Computationally validated SARS-CoV-2 CTL and HTL Multi-Patch vaccines, designed by reverse epitomics approach, show potential to cover large ethnically distributed human population worldwide.

The SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) is responsible for the COVID-19 outbreak. The highly contagious COVID-19 disease has spread to 216 countries in less than six months. Though several vaccine candidates are being claimed, an effective vaccine is yet to come.

Prevalence of alcohol use and the interventions needed among adults: A community study in a rural area in South India.

Background: The health issues and social problems associated with alcohol use are well known. This study seeks to identify the prevalence of alcohol consumption and dependence among alcohol users in a rural area of Trivandrum district.

Objectives: To assess the prevalence of alcohol use among adults of Nellanad Panchayat, a rural area in Trivandrum, Kerala, to find out the interventions required among the alcohol users, and to identify persons with harmful and hazardous use of alcohol using AUDIT.

Voluntary perioperative colorectal cancer registry from Kerala-An initial overview.

Background: Although colorectal cancer (CRC) may not be uncommon in India, accurate data regarding its demographics and surgical outcomes is sparse.

Methods: With an aim to assess demographics and perioperative outcomes of CRC in Kerala, all members of Association of Surgical Gastroenterologists of Kerala (ASGK) were invited to participate in a registry. Data of operated cases of CRC were entered on a web-based questionnaire by participating members from January 2016.

A Case of Acute Esophageal Necrosis from Unruptured Thoracic Aortic Aneurysm.

Acute esophageal necrosis (AEN), also known as black esophagus due to its appearance on endoscopy, classically involves the distal esophagus (97% of cases). AEN affecting the midesophagus with sparing of the distal esophagus is rare and usually occurs in patients with thoracic aortic aneurysmal (TAA) rupture or aortic dissection. Herein, we report a unique case of AEN in the midesophagus in a patient with an unruptured and undissected TAA.

Perforated Jejunal Diverticulitis.

Small intestinal diverticula are very rare; their incidence ranges from 0.06 to 1.3%, with a higher prevalence after the 6th decade of life.

Rhabdomyolysis in a Young Patient due to Hypothyroidism without Any Precipitating Factor.

Hypothyroidism is characterized by decreased hormone production, which results in various clinical manifestations in different organ systems. Muscular symptoms are common in patents with clinical hypothyroidism which includes muscle cramps, myalgia, and mild to moderate elevation of creatinine kinase less than five times the upper limit of normal. However, rhabdomyolysis due to hypothyroidism is rare and in most of the reported cases a precipitating factor has been found.

Pancreatic Pseudoaneurysm from a Gastroduodenal Artery.

Pancreatic pseudoaneurysm is a rare vascular complication of pancreatitis, resulting from erosion of the pancreatic or peripancreatic artery into a pseudocyst. However, it may happen after pancreatic or gastric bypass surgery or trauma. It may lead to fatal complications if left untreated.

Cement pulmonary embolism after balloon kyphoplasty.

Osteoporotic vertebral fractures are common among the geriatric population and are managed by vertebral augmentation procedures. Pulmonary cement embolism is a relatively rare complication of these procedures and can range from mild, transient respiratory sequelae to a more severe pulmonary infarction. We discuss the case of a 75-year-old woman, identified with osteoporotic thoracolumbar vertebral fractures, found to have pulmonary cement embolism four days following multi-level balloon kyphoplasty.

Cohort profile: the Trivandrum non-alcoholic fatty liver disease (NAFLD) cohort.

Purpose: The Trivandrum non-alcoholic fatty liver disease (NAFLD) cohort is a population-based study designed to examine the interaction between genetic and lifestyle factors and their association with increased risk of NAFLD within the Indian population.

Participants: Between 2013 and 2016, a total of 2222 participants were recruited to this cohort through multistage cluster sampling across the whole population of Trivandrum-a district within the state of Kerala, South India. Data were collected from all inhabitants of randomly selected households over the age of 25.

Health-Related Quality of Life at 30 Days Among Indian Patients With Acute Myocardial Infarction.

Background: Despite a high cardiovascular disease burden, data on patient-reported health status outcomes among individuals with cardiovascular disease in India are limited.

Methods And Results: Between November 2014 and November 2016, we collected health-related quality of life data among 1261 participants in the ACS QUIK trial (Acute Coronary Syndrome Quality Improvement in Kerala). We used a translated, validated version of the Seattle Angina Questionnaire administered 30 days after discharge for acute myocardial infarction, wherein higher scores represent better health status.

INASL Guidelines on Management of Hepatitis B Virus Infection in Patients receiving Chemotherapy, Biologicals, Immunosupressants, or Corticosteroids.

Hepatitis B Virus (HBV) reactivation in patients receiving chemotherapy, biologicals, immunosupressants, or corticosteroids is emerging to be an important cause of morbidity and mortality in patients with current or prior exposure to HBV infection. These patients suffer a dual onslaught of illness: one from the primary disease for which they are receiving the culprit drug that led to HBV reactivation, and the other from HBV reactivation itself. The HBV reactivation not only leads to a compromised liver function, which may culminate into hepatic failure; it also adversely impacts the treatment outcome of the primary illness.

Severe de novo Ulcerative Colitis following Ixekizumab Therapy.

Ixekizumab is a selective monoclonal antibody targeting interleukin-17A, approved for the treatment of chronic plaque psoriasis. It has rarely been associated with inflammatory bowel disease (IBD) in randomized trials only. We report a unique case of severe new-onset ulcerative colitis in a young male complicated by cytomegalovirus infection who was on ixekizumab therapy for plaque psoriasis.

Interactive Lecture in the Dissection Hall: Transforming Passive Lecture into a Dynamic Learning Experience.

Traditionally, cadaver dissection and didactic lectures have formed the mainstay of teaching gross anatomy, but, apathy of the learners toward didactic lectures and reduction in the time allotted for teaching anatomy have necessitated adoption of interactive teaching methods that require lesser student contact time. In this study, for two consecutive years, first-year medical students were taught selected gross anatomy topics using Interactive Lecture in the Dissection Hall (ILDH). Instead of discarding the traditional methods, ILDH combined the two into a single, cohesive, interactive session, to teach the topic through multiple, short, segments of lecture alternating with interactive demonstration on the specimen.

Prospective Nonrandomized Comparative Study of Laparoscopic Versus Open Surgical Staging for Endometrial Cancer in India.

Laparoscopic procedures to treat endometrial cancer are currently emerging. At present, we have evidence to do laparoscopic oncologic resections for endometrial cancer as proven by many prospective studies from abroad such as LAP2 by GOG. So, we have decided to assess the safety and feasibility of such a study in our population with the following as our primary objectives: (1) to study whether laparoscopy is better compared to open approach in terms of duration of hospital stay, perioperative morbidity and early recovery from surgical trauma and (2) to study whether the laparoscopic approach is noninferior to the open approach in terms of number of lymph nodes harvested in lymphadenectomy and rate of conversion to open surgery.

Cardiovocal Syndrome: A rare cause of hoarseness in a patient with a history of pulmonary tuberculosis.

Hoarseness is a common clinical condition with underlying causes which can vary from reversible and benign to life-threatening and malignant. Cardiovocal syndrome may cause hoarseness secondary to left recurrent laryngeal nerve palsy when the recurrent laryngeal nerve is mechanically affected due to enlarged cardiovascular structures. We report a 28-year-old male who presented to the Government Medical College, Thiruvananthapuram, India, in 2013 with hoarseness.

Radiofrequency Ablation Followed by Percutaneous Ethanol Ablation Leading to Long-Term Remission of Hyperparathyroidism.

A 30-year-old male with cerebral palsy and motor impairment presented with right femur fracture. He had gradually worsening mobility and contractures of all extremities for the preceding 5 years. Evaluation showed multiple vertebral and femoral fractures, severe osteoporosis, a large parathyroid adenoma, and parathormone (PTH) exceeding 2500 pg/mL.