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1.
Heliyon ; 10(7): e28810, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38596114

RESUMEN

Hepatitis A Virus (HAV) is a significant threat in terms of food safety. A systematic literature search with the research question "What are the clinical outcomes of foodborne Hepatitis A virus infections?" was conducted. The pooled estimate of the outcomes-mortality, hospitalization, and severity rates, along with a 95% confidence interval (CI), was estimated. After screening, 33 studies were included for the data extraction and meta-analysis. The pooled prevalence of hospitalization among the HAV-positive patients was estimated to be 32% (95% CI 21-44), with high heterogeneity (I2 = 98%, p < 0.01). Australia had the highest hospitalization rate, with 82%, followed by Europe (42%). The hospitalization rate showed a significantly increasing trend (beta = 0.015, p=0.002) over the period. The pooled prevalence of mortality among the HAV-positive patients was estimated to be <1%, with low heterogeneity (I2 = 5%, p = 0.39). A wide range of food products were linked with the HAV outbreaks.

2.
J Clin Exp Hepatol ; 14(4): 101373, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38495461

RESUMEN

Background & aims: Frailty in patients with cirrhosis is associated with increased morbidity and mortality. In this study, we aimed to determine the prevalence of frailty and its impact on mortality and hospitalization in patients with cirrhosis. Methods: An elaborate search was undertaken in the databases "PubMed, Scopus, Web of Science, and Cochrane, and preprint servers", and an assessment of all published articles till 17 February 2023 was done. Studies that provided data on prevalence, mortality and hospitalization among frail patients with cirrhosis were included. The study characteristics and data on the prevalence, mortality, and hospitalization were extracted from included studies. The primary outcome was to estimate the pooled prevalence of frailty and determine its impact on mortality and hospitalization in patients with cirrhosis. Results: Overall, 12 studies were included. Data on prevalence of frailty and mortality were available in 11 studies, while seven studies reported data on hospitalization. The analysis conducted among 6126 patients with cirrhosis revealed pooled prevalence of frailty to be 32% (95% confidence interval [CI], 24-41). A total of 540 events of death revealed a pooled mortality rate of 29% (95% CI, 19-41). Six-month and twelve-month pooled estimates of mortality were found to be 24% (95% CI, 17-33) and 33% (95% CI, 23-45), respectively. The pooled hospitalization rate among the seven studies was 43% (95% CI, 21-68). Conclusion: The prevalence of frailty in patients with cirrhosis is high, leading to poor outcomes. Frailty assessment should become an integral part of cirrhosis evaluation. Registry and registration number of study: PROSPERO 2022 CRD42022377507.

3.
JMIR Form Res ; 8: e49964, 2024 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-38526538

RESUMEN

BACKGROUND: Medical students may increasingly use large language models (LLMs) in their learning. ChatGPT is an LLM at the forefront of this new development in medical education with the capacity to respond to multidisciplinary questions. OBJECTIVE: The aim of this study was to evaluate the ability of ChatGPT 3.5 to complete the Indian undergraduate medical examination in the subject of community medicine. We further compared ChatGPT scores with the scores obtained by the students. METHODS: The study was conducted at a publicly funded medical college in Hyderabad, India. The study was based on the internal assessment examination conducted in January 2023 for students in the Bachelor of Medicine and Bachelor of Surgery Final Year-Part I program; the examination of focus included 40 questions (divided between two papers) from the community medicine subject syllabus. Each paper had three sections with different weightage of marks for each section: section one had two long essay-type questions worth 15 marks each, section two had 8 short essay-type questions worth 5 marks each, and section three had 10 short-answer questions worth 3 marks each. The same questions were administered as prompts to ChatGPT 3.5 and the responses were recorded. Apart from scoring ChatGPT responses, two independent evaluators explored the responses to each question to further analyze their quality with regard to three subdomains: relevancy, coherence, and completeness. Each question was scored in these subdomains on a Likert scale of 1-5. The average of the two evaluators was taken as the subdomain score of the question. The proportion of questions with a score 50% of the maximum score (5) in each subdomain was calculated. RESULTS: ChatGPT 3.5 scored 72.3% on paper 1 and 61% on paper 2. The mean score of the 94 students was 43% on paper 1 and 45% on paper 2. The responses of ChatGPT 3.5 were also rated to be satisfactorily relevant, coherent, and complete for most of the questions (>80%). CONCLUSIONS: ChatGPT 3.5 appears to have substantial and sufficient knowledge to understand and answer the Indian medical undergraduate examination in the subject of community medicine. ChatGPT may be introduced to students to enable the self-directed learning of community medicine in pilot mode. However, faculty oversight will be required as ChatGPT is still in the initial stages of development, and thus its potential and reliability of medical content from the Indian context need to be further explored comprehensively.

4.
Egypt Heart J ; 76(1): 29, 2024 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-38409614

RESUMEN

BACKGROUND: The association of homocysteine with coronary artery disease (CAD) has been explored previously with mixed findings. The present Systematic Review and Meta-Analysis (SRMA) has assessed the pooled estimate of association between homocysteine (Hcy) and CAD, and its variation over the period and geography. METHODS: Systematic literature search was done in PubMed, Scopus and Cochrane to identify the observational studies that have reported mean Hcy among cases (CAD) and control. The SRMA was registered in PROSPERO (ID-CRD42023387675). RESULTS: Pooled standardized mean difference (SMD) of Hcy levels between the cases and controls was 0.73 (95% CI 0.55-0.91) from 59 studies. Heterogeneity was high (I2 94%). The highest SMD was found among the Asian studies (0.85 [95% CI 0.60-1.10]), while the European studies reported the lowest SMD between the cases and controls (0.32 [95% CI 0.18-0.46]). Meta-regression revealed that the strength of association was increasing over the years (Beta = 0.0227, p = 0.048). CONCLUSIONS: Higher homocysteine levels might have a significant association with coronary artery diseases, but the certainty of evidence was rated low, owing to the observational nature of the studies, high heterogeneity, and publication bias. Within the population groups, Asian and African populations showed a greater strength of association than their European and American counterparts, and it also increased over the years.

5.
Curr Probl Cardiol ; 49(2): 102153, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37979897

RESUMEN

BACKGROUND: Cardiovascular diseases (CVD), notably coronary artery disease (CAD) and coronary heart disease (CHD), are predominant contributors to global morbidity and mortality. Financial stress is recognized as a non-traditional risk factor for CVD. The objective of this study is to conduct a systematic review and meta-analysis on the association between financial stress and the incidence of major cardiac outcomes. METHODS: A literature search was conducted across multiple databases up until September 20, 2023. Primary studies reporting the association between financial stress and the incidence of CAD, CHD, or major cardiovascular outcomes were included. The quality of the incorporated studies was evaluated using the Newcastle-Ottawa Scale. Statistical analysis was performed using R version 4.3, employing a random-effects model. RESULTS: Out of 2,740 identified studies, seven satisfied the inclusion criteria, displaying a diverse range in design, settings, and participant demographics. A significant association was found between financial stress and major cardiac outcomes, with a combined hazard ratio (HR) of 1.191 (95% CI: 1.00 to 1.47), p<0.001 from five studies. Possible publication bias and variations in definitions and measurements of financial stress were noted among the studies. CONCLUSION: The available literature substantiates an association between financial stress and the incidence of CAD/CHD or major cardiac outcomes, underscoring an urgent need for standardized definitions and measurements of financial stress. Our findings support the integration of financial stress assessments in patient care and the development of health policies emphasizing economic strains to enhance cardiovascular health outcomes and overall well-being.


Asunto(s)
Enfermedades Cardiovasculares , Enfermedad de la Arteria Coronaria , Humanos , Estrés Financiero , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedad de la Arteria Coronaria/epidemiología , Factores de Riesgo , Incidencia
6.
Front Public Health ; 11: 1278343, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38094233

RESUMEN

Background: A pooled estimate of stunting prevalence in refugee and internally displaced under-five children can help quantify the problem and focus on the nutritional needs of these marginalized groups. We aimed to assess the pooled prevalence of stunting in refugees and internally displaced under-five children from different parts of the globe. Methods: In this systematic review and meta-analysis, seven databases (Cochrane, EBSCOHost, EMBASE, ProQuest, PubMed, Scopus, and Web of Science) along with "preprint servers" were searched systematically from the earliest available date to 14 February 2023. Refugee and internally displaced (IDP) under-five children were included, and study quality was assessed using "National Heart, Lung, and Blood Institute (NHLBI)" tools. Results: A total of 776 abstracts (PubMed = 208, Scopus = 192, Cochrane = 1, Web of Science = 27, Embase = 8, EBSCOHost = 123, ProQuest = 5, Google Scholar = 209, and Preprints = 3) were retrieved, duplicates removed, and screened, among which 30 studies were found eligible for qualitative and quantitative synthesis. The pooled prevalence of stunting was 26% [95% confidence interval (CI): 21-31]. Heterogeneity was high (I2 = 99%, p < 0.01). A subgroup analysis of the type of study subjects revealed a pooled stunting prevalence of 37% (95% CI: 23-53) in internally displaced populations and 22% (95% CI: 18-28) among refugee children. Based on geographical distribution, the stunting was 32% (95% CI: 24-40) in the African region, 34% (95% CI: 24-46) in the South-East Asian region, and 14% (95% CI: 11-19) in Eastern Mediterranean region. Conclusion: The stunting rate is more in the internally displaced population than the refugee population and more in the South-East Asian and African regions. Our recommendation is to conduct further research to evaluate the determinants of undernutrition among under-five children of refugees and internally displaced populations from different regions so that international organizations and responsible stakeholders of that region can take effective remedial actions. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=387156, PROSPERO [CRD42023387156].


Asunto(s)
Desnutrición , Refugiados , Niño , Humanos , Prevalencia , Bibliometría , Trastornos del Crecimiento/epidemiología
8.
J Rural Med ; 18(4): 215-221, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37854511

RESUMEN

Objective: Human Immunodeficiency Virus (HIV) Key Populations (KPs) include Female Sex Workers (FSWs), men who have sex with men (MSM), transgender (TG), and transsexual (TS) persons. This study assessed coronavirus disease 2019 (COVID-19) vaccine uptake among KPs for HIV in India, adverse events following immunization (AEFI), and breakthrough infections among the vaccinated. Materials and Methods: This retrospective cohort study was conducted among 421 KPs enrolled in 41 Targeted Intervention (TI) clusters in 31 districts of the Tamil Nadu State Acquired Immunodeficiency Syndrome (AIDS) Control Society (TANSACS), India, from June to September 2022. A semi-structured, bilingual (English and Tamil), interviewer-administered questionnaire was used to collect data on socio-demographic characteristics, vaccination status, AEFIs, and breakthrough infections among the KPs under the TIs. Results: Among the KPs, 45.4% were FSWs, 37.1% were MSM, 16.2% were TG, and 1.4% were TS persons. Among them, 4.3% had HIV, and 2.9% had syphilis or other sexually transmitted infections (STIs). The COVID-19 vaccine uptake rate was 96%. Among the KPs, TG/TS persons had the highest vaccine uptake (98.6%), followed by FSWs (96.3%) and MSM (94.2%). AEFIs were reported by 85.4% of the participants. HIV positive status was significantly associated with the incidence of AEFI. The breakthrough infection rate was 5.4% among the vaccinated participants. Conclusion: The COVID-19 vaccine uptake among HIV KPs was high in Tamil Nadu. AEFIs and breakthrough infections among COVID-19 vaccinated HIV KPs may be low, with mild AEFIs.

9.
Epidemiologia (Basel) ; 4(3): 352-369, 2023 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-37754280

RESUMEN

This index meta-analysis estimated the pooled prevalence of human immunodeficiency virus (HIV) among individuals with monkeypox (mpox) globally. We searched seven databases: PubMed, Scopus, Web of Science, EMBASE, ProQuest, EBSCOHost, and Cochrane, for human studies published in English till 4 January 2023, as per International Prospective Register of Systematic Reviews (PROSPERO) registration protocol (CRD42022383275). A random effects regression model was used to estimate the pooled prevalence owing to high heterogeneity. The risk of bias in the included studies was assessed using the National Heart, Lung, and Blood Institute (NHLBI) quality assessment tool. The systematic search yielded 677 articles; finally, 32 studies were found eligible for systematic review and 29 studies for meta-analysis. The pooled prevalence of HIV infection was 41% (95% confidence interval [CI], 35-48). All studies were rated as fair or good quality. Studies from Europe and North America reported a high prevalence of HIV infection among individuals with mpox- 41% (95% CI 33-49) and 52% (95% CI 28-76), respectively, while studies from Nigeria, Africa reported a relatively low prevalence of HIV infection of 21% (95% CI 15-26). A history of sexual orientation and sexual partners in the last 21 days must be taken from individuals with mpox to identify the potential source and contacts for quarantining and testing them.

10.
Rev Med Virol ; 33(5): e2472, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37529964

RESUMEN

Monkeypox (mpox) is a significant health concern affecting children and adolescents globally. This systematic review and meta-analysis aims to synthesise the available evidence on the proportion of children and adolescents affected by the mpox virus. A comprehensive search was conducted in seven electronic databases (PubMed, Scopus, Web of Science, EMBASE, ProQuest, EBSCOHost, and Cochrane) to identify the original reports on mpox cases in children and adolescents till 15 January 2023. Descriptive reports on probable or laboratory-confirmed mpox in children and adolescents (0-17 years old) were considered eligible. Studies not providing separate data for the above age group and case-control studies were excluded. The primary outcome was pooled proportion of mpox cases among children and adolescents. Proportion meta-analysis and heterogeneity between studies were determined using a restricted maximum likelihood estimator, and a random-effects model was fitted to the data. Sensitivity analysis and subgroup analysis were also conducted. A drapery plot was also provided as a complementary figure to the forest plot. The protocol was prospectively registered with PROSPERO (CRD42023392475). A total of 440 studies were identified, of which 37 were included in the review and 25 in the meta-analysis (62,701 participants with 3306 children and adolescents). The pooled proportion of children and adolescents was 0.46 (95% CI: 0.30-0.63, I2 :100%). The proportion of children and adolescents was significantly lower (p < 0.001) in the ongoing pandemic 0.04 (95% CI: 0.00-0.32) than before 2022 0.62 (95% CI: 0.49-0.74). The meta-regression showed that the higher the study's sample size, the lower the proportion of children among the mpox cases. Both overall and subgroup heterogeneity were high. Adolescents and children below 5 years are commonly affected by the ongoing pandemic. In conclusion, the high proportion of children affected by the mpox virus highlights the need for increased research and targeted interventions to prevent and control the spread of the virus in this population.


Asunto(s)
Mpox , Niño , Adolescente , Humanos , Recién Nacido , Lactante , Preescolar , Estudios de Casos y Controles
11.
Travel Med Infect Dis ; 55: 102633, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37604305

RESUMEN

OBJECTIVE: To estimate the global burden of stillbirths among pregnant women with the COVID-19 vaccination. DATA SOURCE: In this systematic review and meta-analysis, a literature search was carried out in PubMed, Cochrane and Scopus until February 4, 2023, with language restriction (English). STUDY SELECTION: Title-abstract screening followed by full text review was done independently by two authors, based on the research question, "What is the prevalence of stillbirths among the pregnant women vaccinated with COVID-19 vaccines?" DATA EXTRACTION: Two authors independently extracted the relevant data from every study. The third author resolved the conflicts. This study was registered in PROSPERO and followed the PRISMA guidelines. DATA ANALYSIS: A Random effects model was applied to assess the pooled estimate of stillbirths. The I2 test was used to assess the heterogeneity of the articles included in the study. For checking the publication bias, the Doi plot and the contour-enhanced funnel plot were utilized. RESULTS: The database systematic search yielded 168 articles; 11 of them were determined to be eligible for systematic review and 8 of them ended up being included for meta-analysis. The pooled prevalence of stillbirth in pregnant women vaccinated against COVID-19 infection was 0.00509 (5 per 1000 live births delivered by pregnant women vaccinated against COVID-19 (95% CI: 0.00003-0.01676). Statistically significant heterogeneity was reported across studies (I2 = 98%; p < 0.01). CONCLUSIONS: The study concluded that vaccination against COVID-19 among pregnant women had a low stillbirth rate. It adds to the existing evidence that the COVID-19 vaccine is safe and can be taken during pregnancy.

13.
Asian J Psychiatr ; 86: 103661, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37321152

RESUMEN

BACKGROUND: Suicidal behaviour (SB) in adolescents is an emerging public health issue globally. The present study was undertaken to estimate the overall prevalence of SB among the adolescents (10-19 years of age) in India. DATA SOURCES: In this systematic review and meta-analysis (SRMA), an extensive literature search in PubMed, Scopus, EBSCO, Web of Science, ProQuest, Embase, Cochrane, and preprint servers (medRxiv, arXiv, bioRxiv, BioRN, ChiRxiv, ChiRN, and SSRN) and assessment of all published articles until 28th February 2023 as per the PROSPERO registration protocol (CRD42023385550), was undertaken. STUDY SELECTION, DATA EXTRACTION, AND SYNTHESIS: Studies from India which reported the prevalence of suicidal ideation, suicide attempt, and suicidal plan were included. The quality of the included studies was assessed by risk of bias assessment tool. R version 4.2 was used to conduct all the relevant analyses. Heterogeneity was assessed, and a random effects model for estimating the pooled prevalence of the outcomes was applied. Subgroup analyses were planned based on region, locality (urban/rural) and the study settings (educational institutions/community-based). A meta-regression to analyze the effects of potential moderators on outcomes was done. Sensitivity analyses were planned based on the removal of outliers and poor-quality studies. Publication bias was tested by Doi plot and LFK index. MAIN OUTCOMES: Pooled prevalence of suicide attempts, suicide ideations and suicide plans RESULTS: A total of 20 studies were identified as eligible for the systematic review, and 19 studies were identified as eligible for the meta-analysis. The pooled prevalence of suicidal ideation was estimated to be 11% (95 % CI 7-15); heterogeneity between the studies was high (I2 98 %, p < 0.01). The pooled prevalence of suicidal attempts and suicidal plan was estimated to be 3 % each (95 % CI 2-5); with heterogeneity being high (I2 96 %, p < 0.01). Subgroup analysis revealed a significant variation in suicidal ideation and attempts between different regions of India (South > East > North), and higher prevalence among the educational-institute-based settings and urban areas. CONCLUSION: Overall, the prevalence of suicidal behavior among the adolescents in India is high, and they experience all types of suicidal behavior (ideations, plans and attempts).


Asunto(s)
Ideación Suicida , Intento de Suicidio , Humanos , Adolescente , Prevalencia , Investigación Cualitativa , Bibliometría
14.
Int J Public Health ; 68: 1605654, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37350797

RESUMEN

Objectives: The study aims to examine the coexisting forms, patterns, and predictors of concurrent wasting and stunting (WaSt) among children under five in India. Methods: We used data from the National Family Health Survey to understand the trend and association of WaSt among children under five-year-old in India. Univariate analysis and cross-tabulations were performed for WaSt cases. The association was determined using multilevel binary logistic regression and multilevel regression, and the results were provided as adjusted odds ratios (aOR) with 95% confidence intervals at the significance level of p < 0.05. Results: The prevalence of WaSt has decreased from 8.7% in 2005-06 to 5.2 percent in 2019-2020. The proportion of WaSt children grew rapidly from 6 to 18 months, peaked at 19 months (8%), then dropped after 24 months. The prevalence of concurrent wasting and stunting is higher among boys compared to girls. Compared to children of different birth orders, those in the higher birth order are 1.2 times more likely to be WaSt cases (aOR = 1.20, 95% CI = 1.09, 1.33). The education of the mother is strongly correlated with WaSt instances, and children of more educated mothers have a 47% lower chance of being WaSt cases (aOR = 0.63, 95% CI = 0.57, 0.71). Children from wealthy families are 52% less likely to be WaSt cases (aOR = 0.48, 95% CI = 0.43, 0.55). Conclusion: This study emphasizes the importance of concurrent wasting and stunting and its relationship with socioeconomic factors among children under five in India.


Asunto(s)
Desnutrición , Madres , Masculino , Femenino , Humanos , Niño , Lactante , Preescolar , Análisis Multinivel , Trastornos del Crecimiento/epidemiología , Prevalencia , India/epidemiología , Desnutrición/epidemiología
16.
Indian Heart J ; 75(2): 139-144, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36863611

RESUMEN

BACKGROUND: Vaccines against the COVID-19 pandemic were introduced in late 2020. The present study has been conducted to study the serious Adverse Events Following Immunization (AEFIs) reported for COVID-19 vaccines from India. METHODS: Secondary data analysis of the causality assessment reports for the 1112 serious AEFIs published by the Ministry of Health & Family Welfare, Government of India, was conducted. For the current analysis, all the reports published till 29.03.2022 were included. The primary outcome variables analyzed were the consistent causal association and the thromboembolic events. RESULTS: The majority of the serious AEFIs assessed were either coincidental (578, 52%) or vaccine product related (218, 19.6%). All the serious AEFIs were reported among the Covishield (992, 89.2%) and COVAXIN (120, 10.8%) vaccines. Among these, 401 (36.1%) were deaths, and 711 (63.9%) were hospitalized and recovered. On adjusted analysis, females, the younger age group and non-fatal AEFIs showed a statistically significant consistent causal association with COVID-19 vaccination. Thromboembolic events were reported among 209 (18.8%) of the analyzed participants, with a significant association with higher age and case fatality rate. CONCLUSION: Deaths reported under serious AEFIs were found to have a relatively lower consistent causal relationship with the COVID-19 vaccines than the recovered hospitalizations in India. No consistent causal association was found between the thromboembolic events and the type of COVID-19 vaccine administered in India.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Inmunización , Femenino , Humanos , Sistemas de Registro de Reacción Adversa a Medicamentos , ChAdOx1 nCoV-19 , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Inmunización/efectos adversos , India/epidemiología , Pandemias , Vacunación/efectos adversos , Vacunas/efectos adversos
17.
Front Public Health ; 11: 1118685, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36992884

RESUMEN

Background: Due to the COVID-19 pandemic, physical meetings and continuing medical education (CMEs) are being conducted in virtual mode. Digital sobriety has been advocated as a strategy for controlling the environmental emission from online events. The present study was undertaken to assess the impact of virtual CMEs on the environment and the participants' perception, knowledge, attitude, and practices of digital sobriety during the CMEs. Methods: A retrospective cross-sectional Google form-based online study was conducted among the 1,311 registrants of 23 virtual CMEs hosted in India. A pre-tested English questionnaire was used to collect the data. The potential carbon footprint of the significant physical CME activities and the carbon emission (CE) of the virtual CMEs were estimated. Among the registrants contacted, 251 consented and participated in the study. Results: The CE of the virtual CMEs was 0.787 metric tons of carbon dioxide equivalent (MT CO2 Eq). If the CMEs were conducted physically, the potential CE was estimated to be 290.094 MT CO2 Eq. The awareness rate of digital sobriety was 35%. Most of the participants (58.7%) from the current study preferred the hybrid mode of CMEs. Conclusions: Virtual, digitally sober CMEs have reduced the potential CE by 99.7% compared to physical CMEs in India. The awareness and knowledge about digital sobriety is low in India. Knowledge, networking, social interactions, and overall satisfaction were relatively lower in the virtual mode of CMEs than in the physical mode.


Asunto(s)
COVID-19 , Educación Médica Continua , Humanos , Estudios Transversales , COVID-19/prevención & control , Huella de Carbono , Pandemias , Dióxido de Carbono , Salud Pública , Estudios Retrospectivos
18.
Pathogens ; 12(3)2023 Mar 14.
Artículo en Inglés | MEDLINE | ID: mdl-36986374

RESUMEN

BACKGROUND: The accurate estimation of the prevalence of mpox-induced ophthalmic lesions will enable health departments to allocate resources more effectively during the ongoing mpox pandemic. The aim of this meta-analysis was to estimate the global prevalence of ophthalmic manifestations in mpox patients. METHODS: A systematic search was carried out in seven databases-Pub Med, Scopus, Web of Science, EMBASE, ProQuest, EBSCOHost, and Cochrane-for studies published on or before 12 December 2022. The pooled prevalence of ophthalmic manifestations was estimated by the random effects model. Risk of bias assessment of the studies and sub-group analysis to explain heterogeneity were undertaken. RESULTS: Overall, 12 studies were included, with 3239 confirmed mpox cases, among which 755 patients reported ophthalmic manifestations. The pooled prevalence of ophthalmic manifestations was 9% (95% confidence interval (CI), 3-24). Studies from Europe reported a very low prevalence of ocular manifestations of 0.98% (95% CI 0.14-2.31), compared to studies from Africa with a substantially higher prevalence of 27.22% (95% CI 13.69-43.26). CONCLUSIONS: A wide variation in the prevalence of ocular manifestations among mpox patients was observed globally. Healthcare workers involved in mpox-endemic African countries should be aware of ocular manifestations for early detection and management.

19.
J Rural Med ; 17(4): 228-235, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36397796

RESUMEN

Objectives: The most commonly used vaccine in India, Covishield, is a recombinant adenovirus vector vaccine for which safety data in pregnant women are not available. The present study was conducted to assess the uptake of COVID-19 vaccines and monitor adverse events following COVID-19 immunization among pregnant women in northern India. Patients and Methods: A prospective cohort study was conducted among pregnant women registered with the antenatal clinics in Chandigarh Union Territory (U.T.) in northern India. The study included 247 pregnant women and a comparative group of age-matched, non-pregnant women (247) who received the first dose of the COVID-19 vaccine and were followed up by telephone interviews for adverse events following immunization at three time points until 28 days after vaccination. Multivariate regression (logistic and linear) was used for the adjusted analysis, with adverse events following immunization and the duration of adverse events following immunization as the outcomes. Results: The COVID-19 vaccination uptake rate was 66.8% among the pregnant women. The 28-day incidence rate of adverse events following immunization among the pregnant women was 76.5%. The overall 28-day incidence of adverse events following immunization in pregnant women did not differ significantly from that of non-pregnant women (P=0.153). Conclusion: The Covishield vaccine is safe for pregnant women in India. Further follow-up of the cohort for feto-maternal outcomes needs to be conducted with an adequate sample size to confirm the overall safety profile of the vaccine.

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