Effectiveness of RCTs Pooling Evidence on Mesenchymal Stem Cell (MSC) Therapeutic Applications During COVID-19 Epidemic: A Systematic Review

Background

Global pandemic identified as coronavirus disease 2019 (COVID-19) has resulted in a variety of clinical symptoms, from asymptomatic carriers to those with severe acute respiratory distress syndrome (SARS) and moderate upper respiratory tract symptoms (URTS). This systematic review aimed to determine effectiveness of stem cell (SC) applications among COVID-19 patients.

Methods

Multiple databases of PubMed, EMBASE, Science Direct, Google Scholar, Scopus, Web of Science, and Cochrane Library were used. Studies were screened, chosen, and included in this systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 flowchart diagram and PRISMA checklist. Included studies' quality was assessed employing Critical Appraisal Skills Programme (CASP) quality evaluation criteria for 14 randomized controlled trials (RCTs).

Results

Fourteen RCTs were performed between the years of 2020 to 2022, respectively, with a sample size n = 574 (treatment group (n = 318); control group (n = 256)) in multiple countries of Indonesia, Iran, Brazil, Turkey, China, Florida, UK, and France. The greatest sample size reported from China among 100 COVID-19 patients, while the lowest sample of 9 COVID-19 patients from Jakarta, Indonesia, and the patient's age ranges from 18 to 69 years. Studies applied to the type of SC were "Umbilical cord MSCs, MSCs secretome, MSCs, Placenta-derived MSCs, Human immature dental pulp SC, DW-MSC infusion, Wharton Jelly-derived MSCs". The injected therapeutic dose was 1 × 10⁶ cells/kg, 1 × 10⁷ cells/kg, 1 × 10⁵ cells/kg, and 1 million cells/kg as per the evidence from the different studies. Studies focused on demographic variables, clinical symptoms, laboratory tests, Comorbidities, respiratory measures, concomitant therapies, Sequential Organ Failure Assessment score, mechanical ventilation, body mass index, adverse events, inflammatory markers, and PaO₂/FiO₂ ratio were all recorded as study characteristics.

Conclusion

Clinical evidence on MSC's therapeutic applications during COVID-19 pandemic has proven to be a promising therapy for COVID-19 patient recovery with no consequences and applied as a routine treatment for challenging ailments.

Effectiveness of COVID-19 Convalescent Plasma (CCP) During the Pandemic Era: A Literature Review

Worldwide pandemic with coronavirus disease-2019 (COVID-19) was caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). As November 2, 2022, World Health Organization (WHO) received 628,035,553 reported incidents on COVID-19, with 6,572,800 mortalities and, with a total 12,850,970,971 vaccine doses have been delivered as of October 31, 2022. The infection can cause mild or self-limiting symptoms of pulmonary and severe infections or death may be caused by SARS-CoV-2 infection. Simultaneously, antivirals, corticosteroids, immunological treatments, antibiotics, and anticoagulants have been proposed as potential medicines to cure COVID-19 affected patients. Among these initial treatments, COVID-19 convalescent plasma (CCP), which was retrieved from COVID-19 recovered patients to be used as passive immune therapy, in which antibodies from cured patients were given to infected patients to prevent illness. Such treatment has yielded the best results in earlier with preventative or early stages of illness. Convalescent plasma (CP) is the first treatment available when infectious disease initially appears, although few randomized controlled trials (RCTs) were conducted to evaluate its effectiveness. The historical record suggests with potential benefit for other respiratory infections, as coronaviruses like Severe Acute Respiratory Syndrome-CoV-I (SARS-CoV-I) and Middle Eastern Respiratory Syndrome (MERS), though the analysis of such research is constrained by some non-randomized experiments (NREs). Rigorous studies on CP are made more demanding by the following with the immediacy of the epidemics, CP use may restrict the ability to utilize it for clinical testing, non-homogenous nature of product, highly decentralized manufacturing process; constraints with capacity to measure biologic function, ultimate availability of substitute therapies, as antivirals, purified immune globulins, or monoclonal antibodies. Though, it is still not clear how effectively CCP works among hospitalized COVID-19 patients. The current review tries to focus on its efficiency and usage in clinical scenarios and identifying existing benefits of implementation during pandemic or how it may assist with future pandemic preventions.

Medication adherence and associated factors among psychiatry patients at Asella Referral and Teaching Hospital in Oromia, Ethiopia: Institution based cross sectional study

BACKGROUND

Medication adherence is the first and main determinant of treatment success. It is defined by world health organization as "the degree to which the person's behavior corresponds to the agreed recommendations from a health care provider". Non-adherence is a multi-factorial phenomenon that can result from five major interacting factors. These are health team and health system-related factors; patient-related factors; therapy-related factors; socio-economic factors; and condition-related factors. The prevalence of non-adherence in mental illness was found to be 40% to 60% world wide. In developing countries, the magnitude of poor adherence is expected to increase. So this study aimed to assess medication adherence status and its associated factors among psychiatric patients in Asella Referral and Teaching Hospital in Oromia, Ethiopia.

METHODS

An institution-based cross-sectional study was conducted from March 18, 2022 to May 25, 2022, with a total sample of 422 patients. Medication adherence was measured by a modified version of the medication adherence rating scale in the psychiatric setting to determine treatment adherence status, and unstructured questionnaires were assessed by interviewing the patient. Additional data concerning the medication-taking behavior of the patient was collected from caregivers. Bivariate logistic regression was performed to see the association between each explanatory variable and the outcome variable. The odds ratio and 95% confidence interval were used to see the association between treatment adherence and the strength of the link.

RESULTS

A total of 395 study participants were interviewed, making a response rate of 93.6%. The prevalence of treatment adherence was 246(62.3%). Medication adherence show high association with lifetime alcohol use [AOR: 3.18, 95% CI:1.31-7.72] compared to those who had no alcohol use histroy, and perceived stigma [AOR (95% CI: 2.31 (1.01-5.31)] compared with those who had no perceived stigma, where as adherence show low association with having slight or superficial insight about illness [AOR (95% CI: 0.25 (0.12-0.53)] compared to those who reported cured off their illness and belief in medication [AOR: 0.36, 95% CI: 0.16-0.81)] compared to those who didn't belief in the medication they are taking.

CONCLUSION

The prevalence of mediation adherence was found to be lower. In this study, factors such as having the slight insight or poor insight about their illness and belief in the medication decreased medication adherence, whereas having an alcohol use history in their lifetime and perceived stigma increased medication adherence. For a better health outcome, awareness creation at an insight level needs to be worked on by psychiatric professionals working on the follow-up psychiatric patients at psychiatry clinic of Assela Referral and Teaching Hospital to enable them to well adhere to their medication.

Determination on Level of Iodized Salt Availability in Households and Related Factors

Background:

Iodine deficiency (ID) affects 1.88 billion people worldwide. The World Health Organization (WHO) suggested that 90% of households should consume at least 15 ppm (parts per million) of iodized salt (IS) to effectively manage iodine deficiency disorders (IDD) in a world population. The principal goal of this study was to assess the availability of IS and associated factors among households in the Afar region of Ethiopia.

Methods:

At the community of Afar Region (AR), the cross-sectional study (CSS) was undertaken among 549 household members from December 01 to 30, 2017 G.C. A multi-stage stratified and systematic random sampling technique (SRST) was applied to select the study participants. A well-structured questionnaire was used to collect data among the study population, and salt samples were analysed using a Rapid test kit (RTK). The collected data was entered into Epi-info (EI) version 7 for cleaning and exported to Statistical Package for the Social Sciences (SPSS) 20.0 for further analysis completion. A Binary Logistic Regression (BLR) has been used to investigate the relationship between several parameters and the level of availability of IS with a considered statistically significant p-value of <0.05, and the study reported as per the Strengthening the reporting of observational studies in epidemiology (STROBE) checklist guidelines.

Result:

The study found that 38.1% [95 % CI: 33.9 – 42.3] of households had access to IS. However, the salt type usage [AOR=1.86, 95% CI: 1.075, 3.241], container used type [AOR=4.42, 95% CI: 2.53, 7.73], storage place [AOR=2.03, 95% CI: 1.271, 3.273) and storage duration [AOR=1.66, 95% CI: 1.003, 2.760] of factors were statistically associated with the level availability of IS at household.

Conclusion:

The research region has a poor availability of appropriate IS at the household level. The type of salt used, type of container used for storage, place of storage, and duration of storage were factors associated with the availability of IS. As a result, households should be educated about the need for IS and its safe management.

Promising Stem Cell therapy in the Management of HIV and AIDS: A Narrative Review

Stem cell therapies are becoming a major topic in biomedical research all over the planet. It may be a viable treatment choice for people suffering from a wide range of illnesses and injuries. It has recently emerged as an extremely intriguing and well-established science and research topic. Expectations have risen due to advancements in therapeutic approaches. Multiple laboratory testing of regulated stem cell culture and derivation is carried out before the formation of stem cells for the use of therapeutic process. Whereas HIV infection is contagious and can last a lifetime. Researchers are still working to develop a comprehensive and effective treatment for HIV and its associated condition, as well as AIDS. HIV propagation is primarily restricted to the immune system, notably T lymphocytes, as well as macrophages. Large numbers of research studies have contributed to a plethora of data about the enigmatic AIDS life cycle. This vast amount of data provides potential targets for AIDS therapies. Currently, stem cell transplantation, along with other procedures, provided novel insights into HIV pathogenesis and offered a glimpse of hope for the development of a viable HIV cure technique. One of its existing focus areas in HIV and AIDS research is to develop a novel therapeutic strategic plan capable of providing life-long complete recovery of HIV and AIDS without regular drug treatment and, inevitably, curative therapy for HIV and AIDS. The current paper tries to address the possibilities for improved stem cell treatments with “bone marrow, Hematopoietic, human umbilical cord mesenchymal, Genetical modifications with CRISPR/Cas9 in combination of stem cells, induced pluripotent stem cells applications” are discussed which are specifically applied in the HIV and AIDS therapeutic management advancement procedures.

The global prevalence and its associated factors toward domestic violence against women and children during COVID-19 pandemic-"The shadow pandemic": A review of cross-sectional studies

Globally, domestic violence affects women across their life span. Domestic violence against women and children during COVID-19 is a critical and substantial public health issue. This review article was aimed to determine the prevalence and its associated factors toward domestic violence against women and children during COVID-19. Several studies showed that the prevalence of domestic violence against women and children has been alarmingly enlarged during this COVID-19. Domestic violence is a significant and essential problem that is occurring all over the world for many years now, but this condition has been augmented during the lockdown situation because of this pandemic. Women and children of the worldwide are facing twin health emergencies that are COVID-19 and domestic violence. The pandemic was found as a threat to commit domestic violence against women and children. This is because, even though the measurements taken to avoid COVID-19 spread are supportive strategies and also the only opportunity to do so, reducing the risk of COVID-19 was found to raise the risk of domestic violence against women and children. Factors associated with domestic violence against women and children were; being housewives, age < 30 years, marriage, husband's age being between 31 and 40 years, physical victimization, and sexual victimization were factors associated with domestic violence. Depression, spending more time in close contact, job losses, financial insecurity, lockdowns, addiction (alcohol or drugs), control of wealth in the family, technology, and quarantine were factors considered as risk factors for domestic violence. This review will serve as a "call to action" to address this crisis effectively by coming together since this crisis is the global aspect. This is a shadow pandemic growing during this COVID-19 crisis and a global collective effort is needed to prevent it. The life of women and children moves from their needs to their rights during this pandemic. It is essential to undertake urgent actions to intervene in it.

Magnitude and Factors Affecting Parental Stress and Effective Stress Management Strategies Among Family Members During COVID-19

The pandemic outbreak, coronavirus disease 2019 (COVID-19) threatens proper family patterns by disrupting normal day-to-day activities, such as working patterns of parents by working from home, online children’s education rather than regular school, a dilemma in children’s education and health constrained movement by complete or partial home lockdowns to prevent disease spread, anxiety of disease spread, failure of home quarantine due to insufficient home situation and reduced personal protective equipment usage due to the extra financial burden, reduced social communications, increased health burdens than usual along with enormous toil with dependent family members, demands of financial burdens by multiple factors, reduced monthly income during pandemics, lack of employment or job insecurity, deviations in mental health among family members such as fear, anxiety, insomnia, severe depression, hetero aggression, child verbal or physical abuses, increased alcohol consumption and substance abuse or drug addictions, aggressive behavior, self-blaming or injury, unintentional suicidal tendencies, mood disorders, posttraumatic stress disorder and failure to meet health demands due to a lack of health facilities. Many contributing factors are affecting the normal family status than usual circumstances such as reduced hospital equipment or resources which is due to pandemic effects, social isolation due to outside quarantine measures, insecurity of the future and ongoing pandemic situation, fear of vaccination side effects, and so on. Therefore, we hope to raise awareness about the magnitude of parental stress levels and contributing factors. Moreover, these findings would encourage effective stress management to overcome the factors that contribute to parenteral stress and to improve coping skills to face the coming darkness with ease. It supports the preservation of physical, mental, and social well-being in families as well as minimizing or overcoming stressors, maintaining strong familial ties, and improving life expectancy globally during this pandemic.

Assessment of Quality of Life Among Health Professionals During COVID-19: Review

In 2019, coronavirus disease pandemic (COVID-19) influences the quality of life of health personnel who are on the front lines in dealing with COVID-19 patients. The purpose of this study is to assess the quality of life of health professionals during the COVID-19 epidemic. The novel coronavirus disease-19 (COVID-19) has spread across the globe with the direct causal viral agent of severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2) and infected many people. All health professionals (HPs) such as physicians, nurses, and other allied health staff members are primary caregivers in hospitals and other health care settings, specifically under pandemic situations such as COVID-19. The emergence of the COVID-19 pandemic has caused numerous diversions in the preservation of the quality of life (QoL) of health professionals by deviations from normal physical, mental, and social wellbeing aspects. HPs are the most vulnerable population to COVID-19 viral transmission while delivering emergency medical services to persons infected with the virus in various health care sectors, such as direct engagement in lifesaving management. In this perspective, some recent literature on QoL of health professionals was examined, uncovering that they frequently experience fear and anxiety due to viral transmissions in the place of work and probable cross-contamination among family members, tend to experience insomnia caused by sudden increased work pressure, struggle to balance professional and personal life, suffering from mental health disturbances such as depressive episodes, mood disturbances, and suicidal tendencies due to the unpredictability of the disease outbreak. The current review is looking to determine and address the degree of QoL maintained by specific types of health professionals during critical moments of COVID-19 pandemics. This study may assist health organization stakeholders in enhancing QoL among health professionals by introducing required provisions, measures, or initiatives for the welfare of health professionals, notably in resolving pandemic demands in all health organizations.