ABSTRACT
SARS-CoV-2, the causative agent of COVID-19, claimed multiple lives in a very short span of time. Seeing the urgency of situation, vaccines were developed in hitherto unseen time frame. Vaccines definitely passed the test of safety and efficacy in clinical trials, but post mass vaccination data revealed cases of fatal adverse conditions in the temporal association of vaccination. The temporal association does not guarantee that the fatality is due to vaccination, but at the same time, it does create a concern. To overcome this concern and improve the safety of vaccination, we reviewed literature and collected data of 15 studies comprising of total 22 cases of fatal adverse condition/death in the temporal association of COVID-19 vaccination. Analysis of these data shows that many persons (40.90%) who succumbed were previously healthy individuals. All those who died developed symptoms or were admitted to hospital within a period of 3 weeks after vaccination. 86.36% cases of death took place within a period of 3 weeks after vaccination/presentation/admission/intervention. Complications which lead to death were CVST, thrombocytopenia/thrombosis /VITT, DIC and haemorrhage in 81.18% of cases. 81.81% cases of death were noted in the temporal association with ChAdOx1 nCoV-19 vaccine. 68.18% persons developed symptoms after first dose. Death was more common in females (59.09%), and the most commonly affected age group was 20 to 60 years (86.36%). Knowledge of fatal adverse conditions in the temporal association of vaccination will help to tackle these situations well and improve the safety of vaccination drive further.
ABSTRACT
Corona virus disease (COVID-19), caused by SARS-CoV-2, is rapidly spreading all around the world and is posing a threat to mankind. Since SARS-CoV-2 is a novel virus, little is known about it and no effective drug is available for its treatment. While many drugs are being evaluated, an effective therapeutic measure is still lacking. SARS-CoV-2 like SARS-CoV binds with angiotensin-converting enzyme 2 (ACE2) present on human cells. SARS-CoV has been found to downregulate ACE2 and SARS- CoV-2 infection has been found to be associated with increased level of Angiotensin II. Based on these facts, we presume that SARS-CoV-2 like SARS-CoV downregulates ACE2, and in absence/reduced activity of ACE2, level of angiotensin (1-7) and angiotensin (1-9) is decreased while that of angiotensin II is increased and increased level of angiotensin II has been found to correlate with lung injury and viral load. We presume that restoration of normal functioning of renin-angiotensin system with recombinant human angiotensin-converting enzyme 2 (rhACE2), angiotensin (1-7) and angiotensin (1-9) may be an effective therapeutic measure but studies will be required to test this hypothesis and explore its possible role in treatment of COVID-19.
ABSTRACT
Carcinosarcoma, a tumor having both carcinomatous and sarcomatous elements, occurring in the breast, is a rare condition. The tumor consists of both epithelial and mesenchymal cell lines and tends to behave aggressively. It has clinical features like that of invasive breast carcinoma but sometimes there can be diagnostic confusion as it can mimic or present as breast abscess. Treatment is multimodal. Surgery plays the vital role. Post-op radiation and chemo are indicated. Hormone therapy is usually inapplicable as most of the time, it is hormone receptor negative.
ABSTRACT
PURPOSE: The repetitive micro traumatic stresses placed on the athletes shoulder joint complex during the throwing motion challenge the surrounding tissues. The purpose of this study was to compare shoulder rotational strength, range of motion and proprioception between the throwing athletes and non-athletic persons. METHODS: Fifteen throwing athletes and 15 non-athletes participated in a nonrandom case - control study. Strength of shoulder rotational movements was tested with a hand held dynamometer. The ranges of internal and external rotation of shoulder were measured by a standard goniometer. The ability of subjects to replicate the target position and kinesthetic sense was examined on the subjects' right shoulder by using a continuous passive motion device. Independent and paired t tests were used to statistically analyze between and within group differences. RESULTS: No significant difference was detected on the range of internal rotation between throwing athletes and non-athletic candidates (P=0.3). The range of external rotation was significantly more in athletic subjects (P=0.03). The results also showed that throwing athletes demonstrated a significantly higher isometric strength of shoulder external and internal rotation than the non-athletic group (P<0.05). However, the comparison of the internal and external rotation strength of dominant side in each group showed that throwing athletes showed a significant lower isometric strength of shoulder external rotation than internal rotation (P<0.001). It was also demonstrated higher joint position acuity in the throwing athletes than non athlete subjects (P=0.01). CONCLUSION: The repetitive nature of overhead throwing and the high forces that it causes result in adaptive changes of the dominant extremity. Throwing can lead to mobility, strength and neural adaptation.
