ABSTRACT
Objectives: To study safety and efficacy of Cladribine tablets (Clad T) treatment in RMS patients over 2 years in a real-world clinical setting. Aim(s): To describe the efficacy and safety in Real-world experience in an Arab Population. Method(s): This is a retrospective single-centre observational study in Qatar. Medical records of Relapsing Multiple Sclerosis (RMS) patients who received at least one year treatment of Cladribine treatment between January 2018 through December 2021 were reviewed. Demographic and clinical aspects, EDSS, previous disease-modifying drugs (DMD) and annual relapse rate (ARR) were recorded. MRI data of patients who completed at least first-year course of Cladribine tablets were assessed as well adverse events. Result(s): A total of 49 RMS patients (46 RRMS, 3 SPMS) were included, from those 34 (69%) were females. Mean age at Clad T initiation was 32 (18-59), mean disease duration is 7.6 (1-25) years. 25 patients (51%) were treatment naive, and 24 patients (49%) had one or more disease modifying therapy (DMT) before treatment. The most common reason for treatment with cladribine was disease activity (68 %), pregnancy planning (11%), compliance (10%) and side effects (11%). Prior DMTs included DMF (40%), Fingolimod (16%), Teriflunomide (16%), Natalizumab (12%), Interferon Beta (12%) and Ocrelizumab (5%). By December 2021, 32 patients finished the two courses of the drug. The Median follow-up period of the total cohort was 32 months. 26/32 (81.25%) patients were relapse free post treatment compared to 25% pretreatment. Annualised relapse rate (ARR) was reduced by 92% (0.08 vs 0.97). 75% of patients were free of Gd+ T1 lesions post treatment compared to 37.5% at the baseline. Majority of MRI findings (7/8) were observed in the 1st year of treatment and only one patient experimented radiological activity after the second-year course. 31 patients (96.8%) had no 3 months confirmed EDSS progression. Only mild Adverse events were reported and single case of herpes zoster, urinary tract infection and oral candidiasis. All COVID-19 cases (n=12) were mild and didn't need hospitalization. Grade 3 lymphopenia was recorder for 5 patients (1.5%) and no grade 4 was observed. Conclusion(s): Our real-world experience confirms good efficacy, tolerability, and safety of cladribine tablets in consistency with data from phase 3 clinical trials and other real-life studies. Reported adverse events showed lower frequency of lymphocytopenia.
ABSTRACT
Corona Virus (COVID-19) outbreak has threatened the world, since it has become pandemic and spread all over the world. The causative agent SARS-COV2 has proved lethal caused serious public health concern worldwide. Our aims were to describe the SARS-COV-2 genetic connections and check for recombination of all genome. The recombination was investigated by RDP5 and conflicting phylogenetic clustering in individual genomic fragments was established by phylogenetic study by maximum likelihood and Bayesian methods. Our analysis suggests that the available sequences from currently genomes of various strain were retrieved from different countries including Japan, French Republic, Spain, Peru, China, Vietnam, Taiwan, Brazil, U.S.A., South Korea, Sweden, Australia, Nepal, India, Iran, and Italy. The phylogeny of SARS-COV-2 observed the largest number of genome is Vietnam 29891-bp, while France is the smallest member identified with 29679-bp. Using Recombination Detection program5 (RDP5) the china strains was taken as parental strain but there were no recombination in the all strains. In our study we identified the mutation in Pakistani strains in high conserved region of Corona nucleoca super family domain at the nucleotide position (394: C replace with T, Position: 858: C replace with T and Position: 997 G replace A).
ABSTRACT
The coronavirus disease 2019 (Covid-19) outbreak represents a thankfully rare yet extremely salient incident that had an adverse effect on individuals, families, and societies throughout the world. COVID-19 has the highest infectivity and spreading rate as compared to other human coronaviruses. SARS-CoV-2 was recognized as the disease causative agent that initially targets humans' respiratory system that may lead to multi-organ failure and death. To date, COVID-19 spread to 220 countries/regions of the world, including Pakistan. This study aimed to examine the prevalence of COVID-19 among the general population in District Mardan of Khyber Pakhtunkhwa Province, Pakistan. A total of 4199 suspected individuals (2898 were males, and 1301 were females) were screened through RT-PCR. The age of suspected individuals was ranging from 10-90 years, and the average age was found 42 +/- 20.8 years. Among all suspected individuals, 753 were SARS-CoV-2 positive and diagnosed with COVID-19. Among the positive individuals, 500 (66%) were males, and 253 (34%) were females. The overall prevalence was found at 17.93%. Most of the SARS-CoV-2 positive individuals were belonging to age -group 31 to 40 (n=182), followed by age-group 21 to 30 (n=166). The prevalence of COVID-19 in the Mardan district is very high and needs WHO recommended SOPs to control the spread of COVID-19.
ABSTRACT
A novel virus is discovered recently, named as Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). It causes the Coronavirus Disease 2019 (COVID-19), which is spreading rapidly worldwide. The emerging genetics and clinical evidence of the SARS-CoV-2 virus suggest a similar path to those of Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). Coronavirus causes respiratory illness in humans and infect several other species of animals. It was one of the best interests of researchers as it attracted virologist's attention in last two decades. It was clear from an epidemic in 2002-2003 of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) that human civilization may have animal coronavirus as its potential threat in the future. However, the mechanism of this virus spreading from one specie to another remained obscure these years. The 2012 Middle East Respiratory Syndrome Coronavirus (MERS-CoV) epidemic of animals, and now this COVID-19 pandemic prioritizes the human coronavirus for further research and exploration. However, General hygiene, social distancing, and disinfection can prevent the person-to-person spread of coronavirus. This review focuses on SARS-CoV-2, which is emerged from China in December 2019 and caused a novel disease named as COVID-19. The current review has an insight to possible treatment COVID-19 followed by a short review of In silico candidate drug design and prevention;This systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Databases, including Health Research and Development Information network Plus (HERDIN Plus), Science direct, PubMed and google scholar were visited to search the articles. Further, the forecasting results of the fitted model show a significant decrease in the weekly global deaths from the 51th week of 2020 16th week of 2021 but 95% limit has also shown the potential of getting the situation worser amid COVID-19 second wave.