Asia and its Hindu Kush Himalayan(HKH)region is particularly vulnerable to environmental change,especially climate and land use changes further influenced by rapid population growth,high level of poverty and unsustain...
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Asia and its Hindu Kush Himalayan(HKH)region is particularly vulnerable to environmental change,especially climate and land use changes further influenced by rapid population growth,high level of poverty and unsustainable *** has been a hotspot of dengue fever and chikungunya mainly due to its dense human population,unplanned urbanization and *** an urban cycle,dengue virus(DENV)and chikungunya virus(CHIKV)are transmitted by Aedes aegypti and *** mosquitoes which are also competent vectors of Zika virus(ZIKV).Over the last decade,DENV and CHIKV transmissions by *** have extended to the Himalayan countries of Bhutan and Nepal and ZIKV could follow in the footsteps of these viruses in the HKH *** already established distribution of human-biting Aedes mosquito vectors and a naïve population with lack of immunity against ZIKV places the HKH region at a higher risk of *** of the countries in the HKH region have already reported ZIKV *** have documented an increasing threat of ZIKV in Asia and its HKH region because of the high abundance and wide distribution of human-biting mosquito vectors,climate change,poverty,report of indigenous cases in the region,increasing numbers of imported cases and a naïve population with lack of immunity against *** outbreak anywhere is potentially a threat ***,in order to ensure international health security,all efforts to prevent,detect,and respond to ZIKV ought to be intensified now in Asia and its HKH *** prepare for possible ZIKV outbreaks,Asia and the HKH region can also learn from the success stories and strategies adopted by other regions and countries in preventing ZIKV and associated *** future control strategies for DENV,CHIKV and ZIKV should be considered in tandem with the threat to human well-being that is posed by other emerging and re-emerging vector-borne and zoonotic diseases,and by the continuing urgent need to strengthen public
BACKGROUND Data regarding the worldwide gastrointestinal surgery rates in patients with Crohn’s disease(CD)remains *** To systematically review the global variation in the rates of surgery in *** A comprehensive sear...
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BACKGROUND Data regarding the worldwide gastrointestinal surgery rates in patients with Crohn’s disease(CD)remains *** To systematically review the global variation in the rates of surgery in *** A comprehensive search analysis was performed using multiple electronic databases from inception through July 1,2020,to identify all full text,randomized controlled trials and cohort studies pertaining to gastrointestinal surgery rates in adult patients with *** included continent based demographic data,CD surgery rates over time,as well as the geoepidemiologic variation in CD surgery *** analyses were conducted using *** Twenty-three studies spanning four continents were *** median proportion of persons with CD who underwent gastrointestinal surgery in studies from North America,Europe,Asia,and Oceania were 30%(range:1.7%-62.0%),40%(range:0.6%-74.0%),17%(range:16.0%-43.0%),and 38%*** clear association was found regarding the proportion of patients undergoing gastrointestinal surgery over time in North America(R^(2)=0.035)and Europe(R^(2)=0.100).A moderate,negative association was seen regarding the proportion of patients undergoing gastrointestinal surgery over time(R^(2)=0.520)in *** There appears to be significant inter-continental variation regarding surgery rates in *** evidencebased guidelines accounting for the geographic differences in managing patients with CD is ***,as a paucity of data on surgery rates in CD exists outside the North American and European continents,future studies,particularly in less studied locales,are warranted.
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