Background: The current study aimed to identify the perceptions and issues regarding the affordability, availability, and accessibility of COVID-19 vaccination and determine the extent of vaccine ...hesitancy among non-vaccinated individuals. Methods: A Prospective cross-sectional study was conducted among 575 individuals for a period of six months. All the relevant information was collected using the peer-validated survey questionnaire. An independent t-test was applied to check the association between variables. Results: Among 575 participants, 80.8% were vaccinated, and 19.2% were non-vaccinated. Among the vaccinated, 35.1% were vaccinated in private centres and 64.9% in public health centres (PHC). In total, 32% had accessibility issues and 24.5% had availability issues. However, responders vaccinated at PHC were having more issues in comparison to other groups which was statistically significant (p < 0.05). Among the 163 privately vaccinated participants, 69.9% found it completely affordable. Another 26.9% and 3.1% found vaccines partly affordable and a little unaffordable. Among the 110 non-vaccinated, 38.1% were found to be vaccine-hesitant. Conclusions: Individuals vaccinated at PHC experienced issues such as long waiting times, unavailability of doses, and registration. Further, a significant level of hesitancy towards COVID-19 vaccines was observed. The safety and efficacy of COVID-19 vaccines contributed to negative attitudes.
Objective
To provide an integrated approach for deprescribing practice in oncology setting.
Data sources
The data on deprescribing in oncology settings has been retrieved from the PubMed, Scopus and ...Google Scholar. We used “deprescribing,” “potentially inappropriate medication” and “cancer” as a keyword for the conducting general search. The articles relevant to guidelines or tools used to deprescribe in cancer care were included.
Data summary
The nature of cancer, its treatment strategies, adverse effects of therapy and multimorbidity impact negatively on quality of life (QoL). Further, they invite polypharmacy which puts the patient at higher risk of drug-related problems like drug interactions, adverse drug reactions and addition of potentially improper medications, etc. In older adults with cancer, the incidence of potentially inappropriate medications (PIMs) was between 41% and 52%. Over the decades, multiple strategies have been developed to assess the appropriateness of therapy. One such approach is deprescribing. OncPal and oncoSTRIP (Systematic Tool to Reduce Inappropriate Prescribing) are the cancer specific guidelines whereas BEERs criteria, Screening Tool to Alert to Right Treatment/Screening Tool of Older Person's Prescriptions criteria (START/STOPP criteria), medication appropriateness index (MAI) are the cancer nonspecific tools to identify PIM among cancer patients. Here, we provided an integrative approach and algorithm for deprescribing in oncology setting which includes patient and caregiver goals, life expectancy (LE), review of medications, determining medication appropriateness, assessment of time to benefit (TTB), symptomatic and asymptomatic care, identifying medications to cease, implementation of the plan, monitoring and reviewing.
Conclusion
Deprescribing in oncology setting is a novel and effective patient-centric approach to counteract the use of PIM, which helps to mitigate polypharmacy, drug–drug interactions, and adverse effects.
H5N1 is a highly pathogenic avian influenza virus that can infect humans and has an estimated fatality rate of 53%. As shown by the current situation of the COVID-19 pandemic, emerging and ...re-emerging viruses such as H5N1 have the potential to cause another pandemic. Thus, this study outlined the hub genes and pathways associated with H5N1 infection in humans.
The genes associated with H5N1 infection in humans were retrieved from the NCBI Gene database using "H5N1 virus infection" as the keyword. The genes obtained were investigated for protein-protein interaction (PPI) using STRING version 11.5 and studied for functional enrichment analysis using DAVID 2021. Further, the PPI network was visualised and analysed using Cytoscape 3.7.2, and the hub genes were obtained using the local topological analysis method of the cytoHubba plugin.
A total of 39 genes associated with H5N1 infection in humans significantly interacted with each other, forming a PPI network with 38 nodes and 149 edges modulating 74 KEGG pathways, 76 biological processes, 13 cellular components, and 22 molecular functions. Further, the PPI network analysis revealed that 33 nodes interacted, forming 1056 shortest paths at 0.282 network density, along with a 1.947 characteristic path length. The local topological analysis predicted IFNA1, IRF3, CXCL8, CXCL10, IFNB1, and CHUK as the critical hub genes in human H5N1 infection.
The hub genes associated with the H5N1 infection and their pathways could serve as diagnostic, prognostic, and therapeutic targets for H5N1 infection among humans.
Plasma cell leukemia (PCL) is one of the rare cancer which is characterized by the uncontrolled proliferation of plasma cells in peripheral blood and bone marrow. The aggressive behavior of the ...disease and high mortality rate among PCL patients makes it a thirst area to be explored.
The dataset for PCL was obtained from the GEO database and was analyzed using GEO2R for differentially expressed genes. Further, the functional enrichment analysis was carried out for DEGs using DAVID. The protein-protein interactions (PPI) for DEGs were obtained using STRING 11.5 and were analyzed in Cytoscape 3.7.2. to obtain the key hub genes. These key hub genes were investigated for their interaction with suitable drug candidates using DGIdb, DrugMAP, and Schrodinger's version 2022–1.
Out of the total of 104 DEGs, 39 genes were up-regulated whereas 65 genes were down-regulated. A total of 11 biological processes, 2 cellular components, and 5 molecular functions were enriched along with the 7 KEGG pathways for the DEGs. Further, a total of 11 hub genes were obtained from the PPI of DEGs of which TP53, MAPK1, SOCS1, MBD3, and YES1 were the key hub genes. Oxaliplatin, mitoxantrone, and ponatinib were found to have the highest binding affinity towards the p53, MAPK1, and YES1 proteins respectively.
TP53, MAPK1, SOCS1, MBD3, and YES1 are the signature hub genes that might be responsible for the aggressive prognosis of PCL leading to poor survival rate. However, p53, MAPK1, and YES1 can be targeted with oxaliplatin, mitoxantrone, and ponatinib.
•Plasma cell leukemia is distinguished by the excessive proliferation of plasma cells in the peripheral blood and bone marrow.•TP53, MAPK1, SOCS1, MBD3, and YES1 are expressed in patients with newly diagnosed plasma cell leukemia.•Oxaliplatin, mitoxantrone, and ponatinib possess binding affinity towards TP53, MAKP1, and YES1 providing a strategy to treat plasma cell leukemia.
Diabetes mellitus imposes a huge economic burden along with impairing health related quality of life (HRQoL) among patients. The purpose of this study was to determine the effect of healthcare ...expenditure on HRQoL among diabetic patients.
A Cross -Sectional study was carried out among 328 Type 2 diabetics in Southern India. HRQoL was assessed using EQ-5D-5L questionnaire and data regarding expenditure were gathered using a validated questionnaire. Poisson regression and Multivariate regression analysis were performed to predict the factors associated with healthcare expenditure and quality of life respectively.
The annual expenditure in management of diabetes was INR 10969.6 (USD 132.83) with direct medical cost INR 8727 (USD 105.67) forming the bulk. 11.6% of participants spent over 30% of their annual income in diabetes care. Older age group, being obese, lower socioeconomic status, longer duration of diabetes, presence of complication, episodes of hospitalization were associated with higher healthcare expenditure. Mean quality of life score was 0.84 ± 0.13 and mean visual analog score was 73.15 ± 11.21. Participants with EQ-5D-5L index of range (0.0–0.3) had an expenditure of INR 31703.56. On linear regression analysis, proportion of total income spent for diabetes care was associated with poor quality of life (β = −0.163, 95% CI = −0.239 to −0.086, p < 0.001).
Cost of diabetes care was inordinately high and an increased spending particularly among the socioeconomically disadvantaged group, resulting in poorer QoL. Policymakers need to focus on strengthening primary healthcare facilities for Non-Communicable diseases and implementing cost containment policy for reducing the financial burden.
Background
Alpha-blockers prescribed as medical expulsion therapy (MET) have replaced minimally invasive procedures as the primary line of treatment for minor ureteric stones. This study aims to ...investigate the efficacy of MET with alpha-blockers in terms of stone expulsion rate and time and evaluate the safety of several alpha-blockers.
Methodology
Google Scholar, PubMed, and Web of Science databases were searched for relevant publications using keywords published between December 2013 and August 2021. Additional relevant research was found by looking through the references in the articles.
Results
To determine the efficacy and safety of alpha-blockers as a medical expulsive therapy for the management of distal ureteral stones, 15 studies were included, 12 randomized control trials, 2 retrospective observational studies, and 1 prospective study. The most commonly studied primary endpoint was stone expulsion rate and time. According to findings, silodosin appears to be more effective than other alpha-blockers. The data revealed no life-threatening adverse effects were associated with alpha-blockers.
Conclusion
Alpha-blockers are recommended as the first-line therapy for distal ureteral stones. Silodosin was the most efficacious medicine, according to the data. The side effects of alpha-blockers, on the other hand, were minor, consisting primarily of orthostatic hypotension. The alpha-blocker choice differs from urologist to urologist in the management of MET, depending on their experience and the patient's condition.
