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Insufficient vitamin D levels in the bloodstream, together with the presence of specific genetic variations known as single nucleotide polymorphisms (SNPs) within the VDR gene, have consistently been linked to a higher likelihood of contracting and experiencing more severe forms of various diseases such as the ongoing COVID-19 pandemic. We aimed to explore the potential relationship between vitamin D levels, Bsml and FOKI polymorphisms, and COVID-19 infection outcomes. A case-control study was conducted with COVID-19 patients and a control group of non-COVID-19 patients (n = 107 each). The associations between vitamin D status, polymorphisms, and COVID susceptibility were investigated. Participants diagnosed with COVID-19 exhibited an average age of 48.84 ± 12.18, while non-COVID-19 patients had an average age of 46.82 ± 9.903. Disease severity, assessed by the CT severity score, showed a negative correlation with the Vitamin D levels. Among participants with COVID-19, the mean level of vitamin D was 35.25 ± 9.40 ng/mL while non-COVID-19 patients showed 38.85 ± 9.40 ng/mL with a significant difference (p = 0.004**) although among COVID-19 cases, 87 (81.3%) individuals had sufficient vitamin D levels and non-severity of disease was more common i.e. 54 (50.5%) among the COVID patients who had sufficient level of Vitamin D. The study found no significant association between Vitamin D levels and rs1544410 Bsml polymorphism (p = 0.429). However, it is important to highlight a weak significant association observed between with Fok1 polymorphism (p = 0.049). These findings underscore the weak influence of genetic factors, particularly VDR Fok1 gene variants, in shaping an individual’s susceptibility to COVID-19. A significant difference in vitamin D status was observed between the COVID-19 and non-COVID-19 groups and lower level was observed in the COVID-19 infected patients. Furthermore, a weak significant association was observed between Fok1 rs2228570 genotype and COVID-19 susceptibility. Larger sample sizes are required to comprehensively understand the association between different genotypes and COVID-19 outcomes.

Abstract Background Celiac disease (CD) is an autoimmune disorder characterized by gluten intolerance, primarily affecting the gastrointestinal system but potentially influencing cardiovascular health. Emerging evidence suggests an association between CD and myocardial infarction (MI), though studies have produced inconsistent results. This study aimed to systematically review and conduct a meta-analysis of existing literature to quantify the risk of MI in individuals diagnosed with CD. Methods A comprehensive literature search was performed across PubMed, Embase, and Web of Science up to August 2024. Studies were included if they investigated the association between CD and MI in adult populations and provided relevant effect estimates. Data from eligible studies were extracted, and a random-effects meta-analysis was conducted to calculate pooled hazard ratios (HRs) and odds ratios (ORs), along with an assessment of heterogeneity. Statistical analysis has been performed by R software (V 4.4). Results A total of 8 studies were included in the systematic review. Pooled HR analysis showed no significant association between CD and MI (HR = 1.143, 95% CI: 0.619–2.109), and pooled OR analysis also revealed non-significant results (OR = 0.879, 95% CI: 0.481–1.606). High heterogeneity was observed (I2 = 86% for HR, 99% for OR). Conclusion This meta-analysis found no significant association between CD and MI. However, substantial heterogeneity across studies indicates variability in results, highlighting the need for further research with larger, more homogeneous cohorts to better understand cardiovascular risks in CD patients. Future studies should explore subgroups and the impact of gluten-free diet adherence.

Abstract Background The COVID-19 pandemic has significantly impacted public health, with emerging evidence suggesting substantial effects on maternal and neonatal health. This systematic review and meta-analysis aimed to quantify the prevalence and risk of respiratory distress syndrome (RDS) in newborns born to mothers infected with SARS-CoV-2, the virus responsible for COVID-19. Methods We conducted a literature search in Embase, PubMed, and Web of Science up to April 20, without language or date restrictions. Observational studies reporting on the prevalence or risk of RDS among newborns from mothers with confirmed SARS-CoV-2 infection were included. Quality assessment was performed using the JBI tool. Statistical analysis was performed by using R software version 4.3. Results Twenty-two studies met the inclusion criteria. The pooled prevalence of RDS among newborns born to COVID-19-infected mothers was 11.5% (95% CI: 7.4–17.3%), with significant heterogeneity (I² = 93%). Newborns from infected mothers had a significantly higher risk of developing RDS, with a pooled risk ratio (RR) of 2.69 (95% CI: 1.77 to 4.17). Conclusion Newborns born to mothers with COVID-19 have a substantially increased risk of developing RDS. These findings emphasize the need for vigilant monitoring and appropriate management of pregnant women with COVID-19 to mitigate adverse neonatal outcomes.

Abstract Background Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality worldwide, with increased prevalence in individuals with chronic liver conditions and type 2 diabetes mellitus (T2DM). Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RAs) have shown promise in diabetes management and may influence liver disease progression. This systematic review and meta-analysis aimed to assess the efficacy of GLP-1 RAs in reducing the risk of HCC in patients with T2DM. Methods We conducted a literature search of PubMed, EMBASE, and Web of Science up to August 1, 2024. Studies that evaluated the incidence of HCC in T2DM patients treated with GLP-1 RAs compared to other therapies were included. Meta-analyses were performed using a random-effects model to compute pooled hazard ratios (HRs) and 95% confidence intervals (CIs), and heterogeneity was assessed using the I² statistic. All statistical analyses were performed in R software version 4.3. Results Eight studies met the inclusion criteria. The pooled analysis demonstrated that GLP-1 RA treatment was associated with a significant reduction in HCC risk compared to insulin or no GLP-1 RA treatment (pooled HR = 0.41, 95% CI: 0.28 to 0.55), with considerable heterogeneity (I² = 74%). Compared to metformin and DPP-4 inhibitors, GLP-1 RAs did not significantly alter HCC risk (HR = 0.99, 95% CI: 0.79 to 1.27 for metformin; HR = 1.05, 95% CI: 0.80 to 1.39 for DPP-4 inhibitors). However, GLP-1 RAs were associated with a reduced risk compared to sulfonylureas (HR = 0.78, 95% CI: 0.65 to 0.93). Conclusion GLP-1 RAs may offer protective benefits against HCC in T2DM patients compared to insulin or no GLP-1 RAs, but not significantly over other antidiabetic medications. This review indicates the need for further randomized controlled trials to clarify the role of GLP-1 RAs in HCC risk mitigation and to explore their mechanistic pathways in liver disease management.

Abstract Background As e-cigarettes gain popularity as potential tobacco cessation aids, concerns arise about their dual use with traditional cigarettes, especially among pregnant women, potentially subjecting both women and fetuses to heightened risks. This systematic review and meta-analysis aimed to determine the overall prevalence of dual use of tobacco smoking and e-cigarette use in pregnant women. Methods A literature search was conducted across databases including PubMed, Embase, Web of Science, and Cochrane on October 20, 2023. The included studies reported the number of pregnant women and the count of those who were dual users. Quality assessment was undertaken using the JBI tool. The pooled prevalence of dual use was determined via a random-effects model. All statistical analyses were executed using R software, version 4.3. PROSPERO: CRD42023486020. Results Eighteen studies were analyzed, encompassing 5,983,363 pregnant women. The meta-analysis indicated an overall prevalence of 4.6% (95% CI: 2.0-10.3) for dual users with significant heterogeneity (I2 = 100%). Subgroup analysis based on the country showed a prevalence of 4.9% (95% CI: 2.0 to 11.6) for USA and 8.1% (95% CI: 0.00 to 1.00) for UK. Meta-regression revealed reduction of prevalence of dual use from 2019 to 2023. A potential publication bias was indicated by the LFK index and the Doi plot. Conclusion The dual consumption of e-cigarettes and traditional tobacco in pregnant women is a significant health concern, with a notable prevalence. Given the established risks of tobacco smoking during pregnancy and the uncertainties surrounding e-cigarettes, more comprehensive research and public health interventions are urgently needed to address this issue.

Abstract Background People living with HIV (PLWH) are more vulnerable to infectious and non-infectious comorbidities due to chronic inflammation and immune dysfunction. Air pollution is a major global health risk, contributing to millions of deaths annually, primarily from cardiovascular and respiratory diseases. However, the link between air pollution and mortality risk in PLWH is underexplored. This systematic review assesses the association between exposure to pollutants such as particulate matter (PM), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) and mortality risk in PLWH. Methods A systematic search of PubMed, Web of Science, and Embase was conducted for studies published up to August 2024. Eligibility criteria included cohort, case-control, and cross-sectional studies assessing air pollution exposure and mortality in PLWH. Nested-Knowledge software was used for screening and data extraction. The Newcastle-Ottawa Scale was applied for quality assessment. A narrative approach and tabular summarization were used for data synthesis and presentation. Results Nine studies, mostly from China, demonstrated a significant association between long-term exposure to PM1, PM2.5, and PM10 and increased risks of AIDS-related and all-cause mortality in PLWH. Hazard ratios for mortality increased by 2.38–5.13% per unit increase in PM concentrations, with older adults (> 60), females, and those with lower CD4 counts (

Abstract Background The global COVID-19 vaccination campaign, with 13.53 billion doses administered by early 2024, has significantly reduced severe illness and mortality. However, potential adverse effects, such as Postural Orthostatic Tachycardia Syndrome (POTS), have raised concerns. This systematic review evaluates the incidence, mechanisms, and clinical implications of POTS following COVID-19 vaccination. Methods A systematic search of PubMed, EMBASE, and Web of Science was conducted up to June 7, 2024, following PRISMA guidelines to identify studies related to COVID-19 vaccines and POTS. Eligible studies included randomized controlled trials, cohort studies, cross-sectional studies, case-control studies, case series, and case reports. Screening, data extraction, and quality assessment were independently performed by two reviewers using the Joanna Briggs Institute Checklists and the Newcastle-Ottawa Scale. Results Of the 1,531 articles identified, 10 met the inclusion criteria, encompassing a total of 284,678 participants. These studies included five case reports, two case series, one cross-sectional study, one prospective observational study, and one cohort study. The cohort study reported that the odds of new POTS diagnoses post-vaccination were 1.33 (95% CI: 1.25–1.41) compared to the 90 days prior. In contrast, the post-infection odds were 2.11 (95% CI: 1.70–2.63), and the risk of POTS was 5.35 times higher (95% CI: 5.05–5.68) post-infection compared to post-vaccination. Diagnostic findings across studies included elevated norepinephrine levels and reduced heart rate variability. Reported management strategies involved ivabradine, intravenous therapies, and lifestyle modifications. Conclusion The risk of POTS following COVID-19 vaccination is lower than that observed post-SARS-CoV-2 infection; however, existing studies are limited by small sample sizes and methodological variability. Further research is needed to clarify the incidence, mechanisms, and long-term outcomes of vaccine-related POTS to inform effective clinical management strategies.

Abstract Background Cancer poses a significant public health challenge in India, making it crucial to predict its future impact for effective healthcare planning. This study forecast cancer incidence, mortality, and disability-adjusted life years (DALYs) in India from 2022 to 2031. Methods We extracted age-standardized data on incidence, prevalence, DALYs, and mortality from 1990 to 2021 from the Global Burden of Disease (GBD) study. We used Decadal Average Percentage Change techniques to identify trends in cancer burden over decades and the Autoregressive Integrated Moving Average (ARIMA) method were used for forecasting. The ARIMA (2,2,2) model was identified as the best for predicting cancer incidence, ARIMA (0,3,3) for DALYs, and ARIMA (0,2,2) for mortality. Results The cancer incidence rate is expected to rise from 529.40 (95% CI: 525.41-533.38) in 2022 to 549.17 (95% CI: 487.43-610.92) per 100,000 population in 2031. The DALYs rate is projected to decrease from 2001.53 (95% CI: 1964.24-2038.82) in 2022 to 1842.08 (95% CI: 1273.57-2410.60) per 100,000 population in 2031, indicating improvements in cancer burden management. Mortality rates are forecasted to increase slightly, from 71.52 (95% CI: 69.91–73.12) in 2022 to 73.00 (95% CI: 60.88–85.11) per 100,000 population in 2031. Overall, while incidence and mortality rates show a slight upward trend, the DALYs rate is projected to decrease, reflecting potential advancements in cancer management and treatment over the forecast period. Conclusions Over the next decade, cancer incidence and mortality are expected to increase in India, highlighting the need for enhanced prevention, early detection, and proper treatment strategies. Despite these increases, the anticipated decrease in DALYs suggests potential advancements in cancer management, warranting further investigation into the drivers of this positive trend and measures to sustain it.

Abstract Background Periodontitis, a prevalent inflammatory disease affecting tooth-supporting structures, leads to significant oral health and systemic complications if untreated. While traditional smoking is a well-known risk factor for periodontitis, the impact of electronic cigarettes (e-cigarettes) on periodontal health remains unclear. This systematic review and meta-analysis aim to synthesize existing evidence on the effects of e-cigarette use on periodontitis and other periodontal outcomes. Methods A literature search was conducted across PubMed, EMBASE, and Web of Science from their inception up to June 15 2024. Eligible studies included those assessing the impact of e-cigarette use on periodontal outcomes such as bleeding on probing (BOP), plaque index, probing depth, clinical attachment loss, and marginal bone loss. Data were extracted and analyzed using random-effect models to calculate pooled mean differences. R statistical software was used to perform meta-analyses. Results Twelve studies were included in the meta-analysis. E-cigarette users showed a significantly lower mean BOP score compared to non-users (pooled mean difference: -14.233; 95% CI: -20.424 to -8.043; I² = 99%). For other periodontal outcomes, the findings were as follows: Plaque Index (MD: -0.160; 95% CI: -0.680 to 0.360; I² = 95%), Clinical Attachment Loss (MD: 0.120; 95% CI: -0.045 to 0.285; I² = 90%), Probing Depth (MD: 0.056; 95% CI: -0.070 to 0.182; I² = 85%), and Marginal Bone Loss (MD: -0.052; 95% CI: -0.168 to 0.064; I² = 88%). Conclusion Present studies have not identified a significant link between e-cigarette use and adverse effects on periodontal health, but the available research is limited. Further longitudinal research is necessary to evaluate the long-term effects of e-cigarette use on periodontal health and to clarify any associated risks.

Abstract Background Dengue infection poses a significant global health challenge, particularly in tropical and subtropical regions. Among its severe complications, Acute kidney injury (AKI) stands out due to its association with increased morbidity, mortality, and healthcare burdens. This Meta-analysis aim to identify and evaluate the predictors of AKI among dengue patients, facilitating early detection and management strategies to mitigate AKI’s impact. Methods We searched PubMed, EMBASE, and Web of Science databases, covering literature up to February 2024. We included human observational studies reporting on AKI predictors in confirmed dengue cases. Nested-Knowledge software was used for screening and data extraction. The Newcastle-Ottawa Scale was used for quality assessment. R software (V 4.3) was utilized to compute pooled odds ratios (ORs) and 95% confidence intervals (CIs) for each predictor. Results Our search yielded nine studies involving diverse geographic locations and patient demographics. A total of 9,198 patients were included in the studies, with 542 diagnosed with AKI. in which key predictors of AKI identified include severe forms of dengue (OR: 2.22, 95% CI: 1.02–3.42), male gender (OR: 3.13, 95% CI: 1.82–4.44), comorbidities such as diabetes mellitus (OR: 3.298, 95% CI: 0.274–6.322), and chronic kidney disease (OR: 2.2, 95% CI: 0.42–11.24), as well as co-infections and clinical manifestations like rhabdomyolysis and major bleeding. Conclusion Our study identifies several predictors of AKI in dengue patients. These findings indicate the importance of early identification and intervention for high-risk individuals. Future research should focus on standardizing AKI diagnostic criteria within the dengue context and exploring the mechanisms underlying these associations to improve patient care and outcomes.

BackgroundNeurological disorders are a major global health concern, especially in BRICS nations (Brazil, Russia, India, China, South Africa), where demographic and socio-economic changes have amplified their impact. This study evaluates trends in incidence, prevalence, mortality, and Disability-Adjusted Life Years (DALYs) associated with neurological diseases in these countries from 1990 to 2021, focusing on sex disparities and key risk factors.MethodsData were obtained from the Global Burden of Disease (GBD) 2021 database. Join point regression and Estimated Annual Percentage Change (EAPC) analyses were used to assess trends in neurological disease burden. Age-standardized rates for incidence, prevalence, and mortality were calculated, along with DALYs, and key risk factors were analyzed.ResultsChina showed the largest increase in incidence (7541.89 to 8031.37 per 100,000) and prevalence (26494.85 to 28534.79 per 100,000). Mortality increased in India (21.01 to 24.27 per 100,000) and South Africa (27.66 to 30.65 per 100,000), while China showed a decline (39.59 to 37.30 per 100,000). Brazil experienced a substantial rise in DALYs (1610.65 to 42024.59). Sex disparities showed higher DALY rates for females across all nations.ConclusionThe research highlights the rising burden of neurological disorders in BRICS nations, especially in China and Brazil due to aging populations and metabolic risks. It emphasizes the need for targeted interventions in India and South Africa, where increasing mortality rates and DALYs are concerning. Effective health policies should focus on early detection, managing metabolic risks, and implementing sex-specific strategies to address these issues.

West Nile Virus (WNV), first identified in Uganda in 1937, remains a significant global health threat, adapting across diverse ecosystems and expanding geographically, particularly into temperate regions of Europe and North America. This review provides a comprehensive exploration of the latest insights and challenges in WNV management, focusing on epidemiological trends, molecular advancements, and public health implications. Recent data highlight WNV's expansion, driven by climate changes such as milder winters and longer warm seasons that increase mosquito activity and enable the virus to overwinter within mosquito populations. This facilitates year-round transmission and challenges current control strategies. Molecularly, advancements in genomic and proteomic technologies have deepened our understanding of WNV's replication and pathogenesis, identifying new therapeutic targets and improving diagnostic methods. However, the absence of an approved human vaccine leaves management dependent on supportive care, particularly for severe neurological cases. Effective vector control remains crucial, with innovative strategies including genetically modified mosquitoes and novel insecticides being pivotal. Furthermore, environmental factors like climate change and urbanization are altering vector behaviors and WNV transmission dynamics, necessitating adaptive public health strategies to manage these evolving threats. The review underscores the need for ongoing research, vaccine and therapeutic development, and enhanced public health infrastructures to better respond to WNV challenges. It stresses the critical role of integrating scientific research, public health policy, and community engagement to effectively address the persistent threat of WNV.

Background: Tuberculosis (TB) is a major public health issue in South Asia and accounts for a large share of the global TB burden. Despite global efforts to curb TB incidence and mortality, progress in South Asia has been uneven, necessitating focused regional analysis to guide effective interventions. This study aims to analyse the trends in the TB burden in South Asia from 1990 to 2021 and project future TB incidence rates up to 2031. Methods: This study utilized data from the Global Burden of Disease (GBD) 2021 results to analyse trends in age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (DALYs) rates (ASDR) associated with TB in South Asia from 1990 to 2021. Joinpoint regression analysis was employed to identify significant trends, whereas ARIMA models were used to project future TB incidence rates up to 2031. Results: This study revealed significant declines in the ASIR, ASPR, ASDR, and ASMR related to TB in South Asia over the past three decades. Prominent reductions were found in Bangladesh and Bhutan, whereas India, Pakistan, and Nepal continue to bear the highest TB burdens. The ARIMA model projections indicate a continued decline in TB incidence across the region, although the extent of the decline varies by country, with less favourable trends observed in Nepal and Pakistan. The analysis also highlights tobacco use, high fasting plasma glucose, and high body mass index as significant risk factors contributing to the TB burden. Conclusions: Substantial progress has been made in reducing the TB burden in South Asia; however, sustained and intensified efforts are needed, particularly in countries with inconsistent progress. These findings emphasize the need for targeted interventions to meet the WHO End TB Strategy (WETS) targets by 2035. Continuous monitoring and adaptive strategies will be crucial in maintaining and accelerating progress toward TB elimination in South Asia.

Background and objective: Graft versus host disease (GVHD) is the common complication seen after allogeneic hematopoietic stem cell transplantation (HSCT) and a pleomorphic syndrome that resembles autoimmune and other immunologic disorders, leading to profound immune dysregulation and organ dysfunction. The most common targets of GVHD are skin, gastrointestinal tract and liver. GVHD is classified as acute graft versus host disease (aGvHD) if it occurs within the first 100 days after HSCT and chronic graft versus host disease(cGVHD) if it occurs after day 100. The skin is most frequently and earliest affected by aGvHD, followed by the gastrointestinal tract and liver. An ideal biomarker would predict the onset and severity of clinical acute GVHD and help to direct management, and this is an area of active research regarding the use of biomarkers for diagnosis and prognosis of acute GVHD. Recently, elafin has been identified as a potential plasma biomarker for aGVHD.Method: We searched the databases PubMed, Cochrane library, and medRxiv for all studies investigating the Diagnostic or prognostic role of elafin in GVHD. We set the search strategy incorporating the search terms, ‘elafin’, ‘graft versus host’, and ‘GVHD’, and operated using the Boolean operators ‘AND’, and ‘OR’. Thus, retrieved articles were then exported on an Excel® sheet, and duplicates were removed. The systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After selecting the study based on inclusion criteria, data on study characteristics and biomarker description was extracted on a pre-determined data extraction table on the Microsoft Excel version. The quality assessment of the included studies was determined using the QUIPS tool.Result: The search revealed 547 studies and 6 studies that met the eligibility criteria of this review have been included. The major finding of our study is the significant elevation of elafin in skin aGVHD.Conclusion: Elafin is a significant biomarker for diagnosis and prognosis of skin aGVHD and should be assessed within 2 weeks of the onset of the disease.

The Nipah virus, classified by the World Health Organization as a priority pathogen due to its potential to cause epidemics, continues to present substantial challenges to public health systems with its episodic outbreaks and significant mortality rates. This zoonotic virus induces severe respiratory and neurological symptoms, often leading to multiorgan failure and high mortality. In India, the state of Kerala has become a focal point for NiV surveillance following repeated outbreaks that have highlighted the deadly impact of the virus and the urgent need for effective management strategies. Despite advances in diagnostics, the absence of specific treatments and vaccines complicates the effective management of these outbreaks. This article discusses the epidemiological trends, clinical challenges, and strategic imperatives for managing and preventing NiV. It highlights the ongoing transmission dynamics, including the genetic consistency of NiV that suggests a stable but continuously threatening viral reservoir in local bat populations. Moreover, the transmission mechanisms from fruit bats to humans, the pathogenesis within the human body, and the severe health outcomes resulting from infection have been discussed. The public health responses are essentially focused on surveillance, community engagement, and education, which are vital yet challenged by the lack of specific medical countermeasures. There is a need for global collaboration in research and public health preparedness to effectively address the challenges posed by NiV and promptly reduce the impact of future outbreaks.

Enteroviruses include polioviruses, which are classified into three types: type 1, type 2, and type 3. The oral polio vaccine (OPV), which contains attenuated strains of these three types, has been pivotal in reducing polio incidence worldwide. However, OPV can lead to vaccine-derived poliovirus (VDPV) cases, including circulating VDPV1 (cVDPV1), cVDPV2, and cVDPV3. In contrast, the inactivated or ‘killed’ polio vaccine (IPV), effectively prevents poliomyelitis without the risk of causing cVDPV cases. On 26 May 2024, a novel mutated form of poliovirus was detected in sewage samples from Kathmandu, Nepal, indicating an ongoing risk of poliovirus reintroduction and transmission. This finding highlights the importance of robust surveillance and containment measures. Historically, the Salk vaccine (IPV) and the Sabin vaccine (OPV) have been used against poliovirus, each with its advantages and limitations. Moving forward, it is necessary to replace OPV with genetically modified OPV, or new IPV formulations. Enhanced vaccination strategies and continued surveillance are crucial for achieving complete poliovirus eradication and preventing future outbreaks.

The recent identification of bacterial endotoxins in Ringer’s Lactate (RL) from a manufacturing batch by M/s. Vision Parenteral Pvt. Ltd. has raised significant concerns regarding the safety of intravenous solutions. These endotoxins, originating from Gram-negative bacteria, can trigger severe systemic inflammatory responses, worsening conditions like haemorrhagic shock and leading to organ dysfunction and increased mortality. The interaction between RL and endotoxins is particularly problematic, as it can exacerbate inflammation, disrupt fluid balance, and complicate metabolic and immune responses. This situation underscores significant gaps in pharmaceutical manufacturing practices and highlights the urgent need for stricter regulatory oversight and quality control. The healthcare community must reassess the use of RL in clinical settings, particularly in cases where endotoxin contamination could pose a significant risk, to protect patient health and safety.

Abstract Background Mpox infection is a zoonotic illness that resembles smallpox. Vaccination is widely regarded as a vital effective method of preventing mpox, however, there is lack of consensus of effectiveness of a single dose of mpox vaccine in the current 2022–2023 outbreak. We pooled data from real‐world studies to evaluate the efficacy of the JYNNEOS vaccination given as a single dosage. Method We carried out a thorough literature search in PubMed, Web of Science, and Scopus up until August 2023. We estimated the pooled vaccine effectiveness (VE) for mpox using inverse variance method in a random‐effects meta‐analysis. We expressed the results as VE, 95% confidence interval (95% CI), and 95% prediction interval (95% PI) using R v4.3.0. We assessed influence, heterogeneity contribution, and influence of studies using several tests and conducted sensitivity analysis accordingly. We used Doi plot and Luis Furuya‐Kanamori (LFK) index to evaluate publication bias. Results With a total sample size of 35,326 individuals, we involved 11 studies in the meta‐analysis. The VE of a single dose of JYNNEOS vaccine was 78.23% (95% CI: 62.79%–87.27%) by pooling data of 24,784 individuals over seven studies. The findings were heterogenous with a 95% PI of −32.14% to 96.41% depicting the expected range of VE in similar settings. Notably, VE increased to 83.02% (74.62%–88.64%) with a prediction interval of (44.67%–94.79) after sensitivity analysis by leaving out outliers. The results were robust in light of several sensitivity analyses. An asymmetric Doi plot with LFK index of −2.25 showed potential publication bias. Pooled prevalence of mpox infection among vaccinated individuals (breakthrough infection) in six studies was 2.19% (0.37%–5.32%). Conclusion The present findings provide compelling evidence that a single dose of JUNNEOS vaccine can protect recipients from mpox infection. With a 78.23% estimated efficacy rate, the vaccine is thought to be a useful tool in preventing further spread of mpox. However, more research and ongoing surveillance are required to fully understand the reasons behind breakthrough infections and to improve immunization strategies for better protection against mpox.

Chikungunya virus (CHIKV), a single-stranded RNA virus transmitted by Aedes mosquitoes, poses a significant global health threat, with severe complications observed in vulnerable populations. The only licensed vaccine, IXCHIQ, approved by the US FDA, is insufficient to address the growing disease burden, particularly in endemic regions lacking herd immunity. Monoclonal antibodies (mAbs), explicitly targeting structural proteins E1/E2, demonstrate promise in passive transfer studies, with mouse and human-derived mAbs showing protective efficacy. This article explores various vaccine candidates, including live attenuated, killed, nucleic acid-based (DNA/RNA), virus-like particle, chimeric, subunit, and adenovirus vectored vaccines. RNA vaccines have emerged as promising candidates due to their rapid response capabilities and enhanced safety profile. This review underscores the importance of the E1 and E2 proteins as immunogens, emphasizing their antigenic potential. Several vaccine candidates, such as CHIKV/IRES, measles vector (MV-CHIK), synthetic DNA-encoded antibodies, and mRNA-lipid nanoparticle vaccines, demonstrate encouraging preclinical and clinical results. In addition to identifying potential molecular targets for antiviral therapy, the study looks into the roles played by Toll-like receptors, RIG-I, and NOD-like receptors in the immune response to CHIKV. It also offers insights into novel tactics and promising vaccine candidates. This article discusses potential antiviral targets, the significance of E1 and E2 proteins, monoclonal antibodies, and RNA vaccines as prospective Chikungunya virus vaccine candidates.