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Article ; Online: SARS-CoV-2 variant biology and immune evasion.

Zaidi, Asiya Kamber / Singh, Rohan Bir

Progress in molecular biology and translational science

2024 Volume 202, Page(s) 45–66

Abstract: This chapter discusses the SARS-CoV-2 variants and their immune evasion strategies, shedding light on the dynamic nature of the COVID-19 pandemic. The ecological dynamics and viral evolution of SARS-CoV-2 are explored, considering carriers of infection, ... ...

Abstract	This chapter discusses the SARS-CoV-2 variants and their immune evasion strategies, shedding light on the dynamic nature of the COVID-19 pandemic. The ecological dynamics and viral evolution of SARS-CoV-2 are explored, considering carriers of infection, individual immunity profiles, and human movement as key factors in the emergence and dissemination of variants. The chapter discusses SARS-CoV-2 mutation, including mutation rate, substitution rate, and recombination, influencing genetic diversity and evolution. Transmission bottlenecks are highlighted as determinants of dominant variants during viral spread. The evolution phases of the pandemic are outlined, from limited early evolution to the emergence of notable changes like the D614G substitution and variants with heavy mutations. Variants of Concern (VOCs), including Alpha, Beta, Gamma, and the recent Omicron variant, are examined, with insights into inter-lineage and intra-lineage dynamics. The origin of VOCs and the Omicron variant is explored, alongside the role of the furin cleavage site (FCS) in variant emergence. The impact of structural and non-structural proteins on viral infectivity is assessed, as well as innate immunity evasion strategies employed by SARS-CoV-2 variants. The chapter concludes by considering future possibilities, including ongoing virus evolution, the need for surveillance, vaccine development, and public health measures.
MeSH term(s)	Humans ; SARS-CoV-2 ; COVID-19 ; Immune Evasion/genetics ; Pandemics ; Mutation/genetics ; Biology
Language	English
Publishing date	2024-01-04
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2471995-X
ISSN	1878-0814 ; 0079-6603 ; 1877-1173
ISSN (online)	1878-0814
ISSN	0079-6603 ; 1877-1173
DOI	10.1016/bs.pmbts.2023.11.007
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Article ; Online: Epidemiology of COVID-19.

Zaidi, Asiya Kamber / Singh, Rohan Bir

Progress in molecular biology and translational science

2024 Volume 202, Page(s) 25–38

Abstract: This chapter provides a detailed exploration of the epidemiology of COVID-19, focusing on several key aspects that offer valuable insights into the disease progression. A comprehensive comparison is made between the three related coronaviruses: SARS-CoV, ...

Abstract	This chapter provides a detailed exploration of the epidemiology of COVID-19, focusing on several key aspects that offer valuable insights into the disease progression. A comprehensive comparison is made between the three related coronaviruses: SARS-CoV, MERS-CoV, and SARS-CoV-2, elucidating their similarities and differences in terms of transmission dynamics, clinical presentation, laboratory and radiological findings, infection mechanisms, and mortality rates. The concept of herd immunity is then discussed, exploring its relevance and potential implications for controlling the spread of COVID-19. Next, the chapter delves into the changing epidemiology of the disease, examining how various factors such as human behavior, public health interventions, and viral mutations have influenced its transmission patterns and severity over time. Finally, the timelines and evolution of COVID-19 are outlined, tracing the origins of the virus, its rapid global spread, and the emergence of new variants.
MeSH term(s)	Humans ; COVID-19/epidemiology ; SARS-CoV-2 ; Middle East Respiratory Syndrome Coronavirus/genetics ; Public Health
Language	English
Publishing date	2024-01-04
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2471995-X
ISSN	1878-0814 ; 0079-6603 ; 1877-1173
ISSN (online)	1878-0814
ISSN	0079-6603 ; 1877-1173
DOI	10.1016/bs.pmbts.2023.09.002
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Article: Review of Baricitinib in the Treatment of Alopecia Areata.

Singh, Rohan / Driscoll, Marcia S

Journal of drugs in dermatology : JDD

2023 Volume 22, Issue 9, Page(s) 935–940

Abstract: Background: Alopecia areata (AA) is a debilitating autoimmune disease that results in non-scarring hair loss. Baricitinib is the Food and Drug Administration (FDA) approved treatment for AA. Objective: Review the mechanism of action, pharmacokinetics, ... ...

Abstract	Background: Alopecia areata (AA) is a debilitating autoimmune disease that results in non-scarring hair loss. Baricitinib is the Food and Drug Administration (FDA) approved treatment for AA. Objective: Review the mechanism of action, pharmacokinetics, pharmacodynamics, efficacy, and safety of baricitinib in the treatment of AA. Methods: A literature review was conducted using the MEDLINE (PubMed) and EMBASE databases for articles published between January 2010 to November 2022. Articles in English discussing baricitinib's efficacy and safety in AA, pharmacodynamic, and pharmacokinetic profiles were included. Results: Two identical phase III trials (BRAVE-AA1 and BRAVE-AA2) were evaluated. A greater percentage of subjects receiving baricitinib 4 mg or 2 mg dose achieved a Severity of Alopecia Tool score equal to or less than 20 vs placebo. In BRAVE-AA1, for 4 mg, 2 mg, and placebo, respectively, these values were 38.8%, 22.8%, and 6.2%; in BRAVE-AA2, these values were 35.9%, 19.4%, and 3.3% (P<0.001). Discussion: Baricitinib is the first FDA-approved treatment for AA. Other treatments for AA are used off-label with variable efficacy. Baricitinib is associated with black-box warnings due to adverse effects (AEs) associated with other Janus Kinase (JAK) inhibitors or use in other diseases. In the two large AA trials, AEs were considered mild or moderate; those reported more often with baricitinib than placebo included acne, elevations of low- and high-density lipoprotein cholesterol, and elevation of creatinine kinase. Baricitinib is a relatively tolerable and safe therapeutic alternative for severe AA, although additional study is needed to assess its long-term efficacy and safety. Citation: Singh R, Driscoll MS. Review of baricitinib in the treatment of alopecia areata. J Drugs Dermatol. 2023;22(9):935-939. doi:10.36849/JDD.7357.
MeSH term(s)	United States ; Humans ; Alopecia Areata/diagnosis ; Alopecia Areata/drug therapy ; Azetidines/adverse effects ; Purines/adverse effects ; Janus Kinase Inhibitors/adverse effects
Chemical Substances	baricitinib (ISP4442I3Y) ; Azetidines ; Purines ; Janus Kinase Inhibitors
Language	English
Publishing date	2023-09-08
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	2145090-0
ISSN	1545-9616
ISSN	1545-9616
DOI	10.36849/JDD.7357
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Article ; Online: Response to Comment on: Prevalence and Economic Burden of Keratoconus in the United States.

Singh, Rohan Bir / Parmar, Uday Pratap Singh / Jhanji, Vishal

American journal of ophthalmology

2024 Volume 260, Page(s) 213

MeSH term(s)	Humans ; United States/epidemiology ; Keratoconus/epidemiology ; Prevalence ; Financial Stress ; Cost of Illness
Language	English
Publishing date	2024-02-01
Publishing country	United States
Document type	Letter
ZDB-ID	80030-2
ISSN	1879-1891 ; 0002-9394
ISSN (online)	1879-1891
ISSN	0002-9394
DOI	10.1016/j.ajo.2024.01.028
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Article ; Online: Demographic Characteristics, Clinical Presentations, and Risk Factors Impacting Visual Outcomes in Peripheral Ulcerative Keratitis.

Singh, Rohan Bir / Atta, Sarah / Srikumaran, Divya / Jhanji, Vishal

Cornea

2024

Abstract: Purpose: To assess the demographic characteristics, ophthalmic and systemic presentations, and risk factors impacting the outcomes in patients diagnosed with peripheral ulcerative keratitis (PUK).: Methods: This retrospective study includes patients ... ...

Abstract	Purpose: To assess the demographic characteristics, ophthalmic and systemic presentations, and risk factors impacting the outcomes in patients diagnosed with peripheral ulcerative keratitis (PUK). Methods: This retrospective study includes patients diagnosed with PUK at a tertiary care center over 13 years. A descriptive analysis of the demographics, clinical history, and presentation was performed. A reverse risk analysis was performed to assess the PUK resolution in patients with underlying autoimmune and non-autoimmune etiologies. Finally, we evaluated the correlation between treatment duration and final best corrected visual acuity (BCVA) and continuous and categorical variables. Results: A total of 58 eyes of 51 patients with a mean age of 59.67 ± 13.41 years diagnosed with PUK were included in the study; 58.82% were female. The resolution duration was significantly shorter in patients with autoimmune etiologies (vs. non-autoimmune etiologies, P = 0.028) and female patients (vs. male patients, P = 0.008). The BCVA worsened in patients with non-autoimmune etiologies after treatment (P = 0.17). Despite worse BCVA at presentation in patients with underlying autoimmune etiologies, significantly better final vision outcomes were observed (P = 0.04). Linear regression analysis showed that longer treatment duration (P = 0.001; R2 = 0.1704) and worse vision (P = 0.002; R2 = 0.1502) at presentation were the primary risk factors of poor vision outcomes. Similarly, the treatment duration was significantly longer in male compared with female patients (P < 0.001; R2 = 0.2027). Conclusions: The clinical outcomes in PUK with underlying autoimmune disorders were observed to be better than non-autoimmune etiologies, which may be attributed to the early detection of the PUK-related changes and aggressive medical management. A delayed diagnosis of PUK leads to poor vision outcomes.
Language	English
Publishing date	2024-03-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	604826-2
ISSN	1536-4798 ; 0277-3740
ISSN (online)	1536-4798
ISSN	0277-3740
DOI	10.1097/ICO.0000000000003541
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Article ; Online: Refusal of Retreatment With Topical 5-Fluorouracil Among Patients With Actinic Keratosis: Qualitative Analysis.

Singh, Rohan / McCain, Sarah / Feldman, Steven R

JMIR dermatology

2023 Volume 6, Page(s) e39988

Abstract: Background: Actinic keratosis (AK) is a common premalignant skin lesion, and topical 5-fluorouracil (5-FU) is commonly used in field-directed therapy. However, 5-FU is associated with frequent local skin reactions.: Objective: This study aimed to ... ...

Abstract	Background: Actinic keratosis (AK) is a common premalignant skin lesion, and topical 5-fluorouracil (5-FU) is commonly used in field-directed therapy. However, 5-FU is associated with frequent local skin reactions. Objective: This study aimed to qualitatively assess experiences among patients with AK who refuse retreatment with 5-FU. Methods: Semistructured interviews were conducted with 10 adult participants who had received treatment with 5-FU for AK between January 1, 2017, and January 1, 2020, and refused future treatment with 5-FU. Results were analyzed using qualitative research methods. Results: Although most participants had low concern upon having received a diagnosis of AK, most felt that treatment is very important. When initiating treatment with 5-FU, most cited recommendation by their health care professionals as the primary motivator and initially had low concern regarding treatment. The side effects associated with treatment were physically and psychosocially burdensome for most participants and led to temporary lifestyle adjustments. After treatment, most did not believe that their health care provider prepared them for treatment or were unsure. While half of the participants felt that 5-FU helped treat AKs, half were either unsure, due to premature discontinuation, or did not think that 5-FU treated their AKs. Conclusions: 5-FU is one of the most commonly prescribed treatments for AKs, yet most patients experienced both a physical and psychosocial burden with the treatment. Inability to assess efficacy due to premature discontinuation secondary to 5-FU-related reactions is common, and shared decision-making, navigating treatment options, and taking into account patient preferences may be critical to help assure better adherence and outcomes. Although our study was limited by input from participants who refused future treatment with 5-FU, most stated that they would still continue to seek treatment for AKs in the future and would consider other topical treatments, especially if associated with a milder tolerability profile.
Language	English
Publishing date	2023-02-15
Publishing country	Canada
Document type	Journal Article
ISSN	2562-0959
ISSN (online)	2562-0959
DOI	10.2196/39988
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Article: Reasons for Patient Call-backs while being Treated with Topical 5-fluorouracil: A Retrospective Chart Review.

Singh, Rohan / Shah, Milaan A / Feldman, Steven R

The Journal of clinical and aesthetic dermatology

2023 Volume 16, Issue 6, Page(s) 53–54

Abstract: Objective: To assess the frequency and character of adverse events (AE) associated with 5-FU and compare rate of these events to topical tacrolimus, another irritating topical treatment, as a control.: Methods: Patients prescribed 5-FU for Actinic ... ...

Abstract	Objective: To assess the frequency and character of adverse events (AE) associated with 5-FU and compare rate of these events to topical tacrolimus, another irritating topical treatment, as a control. Methods: Patients prescribed 5-FU for Actinic keratosis (AK) between 1/2015 to 10/2021 were contacted via phone to assess frequency of AE and why they did or did not contact their dermatologist via retrospective chart review. A similar retrospective chart review was done for patients prescribed topical tacrolimus between 1/2015 to 10/2021. Results: Participants frequently reported AE with 5-FU treatment (58%), which most commonly included redness or inflammation (38%) and burning, stinging, or pain (27%). There were 33 call backs for 5-FU (37 distinct questions) and the most common reasons included issues obtaining the medication (n=12) and inquiries about severe LSR (n=11). There were two call backs for topical tacrolimus related to issues obtaining the medication. Limitations: Topical tacrolimus as a control helps address the lack of objective assessment of AE severity and potential recall bias limitations of the study methodology. Conlcusion: Participants in our cohort frequently reported AE, and those who reported AE often contacted their dermatologist. The irritation induced by 5-FU is of greater severity compared to topical tacrolimus, as evidenced by much greater call-back rate. Addressing the risks and benefits of 5-FU, severity of LSR, and use of alternative treatments may improve AK treatment outcomes.
Language	English
Publishing date	2023-06-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2571623-2
ISSN	1941-2789
ISSN	1941-2789
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Article: Shedding new light on actinic keratoses and squamous cell carcinoma in situ.

Khachemoune, Amor / Juan, Hui Yu / Singh, Rohan

JAAPA : official journal of the American Academy of Physician Assistants

2023 Volume 37, Issue 1, Page(s) 1–6

Abstract: Abstract: Cutaneous squamous cell carcinoma can arise from various premalignant lesions such as actinic keratosis, Bowen disease, and premalignant genital squamous cell lesions. Identification and treatment can prevent malignant transformation and death. ...

Abstract	Abstract: Cutaneous squamous cell carcinoma can arise from various premalignant lesions such as actinic keratosis, Bowen disease, and premalignant genital squamous cell lesions. Identification and treatment can prevent malignant transformation and death. This article describes the causes, epidemiology, and characteristics of suspicious premalignant squamous cell lesions so that clinicians can identify these lesions and refer patients for specialist treatment as appropriate.
MeSH term(s)	Humans ; Keratosis, Actinic/diagnosis ; Keratosis, Actinic/epidemiology ; Keratosis, Actinic/therapy ; Carcinoma, Squamous Cell/diagnosis ; Carcinoma, Squamous Cell/epidemiology ; Carcinoma, Squamous Cell/etiology ; Skin Neoplasms/diagnosis ; Skin Neoplasms/epidemiology ; Skin Neoplasms/etiology
Language	English
Publishing date	2023-12-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2415226-2
ISSN	0893-7400 ; 1547-1896
ISSN (online)	0893-7400
ISSN	1547-1896
DOI	10.1097/01.JAA.0000995696.23729.37
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Article ; Online: Prevalence and Economic Burden of Keratoconus in the United States.

Singh, Rohan Bir / Parmar, Uday Pratap Singh / Jhanji, Vishal

American journal of ophthalmology

2023 Volume 259, Page(s) 71–78

Abstract: Purpose: To assess the prevalence and economic burden of keratoconus in the United States.: Design: Retrospective cohort study.: Methods: Patients enrolled in Medicaid and Children's Health Insurance Program (CHIP) who were diagnosed with ... ...

Abstract	Purpose: To assess the prevalence and economic burden of keratoconus in the United States. Design: Retrospective cohort study. Methods: Patients enrolled in Medicaid and Children's Health Insurance Program (CHIP) who were diagnosed with keratoconus between 2016 and 2019 were included. The data reported to the Centers for Disease Control and Prevention (CDC) Vision and Eye Health Surveillance System (VEHSS) were analyzed. The crude prevalence rates (national and statewise) were obtained from the database and extrapolated to estimate the keratoconus case count in the United States. The keratoconus prevalence was compared between male and female individuals using the Mann-Whitney test, whereas Brown-Forsythe 1-way analysis of variance was used to compare prevalence between age and racial groups. The Dunnett T3 multiple comparison test was used for intergroup comparison. Finally, the economic burden of keratoconus was assessed by inflation-adjusted direct costs to patients and total cases in the country. Results: In the cohort of 69,502,000 patients enrolled for Medicaid and CHIP, the national prevalence of keratoconus was computed to be 0.04% in 2019 and had increased from 0.03% in 2016. The highest prevalence of keratoconus was observed in patients 18 to 39 years of age, followed by patients 40 to 64 years of age; comparable prevalence rates were observed in these age groups in the Black population. The prevalence was moderately higher in female compared to male individuals; however, significantly higher keratoconus prevalence was observed in Black female individuals compared to male individuals. A significantly high prevalence of keratoconus was observed in the Black population, followed by Hispanic population. In 2019, the average inflation-adjusted lifetime cost of keratoconus treatment was USD 28,766.69, with a cumulative economic burden of USD 3.8 billion. Conclusions: In the United States, keratoconus is most prevalent in individuals 18 to 39 years of age. The keratoconus prevalence is higher in the Black population, specifically female individuals, and the diagnosis is often delayed in these patients.
MeSH term(s)	Child ; Humans ; Male ; Female ; United States/epidemiology ; Adult ; Middle Aged ; Health Care Costs ; Keratoconus/diagnosis ; Keratoconus/epidemiology ; Cost of Illness ; Prevalence ; Retrospective Studies ; Financial Stress
Language	English
Publishing date	2023-11-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	80030-2
ISSN	1879-1891 ; 0002-9394
ISSN (online)	1879-1891
ISSN	0002-9394
DOI	10.1016/j.ajo.2023.11.009
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Article ; Online: Aggressive squamous cell carcinoma of lip in a village woman.

Singh, Rohan Kumar / Mishra, Gaurav Vedprakash

The Pan African medical journal

2021 Volume 39, Page(s) 224

Language	English
Publishing date	2021-08-02
Publishing country	Uganda
Document type	Journal Article
ZDB-ID	2514347-5
ISSN	1937-8688 ; 1937-8688
ISSN (online)	1937-8688
ISSN	1937-8688
DOI	10.11604/pamj.2021.39.224.30137
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