Procalcitonin is an inflammatory marker that had shown marked potential as an antimicrobial stewardship tool for administering antibiotics when needed in patients with pneumonia as it raises concurrently with other inflammatory markers, yet no systematic review has assessed its potential in COVID-19 patients. This systematic review aimed to assess the potential appropriateness of procalcitonin as an antimicrobial stewardship tool in COVID-19 patients with superimposed bacterial and non-bacterial infections. All study designs published after 2019 were included in this systematic review. We included all studies that had reported procalcitonin levels in COVID-19 patients with suspected superimposed secondary infection(s). We searched MEDLINE, Scopus, and the Directory for Open Access Journal from April 2022 to May 2022 and retrieved all related articles for screening with no restrictions on language. We conducted risk of bias assessment according to the Critical Appraisal Skills Programme (CASP) criteria for cohort and case-control studies. Results were presented according to procalcitonin cut-off values, gold standard test used to confirm infection, and overall study conclusion(s), among other variables. This systematic review included 18 articles with 7196 patients in 8 countries. Despite different cut-off values of procalcitonin used, thirteen studies had indicated the appropriateness of using procalcitonin as antimicrobial stewardship tool in COVID-19 patients. We urge physicians to take this into account when treating COVID-19 patients suspected of superimposed infections and we look forward to further studies with standardized procalcitonin cut-off values that may provide appropriate quantitative data that can contribute to clinical guidelines. Registration (PROSPERO): CRD42022315013.
Background: Vesatolimod is a toll-like receptor (TLR) agonist that is thought to suppress chronic hepatitis B (HBV) infection. This systematic review aimed to assess the safety and efficacy of vesatolimod in treating chronic hepatitis B. Methods: We included randomized clinical trials (RCTs) that assessed vesatolimod in patients with hepatitis B infection without hepatocellular carcinoma or liver transplantation and with reported levels of hepatitis B surface antigen (HBsAg) or liver transaminases post-intervention. We searched MEDLINE, SCOPUS, Springer, Google Scholar, ClinicalTrials.gov, and Cochrane Central Register of Clinical Trials for all related articles during May 2022. Two independent authors screened articles for inclusion, and discrepancies were resolved by consensus and a third reviewer. Two independent reviewers assessed studies included in this systematic review using the Critical Appraisal Skills Programme checklist for RCTs. Results and conclusion: Only 4 were considered eligible from 391 articles identified through our search. All eligible studies did not report any clinically significant outcomes following the use of vesatolimod, as evidenced by the persistence of HBsAg. However, vesatolimod was associated with induction of interferon-stimulated genes (ISGs) and only mild side effects, warranting further studies to evaluate its potential for future use as a safe, tolerable anti-HBV medication. No significant differences were noted amongst trials included in either of Vesatolimod doses (Vesatolimod 1 mg, RR = 0.99, 95% CI 0.76–1.30, P = .95, I 2 = 0%; Vesatolimod 2 mg, RR = 1.06, 95% CI 0.82–1.37, P = .66, I 2 = 0%; Vesatolimod 4 mg, RR = 1.06, 95% CI 0.82–1.37, P = .66, I 2 = 0%;), further suggesting its comparable safety in comparison to oral antiviral agents.
Introduction: The coronavirus disease 2019 (COVID-19) caused a global pandemic with long-lasting economic and cultural impacts. International governments have attempted to scale up vaccine production to mitigate this crisis. However, vaccine hesitancy, particularly among healthcare providers, remains an understudied subject that may hinder vaccine effectiveness. Methods: We performed a cross-sectional study to evaluate vaccine hesitancy among medical students using a pre-validated survey based on the 5C model of psychological antecedents, which includes confidence, complacency, constraints, calculation, and collective responsibility. Results: The majority of medical students had high scores for confidence (79.7%), non-complacency (88%), and not having constraints against receiving the COVID-19 vaccine (97.4%). Surprisingly, students had low scores for calculation (38%) and collective responsibility (14.7%). Many predictors of the psychological antecedents included in the 5C model have been reported, including academic year and gender. Conclusion: We observed moderate levels of vaccine hesitancy among the medical students included in our study. We urge medical students to be more aware of community public health concerns. We recommend that authorized institutions lay out urgent reforms to increase awareness of COVID-19 and available vaccines.
Background: Medical research has become an essential part of medical students’ curricula at several medical colleges in Saudi Arabia. This study aimed to assess medical students' attitudes and identify factors influencing their willingness to conduct medical research. Methods: This cross-sectional study was conducted between December 2021 and April 2022 using the students' attitudes towards research and the students’ perceived influential factors toward participating in research activities questionnaires. A 5-Likert scale to calculate the average of the students’ responses, where 5 indicated ‘strongly agree’ and 1 indicated ‘strongly disagree’. The survey was distributed to medical students at the College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Saudi Arabia. Results: A total of 500 responses were collected from the students (67.2% male and 32.8% female). Most students agreed with the following statement: ‘Research is important for identifying and investigating problems in a subject matter’ (N=399, 79.8%). More than half of the students agreed with the following statement: ‘I am very interested in participating in research activities at the undergraduate level’ (N=318, 63.6%). The top three influential factors for conducting medical research were ‘to facilitate entry into competitive residency programs’, followed by ‘interest in specific research fields or medical topics’ and ‘to improve curriculum vitae (CV).’ Conclusion: The majority of the surveyed students showed a positive attitude towards conducting medical research in King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia. Most students conduct research to gain a competitive edge and explore specialties of interest.
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