Sputnik V vaccine perception and hesitancy in a tertiary health care centre transformed to Covid-19 vaccine centre: A case study.

BACKGROUND: Sputnik V vaccine was approved in India in April 2021 to tackle the pandemic situation. However, there was lack of information on the effects, side effects, and peoples' perception toward it. The present case study aims to evaluate the vaccine coverage, the awareness, and perception toward it and compare the adverse effects after each dose. MATERIALS AND METHODS: A unique case study was conducted in a sample of 200 participants comparing 2 groups of population who took first and second dose of Sputnik V vaccine during June to November 2021. The data were collected by a prevalidated questionnaire, follow-up telephonic interviews focused on knowledge, awareness, side effects of vaccine, and analyzed using descriptive statistics such as frequency, percentages, mean, and standard deviation. RESULTS: The vaccine coverage for first and second doses were 98.3% and 96.5%, respectively. The mean age of the participant was 29 + 9.5 years and majority 68.5% were males. Seventeen percent experienced the S/E for the vaccine with 9.5% from second dose. There were usual side effects; however, it was more after second dose of vaccination. Friends and healthcare workers were the main source of information (33.5%) and motivation (43%). Majority (73.5%) were aware of the side effects. Forty three point five percent took vaccine attributed to its protective role, availability, and peer pressure. There was no significant association between type of doses and side effects of the respective doses of vaccine. CONCLUSION: The vaccine coverage was >90%. Participants were well aware of the vaccine and side effects which were more in second dose. However, there was no significant difference between the two doses of vaccine.

"Proximal to distal" sequence of the release of the upper extremity post-burn contracture: Rule or case-based approach?

Post-burn contractures are common entities seen in developing countries. There are multiple reasons for the development of contractures, most are preventable. In extensive contractures, a strategic plan is necessary to release all contractures and yet not antagonize post-operative positions. It is also necessary to be cost-effective and minimize the number of surgeries needed. Conventionally the release sequence in extensive burn contractures is proximal to distal. In this case report, we discuss an unusual sequence where we released distal contractures before the proximal to achieve optimum results. A 3-year-old child with post-burn contracture of hand, wrist, elbow, and axilla was treated in 2 stages, with the release of wrist contracture and cover with pedicled abdominal flap in the first stage and division of pedicled flap with the release of axilla and elbow contracture in the second stage. Thus, the release of all contractures was achieved without antagonizing post-operative positions and minimized the number of surgeries. A case-based approach may be crucial in making a strategic surgical plan to minimize the rehabilitation phase, rather than following known dictums.

Safety and efficacy of newer biologics DMARDs in the management of rheumatoid arthritis: A systematic review.

Objective: To analyze the safety and efficacy of certain biologics DMARDs (Adalimumab, Baricitinib, Pefacitinib and Sirukumab) either used alone or as a combination with MTX for management of rheumatoid arthritis. Method: We conducted a systematic literature review on various phase 3 Randomized controlled trails, double blind, placebo controlled, parallel group clinical trials for 52 weeks from 2017 to 2019 conforming to the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. The primary efficacy endpoints were American College of Rheumatology 20 response rate improvement criteria, other secondary endpoints were American College of Rheumatology 50/70 response rates, Health Assessment Questionnaire Disability Index, Disease Activity Score-28 for rheumatoid arthritis with Erythrocyte Sedimentation Rate/C Reactive Protein and Radiographic outcomes. Results: Finally, four studies were included for qualitative synthesis in which we observed improvement in ACR 20 response rate was found in the newer agents study group. SB5 (72.4%) at week 24, Baricitinib (70%) at week 12, Pefacitinib 100 mg and 150 mg (57.7% & 74.5%) at week 12 and Sirukumab 50 mg and 100 mg (55% & 54%) at week 16 respectively. ACR 50 and ACR 70 response rate at different point in time was also found to be higher in the study group which indicates their efficacy. Conclusion: In this systematic review, we observed an improvement in ACR 20 response rate and other secondary efficacy outcomes with an acceptable safety margin. From the evidence of RCTs, we have identified that newer therapeutic agents has beneficial effects when compared to existing therapy.

Chitosan: An undisputed bio-fabrication material for tissue engineering and bio-sensing applications.

Biopolymers have been serving the mankind in various ways since long. Over the last few years, these polymers have found great demand in various domains which includes bio medicine, tissue engineering, bio sensor fabrications etc. because of their excellent bio compatibility. In this context, chitosan has found global attention due to its environmentally benign nature, biocompatibility, biodegradability, and ease of availability. In last one decade or so, extensive research in active biomaterials, like chitosan has led to the development of novel delivery systems for drugs, genes, and biomolecules; and regenerative medicine. Additionally, chitosan has also witnessed its usage in functionalization of biocompatible materials, nanoparticle (NP) synthesis, and immobilization of various bio-recognition elements (BREs) to form active bio-surfaces with great ease. Keeping these aspects in mind, we have written a comprehensive review which aims to acquaint its readers with the exceptional properties of chitosan and its usage in the domain of biomedicine, tissue engineering, and biosensor fabrication. Herein, we have briefly explained various aspects of direct utilization of chitosan and then presented vivid strategies towards formulation of chitosan based nanocomposites for biomedicine, tissue engineering, and biosensing applications.

Effect of Transcutaneous Electrical Nerve Stimulation on Parotid Saliva Flow in Patients with Hyposalivation.

CONTEXT: In recent days, we have come across an increase incidence of dry mouth as a side effects of drugs and in order to bring an awareness about a simple non- invasive method to increase the salivary flow, we have used TENS which in many way is beneficial to patients with metabolic disorders. AIMS AND OBJECTIVES: The aim is to assess the effectiveness of transcutaneous electrical nerve stimulation on salivary gland function in patients with hyposalivation. SUBJECTS AND METHODS: The present study included total of 25 subjects with complaint of hyposalivation. Written informed consent was obtained from all the participants. Subjects with pacemakers, autoimmune diseases, pregnancy, and history of salivary gland pathology were excluded from the study. Subjects were asked to refrain from eating, drinking, chewing gum, smoking, and oral hygiene procedures for at least 1 h before the appointment. Unstimulated saliva was collected using modified Carlson Crittenden cup placed over the Stenson's duct bilaterally for 5 min and measured. TENS pads were placed over the parotid region and were activated. The intensity control switch was adjusted for patient's comfort. The intensity was turned up 1 increment at a time at 5 s intervals until the optimal intensity level was reached and stimulated saliva was then collected for 5 min using the modified Carlson Crittenden cup and measured. Any increase in parotid salivary flow (SF) with electrostimulation was considered a positive finding. STATISTICAL ANALYSIS USED: A paired t-test, evaluating mean changes in stimulated versus unstimulated SF rates, was applied to look for statistically significant differences using PASW 18.0 for Windows. An independent sample t-test was performed to note difference between genders. RESULTS: There was significant increase in parotid SF in 19 of 25 patients after transcutaneous electrical nerve stimulation. Males showed more salivary secretion when compared to females. CONCLUSIONS: From the results of the study and within limitations of the study, it can be concluded that TENS was effective in increasing the SF rate in hyposalivatory patients with residual saliva. TENS was less effective in patients who are under xerogenic drugs. Thus, TENS may be an ever-growing armamentarium in the management of salivary gland hypofunction when other therapies have failed or are contraindicated.