Importance The coronavirus disease 2019 (COVID-19) pandemic and the policies to contain it have been a near ubiquitous exposure in the US with unknown effects on depression symptoms. Objective To estimate the prevalence of and risk factors associated with depression symptoms among US adults during vs before the COVID-19 pandemic. Design, Setting, and Participants This nationally representative survey study used 2 population-based surveys of US adults aged 18 or older. During COVID-19, estimates were derived from the COVID-19 and Life Stressors Impact on Mental Health and Well-being study, conducted from March 31, 2020, to April 13, 2020. Before COVID-19 estimates were derived from the National Health and Nutrition Examination Survey, conducted from 2017 to 2018. Data were analyzed from April 15 to 20, 2020. Exposures The COVID-19 pandemic and outcomes associated with the measures to mitigate it. Main Outcomes and Measures Depression symptoms, defined using the Patient Health Questionnaire-9 cutoff of 10 or higher. Categories of depression symptoms were defined as none (score, 0-4), mild (score, 5-9), moderate (score, 10-14), moderately severe (score, 15-19), and severe (score, ≥20). Results A total of 1470 participants completed the COVID-19 and Life Stressors Impact on Mental Health and Well-being survey (completion rate, 64.3%), and after removing those with missing data, the final during–COVID-19 sample included 1441 participants (619 participants [43.0%] aged 18-39 years; 723 [50.2%] men; 933 [64.7%] non-Hispanic White). The pre–COVID-19 sample included 5065 participants (1704 participants [37.8%] aged 18-39 years; 2588 [51.4%] women; 1790 [62.9%] non-Hispanic White). Depression symptom prevalence was higher in every category during COVID-19 compared with before (mild: 24.6% [95% CI, 21.8%-27.7%] vs 16.2% [95% CI, 15.1%-17.4%]; moderate: 14.8% [95% CI, 12.6%-17.4%] vs 5.7% [95% CI, 4.8%-6.9%]; moderately severe: 7.9% [95% CI, 6.3%-9.8%] vs 2.1% [95% CI, 1.6%-2.8%]; severe: 5.1% [95% CI, 3.8%-6.9%] vs 0.7% [95% CI, 0.5%-0.9%]). Higher risk of depression symptoms during COVID-19 was associated with having lower income (odds ratio, 2.37 [95% CI, 1.26-4.43]), having less than $5000 in savings (odds ratio, 1.52 [95% CI, 1.02-2.26]), and exposure to more stressors (odds ratio, 3.05 [95% CI, 1.95-4.77]). Conclusions and Relevance These findings suggest that prevalence of depression symptoms in the US was more than 3-fold higher during COVID-19 compared with before the COVID-19 pandemic. Individuals with lower social resources, lower economic resources, and greater exposure to stressors (eg, job loss) reported a greater burden of depression symptoms. Post–COVID-19 plans should account for the probable increase in mental illness to come, particularly among at-risk populations.

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Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic.

Pharmacogenetics is the study of how interindividual variations in the DNA sequence of specific genes affect drug response. This article highlights current pharmacogenetic knowledge on important human drug-metabolizing cytochrome P450s (CYPs) to understand the large interindividual variability in drug clearance and responses in clinical practice. The human CYP superfamily contains 57 functional genes and 58 pseudogenes, with members of the 1, 2, and 3 families playing an important role in the metabolism of therapeutic drugs, other xenobiotics, and some endogenous compounds. Polymorphisms in the CYP family may have had the most impact on the fate of therapeutic drugs. CYP2D6, 2C19, and 2C9 polymorphisms account for the most frequent variations in phase I metabolism of drugs, since almost 80% of drugs in use today are metabolized by these enzymes. Approximately 5-14% of Caucasians, 0-5% Africans, and 0-1% of Asians lack CYP2D6 activity, and these individuals are known as poor metabolizers. CYP2C9 is another clinically significant enzyme that demonstrates multiple genetic variants with a potentially functional impact on the efficacy and adverse effects of drugs that are mainly eliminated by this enzyme. Studies into the CYP2C9 polymorphism have highlighted the importance of the CYP2C9*2 and *3 alleles. Extensive polymorphism also occurs in other CYP genes, such as CYP1A1, 2A6, 2A13, 2C8, 3A4, and 3A5. Since several of these CYPs (e.g., CYP1A1 and 1A2) play a role in the bioactivation of many procarcinogens, polymorphisms of these enzymes may contribute to the variable susceptibility to carcinogenesis. The distribution of the common variant alleles of CYP genes varies among different ethnic populations. Pharmacogenetics has the potential to achieve optimal quality use of medicines, and to improve the efficacy and safety of both prospective and currently available drugs. Further studies are warranted to explore the gene-dose, gene-concentration, and gene-response relationships for these important drug-metabolizing CYPs.

Polymorphism of human cytochrome P450 enzymes and its clinical impact

https://www.mdpi.com/2076-393X/8/3/482/pdf

Acceptance of covid-19 vaccination during the covid-19 pandemic in china

BACKGROUND At the end of 2019, the COVID-19 outbreak began in Wuhan, Hubei, China, and spread rapidly to the whole country within 1 month. This new epidemic caused a great mental reaction among the public. This study aimed to assess and compare the prevalence and associated factors of anxiety and depression among the public affected by quarantine and those unaffected during the COVID-19 outbreak in southwestern China in early Feb. 2020. MATERIAL AND METHODS Data were collected using the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) administered to 1593 respondents aged 18 years and above. The respondents were grouped as 'affected group' and 'unaffected group' on the basis of whether they or their families/colleagues/classmates/neighbors had been quarantined. RESULTS Among 1593 participants, the prevalence of anxiety and depression was approximately 8.3% and 14.6%, respectively, and the prevalence in the affected group (12.9%, 22.4%) was significantly higher than that in the unaffected group (6.7%, 11.9%). Lower average household income, lower education level, having a higher self-evaluated level of knowledge, being more worried about being infected, having no psychological support, greater property damage, and lower self-perceived health condition were significant associated with higher scores on the SAS and SDS. People living in Chongqing had higher SAS and SDS scores than those living in Yunnan Province. CONCLUSIONS The prevalence of anxiety and depression of the affected group are higher than in the unaffected group during the COVID-19 outbreak in southwestern China in early Feb. 2020. The government should focus more on providing economic and medical support to improve the general population's mental state.

/pdf/comparison-of-prevalence-and-associated-factors-of-anxiety-2lib4u8vkn.pdf

Comparison of Prevalence and Associated Factors of Anxiety and Depression Among People Affected by versus People Unaffected by Quarantine During the COVID-19 Epidemic in Southwestern China.

https://research.birmingham.ac.uk/portal/files/132683945/1_s2.0_S2214109X21000796_main.pdf

Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis.

RésuméObjectifsÉvaluer la faisabilité de la prostatectomie radicale, sa morbidité et ses résultats à court terme.Matériel et méthodesNous avons réalisé une étude descriptive basée sur l’étude de dossiers des 18 cas de prostatectomie radicale réalisés dans notre service de juin 2004 à mai 2007. Nous nous sommes intéressés aux paramètres suivant: âge, circonstances de diagnostic, taux de l’antigène spécifique de la prostate (PSA), type histologique, stade TNM, voie d’abord, suites opératoires et évaluation clinique et biologique à trois mois. L’analyse des données s’est faite par calculs de fréquence et de moyenne.RésultatsL’âge moyen était de 60,9 ans. Le taux moyen de PSA total était de 31,9 ng/ml. L’élévation du PSA était la circonstance de diagnostic dans 33,4 contre 66,6 % de troubles mictionnels. Les tumeurs étaient localisées: sept cas de cT1 (38,9 %) et 11 cas de cT2 (61,1 %). Un adénocarcinome a été trouvé pour tous les patients avec un score de Gleason moyen de 6,3. Quatorze patients avaient bénéficié d’un abord rétropubien avec curage ganglionnaire et les quatre autres, d’un abord périnéal sans curage ganglionnaire. La durée moyenne de l’intervention était de 160,3 minutes (90 et 200). Le volume moyen de perte sanguine était de 1 071,1 ml. En postopératoire, nous avons eu deux cas d’hématurie (11,1 %), deux fistules anastomotiques (11,1 %) et une infection urinaire. Le délai moyen d’ablation de la sonde était de 13,9 jours. L’évaluation de l’érection à trois mois postopératoire avait montré six cas de bonne érection (33,3 %), trois cas d’érection semi-rigide (16,6 %) et huit cas d’absence d’érection (44,4 %), deux cas d’incontinence (11,1 %) et un cas non évalué. Le taux de PSA était inférieur ou égal à 0,2 ng/ml dans six cas (33,3 %), indétectable dans sept cas (38,9 %) et élevé dans les cinq autres cas.ConclusionLa prostatectomie radicale est un traitement accessible sans risque grave pour les patients. Il faudrait toutefois plus de recul et de cas pour mieux l’apprécier.AbstractObjectivesTo evaluate the feasibility of radical prostatectomy, its morbidity and its short-term results.Materials and methodsWe carried out a descriptive study based on study of the records of the 18 radical prostatectomy cases carried out in our department from June 2004 to May 2007. We were interested in the following parameters: age, diagnostic circumstances, PSA, histological type, TNM stage, approach, operative follow-up and clinical and biological evaluation after three months. The analysis of the data was done using frequency and average calculations.ResultsThe average age was 60.9 years (53, 68). The average total PSA rate was 31.9 ng/ml (6.1, 143.1). The rise in PSA was a result of diagnostic circumstances in 33.4 against 66.6% of urinary disorders. The tumours were localised: seven cases of cT1 (38.9%) and 11 cases of cT2 (61.1%). An adenocarcinoma was found in all patients with an average Gleason score of 6.3 (3; 8). Fourteen patients had been treated via the retropubic approach, with ganglionic curage; and in four others, a perineal approach was used, with no curage. The average intervention duration was 160.3 minutes (90: 200). The average blood loss volume was 1 071.1 ml (300; 2600). Postoperatively, we had two cases of hematuria (11.11%), two anastomotic fistulae (11.1%) and one urinary infection. The average time for catheter ablation was 13.9 days (2; 22). Erection evaluation three months postoperatively showed six cases of good erection (33.3%), three cases of semi rigid erection (16.7%) and eight cases of lack of erection (44.4%), including three cases of erectile dysfunction before surgery. Erection was not evaluated in one case. With regard to continence three months postoperatively, we noted seven cases of normal continence without leakages of urine (38.88%), eight cases of urine leakages accompanying normal micturition (44.4%), two cases of incontinence (11.1%) and one non-evaluated case.ConclusionRadical prostatectomy is an accessible treatment without serious risk for the patients. However, more remissions and cases are required for a more complete evaluation.

Prostatectomie radicale : évaluation à court terme à propos de 18 cas Radical prostatectomy: short term evaluation of 18 cases

Our findings suggest that health workers and faith leaders are important sources of information to deliver vaccination messages, given their strong association with vaccination confidence and uptake. In this context, vaccination promotion efforts that integrate faith leaders and health workers may help increase vaccination uptake. Key Findings Exposure to vaccination information from faith leaders and health facilities was associated with increased likelihood of vaccination uptake. The significant association between exposure to a greater number of immunization information sources and increased likelihood of vaccination uptake reinforces the need for multiple sources to provide consistent and accurate immunization information to facilitate positive vaccination behavior. Key Implications Social and behavior change communication interventions may optimize the promotion of immunization services through multiple information sources such as health facilities and community-based assets including faith leaders and lay community health workers. Religion and faith play an important role in how people understand health and make health decisions. In Sierra Leone and other similar settings, interventions to improve uptake of immunization services may be enhanced by proactively engaging faith leaders. ABSTRACT Introduction: There is limited understanding of the potential impact of information sources on vaccination attitudes and behaviors in low-income countries. We examined how exposure to immunization information sources may be associated with vaccination uptake in Sierra Leone. Methods: In 2019, a household survey was conducted using multistage cluster sampling to randomly select 621 caregivers of children aged 12–23 months in 4 districts in Sierra Leone. We measured exposure to various sources of immunization information and 2 outcomes: (1) vaccination confidence using an aggregate score (from 12 Likert items, informed by previously validated scale) that was dichotomized into a binary variable; (2) uptake of the third dose of diphtheria-pertussis-tetanus-hepatitis B-Haemophilus influenzae type-b-pentavalent vaccine (penta-3) based on card record or through caregiver recall when card was unavailable. Associations between information sources and the outcomes were examined using modified Poisson regression with robust variance estimator. Results: Weighted estimate for penta-3 uptake was 81% (75.2%–85.5%). The likelihood of uptake of penta-3 was significantly greater when caregiver received information from health facilities (adjusted prevalence ratio [aPR]=1.26, 95% confidence interval [CI]=1.1, 1.5), faith leaders (aPR=1.16, 95% CI=1.1, 1.3), and community health workers (aPR=1.13, 95% CI=1.003, 1.3). Exposure to greater number of information sources was associated with high penta-3 uptake (aPR=1.05, 95% CI=1.02, 1.1). Discussion: Immunization information received during health facility visits and through engagement with religious leaders may enhance vaccination uptake. Assessments to understand context-specific information dynamics should be prioritized in optimizing immunization outcomes.

https://www.ghspjournal.org/content/ghsp/10/1/e2100237.full.pdf

Role of Information Sources in Vaccination Uptake: Insights From a Cross-Sectional Household Survey in Sierra Leone, 2019

Ellen Idler and colleagues argue that durable partnerships with religious bodies can contribute to better population health outcomes

Religion as a social force in health: complexities and contradictions

Penile duplication or diphallia is a rare congenital anomaly. The authors report of diphallia in a 54 year old man who was received in consultation for the management of inguinal hernia. A review of the literature describes the clinical presentations and associated malformations and the therapeutic options ranging from a simple excision of the supernumerary penis to a complex reconstruction when associated with severe malformations. This case report did not undergo plastic surgery.

https://www.longdom.org/open-access/penile-duplication-a-case-report-2168-9857-1000160.pdf

Penile Duplication: A Case Report

Objective. The aim of our study is to assess the diagnostic aspects of bladder bilharzioma in the Urology Department of Idrissa Pouye General Hospital (Senegal). Materials and Methods. It is a descriptive study from January 2013 to December 2018. The patients included in the study were those who had anatomopathological examination of bladder biopsy that showed a schistosomiasis pseudotumor of the bladder. The variables studied were sociodemographic, clinical symptoms, imaging findings, histology, and treatment. The data have been saved and analyzed by the 2013 Excel software. Results. Thirteen patients were included in our study. The average age was 27 ± 12.1 years. Sex ratio was 1.6. The majority of the patients were from the northern part of Senegal. Hematuria was the main symptom for all the patients. Cystoscopy was performed for all the patients and showed 5 granulomas and 8 fibrocalcic polyps. A transurethral resection of the bladder was performed, and treatment with praziquantel (40 mg/kg of bodyweight) has been carried out. One patient presented precancerous lesions such as metaplasia and dysplasia of the bladder mucosa. After a median follow-up of 40 months (6–57 months), ten patients had a favorable clinical and endoscopic outcome. Conclusion. Granulomas and fibrocalcic polyps of the bladder mucosa are, respectively, confused with squamous cell carcinoma and bladder lithiasis in endemic areas of schistosomiasis. Good cystoscopy interpretation can provide the diagnosis of bladder bilharzioma and start the treatment.

/pdf/epidemiological-and-diagnostic-aspects-of-bladder-4h8i5oz1nd.pdf

Mohamed F Jalloh

Papers

Prostatectomie radicale : évaluation à court terme à propos de 18 cas Radical prostatectomy: short term evaluation of 18 cases

Role of Information Sources in Vaccination Uptake: Insights From a Cross-Sectional Household Survey in Sierra Leone, 2019

Religion as a social force in health: complexities and contradictions

Penile Duplication: A Case Report

Epidemiological and Diagnostic Aspects of Bladder Bilharziomas in the Urology Department of Idrissa Pouye General Hospital (HOGIP)