Immunogenicity and Safety Analysis of Inactivated Virus Vaccine against SARS-CoV-2: A Systematic Review of Phase 1/2 Clinical Trials

Introduction: The lingering Severe Acute Respiratory System-Coronavirus-2 (SARS-CoV-2) pandemic worldwide has called scientists to accelerate vaccine production and reduce the spread of the virus. The inactivated virus vaccine has been administered widely due to its potency. Following its recent public use, we aim to summarize the efficacy and safety of the inactivated vaccine, especially following Indonesia’s settlement on the SinoVac vaccine. Materials and Methods: A systematic review was performed, searching for randomized controlled trials, according to the PRISMA statement throughout four online databases with studies published up to 2 February 2021. Critical appraisal was further conducted utilizing the Cochrane Risk of Bias Tool 2.0. Results and Discussions: The search yielded six phase ½ clinical trials with a total of 3251 subjects. The outcome was obtained in seroconversion rates (%) after two doses of vaccine. Four studies administered the CoronaVac inactivated vaccine and resulted in a high seroconversion rate, ranging from 89—90%. The other two studies administered the BBV152 and BBIBP-CorV inactivated vaccine and showed similar results. Furthermore, a dose dependent relation is shown with higher doses showing higher seroconversion rates. The safety analysis reported injection site pain as an insignificant but most prevalent local adverse reaction, with other adverse reactions being mild to moderate respiratory tract infections Conclusion: The inactivated vaccine’s efficacy has been proven to stimulate antibody response regardless of dosage, period of administration, and age, with insignificant adverse effects. Further phase 3 clinical trials and widespread administration with the help of non-governmental and medical student organizations are recommended

A rare case of compression atelectasis due to spontaneous diaphragmatic hernia: a case report

Type IV diaphragmatic hernia is a rare case which has various clinical manifestations. The clinical manifestations as a result of protruded organ towards thoracic cavity in diaphragmatic hernia are varied from gastrointestinal symptoms such as epigastric pain, dysphagia and acid reflux. However, in a rare occasion, dyspnea may present as a result of compression atelectasis due to excessive increased in intrathoracic pressure. Here, we report a 57-year-old male patient who had spontaneous diaphragmatic hernia admitted with dyspnea as a chief complaint. This report might add another perspective to the physicians in facing the patient with atelectasis as the result of a high level of lung compression secondary to type IV diaphragmatic hernia.

CO2 Laser Ablation for the Manifestations of Multiple Cutaneous Neurofibromas in an Adult with Neurofibromatosis Type 1(NF1)

Introduction: Neurofibromatosis type 1 is a rare genetic disorder that is characterized by the growth of noncancerous neurocutaneous tumors that form near the spinal cord and along the peripheral nerves in the body. Symptoms NF-1 are usually detected in infancy or early childhood. However, in some cases, children and adults without family history may have a spontaneous genetic mutation of unknown cause. There are several modalities to treat NF-1, which include conventional surgery removal and CO2 laser ablation. The review of literature aims to compare the efficacy and outcomes of these two modalities. Case presentation: A 32-year old post-partum Australian woman is presented to the neurosurgery department outpatient clinic. When she was around 20-year old, non-painful multiple noncancerous growth along her spine and peripheral nerves and multiple café-au-lait spots started to appear. The size and numbers of growth and spots are gradually increasing as she aged. The diagnosis of NF-1 was made according to the presence of four of the seven diagnostic criteria of the National Institute of Health Consensus Development Conference. Patient is scheduled to go to NF clinic 2 months after the meeting, in which the patient is planned to undergo a treatment of CO2 laser ablation. Conclusions: Studies have shown that CO2 has outperformed conventional surgery in managing the clinical manifestation of NF-1 in term of effectivity and cosmetic outcomes. Keywords: neurofibromatosis type I, von Recklinghausen’s disease, adult, post-partum woman, CO2 laser ablation

Pathomorphological Changes In The Lungs Of COVID-19 Patients

In December 2019, a novel virus was discovered in China causing severe acute respiratory distress syndrome and the virus was designated as SARS-CoV-2 [1]. On 11th March 2020, the Corona Virus (SARS-CoV-2) was declared a pandemic by World Health Organization (WHO) [2]. Millions of people worldwide have been affected by this virus [3]. Most of the patients shows mild symptoms. Severe cases lead to the death of patients due to severe respiratory failure. Multiple organ failure has been seen in many patients suffering from COVID-19

Obesity, Lung Cancer, and The Paradox of its Association: A Narrative Review

Background: The obesity rate in Indonesia always increases every year. RISKESDAS (Indonesian National Health Research Data) 2007, 2013 and 2018 showed that obesity rate is always increasing in Indonesia. Lung cancer is the most common cancer in Indonesia which causes death. Objective: This review aims to explain various diseases which are associated with obesity, risk factors of lung cancer and the association between them. Methods: Literature search was conducted in pubmed and textbooks regarding obesity and lung cancer risk factors. The literature search on association between obesity and lung cancer was done in pubmed with the keyword "(Lung Cancer [Title]) AND (Obesity [Title])". Results: Based on the research conducted, it was found that obesity was associated with various diseases including type 2 diabetes, dyslipidemia, cancer risk, mood disorders, heart disease, hypertension, liver disease, and reproductive disorders. Furthermore, there are various risk factors for lung cancer, including gender, genetics, tobacco use, and exposure to toxic agents. The association between obesity and lung cancer is a paradoxical phenomenon that occurs, in which obese patients have a lower risk of developing lung cancer based on the meta-analysis research (RR: 0.79; 95% CI 0.73-0.85). Conclusion: Obesity can increase the risk of various diseases, and lung cancer which is one of the most common cancers in Indonesia also has various risk factors. However, current clinical research studies have shown that obesity actually reduces the risk of lung cancer. Thus we advise researchers around the world to further enhance experimental research either in clinical or laboratory about the body mechanisms that can explain this phenomenon. Regardless of this paradox association, we also suggest that the public should keep on controlling body weight because of the risk of various diseases associated with obesity.

Comparison of Colorectal cancer prognosis between developed and developing countries: A literature review.

Background: The cancer is caused when cells start dividing abnormally in the body. Age, genetics and lifestyle are major risk factors in developing cancer. The World Cancer Research Fund states that colorectal cancer incidence is globally ranked third in men and second in women. This highlights the need for effective screening and management of colorectal cancer to achieve better prognosis to prevent mortality and morbidity. Screening and management are not uniform all over the world, and it is affected by the economy of individual countries. In this context, we aimed to explore the prognosis of colorectal cancer in developed and developing countries and also to look for the factors affecting the prognosis.Material and Methods: A systematic search of the peer-reviewed journals from databases at Perdana University library which includes British Medical Journal, Up To Date, The Lancet, and Pubmed was done to answer the research questions. Results: We found that developed countries were in the west having a predominantly Caucasian population. The 5-year survival of patients with colorectal cancer (2008-13) was found to be least in Poland and the highest in Australia. In the developing countries it was found to have a broad representation from different ethnicities. The 5-year survival of colorectal cancer fwas ound to be least in Ghana and highest in Turkey.Conclusion: Looking at the results, the range of prognosis among developed countries is narrower than those in developing countries. This may be due to standardized screening and treatment practice in developed countries.

Unrooting the Potential of Intranasal Administration of Curcumin as a Novel Asthma Controller by Alleviating Airway Inflammation

Asthma is a chronic disease where air passage of the lung is inflamed and swollen. It is among major non-communicable diseases (NCDs) with more than 339 million sufferers and affects patients’ quality of life. Some drugs are currently used to control asthma symptoms, but it has its own economic burden. The aim of this literature review is to assess the potential use of curcumin to control asthma, as curcumin is cheaper and widely available in Indonesia. A total of eight literature was acquired after searching through Pubmed, Clinical Key, Scopus, Science Direct, Proquest, and Wiley Online databases with keywords including “intranasal”, “curcumin”, “asthma”, “inflammation”, and “airway”. Since inflammation is the most featured phenomenon in asthmatics that may lead to airway obstruction, it is important to lessen airway inflammation and thus control asthma. This mechanism can be seen in administration of curcumin, which although having a wide array of interaction with pathways, showcased to have anti-inflammatory effect which is beneficial in asthma. The anti-inflammatory effect of curcumin also negates other pathologic events relevant in asthma and appears to be preventive if administered before exacerbation. Intranasal administration displayed to be the most efficacious in asthma model, bested the efficacy of standard drugs. Lastly, no toxicity was observed by included studies.

Are We Thinking Too Straight? Why We Need More LGBTQ+ Studies in India: A Perspective

Despite India’s antiquity recognizing all types of queer sexualities, there is still much stigma and taboo that surrounds the Indian LGBTQ+ community. This stigmatization can be reflected in the scarcity of literature that focuses on the community. This article discusses the lack of LGBTQ+ studies in India, the consequences, and how encouraging more studies for this community can help eradicate prejudice and discrimination.

First Trimester Glycated Hemoglobin (HBA1C) Level as a Novel Predictor of Gestational Diabetes Mellitus: a Systematic Review and Meta-Analysis

Introduction: Gestational diabetes mellitus (GDM) is a severe yet neglected threat to maternal and child health, due to its association with multiple adverse pregnancy outcomes. glycated hemoglobin (HbA1c) level is one of the most promising predictor of GDM in early pregnancy based on several cohort studies done recently. Purpose of study: This systematic review and meta-analysis aims to evaluate the potency of HbA1c level in first trimester as a novel predictor of GDM. Methods: This review selects cohort studies found by database searching systematically using previously determined inclusion, such as pregnant woman as the subject, assess Hb1Ac level in the first trimester, and assess odds ratio towards (GDM), and exclusion criteria such as assess outcome at postpartum, not assess GDM outcomes, and studies written in languages other than English or Bahasa Indonesia. This review was arranged based on PRISMA guideline. Results and Discussion: This review included seven cohort studies with the pooled OR of 4.36 [95%CI: 3.66-5.20]. Quantitative analysis shows that HbA1c level in the first trimester is a significant risk factor of GDM development (p<0.00001). However, heterogeneity analyses revealed substantial heterogeneity are detected in the pooled studies. Therefore, to understand the significance of HbA1c level and the development of GDM, further studies are needed. Conclusion: This study has proven the potency of first trimester HbA1c level as a novel predictor of gestational diabetes mellitus. Thus, it is necessary to integrate the use of HbA1c level screening as part of antenatal care in the first trimester of pregnancy.

Statins and the COVID-19 Vaccines: a viewpoint

The COVID-19 pandemic has caused many scientists to promptly make vaccines against the disease. A large number of people who will receive the vaccines will likely be older adults, many of whom being long-term statin users. Statins, known to be immunomodulators, can interact with vaccines and alter their effects. Whether this effect is significant or not is up for debate, like in the case of the influenza vaccine. Thus, the interaction between statins and the COVID-19 vaccines should be investigated and understood, and guidelines should be written to ensure that the vaccines perform optimally.