1.Global Awareness of Myocardial Infarction Symptoms in General Population: a Systematic Review and Meta-Analysis
Akash SHARMA ; Karavadi VIDUSHA ; Harshini SURESH ; Ajan M. J. ; Kavinkumar SARAVANAN ; Madhvi DHAMANIA ; Nisha B ; Rabbanie Tariq WANI
Korean Circulation Journal 2021;51(12):983-996
Background and Objectives:
Knowledge about myocardial Infarction (MI) symptoms is crucial because inadequate awareness ensures direct association with patient delay and adverse health events subsequently.
Methods:
PRISMA guidelines were followed while conducting the systematic review with PROSPERO number CRD42020219802. An electronic search was conducted comprehensively through 5 databases to find those relevant articles systematically. Prevalence was calculated for each typical symptom of MI separately and subgroup analysis according to continent, country, gender and ethnicity was done. Meta-Analysis was conducted by using statistical software R version 3.4.3. A random-effects model was used.
Results:
Studies from 35 different countries with 120,988,548 individuals were included in the final analysis. The prevalence of chest pain awareness was highest, while it was lowest for jaw, back, and neck pain. There was no difference in terms of awareness in males and females. Prevalence of awareness of typical MI symptoms was higher in the Caucasian white, white, and non-Hispanic white groups than in other groups. The prevalence varies from less than 5% in African countries such as Kenya, Tanzania and Asian countries such as Nepal to as high as 90% in Germany.
Conclusions
People are well aware of chest pain as a symptom of MI. However, there is limited knowledge regarding other typical symptoms of MI.
2.Incidence of Dural Tears in Open versus Minimally Invasive Spine Surgery: A Single-Center Prospective Study
Ayush SHARMA ; Akash SHAKYA ; Vijay SINGH ; Priyank DEEPAK ; Nilesh MANGALE ; Ajay JAISWAL ; Nandan MARATHE
Asian Spine Journal 2022;16(4):463-470
Methods:
This study included 420 operated cases of degenerative lumbar pathology with a prospective follow-up of at least 6 months. Patients were divided into the open surgery and MIS groups, and the incidences of DT, early return to work, and various demographic and operative factors were compared.
Results:
A total of 156 and 264 patients underwent MIS and open surgery, respectively. Incidental durotomy was documented in 52 cases (12.4%); this was significantly less in the MIS group versus the open surgery group (6.4% vs. 15.9%, p <0.05). In the open surgery group, four patients underwent revision for persistent dural leak or pseudomeningocele, but none of the cases in the MIS group had revision surgery due to DT-related complications. The incidence of DT was higher among patients with high body mass index, patients with diabetes mellitus, and patients who underwent revision surgery (p <0.05) regardless of the approach. The MIS group returned to work significantly earlier.
Conclusions
MIS was associated with a significantly lower incidence of DT and earlier return to work compared with open surgery among patients with degenerative lumbar pathology.
3.A comparison of femoral tunnel placement in ACL reconstruction using a 70° arthroscope through the anterolateral portal versus a 30° arthroscope through the anteromedial portal: a pilot 3D-CT study
Jonathan D KOSY ; Katie WALMSLEY ; Akash D. SHARMA ; Elizabeth A. GORDON ; Sadie V. HEDDON ; Rahul ANASPURE ; Peter J. SCHRANZ ; Vipul I. MANDALIA
The Journal of Korean Knee Society 2020;32(2):e17-
Background:
Graft malposition is a risk factor for failure of anterior cruciate ligament reconstruction. A 70° arthroscope improves visualisation of the medial wall of the lateral femoral condyle without switching portals. We investigated whether the use of this arthroscope affected the accuracy and precision of femoral tunnel placement.
Methods:
Fifty consecutive adult patients were recruited. Following one withdrawal and two exclusions, 47 patients (30 in group 1 (70° arthroscope), 17 in group 2 (30° arthroscope)) underwent three-dimensional computed tomography imaging using a grid-based system to measure tunnel position.
Results:
No difference was found in the accuracy or precision of tunnels (mean position: group 1 = 33.3 ± 6.0% deep–shallow, 27.2 ± 5.2% high–low; group 2 = 31.7 ± 6.9% deep–shallow, 29.0 ± 6.2% high–low; not significant). A post-hoc power analysis suggests a study of 106 patients would be required.
Conclusions
This pilot study suggests that tunnel position is not affected by the arthroscope used. An appropriately powered study could investigate this finding alongside other potential benefits of using a 70° arthroscope for this procedure.Trial registration: ClinicalTrials.gov, NCT02816606. Registered on 28 June 2016.