The landscape of development of treatment modalities and preventive measures for COVID-19 has progressed expeditiously since the beginning of the pandemic. However, low cost-effectiveness and availability, and the requirement of parenteral administration by trained medical personnel in an in-hospital setting may limit the use of these therapeutic agents in clinical practice. 1 Thus, the development of safe and efficacious oral agents that can be administered on an outpatient basis is warranted. On December 22, 2021, the US Food and Drug Administration (FDA) issued an emergency use authorization for an oral antiviral, nirmatrelvir-ritonavir (Paxlovid™), for the treatment of patients with mild-to-moderate COVID-19 and at high risk for progression to severe disease, including hospitalization or death. 2 Therefore, we conducted this meta-analysis to address these limitations and evaluate the efficacy and safety of nirmatrelvir-ritonavir in COVID-19 patients, and explore the role of previous immunity to SARS-CoV-2 and age as potential effect modifiers.Our meta-analysis was performed according to the guidelines of the Cochrane Handbook for Systematic Reviews of Intervention and the protocol was registered with PROSPERO (CRD42022364219). We searched PubMed, Embase, the Cochrane Library, medRxiv, and ClinicalTrials.gov from inception to October 10, 2022, using a search strategy consisting of terms related to "nirmatrelvir-ritonavir" and

Background: Presently, there is conflicting evidence regarding the efficacy of probiotics in the prevention of ventilator-associated pneumonia (VAP). This meta-analysis was conducted to update current clinical evidence and evaluate the efficacy and safety of probiotics for the prevention of VAP. Methods: We searched three databases and two trial registers to retrieve randomised controlled trials (RCTs) comparing probiotics or synbiotics with placebo or standard treatment for the prevention of VAP in adult patients receiving mechanical ventilation in the intensive care unit (ICU). Results: Our meta-analysis included 18 RCTs involving 4893 patients. Our results showed that probiotics may reduce the incidence of VAP (RR 0.68, 95% CI: 0.55–0.84; low certainty). However, in our subgroup and sensitivity analyses, the effect was not significant in double-blind studies, and in studies with a low risk of bias in the randomisation process. Probiotics reduced the length of ICU stay (MD −2.22 days, 95% CI: −4.17 to −0.28; moderate certainty) and the duration of antibiotic use (MD −1.25 days, 95% CI −1.86 to −0.64; moderate certainty). Conclusions: Probiotics may reduce the incidence of VAP but due to the low quality of pooled evidence, the use of probiotics warrants caution. Further, large-scale, high-quality RCTs need to be conducted to provide conclusive evidence.

No abstract

No abstract

Although the Global Polio Eradication Initiative has been largely successful in elimination of polio from various parts of the world, sporadic local outbreaks in non‐endemic areas continue to pose a threat to global polio eradication efforts. In the two endemic countries, Pakistan and Afghanistan, a staggering 176 cases of wild poliovirus 1 (WPV1) were reported in 2019. In 2020 alone, 959 cases of Circulating Vaccine Derived Poliovirus 2 were reported globally from 27 countries. After staying polio‐free for years, cases of WPV were detected in Malawi and Mozambique in 2022. The roots of the reported strains matched with the WPV strain from Pakistan. The emergence of WPV cases in Malawi and Mozambique underscores the fact that WPV still has the chance to spread beyond the Afghanistan‐Pakistan region and sustained efforts are required for its complete eradication. In the case of smallpox, surveillance‐containment was the key to eradication as many countries had already eradicated smallpox and the bigger concern was to track and contain any new cases emerging. Smallpox eradication followed a comprehensive plan which included elements like quality control and standardisation of vaccination protocols. Governments all over the world should prioritise immunisation drives, surveillance, and awareness campaigns to achieve the dream of a polio‐free world.