Background and aims Micronutrient supplements such as vitamin D, vitamin C, and zinc have been used in managing viral illnesses. However, the clinical significance of these individual micronutrients in patients with Coronavirus disease 2019 (COVID-19) remains unclear. We conducted this meta-analysis to provide a quantitative assessment of the clinical significance of these individual micronutrients in COVID-19. Methods We performed a comprehensive literature search using MEDLINE, Embase, and Cochrane databases through December 5th, 2021. All individual micronutrients reported by ≥3 studies and compared with standard-of-care (SOC) were included. The primary outcome was mortality. The secondary outcomes were intubation rate and length of hospital stay (LOS). Pooled risk ratios (RR) and mean difference (MD) with corresponding 95% confidence intervals (CI) were calculated using the random-effects model. Results We identified 26 studies (10 randomized controlled trials and 16 observational studies) involving 5633 COVID-19 patients that compared three individual micronutrient supplements (vitamin C, vitamin D, and zinc) with SOC. Nine studies evaluated vitamin C in 1488 patients (605 in vitamin C and 883 in SOC). Vitamin C supplementation had no significant effect on mortality (RR 1.00, 95% CI 0.62-1.62, P=1.00), intubation rate (RR 1.77, 95% CI 0.56-5.56, P=0.33), or LOS (MD 0.64; 95% CI -1.70, 2.99; P=0.59). Fourteen studies assessed the impact of vitamin D on mortality among 3497 patients (927 in vitamin D and 2570 in SOC). Vitamin D did not reduce mortality (RR 0.75, 95% CI 0.49-1.17, P=0.21) but reduced intubation rate (RR 0.55, 95% CI 0.32-0.97, P=0.04) and LOS (MD -1.26; 95% CI -2.27, -0.25; P=0.01). Subgroup analysis showed that vitamin D supplementation was not associated with a mortality benefit in patients receiving vitamin D pre or post COVID-19 diagnosis. Five studies, including 738 patients, compared zinc intake with SOC (447 in zinc and 291 in SOC). Zinc supplementation was not associated with a significant reduction of mortality (RR 0.79, 95% CI 0.60-1.03, P=0.08). Conclusions Individual micronutrient supplementations, including vitamin C, vitamin D, and zinc, were not associated with a mortality benefit in COVID-19. Vitamin D may be associated with lower intubation rate and shorter LOS, but vitamin C did not reduce intubation rate or LOS. Further research is needed to validate our findings.

Background: The use of illicit drugs has seen an upswing during the last years in the West Bank. Political, social, economic, and demographic factors may play roles in the increasing use of illicit drugs in the West Bank. This study aimed to describe drug possession among Palestinians in order to provide insight into the extent of illicit substances use, to assess their risk, and to explore new forms in order to raise awareness of these drugs. Files (3674) related to drug possession in Anti narcotic drug departments in the West Bank from 2010to 2014 were reviewed and analysed. Results: Most arrestees (99%) were males, (55.9%) aged 18-< 30, (48.8%) singles, (56.7%) with a primary level of education, and (81.8%) had used drugs for a year or more. The most common seized and used substances were cannabis, hashish (74.3%) and marijuana (15.2%), followed by synthetic cannabinoids, hydro (26.6%). MDMA (Ecstasy) was used (3.6%) more than LSD (3.1%) and more than heroin and cocaine combined (3.3%). Liquid methamphetamine was emerged as a new homemade yellow substance, with a street name (GG) that is used for improving libido. Attempts to cultivate marijuana using 31,116 seedlings and seeds were recorded. Conclusion: Tracking the possession of high-risk drugs and new psychoactive substances in a society is important for policy makers in order to investigate the circumstances and impact of these substances. There is a trend in emerging new psychoactive substances (synthetic cannabinoids), manufacturing a new drug (liquid methamphetamine), and cultivating illegal drugs (marijuana) starting from the year 2013. These results are important for prevention, treatment and control, and for law enforcement in the West Bank. Policies, strategies and action plans in the controlling new substances should be developed taking into account local and regional socioeconomic issues.

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Introduction: Recent randomized controlled trials (RCTs) and metaanalysis have demonstrated improved adenoma detection rate (ADR) for colonoscopy with artificial intelligence (AI) compared with highdefinition (HD) colonoscopy without AI. We aimed to perform a systematic review and network meta-analysis of all RCTs to assess the impact of AI compared with other endoscopic interventions aimed at increasing ADR such as distal attachment devices, dye-based/virtual chromoendoscopy, water-based techniques, and balloon-assisted devices.Methods: A comprehensive literature search of PubMed/Medline, Embase, and Cochrane was performed through May 6, 2022, to include RCTs comparing ADR for any endoscopic intervention mentioned above. Network meta-analysis was conducted using a frequentist approach and random effects model. Relative risk (RR) and 95% CI were calculated for proportional outcome. Results: A total of 94 RCTs with 61,172 patients (mean age 59.1 ± 5.2 y, females 45.8%) and 20 discrete study interventions were included. Network meta-analysis demonstrated significantly improved ADR for AI compared with autofluorescence imaging (

Background: Coronavirus disease 2019 (COVID-19) caused significant mortality and mortality worldwide. There is limited information describing the outcomes of COVID-19 in cancer patients. Methods: We utilized the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS) 2020 database to collect information on cancer patients hospitalized for COVID-19 in the United States. Using the International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM) coding system, adult (≥18 years) patients with COVID-19 were identified. Adjusted analyses were performed to assess for mortality, morbidity, and resource utilization among cancer patients. Results: A total of 1,050,045 patients were included. Of them, 27,760 had underlying cancer. Cancer patients were older and had more comorbidities. The all-cause in-hospital mortality rate in cancer patients was 17.58% vs. 11% in non-cancer. After adjusted logistic regression, cancer patients had a 21% increase in the odds of all-cause in-hospital mortality compared with those without cancer (adjusted odds ratio (aOR) 1.21, 95%CI 1.12–1.31, p-value < 0.001). Additionally, an increased odds in acute respiratory failure rate was found (aOR 1.14, 95%CI 1.06–1.22, p-value < 0.001). However, no significant differences were found in the odds of septic shock, acute respiratory distress syndrome, and mechanical ventilation between the two groups. Additionally, no significant differences in the mean length of hospital stay and the total hospitalization charges between cancer and non-cancer patients. Conclusion: Cancer patients hospitalized for COVID-19 had increased odds of all-cause in hospital mortality and acute respiratory failure compared with non-cancer patients.

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