Chorioangioma: a single tertiary care center retrospective study.

OBJECTIVES: Chorioangioma represents a challenge due to the rarity of the condition, paucity of sufficient management guidelines, and controversies regarding the best invasive fetal therapy option; most of the scientific evidence for clinical treatment has been limited to case reports. The aim of this retrospective study was to review the natural antenatal history, maternal and fetal complications, and therapeutic modalities used in pregnancies complicated with placental chorioangioma at a single Center. METHODS: This retrospective study was conducted at King Faisal Specialist Hospital and Research Center (KFSH&RC) in Riyadh, Saudi Arabia. Our study population included all pregnancies with ultrasound features of chorioangioma, or histologically confirmed chorioangiomas, between January 2010 and December 2019. Data were collected from the patients' medical records, including the ultrasound reports and histopathology results. All subjects were kept anonymous; case numbers were used as identifiers. Data collected by the investigators were entered into Excel worksheets in an encrypted format. A MEDLINE database was used to retrieve 32 articles for literature review. RESULTS: Over a 10-year period between January 2010 and December 2019, 11 cases of chorioangioma were identified. Ultrasound remains the gold standard for diagnosis and follow-up of the pregnancy. Seven of the 11 cases were detected by ultrasound, allowing proper fetal surveillance and antenatal follow-up. Of the remaining six patients, one underwent radiofrequency ablation, two underwent intrauterine transfusion for fetal anemia due to placenta chorioangioma, one had vascular embolization with an adhesive material, and two were managed conservatively until term with ultrasound surveillance. CONCLUSIONS: Ultrasound remains the gold standard modality for prenatal diagnosis and follow-up of pregnancies with suspected chorioangiomas. Tumor size and vascularity play a significant role in the development of maternal-fetal complications and the success of fetal interventions. To determine the superior modality of fetal intervention mandates more data and research; nevertheless, Fetoscopic Laser Photocoagulation and embolization with adhesive material seem to be a lead choice, with reasonable fetal survival.

Efficacy of lidocaine local anesthesia on pain perception during amniocentesis: A meta-analysis of randomized controlled trials.

To evaluate the efficacy of lidocaine local analgesia on maternal pain reduction during amniocentesis. Web of Science, Scopus, PubMed, and CENTRAL databases were screened from inception and updated in July 2022. The included randomized controlled trials (RCTs) were evaluated for the risk of bias via the Cochrane tool. The primary outcome was pain perception using the 10 cm visual analog scale, and was summarized as mean difference (MD) with 95% confidence interval (CI) in a random-effects model. Subgroup analysis was performed according to the mode of administration. Meta-analysis was done via Review Manager software. We included five RCTs totaling 1004 women (lidocaine arm n=502 patients and control arm n=502 patients). Overall, there was no significant difference between both arms [MD=-0.21, 95% CI (-0.48, 0.07), p=0.80]. The pooled analysis showed homogeneity (p=0.13, I2=43%). Subgroup analysis according to the mode of administration showed that pain perception did not significantly differ between both arms when lidocaine was employed as injection [n=3 RCTs, MD=-0.26, 95% CI (-0.76, 0.23), p=0.29] or non-injection [n=2 RCTs, MD=-0.18, 95% CI (-0.55, 0.18), p=0.33]. The pooled analyses showed heterogeneity (p=0.05, I2=66%) and homogeneity (p=0.27, I2=19%), respectively. There was no noteworthy change concerning maternal pain perception between the lidocaine and control arms. Most women reported just minimal discomfort during amniocentesis. Counseling should educate patients that the pain they might experience during amniocentesis is comparable to venous blood sampling.

The effect of hyoscine-N-butylbromide on pain perception during and after hysterosalpingography in infertile women: a systematic review and meta-analysis of randomised controlled trials.

This paper reports a systematic review and meta-analysis of the effectiveness of hyoscine-N-butylbromide (HBB) administration in hysterosalpingography (HSG). Four electronic databases were searched for randomised controlled trials (RCTs) that compared HBB versus placebo or no intervention in infertile women undergoing HSG. Pain during and after HSG and different adverse events including nausea, vomiting, and dizziness were evaluated. Three RCTs with 335 patients were included. The analysis showed HBB was significantly effective in reducing pain during and after HSG (MD = -0.76 mm, 95% CI [-1.35, -0.17], p = 0.01) and (MD = -0.81 mm, 95% CI [-1.07, -0.56], p < 0.001), respectively. There were no significant differences in adverse events between HBB and control groups. The methodological evidence quality was high as evaluated by GRADEpro. In conclusion, this review provides good evidence that prior administration of HBB is effective in reducing induced pain during and after HSG with tolerable side effects.

Understanding of medical students about predatory journals: A comparative study from KSA and New Zealand.

OBJECTIVE: This study examines the extent of understanding of medical students from KSA and New Zealand (NZ) about predatory journals. METHODS: From March to July 2019, self-administered questionnaires were sent to fourth- and fifth-year students of two medical schools in KSA and NZ. Between-group comparisons were carried out using the two-sided Student's t test and the Chi-square test. Statistical significance was determined at a p-value <0.05. RESULTS: A total of 263 students completed the questionnaire (response rate: 59.1 percent KSA; 31 percent NZ). Prior research experience was significantly higher among KSA students (56.6 percent) as compared to NZ students (32.3 percent; p = 0.0006). A significantly higher number of KSA students (75.6 percent) felt that they were under pressure to publish studies during their term at medical school as compared to only 12.3 percent of NZ medical students (p < 0.0001). While one-third of the students in both countries were familiar with 'open-access publishing' (30.8 percent KSA versus 42.2 percent NZ), only a few displayed awareness about 'predatory journals' (9.1 percent KSA versus 7.8 percent NZ; p = 0.7) or 'Beall's list' (2.5 percent KSA versus 0 percent NZ; p = 0.02). A small number of students from both countries had published in predatory journals (26.1 percent [n = 6/23] KSA versus 12.5 percent [n = 1/8] NZ, p = 0.4). A few students had received warnings or advice regarding predatory journals (4.5 percent KSA versus 1.5 percent NZ; p = 0.2). A majority of respondents from both the countries found it hard to identify predatory journals. CONCLUSION: This study identified that the understanding and knowledge of medical students regarding predatory journals is rather poor. This indicates that curricular, extracurricular, and institutional measures to promote awareness about predatory journals are warranted.