The diagnostic utility of heparin-binding protein among patients with bacterial infections: a systematic review and meta-analysis.

BACKGROUND: Bacterial infections are considered a leading cause of hospitalization and death globally. There is still a need for a rapid and feasible biomarker for bacterial infections. Heparin-binding protein (HBP) was shown to be related to bacterial infections. The objective of the study is to investigate the diagnostic accuracy of HBP in bacterial infections. METHODS: Articles were screened in PubMed, SCOPUS, Web of Science, and Cochrane to recognize eligible studies. We included studies investigating the diagnostic accuracy of HBP and reported the necessary data to construct 2 × 2 tables. A univariate analysis was conducted to determine the pooled sensitivity and specificity, and a bivariate diagnostic random-effects model was used to calculate the optimal cut-off point. RESULTS: The analysis comprised sixteen studies in total. Plasma HBP showed a sensitivity of 0.90 (95% CI: [0.79, 0.96]) and a specificity of 0.87 (95% CI: [0.66, 0.96]) in diagnosing bacterial infections using blood samples. Pooling data from seven studies revealed that HBP in cerebrospinal fluid (CSF) has sensitivity and specificity of 96% (95% CI: [0.85, 0.99]), and 95% (95% CI: [0.89, 0.97]), respectively, for the diagnosis of bacterial meningitis. In urinary tract infections (UTI), urine-HBP was revealed to have a high diagnostic value in discriminating bacterial from non-bacterial UTI infection at a cut-off value of 32.868 ng/ml with sensitivity and specificity of 87%. CONCLUSION: HBP has shown a high diagnostic accuracy of bacterial infections, including UTI and meningitis. Further studies are needed to determine its prognostic value and whether it could guide antibiotic therapy.

Efficacy of intravenous N acetylcysteine as an adjuvant therapy in the treatment of acute aluminum phosphide Poisoning: a systematic review and meta-analysis.

BACKGROUND: Aluminum phosphide toxicity is a serious problem in many countries. Unfortunately, there is no specific antidote. N-acetylcysteine has been used in some studies as adjuvant therapy depending on to its antioxidant properties. We hypothesized that IV N-acetylcysteine is effective in reducing mortality rate compared to supportive treatment alone. METHODS: We searched in PubMed, Scopus, Web of Science, and Cochrane Library databases. We only included randomized controlled trials that assessed the efficacy of IV N-acetylcysteine and supportive treatment versus supportive treatment alone in acute aluminum phosphide poisoning. Four investigators independently screened the studies' results and designed the data extraction sheet. The primary and secondary outcomes were mortality and the need for mechanical ventilation rates. Random effects estimators with weights were used to result in the pooled risk ratios. RESULTS: We included four randomized controlled trials with 177 patients. 91 patients were distributed in N-acetylcysteine group and 86 patients in the control group. Mortality rates in N-acetylcysteine group and in the control group were 43.95% 66.27% respectively. There was a statistically significant reduction in mortality rate after leave out test (pooled risk ratio, 0.5; 95% confidence interval, 0.32-0.77). Regarding the need for mechanical ventilation, it was measured only in three RCTs. It was assessed in 67 patients in N-acetylcysteine group and 60 patients in the control group. 24 patients were ventilated in N-acetylcysteine group (35.8%) and 29 patients in the control group (48.3%). But it was statistically nonsignificant (pooled risk ratio, 0.71; 95% confidence interval, 0.48-1.04). CONCLUSION: Our meta-analysis revealed that IV N-acetylcysteine may be effective in reducing mortality of severe aluminum phosphide poisoning cases. TRIAL REGISTRATION: Registration number in Prospero CRD42022375344 on 25 NOVEMBER 2022, retrospectively registered.

Profile and outcomes of acute poisoning in the toxicology treatment and control center at Tanta University Hospital, Egypt.

BACKGROUND: Poisoning is a major health problem especially in developing countries and leads to high morbidity and mortality. AIM: To identify the profile of acute poisoning in the Toxicology Unit at Tanta University Hospital, Egypt (2017-2021). METHODS: A cross-sectional study using data extracted from medical records from beginning of January 2017 to end of December 2021. Data including demographic data, Glasgow coma scale, type of poisons, manner of poisoning, time of admission and discharge and state at discharge. RESULTS: This study included 9713 cases. Rodenticides represented the most frequent cause of poisoning among both males (30%) and females (27%). Pharmaceutical drugs, CNS abused pharmaceutical drugs, and chemicals represent the most common categories (24%, 22%, and 21%, respectively) among children (up to 12 years). Rodenticides and pharmaceutical drugs represent the highest categories among other age groups. Evening admissions represented 52% of cases. Glasgow coma scale was 15 among 86.3% of cases. Intentional poisoning was more common than accidental poisoning (58.6% and 34.7%, respectively). One half (52.2%) of the admitted cases were discharged within 24 hours of admission and 44.4% of them were discharged after 48-72 hours. Family request was the main reason of discharge of cases (70.3%), 15.7% were improved, 4% died. Mortality by rodenticide was 12.5%. CONCLUSION: Rodenticides, pharmaceutical and CNS abused pharmaceutical drugs were the most common categories of poisoning. Intentional poisoning was more common than accidental poisoning. Rodenticides were responsible for most deaths.

Parents' perception of COVID-19 risk of infection and intention to vaccinate their children.

Background: Parent's perception of the COVID-19 vaccines is very important to protect themselves and their children and achieve maximum effect of vaccination programs. Objective: Evaluate the perception and attitude of parents towards COVID-19 risk of infection and intentions to vaccinate their children. Method: Cross-sectional study including 1032 participants who have children aged from 5 to 18 years using a structured questionnaire. Results: Overall, 65.0% of participants or their family members suffered from comorbidities that poses them at risk for COVID-19 infection such as hypertension (25.1%) and diabetes mellitus (16.1%). The prevalence of tobacco smoking in the studied families was 36.9%. Among participants, 40.6% had a family member with history of confirmed COVID-19 infection. Nearly one-half of studied parents (48.2%) reported COVID-19 as a serious infection and the majority were worried about getting a family member infected (86.8%). Among participants 62.0% of male parents and 57.8% of female parents agreed that vaccine information is reliable. Participants reporting safety of COVID-19 vaccination represented 45.3%. If vaccine is available, 40.1% of parents intended to vaccinate their children. The main factors associated with the willingness to vaccinate children were vaccine is not suitable for children under 18 years (OR = 11.508), concern about vaccination safety (OR = 8.678), doubts about reliability of vaccine information (OR = 7.811) and ability of vaccine to prevent infection (OR = 5.766). Conclusion: Our study provides a brief insight about how parents think about COVID-19 vaccines and acceptance to vaccinate their children.

Antecedentes: La percepción de los padres sobre las vacunas contra el COVID-19 es muy importante para protegerse a sí mismos y a sus hijos y lograr el máximo efecto de los programas de vacunación. Objetivo: Evaluar la percepción y actitud de los padres hacia el riesgo de infección por COVID-19 y las intenciones de vacunar a sus hijos. Método: Estudio transversal que incluyó a 1032 participantes que tenían hijos de 5 a 18 años mediante un cuestionario estructurado. Resultados: En general, el 65,0% de los participantes o sus familiares padecieron comorbilidades que los ponen en riesgo de infección por COVID-19, como hipertensión (25,1%) y diabetes mellitus (16,1%). La prevalencia de tabaquismo en las familias estudiadas fue del 36,9%. Entre los participantes, el 40,6% tenía un familiar con antecedentes de infección confirmada por COVID-19. Casi la mitad de los padres estudiados (48,2%) informaron que la COVID-19 era una infección grave y la mayoría estaba preocupada por la posibilidad de que un miembro de la familia se infectara (86,8%). Entre los participantes, el 62,0% de los padres varones y el 57,8% de las mujeres acordaron que la información sobre las vacunas es confiable. Los participantes que informaron sobre la seguridad de la vacunación contra la COVID-19 representaron el 45,3%. Si la vacuna está disponible, el 40,1% de los padres tenía la intención de vacunar a sus hijos. Los principales factores asociados al deseo de vacunar a los niños fueron la vacuna no apta para menores de 18 años (OR = 11.508), preocupación por la seguridad vacunal (OR = 8.678), dudas sobre la confiabilidad de la información vacunal (OR = 7.811) y capacidad de vacuna para prevenir la infección (OR = 5.766). Conclusión: Nuestro estudio proporciona una breve perspectiva sobre cómo piensan los padres sobre las vacunas contra el COVID-19 y la aceptación de vacunar a sus hijos.