Overview of the Parents’ Knowledge, Attitude and Practice of Children Vaccinations: A Systematic Review

Background: It is the parents' responsibility to vaccinate their children. As a result, parents' attitudes, knowledge, and beliefs about vaccination are critical because they influence their activities toward timely and full immunization.  Objectives: This systematic review comprehensively investigated the recently published literature on parents’ knowledge regarding children’s vaccination.  Methods: PubMed, SCOPUS, Web of Science, Science Direct, and Google Scholar were systematically searched to include the relevant literature. Rayyan QRCI was used throughout this systematic approach. Results & interpretation: This review included twenty-four studies with a total of 13082 parents, and 70.9% were mothers. Knowledge level about children’s vaccination among parents was significantly related to their fathers' age, education level, women's employment status, and family type. Younger mothers were found to have a higher level of expertise. Good knowledge levels and positive attitudes towards the seasonal influenza vaccine were reported. Good knowledge with caution was reported among parents regarding COVID-19 vaccination. The knowledge about HPV infection and vaccination: All of them reported low vaccination rates and willingness to vaccinate their children. The findings of our study highlight the significance of parental understanding of vaccinations and immunization. Health officials should make additional efforts to promote the benefits of vaccination while emphasizing the risks of non- or late pediatric immunization

Association between the expression of toll-like receptors, cytokines, and homeostatic chemokines in SARS-CoV-2 infection and COVID-19 severity

The recent identification of the involvement of the immune system response in the severity and mortality of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection highlights the importance of cytokines and chemokines as important factors in the clinical outcomes of COVID-19. However, the impact and roles of the BAFF/APRIL cytokine system, homeostatic chemokines (CXCL12, CXCL13, CCL19, and CCL21), as well as Toll-like receptor (TLR)-3/4 in COVID-19, have not been investigated. We sought to assess the expression levels and roles of TLR3/4, BAFF, APRIL, IFN-β, homeostatic chemokines (CXCL12, CXCL13, CCL19, and CCL21), SARS-CoV-2 IgG and IgM antibodies in patients with critical (ICU) and non-ICU (mild) COVID-19 and their association with mortality and disease severity. Significant high levels of TLR-4 mRNA, IFN-β, APRIL, CXCL13, and IgM and IgG antibodies were observed in ICU patients with severe COVID-19 compared to non-ICU COVID-19 patients and healthy controls. On the other hand, BAFF and CCL21 expression were significantly upregulated in non-ICU patients with COVID-19 compared with that in critical COVID-19 patients. The two groups did not differ in TLR-3, CXCL12, and CCL19 levels. Our findings show high expression levels of some inflammatory chemokines in ICU patients with COVID-19. These findings highlight the potential utility of chemokine antagonists as an immune-based treatment for the severe form of COVID-19. We also believe that selective targeting of TLR/spike protein interactions might lead to the development of a new COVID-19 therapy

Assessment of Knowledge and Attitude of Dental Students towards HIV and Its Oral Manifestations in Saudi Arabia—A Cross-Sectional Study

Background: It is essential for practicing dentists to have adequate knowledge of HIV/AIDS and its implications in the dental practice. Their attitudes should also be up to the professional expectations. This study aimed to assess knowledge of HIV/AIDS infection and attitudes towards its patients among dental students in Saudi Arabia. Methods: A questionnaire was prepared and distributed among a sample of dental students in Saudi Arabia. Twenty questions related to knowledge, attitudes, and oral manifestation of HIV were presented. Results: A total of 405 questionnaires were completed (67% response rate). Participants showed low knowledge of safety regarding HIV (39.5%) and 44.2% indicated that they would take an HIV test after needle stick injury. The proportion of correct answers regarding transmission of HIV through saliva, cardiopulmonary resuscitation, and aerosols by hand pieces was 41%, 37.5%, and 26.4%, respectively. Almost 50% of the surveyed dental students expressed unwillingness to treat HIV-positive patients. Poor knowledge was noted regarding oral manifestations of HIV (32.7%). Of the participants, 57.8% indicated that infection control procedures are very important for the treatment of HIV patients and 50.6% believed that a dentist can make a decision to reject the treatment of HIV patients. According to the participating dental students, the three major oral manifestations in HIV patients are hairy leukoplakia (47.4%), oral candidiasis (44.7%), and Kaposi’s sarcoma (43.5%). Conclusion: Inadequate knowledge and unprofessional attitude towards HIV/AIDS patients were identified among this group of dental students in Saudi Arabia. Dental educators and health care planners in Saudi Arabia should plan to promote the knowledge and attitudes of dental students in Saudi Arabia towards the treatment of HIV patients

MANAGEMENT OF HIP DISLOCATION IN EMERGENCY DEPARTMENT

Hip dislocations following trauma are a common occurrence in the emergency room. Since the hip is a ball and socket joint with concomitant muscular and ligamentous attachments, it often takes a large amount of force to dislocate a hip. Due to the needed force, hip dislocations frequently come together with additional serious injuries. 90% of the time, hip trauma appears as a posterior dislocation when detected because the anterior ligaments are stronger. The rectus femoris, gluteal muscles, and short external rotators make up dynamic muscular support. 95% of patients who had a hip dislocation following a car accident also had an accompanying injury that needed hospital treatment. Therefore, a thorough neurologic and musculoskeletal evaluation with further x-rays or CT scans for assessment is required in cases with native hip dislocation. Standard AP (anteroposterior) scans of the pelvis often show hip dislocations clearly. However, a cross-table lateral of the injured joint is often included in comprehensive imaging. Hip dislocations can be more difficult to reduce than other types of dislocations, and most patients need procedural anaesthesia to make the reduction easier. Before considering surgical reduction, experts advise making up to three closed reduction efforts. However, 10% of hip dislocations may not be treatable in the emergency room and require surgical reduction under general anaesthesia

Full logistic regression model.

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ROC curve of predictive ability of logistic regression model.

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Survival till occurrence of CPR.

Survival till occurrence of CPR.</p

Modified Early Warning Score.

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Primary and secondary outcomes.

Primary and secondary outcomes.</p