Background Neonatal disorders represent a significant public health challenge, particularly in low- and middle-income countries, where they account for 79% of global neonatal mortality. South Asia, comprising countries such as India, Pakistan, Bangladesh, Nepal, and Bhutan, bears a disproportionately high burden, contributing to 38% of the world’s neonatal deaths. Despite notable progress, South Asia remains off track in meeting the Sustainable development goals (SDG). This study aims to assess the current burden, trends in neonatal disorders, and forecast mortality rates across South Asian countries, providing insights to guide investment priorities and improve neonatal outcomes. Methods Data for this study were sourced from the Global burden of disease (GBD) 2021 study, which utilizes a Bayesian meta-regression model to estimate mortality, prevalence, and disability-adjusted life years (DALYs). Spatial maps depicting the age-standardized prevalence rate and age-standardized mortality rate for neonatal disorders in South Asia were generated using QGIS software. Mortality forecasts for the period 2022–2031, attributed to various neonatal disorders, were produced employing the Auto-Regressive Integrated Moving Average model in R software. Additionally, an analysis of overall neonatal mortality trends from 1980 to 2021 was conducted, supplemented by a heat map that compares DALYs attributable to various neonatal disorders across South Asian countries in 2021. Results Between 1980 and 2021, South Asia experienced a substantial decline in neonatal mortality rates, with India and Bangladesh leading the progress. Mortality decreased by 40%, while DALYs fell by 35%, despite a 15% increase in the prevalence. The prevalence of neonatal encephalopathy due to birth asphyxia and trauma surged by 355%, yet its mortality dropped by 31%. Pakistan recorded the highest neonatal mortality and disease burden, particularly for hemolytic disease and other neonatal jaundice and neonatal encephalopathy due to birth asphyxia and trauma. In India and Bangladesh, neonatal preterm birth and neonatal sepsis and other neonatal infections contributed most to mortality. Neonatal encephalopathy due to birth asphyxia and trauma accounted for the highest DALYs. Forecasts predict continued reductions in neonatal mortality across South Asia, except in Pakistan, where persistently high rates are expected till 2031. Conclusion For South Asian countries to meet the SDG target for neonatal mortality by 2030, intensified and continuous efforts are required. These efforts should focus on identifying high-risk pregnancies and improving the quality of care during childbirth to address the root causes and reduce preventable neonatal deaths.

Chronic Obstructive Pulmonary Disease (COPD) is a long-standing respiratory illness marked by ongoing airflow obstruction and inflammation. It continues to

ObjectiveThe rapid deployment of COVID-19 mRNA vaccines, specifically Pfizer (BNT162b2) and Moderna (mRNA-1273), had raised concerns about rare cardiac side effects, notably myocarditis. The aim of this systematic review and meta-analysis was to comprehensively compare the risk of myocarditis associated with two mRNA COVID-19 vaccines: Pfizer (BNT162b2) and Moderna (mRNA-1273). MethodsFollowing PRISMA guidelines, this review included observational cohort studies and case series comparing myocarditis risk in individuals receiving either of the two vaccines Pfizer (BNT162b2) and Moderna (mRNA-1273). Studies were identified through a systematic search of PubMed, EMBASE, and Web of Science. Data extraction focused on myocarditis incidence, demographic characteristics, vaccine type, and the number of doses. Meta-analysis was performed using a random-effects model. The risk of bias was assessed using JBI critical appraisal tools. ResultsNine studies were found to meet the inclusion criteria, consisting of four cohort studies and five case series. Together, they encompassed data on 294,731,021 doses of the Moderna vaccine and 426,526,128 doses of the Pfizer vaccine. The combined risk ratio (RR) for myocarditis was 1.62 (95% CI: 1.02, 2.56) when comparing Moderna to Pfizer, suggesting a marginally increased risk with the Moderna vaccine, though it was not statistically significant. Additionally, a subgroup analysis based on the first and second doses indicated different risk levels. For the first dose, the RR was 1.14 (95% CI: 0.79, 1.64) for myocarditis in those who received Moderna compared to Pfizer. For the second dose, a higher RR of 1.69 (95% CI: 0.79, 3.59) was noted for myocarditis among Moderna recipients compared to Pfizer. ConclusionMyocarditis following mRNA COVID-19 vaccination was rare, with a very slight increased risk observed in Moderna recipients compared to Pfizer. These findings suggested the need for ongoing surveillance and further research to understand the nuanced differences in risk profiles between these vaccines.

Malaria in pregnant women, particularly those infected with HIV, poses significant health risks, including adverse maternal and neonatal outcomes. This perspective examines various prophylactic strategies, emphasizing recent clinical trial findings on the efficacy and safety of newer antimalarial drugs. Sulfadoxine-pyrimethamine (SP) has been a conventional choice for intermittent preventive treatment during pregnancy (IPTp). However, its effectiveness is compromised due to its interaction with cotrimoxazole (CTX), a medication frequently used for individuals with HIV. This interaction limits it’s utility. Recent research emphasizes the promise of dihydroartemisinin-piperaquine (DP) as an effective alternative, given its prolonged half-life and robust safety profile, including among HIV-infected pregnant women in regions with minimal malaria transmission. While DP did not notably lower the incidence of placental malaria, it effectively reduced the occurrence of clinical malaria and overall Plasmodium falciparum infections, indicating its potential to improve maternal health in endemic areas. Mefloquine (MQ), another alternative, though effective, is associated with severe side effects and increased HIV transmission risks, highlighting the need for cautious implementation. This narrative underscores the complexities of managing malaria prophylaxis in this vulnerable population, urging a tailored approach based on regional epidemiology and resistance patterns. The integration of these findings into health policies could significantly improve outcomes for mothers and newborns in sub-Saharan Africa, where malaria and HIV prevalently intersect. The ongoing adaptation of these interventions is critical to addressing the dynamic challenges of co-infections in pregnancy, ensuring effective and safe treatment pathways.