Patent foramen ovale closure versus medical therapy after cryptogenic stroke: An updated meta-analysis of all randomized clinical trials

Background: Cryptogenic strokes can be attributed to paradoxical emboli through patent foramen ovale (PFO). However, the effectiveness of PFO closure in preventing recurrent stroke is uncertain and the results of previous randomized clinical trials (RCTs) have been inconclusive. Hence, this study pro- vides an updated meta-analysis of all RCTs comparing PFO closure with medical therapy for secondary prevention of cryptogenic stroke. Methods: All RCTs were identified by a comprehensive literature search of PubMed, Embase, the Cochrane Collaboration Central Register of Controlled Trials, Scopus, and Clinicaltrials.gov. The primary outcome was recurrent ischemic stroke and secondary outcomes were transient ischemic at- tack (TIA), all-cause mortality, new-onset atrial fibrillation (AF), serious adverse events, and major bleeding. Results: Five RCTs with 3440 participants were included in the present study (1829 patients under- went PFO closure and 1611 were treated medically). Pooled analysis showed a statistically significant reduction in the rate of recurrent stroke with PFO closure in comparison to medical therapy (OR 0.41; 95% CI 0.19–0.90; p = 0.03). However, there were no statistically significant reductions of recurrent TIAs (OR 0.77; 95% CI 0.51–1.14; p = 0.19) or all-cause mortality (OR 0.76; 95% CI 0.35–1.65; p = 0.48). The risk of developing new-onset AF was increased significantly with PFO closure (OR 4.74; 95% CI 2.33–9.61; p < 0.0001), but no significant differences in terms of serious adverse events or major bleeding between both groups. Conclusions: Patent foramen ovale closure in adults with recent cryptogenic stroke was associated with a lower rate of recurrent strokes in comparison with medical therapy alone.

Correction to: Vitamin D deficiency and risk of cardiovascular diseases: a narrative review

In the original publication of this article [1], the reference number [42] under the section ‘vitamin D and Cardiovascular diseases’ (page no.2) should be [37]

Vitamin D deficiency and risk of cardiovascular diseases: a narrative review

Abstract Vitamin D, a fat-soluble prohormone, has wide-ranging roles in the regulation of many physiological processes through their interactions with the vitamin D receptors (VDR). It plays a major role in bones and calcium metabolism. Vitamin D deficiency is not uncommon and it has been associated with many health-related issues, including skeletal and non-skeletal complications. The association of low vitamin D and cardiovascular diseases and risk factors has been explored in both animal and human studies. However, studies and trials on the effect of vitamin D supplementation on cardiovascular risk factors and hypertension are conflicting with inconsistent results. Therefore, large, well-powered randomized controlled trials are warranted. If successful, supplementation with easy and low-cost vitamin D can impact our health positively. Here, we summarized the evidence for the association of vitamin D, cardiovascular diseases and risk factors, including coronary artery diseases, stroke, and hypertension, and mortality, with special consideration to resistant hypertension

Assessing quality of academic programmes: comparing different sets of standards

Purpose: Standards should provide a means for transparently comparing academic programmes delivered by higher education providers and the research activities they carry out. The purpose of this study is to investigate the different sets of standards related to the quality assurance of academic programmes in four countries with regard to the European Standards and Guidelines (ESG), developed by the European Association for Quality Assurance, for internal quality assurance within higher education institutions. The main aim is to find the convergence and divergence points and to test the consistency of terminologies in use which may impede international collaboration to develop one comprehensive international quality assurance system. Design/methodology/approach: The study relied solely on desk-based research and no fieldwork or interviews were conducted for data collection; a point-by-point comparative approach has been applied to explore the standards related to quality assurance of academic programmes. Findings: Although there is a great deal of convergence between the different sets of standards compared in this study, fundamental differences still exist. Research limitations/implications: This study compared the standards of academic programmes in four countries with the ESG. To generalise the findings of this study, future research may include other standards for comparison. Originality/value: This study engages in the debate of how quality of higher education will remain maintained, in times, when higher education is facing challenges such as internationalisation, which requires new initiatives and integrated mechanisms to facilitate mutual recognition of qualifications of students and staff moving across borders

Social networking and fear of missing out (FOMO) among medical students at University of Khartoum, Sudan 2021

Abstract Background With students becoming more involved in the internet and social networking sites, they become more prone to their consequences. This study focuses on measuring the social networking intensity and the fear of missing out among the medical students of University of Khartoum, then examining the association between them. Methods Facility-based, descriptive, cross-sectional study was conducted at Faculty of Medicine, Khartoum University between January and March 2021. A total of 333 students were selected by simple random sampling. Data was collected from the participants using a structured self-administered questionnaire that involved the social networking intensity (SNI) scale and fear of missing out (FOMO) scale. The data was analyzed by the Statistical Package for Social Science (SPSS) software version 26. Results Moderate positive correlation between social networking intensity and fear of missing out was found (p-value < 0.01). Of the total participants; 51 participants (15.4%) experienced low SNI and low FOMO. Another 78 participants (23.6%) had moderate SNI and moderate FOMO and only 16 Participants (4.8%) showed high SNI and high FOMO. There were no significant differences in SNI or FOMO scores among the different socio-demographic variables, except for the SNI score which was positively correlated to the monthly income. Conclusion An association between SNI and FOMO was found. SNI was not affected by socio-demographic factors except for the monthly income

Parkinsonism Relat Disord

Background: Several studies suggested a significant role of epigenetic changes, including alterations in miRNA, histone modifications, and DNA methylation of α-synuclein (SNCA) in Parkinson’s disease (PD) pathogenicity. As of yet, only very few studies have been carried out in this field in Africa and none in Sudan. Materials and methods: We collected DNA from 172 Sudanese individuals (90 cases, 82 controls) who donated saliva for DNA extraction (mean age of onset: 40.6 ± 22.4 years). A family history of PD was evident in 64 patients. DNA preparation and bisulfite sequencing of SNCAintron1 was performed as described earlier. Results: Of the fourteen analyzed CpGs of SNCAintron1, CpGs 16-23 were hypomethylated in PD (P-value ranged from 0.023 to 0.003). P–values improved, when sporadic cases were excluded from the analysis. Conclusion: We identified the presence of a specific pattern of DNA methylation in a young Sudanese cohort of familial PD, which confirms the importance of the methylation of SNCAintron1 for PD. This phenomenon appears to be independent of ethnicity, the impact of environmental factors, drug history, or familial clustering