Background Optimal management of ruptured abdominal aortic aneurysms (rAAA) has been heavily debated in the literature. The aim of this review is to assess comparative outcomes from propensity-matched studies of endovascular versus open for rAAA. Methods Electronic databases (MEDLINE and Embase) were searched in January 2021 using the Healthcare Databases Advanced Search interface. Eligible studies compared endovascular versus open repair for rAAA using propensity-matched cohorts. Pooled estimates of perioperative outcomes were calculated using odds ratio (OR) or mean difference (MD) and 95% confidence interval (CI) using the random-effects model. Time-to-event data meta-analysis was conducted using the inverse-variance method and reported as summary hazard ratio (HR) and associated 95% CI. The quality of evidence was graded using a system developed by the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) working group. Results Six studies published between 2010 and 2020 were selected for qualitative and quantitative synthesis, reporting a total of 6731 patients. The odds of perioperative mortality after endovascular aneurysm repair (EVAR) were significantly lower than after open surgical repair (OSR) (OR 0.52, 95% CI 0.41–0.65). The hazard of overall mortality during follow-up was lower, although not significantly, after EVAR than after OSR (HR 0.79, 95% CI 0.62–1.01). The odds of acute kidney injury and early aneurysm-related reintervention were both significantly lower after EVAR than after OSR (OR 0.34, 95% CI 0.14–0.78 and OR 0.57, 95% CI 0.33–0.98, respectively). Patients treated with EVAR stayed in hospital for significantly less time than those treated with OSR (MD −5.13, 95% CI −7.94 to −2.32). The certainty of the body of evidence for perioperative mortality was low and for overall mortality was very low. Conclusion The evidence suggests that EVAR confers a significant benefit on perioperative mortality.

Background: Recent evidence suggests a benefit in platelet-rich plasma injections (PRP) for the knee in the management of mild to moderate osteoarthritis (OA). There is a reported reduction in pain, stiffness, and improved function. However, there is very little level-one literature available that supports this practice and conclusively proves a benefit gained throughout the course. Three main randomized control trials (RCTs) conducted in North America are often referenced and cited to prove their efficacy. This study aimed to look at the outcomes of patients having undergone this treatment to determine if there was any benefit. Aims: This study aimed to determine if PRP injections administered in patients with knee OA over a six to eight-week time period demonstrated any benefit. Methods: The Western Ontario and McMaster Universities arthritis index (WOMAC) tool was used before each of the three PRP injections over the six to eight-week period, and six weeks after the final injection in 31 patients. Each injection was given spaced two to three weeks apart. The outcomes observed were pain, stiffness, and physical function, and the total WOMAC score was calculated. Results: The third injection showed a reduction in total WOMAC score, pain, stiffness, and physical function by 16.36%, 16.37%, 5.12%, and 18.03%, respectively. However, all scores returned close to baseline at the sixth-week follow-up post treatment. Conclusion: Results showed a trend of reduction in the WOMAC score. However, they are overall indicative of a placebo effect from the injections. Further studies are needed to explore whether the grade of OA and patients’ weight have a significant impact on the results.

Gestational diabetes mellitus is the type of diabetes that occur during pregnancy and ended after pregnancy in many cases. The term gestation was used in the late twenty centuries. The release of glucose increases during the normal pregnancy and insulin releases from the pancreas and control the glucose level. During gestational period, the insulin release fell down and glucose molecules are not properly breakdown into their substrates. The prevalence of GDM has been observed in the age group of 27 years. GDM affect both children and mother as it causes retinopathy, neuropathy and CVDs. In children, it causes the broad shoulder of fetus and can affect many organs of baby. The high level of glucose can cause complications during delivery. Insulin therapy and metformin are safe treatment for the gestational diabetes. The mechanism underlying the effect cause in the fetus due to gestational diabetes are still known. The studies can be done to find out these mechanisms.

Background: There is growing evidence identifying coronavirus disease 2019 (COVID-19) as a significant risk factor for thrombosis in inpatients. However, it remains uncertain if patients in the community have been influenced during the COVID-19 pandemic and national lockdown. This study, across four centres in the United Kingdom (UK), reviewed outpatients with deep vein thrombosis (DVT).Aim: This study aims to find out whether lockdown and COVID-19 led to a change in the characteristics of DVT and patients who are afflicted with it, alongside a review of DVT service.

ResultsWe identified a total of 195 MCA occlusion patients over a 3 ½ year period meeting our inclusion criteria. There were no significant differences in age, gender, race, comorbidities, or median NIHSS between the ATA not visualized (n=103) versus visualized (n=92) cohort. There were significantly more wake-up strokes in the ATA visualized group (26.7% vs 11.9%, p=0.0091). In regard to imaging variables, there was no significant differences in baseline ASPECT scores, post intervention TICI scores, or interval from last known well to revascularization (p=0.7499, p=0.7235, and p=0.5337, respectively). Perfusion parameters were less favorable in patients were the ATA was not visualized with larger core infarct (8cc vs 0cc, p=0.005, CBF < 30% of normal tissue) and larger penumbra (134cc vs. 117cc, p=0.004, T max >6 seconds). There was a non-significant trend for favorable outcome (mRS£3) at 90 days in patients where the ATA is visualized (69.6% vs. 56.3%, p=0.0562) (figure 1). Independent predictors of favorable outcome were age (p<0.0001), hypertension (p=0.02), and baseline NIHSS (p<0.0001). Conclusion Though the presence of the anterior temporal artery in patients undergoing recanalization for MCA occlusion did not reach statistical significance for predicting independent outcomes, there was a strong trend for improved outcomes. Particularly for institutions without CTP capability or when CTP data is not-reliable, this association with ATA visualization should be further investigated as a predictor for good outcome after successful mechanical thrombectomy.