Given the increasing anti-vaccine movements erroneously touting vaccine danger, this review has investigated the rare adverse events potentially associated with BNT162b2 (Pfizer-BioNTech), an mRNA vaccine against the severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2). Only real-world surveillance studies with at least 0.1 million BNT162b2-vaccinated participants and one unvaccinated control group were selected for review. A total of 21 studies examining the potential association of BNT162b2 with cardiovascular, herpetic, thrombotic or thrombocytopenic, neurological, mortality, and other miscellaneous rare adverse events were described in this review. Only myocarditis is consistently associated with BNT162b2. An unclear direction of association was seen with stroke (hemorrhagic and ischemic), herpes zoster, and paresthesia from BNT162b2, which may require more studies to resolve. Fortunately, most surveillance studies detected no increased risks of the remaining rare adverse events reviewed herein, further reassuring the safety of BNT162b2. In conclusion, this review has concisely summarized the current rare adverse events related and unrelated to BNT162b2, arguably for the first time in sufficient depth, to better communicate vaccine safety to the public.

Asthma is one of the most common chronic diseases in children and worldwide its prevalence has increased dramatically in the last three decades. We aimed to compare single dose oral dexamethasone versus multiple doses of oral prednisolone in children with acute exacerbation of asthma in terms of post treatment requirement of systemic steroids. This Randomized control trial has been conducted in the Department of paediatrics, KRL Hospital, Islamabad from Dec 2018 to June 2019.312 patients between the age of 2–12 years patients were randomized into Group A receiving a STAT single dose of oral dexamethasone 0.3 mg/kg and Group B receiving prednisolone 1 mg/kg/day followed by two doses on Day 2 and 3. further dose of systemic steroids were ascertained through PRAM score. In this study mean age in Group A was 8 years with SD ± 5.68 while mean age in Group B was 7 years with SD ± 6.12. In Group A 58% patients were male and 42% patients were female. Whereas in Group B 59% patients were male and 41% patients were female. In Group A 12% patients had further requirement of systemic steroids while in Group B 18% patients had further requirement of systemic steroids while 82% patients didn't had further requirement of systemic steroids. Our study concludes that post treatment requirement of systemic steroids is less in single dose oral dexamethasone as compare to multiple doses of oral prednisolone in children with acute exacerbation of asthma.

Introduction: Several drugs are in use for nebulization in children with acute bronchiolitis and no study has yet been conducted to compare the treatment outcome of nebulized ipratropium bromide and nebulized 3% hypertonic saline in Pakistan. Objective: The objective was to compare the treatment outcome of nebulized hypertonic saline and ipratropium bromide in children with acute bronchiolitis. Setting: Department of Pediatrics. Study duration: October 2019 to March 2020. Subjects and methods: A total of one hundred (n=100) children of either sex diagnosed with acute bronchiolitis were enrolled and randomized either to be nebulized with 3% hypertonic saline or ipratropium bromide. Outcomes were assessed in terms of respiratory rate, heart rate, and SpO₂ and respiratory distress assessment instrument score at different time intervals, length of hospital stay, and need of admission. Results: Respiratory rate and SPO₂ improved significantly at 60 min and 24 h, respiratory distress assessment instrument improved significantly at 30 min, 60 min, and 24 h after the treatment in patients who were nebulized with hypertonic saline when compared to those nebulized with ipratropium bromide. The length of hospital stay was significantly shorter (2.63 vs. 3.82 days, P=0.008) and a lesser number of patients needed hospital admission (22% vs. 44%, P=0.019) in patients who were nebulized with hypertonic saline when compared to those nebulized with ipratropium bromide. Conclusions: Nebulization with 3% hypertonic saline resulted in significant improvement in symptoms, a shorter duration of hospital stay, and a lesser number of hospital admissions as compared to nebulization with ipratropium bromide in children with acute bronchiolitis.

Type II Diabetes Mellitus (T2DM) is a high-risk metabolic condition associated with high mortality due to hyperglycemia. Many studies have focused on how inflammation, aging, or oxidative stress influences the pathogenesis of T2DM. The functional anomalies of the pancreatic beta cells attribute to insulin resistance which is the primary cause of T2DM manifestations and complications. This is evidenced in polymorphism in the TNF-α gene which inhibits insulin production, metabolism, and utilization during T2DM development. The dysregulation of insulin signaling involves multiple pathways. Various factors such as epigenetics, oxygen radicals, and glucolipotoxicity are implicated in the pathogenesis. Low-grade inflammation mediated by pro-inflammatory cytokines and chemokines such as interleukin-1 attack peripheral tissues and mediates the activation of critical pathways involved in T2DM pathogenesis via transcriptional factors. The core factor resulting in inflammation is hyperglycemia. The result is the release of inflammatory mediators which then affect neurons in the nervous system and alter microvascular and enzymatic pathways to elicit severe complications such as neuropathy. Oxidative stress and inflammation share an intertwined relationship in the pathogenesis of T2DM. High levels of reactive oxygen species increase the level of DNA damage markers and expose pancreatic beta-cell lines to dysregulation through reduced expression of the insulin gene. The link between the interaction of oxidative stress and inflation in the human body increases the level of interleukin-6 which triggers superoxide radicles and oxidative stressors increase which have been shown to affect free fatty acids metabolism inversely Finally, the aspect of cellular senescence in adipocytes and pancreatic beta cells explain why age is a critical factor in T2DM pathogenesis. Overall, the three factors discussed have a crucial role in T2DM disease states, progressions, and complications.

Background: Cardiometabolic diseases like type 2 diabetes, metabolic syndrome, heart failure, and other cardiovascular complications are the leading cause of mortality and morbidity across the globe. These conditions are directly attributed to modifiable behaviors such as sedentary activity, poor diet, excessive consumption of alcohol, or smoking. Efforts aimed towards their prevention and management are, therefore, not only essential in the accomplishment of the healthy populations but also for eliminating the associated cost and health burdens. Dietary change is an important approach to the promotion of cardiometabolic health. Omega 3 (C20–22 ω 3) polyunsaturated fatty acids have pleiotropic effects on the functioning of cells, control inflammatory factors, and cellular events in vascular endothelial cells and cardiomyocytes. The hypolipemic, anti-arrhythmic, and anti-inflammatory properties of fatty acids offer cardioprotection. Government agencies and national heart associations recommend increased consumption of omega 3 polyunsaturated fatty acids (PUFA) supplements and fish to prevent cardiometabolic diseases. Purpose of the Study: The purpose of this study is to investigate the role played by ω-3 and ω-6 polyunsaturated fatty acids in promoting cardiometabolic health. Methods: The research study searched databases such as MEDLINE®, Embase, PsycINFO, CINAHL® and the Cochrane Library for relevant research studies evaluating the function/benefits of polyunsaturated fatty acids particularly ω-3 and ω-6 polyunsaturated fatty acids in promoting cardiometabolic functions published between 2011 and 2020. A total of 77 research studies were identified and used in the meta-analysis. Results: Results from the meta-analysis indicated that polyunsaturated fatty acids lower the risk for cardiovascular disease by limiting inflammation of blood vessels, reducing thrombosis, increasing levels of high-density lipoproteins, reducing levels of low-density lipoproteins, and reducing risk factors associated with hypertension. Conclusion: Given the benefits of polyunsaturated fatty acids lower the risk for cardiovascular diseases indicted in the meta-analysis. Therefore, human diets must contain the required amounts of PUFA due to the associated benefits.