BackgroundVaccination, one of the most important and effective ways of preventing infectious diseases, has recently been used to control the COVID-19 pandemic. The present meta-analysis study aimed to evaluate the effectiveness of COVID-19 vaccines in reducing the incidence, hospitalization, and mortality from COVID-19.MethodsA systematic search was performed independently in Scopus, PubMed via Medline, ProQuest, and Google Scholar electronic databases as well as preprint servers using the keywords under study. We used random-effect models and the heterogeneity of the studies was assessed using I2 and χ2 statistics. In addition, the Pooled Vaccine Effectiveness (PVE) obtained from the studies was calculated by converting based on the type of outcome.ResultsA total of 54 studies were included in this meta-analysis. The PVE against SARS-COV 2 infection were 71% [odds ratio (OR) = 0.29, 95% confidence intervals (CI): 0.23–0.36] in the first dose and 87% (OR = 0.13, 95% CI: 0.08–0.21) in the second dose. The PVE for preventing hospitalization due to COVID-19 infection was 73% (OR = 0.27, 95% CI: 0.18–0.41) in the first dose and 89% (OR = 0.11, 95% CI: 0.07–0.17) in the second dose. With regard to the type of vaccine, mRNA-1273 and combined studies in the first dose and ChAdOx1 and mRNA-1273 in the second dose had the highest effectiveness in preventing infection. Regarding the COVID-19-related mortality, PVE was 68% (HR = 0.32, 95% CI: 0.23–0.45) in the first dose and 92% (HR = 0.08, 95% CI: 0.02–0.29) in the second dose.ConclusionThe results of this meta-analysis indicated that vaccination against COVID-19 with BNT162b2 mRNA, mRNA-1273, and ChAdOx1, and also their combination, was associated with a favorable effectiveness against SARS-CoV2 incidence rate, hospitalization, and mortality rate in the first and second doses in different populations. We suggest that to prevent the severe form of the disease in the future, and, in particular, in the coming epidemic picks, vaccination could be the best strategy to prevent the severe form of the disease.Systematic review registrationPROSPERO International Prospective Register of Systematic Reviews: http://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42021289937].

OBJECTIVES: Since poisoning is one of the most important preventable factors contributing to the hospitalization and death of children who present to emergency departments, this study was carried out to investigate the risk factors contributing to the incidence and mortality of acute childhood poisoning.METHODS: This hospital-based case-control study included 243 cases and 489 controls, drawn from daily admissions to the emergency departments of the included hospitals according to the inclusion and exclusion criteria.RESULTS: Gastrointestinal poisoning was the most common poisoning type, found in 87.7% of subjects, and medications were the most common cause of poisoning (49.8%). Multiple logistic regression analysis showed that a history of poisoning (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.58 to 19.51; p<0.001) and the availability of poisonous substances (OR, 8.88; 95% CI, 5.41 to 14.56; p<0.001) were among the most important predictors of childhood poisoning. Respiratory poisoning (OR, 6.72; 95% CI, 1.40 to 32.07; p<0.05) and the presence of addiction in the family (OR, 4.54; 95% CI, 1.10 to 18.68; p<0.05) were the most important predictors of mortality among children with poisoning.CONCLUSIONS: Addiction and the presence of physical or psychological disorders in family members, a history of poisoning, and the availability of poisonous substances were significantly associated with the incidence of childhood poisoning and resultant mortality.

No abstract

Introduction & ObjectiveVaccination is one of the most important and effective ways of preventing infectious diseases, and has recently been used in the COVID-19 epidemic and pandemic. The present meta-analysis study aimed to evaluate the effectiveness of COVID-19 vaccines in reducing the incidence of infection, hospitalization, and mortality in observational studies.Materials and MethodsA systematic search was performed independently in Scopus, PubMed, ProQuest, and Google Scholar electronic databases as well as Preprint servers using the keywords under study. The heterogeneity of the studies was assessed using I2and χ2 statistics, according to which the I2 of > 50% and P -value <0.1 was reported as heterogeneity of the studies. In addition, the Pooled Vaccine Effectiveness (PVE) obtained from the studies was calculated by converting (1-Pooled estimate × 100%) based on the type of outcome.ResultsA total of 54 records were included in this meta-analysis. The rate of PVE against SARS-COV 2 infection was about 71% (OR = 0.29, 95% CI: 0.23-0.36) in the first dose and 87% (OR = 0.13, 95% CI: 0.08-0.21) in the second, and the highest effectiveness in the first and second doses was that of BNT162b2 mRNA and combined studies. The PVE versus COVID-19-associated hospitalization was 73% (OR = 0.27, 95% CI: 0.18-0.41) in the first dose and 89% (OR = 0.11, 95% CI: 0.07-0.17) in the second. mRNA-1273 and combined studies in the first dose and ChAdOx1 and mRNA-1273 in the second dose had the highest effectiveness. Regarding the COVID-19-related mortality, PVE was about 28% (HR = 0.39, 95% CI: 0.23-0.45) in the first dose and 89% (HR = 0.11, 95% CI: 0.03-0.43) in the second.ConclusionThe evidence obtained from this study showed that the effectiveness of BNT162b2 mRNA, mRNA-1273, and ChAdOx1 in the first and second doses, and even combined studies were associated with increased effectiveness against SARS-COV2 infection, hospitalization, and death from COVID-19. In addition, considering that the second dose was significantly more efficient than the first one, a booster dose injection could be effective in high-risk individuals. On the other hand, it was important to observe other prevention considerations in the first days after taking the first dose.

Background:In order to assessment of intravascular fluid measurement of central venous pressure (CVP) is used via central venous catheterization (CVC). This procedure is highly invasive and may cause serious complications such as pneumothorax, infection, hematoma and etc. It is so valuable procedure if we can uses a less invasive or noninvasive procedure to assess patients intravascular fluid in critical positions.Objectives:In this study, the ultrasound was used to measure the central venous pressure (CVP).Patients and Methods:In this study, patients with Central venous catheterization were selected using simple random sampling. The largest diameter of longitudinal, transverse views and the cross-section of inferior vena cava (IVC) and internal jugular vein (IJV) were measured using the ultrasound in the bedside of the patients. Central venous pressure was measured using routine methods. Correlations between variables were analyzed using SPSS and linear regression.Results:Twenty patients with the mean age of 60.3 were studied. The main reason for cardiac catheterization was shock. There are no relationship between anterior posterior diameter of inferior vena cava and CVP of patients (P = 0.257). The longest diameter of IVC in ultrasonographic transverse view had significant association with CVP of patients (P = 0.045) but in patients with BMI > 25 it was not significant. Cross section of internal jugular vein had significant association with CVP of patients (P = 0.003). Longitudinal diameter of internal jugular vein had no significant association with CVP of patients (P = 0.052), but transverse diameter of internal jugular generally had significant association with CVP of patients (P = 0.003). Cross section of internal jugular had significant association with CVP (P = 0.001).Conclusions:Noninvasive assessment of the patient hydration condition using the ultrasound is a simple and practicable measure in emergency. With regard to the considerations, it is possible to estimate CVP via diameter measurement and cross-section of the central veins.