Journal of Research in Health Sciences
Volume:23 Issue: 4, Fall 2023

 Different vaccines have so far been developed and approved to cope with COVID-19 in the world. The aim of this updated network meta-analysis (NMA) was to compare and rank all available vaccines in terms of efficacy and complications simultaneously.

Study Design: 

A systematic review.

 Three major international databases, including Web of Science, Medline via PubMed, and Scopus, were searched through September 2023. The transitivity assumption was evaluated qualitatively in terms of epidemiologic effect modifiers. The exposure of interest in this study was receiving any available COVID-19 vaccine, and the primary outcome of interest was the incidence of symptomatic COVID-19. In this NMA, the relative risk of symptomatic COVID-19 was used to summarize the efficacy of vaccines in preventing COVID-19. The data were analyzed using the frequentist-based approach, and the results were reported using a random-effects model. Finally, the vaccines were ranked using a P-score.

 In total, 34 randomized controlled trials (RCTs) met the eligibility criteria for this systematic review and NMA out of 3682 retrieved references. Based on the results of the NMA, mRNA-1273 was the most effective vaccine in preventing COVID-19 and demonstrated the highest P-score (0.93). The relative risk (RR) for mRNA-1273 versus placebo was 0.07 (95% confidence interval [CI]: 0.03, 0.17). The second and third-ranked vaccines were BNT-162b2 (RR=0.08; 95% CI: 0.04, 0.15; P-score=0.93) and Gam-COVID-Vac (0.09; 95% CI: 0.03, 0.25; 0.88).

 Based on the results of this NMA, it seems that all available vaccines were effective in COVID-19 prevention. However, the top three ranked vaccines were mRNA-1273, BNT-162b2, and Gam-COVID-Vac, respectively.

 According to the findings from observational studies and clinical trials assessing the effect of vitamin D supplements on cardiovascular diseases (CVDs), there are still contradictory results. This systematic review aimed to assess the effect of vitamin D supplements on CVDs considering cohort studies and clinical trials.

Study Design:

 A systematic review.

 MEDLINE/PubMed, Science Direct, Embase, and Cochrane Library databases were reviewed by two reviewers independently until 2022. The study effect is risk ratio (RR) and 95% confidence interval (CI) according to Mantel Haenszel’s random-effects model. Then, Stata version 14 was used for statistical analysis.

 In clinical trial studies, the incidence of CVDs among the vitamin D-consuming group was not significantly different from that in the placebo group (RR: 0.99, 95% CI: 0.95-1.03; P=0.77; I 2=0%). CVD mortality was also not significantly different between the two groups (RR: 0.97, 95% CI: 0.90-1.05; P=0.72; I2=0%). In cohort studies, circulating 25 (OH) D increased the risk of CVD incidence by 31% (RR: 1.31, 95% CI: 1.19-1.45) and CVD mortality by 37% (RR: 1.37, 95% CI: 1.17-1.61).

 According to current evidence from clinical trials, vitamin D supplementation should not be recommended for CVD prevention. However, there is a direct association between vitamin D deficiency and the incidence of CVDs as well as its mortality. According to the results of clinical trial studies carrying higher levels of scientific evidence, it can be concluded that vitamin D supplementation does not exert a significant effect on the incidence, mortality, and reduction of CVDs.

 Hospitalization for peptic ulcer disease (PUD) has been described outside of North America as peaking in the fall and winter. However, no recent literature has so far investigated the seasonal fluctuations and complications of PUD in the USA.

Study Design:

 Cross-sectional population database review.

 Patients with a diagnosis of either acute gastric or acute duodenal ulcers from January 1, 2015, through December 31, 2017, were identified in the Healthcare Cost and Utilization Project’s National Inpatient Sample. The proportion of admissions with either hemorrhage or perforation was determined for each season and further subdivided into geographic regions.

 Of 18829 hospitalizations for PUD, admissions were the highest in the fall (25.9%) while being the lowest in the summer (23.9%). Complications, hemorrhage or perforation, were the highest and the lowest in the fall and spring, respectively (75.7% vs. 73.6%; P=0.060 for comparing all 4 seasons). Geographically, the West had the highest rate of peptic ulcer hemorrhage (64.5%, P=0.004), while the northeast had the highest rate of perforation (14.3%, P=0.003). Hemorrhage was more common in males, those who used aspirin, nonsteroidal anti-inflammatory drugs, or anticoagulants, and diabetics (P<0.05). Perforation was less common in males, those with diabetes, obesity, or hypertension (HTN), or those using aspirin or anticoagulants (P<0.05). Helicobacter pylori infection was more associated with perforation in the fall and winter months.

 Seasonal and regional trends in hospitalizations due to PUD may help identify modifiable risk factors, which can improve diagnostic and treatment outcomes for patients by allowing for more targeted identification of vulnerable populations.

 This study aimed to assess the efficacy of a dengue intervention program in economically deprived urban regions of India, with a particular emphasis on housing conditions and community involvement. Given the global significance of dengue fever as a vector-borne disease, successful vector management requires effective community engagement.

Study Design:

 A quasi-experimental study.

 This study was conducted with 314 participants from Delhi’s Sanjay Colony, divided into control and intervention groups. The study spanned 14 months (August 2020 to September 2021). The intervention program comprised two educational sessions held one month apart, covering dengue awareness, health self-care, and environmental maintenance. Data were collected at baseline, after each intervention session, and during a final follow-up assessment three months later.

 The primary outcome, the house index (HI), revealed statistically significant differences (P<0.001) favoring the intervention group. The total score (TS) for mosquito-borne disease, TS of knowledge, TS of attitude, and TS of practices all exhibited significant improvements in the intervention group. Participants showed an enhanced understanding of dengue causes, symptoms, and mosquito behavior related to breeding and biting. The HI in the intervention group decreased significantly from 21.65% to 4.45% (P<0.05).

 This study, grounded in the health belief model (HBM), demonstrated the effectiveness of the intervention program in reducing HI and improving knowledge and preventive practices regarding dengue fever in impoverished urban neighborhoods of Delhi. The intervention program may be beneficial in such a poor urban community.

 The Maluku region encompasses thousands of islands. The study analyzed factors related to stunting among children under two years old in the Maluku Region of Indonesia.

Study Design: 

A cross-sectional study.

 This cross-sectional study examined 4764 children under two years. In addition to nutritional status (stature), the study analyzed ten independent variables (province, residence, maternal age, marital status, maternal education, employment, wealth, children’s age, gender, and early initiation of breastfeeding [EIBF]). Finally, the contribution of various factors to stunting was examined using logistic regression.

 Children in Maluku province were 1.13 times more likely than those in North Maluku province to become stunted. In addition, children aged 12-13 months were 4.09 times more likely than<12 months, and boys were 1.87 times more likely than girls to have the patterns of stunting. Children in rural areas were 1.10 times more likely to become stunted than those in urban areas (95% confidence interval: 1.06, 1.14). Divorced/widowed mothers were 1.88 times more likely than married mothers. Mothers of all education levels were more likely than those without formal education, and unemployed mothers were 1.07 times more likely than employed mothers to have stunted children. The possibility of becoming stunted was lower when the children were wealthier.

 Nine variables were related to stunted incidence, including province, residence, maternal age, marital status, maternal education, employment, wealth, children’s age, and gender.

 The relationship between anemia and depression remains controversial. This study aimed to investigate the association between hemoglobin (Hb) levels and depressive symptoms.

Study Design:

 A cross-sectional study.

 This study was conducted using National Health and Nutrition Examination Survey data from 2005–2018. Hb levels were obtained from laboratory files, and depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Multivariable logistic regression analysis and smoothing plots were performed to examine the relationship between anemia and depression, including potential nonlinear associations.

 The study included 6008 male adults. Multivariable analysis revealed that anemia was associated with an increased odds ratio for mild (OR=1.49, 95% CI: 1.06, 2.10) and moderate (OR=2.05, 95% CI: 1.14-3.70) anemia. Additionally, each additional g/dL of Hb was significantly inversely associated with developing depression (OR=0.91, 95% CI: 0.85, 0.96). A nonlinear relationship was detected between Hb and depression, with an inflection point at 15 g/dL. Below this threshold, there was a significantly negative association between Hb and depression (OR=0.88, 95% CI: 0.79, 0.98); no significant relationship was observed above it (OR=1.05, 95% CI: 0.84, 1.31).

 Anemia was positively associated with depression in non-White American men. A nonlinear relationship between Hb and depression was detected, and it had a saturation effect. A significant negative correlation with depression was observed when the Hb level was below 15 g/dL.

 Health literacy (HL) plays a crucial role in the adolescent’s behavior. Inadequate HL can contribute to engaging in risky alcohol consumption, but little is known about this relationship among medical students. We aimed to investigate the relationship between HL and alcohol use among Chinese medical students.

Study Design: 

A cross-sectional design.

 This research was conducted on 1146 medical students in Hubei province, China. The data were collected using a web-based online questionnaire. Multiple logistic regression was applied to investigate factors related to alcohol use.

 Approximately 45.3% of medical students were drinkers, about 11.5% were hazardous drinkers, and 33.8% were low-risk drinkers; furthermore, about 49.3% of them reported lower levels of HL. In both the low-risk and hazardous drinking groups, the subjects who had low levels of all six dimensions of HL were more likely to use alcohol after adjusting for other covariates, including cognitive skill (adjORfor low-risk=3.50; 95% CI: 2.41, 5.07, adjORhazardous=2.07; 95% CI: 1.22, 3.51), access skill (adjORfor low-risk=2.11; 95% CI: 1.46, 3.05, adjORhazardous=2.40; 95% CI: 1.37, 4.19), communication skill (adjORfor low-risk=1.72; 95% CI: 1.20, 2.47, adjORhazardous=2.21; 95% CI: 1.22, 4.00), self-management skill (adjORfor low-risk=1.73; 95% CI: 1.15, 2.59, adjORhazardous=4.01; 95% CI: 1.91, 8.44), media skill (adjORfor low-risk=1.50; 95% CI: 1.01, 2.23, adjORhazardous=4.68; 95% CI: 2.15, 10.17), and decision skill (adjORfor low-risk=2.12; 95% CI: 1.49, 3.00, adjORhazardous=2.25; 95% CI: 1.35, 3.74).

 Inadequate HL plays an important role in increasing alcohol use. Thus, prevention and intervention strategies should be based on improving medical students’ HL.

 Evidence suggests that train drivers experience a high level of fatigue and mental workload. The present study aimed to assess overall, physical, and mental fatigue levels and their correlations with the mental workload in the metro train operation.

Study Design: 

A cross-sectional study.

 This study was conducted on all 1194 train drivers in the Tehran Metro. The train drivers completed the Samn-Perelli Fatigue Scale and the Fatigue Assessment Scales at the beginning and end of the shift. In addition, they completed the National Aeronautics and Space Administration Task Load Index in the middle and at the end of the shift. Correlation and regression analyses were performed on the data to test the study hypothesis.

 Overall, physical, and mental fatigue levels increased significantly at the end of the shift compared to the onset of the shift (P<0.001). The mental workload and related dimensions were significantly increased at the end of the shift compared to the middle of the shift (P<0.001). Mental demand was the most important workload problem among the train drivers. The highest correlation was found between overall workload and time pressure (R=0.68, P<0.001).

 The mental workload had a significant correlation with work fatigue in the train drivers. Control measures should be focused on the mental workload and related dimensions, especially mental demand and time pressure.