Background/Aims: Non-alcoholic fatty liver disease (NAFLD) is associated with the development of cardiovascular disease. While existing studies have examined cardiac remodeling in NAFLD, there has been less emphasis on the development of carotid atherosclerosis and stroke. We sought to conduct a meta-analysis to quantify the prevalence, risk factors, and degree of risk increment of carotid atherosclerosis and stroke in NAFLD. Methods: Embase and Medline were searched for articles relating to NAFLD, carotid atherosclerosis, and stroke. Proportional data was analysed using a generalized linear mixed model. Pairwise meta-analysis was conducted to obtain odds ratio or weighted mean difference for comparison between patients with and without NAFLD. Results: From pooled analysis of 30 studies involving 7,951 patients with NAFLD, 35.02% (95% confidence interval [CI], 27.36–43.53%) had carotid atherosclerosis with an odds ratio of 3.20 (95% CI, 2.37–4.32; P<0.0001). Pooled analysis of 25,839 patients with NAFLD found the prevalence of stroke to be 5.04% (95% CI, 2.74–9.09%) with an odds ratio of 1.88 (95% CI, 1.23–2.88; P=0.02) compared to non-NAFLD. The degree of steatosis assessed by ultrasonography in NAFLD was closely associated with risk of carotid atherosclerosis and stroke. Older age significantly increased the risk of developing carotid atherosclerosis, but not stroke in NAFLD. Conclusions This meta-analysis shows that a stepwise increment of steatosis of NAFLD can significantly increase the risk of carotid atherosclerosis and stroke development in NAFLD. Patients more than a third sufferred from carotid atherosclerosis and routine assessment of carotid atherosclerosis is quintessential in NAFLD.

Introduction: Cardiac resuscitation skills are a necessity for newly graduated doctors as they are first responders during a crisis. Despite undergraduate exposure, interns still struggle in an actual crisis. We evaluated final year medical students’ long-term retention of knowledge following cardiac life support training prior to exit from medical school to determine the need to revise and re-strategize. Methods: Thirty-seven final year medical students participated in a quasi-experimental research after a cardiac life support (CLS) course where results of their one best answer assessment-pretest, immediate posttest and 6 months posttest were analyzed. Results: A repeated measure ANOVA was conducted on mean test scores of 30-items one best answer (OBA) questions, measured as pre-test, immediate and 6 months posttests after the course. The result showed significant time effect, Wilks Lambda = 0.126, F (2,35) = 121.468, P = <.001. Follow up comparison indicated that each pairwise comparison difference was significant (p ≤ 0. 05). Both immediate and after 6 months post-course test scores were statistically better than the pretest scores suggesting that there was improvement in knowledge after the course despite the decay. Conclusion Our results showed that retention of knowledge as a short-term memory worked well immediately after the hands-on cardiac resuscitation course. However, though there was improved knowledge even after 6 months compared to before the course, there was decay in knowledge. There is a need to re-strategize to improve knowledge retention.
Knowledge ; Cardiopulmonary Resuscitation