Regional and demographic variations of Carotid artery Intima and Media Thickness (CIMT): A Systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: Carotid artery intima media thickness (CIMT) is a strong predictor of Coronary Heart Disease (CHD) and independent phenotype of early atherosclerosis. The global variation of CIMT and its demographic association is yet unclear. We evaluated regional variations of CIMT based on WHO regions and assessed the differences by age and sex. METHODS: A systematic search was conducted on studies published between 1980 January up to December 2020. PubMed, Oxford Medicine Online, EBSCO, Taylor & Francis, Oxford University Press and Embase data bases were used for searching. Supplementary searches were conducted on the Web of Science and Google Scholar. Grey literature was searched in "Open Grey" website. The two major criteria used were "adults" and "carotid intima media". The search strategy for PubMed was created first and then adapted for the Oxford Medicine Online, EBSCO, Taylor & Francis, Oxford University Press and Embase databases. Covidence software (Veritas Health Innovation, Melbourne, Australia; http://www.covidence.org) was used to manage the study selection process. Meta-analyses were done using the random-effects model. An I2 ≥ 50% or p< 0:05 were considered to indicate significant heterogeneity. RESULTS: Of 2847 potential articles, 46 eligible articles were included in the review contributing data for 49 381 individuals (mean age: 55.6 years, male: 55.8%). The pooled mean CIMT for the non-CHD group was 0.65mm (95%CI: 0.62-0.69). There was a significant difference in the mean CIMT between regions (p = 0.04). Countries in the African (0.72mm), American (0.71mm) and European (0.71mm) regions had a higher pooled mean CIMT compared to those in the South East Asian (0.62mm), West Pacific (0.60mm) and Eastern Mediterranean (0.60mm) regions. Males had a higher pooled mean CIMT of 0.06mm than females in the non CHD group (p = 0.001); there were also regional differences. The CHD group had a significantly higher mean CIMT than the non-CHD group (difference = 0.23mm, p = 0.001) with regional variations. Carotid artery segment-specific-CIMT variations are present in this population. Older persons and those having CHD group had significantly thicker CIMTs. CONCLUSIONS: CIMT varies according to region, age, sex and whether a person having CHD. There are significant regional differences of mean CIMT between CHD and non-CHD groups. Segment specific CIMT variations exist among regions. There is an association between CHD and CIMT values.

An Innovative Telemedicine Initiative From Sri Lanka: The Value of Volunteerism in a Resource-Constrained Scenario During the COVID-19 Pandemic.

The unprecedented rise in COVID-19 cases in Sri Lanka since July 2021 led to a situation where the health system was getting overwhelmed. The priority shifted toward triaging patients and identifying those who need immediate medical intervention and managing the rest in home settings. An integrated patient management system where patients could access a medical professional through a short messages service (SMS) and calling system was established. This service provided telephone triage, patient advice, and coordinated with the national ambulance system to evacuate ill patients. This integrated helpline system had a major impact on the management of the recent surge of COVID-19 pandemic in Sri Lanka by patients needing urgent care were directed for hospitalization and the rest managed at home with support, reassurance, and guidance. The numbers of oxygen-dependent patients and deaths declined rapidly and the number of available beds increased. The system played a major role in bringing the crisis under control. Despite many challenges, this innovative integrated system is a unique example of medical volunteerism. The pandemic catalyzed the utilization of information and communication technologies effectively by providing healthcare with a reduction of the burden on healthcare institutions and professionals.

Covid-19 vaccines for children

In the last few months of evident uncertainty regarding the likely progression of SARS-CoV-2, there is considerable apprehension and intense anxiety amongst the general populace of our country. With the added complication of mutant variants, all designated by the letters of the Greek alphabet, the melting pot actually boils and even overflows. In addition to scientific data and proper pedagogic assessments, there is substantial misinformation and disinformation, particularly regarding the Covid-19 vaccines, especially in the social media. Some totally unsubstantiated allegations, stipulations, postulations and prophesies of gloom, are being widely circulated. People who flatly refuse to take the vaccine, those who are hesitant to receive it and confirmed anti-vaxxers, are having a field day in trying to dissuade the general public from taking the vaccine © 2022. Open Access Article published under the Creative Commons Attribution CC-BY License

Search for fast radio transients using Arecibo drift-scan observations at 1.4 GHz

We conducted a drift-scan observation campaign using the 305-m Arecibo telescope in 2020 January and March when the observatory was temporarily closed during the intense earthquakes and the initial outbreak of the COVID-19 pandemic, respectively. The primary objective of the survey was to search for fast radio transients, including fast radio bursts (FRBs) and rotating radio transients (RRATs). We used the seven-beam ALFA receiver to observe different sections of the sky within the declination region similar to(10 degrees-20 degrees) on 23 nights and collected 160 h of data in total. We searched our data for single-pulse transients, of covering up to a maximum dispersion measure of 11 000 pc cm(-3) at which the dispersion delay across the entire bandwidth is equal to the 13-s transit length of our observations. The analysis produced more than 18 million candidates. Machine learning techniques sorted the radio frequency interference and possibly astrophysical candidates, allowing us to visually inspect and confirm the candidate transients. We found no evidence for new astrophysical transients in our data. We also searched for emission from repeated transient signals, but found no evidence for such sources. We detected single pulses from two known pulsars in our observations and their measured flux densities are consistent with the expected values. Based on our observations and sensitivity, we estimated the upper limit for the FRB rate to be <2.8 x 10(5) sky(-1) d(-1) above a fluence of 0.16 Jy ms at 1.4 GHz, which is consistent with the rates from other telescopes and surveys.

COVID-19 and people with intellectual disability: impacts of a pandemic.

The impacts of the COVID-19 pandemic affect all groups in society. People with intellectual disability (ID) are especially vulnerable to the physical, mental and social effects of the pandemic. Cognitive impairments can limit understanding of information to protect them relying on carers to be vigilant on their behalf during quarantine. Restrictions on usual activities are likely to induce mental stress especially among those who are autistic leading to an escalation in challenging behaviours, risk of placement breakdown and increased the use of psychotropic medication. People with ID are vulnerable to exploitation by others where the usual community supports no longer function to protect them. In future pandemics, it is important that lessons are learned from the impacts COVID-19 have on people with ID. Collecting the evidence through a rigorous approach should help to empower people with ID and their carers to face future outbreaks of infectious diseases.