Browsing by Author "Ashish Kumar Yadav"

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A prospective observational safety study on ChAdOx1 nCoV-19 corona virus vaccine (recombinant) use in healthcare workers- first results from India
(Elsevier Ltd, 2021) Upinder Kaur; Bisweswar Ojha; Bhairav Kumar Pathak; Anup Singh; Kiran R. Giri; Amit Singh; Agniva Das; Anamika Misra; Ashish Kumar Yadav; Sangeeta Kansal; Sankha Shubhra Chakrabarti
Background: We provide the first post-approval safety analysis of COVISHIELD in health care workers (HCWs) in northern India. Methods: This continuing prospective observational study (February 2021 to May 2022) enrolled participants ≥18 years receiving COVISHIELD vaccination. Primary outcome was safety and reactogenicity. Categories (FDA toxicity grading) and outcomes of adverse events following immunization (AEFIs) were recorded, causality assessment performed, and risk factors analysed. Findings: We present the results of an interim analysis of 804 participants. AEFIs following first dose were reported in 321 (40%; systemic involvement in 248). Among 730 participants who completed a 7-day follow-up post second dose, AEFIs occurred in 115 (15.7%; systemic in 99). Majority of AEFIs were mild-moderate and resolved spontaneously. Serious AEFIs, leading to hospitalization was noticed in 1 (0.1%) participant with suspicion of immunization stress related response (ISRR). AEFIs of grade 3 severity (FDA) were recorded in 4 participants (0.5%). No deaths were recorded. Regression analysis showed increased risk of AEFIs in younger individuals, a two times higher odds in females, those with hypertension or with history of allergy; and three times higher odds in individuals with hypothyroidism. Interpretation: COVISHIELD carries an overall favourable safety profile with AEFI rates much less than reported for other adenoviral vaccines. Females, those with hypertension, individuals with history of allergy and hypothyroidism may need watchful vaccine administration. This being an interim analysis and based on healthcare workers who may not reflect the general population demographics, larger inclusive studies are warranted for confirming the findings. Funding: No funding support. © 2021 The Author(s)
Antibacterial Photodynamic Therapy by Zn(II)-Curcumin Complex: Synthesis, Characterization, DFT Calculation, Antibacterial Activity, and Molecular Docking
(John Wiley and Sons Inc, 2024) Rajesh Kushwaha; Rohit Rai; Vedant Gawande; Virendra Singh; Ashish Kumar Yadav; Biplob Koch; Prodyut Dhar; Samya Banerjee
The increase in antibacterial drug resistance is threatening global health conditions. Recently, antibacterial photodynamic therapy (aPDT) has emerged as an effective antibacterial treatment with high cure gain. In this work, three Zn(II) complexes viz., [Zn(en)(acac)Cl] (1), [Zn(bpy)(acac)Cl] (2), [Zn(en)(cur)Cl] (3), where en=ethylenediamine (1 and 3), bpy=2,2’-bipyridine (2), acac=acetylacetonate (1 and 2), cur=curcumin monoanionic (3) were developed as aPDT agents. Complexes 1–3 were synthesized and fully characterized using NMR, HRMS, FTIR, UV-Vis. and fluorescence spectroscopy. The HOMO–LUMO energy gap (Eg), and adiabatic splittings (ΔS1−T1 and ΔS0−T1) obtained from DFT calculation indicated the photosensivity of the complexes. These complexes have not shown any potent antibacterial activity under dark conditions but the antibacterial activity of these complexes was significantly enhanced upon light exposure (MIC value up to 0.025 μg/mL) due to their light-mediated 1O2 generation abilities. The molecular docking study suggested that complexes 1–3 interact efficiently with DNA gyrase B (PDB ID: 4uro). Importantly, 1–3 did not show any toxicity toward normal HEK-293 cells. Overall, in this work, we have demonstrated the promising potential of Zn(II) complexes as effective antibacterial agents under the influence of visible light. © 2023 Wiley-VCH GmbH.
Burden of Chronic Nonhealing Wounds: An Overview of the Worldwide Humanistic and Economic Burden to the Healthcare System
(SAGE Publications Inc., 2024) Aditya Sharma; Ravi Shankar; Ashish Kumar Yadav; Arvind Pratap; Mumtaz Ahmad Ansari; Vivek Srivastava
Chronic wounds have long been a significant public health concern, but the true impact of these wounds is unknown since research designs and measuring techniques vary, leading to inconsistent estimates. The definition of a wound is a loss of epithelial continuity caused by damage to the tissue. The following conditions can cause chronic wounds: panniculitis, pyoderma gangrenosum, traumatic, neurological, metabolic, hematologic, neoplastic, or infection-related. The growing global incidence of diabetes and the aging population necessitate greater attention to chronic wounds. Regrettably, it is sad that significant healthcare institutions have overlooked wound research. The study of health-related illnesses and occurrences in particular populations, including their distribution, frequency, and determinants, and the application of this research to control health problems. © The Author(s) 2024.
Classification Accuracy of Linear Discriminant Function using Principal Components with Multiple Correlated Variables: A Simulation based Exploration
(Wolters Kluwer Medknow Publications, 2025) Akash Mishra; Sachit Ganapathy; Narayanapillai Sreekumaran Nair; Durgesh Shukla; Ashish Kumar Yadav; Rajaat Vohra; Kuldeep Soni
Background: Linear Discriminant Analysis (LDA) is a powerful and widely used technique for classification with correlated variables. Principal Components (PCs) group these variables into linear combinations and produce independent variables. The LDA on these PC’s may provide better classification accuracy in clinical diagnostics than on usual measurements. Methodology: Two datasets were utilized for demonstration: one from a Sudden Sensorineural Hearing Loss (SSNHL) case-control study and the other from a Gall Bladder (GB) case-control study. Linear Discriminant Analysis (LDA) was conducted on the actual correlated measured variables for group classification, as well as on the derived principal component variables, to compare their classification accuracies. Performance metrics including Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), Classification Accuracy, and F1 Score were assessed. For validation, a third simulated dataset was employed. Additionally, LDA was performed on each dataset using eigenvectors of the control group applied to the cases and vice versa, revealing a strong agreement in classification as measured by the kappa statistic. Results: When LDA was applied to the actual lipid measurements in the SSNHL dataset, the classification accuracy was 57.2%, and the F1 score was 39.7%. However, when LDA was performed using principal components (PCs), the classification accuracy markedly improved to 99.2%, with an F1 score of 98.5%. Similarly, for the GB cancer dataset, the classification accuracy and F1 score were initially 77.2% and 77.3%, respectively. Upon applying LDA with the PCs, these metrics were significantly enhanced to 98.4% and 98.3%, respectively. For the simulated dataset, both the classification accuracy and F1 score were 99.1%. The study also demonstrated that the classification accuracy and F1 score remained consistent regardless of whether the eigenvectors from the cases or controls were used to classify new subjects (Kappa Statistic = 0.962, P < 0.001). Conclusion: In group separation, utilizing principal components significantly improves classification accuracy and overall performance metrics, outperforming the use of the original correlated predictors. © 2025 Medical Journal of Dr. D.Y. Patil Vidyapeeth.
Comparative Study of Sonodynamic and Photoactivated Cancer Therapies with Re(I)-Tricarbonyl Complexes Comprising Phenanthroline Ligands
(American Chemical Society, 2024) Rajesh Kushwaha; Virendra Singh; Silda Peters; Ashish Kumar Yadav; Tumpa Sadhukhan; Biplob Koch; Samya Banerjee
Herein, we have compared the effectivity of light-based photoactivated cancer therapy and ultrasound-based sonodynamic therapy with Re(I)-tricarbonyl complexes (Re1-Re3) against cancer cells. The observed photophysical and TD-DFT calculations indicated the potential of Re1-Re3 to act as good anticancer agents under visible light/ultrasound exposure. Re1 did not display any dark- or light- or ultrasound-triggered anticancer activity. However, Re2 and Re3 displayed concentration-dependent anticancer activity upon light and ultrasound exposure. Interestingly, Re3 produced 1O2 and OH• on light/ultrasound exposure. Moreover, Re3 induced NADH photo-oxidation in PBS and produced H2O2. To the best of our knowledge, NADH photo-oxidation has been achieved here with the Re(I) complex for the first time in PBS. Additionally, Re3 released CO upon light/ultrasound exposure. The cell death mechanism revealed that Re3 produced an apoptotic cell death response in HeLa cells via ROS generation. Interestingly, Re3 showed slightly better anticancer activity under light exposure compared to ultrasound exposure. © 2024 American Chemical Society
Determinants of COVID-19 Breakthrough Infections and Severity in ChAdOx1 nCoV-19–Vaccinated Priority Groups
(American Society of Tropical Medicine and Hygiene, 2022) Upinder Kaur; Sapna Bala; Bisweswar Ojha; Bhairav Kumar Pathak; Aditi Joshi; Ashish Kumar Yadav; Anup Singh; Sangeeta Kansal; Sankha Shubhra Chakrabarti
The current analysis is a part of an ongoing observational study that began in February 2021 in the Sir Sunder Lal Hospital (Varanasi, Uttar Pradesh) in northern India and is expected to continue until June 2022. This analysis aimed to delineate the clinical presentation and risk factors of occurrence and severity of COVID-19 in vaccinated individuals. The study enrolled health-care workers and the elderly receiving the COVID-19 vaccine at one of three centers linked to the study hospital. The participants received the ChAdOx1 nCoV-19 (Oxford-AstraZeneca) vaccine based on the chimpanzee adenovirus platform (manufactured in India by the Serum Institute of India). The adenovirus codes for the spike (S) protein of SARS-CoV-2. Participants were contacted by phone at pre-decided intervals and questioned about the occurrence of COVID-19, clinical presentation, severity, and persistence of symptoms. A logistic regression analysis was performed to predict the risk factors of occurrence and severity of COVID-19. Of the 1,500 participants included in the analysis, 418 developed COVID-19 (27.9%). Fever was the most common symptom (72%), followed by cough (34%) and rhinitis (26%). Cardiovascular involvement was seen in more than 2% of individuals, and 11% had post-COVID-19 complaints. Regression analysis showed 1.6 times greater odds of contracting the disease in females and in those younger than 40 years, 1.4 times greater odds in individuals who were overweight, and 2.9 times greater odds in those receiving only one dose, compared with respective comparators. Individuals receiving two doses at a gap of ≤ 30 days had 6.7 times greater odds of infection than those receiving at a > 60-day interval. There was no association between COVID-19 occurrence in the vaccinees and pre-vaccination history of SARS-CoV-2 infection. Males were at a 3.6 times greater risk, and persons with preexisting lung disease—mainly asthma—had a 5.9 times greater risk of experiencing moderate to severe COVID-19 than comparators. While an extended interval between the two vaccine doses seems to be a better strategy, gender differences and an association of asthma phenotypes with COVID-19 need to be explored. Copyright © 2022 The author(s)
Did COVID-19 or COVID-19 Vaccines Influence the Patterns of Dengue in 2021? An Exploratory Analysis of Two Observational Studies from North India
(American Society of Tropical Medicine and Hygiene, 2023) Upinder Kaur; Parth Jethwani; Shraddha Mishra; Amol Dehade; Ashish Kumar Yadav; Sasanka Chakrabarti; Sankha Shubhra Chakrabarti
Dengue experienced a rise in disease burden in 2021 in specific regions of India. We aimed to explore the risk factors of dengue occurrence and severity in the post-COVID-19 and post-COVID-19 vaccination era and performed an exploratory analysis involving participants from two prior observational studies conducted from February 2021 to April 2022 in a tertiary hospital in North India. Health care workers constituted the majority of the study participants. Individuals were stratified into five groups based on COVID-19 infection and timing of vaccination: COVID-No Vaccine, Vaccine-No COVID (VNC), COVID After Vaccine (CAV), Vaccine After COVID (VAC), and No Vaccine-No COVID (NVNC) groups. The occurrence of laboratory-confirmed dengue and severe forms of dengue were the main outcomes of interest. A total of 1,701 participants (1,520 vaccinated, 181 unvaccinated) were included. Of these, symptomatic dengue occurred in 133 (7.8%) and was “severe” in 42 (31.6%) cases. Individuals with a history of COVID-19 in 2020 had a 2-times-higher odds of developing symptomatic dengue (P 5 0.002). The VAC group had 3.6 (P 5 0.019)-, 2 (P 5 0.002)-, and 1.9 (P 5 0.01)-times-higher odds of developing symptomatic dengue than the NVNC, VNC, and CAV groups, respectively. The severity of dengue was not affected by COVID-19 vaccination but with marginal statistical significance, a 2-times-higher risk of severe dengue was observed with any COVID-19 of the past (P 5 0.08). We conclude that COVID-19 may enhance the risk of developing symptomatic dengue. Future research should explore the predisposition of COVID-19-recovered patients toward other viral illnesses. Individuals receiving COVID-19 vaccines after recovering from COVID-19 particularly seem to be at greater risk of symptomatic dengue and need long-term watchfulness. Possible mechanisms, such as antibody-dependent enhancement or T-cell dysfunction, should be investigated in COVID-19-recovered and vaccinated individuals. Copyright © 2023 The author(s)
Evaluation of demographic, clinical characteristics and risk factors in patients with persistent hiccups due to traumatic brain injury: A trauma-ICU based study
(IP Innovative Publication Pvt. Ltd., 2024) Manjaree Mishra; Ghanshyam Yadav; Ravi Shankar Prasad; Shashi Prakash Mishra; Ashish Kumar Yadav
Background: Persistent hiccups in neurocritical care patients can lead to negative outcomes, including exhaustion, sleep deprivation, malnutrition, depression, and even death. This study aims to evaluate demographic and clinical characteristics, risk factors, and management in trauma intensive care unit patients. Materials and Methods: This study investigates persistent hiccups in traumatic brain injury (TBI) patients admitted to the Trauma ICU at Banaras Hindu University, Varanasi, from July 2020 to January 2024. The study involved monitoring and recording hiccups during patients’ ICU stays. Exclusion criteria included not participating, having GERD, advanced cancer, spinal cord injury, other CNS pathologies, deranged liver and renal profile, or on drugs causing hiccups, on sedative and neuro-muscular blocking agents. Results: The study involved 59.8% of patients aged <40 years, with a mean age of 41.75±17.16 years. Most patients were male, with a male-to-female ratio of 1.88:1. Road traffic accidents (RTAs) were present in 60.3% of patients, followed by falls from height (17.5%). 75.7% of patients had severe type TBI, while the remaining had moderate type TBI. Out of 189 patients, 86 (45.5%) died and 103 (54.5%) survived. Age was a significant factor in TBI-related persistent hiccups, with severe TBI significantly associated with female gender and ventilator-associated pneumonia and the need for mechanical ventilation. The type of TBI (moderate or severe) and length of ICU stay were also associated with TBI-related persistent hiccups. A strong relationship was observed between severe TBI patients who fall from height and were not responsive to drugs for hiccups compared to moderate TBI. The length of ICU stay was also associated with TBI-related persistent hiccups, with patients with a length of ICU stay of >14 days having a higher risk of hiccups. Conclusion: Severe TBI is linked to female gender, ventilator-associated pneumonia, and mechanical ventilation. The type of TBI and length of ICU stay are also linked to persistent hiccups. Patients with severe TBI who fell from height are less responsive to hiccup drugs. Patients with over 14 days of ICU stay have a higher risk of developing persistent hiccups. © 2024 Author(s).
Financial Burden and financing strategies for treating the cardiovascular diseases in India
(Elsevier Ltd, 2022) Shaziya Allarakha; Jeetendra Yadav; Ashish Kumar Yadav
Health expenditures are a major financial burden for many people in low and middle-income countries. Cardiovascular diseases (CVDs) caused almost a third of the total deaths globally in 2016. The financial burden of CVD s globally was around US$ 863 billion in 2010 and is estimated to rise by 22% (which means around US$ 1044 billion) by 2030. Hence, there is an urgent need to know the burden of CVDs and the financing strategies for CVDs in India. The data for this study was obtained from the 75th round of the National Sample Survey (NSS) on the theme ‘Social consumption: Health’ (2017–18). The present study uses data of 6144 people who sought the treatments from hospitalization care in the last 365 days and 8401 people who sought the treatments from Outpatients (OPD) care in the last 15 days preceding the survey. Almost, 50.3 percent and 43.2 percent of the households faced catastrophic health expenditure due to hospitalization care and OPD care respectively and 19.0 percent and 8.9 percent of the households were forced to below poverty line from above poverty line due to hospitalization care and OPD care respectively due to CVD treatment. Based on our analysis certain important conclusions and recommendations can be proposed. These include increasing the screening for CVDs for timely diagnosis and treatment, improving the healthcare services for the management of CVDs in the public sector, improving awareness amongst the masses for identifying the early signs of CVDs and a multi-stakeholder approach consisting of improvement in areas particularly healthcare, literacy, employment, and women upliftment to limit and manage the burden of CVDs in India. © 2022
Green Light-Triggered Photocatalytic Anticancer Activity of Terpyridine-Based Ru(II) Photocatalysts
(American Chemical Society, 2024) Arif Ali Mandal; Virendra Singh; Sukanta Saha; Silda Peters; Tumpa Sadhukhan; Rajesh Kushwaha; Ashish Kumar Yadav; Apurba Mandal; Aarti Upadhyay; Arpan Bera; Arnab Dutta; Biplob Koch; Samya Banerjee
The relentless increase in drug resistance of platinum-based chemotherapeutics has opened the scope for other new cancer therapies with novel mechanisms of action (MoA). Recently, photocatalytic cancer therapy, an intrusive catalytic treatment, is receiving significant interest due to its multitargeting cell death mechanism with high selectivity. Here, we report the synthesis and characterization of three photoresponsive Ru(II) complexes, viz., [Ru(ph-tpy)(bpy)Cl]PF6 (Ru1), [Ru(ph-tpy)(phen)Cl]PF6 (Ru2), and [Ru(ph-tpy)(aip)Cl]PF6 (Ru3), where, ph-tpy = 4′-phenyl-2,2′:6′,2″-terpyridine, bpy = 2,2′-bipyridine, phen = 1,10-phenanthroline, and aip = 2-(anthracen-9-yl)-1H-imidazo[4,5-f][1,10] phenanthroline, showing photocatalytic anticancer activity. The X-ray crystal structures of Ru1 and Ru2 revealed a distorted octahedral geometry with a RuN5Cl core. The complexes showed an intense absorption band in the 440-600 nm range corresponding to the metal-to-ligand charge transfer (MLCT) that was further used to achieve the green light-induced photocatalytic anticancer effect. The mitochondria-targeting photostable complex Ru3 induced phototoxicity with IC50 and PI values of ca. 0.7 μM and 88, respectively, under white light irradiation and ca. 1.9 μM and 35 under green light irradiation against HeLa cells. The complexes (Ru1-Ru3) showed negligible dark cytotoxicity toward normal splenocytes (IC50s > 50 μM). The cell death mechanistic study revealed that Ru3 induced ROS-mediated apoptosis in HeLa cells via mitochondrial depolarization under white or green light exposure. Interestingly, Ru3 also acted as a highly potent catalyst for NADH photo-oxidation under green light. This NADH photo-oxidation process also contributed to the photocytotoxicity of the complexes. Overall, Ru3 presented multitargeting synergistic type I and type II photochemotherapeutic effects. © 2024 American Chemical Society.
Influence of La3+ doping on structural and optical properties of SrCeO3 perovskite
(Institute of Physics, 2024) Dharmendra Yadav; Pravin Kumar; Alok Kumar Tripathi; Ram Sagar Yadav; Gurudeo Nirala; Sushma Yadav; Ashish Kumar Yadav; Sandip Yadav
The SrCe1-xLaxO3 (x = 0.0, 0.02, 0.4, 0.6, and 0.10) perovskite materials have been successfully synthesized by auto-combustion method and calcined at 1100°C. The XRD patterns reveal a highly crystalline orthorhombic crystal structure with a Pnma space group in all samples. The TEM micrograph shows a spherical morphology of the 10 mol% La3+ doped SrCeO3 perovskite sample alongwith the SAED pattern confirming its highly crystalline nature. The incorporation of La3+ ion in the SrCeO3 perovskite has been confirmed by the Raman and Fourier transform infrared (FTIR) measurements. The UV-vis absorption spectra at room temperature show various bands, with a strong absorption band observed below 400 nm. The optical band gap of the undoped and La3+ doped samples have been calculated and it is smaller for the La3+ doped perovskite samples than that of the undoped perovskite sample. Therefore, the La3+ doped SrCeO3 perovskite may be applicable for optoelectronic applications. © 2024 IOP Publishing Ltd. All rights, including for text and data mining, AI training, and similar technologies, are reserved.
Long-Term Safety Analysis of the ChAdOx1-nCoV-19 Corona Virus Vaccine: Results from a Prospective Observational Study in Priority Vaccinated Groups in North India
(Adis, 2023) Upinder Kaur; Zeba Fatima; Kalika Maheshwari; Vikas Sahni; Amol Dehade; Anju Kl; Ashish Kumar Yadav; Sangeeta Kansal; Vaibhav Jaisawal; Sankha Shubhra Chakrabarti
Introduction: Various vaccines for protection against COVID-19 were provided emergency approval in late 2020 to early 2021. There is a scarcity of long-term safety data for many of these. Objective: The main aim of this study is to provide the one-year safety results of the ChAdOx1-nCoV-19/AZD1222 vaccine and determine the risk factors of adverse events of special interest (AESIs) and persistent AESIs. Methods: This was a prospective observational study conducted from February 2021 to April 2022 in a tertiary hospital in North India and its two associated centers. Health care workers, other frontline workers, and the elderly vaccinated with the ChAdOx1-nCoV-19 vaccine constituted the study population. Individuals were contacted telephonically at pre-decided intervals for one year and health issues of significant concern were recorded. Atypical adverse events developing after a booster dose of the COVID-19 vaccine were assessed. Regression analysis was conducted to determine risk factors of AESI occurrence and determinants of AESIs persisting for at least one month at the time of final telephonic contact. Results: Of 1650 individuals enrolled, 1520 could be assessed at one-year post-vaccination. COVID-19 occurred in 44.1% of participants. Dengue occurred in 8% of participants. The majority of the AESIs belonged to the MedDRA® SOC of musculoskeletal disorders (3.7% of 1520). Arthropathy (knee joint involvement) was the most common individual AESI (1.7%). Endocrinal disorders such as thyroid abnormalities and metabolic disorders such as newly diagnosed diabetes developed in 0.4% and 0.3% of individuals, respectively. Regression analysis showed females, individuals with a pre-vaccination history of COVID-19, diabetes, hypothyroidism, and arthropathy had 1.78-, 1.55-, 1.82-, 2.47- and 3.9-times higher odds of AESI development. Females and individuals with hypothyroidism were at 1.66- and 2.23-times higher risk of persistent AESIs. Individuals receiving the vaccine after COVID-19 were at 2.85- and 1.94 times higher risk of persistent AESIs compared, respectively, to individuals with no history of COVID-19 and individuals developing COVID-19 after the vaccine. Among participants receiving a booster dose of the COVID-19 vaccine (n = 185), 9.7% developed atypical adverse events of which urticaria and new-onset arthropathy were common. Conclusion: Nearly half of the ChAdOx1-nCoV-19 vaccine recipients developed COVID-19 over one year. Vigilance is warranted for AESIs such as musculoskeletal disorders. Females, individuals with hypothyroidism, diabetes, and pre-vaccination history of COVID-19 are at higher risk of adverse events. Vaccines received after natural SARS-CoV-2 infection may increase the risk of persistence of adverse events. Sex and endocrinal differences and timing of the COVID-19 vaccine with respect to natural infection should be explored as determinants of AESIs in the future. Pathogenetic mechanisms of vaccine-related adverse events should be investigated along with comparisons with an unvaccinated arm to delineate the overall safety profile of COVID-19 vaccines. © 2023, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Patterns, outcomes, and preventability of clinically manifest drug-drug interactions in older outpatients: a subgroup analysis from a 6-year-long observational study in North India
(Springer Science and Business Media Deutschland GmbH, 2025) Upinder Kaur; Jaideep Reddy; Noti Taruni Srija Reddy; Indrajeet Singh Gambhir; Ashish Kumar Yadav; Sankha Shubhra Chakrabarti
Older adults are vulnerable to adverse drug reactions (ADRs) and drug-drug interactions (DDIs). Evidence on clinically manifest DDIs in older outpatients is scanty. The present study aims to report clinically manifest DDIs, their risk factors, and preventive measures. A subgroup analysis of a 6-year (2015–2021) long prospective study was conducted in a tertiary hospital in North India. Older outpatients with ADRs constituted the study participants. Among 933 ADRs reported in 10,400 patient registrations, clinically manifest DDIs were involved in 199 (21.3%). DDIs accounted for 29.9%, 26.5%, and 21.3% of drug-related metabolic, vascular, and nervous system disorders, respectively. Movement disorders (n = 18), hypotension (n = 16), and hypoglycemia (n = 15) were the most common manifestations. Eighty-six percent of DDIs were of the pharmacodynamic type, and 13.1% were immune-mediated. Around 35% of DDIs resulted in hospitalization, with hyponatremia, movement disorder, and renal impairment as the common reasons. Older adults with Parkinsonism, infection, coronary artery disease, neuropsychiatric disease, and diabetes mellitus, respectively, had 3.28, 2.85, 1.97, 1.76, and 1.80 times higher odds of DDIs. Those receiving ≥ 10 drugs had 5.31 times higher odds of DDIs compared to individuals receiving 1–4 drugs. “Avoiding the causative drug,” “optimal monitoring of the patient,” and “start-low and go-slow” policy together could prevent 85% of DDIs. In conclusion, every fifth case of ADRs and nearly one third of ADR-related hospitalizations in older adults are related to DDIs. Movement disorder, hypotension, and hypoglycemia are the common manifestations. A holistic approach with drug omission, optimal patient monitoring, and slow titration of therapy can prevent significant DDIs in older adults. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
Persistent Health Issues, Adverse Events, and Effectiveness of Vaccines during the Second Wave of COVID-19: A Cohort Study from a Tertiary Hospital in North India
(MDPI, 2022) Upinder Kaur; Sapna Bala; Aditi Joshi; Noti Taruni Srija Reddy; Chetan Japur; Mayank Chauhan; Nikitha Pedapanga; Shubham Kumar; Anurup Mukherjee; Vaibhav Mishra; Dolly Talda; Rohit Singh; Rohit Kumar Gupta; Ashish Kumar Yadav; Poonam Jyoti Rana; Jyoti Srivastava; Shobha Bhat K; Anup Singh; G. Naveen Kumar P.; Manoj Pandey; Kishor Patwardhan; Sangeeta Kansal; Sankha Shubhra Chakrabarti
Background There is paucity of real-world data on COVID-19 vaccine effectiveness from cohort designs. Variable vaccine performance has been observed in test-negative case-control designs. There is also scarce real-world data of health issues in individuals receiving vaccines after prior COVID-19, and of adverse events of significant concern (AESCs) in the vaccinated. Methods: A cohort study was conducted from July 2021 to December 2021 in a tertiary hospital of North India. The primary outcome was vaccine effectiveness against COVID-19 during the second wave in India. Secondary outcomes were AESCs, and persistent health issues in those receiving COVID-19 vaccines. Regression analyses were performed to determine risk factors of COVID-19 outcomes and persistent health issues. Results: Of the 2760 health care workers included, 2544 had received COVID-19 vaccines, with COVISHIELD (rChAdOx1-nCoV-19 vaccine) received by 2476 (97.3%) and COVAXIN (inactivated SARS-CoV-2 vaccine) by 64 (2.5%). A total of 2691 HCWs were included in the vaccine effectiveness analysis, and 973 COVID-19 events were reported during the period of analysis. Maximum effectiveness of two doses of vaccine in preventing COVID-19 occurrence was 17% across three different strategies of analysis adopted for robustness of data. One-dose recipients were at 1.27-times increased risk of COVID-19. Prior SARS-CoV-2 infection was a strong independent protective factor against COVID-19 (aOR 0.66). Full vaccination reduced moderate–severe COVID-19 by 57%. Those with lung disease were at 2.54-times increased risk of moderate–severe COVID-19, independent of vaccination status. AESCs were observed in 33/2544 (1.3%) vaccinees, including one case each of myocarditis and severe hypersensitivity. Individuals with hypothyroidism were at 5-times higher risk and those receiving a vaccine after recovery from COVID-19 were at 3-times higher risk of persistent health issues. Conclusions: COVID-19 vaccination reduced COVID-19 severity but offered marginal protection against occurrence. The possible relationship of asthma and hypothyroidism with COVID-19 outcomes necessitates focused research. With independent protection of SARS-CoV-2 infection, and high-risk of persistent health issues in individuals receiving vaccine after recovery from SARS-CoV-2 infection, the recommendation of vaccinating those with prior SARS-CoV-2 infection needs reconsideration. © 2022 by the authors.
Platelet Hyperactivity in Patients of Vascular Dementia
(Springer Nature, 2025) Priya Dev; Mohammad Ekhlak; Ashish Kumar Yadav; Debabrata Dash; Abhishek Pathak
Platelet-monocyte (PMA) and platelet-neutrophil aggregations (PNA) are critical in causing acute inflammatory reactions favoring vascular dysfunction. However, the precise pathophysiological link between platelet-leukocyte aggregates and vascular dementia (VaD) remains undetermined. Our study aimed to investigate platelet hyperresponsiveness in patients of VaD. Vascular dementia was diagnosed based on the National Institute of Neurological Disorders and Stroke-Association Internationale pour la recherche et l’Enseignement en Neurosciences (NINDS AIREN) Criteria. All the patients were screened based on our pre-defined inclusion and exclusion criteria, and were enrolled in our study. Platelet from 19 VaD patients and 18 age-matched healthy controls were subjected to different investigations. PMA, PNA, P-selectin externalization, and intracellular free Ca+2 ([Ca+2i]) flux were evaluated either in whole blood or in platelet-rich plasma. The result revealed that PMA, PNA, P-selectin, and [Ca+2]i were found to be significantly outnumbered in the VaD group (4.1, 2.8, 2.7, and 2.5 times higher) compared to the control group with p-value < 0.001, < 0.001, < 0.001, and 0.001 at 95% CI = 31.164 to 54.855, 8.653 to 22.793, 35.064 to 94.369, and 8747.015 to 28,829.618, respectively. Patients with vascular dementia have increased platelet leucocyte interaction, and PMA has the most significant prediction of vascular dementia than in subjects of healthy control. Thus, platelets in VaD patients switch to a “hyperactive” phenotype. © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2025.
Polypyridyl CoII-Curcumin Complexes as Photoactivated Anticancer and Antibacterial Agents
(John Wiley and Sons Inc, 2023) Ashish Kumar Yadav; Virendra Singh; Rajesh Kushwaha; Dependu Dolui; Rohit Rai; Prodyut Dhar; Arnab Dutta; Biplob Koch; Samya Banerjee
Four new CoII complexes, [Co(bpy)2(acac)]Cl (1), [Co(phen)2(acac)]Cl (2), [Co(bpy)2(cur)]Cl (3), [Co(phen)2(cur)]Cl (4), where bpy=2,2’-bipyridine (1 and 3), phen=1,10-phenanthroline (2 and 4), acac=acetylacetonate (1 and 2), cur=curcumin monoanion (3 and 4) have been designed, synthesized and fully characterized. The X-ray crystal structures of 1 and 2 indicated that the CoN4O2 core has a distorted octahedral geometry. The photoactivity of these complexes was tuned by varying the π conjugation in the ligands. Curcumin complexes 3 and 4 had an intense absorption band near 435 nm, which made them useful as visible-light photodynamic therapy agents; they also showed fluorescence with λem≈565 nm. This fluorescence was useful for studying their intracellular uptake and localization in MCF-7 breast cancer cells. The acetylacetonate complexes (1 and 2) were used as control complexes to understand the role of curcumin. The white-light-triggered anticancer profiles of the cytosol targeting complexes 3 and 4 were investigated in detail. These non-dark toxic complexes displayed significant apoptotic photo-cytotoxicity (under visible light) against MCF-7 cells through ROS generation. The control complexes 1 and 2 did not induce significant cell death in the light or dark. Interestingly, 1-4 produced a remarkable antibacterial response upon light exposure. Overall, the reported results here can increase the boundary of the CoII-based anticancer and antibacterial drug development. © 2023 Wiley-VCH GmbH.
Prevalence and risk factors of hypertension with thyroid dysfunction among indian adults: Synthesis from national family health survey (2015-16)
(Wolters Kluwer Medknow Publications, 2023) Rekha Dutt; Kaushik Mukhopadhyay; Amandeep Kaur; Sharath Burugina Nagaraja; Ashish Kumar Yadav; Sonu Goel
Background: Thyroid dysfunction (TD) is considered a common cause of secondary hypertension (HT). Therefore, correcting TD may help in quicker and sustained achievement of desired blood pressure goals. However, there is a paucity of literature from India which estimates the relationship of HT with TD. Objectives: The objective of the study was to estimate the prevalence of TD with HT and to identify associated factors among Indian population. Materials and Methods: The survey data of the National Family Health Survey 4 (NFHS-4), conducted in India during 2015-2016, were analyzed using R statistical software for estimating the relationship between a history of HT and TD among women (N = 687246) aged 15-49 years and men (N = 108492) aged 15-54 years. Descriptive statistical tests and logistic regression were applied. Results: Among the persons suffering from the TD, the prevalence of HT was 32.8%, which was significantly higher than the prevalence of HT (21.9%) in euthyroid individuals. Further, the prevalence of TD was higher among hypertensive adults (2.5%) compared to nonhypertensive (1.5%). Conclusions: The study reported a higher prevalence of TD among the hypertensive persons and higher prevalence of HT among cases of TD. Therefore, screening for thyroid disorders should be routinely considered for better management of HT. © 2023 Indian Journal of Public Health.