The Impact of the COVID-19 Pandemic and Associated Control Measures on the Mental Health of the General Population : A Systematic Review and Dose-Response Meta-analysis.

BACKGROUND: To what extent the COVID-19 pandemic and its containment measures influenced mental health in the general population is still unclear. PURPOSE: To assess the trajectory of mental health symptoms during the first year of the pandemic and examine dose-response relations with characteristics of the pandemic and its containment. DATA SOURCES: Relevant articles were identified from the living evidence database of the COVID-19 Open Access Project, which indexes COVID-19-related publications from MEDLINE via PubMed, Embase via Ovid, and PsycInfo. Preprint publications were not considered. STUDY SELECTION: Longitudinal studies that reported data on the general population's mental health using validated scales and that were published before 31 March 2021 were eligible. DATA EXTRACTION: An international crowd of 109 trained reviewers screened references and extracted study characteristics, participant characteristics, and symptom scores at each timepoint. Data were also included for the following country-specific variables: days since the first case of SARS-CoV-2 infection, the stringency of governmental containment measures, and the cumulative numbers of cases and deaths. DATA SYNTHESIS: In a total of 43 studies (331 628 participants), changes in symptoms of psychological distress, sleep disturbances, and mental well-being varied substantially across studies. On average, depression and anxiety symptoms worsened in the first 2 months of the pandemic (standardized mean difference at 60 days, -0.39 [95% credible interval, -0.76 to -0.03]); thereafter, the trajectories were heterogeneous. There was a linear association of worsening depression and anxiety with increasing numbers of reported cases of SARS-CoV-2 infection and increasing stringency in governmental measures. Gender, age, country, deprivation, inequalities, risk of bias, and study design did not modify these associations. LIMITATIONS: The certainty of the evidence was low because of the high risk of bias in included studies and the large amount of heterogeneity. Stringency measures and surges in cases were strongly correlated and changed over time. The observed associations should not be interpreted as causal relationships. CONCLUSION: Although an initial increase in average symptoms of depression and anxiety and an association between higher numbers of reported cases and more stringent measures were found, changes in mental health symptoms varied substantially across studies after the first 2 months of the pandemic. This suggests that different populations responded differently to the psychological stress generated by the pandemic and its containment measures. PRIMARY FUNDING SOURCE: Swiss National Science Foundation. (PROSPERO: CRD42020180049).

Determination of Heavy Metal Residues in Slaughtered Camels at Sokoto and Gusau Modern Abattoirs, Nigeria.

BACKGROUND: Heavy metals can pose health risks to both animals and humans. Objectives. To determine the concentrations of lead (Pb), cadmium (Cd), and chromium (Cr) in samples taken from the kidney, liver, muscle, hide, and blood of camels slaughtered at both Sokoto and Gusau modern abattoirs. METHODS: The concentrations of Pb, Cd, and Cr in tissues and organs of camels slaughtered at both Sokoto and Gusau modern abattoirs were determined using atomic absorption spectrophotometry. A total of 120 samples were collected. RESULTS: All the samples collected tested positive for Pb, Cd and Cr. The overall mean concentrations of Pb, Cd and Cr in tissues and organs of slaughtered camels at Sokoto modern abattoir ranged from 0.11 mg/kg to 0.35 mg/kg, 0.05 to 0.8 mg/kg and 0.41 to 0.59 mg/kg, respectively, while at Gusau modern abattoir, the overall mean concentrations of Pb, Cd and Cr ranged from 0.20 mg/kg to 1.17 mg/kg, 0.01 to 0.14 mg/kg and 0.13 to 0.51 mg/kg, respectively. DISCUSSION: The concentration of Pb in the tissues and organs of camels slaughtered at Gusau modern abattoir was high compared to in camels slaughtered at Sokoto modern abattoir, while the concentrations of Cd and Cr in the tissues and organs of camels slaughtered at Sokoto modern abattoir were high compared to those in tissues and organs of camels slaughtered at Gusau modern abattoir. There were significant differences (P<0.05) in the concentration of Pb, Cd, and Cr in samples taken from the kidney, liver, muscle, hide, and blood of slaughtered camels at both Sokoto and Gusau. CONCLUSIONS: Camels slaughtered at both Sokoto and Gusau modern abattoirs were exposed to Pb, Cd, and Cr.The tissues and organs of camels slaughtered at both Sokoto and Gusau contain Pb, Cd, and Cr. Prolonged exposure through consumption of these tissues and organs should be avoided. COMPETING INTERESTS: The authors declare no competing financial interests.

Accuracy of MRI scan in the diagnosis of ligamentous and chondral pathology in the ankle.

BACKGROUND: The aim of our study is to determine the accuracy of magnetic resonance imaging (MRI) scan in relation to arthroscopic findings in patients presenting with chronic ankle pain and/or instability. METHODS: All patients who underwent arthroscopy of the ankle as well as MRI from December 2005 to July 2008 in our institution were reviewed by the Orthopaedic surgeons. Twenty-four patients were identified and the results of MRI scans were compared with arthroscopic findings. This study specifically looked at anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL) and osteochondral lesions (OCD). Arthroscopic findings were considered as a gold standard. There were 12 female and 12 male patients with an average age 39 years (11-65 years). Time interval between MRI scan and arthroscopy was 7.0 months (2-18 months). RESULTS: In our study MRI showed 100% specificity for the diagnosis of ATFL and CFL tears and osteochondral lesions. However sensitivity was low particularly for CFL tears. Accuracy of MRI in detecting ATFL tear was 91.7%, CFL tear was 87.5% and osteochondral lesion was 83.3%. CONCLUSIONS: We conclude that MRI scan has very high specificity and positive predictive value in diagnosing tears of ATFL, CFL and osteochondral lesions. However sensitivity was low with MRI. In a symptomatic patient negative results on MRI must be viewed with caution and an arthroscopy may still be required for a definitive diagnosis and treatment. However high resolution scans may differ in their ability to pick up these lesions and further research is required to assess their efficiency as evidence is not currently available.