Current Prevention Strategies Research Articles

Correlates of oral pre-exposure prophylaxis cessation among men who have sex with men in China: implications from a nationally quantitative and qualitative study

BackgroundSeveral studies have demonstrated the population-level effectiveness of oral PrEP in reducing the risk of HIV infection. However, oral PrEP utilization among MSM in China remains below 1%. While existing literature has primarily focused on oral PrEP preference and willingness, there is limited exploration of the underlying factors contributing to oral PrEP cessation in China. This study aims to fill this gap by investigating the factors associated with oral PrEP cessation among MSM in China.MethodsAssisted by MSM community organizations, we collected 6,535 electronic questionnaires from 31 regions across China, excluding Taiwan, Hong Kong, and Macau. The questionnaire focused on investigating MSM's awareness, willingness, usage, and cessation of oral PrEP. Additionally, 40 participants were randomly chosen for key informant interviews. These qualitative interviews aimed to explore the reasons influencing MSM discontinuing oral PrEP.ResultsWe eventually enrolled 6535 participants. Among the 685 participants who had used oral PrEP, 19.70% (135/685) ceased oral PrEP. The results indicated that individuals spending > ¥1000 on a bottle of PrEP (aOR = 2.999, 95% CI: 1.886–4.771) were more likely to cease oral PrEP compared to those spending ≤ ¥1000. Conversely, individuals opting for on-demand PrEP (aOR = 0.307, 95% CI: 0.194–0.485) and those using both daily and on-demand PrEP (aOR = 0.114, 95% CI: 0.058–0.226) were less likely to cease PrEP compared to those using daily PrEP. The qualitative analysis uncovered eight themes influencing oral PrEP cessation: (i) High cost and low adherence; (ii) Sexual inactivity; (iii) Lack of knowledge about PrEP; (iv) Trust in current prevention strategies; (v) Poor quality of medical service and counseling; (vi) PrEP stigma; (vii) Partner and relationship factors; (viii) Access challenges.ConclusionsThe cessation of oral PrEP among MSM in China is associated with various factors, including the cost of oral PrEP medication, regimens, individual perception of HIV risk, stigma, and the quality of medical services. It is recommended to provide appropriate regimens for eligible MSM and develop tailored combinations of strategies to enhance PrEP awareness and acceptance among individuals, medical staff, and the MSM community. The findings from this study can support the refinement of HIV interventions among MSM in China, contributing to efforts to reduce the burden of HIV in this population.

Minimally invasive surgical approach to model hypertrophic scarring in the rabbit ear.

Current strategies for hypertrophic scar prevention and treatment are limited. To facilitate these efforts, a minimally invasive hypertrophic scar model was created in a rabbit ear for the first time based on previous methods used to induce ischemia. Six New Zealand white rabbits (12 ears total) were studied. First, ischemia was achieved by ligating the cranial artery, cranial vein and central artery, while preserving the caudal artery, caudal vein and central vein, respectively. The relative level of ischemia induced at time of surgery, both baseline and maximum perfusion, was assessed with a fluorescent light-assisted angiography and demonstrated lower rates of perfusion in the ischemic ears. Following vascular injury, a 2-cm full thickness linear wound was created on the ventral ear and closed with 4 - 0 Nylon sutures under high tension. For each rabbit, one ear received a combination of ischemia and wounding with suture tension (n = 6), while the other ear was non-ischemic with wounding and suture tension alone (n = 6). Four weeks post-operatively, ischemic ears developed scar hypertrophy (histological scar thickness: 1.1 ± 0.2mm versus 0.5 ± 0.1mm, p < 0.05). Herein, we describe a novel, prototypical minimally invasive rabbit ear model of hypertrophic scar formation that can allow investigation of new drugs for scar prevention.

Tiny Green Army: Fighting Malaria with Plants and Nanotechnology.

Malaria poses a global threat to human health, with millions of cases and thousands of deaths each year, mainly affecting developing countries in tropical and subtropical regions. Malaria's causative agent is Plasmodium species, generally transmitted in the hematophagous act of female Anopheles sp. mosquitoes. The main approaches to fighting malaria are eliminating the parasite through drug treatments and preventing transmission with vector control. However, vector and parasite resistance to current strategies set a challenge. In response to the loss of drug efficacy and the environmental impact of pesticides, the focus shifted to the search for biocompatible products that could be antimalarial. Plant derivatives have a millennial application in traditional medicine, including the treatment of malaria, and show toxic effects towards the parasite and the mosquito, aside from being accessible and affordable. Its disadvantage lies in the type of administration because green chemical compounds rapidly degrade. The nanoformulation of these compounds can improve bioavailability, solubility, and efficacy. Thus, the nanotechnology-based development of plant products represents a relevant tool in the fight against malaria. We aim to review the effects of nanoparticles synthesized with plant extracts on Anopheles and Plasmodium while outlining the nanotechnology green synthesis and current malaria prevention strategies.

#738 Blood type mismatch between donor and recipient is a risk factor for BK viremia one year after kidney transplantation

Abstract Background and Aims Kidney transplanted recipients are at increased risk of infections, including BK virus, for which there is no specific treatment. Current prevention strategies include surveillance and risk stratification. We sought to estimate the contribution of non-identical but compatible (mismatched) ABO blood types to the risk of BKV viremia. Method A retrospective single-center study was conducted in kidney transplant recipients between 1/1/2011 and 1/12/2021. The primary outcome was viremia (&amp;gt;10,000 copies per ml in two consecutive measurements at least one week apart) during the first year following transplantation. The secondary outcome was the time to BK viremia. We created a multivariate model using stepwise forward regression to assess the risk of viremia. Results During the study period, there were 1244 transplantations, with 1084 performed between donors and recipients with identical blood types (BT). Grafts were received from a living donor in 787 (63.3%) cases, 158 (98.8%) of which were in the mismatched BT group, and 629 (58%) were in the control group. There were 78 episodes of significant BK viremia within the first year post-transplantation, with 60 (5.5%) occurring in the matched BT recipients and 18 (11.3%) in the mismatched BT group (OR 2.16, p = 0.006). Among grafts from living donors during the first year following transplantation, there were 47 (6%) cases of viremia, with 29 (4.6%) in the matched BT group and 18 (11.4%) in the mismatched BT group (OR 2.22, p = 0.001). Multivariate analysis showed that the risk of BKV viremia in the living donor group increased in the presence of mismatched BT (OR = 2.75, p = 0.002). Conclusion The association between donor and recipient BT mismatch and BKV viremia was demonstrated for the first time. Mismatched BT recipients experienced higher rates of BKV viremia compared to identical BT recipients. This might be a preventable risk factor that should guide clinicians in organ procurement.

Trends and Characteristics of Human Casualties in Wildlife-Vehicle Accidents in Lithuania, 2002-2022.

We analyzed 474 human casualties in wildlife-vehicle accidents (WVAs) that occurred between 2002 and 2022 in Lithuania, which is a small northern European country. The study revealed the escalating trend of WVAs, since 2018 surpassing other transport accidents, although the number of casualties per WVA was ca. 100 times lower compared to other transport accidents. Moose was the primary contributor, responsible for 66.7% of fatalities and 47.2% of injuries, despite much lower species abundance compared to roe deer, which is the main species involved in WVAs without human casualties. Temporal patterns highlighted seasonal, daily, and hourly variations, with the majority of casualties occurring during dusk or dawn in May and September, on weekends, and between 20:00 and 22:00. Spatially, main roads with high traffic density exhibited the highest casualties per unit length. Most casualties occurred after hitting an animal directly with cars and motorcycles being most vulnerable vehicles. The effectiveness of WVA prevention measures was inconclusive: 9.5% of fatalities and 1.4% of injuries were registered in the area of the warning sign, and 10.4% of all casualties occurred on fenced road segments. These findings suggest the need for a critical evaluation of the current prevention strategies in reducing human casualties associated with WVAs.

The spectrum of pneumonia among intubated neonates in the neonatal intensive care unit.

We review the pathophysiology, epidemiology, diagnosis, treatment, and prevention of ventilator-associated pneumonia (VAP) in neonates. VAP has been studied primarily in adult ICU patients, although there has been more focus on pediatric and neonatal VAP (neo-VAP) in the last decade. The definition as well as diagnosis of VAP in neonates remains a challenge to date. The neonatal intensivist needs to be familiar with the current diagnostic tools and prevention strategies available to treat and reduce VAP to reduce neonatal morbidity and the emergence of antibiotic resistance. This review also highlights preventive strategies and old and emerging treatments available.

COMBATING BURNOUT IN THE IT INDUSTRY: A REVIEW OF EMPLOYEE WELL-BEING INITIATIVES

This study conducts a systematic literature review and content analysis to explore the effectiveness of employee well-being initiatives in combating burnout within the Information Technology (IT) industry. With the rapid pace of technological advancements and the high-pressure environment characteristic of the IT sector, burnout has emerged as a significant concern, affecting not only individual employees' mental and physical health but also organizational productivity and success. The primary objectives of this review were to identify the state of employee well-being in the IT industry, evaluate the current and potential future strategies for burnout prevention, and offer strategic directions for fostering a healthier workplace. Data were sourced from a comprehensive search across multiple academic and professional databases, focusing on studies published in English from 2000 to 2024 The inclusion criteria targeted research explicitly related to well-being initiatives in the IT sector, resulting in a selection of empirical studies, review articles, and grey literature for analysis.Key findings indicate a prevalent issue of burnout among IT professionals, driven by unique industry challenges. However, initiatives such as flexible work arrangements, leadership development, mental health support, and the use of AI for personalized well-being interventions show promise in mitigating these effects. The study concludes that fostering a culture of well-being and resilience within the IT industry requires a multifaceted approach, emphasizing the need for organizational commitment to employee health and continuous adaptation of well-being strategies to meet evolving workforce needs.&#x0D; Keywords: Burnout Prevention, Information Technology (IT), Employee Well-being, Systematic Literature Review

Epidemiology and Risk Factors of Early Bacterial Infections After Pediatric Living Donor Liver Transplantation

Advancements in surgical techniques, immunosuppression regimens, and peri-operative and postoperative care have resulted in marked improvement in outcomes after pediatric living donor liver transplantation (PLDLT). Despite these developments, infectious complications remain a major cause of morbidity and mortality. This is a retrospective cohort analysis of pediatric recipients from January 2004 to December 2018. Patients were classified into infected and non-infected groups based on the occurrence of bacterial infection during the first 3 months after transplant. Perioperative risk factors for early post-transplant bacterial infections and postoperative outcomes were investigated. Seventy-two out of 221 children developed early bacterial infection (32.6%). The first episodes of bacterial infection most frequently occurred in the second week after LDLT (37.5%). In multivariate analysis, active infection before transplant and complications with Clavien-Dindo grading >3 were the only independent risk factors. Early bacterial infections were independently associated with longer intensive care unit stays, longer hospital stays, and a higher incidence of readmission for bacterial infection during the first year after transplant. Additionally, the overall patient survival rate was significantly higher in the non-infected group (P = .001). Risk factors for infection, such as age, weight, disease severity, ABO-incompatible, and other operative factors, were not identified as independent risk factors. We have demonstrated that there are similarities and disparities in the epidemiology and risk factors for early bacterial infection after transplant between centers. Identification and better characterization of these predisposing factors are essential in the modification of current preventive strategies and treatment protocols to improve outcomes for this highly vulnerable group.

Approaches and Challenges in the Current Management of Cytomegalovirus in Transplant Recipients: Highlighting the Role of Advanced Practice Providers (Nurse Practitioners and Physician Assistants).

Cytomegalovirus (CMV) infection is associated with increased morbidity and mortality in hematopoietic cell transplant (HCT) and solid organ transplant (SOT) recipients, with traditional anti-CMV therapies limited by their associated toxicities and the development of resistance. Clinical providers are often faced with challenging and complicated CMV infections that require multiple courses of antiviral therapies. Increasingly, advanced practice providers (APPs) are playing an important role in the day-to-day management of transplant recipients with CMV infection, including resistant/refractory CMV and other complex CMV syndromes. Here, we provide an overview of current preventative and treatment strategies for CMV infection in HCT and SOT recipients, highlighting the challenging aspects of current management and the potential utility of newer antiviral agents. This article also focuses on how a multidisciplinary team, orchestrated by APPs, can improve CMV-associated patient outcomes. Protocols using antiviral agents for the prevention or treatment of CMV infections require carefully designed and meticulously implemented strategies to ensure the best clinical outcomes for patients. APPs, who have increasingly become the frontline providers of outpatient care for transplant recipients, are ideally positioned to design and carry out these protocols.

Non-RhD alloimmunization in pregnancy: an updated review.

RhD alloimmunization in pregnancy is still the main cause of hemolytic disease of the fetus and neonate (HDFN). Nevertheless, there are other antigens that may be associated with the occurrence of this phenomenon and that have been growing in proportion, given that current prevention strategies focus only on anti-RhD antibodies. Although not widespread, the screening and diagnostic management of the disease caused by these antibodies has recommendations in the literature. For this reason, the following review was carried out with the objective of listing the main red blood cell antigen groups described - such as Rh, ABO, Kell, MNS, Duffy, Kidd, among others - addressing the clinical importance of each one, prevalence in different countries, and recommended management when detecting such antibodies during pregnancy.

Mental Health–Related Outpatient Visits Among Adolescents and Young Adults, 2006-2019

Concerns over the mental health of young people have been increasing over the past decade, especially with the rise in mental health burden seen during the COVID-19 pandemic. Examining trends in mental health-related outpatient visits provides critical information to elucidate contributing factors, identify vulnerable populations, and inform strategies to address the mental health crisis. To examine characteristics and trends in mental health-related outpatient visits and psychotropic medication use among US adolescents and young adults. A retrospective cross-sectional analysis of nationally representative data from the National Ambulatory Medical Care Survey, an annual probability sample survey, was conducted from January 2006 to December 2019. Participants included adolescents (age 12-17 years) and young adults (age 18-24 years) with office-based outpatient visits in the US. Data were analyzed from March 1, 2023, to September 15, 2023. Mental health-related outpatient visits were identified based on established sets of diagnostic codes for psychiatric disorders. Temporal trends in the annual proportion of mental health-related outpatient visits were assessed, including visits associated with use of psychotropic medications. Analyses were stratified by age and sex. From 2006 to 2019, there were an estimated 1.1 billion outpatient visits by adolescents and young adults, of which 145.0 million (13.1%) were associated with a mental health condition (mean [SD] age, 18.4 [3.5] years; 74.0 million females [51.0%]). Mental health-related diagnoses were more prevalent among visits by male (16.8%) compared with female (10.9%) patients (P < .001). This difference was most pronounced among young adults, with 20.1% of visits associated with a psychiatric diagnosis among males vs 10.1% among females (P < .001). The proportion of mental health-related visits nearly doubled, from 8.9% in 2006 to 16.9% in 2019 (P < .001). Among all outpatient visits, 17.2% were associated with the prescription of at least 1 psychotropic medication, with significant increases from 12.8% to 22.4% by 2019 (P < .001). In this cross-sectional study, there were substantial increases in mental health-related outpatient visits and use of psychotropic medications, with greater overall burden among male patients. These findings provide a baseline for understanding post-pandemic shifts and suggest that current treatment and prevention strategies will need to address preexisting psychiatric needs in addition to the effects of the COVID-19 pandemic.

The surging cholera epidemic in Africa: a review of the current epidemiology, challenges and strategies for control

Africa, a known region with abundant warm coastal waters and a natural reservoir for Vibrio cholera, is known to bear the highest burden of cholera morbidity and mortality globally. Malawi is currently experiencing the deadliest cholera outbreak in two decades, and neighbouring countries, Mozambique and Zambia, have also reported significant numbers of cases. If the current trend of cholera transmission is sustained, the number of fatalities recorded in 2021, Africa’s deadliest year for cholera over the past decade, might be exceeded. This article aims to review the current epidemiology, prevention and control strategies, and treatment of cholera in Africa to highlight context-specific challenges and recommend possible solutions. The authors found out that cholera outbreaks in Africa are taking place in the midst of epidemics (measles, mumps, etc.) and natural disasters like cyclones and flooding (Mozambique, Malawi), drought (Kenya, and Ethiopia), and conflict (Cameroon, the DR Congo, Nigeria, and Ethiopia). The shortages of medical supplies like cholera kits and oral cholera vaccines in many countries due to constrained and limited resources and antibiotic resistance further make management and control difficult. The outbreak is spreading throughout the region because of poor sanitation, unsafe water supplies, and increased cross-border travel. Cholera in Africa follows a seasonal pattern, suggesting specific periods for heightened outbreak preparedness and response. The authors suggest a targeted multisectorial approach and a coordinated mechanism to respond to the epidemic through sustained political will, formidable partnerships, resource mobilisation, and the provision of technical support and advocacy at sub-national, national, and international levels.

Recent advances in tuberculosis: A comprehensive review of emerging trends in pathogenesis, diagnostics, treatment, and prevention

It is an in-depth analysis of a globally significant infectious disease, tuberculosis (TB). It covers the epidemiology, pathogenesis, diagnosis, treatment and prevention of TB with attention to its successes and shortcomings. The review examines this complicated relationship between Mycobacterium tuberculosis and the human host. It describes how outcomes move from latent infection to active disease. An Overview It introduces the current diagnostic methods, therapeutic regimens and preventive strategies; repeated emphasis is placed on targeted interventions and public health efforts. Also, the review covers future efforts in TB research and control that will further improve prevention and treatment. These include vaccines; new drugs (including a quest for novel agents); improved diagnostics (such as more rapid tests or smear-free methods); public health interventions such as policies on occupational exposures to respiratory rusts; integrated care models including continuity of services between Through these points the review illuminates how much can still be accomplished in terms of controlling--and even eliminating entirely--TB, with ramifications for global public health.

Interventions to prevent postoperative atrial fibrillation in Dutch cardiothoracic centres: asurvey study.

Postoperative atrial fibrillation (POAF) is acommon phenomenon following cardiac surgery. In this study, we assessed current preventive strategies used by Dutch cardiothoracic centres, identified common views on this matter and related these to international guidelines. We developed an online questionnaire and sent it to all cardiothoracic surgery centres in the Netherlands. The questionnaire concerned the management of POAF and the use of pharmaceutical therapies (beta-blockers and calcium antagonists) and non-pharmaceutical methods (posterior left pericardiotomy, pericardial flushing and epicardial botulinum toxin typeA injections). Usage of electrical cardioversions, anticoagulants and left atrial appendage closure were also enquired. Of the 15centres, 14(93%) responded to the survey and 13reported aPOAF incidence, ranging from 20to 30%. Of these 14centres, 6prescribed preoperative AF prophylaxis to their patients, of which non-sotalol beta-blockers were prescribed most commonly (57%). Postoperative medication was administered by all centres and included non-sotalol beta-blockers (38%), sotalol (24%), digoxin (14%), calcium antagonists (13%) and amiodarone (10%). Only 2centres used posterior left pericardiotomy or pericardial flushing as surgical manoeuvres to prevent POAF. Moreover, respondents expressed the need for guidance on anticoagulant use. Despite the use of various preventive strategies, the reported incidence of POAF was similar in Dutch cardiothoracic centres. This study highlights limited use of prophylactic amiodarone and colchicine, despite recommendations by numerous guidelines, and restricted implementation of surgical strategies to prevent POAF.

Predicting the risk and speed of drug resistance emerging in soil-transmitted helminths during preventive chemotherapy

Control of soil-transmitted helminths relies heavily on regular large-scale deworming of high-risk groups (e.g., children) with benzimidazole derivatives. Although drug resistance has not yet been documented in human soil-transmitted helminths, regular deworming of cattle and sheep has led to widespread benzimidazole resistance in veterinary helminths. Here we predict the population dynamics of human soil-transmitted helminth infections and drug resistance during 20 years of regular preventive chemotherapy, using an individual-based model. With the current preventive chemotherapy strategy of mainly targeting children in schools, drug resistance may evolve in soil-transmitted helminths within a decade. More intense preventive chemotherapy strategies increase the prospects of soil-transmitted helminths elimination, but also increase the speed at which drug efficacy declines, especially when implementing community-based preventive chemotherapy (population-wide deworming). If during the last decade, preventive chemotherapy against soil-transmitted helminths has led to resistance, we may not have detected it as drug efficacy has not been structurally monitored, or incorrectly so. These findings highlight the need to develop and implement strategies to monitor and mitigate the evolution of benzimidazole resistance.

A Novel Home-Based Telerehabilitation Program Targeting Fall Prevention in Parkinson Disease: A Preliminary Trial.

Falls in a person with Parkinson disease (PwP) are frequent, consequential, and only partially prevented by current therapeutic options. Notably, most falls in PwPs occur in the home or its immediate surroundings; however, our current strategies for fall prevention are clinic-centered. The primary objective of this nonrandomized pilot trial was to investigate the feasibility and preliminary efficacy of the novel implementation of home-based PD telerehabilitation (tele-physical/occupational therapy) focusing on fall risk reduction and home-safety modification. Persons with mild-to-moderate PD who were identified as being at risk of falls by their movement disorders neurologist were recruited from a tertiary movement disorders clinic. After an initial in-person evaluation by the study physical and occupational therapists, 15 patients with PD (Hoehn and Yahr Stage 2 (n = 8) and Stage 3 (n = 7)) participated in 4 biweekly PT/OT televisits with care partner supervision over the course of 10 weeks. The Goal Attainment Scale (GAS) was implemented to assess progress toward individualized PT/OT goals established at baseline. Outcomes were assessed at the end of the intervention at 10 weeks and at a six-month follow-up. Participants completed all 120 protocol-defined televisits without dropouts and adverse events. At 10 weeks, mean composite PT and OT-GAS scores showed significant improvement from baseline (PT: p < 0.001, OT: p < 0.008), which continued at 6 months (PT: p < 0.0005, OT: p < 0.0005). Home-modification recommendations made through novel virtual home-safety tours were cumulatively met by participants at 87% at 10 weeks and 91% at 6 months. Home-based telerehabilitation is a promising new strategy toward fall prevention in PD. The GAS has the potential to serve as an effective and patient-driven primary outcome variable for rehabilitation interventions for heterogeneous PwPs to assess progress toward personalized goals. ClinicalTrial.gov identifier: NCT04600011.

Nipah Virus: A Multidimensional Update.

Nipah virus (NiV) is an emerging zoonotic paramyxovirus to which is attributed numerous high mortality outbreaks in South and South-East Asia; Bangladesh's Nipah belt accounts for the vast majority of human outbreaks, reporting regular viral emergency events. The natural reservoir of NiV is the Pteropus bat species, which covers a wide geographical distribution extending over Asia, Oceania, and Africa. Occasionally, human outbreaks have required the presence of an intermediate amplification mammal host between bat and humans. However, in Bangladesh, the viral transmission occurs directly from bat to human mainly by ingestion of contaminated fresh date palm sap. Human infection manifests as a rapidly progressive encephalitis accounting for extremely high mortality rates. Despite that, no therapeutic agents or vaccines have been approved for human use. An updated review of the main NiV infection determinants and current potential therapeutic and preventive strategies is exposed.

Cancer-associated thrombosis in hematologic malignancies.

Patients with hematologic malignancies are often complicated not only by severe bleeding due to thrombocytopenia and disseminated intravascular coagulation but also by thromboembolic events, just like in patients with solid cancers, and these events can negatively impact patient outcomes. Nevertheless, the prevention and treatment of cancer-associated thrombosis (CAT) in hematologic malignancies has not been adequately investigated due to the limited size, heterogeneity, and unique pathophysiology of the patient population. This article summarizes the current understanding, risk factors, prediction models, and optimal prevention and treatment strategies of CAT in hematologic malignancies on a disease-by-disease basis, including acute leukemia, lymphoma, myeloma, and myeloproliferative neoplasms. Specific considerations of novel molecular targeted therapeutics introduced in recent years, such as immunomodulatory drugs and tyrosine kinase inhibitors, are also discussed based on the latest clinical trials.

Update on monkeypox virus infection: Focusing current treatment and prevention approaches.

While the world is still facing the global pandemic COVID-19, another zoonosis monkeypox (Mpox) has emerged posing a great threat to society. Insight into the pathogenesis, symptoms, and management strategies will aid in the development of potent therapeutics for the treatment of monkeypox virus infection. To get insight into the current treatment and prevention strategies will aid in effectively coping with the disease. For obtaining information regarding the ongoing treatment and prevention strategies and the drugs under pipeline, we referred to Google Scholar, Pub Med, Pub Chem, and WHO official site. There are a few drugs that came out to be effective for the treatment of Mpox. Tecovirimat acts by inhibiting viral replication and viral wrapping. Another drug is cidofovir, which hinders the activity of viral DNA polymerase but has the drawback of nephrotoxicity. To overcome this, a conjugate of cidofovir is being used-known as brincidofovir-which has a similar mechanism as cidofovir but lesser toxicity. Ribavirin acts via inhibiting inosine monophosphate dehydrogenase (IMPDPH) thus disrupting viral translation. It also interferes with helicase activity. Tiazofurin, Adenosine N1 oxide, and HPMPA have shown efficacy in in-vitro studies by inhibiting IMPDH, DNA polymerase, and viral mRNA translation respectively. In-silico studies have proven the effect of nilotinib, simeprevir, and dihydroergotamine for Mpox treatment. They have shown binding affinity for proteins required for the growth and release of MPXV. Vaccines have also been employed for the prevention of Mpox, which includes JYNNEOS, ACAM2000, and VIGIV. This review highlights the pathogenesis of the virus, disease manifestations, drugs, and vaccines that are being used and those under pipeline for the treatment and prevention of Mpox.

Comparative Analysis of Barium Enema and Computed Tomography Colonography

Background: Large bowel lesions present a diagnostic challenge, with both benign polyps and colorectal cancer requiring accurate identification for effective treatment. Traditional diagnostic methods, notably barium enema (BE), have been hampered by limitations in sensitivity and patient comfort. This necessitates a critical evaluation of more advanced methods, such as computed tomography colonography (CTC), to improve diagnostic outcomes. Objective: This review narrative aimed to (i) conduct a thorough comparative analysis of BE and CTC, specifically concentrating on their diagnostic efficacy, patient experiences, and versatility in diverse clinical settings and (ii) provide clinicians with in-depth insights and actionable recommendations, aimed at enhancing the strategies for imaging and diagnosing large bowel lesions, as well as aiding in the effective setup and planning of diagnostic services. Methods: We conducted an exhaustive literature review across multiple databases including PubMed, MEDLINE, EMBASE, and the Cochrane Library. The selection criteria focused on studies that directly compared BE and CTC. We examined aspects such as diagnostic accuracy, patient experiences during the procedures, and their economic impact on healthcare systems. Results: The findings indicate a marked superiority of CTC over BE in terms of diagnostic sensitivity and specificity, particularly in polyp detection. CTC is shown to be more patient-centric, offering enhanced comfort and suitability, especially for vulnerable groups like the elderly and patients with conditions like renal insufficiency. Furthermore, the integration of CTC with ongoing technological advancements and adherence to contemporary clinical guidelines highlights its pivotal role in current preventive healthcare strategies. The application of CTC presents substantial benefits for long-term patient safety and demonstrates cost-effectiveness, making it a preferential choice for adoption in the radiology departments of new healthcare institutions. Conclusion: CTC stands out as a superior diagnostic tool for large bowel lesions, surpassing BE in effectiveness, patient comfort, and economic viability. It is in harmony with modern healthcare practices and is particularly advantageous in settings with ample resources. This review strongly supports a shift towards CTC in clinical settings, to enhance the quality of patient care and outcomes in the detection and management of colorectal lesions.