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Background The pathological basis of coronary artery disease (CAD) is atherosclerosis which is associated with inflammation and dyslipidemia. However, the involvement of hypersensitive C-reactive protein (hs-CRP) in lipid metabolism and how it affects the pathogenesis of CAD is uncertain. Objective To explore whether the relationship between dyslipidemia and CAD is partly mediated by hs-CRP levels. Methods Three hundred fifteen pairs of randomly sexand age-matched CAD and non-CAD subjects collected from Zhongda Hospital Affiliated to Southeast University were involved in the final analysis. We gathered information about each subjects clinical history as well as their results of detected hs-CRP and lipid levels. Linear regression analysis was used to determine the association between dyslipidemia and hs-CRP levels in which univariate and multivariate logistic regression analyzes were performed to determine the relationship between hs-CRP levels and CAD as well as dyslipidemia and CAD. Mediation analysis was used to evaluate whether hs-CRP levels act as a mediator of the relationship between dyslipidemia and CAD. Results Dyslipidemia and hs-CRP levels were significantly associated with an increased risk of CAD, with β = 0.594 (P = 0.001) and β = 0.016 (P = 0.024), respectively, and there was a correlation between dyslipidemia and hs-CRP levels (β = 3.273, P = 0.004). Mediation analysis results revealed that the correlation between dyslipidemia and CAD was 8.27% mediated by hs-CRP levels with a direct effect of 0.621 and an indirect effect of 0.056. Conclusion Hs-CRP levels played a partial mediation role in the association between dyslipidemia and CAD.

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During the COVID-19 pandemic, evacuation and repatriation of nationals have been done by many countries. However, this has posed several socio-economic and public health issues that are worth exploring. This commentary, therefore, aims at exploring the impact of evacuation and repatriation amidst the COVID-19 pandemic. Evacuation and repatriation helped to alleviate the psycho-social effects of the pandemic on foreign nationals, and also creates a sense of relief for host nations due to the reduced stress related to caring for a potentially larger number of people. It also contributed to the enhancement of the healthcare systems of several countries. However, evacuation and repatriation have contributed to the importation of the virus into various countries. It presents significant logistic and economic challenges as it requires trained personnel and equipment. Therefore, there is a need for proper planning, financing and supervision to avoid possible importation of the virus during the expedition. In addition, community awareness regarding returnees is essential to prevent social discrimination and stigma. Doi: 10.28991/SciMedJ-2021-03-SI-7 Full Text: PDF

BackgroundThe results of randomized controlled studies on aspirin for the prevention of preeclampsia (PE) are conflicting, and some of the related meta-analyses also have limitations or flaws.Data sourcesA search was conducted on PubMed, Embase, and Cochrane Central Register of Controlled Trials databases, with no time or language restrictions.Study eligibility criteriaRandomized controlled studies comparing aspirin for the prevention of PE were conducted.MethodsSystematic reviews were performed according to the Cochrane Manual guidelines. A fixed-effects model or a random-effects model was chosen to calculate pooled relative risks with 95% confidence intervals based on the heterogeneity of the included studies. The study aimed to investigate the effect of aspirin on the development of PE in high-risk and general populations of women. Publication bias was assessed by funnel plots. All included studies were assessed for bias by the Cochrane Manual of Bias Assessment. Subgroup analyses were conducted on the aspirin dose, time of initial aspirin intervention, and the region in which the research was conducted, to explore the effective dose of aspirin and time of initial aspirin intervention and to try to find sources of heterogeneity and publication bias.ResultsA total of 39 articles were included, including 29 studies involving pregnant women at high risk for PE (20,133 patients) and 10 studies involving a general population of pregnant women (18,911 patients). Aspirin reduced the incidence of PE by 28% (RR 0.72, 95% CI 0.62–0.83) in women at high risk for PE. Aspirin reduced the incidence of PE by 30% in the general population (RR 0.70, 95% CI 0.52–0.95), but sensitivity analyses found that aspirin in the general population was not robust. A subgroup analysis showed that an aspirin dose of 75 mg/day (RR 0.50, 95% CI 0.32–0.78) had a better protective effect than other doses. Starting aspirin at 12–16 weeks (RR 0.62, 95% CI 0.53–0.74) of gestation or 17–28 weeks (RR 0.62, 95% CI 0.44–0.89) reduced the incidence of PE by 38% in women at high risk for PE, but the results were more reliable for use at 12–16 weeks. Heterogeneity and publication bias of the included studies may be mainly due to the studies completed in Asia.ConclusionAspirin is recommended to be started at 12–16 weeks of pregnancy in women at high risk for PE. The optimal dose of aspirin to use is 75 mg/d.Systematic review registration[www.ClinicalTrials.gov], identifier [CRD42022319984].