Systematic review and meta-analysis comparing Manta device and Perclose device for closure of large bore arterial access.

Data comparing MANTA device with Perclose device for large bore arterial access closure is limited. We performed meta-analysis to compare safety and efficacy of the two devices in large (⩾14 Fr sheath) arteriotomy closure post-TAVR. Relevant studies were identified via PubMed, Cochrane, and EMBASE databases until June, 2022. Data was analyzed using random effect model to calculate relative odds of VARC-2 defined access-site complications and short-term (in-hospital or 30-day) mortality. A total of 12 studies (2 RCT and 10 observational studies) comprising 2339 patients were included. The odds of major vascular complications (OR 0.99, 95% CI 0.51-1.92; p = 0.98); life threatening and major bleeding (OR 0.77, 95% CI 0.45-1.33; p = 0.35); minor vascular complications (OR 1.37, 95% CI 0.63-2.99; p = 0.43); minor bleeding (OR 0.94, 95% CI 0.57-1.56; p = 0.82); device failure (OR 0.74, 95% CI 0.49-1.11; p = 0.14); hematoma formation (OR 0.76, 95% CI 0.33-1.75; p = 0.52); dissection, stenosis, occlusion, or pseudoaneurysm (OR 1.08, 95% CI 0.71-1.62; p = 0.73) and short-term mortality (OR 1.01, 95% CI 0.55-1.84; p = 0.98) between both devices were similar. MANTA device has a similar efficacy and safety profile compared to Perclose device.

Career Intentions and Their Influencing Factors Among Medical Students and Graduates in Peshawar, Pakistan: A Cross-Sectional Study on Brain Drain.

BACKGROUND AND OBJECTIVE:  Physician brain drain is of mounting concern worldwide, especially in lower-middle-income countries like Pakistan, where the healthcare sector is overworked, and the exodus of talented health professionals further deteriorates the country's health statistics. Our study's objective was to investigate the career and migration intentions of medical undergraduates and graduates in Peshawar. DESIGN, SETTINGS, AND PARTICIPANTS:  A cross-sectional self-structured questionnaire was distributed among 305 fourth- and final-year medical students and demonstrators at Khyber Medical College and graduates working as house officers, medical officers, and training medical officers at its conjugate hospital, Khyber Teaching Hospital, Peshawar. The questionnaire consisted of four sections designed to collect demographic details, determine participants' career and migration intentions, evaluate reasons for and against migration, and assess their reasons for establishing these intentions. The data were analyzed using IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. RESULTS:  67.5% of our respondents intended to migrate abroad, most of whom were men. The UK emerged as the top destination for those wishing to relocate. The most common reasons participants wanted to migrate were better quality of training and research, followed by a gain in professional skills over others, and lastly, better remuneration abroad. Most of those who wished to stay back chose family ties, a desire to serve the nation, and fixing flaws in the country's healthcare system as the most influential factors behind their decision to stay back. CONCLUSION:  The threat of brain drain is far-reaching and profound, putting Pakistan's people's health at risk. Policymakers must act to address the country's healthcare workers' concerns.