Mpox vaccine acceptance among healthcare workers: a systematic review and meta-analysis.

INTRODUCTION: Mpox is a zoonotic viral disease that emerged in May 2022 and has since shown a high prevalence in non-mpox-endemic areas, resulting in an outbreak that caused more than 84,000 cases in 110 countries around the globe. Several vaccines are available to prevent the disease, and multiple studies have been conducted to assess the attitudes of different populations toward receiving the mpox vaccine. This study systematically reviews all the studies conducted on mpox vaccine acceptance/hesitancy among healthcare workers. METHODS: A systematic literature search was conducted through four electronic databases, including PubMed, Scopus, Web of Science, and Google Scholar, up to March 2023. Studies that described mpox vaccine acceptance/hesitancy among healthcare workers were included, and the data were extracted using a uniform extraction sheet. Following the extraction, the meta-analysis included ten studies with 7322 healthcare workers. Three researchers independently assessed the risk of bias in the included study using the Newcastle-Ottawa Scale (NOS). RESULTS: Ten studies were included in the review. This review indicates that the prevalence of mpox vaccine acceptance was 58.5%, and the prevalence of mpox vaccine hesitancy was 41.5%. There was a higher prevalence of acceptance in countries located in Asian and African areas compared to those in North America and Europe, estimated at 68% and 44.3%, respectively. Among the studies conducted solely among physicians, there was a high prevalence of mpox vaccine acceptance, at 77.1%, compared to 49% in studies that included all healthcare workers. CONCLUSION: There is a significant variation in the prevalence of mpox vaccine acceptance among different populations. Further research is needed to identify the factors that contribute to this variation and to develop interventions to increase vaccine acceptance. In addition, it is important to promote research on mpox vaccine acceptance and hesitancy among healthcare workers in countries where data is limited. This research will help policymakers develop effective policies to increase acceptance and reduce the disease burden.

Zika virus disease: an alarming situation resurfacing on the radar - a short communication.

Background/introduction: On the 13th of December 2022, a 5-year-old girl from Karnataka, India, tested positive for Zika virus. The first Zika virus was isolated from the serum of a rhesus monkey in the Zika Forest of Uganda in 1947. Zika virus was largely dormant for about 70 years before suddenly resurfacing across all of America, from Brazil to the Pacific Islands and is connected to a grouping of microcephaly phenotypes based on a complete virus genome analysis. All of the aforementioned research provides an overview of the migration of this virus from the Americas to continental Africa via mosquitoes. The current study, therefore, aims to evaluate the virologic characteristics, prophylaxis, transmitting mechanisms, diagnosis, clinical manifestations, and treatment of ZIKV infection in light of the virus's widespread dissemination and deadly nature. Aim: The investigation's findings aim to demonstrate that in order to prevent further outbreaks, there is a national requirement for active epidemiological and entomological observation of Zika. Materials and methods: Data were extracted from academic journals of medicine published in MEDLINE, PubMed, ScienceDirect, Ovid, and Embase inventory databases with a predetermined search strategy. Articles considering the Zika virus and its clinical manifestations, especially neurological, were included. Results: The Zika virus has been declared a public health emergency of global significance by the World Health Organization (WHO). It is of alarming concern that it is now one of the most prevalent infectious diseases associated with birth abnormalities discovered in the past five decades. The onset and accelerated spread of disease to other parts of the world is attributed to the migration of infected hosts and climate change. Rapid laboratory diagnosis, evaluation of serological techniques, and virus isolation are urgently needed, along with newer modalities such as mathematical modeling as prediction devices to curb this issue. Due to its grave neurological manifestations, it is mandated to engineer peptide therapies and a virus-specific vaccination to treat this neurotropic virus. Conclusion: There is currently no vaccination against Zika virus infection. If societies are not adequately prepared, the epidemiological wave will have an impact on the workforce and could pose a serious threat. To alleviate the significant cost on health systems and manage its promotion globally, improved investigation and response activities are needed.

A review on acute, severe hepatitis of unknown origin in children: A call for concern.

Hepatitis is defined as the inflammatory reaction of the liver parenchyma. It is either acute, which resolves within six months or may be chronic. An outbreak of severe, acute hepatitis of unknown origin in children was reported in nearly all World Health Organisation (WHO) regions except in the Africa. As per the recent update on the 26th of May, approximately 650 cases have met the WHO's probable criteria. While some are yet to be confirmed, the WHO warns that the figure may be underestimating the real situation. The observed clinical presentation includes outstanding immoderate levels of transaminases, vomiting from the previous presentation, pale/mild stools, and jaundice. So far, the viruses which can cause viral hepatitides, like Hepatitis A, B, C, D, and E, have not been detected in any of the identified cases. Some literature reported human enteric adenovirus type 41F in the majority of cases aged sixteen or younger, with few cases of co-infection with SARS-CoV-2. Currently, only several hypotheses have discussed the causality of the outbreak. However, no consensus has been reached. During this outbreak, it is important to adhere to both hand and body hygiene, general infection and control prevention strategies, and lastly, case presentation matching the criteria of case definition set by the WHO. Said identified cases should be reported to concerned health authorities on an urgent basis and must be kept under proper surveillance.

Prevalence of irritable bowel syndrome and functional dyspepsia and their relationship with generalized anxiety disorder among medical students in Karachi.

OBJECTIVE: To assess the prevalence of inflammatory bowel syndrome and functional dyspepsia in medical students and their relationship with generalised anxiety disorder and other relevant factors. METHODS: The descriptive cross-sectional study was conducted in Karachi from August to November 2020 after approval from the ethics review board of Jinnah Sindh Medical University, and comprised students of either gender aged at least 18 years from different medical colleges in the city. Data was collected using validated tools Rome III criteria for inflammatory bowel syndrome and functional dyspepsia and Generalised Anxiety Disorder-7. Data was analysed using SPSS 26. RESULTS: Of the 305 subjects, 185(60.70%) were male and 120(39.30%) were female. The overall mean age was 21.43±2.13 years. The prevalence of inflammatory bowel syndrome was 17(5.57%), while that of functional dyspepsia was 2(0.66%). Further, 122(40%) students had minimal anxiety, 112(36.72%) mild, 43(14.10%) moderate and 28(9.18%) had severe anxiety. There was no significant relationship of either inflammatory bowel syndrome or functional dyspepsia diagnosis with generalised anxiety disorder (p>0.05), but a significant relationship existed between inflammatory bowel syndrome diagnosis and generalised anxiety disorder score (p=0.041). Significant relationships were found between inflammatory bowel syndrome diagnosis and use of non-steroidal anti-inflammatory drugs. The relationship of generalised anxiety disorder diagnosis with gender and probiotic use was significant (p<0.05), and so was the relationship of generalised anxiety disorder score with gender and level of physical activity (p<0.05). CONCLUSIONS: Medical students with a higher generalised anxiety disorder score and those who used non-steroidal anti-inflammatory drugs frequently had a higher likelihood of developing inflammatory bowel syndrome.

Postpartum Depression: Prevalence and Associated Risk Factors Among Women in Sindh, Pakistan.

Introduction Postpartum depression (PPD) is defined as the onset of depressive symptoms within six weeks of childbirth. PPD is more common in resource-constrained countries as compared to developed countries. The study aimed to evaluate the factors associated with PPD among women in Sindh, Pakistan. Methods A multi-centre, cross-sectional study was conducted at three major tertiary care setups in Sindh, Pakistan. All women presenting to the outpatient department within six weeks of giving live birth were eligible to participate. All women who had stillbirths, abortions, or were treated for a past psychiatric illness or neurological disease were excluded from the study. The Edinburgh postpartum depression scale (EPDS) was used as a screening tool. All socio-demographic factors were documented in a predefined pro forma. The data was analyzed using Statistical Package for Social Sciences (SPSS, Version 26, IBM, Chicago, IL). Results According to the Edinburgh postpartum depression scale (EPDS), the incidence of postpartum depression in the current study population was 19.3%. Of these, 12 (3.3%) women had persistently thought about self-harming. Over 100 women did not receive any formal education, constituting the majority of the study population. Formula milk feeding of the newborn was significantly associated with an increased frequency of postpartum depression (p= 0.0001). Conclusion The current study highlights the significant burden of postpartum depression in Pakistan. However, the present study failed to find any significant risk factors associated with postpartum depression. Only formula milk feeding was significantly associated with a higher frequency of PPD among study patients.