Key Points
Question
What is the association of the use of checkpoint inhibitors with the risk of neurological adverse events?
Findings
In this meta-analysis of 39 trials evaluating the use of checkpoint inhibitors to treat various malignant neoplasms, the risk of neurological adverse events was lower when compared with chemotherapy. However, the risk of neurologic adverse events was higher with checkpoint inhibitors compared with placebo.
Meaning
These results suggest patients treated with checkpoint inhibitors are less likely to develop neurologic adverse events compared with other cancer medications, particularly cytotoxic chemotherapy.
A wide range of antimicrobial agents were touted as potential remedies during the COVID-19 pandemic. While both developed and developing countries have recorded an increase in the use of antimicrobial drugs, use and misuse have occurred to a far greater degree in developing countries. This can have deleterious consequences on antimicrobial resistance, especially when various developing countries have already reported the emergence of various drug-resistant organisms even before the pandemic. Telemedicine services, societal and cultural pressures, and bacterial co-infections can predispose to overwhelming antimicrobial prescriptions. The emergence of new multidrug resistance species is a major concern for the developing world especially since health services are already overburdened and lack the diagnostic capabilities and basic amenities for infection prevention and control. This can lead to outbreaks and the rampant spread of such microorganisms. Improper waste management and disposal from hospitals and communities establish freshwater runoffs as hubs of various microorganisms that can predispose to the rise of multidrug-resistant species. Microplastics' ability to act as vectors for antibioticresistant organisms is also particularly concerning for lower-middle-income countries. In this review, we aim to study the impact of antimicrobial use during the COVID-19 pandemic and antimicrobial resistance in lower middle-income countries, by understanding various determinants of resistance unique to the developing world and exploring solutions to combat the problem.
Recently, in Pakistan, several cases of mysterious dengue‐like illness are being reported, which has concerned the authorities and requires prompt action. We present a case of a 52‐year‐old female patient presenting with a history of continuous fever, documented up to 104 F, for 5 days. The symptoms were associated with headache, nausea, retro‐orbital headache, arthralgia, and myalgia. Currently, to the best of our knowledge, this is the first reported case in the literature for the endemic mysterious virus and may serve as the groundwork for future studies.
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