Coil Embolization as a Life-Saving Treatment for Pulmonary Artery Perforation Secondary to Large-Bore Catheterization.

We present a case of left pulmonary artery perforation during mechanical thrombectomy for treatment of pulmonary embolism. The patient's condition became hemodynamically unstable, with massive hemoptysis requiring intubation and multiple vasopressor agents. Prompt balloon tamponade and 0.035-mm coil embolization halted the extravasation. Coil embolization can be a lifesaving treatment for large vessel perforations. (Level of Difficulty: Intermediate.).

Complementary administration of curcumin in PCOS: a systematic review.

INTRODUCTION: The clinical benefit of curcumin, the active ingredient in turmeric, among women diagnosed with polycystic ovarian syndrome (PCOS) is unclear. In this systematic review, we aim to provide a brief review of the existing literature on the association between curcumin supplementation and PCOS. EVIDENCE ACQUISITION: Published articles relevant to the topic was obtained through extensive search using relevant keywords such as "polycystic ovarian syndrome," "PCOS," "turmeric," and "curcumin." Inclusion criteria included studies that investigated PCOS and turmeric/curcumin, while studies that investigated the use of curcumin in other gynecological disorders, infertility, rodent studies, and non-RCTs were excluded. EVIDENCE SYNTHESIS: A total of 14 articles were found and only five studies were incorporated based on the exclusion criteria. The main findings were that curcumin supplementation aids in improvement of lipid and glycemic profiles, Body Mass Index (BMI) and lowers androgen levels associated with PCOS. CONCLUSIONS: We shed light on additional therapeutic management for PCOS other than the conventional treatment. Further studies are required with larger sample sizes and diverse patient population to derive definitive conclusions regarding benefits of curcumin supplementation in PCOS.

COVID-19 vaccine hesitancy among medical students: A systematic review.

BACKGROUND: Vaccine hesitancy leads to an increase in morbidity, mortality, and health-care burden. Reasons for vaccine hesitancy include anti-vax group statements, misinformation about vaccine side effects, speed of vaccine development, and general disbelief in the existence of viruses like COVID-19. Medical students are future physicians and are key influencers in the uptake of vaccines. Hence, investigating vaccine hesitancy in this population can help to overcome any barrier in vaccine acceptance. METHODS: In this paper, we review five articles on COVID-19 vaccine hesitancy in medical students and consider potential future research. All published papers relevant to the topic were obtained through extensive search using major databases. Inclusion criteria included studies that specifically investigated COVID-19 vaccine hesitancy in medical students published between 2020 and 2021. Exclusion criteria included studies that investigated vaccine hesitancy in health-care professionals, allied health, and viruses apart from COVID-19. A total of 10 studies were found from our search. RESULTS: Based on our exclusion criteria, only five studies were included in our review. The sample size ranged from 168 to 2133 medical students. The percentage of vaccine hesitancy in medical students ranged from 10.6 to 65.1%. Reasons for vaccine hesitancy included concern about serious side effects, vaccine efficacy, misinformation and insufficient information, disbelief in public health experts, financial costs, and belief that they had acquired immunity. CONCLUSION: These results suggest that vaccine hesitancy is an important cause of the incidence and prevalence of COVID-19 cases. Identifying the barriers of vaccine hesitancy in prospective physicians can help increase vaccination uptake in the general public. Further research is necessary to identify the root cause of these barriers.

Efficacy and Cardiovascular Safety of GLP-1 Receptor Analogues.

Glucagon-like peptide- 1 receptor analogs (GLP-1RAs) are incretin mimetics with potent glucose-dependent insulinotropic action that translates to glycemic control in people with type- -2 diabetes mellitus (T2DM). These agents potentially have the ability to stimulate proliferation or prevent apoptosis of pancreatic ß-cells, induce weight-loss and provide vascular benefits in patients with T2DM. Newer GLP-1RA, semaglutide has shown a robust reduction in HbA1c up to 1.5 - 1.8%. However, individual differences exist between the different GLP-1RAs, in terms of efficacy, pharmacokinetics, tolerability, and vascular protection. The potential of vascular protection offered by newer anti-diabetic agents has generated a lot of excitement in the field of diabetes, and to a large extent, is now driving treatment decisions. So far, six cardiovascular outcome trials of GLP-1 RAs have been published, analyzing lixisenatide (ELIXA), liraglutide (LEADER), semaglutide (SUSTAIN-6), long-acting exenatide (EXSCEL), dulaglutide (REWIND), and oral semaglutide (PIONEER 6) with a follow-up duration of 2-4 years. LEADER, REWIND and SUSTAIN-6 trials have demonstrated a reduction in rates of major adverse cardiovascular events with active GLP-1 RA treatment, but ELIXA, PIONEER 6 and EXSCEL, have been neutral. In this review, we discuss the available evidence from randomized controlled trials (RCTs) analyzing the cardiovascular effects of various GLP-1 RAs with the aim of comparing individual drugs. We have also summarized the general aspects of GLP-1RAs that can be applied in clinical practice.