Background Earlier serosurveys in India revealed SARS-CoV-2 seroprevalence of 0.73% during May-June and 7.1% during August-September 2020. We conducted the third serosurvey during Dec 2020 and Jan 2021, to estimate the seroprevalence of SARS-CoV-2 infection among general population and healthcare workers (HCWs) in India. Methods We conducted the serosurvey in the same 70 districts selected for the first and second serosurveys. From each district, we enrolled at least 400 individuals aged ≥ 10 years from general population and 100 HCWs from sub-district level health facilities. Sera from general population were tested for presence of IgG antibodies against nucleocapsid (N) and spike protein (S1-RBD) of SARS-CoV-2, whereas sera from HCWs were tested for anti-S1-RBD. We estimated weighted seroprevalence adjusted for assay characteristics. Results Of the 28,598 sera from general population, 4585 (16%) had IgG antibodies against N, 6647 (23.2%) against S1-RBD and 7436 (26%) against either. The weighted and assay characteristic adjusted seroprevalence against either of the antibodies was 24.1 (95%CI: 23.0%-25.3%). Among 7385 HCWs, the seroprevalence of anti-S1-RBD IgG antibodies was 25.6% (95% CI: 23.5%-27.8%). Conclusions Nearly one in four individuals aged > = 10 years from general population as well as HCWs in India were exposed to SARS-CoV-2 by December 2020.

Introduction: As artificial intelligence (AI)-assisted diagnosis gained immense popularity, it is imperative to consider its utility and efficiency in the early diagnosis of colorectal cancer (CRC), responsible for over 1.8 million cases and 881 000 deaths globally, as reported in 2018. Improved adenoma detection rate, as well as better characterizations of polyps, are significant advantages of AI-assisted colonoscopy (AIC). This systematic review (SR) investigates the effectiveness of AIC in the early diagnosis of CRC as compared to conventional colonoscopy. Materials and Methods: Electronic databases such as PubMed/Medline, SCOPUS, and Web of Science were reviewed for original studies (randomized controlled trials, observational studies), SRs, and meta-analysis between 2017 and 2022 utilizing Medical Subject Headings terminology in a broad search strategy. All searches were performed and analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology and were conducted from November 2022. A data extraction form based on the Cochrane Consumers and Communication Review group’s extraction template for quality assessment and evidence synthesis was used for data extraction. All included studies considered for bias and ethical criteria and provided valuable evidence to answer the research question. Results: The database search identified 218 studies, including 87 from PubMed, 60 from SCOPUS, and 71 from Web of Science databases. The retrieved studies from the databases were imported to Rayyan software and a duplicate article check was performed, all duplicate articles were removed after careful evaluation of the data. The abstract and full-text screening was performed in accordance with the following eligibility criteria: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for observational studies; Preferred Reporting Items for Systematic Reviews and Meta-Analysis for review articles, ENTREQ for narrative studies; and modified JADAD for randomized controlled trials. This yielded 15 studies that met the requirements for this SR and were finally included in the review. Conclusion: AIC is a safe, highly effective screening tool that can increase the detection rate of adenomas, and polyps resulting in an early diagnosis of CRC in adults when compared to conventional colonoscopy. The results of this SR prompt further large-scale research to investigate the effectiveness in accordance with sex, race, and socioeconomic status, as well as its influence on prognosis and survival rate.

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Attention deficit hyperactivity disorder (ADHD) is a common childhood disorder, with only 2–3% prevalence into adulthood. The epidemiology and proposed causes of ADHD are multifactorial, including genetic, prenatal and environmental influences. The diagnosis of ADHD is often complicated by masking coping mechanisms, an overlap of symptoms with other, more commonly diagnosed disorders. Traditionally, it has been treated with stimulant medications. Non-stimulant options often target norepinephrine and dopamine regulation and are preferred in cases of comorbid substance use disorder, anxiety and other complicating factors, due to an improved side-effect profile and patient preference. They include atomoxetine and viloxazine. The latter, Viloxazine, in the form of extended-release capsules, is the first novel, non-stimulant option approved for adults with ADHD, in the past two decades. Its therapeutic effects are predominantly produced by its action as a norepinephrine reuptake inhibitor and may also modulate the serotonergic system. Viloxazine is relatively safe and effective in treating other disorders such as depression, anxiety, epilepsy and substance use disorder. Its pharmacokinetics includes metabolization by CYP enzymes. As antiepileptics inhibit CYP1A2, therefore, a special consideration would be needed, when co-administering with anti-epileptic drugs. Similarly, individuals with liver or cardiovascular disease and a personal or family history of bipolar disorder require close monitoring, while on this medication. A thorough review of the history, mechanism of action, pharmacokinetics and drug–drug interactions has been presented here, with special attention on treatment in adults with comorbid conditions. This study conducted an all-language literature search on Medline, Cochrane, Embase, and Google Scholar until December 2022. The following search strings and Medical Subject Headings (MeSH) terms were used: “Viloxazine,” “ADHD,” “Stimulants,” and “adult ADHD.” We explored the literature on the growing knowledge of Viloxazine. A thorough review of the history, mechanism of action, pharmacokinetics, and drug–drug interactions are reviewed here with special attention on treatment in adults with comorbid conditions.

Madam, rabies is a deadly virus which is most of the time spread by the bite of the infected animals (1). In Pakistan, it is endemic with infections mainly caused due to dog bite(2).The lack of proper data on infections caused by rabies makes it very difficult to estimate the fatalities. However, it is believed that the deaths caused by rabies in Pakistan is somewhere between 2000 to 5000 every year (2). Moreover, the recent reported cases of rabies pose a grave concern to the struggling health-set-up of Pakistan (3). Furthermore, most of the viral infections share similar clinical symptoms at first. Rabies and COVID-19 cases also share some same clinical symptoms. Few of the same clinical symptoms may include fever, headache, nausea and vomiting (1, 4). It can be very difficult for the health care workers to diagnose and develop a treatment plan for such patients leading to poor prognosis and unfavourable outcomes. Meanwhile, the emergence and increase in cases of new variants of COVID-19 infections is a big challenge for the country. Recently, Pakistan has been reporting more than 4000 daily COVID-19 infections with most of those caused by delta variant of corona virus and therefore experiencing the fourth wave (5). Furthermore, there is a sharp increase in general trend of dog bites in the months from May-Aug, which supports the fact that summer is the month of hosting of most of the infections caused by Rabies. The improper sanitation of most of the cities of Pakistan plays a major role in aggravating different endemics in the region. Lack of awareness, vaccine hesitancy and knowledge gap further exacerbates the prognosis (3).  Proper management plan for treating patients with Rabies should be designed by health regulating bodies which will then help in proper diagnosis of rabies patients by health care workers. Vaccine shortage should be addressed in an efficient way and areas where the prevalence of disease is higher should be well-stocked. Government should devise a proper plan with the help of international organizations like WHO to work on strategies which should be effective enough to minimize the emergence of Rabies amidst COVID-19. The hospitals in Pakistan have already been overwhelmed by COVID cases. If proper action is not taken, not only patients with Rabies will be neglected a proper treatment but the risk of mortality, mutation and simultaneous occurrence of both the viral infections will also increase. Continue...