The re-emerging monkeypox disease.

BACKGROUND: On 7th May 2022, human monkeypox was identified in the United Kingdom, a non-endemic zone, with subsequent multi-country outbreaks. About 6 weeks later, the European Centre for Disease Prevention and Control reported 1158 confirmed cases in non-endemic countries scattered within the European Economic Area (EEA), and a total of 1882 cases confirmed worldwide, inclusive of the EEA. These numbers are expected to increase with high alert and amplified surveillance established in non-endemic regions. In light of a looming epidemic, current understanding of the virus, and identification of gaps in the literature remain critical hence warranting a scoping review of available literature. METHODS: Literature searches were performed through PubMed, SCOPUS, ScienceDirect and Hinari to identify studies eligible for inclusion in accordance with PRISMA guidelines. RESULTS: Seventy-seven articles were included in the review. Majority of the cases were from the Central African clade (n = 29,905) versus the West African clade (n = 252). 6/16 articles that reported vaccination status stated that none of the cases were vaccinated. In the remaining articles, approximately 80%-96% cases were unvaccinated. It was noted that 4%-21% of the vaccinated individuals got infected. The secondary attack rate ranged from 0% to 10.2%, while the calculated pooled estimated case fatality rate was 8.7%. CONCLUSION: This scoping review provides an extensive look at our current understanding on monkeypox disease. Further studies are needed to better understand its risk factors, genetics and natural history, in order for public health strategists to generate prevention strategies and management decisions.

The prevalence of the Rouviere's sulcus: A meta-analysis with implications for laparoscopic cholecystectomy.

Rouvière's sulcus (RS) is increasingly being recognized as an important extra-biliary landmark during laparoscopic cholecystectomy (LC). The aim of this study was to conduct a systematic analysis of the prevalence and morphological types of RS. A systematic search was conducted through the major databases PubMed, ScienceDirect, Google Scholar, China National Knowledge Infrastructure (CNKI), SciELO, and the Cochrane Library to identify studies eligible for inclusion. The data were extracted and pooled into a random-effects meta-analysis using STATA software. The primary and secondary outcomes of the study were the pooled prevalence of RS and its morphological types, respectively. A total of 23 studies (n = 4,495 patients) were included. The overall pooled prevalence of RS was 83% (95% confidence interval [CI] [78, 87]). There were no significant differences in prevalence between cadaveric studies (82%, 95% CI [76, 87]) and laparoscopic studies (83%, 95% CI [77, 88]). The open RS constituted 66% (95% CI [61, 71]) of all cases, while the closed type was present in 34% (95% CI [29, 39]). RS is a relatively constant anatomical structure that can be reliably identified in most patients undergoing cholecystectomy. It can therefore be used as a fixed extra-biliary landmark for the appropriate site at which to start dissecting during LC to help prevent iatrogenic bile duct injury.

Prevalence of the Retro-Renal Colon: A Systematic Review and Meta-Analysis with Implications for Percutaneous Nephrolithotomy.

Background: This systematic review and meta-analysis aims to determine the prevalence of the retrorenal colon (RRC) and its implications in percutaneous nephrolithotomy with the overall objective of promoting the prevention of associated iatrogenic complications. Methods: A systematic search of literature was conducted on the electronic databases PubMed, ScienceDirect, and Hinari to identify studies eligible for inclusion. Search results were screened by title and abstract, and those potentially relevant were evaluated by full text. Studies were deemed eligible for inclusion if they reported clear extractable data regarding the prevalence of the retro-renal colon. A meta-analysis was completed using MetaX1 to calculate the pooled prevalence of the retro-renal colon. Sub-group analysis was performed based on geographical regions from which the studies originated, imaging modality, and patient position. Results: 174 records were screened and a total of 10 records included in the analysis with retrospective cohort studies being the most common study design. A male predominance was seen in most sample sizes that had reported data on gender demographics ranging from 41.5-62%. The most common imaging modality utilized was computerized tomography (CT) scan followed by ultrasound. The range of the unweighted prevalence of retro-renal colon across all studies that had absolute numbers reported was from 3.5-25%. One of the studies reported a colonic perforation rate of 0.3% in patients without CT images. Conclusion: The retro-renal colon is a relatively common finding with observed preponderance to females and left lateralization. The presence of RRC increases the likelihood of colon perforations while gaining percutaneous access to the kidney. Pre-procedural imaging can help detect its presence and choose an appropriate route of entry. USG and CT have both been found useful as a modality to pick up RRC.