Immunogenicity and safety of pandemic influenza A (H1N1) 2009 vaccine: systematic review and meta-analysis

The emergence of the 2009 H1N1 pandemic has highlighted the need to have immunogenicity and safety data on the new pandemic vaccines. There is already considerable heterogeneity in the types of vaccine available and of study performed around the world. A systematic review and meta-analysis is needed to assess the immunogenicity and safety of pandemic influenza A (H1N1) 2009 vaccines. We searched Medline, EMBASE, the Cochrane Library and other online databases up to 1st October 2010 for studies in any language comparing different pandemic H1N1 vaccines, with or without placebo, in healthy populations aged at least 6 months. The primary outcome was seroprotection according to haemagglutination inhibition (HI). Safety outcomes were adverse events. Meta-analysis was performed for the primary outcome. We identified 18 articles, 1 only on safety and 17 on immunogenicity, although 1 was a duplicate. We included 16 articles in the meta-analysis, covering 17,921 subjects. Adequate seroprotection (≥70%) was almost invariably achieved in all age groups, and even after one dose and at low antigen content (except in children under 3 years receiving one dose of non-adjuvanted vaccine). Non-adjuvanted vaccine from international companies and adjuvanted vaccines containing oil in water emulsion (e.g. AS03, MF59), rather than aluminium, performed better. Two serious vaccination-associated adverse events were reported, both of which resolved fully. No death or case of Guillain-Barré syndrome was reported. The pandemic influenza (H1N1) 2009 vaccine, with or without adjuvant, appears generally to be seroprotective after just one dose and safe among healthy populations aged ≥36 months; very young children (6-35 months) may need to receive two doses of non-adjuvanted vaccine or one dose of AS03(A/B)-adjuvanted product to achieve seroprotection.     

The positive impact of social media on health behavior towards the COVID-19 pandemic in Bangladesh: A web-based cross-sectional study

BackgroundHealth information has a profound impact on developing awareness and ultimately preventing the burden of coronavirus disease-2019 (COVID-19) pandemic, but study in Bangladesh is lacking.AimsTherefore, this study was conducted to investigate the impact of information from social media and television in developing health awareness among people amid the COVID-19 pandemic.MethodsData was collected during December 10, 2020 to February 10, 2021 from 1808 people. Data was collected by using questionnaire about information source and their impact on COVID-19 related health measures. Pearson's correlation analyses was conducted.ResultsFemale (52%, 937 of 1808) was the most prevalent sex and the mean age was 24 ± 3.9 years. Most of the social media users were students (63%, 1131 of 1808). Social media (53%, 959 of 1808) and television (44%, 800 of 1808) were the most popular sources and Facebook (66.5%, 1203 of 1808) was the most common source of getting health information. About 87% people received health information on social media and television. Users of social media had about 3 times more likelihood to follow the health rules. About 80% participants who used social media followed the health measures after 0–28 days of getting the information. The strongest correlation was found between social distancing and the information on television (r = 0.943).ConclusionStrong correlation of health information was present among the participants in building awareness about taking preventive measures. This is the first study to describe the positive influence of information amid COVID-19 in Bangladesh.     

Healthcare cost of type 2 diabetes mellitus in Bangladesh: a hospital-based study

Healthcare-related expenditure for diabetes is increasing at an alarming rate all over the world, resulting in a huge burden on patients. The purpose of this cross-sectional study was to estimate the healthcare cost incurred by patients with type 2 diabetes mellitus (T2DM). The study included 531 registered patients with diabetes of more than 1 year. All the treatment-related records of the last 12 months were collected from the patients’ guide books. Data were analyzed to determine the average cost (exchange rate: US$1?=?Bangladeshi Taka 80) incurred by the diabetic patients in treating the disease and were calculated based on the total amount spent by them to that of total number of patients. The mean?±?SD age of the patients (male 46.5 % and female 53.5 %) was 53.0?±?10 years with duration of diabetes 9?±?6.7 years. The average annual cost of care was US$314 (direct cost US$283 and indirect cost US$31). Drugs accounted for the largest share (68 %) of the direct cost, followed by laboratory investigations (12.5 %) and consultation fees (11.7 %). Results of bivariate analysis showed that the annual direct cost of care significantly increased with age, monthly household income, duration of diabetes, and the number of co-morbidities/complications. However, results of multivariable analysis showed that, except age, all other remained significant (p?<?0.001) explanatory variable of direct cost. The annual cost of diabetes care per person in the outpatient department of a tertiary care facility was US$314. Based on this finding, it is estimated that the total annual burden of some 5.1 million diabetic patients will be US$1.5 billion, which is a large burden for a developing country like Bangladesh. Primary prevention should be in focus to combat the economic burden of diabetes.     

96例“四防”病人的心理分析

精神病人常发生自杀、伤人、毁物及外逃等意外,这四种病人统称为“四防”病人。本文对“四防”病人的心理特征进行了调查分析。结果表明多数精神病人出现“四防”行为是由病态心理所致,其中自杀病人以忧郁、悲观心理占多数;伤人、毁物病人以妄想支配心理者为多;外逃病人以无自知力及想家思亲心理者为多。     

交流：临床听力学的发展之路

20世纪50年代．刘瑞华教授将听力学引入我国。随后的五十年间,各种听力学的著作陆续出版,致聋原因的调查研究也相继在全国各地展开,听力学检测技术、专业人员的培养及各种听力学相关机构都有了很大的发展,尤其在近十年更是有了巨大的飞跃。     

Cerebellar toxoplasmosis in HIV/AIDS infant: case report and review of the literature

Cerebellar mass lesion is an uncommon presentation of toxoplasmosis. The authors report one rare case in an 11-month-old HIV/AIDS female infant who presented with deterioration in her developmental milestones. CT scan revealed a ring-enhancing mass lesion in the right cerebellar hemisphere with secondary obstructive hydrocephalus. A ventriculoperitoneal shunt was inserted prior to posterior fossa decompression and biopsy of the lesion. The specimens obtained were divided into two. One specimen was sent for histological diagnosis immediately after surgery while the second specimen was preserved until the release of the histology report. The initial histopathology report indicated a neoplastic process. Immunohistochemical stains were attempted but interpreted with difficulty due to severe tissue necrosis. After waiting for close to 6?weeks without a definite histological diagnosis, the preserved second specimen was sent for histological analysis as a fresh specimen, and reported a diagnosis of toxoplasmosis. This case presented diagnostic challenges to the authors whose radiological impressions of either a neoplastic lesion or a tuberculoma (based on our local neuroepidemiology) were reinforced by intraoperative findings highly suggestive of tuberculoma but which contrasted with the histological report, first as a neoplastic lesion and later toxoplasmosis. Although cerebellar toxoplasmosis is a rare complication of HIV/AIDS, this case report shows that toxoplasmosis should not be overlooked as a differential diagnosis of ring-enhancing cerebellar masses in HIV/AIDS patients irrespective of the patient’s age and the absence of constitutional symptoms of toxoplasmosis.