impact of Piper- Nigrum (Piperine) Against Arsenic Induced Hepatic and Renal Toxicity in Experimental Mice

In view of the increasing risk of arsenic on human health, the present study has been carried out to investigate the hepato-protective effect of piperine on arsenic induced-hepatic and renal toxicity in mice. Various oxidative stress parameter, antioxidant level and micro nutrients were analyses in hepatic and hepatic renal organ of mice. Methods: Mice exposed arsenic (sodium arsenate 5 mg/kg body weight p.o. for 45 days) caused a significant increases oxidative stress in hepatic and renal tissue as compared to controls group. Results: Abnormal levels of arsenic in hepatic and renal tissue increased the levels of ROS, LPO, and decreased the levels of GSH with SOD, CAT, and GPx activities in the hepatic and renal tissue of mice as compared to controls. Co-treatment of arsenic with piperine (1.5 mg/kg body weight p.o. for 45 days) decreased the levels of ROS, LPO, and increased the level of GSH, also increased SOD, CAT, and GPx activity and showed improvements in hepatic and renal tissue of mice as compared to arsenic-treated groups. Conclusion: Our results proved that piperine worked as antioxidant, anti- inflammatory in nature.

Etiopathogenesis of Clefts of Lip and Palate – An Invited Review

Orofacial clefts i.e., cleft lip (CL), cleft lip and palate (CLP), cleft palate (CP) alone, as well as median, lateral (transversal), oblique facial clefts) are among the most common congenital anomalies seen in humans.

Myofibroblasts in Epithelial Mesenchymal Transition and its Clinical Significance

Myofibroblasts differentiate, invade and repair injured tissues by secreting and organizing the extracellular matrix and by developing contractile forces. Under physiological conditions, the secretory and contractile activities of myofibroblasts are terminated when the repair is complete (scar formation) but the functionality of the tissue is only rarely perfectly restored. At the end of the normal repair process, myofibroblasts disappear by apoptosis but in pathological situations, myofibroblasts likely remain leading to excessive scarring. These diverse cell types probably contribute to the appearance of myofibroblast subpopulations which show specific biological properties and which are important to understand in order to develop new therapeutic strategies for treatment of fibrotic and scarring diseases.

Uncommon parathyroid mediastinal cyst compressing the trachea.

Mediastinal parathyroid cyst is a rare cause of space occupying lesion in the mediastinum. No specific symptomatology may be attributed to the non-functioning parathyroid cyst. The diagnosis is rarely made before exploration. The cysts are thin walled, smooth, of varying sizes and contained clear, opalescent or haemorrhagic fluid. Histopathological examination reveals clusters of parathyroid cells dispersed in the wall of the cyst. Surgical removal is the treatment of choice and can be performed with minimal morbidity.