Calamity Of Secondary Dengue Virus Followed By Climatic Changes

Madam, This is to bring your attention to a long-standing issue despite several activities devised to curb it. Being aware of the effect of drastic climatic changes, developing countries like Pakistan should remain alert about the emergence of infectious outbreaks. The stagnant water after heavy rainfall and flood is a ground for the breeding of dengue vector called Aedes aegypti mosquitoes. The virus is transmitted from one person to another through these mosquitoes. Lately, the surge in the cases of dengue virus was due to massive flooding in Pakistan in 2022. A total of 25932 cases were reported and 62 deaths were recorded during the dengue outbreak during the flood crisis of 2022[1]. Dengue virus comprises of four serotypes 1, 2, 3, and 4. A person infected by a distinct serotype of the virus gains immunity against it and future infection by the same DENV will not affect the person’s health but infection by a heterogenous serotype causes secondary infection in the form of dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Expansive capillary leakage in DHF due to an increase in the permeability of blood vessels can turn on a shock state called DSS. This deprivation of blood to highly functional organs like the brain, kidney, and heart puts them at risk of multi-organ failure [2]. The seasonal surge of secondary infection puts a burden on hospitals as the patient requires vigilant inpatient hospital care. The patient's health deteriorates further because of self-treatment at home with local herbs and over-the-counter (OTC) drugs [3]. As modern medicine is focused more on prevention than treatment, the need for the approval of the use of the dengue vaccine on high-risk individuals in an endemic country like Pakistan should be considered. The DENGVAXIA is a well-tolerated vaccine protecting against all the serotypes and is approved for use in individuals 9 to 45 years who are previously infected by the dengue virus in the past. [4] The vaccine will restrain the rise in DHF and DSS cases as it is for high-risk individuals who are already infected in the past thus curbing the incidence of secondary infection. Many endemic countries like the Philippines and Brazil have already taken a step against secondary dengue by granting the license of DENGVAXIA [5]. As Pakistan is developing country, approving the license for DENGVAXIA should be considered.

Mediterranean Diet and its Effect on Endothelial Function: A Meta-analysis and Systematic Review

BACKGROUND

Endothelial dysfunction serves as an early marker for the risk of cardiovascular disease (CVD); therefore, it is a site of therapeutic interventions to reduce the risk of CVD.

AIMS

To examine the effect of the Mediterranean diet (MedDiet), as an intervention, on structural and functional parameters of endothelial function, and how it may reduce the risk of CVD and associated mortality.

METHODS

Medline database was searched for randomized controlled trials. Random-effects meta-analysis was conducted on 21 independent datasets. Meta-regression and subgroup analysis were performed to assess whether the effect of MedDiet was modified by health status (healthy subjects or with increased CVD risk), type of MedDiet intervention (alone or combined), type of parameter (functional or structural), study design (cross-over or parallel), BMI, age, and study duration. Our study used sample size, mean, and standard deviation of endothelial function measurements for both MedDiet intervention and control in the analyses.

RESULTS

Inverse relationship between endothelial function and intake of MedDiet was observed (SMD: 0.34; 95% CI: 0.16, 0.52; P = 0.0001). Overall, MedDiet increased FMD by 1.39% (95% CI: 0.47, 2.19; P < 0.001). There was a significant improvement in endothelial function in both healthy patients and in those with an increased risk of CVD. No significant variation was observed in the effects of MedDiet on endothelial function, due to study design or type of intervention.

CONCLUSIONS

These findings support that MedDiet can reduce the risk of CVD by improving endothelial function.

Psychological impact of COVID-19 Pandemic and associated factors on college students

OBJECTIVE

To determine the psychological impact of coronavirus disease-2019 pandemic on college students, and to explore factors influencing their anxiety and depression levels.

METHODS

The cross-sectional study was conducted from October 2020 to January 2021 at the Jinnah Sindh Medical University, Karachi, and comprised medical students of either gender in the first to third year of the academic programme. Data was collected using a pretested online structured questionnaire comprising demographic information, academic problems, daily life difficulties and the 25-item Aga Khan University Anxiety and Depression Scale. Data was analysed using SPSS22.

RESULTS

Of the 397 students, 72(18.1%) were males and 325(81.9%) were females. The overall mean age of the sample was 19.9±1.2 years. Of the total, 221(55.7%) students were found to be anxious and depressed. Factors related to academic difficulties and daily life issues had significant correlation (p<0.05) with anxiety and depression. Multiple linear regression analysis indicated that the need for some form of mental health support was the most significant (p<0.001) predictor of anxiety and depression, followed by family issues (p<0.001) and social media (p<0.001). Anxiety and depression were also significantly associated with fear of family or friend getting coronavirus disease-2019 (p=0.003), lack of attentiveness to study (p=0.040) and felt anxiety when ordering food online (p=0.019).

CONCLUSIONS

With better understanding, academic institutions and healthcare policymakers may take measures and mitigate students' distress during the pandemic.