No abstract

Background and aims There is limited data available on longitudinal humoral antibody dynamics following two doses of ChAdOx1-nCOV (Covishield™) and BBV-152 (Covaxin™) vaccine against SARS-CoV-2 among Indians. Methods We conducted a 6-month longitudinal study in vaccinated healthcare workers by serially measuring quantitative anti-spike antibody at 3-weeks, 3-months and 6-months after the completion of second dose. Geometric mean titer (GMT) and linear mixed models were used to assess the dynamics of antibody levels at 6 months. Results Of the 481 participants, GMT of anti-spike antibody decreased by 56% at 6-months regardless of age, gender, blood group, body-mass index and comorbidities in 360 SARS-CoV-2 naive individuals but significantly more in hypertensives. Participants with past infection had significantly higher GMT at all time points compared to naive individuals. Among SARS-CoV-2 naive cohorts, a significantly higher GMT was noted amongst the Covishield recipients at all time points, but there was a 44% decline in GMT at 6-month compared to peak titer period. Decline in GMT was insignificant (8%) in Covaxin recipients at 6-month despite a lower GMT at all time points vs. Covishield. There was 5.6-fold decrease in seropositivity rate at 6-month with both vaccines. Participants with type 2 diabetes mellitus have a lower seropositivity rate at all the time points. While seropositivity rate was significantly higher with Covishield vs. Covaxin at all time points except at 6-month where Covaxin recipients had a higher seropositivity but no difference noted in propensity-matched analysis. Conclusions There is waning humoral antibody response following two doses of either vaccine at six months. Covishield recipients had a higher anti-spike antibody GMT compared with Covaxin at all-time points, however a significant decline in antibody titers was seen with Covishield but not with Covaxin at 6-months.

Background: As type 2 DM has posed challenging and formidable problem globally lots of scientific research work have been targeted and concepts are evolving every other day to unleash newer etiological factor in its causation and side by side risk factors so that proper aggressive strategy can be instituted to contain the disease at the very outset. Keeping these ideas in the back of our mind we embarked upon this small but compact path finding study. Methodology:The study conducted in the Dept. of Endocrinology, Medical College and Hospital, Kolkata. Patients suffering from Type-2 DM (diagnosed by ADA criterion) attending our diabetic clinic and diabetic patients admitted including the Dept. of Endocrinology and Internal Medicine were selected for this study. Study was conducted from March 2013 to December 2014. 276, Type-2 diabetic patients and 117 healthy control subjects among the relative of patients and volunteers were selected for this study to compare distribution of ABO blood groups. All the study subjects were selected by random sampling technique. ABO blood grouping (determined by using Tulip Diagnostic Kit). Screening of complications done by appropriate clinical examinations and laboratory investigations.Results: Total 276 patients with type 2 DM were included in this study. Of those 276 diabetic patients 152(55%) were male and 124(45%) were female. 117 healthy control subjects among the relative of patients and volunteers were selected for this study to compare distribution of ABO blood groups. Mean age of diabetic patient was 50.46(±10.38) and non-diabetic control subjects was 40.52(±12.21). Mean BMI was 24.18(±3.77) in diabetic subjects and was 25.40(±3.92) in control population. Chi-square statistical analysis among different blood groups between non-diabetic (n=111) and diabetic population (N=276) revealed no significant relationship of any blood group with type 2 DM (p˃0.05). But relative risk (RR) were calculated in reference to blood group O, it has been observed that slight increase of risk of developing type 2 DM among AB( RR 1.075), A(1.044) and B(1.033).With regards to distribution of patients (in number) with type 2 DM with different microvascular complications, Nephropathy was the most common complication observed among different blood groups (37.2% in B, 36.6% in O, 36.5% in A and 34.5% in AB).Further exploring the association between specific blood groups in type 2 diabetes subjects and microvascular complications, no significant association observed with type 2 DM and neuropathy, nephropathy and retinopathy (p˃0.05). However, taking blood group O as a reference group, Blood group AB (RR 0.583 and blood group A(RR0.698) were less likely to develop neuropathy compare to blood group O. However no difference in relative risk found for development of nephropathy and retinopathy. Conclusion:We found that person with O+ve blood group has least chance of developing Type 2 DM whereas subject with AB+ve blood group are more vulnerable to develop Type 2 DM. Therefore, the effects of blood group...

Background: The levothyroxine absorption test for evaluation of pseudomalabsorption in patients with primary hypothyroid is not standardised. An individual in whom a workup for malabsorption is warranted remains undefined. Methods: Twenty-five euthyroid, 25 newly diagnosed hypothyroid, 25 treated hypothyroid with normalised TSH, and 25 hypothyroid subjects with elevated TSH despite adequate dose of levothyroxine for more than 6 months, and 10 euthyroid subjects with true malabsorption were administered levothyroxine (10 μg/kg or maximum 600 μg) to study its absorption profile by measuring free T4 level at hourly intervals for 5 h. Results: Free T4 peaked at 3 h with marginal insignificant decline at 4 h in all groups. The increments of free T4 (between baseline and 3 h) of the four groups (except malabsorption) were not statistically different. The mean increment of free T4 in true malabsorption was 0.39 ng/dL (95% CI: 0.29–0.52) and it was 0.78 ng/dL (95% CI: 0.73–0.85) (10.4 pmol/L) for other groups combined together. The cut off of free T4 increment at 3 h from baseline above 0.40 ng/dL had a sensitivity of 97% and specificity of 80% (AUC 0.904, p < 0.001) to exclude true malabsorption. Conclusion: Subjects with elevated TSH on adequate dose of LT4 can be reliably diagnosed to be non-adherent to treatment with levothyroxine absorption test. The incremental value above 0.40 ng/dL (5.14 pmol/L) at 3 h may be useful to identify individuals where workup of malabsorption is unwarranted.

No abstract