Beliefs regarding SARS-COV-2 vaccine in patients with transfusion-dependent thalassemia

Background: SARS-CoV-2 vaccination drive generated varying responses in the general public. This study aimed to assess the vaccination acceptance amongst patients with thalassemia and to elucidate their beliefs regarding SARS-CoV-2 vaccines.Methods: A prospective observational study was done involving thalassemia patients above the age of 18 years in the thalassemia day care center of our hospital.Results: The study assessed 145 patients with a male to female ratio of 1.5:1 and a mean age of 25.6±6 years. Seventy-six (52.4%) of the study population had already been vaccinated with the first dose, 25.5% (n=37) were willing to get vaccinated, however, 22% were vaccine-hesitant. Vaccine hesitancy was 25.5% in males compared to 16.9% in females. The fear of adverse effects to the vaccine is a major deterrent to the vaccination. Patients considered themselves at high risk of COVID-19 disease and adverse effects of the SARS-CoV-2 vaccine.Conclusions: Vaccine hesitancy was observed in 22% of patients. A significantly higher proportion of these patients considered vaccines unsafe and ineffective. Public sharing of safety and efficacy data may help in improving trust in the vaccine.

Risk factors for extubation failure in mechanically ventilated children in pediatric intensive care unit

Background: Mechanical ventilation is lifesaving in children with respiratory failure. However, its unnecessary prolongation once a child is capable of sustaining spontaneous effective ventilation is associated with significant complications. Objective: To identify the factors that lead to higher chance of extubation failure in mechanically ventilated children. Materials and Methods: A prospective, observational study was conducted over a period of 1 year. Children admitted to pediatric intensive care unit of a tertiary care hospital of Northern India aged 1 month–17 years, needing mechanical ventilation were included in the study. Predefined criteria were used to decide the timing of extubation. Relevant details were recorded to study various patient-related parameters and their association with extubation outcome. Results: Mean age of the study group was 50 months with a male:female ratio of 3:1. Extubation failure rate was 14.5%. Extubation failure was significantly higher in patients ventilated for >7 days (p=0.01), those with the pediatric risk of mortality score >10 at admission (p=0.009), in addition to peak inspiratory pressure >16 cm H2O (p=0.009) and FiO2 ≥0.35 (p=0.01) before extubation. Accidental extubation was also associated with higher extubation failure (p<0.001). Conclusion: Our study demonstrates that even though sicker patients requiring ventilation for longer duration are more prone to failed extubations, protocol based, and planned extubations lead to better extubation success

Complications of exodontia: A retrospective study

Purpose: The purpose of this study was to analyze the incidence of various complications following routine exodontia performed using fixed protocols. Materials and Methods: A total of 22,330 extractions carried out in 14,975 patients, aged between 14 and 82 years, who reported to the Department of Oral and Maxillofacial Surgery at Padmashree Dr. D. Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, were evaluated for various complications. Results: The most common complications encountered were tooth fracture, trismus, fracture of cortical plates and dry socket. Wound dehiscence, postoperative pain and hemorrhage were encountered less frequently. Luxation of adjacent teeth, fracture of maxillary tuberosity, and displacement of tooth into adjacent tissue spaces were rare complications. Conclusion: The practice of exodontia inevitably results in complications from time to time. It is imperative for the clinician to recognize impending complications and manage them accordingly

EXTENSIVE RADICULAR CYST OF THE MANDIBLE: A RARE CASE REPORT

The radicular cyst is the most common inflammatory odontogenic cystic lesion of the jaws. It usually originates as a sequel to a periapical inflammatory process, following chemical, physical or bacterial injury. Due to its chronic etiology, the cyst usually appears towards the later stage of life. It has a male sex predilection, with the maxillary anterior region as the most common site of involvement. This article reports a rare case of a large radicular cyst in the mandible, its management and follow up along one year

O-hexadecyl-dextran entrapped berberine nanoparticles abrogate high glucose stress induced apoptosis in primary rat hepatocytes.

Nanotized phytochemicals are being explored by researchers for promoting their uptake and effectiveness at lower concentrations. In this study, O-hexadecyl-dextran entrapped berberine chloride nanoparticles (BC-HDD NPs) were prepared, and evaluated for their cytoprotective efficacy in high glucose stressed primary hepatocytes and the results obtained compared with bulk berberine chloride (BBR) treatment. The nanotized formulation treated primary hepatocytes that were exposed to high glucose (40 mM), showed increased viability compared to the bulk BBR treated cells. BC-HDD NPs reduced the ROS generation by ∼ 3.5 fold during co-treatment, prevented GSH depletion by ∼ 1.6 fold, reduced NO formation by ∼ 5 fold and significantly prevented decline in SOD activity in stressed cells. Lipid peroxidation was also prevented by ∼ 1.9 fold in the presence of these NPs confirming the antioxidant capacity of the formulation. High glucose stress increased Bax/Bcl2 ratio followed by mitochondrial depolarization and activation of caspase-9/-3 confirming involvement of mitochondrial pathway of apoptosis in the exposed cells. Co- and post-treatment of BC-HDD NPs prevented depolarization of mitochondrial membrane, reduced Bax/Bcl2 ratio and prevented externalization of phosphatidyl-serine confirming their anti-apoptotic capacity in those cells. Sub-G1 phase apparent in high glucose stressed cells was not seen in BC-HDD NPs treated cells. The present study reveals that BC-HDD NPs at ∼ 20 fold lower concentration are as effective as BBR in preventing high glucose induced oxidative stress, mitochondrial depolarization and downstream events of apoptotic cell death

Effect of BBR and BC-HDD NPs on ROS production in high glucose treated hepatocytes.

<p>DCFH-DA dye was used to assess the ROS production. Data shown are mean evaluated from three different sets of experiments. The S.D. was below ±5% in all cases. Where CNB: Co-BC-HDD NPs; CB:Co-BBR; PNB: Post-BC-HDD NPs and PB: Post-BBR.</p

BC-HDD NPs prevent loss of mitochondrial membrane potential.

<p>(<b>A</b>) Effect of BBR and BC-HDD on mitochondrial polarisation as seen using Rhodamine123. (<b>B</b>) Effect on mitochondrial membrane potential as seen using JC-1. Results are shown as mean ± S.E. # denotes significant difference compared with control values and *P<0.05, **P<0.01 and ***P<0.001 denotes significant difference compared with 40 mM glucose. Where CNB: Co-BC-HDD NPs; CB:Co-BBR; PNB: Post-BC-HDD NPs and PB: Post-BBR.</p

Modulation in hyperglycemia induced apoptosis by BBR and BC-HDD.

<p>Effect of BBR and BC-HDD NPs on hyperglycemia induced apoptosis in hepatocytes as assessed by Annexin-PI staining. The S.D. was below ±5% in all cases. Results are representative of three separate experiments. Where CNB: Co-BC-HDD NPs; CB: Co-BBR; PNB: Post-BC-HDD NPs and PB: Post-BBR.</p

Flow cytometric analysis of uptake of BBR and BC-HDD NPs by the primary rat hepatocytes.

<p>The cellular uptake in case of co-treatment was observed after 90 min of treatment whereas in case of post-treatment the uptake was observed after 30 min of BBR and BC-HDD treatment (as per the treatment schedule in the study). Results are shown as mean ± S.E. from three independent experiments. Significant difference compared with control values *P<0.05, and ***P<0.001. Where CNB: Co-BC-HDD NPs; CB: Co-BBR; PNB: Post-BC-HDD NPs, PB: Post-BBR.</p

Physiochemical characterization of berberine chloride loaded HDD NPs.

<p>(a) Transmission electron microscopy of berberine chloride loaded HDD NPs(BC-HDD NPs) depicting the spherical nature of the nanoparticles having more or less uniform size. Scale bar is 100 nm. (b) <i>In vitro</i> drug release following standard dialysis method exhibited by berberine chloride dextran nanoparticles in PBS over a period of 96 hrs. Values are represented as ± SD.</p