Short Term Side Effects Of Inactivated COVID-19 Vaccines Among Pakistani Population: A Survey-Based Cross-Sectional Study.

Objectives: To assess the short-term adverse effects of two inactivated coronavirus disease-2019 vaccines, and the demographic factors associated with such events. METHODS: The cross-sectional study was conducted in Karachi from August to October 2021 after approval from the ethics review board of Dow University of Health Sciences, Karachi, and comprised adults of either gender who had received at least one dose of either Sinopharm or CoronaVac vaccine. Data was collected using online and printed survey forms. The questionnaire investigated the symptoms experienced by the participants after the administration of the vaccine dose. Data was analysed using SPSS 22. RESULTS: Of the 1000 survey forms filled, 896 were analysed; 505(56.4%) women and 391(43.6%) men were included in the study. Most of the participants were aged 18-30 years 644(71.9%). Overall, 581(64.8%) subjects had received Sinopharm vaccine, and 315(35.2%) received CoronaVac. The incidence of side effects after the first and second dose respectively was 63.3% (368 out of 581) and 55.2% (239 out of 433) for Sinopharm and 65.4% (206 out of 315) and 61.4% (89 out of 145) for CoronaVac. The factors associated with a higher risk of side effects were female gender and young age (p<0.05). CONCLUSIONS: Most of the reported symptoms were minor in nature, like pain at the injection site, and women and those of young age reported such symptoms more than men and the elderly.

Thoracostomy tube withdrawal during latter phases of expiration or inspiration: a systematic review and meta-analysis.

PURPOSE: In patients with thoracic injuries, tube thoracostomy is routinely employed. There is disagreement over which manner of tube withdrawal is best, the latter phases of expiration or inspiration. Considering several earlier investigations' inconsistent findings, their comparative effectiveness is still up for debate. In light of this, we carried out a systematic analysis of studies contrasting the withdrawal of thoracostomy tubes during the latter stages of expiration versus inspiration for traumatic chest injuries. Analyzed outcomes are recurrent pneumothoraces, reinsertion of the thoracostomy tube, and hospital stay. METHODS: We looked for papers comparing the withdrawal of the thoracostomy tube during the last stages of expiration and inspiration for the management of thoracic injuries on Embase, Pubmed, Cochrane Library and Google Scholar. Review Manager was used to determine mean differences (MD) and risk ratios (RR) using a 95% confidence interval (CI). RESULTS: The primary outcomes showed no significant difference between the inspiration and expiration groups: recurrent pneumothorax (RR 1.27, 95% CI 0.83-1.93, P 0.28) and thoracostomy tube reinsertion (OR: 1.84, CI 0.50-6.86, P 0.36, I2 5%). However, the duration of hospital stay was significantly lower in patients in whom the thoracostomy tube was removed at the end of inspiration (RR 1.8, 95% CI 1.49-2.11, P < 0.00001, I2 0%). The implications of these findings warrant cautious interpretation, accounting for potential confounding factors and inherent limitations that may shape their significance. CONCLUSION: The thoracostomy tube can be removed during both the end-expiratory and end-inspiratory stages of respiration with no appreciable difference. Nevertheless, caution should be exercised when ascertaining the implications of these findings, taking into account the potential limitations and confounding variables that may exert influence upon the outcomes.

The association of antibiotic exposure with new-onset inflammatory bowel disease: A systematic review and meta-analysis.

INTRODUCTION: The role of antibiotics in the development of inflammatory bowel disease (IBD) remains controversial, primarily due to conflicting data from individual studies. We conduct a systematic review and meta-analysis to study the effect of antibiotic exposure on IBD development. METHODOLOGY: The MEDLINE and Cochrane CENTRAL databases were queried from their inception to April 2021 for published articles studying the association between antibiotic exposure and new-onset IBD. Our analysis was stratified by timing of antibiotic exposure - exposure in childhood and any lifetime exposure. Adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) from each study were pooled using a random-effects model. RESULTS: 10 case-control studies and 2 cohort studies (N = 29,880 IBD patients and N = 715,548 controls) were included. Patients with Crohn's Disease (CD), compared with controls, were associated significantly with antibiotic exposure in childhood and any lifetime exposure to antibiotics (OR 1.52 [1.23-1.87]; p<0.00001). Patients with Ulcerative Colitis (UC), compared with controls, reported non-significant association with antibiotic exposure in childhood and any lifetime exposure. (OR 1.11 [0.93-1.33]; p = 0.25) CONCLUSION: This meta-analysis suggests that exposure to antibiotics significantly increases the odds of developing CD and IBD. These findings re-emphasize the importance of cautious and judicious use of antibiotics.

Comparative effectiveness of calfactant and beractant in neonatal respiratory distress syndrome: A systemic review and meta-analysis.

INTRODUCTION: Animal derived surfactants are considered to be the standard treatment for neonatal respiratory distress syndrome (NRDS). However, their comparative effectiveness remains inconclusive given the multiple prior studies with inconsistent results. Therefore, we conducted a systematic review and meta analysis to compare the effectiveness of two animal extract surfactants (calfactant and beractant) for the management of NRDS. METHODS: We searched Pubmed, Scopus, and Google Scholar for studies comparing efficacy of calfactant and beractant for the treatment of NRDS. Mean differences (MD) and risk ratios (RR) with a 95% confidence interval (CI) were calculated using Review Manager. RESULT: We found no significant difference between calfactnat and beractant groups in the primary outcomes: neonatal mortality before the age of 28 days (RR = 1.19, 95% CI = 0.97-1.46, p = 0.09), mortality before the hospital release (RR = 1.12, 95% Cl = 0.94-1.33, p = 0.22), oxygen requirement at 28 days of age (RR = 0.97, 95% CI = 0.90-1.05, p = 0.52), and death or oxygen need at 36 weeks postmenstrual age (RR = 0.99, 95% CI = 0.91-1.08, p = 0.81). The duration of supplementary oxygen was significantly lower in calfactant users (MD = -4.95, 95% CI = -7.60--2.30, p = 0.0002). Calfactant significantly lowered the duration of hospital stay, risk of pneumothorax and air leak syndrome whereas beractant users had lower risk of intraventricular hemorrhage (Grades 3 and 4). CONCLUSION: There is no substantial difference in the efficacy of both surfactants in the prophylaxis and treatment of NRDS.