Vaccine hesitancy for coronavirus SARS-CoV-2 in North India

With the roll-out of worlds largest vaccine drive for Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) by Government of India on January 16 2021, India has targeted to vaccinate its entire population by the end of year 2021. Struggling with vaccine procurement and production earlier, India came up with these hurdles but the Indian population still did not seem to be mobilizing swiftly towards vaccination centers. With the initial hesitancy, as soon as the vaccination started to speedup, India was hit severely by the second wave. The severe second wave has slowed down the vaccination pace and also it was one of the major contributing factor of vaccine hesitancy. To understand the nature of vaccine hesitancy and factors underlying it, we conducted an extensive online and offline surveys in Varanasi and adjoining regions using structured questions. Majority of respondents though were students (0.633), respondents from other occupations such as government officials (0.10) were also included in the study. We observed several intriguing opinions on our eleven questions. It is interesting to note that the majority of the people (0.75) relied on fake news and did not take COVID-19 seriously. Most importantly, we noticed that a substantial proportion of respondents (relative frequency 0.151; mean age 24.8 years) reported that they are still not interested in vaccination. People who have neither been vaccinated nor have ever been infected may become the medium for spreading the virus and creating new variants. This could also lead to a resistant variant of the vaccine in the future. We expect that this extensive survey may help the government to upgrade their vaccination policies for COVID-19 in North India.

The association of ABO blood group with the asymptomatic COVID-19 cases in India

The COVID-19 pandemic has resulted several waves of infection in many countries worldwide. The large variations in case fatality ratio among different geographical regions suggests that the human susceptibility against this virus varies substantially. Several studies from different parts of the world showed a significant association of ABO blood group and COVID-19 susceptibility. It was shown that individuals with blood group O are at the lower risk of coronavirus infection. To establish the association of ABO blood group in SARS-CoV-2 susceptibility, we for the first time analysed SARS-CoV-2 neutralising antibodies as well as blood groups among 509 random individuals from three major districts of Eastern Uttar Pradesh region of India.. Interestingly, we found neutralising antibodies in significantly higher percentage of people with blood group AB (0.36) followed by B (0.31), A (0.22) and lowest in people with blood group O (0.11). This indicates that people with blood group AB are at comparatively higher risk of infection than other blood groups. Further, in line to previous reports we too observed that people with blood group O have significantly decreased risk of SARS-CoV-2 infection. Thus, among the asymptomatic SARS-CoV-2 infected individuals with blood group AB has highest, whilst blood group O has lowest risk of infection.

Lichen amyloidosus: a study of clinical, histopathologic and immunofluorescence findings in 30 cases.

BACKGROUND: Lichen amyloidosus (LA) is a primary localized cutaneous amyloidosis characterized clinically by discrete hyperkeratotic hyperpigmented papules and histologically by deposition of amyloid material in previously normal skin without any evidence of visceral involvement. AIMS AND OBJECTIVES: The aim of this work was to study the etiology, clinical features, histopathology and direct immunofluorescence findings in LA. METHODS: A prospective study of 30 patients with clinical, histological and immunofluorescence findings suggestive of LA was undertaken. After a detailed history and clinical examination, two punch biopsies for histopathology and immunofluorescence were taken. RESULTS: Of the 30 patients, 19 (63.3%) were males and 11 (36.7%) were females with duration of LA ranging from 6-20 months. Pruritus was the presenting symptom in 27 (90%) patients. Shin was involved in 26 (86.7%) followed by arms in three (10%) and back in one (3.3%). Seventeen patients (56%) had used scrubs for more than 2 years. Histopathology, direct immunofluorescence and Congo red staining detected amyloid in all cases. CONCLUSIONS: LA commonly presents over the shins as pruritic discrete hyperpigmented papules. Familial predisposition and friction may have a pathogenic role. Histopathological examination is very useful in the detection of amyloid which may be supplemented with direct immunofluorescence and Congo red staining.

Clinical profile of forefoot eczema: a study of 42 cases.

BACKGROUND: Forefoot eczema (FE) is characterized by dry fissured dermatitis of the plantar surface of the feet. AIM: To study the clinical profile of FE and the possible etiological factors. METHODS: Forty-two patients with FE were included in the study. A detailed history was recorded and examination done. Fungal scrapings and patch test with Indian Standard Series (ISS) were performed in all patients. RESULTS: The most common site affected was the plantar surface of the great toe in 16 (38.09%) patients. Hand involvement, with fissuring and soreness of the fingertips and palm, was seen in four patients (9.5%). Seven patients (16.6%) had a personal history of atopy whereas family history of atopy was present in six (14.2%). Seven patients (16.6%) reported aggravation of itching with plastic, rubber or leather footwear, and 13 (30.9%), with detergents and prolonged contact with water. Negative fungal scrapings in all patients ruled out a dermatophyte infection. Patch testing with ISS was performed in 19 patients and was positive in five. CONCLUSIONS: FE is a distinctive dermatosis of the second and third decade, predominantly in females, with a multifactorial etiology, possible factors being chronic irritation, atopy, footwear and seasonal influence.

Extensive larva migrans.

Larva migrans is characterized by tortuous migratory lesions of the skin caused by larvae of nematodes. A 26-year-old fisherman presented to us with complaints of an itchy eruption on his back and arms of two months' duration. Clinical examination revealed multiple wavy serpentine tracts and fork like lesions with a raised absolute eosinophil count of 3800 cells/cmm. Biopsy was inconclusive. This case is reported to highlight the extensive involvement by larva migrans.