The novel coronavirus and its emerging variants have continued to affect 50.4 million people worldwide, increasing the need for safe and effective vaccines. According to the World Health Organization guidelines, the efficacy of a vaccine should be at least 30% in all age groups and protect for a longer duration without any life-threatening adverse effects. At present, there are 319 vaccines in various stages of development, of which 16 are authorized for emergency use. Of these 16 vaccines, five vaccines are based on adenoviral vectors. This review is focused on understanding the safety and efficacy of the approved adenoviral vector vaccines for COVID-19, particularly highlighting the interim analysis of phase 3 clinical trials of AZD1222, Gam-Covid-Vac, Ad26.COV2.S, and AD5-nCOV vaccine. The efficacy of AZD1222, Gam-Covid-Vac, Ad26.COV2.S, and AD5-nCOV vaccine were found to be 70.4%, 95%, 66%, and 65.7%, respectively. Some serious adverse events such as deep vein thrombosis and thrombosis with thrombocytopenia syndrome were observed among AZD1222 and Ad26.COV2.S vaccinated individuals. Meanwhile, Gam-Covid-Vac and AD5- nCOV vaccines did not report any significant adverse events. In addition, we have also focused on the efficacy of these vaccines against SARS-CoV-2 variants such as B.1.1.7, B.1.351, and P.1. Although the efficacy of these approved vaccines against novel SARS-CoV-2 variants, pediatric and geriatric population and long-term efficacy remains uncertain, they are reasonably efficient in preventing mortality due to COVID-19.
Guillain-Barré syndrome (GBS) is an acute, inflammatory peripheral nerve disorder characterized by rapidly progressive, ascending, symmetrical paresthesia, and motor weakness. Some patients may develop respiratory failure requiring ventilation. The annual incidence of GBS is ~1.7 persons per 100,000 population. We describe the case of a 61-year-old male complaining of headache, one episode of vomiting, giddiness, slight slurring of speech, and inability to close his left eyelid. The patient received intravenous immunoglobulin therapy, with improvement in his symptoms at the time of discharge. In addition, we have also summarized 41 cases of GBS reported on post-COVID-19 vaccination. The intention of this case report is to highlight on the incidence of GBS in individuals who have received COVID-19 vaccine. Moreover, physicians should be aware of GBS in every patient presenting with neurological complaints on OPD.
Eucalyptus oil (EO) is an essential oil which has been used as a traditional remedy in upper respiratory tract infection. It contains approximately 90% cineole and is readily available worldwide in over-the-counter cough drops, liniments, toothpaste, mouthwashes, cold preparations, and hair lice remover. EO-induced adverse drug reaction is rare in both adults and children. The signs and symptoms of EO poisoning are CNS depression, hypotension, tachycardia, epigastric pain, nausea, vomiting, and contact dermatitis. Symptom onset is usually rapid and resolves within 24 h. We report the case series of four adult patients with EO-induced seizure in India, who inhaled EO for common cold and presented to the critical care with single first attack of generalized tonic-clonic seizures. On further evaluation, none of them had a family background of seizures/febrile seizures. EEG and brain MRI were found to be normal in all patients. All the patients were managed with anti-epileptic drugs and standard supportive care. All medical practitioners should be aware of the toxic effects of EO, a common OTC medication used in Indian households. Warning labels may be attached on EO comprised products.
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