Long-term outcomes of titanium-nitride-oxide coated stents and drug-eluting stents in acute coronary syndrome: A systematic review and meta-analysis.

BACKGROUND: In severe cases of coronary artery disease, percutaneous coronary intervention provide promising results. The stent used could be a drug-eluting stent (DES) or a titanium-nitride-oxide coated stent (TiNOS). AIM: To compare the 5-year effectiveness and safety of the two stent types. METHODS: The following systematic review and meta-analysis was conducted in accordance with the preferred reporting items for systematic reviews and meta-analysis guidelines, and PubMed/MEDLINE, Scopus, and Cochrane Central were searched from inception till August 2023. Primary outcomes were major adverse cardiac events (MACE), cardiac death, myocardial infarction (MI), cardiac death or MI, and ischemia-driven total lesion revascularization (ID-TLR). RESULTS: Four randomized controlled trials (RCT), which analyzed a sum total of 3045 patients with acute coronary syndrome (ACS) after a median follow-up time of 5 years were included. Though statistically insignificant, an increase in the ID-TLR was observed in patients receiving TiNOSs vs DESs. In addition, MI, cardiac death and MI, and definite stent thrombosis (DST) were significantly decreased in the TiNOS arm. Baseline analysis revealed no significant results with meta-regression presenting non-ST elevated MI (NSTEMI) as a statistically significant covariate in the outcome of MACE. CONCLUSION: TiNOS was found to be superior to DES in terms of MI, cardiac death or MI, and DST outcomes, however, the effect of the two stent types on ID-TLR and MACE was not significant. A greater number of studies are required to establish an accurate comparison of patient outcomes in TiNOS and DES.

Toward a meta-vaccine future: Promoting vaccine confidence in the metaverse.

The metaverse has a promising role to serve as a global platform and tackle one of the most intractable public health challenges; vaccine hesitancy. Active efforts in this field can enhance vaccine acceptance thus leading to better community health protection. By embracing digital health innovations, the metaverse potentially creates an interactive environment for interdisciplinary collaborations that can foster novel approaches in tackling vaccine hesitancy as well as future pandemics. This paper aims to highlight the unique areas where the metaverse can enhance vaccination confidence, educate about vaccine working principles, and offer collaborative healthcare initiatives in this virtual community.

Infant & Child Mortality in Pakistan and its Determinants: A Review.

Over the years, several developing countries have been suffering from high infant and child mortality rates, however, according to the recent statistics, Pakistan falls high on the list. Our narrative review of copious research on this topic highlights that several factors, such as complications associated with premature births, high prevalence of birth defects, lack of vaccination, unsafe deliveries, poor breastfeeding practices, complications during delivery, sudden infant death syndrome (SIDS), poor socioeconomic conditions, and a struggling healthcare system, have influenced these rates. Bearing in mind the urgency of addressing the increased infant and child mortality rate in Pakistan, multiple steps must be taken in order to prevent unnecessary deaths. An effective initiative could be spreading awareness and education among women, as a lack of education among women has been indirectly linked to increased child mortality in Pakistan across many researches conducted on the issue. Furthermore, the government should invest in healthcare by hiring more physicians and providing better supplies and improving infrastructure, especially in underdeveloped areas, to decrease child mortality due to lack of clean water and poor hygiene. Lastly, telemedicine should be made common in order to provide easy access to women who cannot visit the hospital.

The Past, Present, and Future of Monkeypox: A Rapid Review Regarding Prevalence and Prevention.

While monkeypox virus (MPXV) remained endemic in central and western African countries, a sudden unusual spike of global cases among non-endemic countries is an enigma for scientists. With 257 cases reported as of 26th May 2021, a multi-country outbreak of monkeypox has been declared in countries including the UK, EU/EEA states, and North America. Even though the likelihood of transmissibility of MPXV is limited compared to COVID-19, yet a coordinated multidisciplinary effort is required to prevent any further global expansion. Few appropriate responsive approaches to contain the infection could be; limiting the contact with potential animal reservoirs, isolation of confirmed cases, using PPEs to prevent human-human transmission, awareness activities, and administration of pre and post prophylactic vaccination. In this review, we have discussed the previous and current outbreaks of MPXV along with the abrupt actions that are needed to address the situation.

The Cholera outbreak in Karachi, Pakistan: Challenges, efforts and recommendations.

Sindh Health Authorities have declared a new outbreak of cholera in Karachi, Pakistan after 129 lab-confirmed cases were reported from the Central, East, and South districts. With COVID-19 already having wreaked havoc on the country's health condition in the past years, any neglect in early preventative measures against this cholera outbreak implies progression to a perilous situation with millions of individuals at stake of acquiring the disease. Factors contributing to the occurrence of cholera outbreak include poor hygiene practices, overpopulation, increasing poverty and climate change. Appropriate responsive approaches by health authorities in cooperation with the World Health Organization (WHO) must be implemented to address the situation accordingly.

The effect of child malnourishment on measles spread amidst the COVID-19 pandemic in Afghanistan.

Child malnourishment is a long-lasting concern that Afghanistan has been facing for many years now. This major factor amongst countless others like growing socioeconomic disparity, ineffective healthcare due to lack of funding and political instability has caused increase in nutritional instability through Afghanistan. This has increased the likelihood of numerous malnourished children contracting deadly infectious diseases like measles. Despite receiving nutritional aid, vaccines (reduce measles spread) and funding from international organizations much of these efforts have fell short due to the political instability and lack of sustained support. Emergence of COVID-19 has further intensified the already existing challenges faced by vulnerable Afghan children. The pandemic has impeded with the eradication of measles and vaccine coverage as much of the funding and attention has shifted to containing COVID-19 spread posing a greater threat for malnourished children. The combined effect of both infections has exacerbated and increased mortality in malnourished children as rate of measle spread increases. Afghan healthcare systems are now struggling more as much of their efforts are ineffectual due to lack of facilities and resources.