International journal of medical students最新文献

{"title":"Hearing Loss After COVID-19 Vaccines: A Systematic Review and Meta-Analysis","authors":"K. Albakri, Y. Alabdallat, O. Abdelwahab, M. Gabra, Mohamed H Nafady, Dr Ebraheem Albazee","doi":"10.5195/ijms.2022.1832","DOIUrl":"https://doi.org/10.5195/ijms.2022.1832","url":null,"abstract":"ABSTRACT. \u0000Background: Hearing loss is generally classified as conductive hearing loss (CHL) and sensory-neural hearing loss (SNHL). It has been reported that COVID-19 infection may affect the vestibular-hearing system causing dizziness, tinnitus, vertigo, and hearing impairment. However, other studies reported that COVID-19 did not lead to significant hearing impairment. Many studies in the literature have reported hearing loss as a complication of COVID-19 vaccines. However, no systematic review or meta-analysis summarizes the literature on this topic.\u0000 \u0000Method: We performed a comprehensive search for the following databases: PubMed, Cochrane (Medline), Web of Science, and Scopus. All studies published in English till October 2022 were included. These include case reports, case series, prospective and retrospective observational studies, and clinical trials reporting hearing loss following COVID-19 vaccines. Newcastle Ottawa scale (NOS) was used to assess the risk of bias for observational studies. NIH tools were used for non-controlled before and after clinical trials and case reports and case series. A third author solved any disagreements. We analyzed the data using SPSS Software version 26.\u0000 \u0000Results: A total of 630 patients were identified, with a mean age of 57.3 that ranged from 15 to 93 years old. The majority of the patients were females, 339 (53.8%). In addition, 328 out of 609 vaccinated patients took the Pfizer-BioNTech BNT162b2 vaccine, while 242 (40%) took the Moderna COVID-19 vaccine. The mean time from vaccination to hearing impairment was 6.2, ranging from a few hours to one month after the last dose. Most patients reported unilateral sensorineural hearing loss post-vaccination 593 (94.1%). In order to report the fate of cases, a follow-up was initiated with a mean of 15.6 and a range of 2 to 63 days after the initiation of the treatment. A total of 20 patients were fully recovered, and 11 reported no response. Three out of 328 patients who took the Pfizer-BioNTech BNT162b2 vaccine fully recovered, while five reported partial recovery. According to the chi-squared test, there is a statistically significant difference between patients in terms of fate and the type of COVID-19 vaccination (P-value = 0.001) while reporting no significant difference in dose number prior to the onset of the symptoms (P-value = 0.65) and gender (P-value = 0.4). The ANOVA test was conducted to compare vaccine types and the number of doses in terms of mean time from vaccination to hearing impairment onset. The results found a significant difference between vaccine types (P-value < 0.000) while showing no significance in terms of the number of doses prior to the onset (P-value = 0.6).\u0000 \u0000Conclusion: There is a statistically significant difference between patients in terms of fate and the type of COVID-19 vaccination while reporting no significant difference in dose number prior to the onset of the symptoms and gender. Further, we concluded that there is ","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72772174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Students’ Perspective on University Education and Well-Being One-Year into the COVID-19 Pandemic","authors":"Akira Gareeb, Isabella Gavazzi, N. Woodman, C. Goonasekera, A. Lombard, M. Faruq, Joanna Ray, Rasika Dhanapala, Sadhani Sandarenu, Mosarrat Mahjabeen, S. Hashmi, D. Kottahachchi, E. Elmien Claassens, M. N. Zafar","doi":"10.5195/ijms.2022.1801","DOIUrl":"https://doi.org/10.5195/ijms.2022.1801","url":null,"abstract":"We report university student perspectives on COVID-19 impact on education, general health and well-being, one year into the pandemic.\u0000 \u0000A ‘low risk’ questionnaire with modified General Health (GHQ-28) and Anxiety Disorder (GAD-7) instruments was shared with students via an email link over a 4-week period.\u0000 \u0000725 students responded from five countries. Half of the students reported significant general health difficulties and more than ten per cent experienced a severe state of generalised anxiety disorder. The virtual learning techniques adopted during the pandemic were welcomed by students but many were frustrated by the poor quality teaching material, poor scheduling of virtual sessions with inadequate spacing and assessments not being truly representative of what was taught. Digital poverty due to inadequacies in hardware, software compatibility and connectivity were major hindrances to virtual learning.\u0000 \u0000Universities should urgently modify the virtual training methods and enhance mental health and wellbeing support before disaster strikes.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85892527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aberrant Right Subclavian Artery: Cadaver Case Report","authors":"Jason A. Kopp, Ahmad Irshaid, Justin N. Baker, J. Fitzsimmons, Judith C. Lin","doi":"10.5195/ijms.2022.1647","DOIUrl":"https://doi.org/10.5195/ijms.2022.1647","url":null,"abstract":"While examining the anatomy of a cadaver in a medical school gross anatomy course, an aortic arch anomaly was discovered. This variant is consistent with an aberrant right subclavian artery (ARSA). In this variant the right subclavian artery branches from the most distal part of the aortic arch and runs both retrotracheal and retroesophageal as it courses to the right shoulder. This variant is a result of aberrant development of the aortic arch and may include presenting symptoms such as dysphagia and shortness of breath, if any at all. Additional to the ARSA exists a common bicarotid trunk and a direct branching of the left vertebral artery from the aortic arch, both of which are rare anomalies. The cadaver’s medical history includes dysphagia and stretched esophagus, although the severity is unknown. This case report draws attention to these rare anatomical anomalies and includes a discussion of the most common clinical presentation, and surgical implications of an aberrant right subclavian artery anomaly.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74707121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Early Movements of Swollen Lymph Nodes Caused by COVID-19/ Vaccine of COVID-19 on Recovery","authors":"Usama A. Aljameey, S. Bergman","doi":"10.5195/ijms.2022.1752","DOIUrl":"https://doi.org/10.5195/ijms.2022.1752","url":null,"abstract":"Background: The swelling of the lymph nodes may raise some concerns and anxiety for people after getting the vaccination, especially for COVID-19. Many women seek medical attention for the enlarged lymph node due to the known relationship between lymph nodes and breast cancer. This research is intended to enrich the data of the most recent COVID-19 pandemic and the vaccines that were developed shortly after. The aim is to see if there is an effect of early movement of the swollen axillary lymph nodes caused by the COVID-19 vaccination and to enrich the data of the most recent COVID-19 pandemic and its developed vaccines shortly after. \u0000Methods: A voluntary survey was used to collect data from recently vaccinated individuals. Data were analyzed for associations between early movement and resolution of lymphadenopathy. \u0000Results: 32 (20.38%) of 157 participants reported swelling of axillary lymph nodes that resulted from COVID-19 vaccination.  Duration of swelling ranged from 1 to more than two weeks.  The early movement did not show a statistically significant reduction in the course of swelling. \u0000Conclusion: Early movement of areas affected with lymph node enlargement, whether active or passive, does not seem to cause additional side effects.  The effect of early action seems comparable to rest (see Fig.), although it may lessen erythema due to improved circulation, just like the newer concept of early movement after a skeletal injury has a better outcome than merely resting, which was the older method of recovery. However, the current data is limited to support the benefit of such a concept.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74820668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mycosis Fungoides: A Diagnostic Challenge","authors":"Siddhartha Nath, Arunima Dhabal, I. Podder","doi":"10.5195/ijms.2022.1758","DOIUrl":"https://doi.org/10.5195/ijms.2022.1758","url":null,"abstract":"Background: Mycosis fungoides (MF) is the most frequent type of cutaneous T-cell lymphomas (CTCL), a heterogeneous group of non-Hodgkin lymphoma of T-cell origin. CTCLs accounts for about 4% of all non-Hodgkin lymphoma. MF mainly involves the skin but in advanced cases it may involve the lymph, blood and other organs. It mimics other skin disorders like erythema necroticans, leprosy, psoriasis etc which leads to delayed diagnosis and subsequent treatment.\u0000Case report: A 61 year old male patient visited the OPD of a tertiary care hospital in Eastern India with multiple reddish elevated lesions for last 6 months which later became dome shaped and then ulcerated. He did not have any fever or itching. He informed that he had been taking Homeopathic medicine previously, but the identity of the said medicine could not be confirmed.\u0000Physical examination ruled out the presence of pallor, jaundice, oedema and cyanosis. Pulse and BP were within normal range. Systemic examination was unremarkable except mild hepatomegaly. Cutaneous examination revealed multiple erythematous indurated plaques, papules and nodules over chest, abdomen, back, limbs and face. Few of the plaques present on the trunk and left arm had developed ulcers having a necrotic floors. Cervical, axillary and inguinal lymph nodes were palpable, being firm in consistency and mobile in nature. Hair, nail and mucosal examination revealed normal results.\u0000Complete blood count (CBC), peripheral blood smear(PBS), serum urea and creatinine level did not deviate from normal findings. Ultrasonography of whole abdomen showed a mildly enlarged liver. A prominent lymph node in the aortocaval groove could be appreciated on the computed tomography(CT) scan of  whole abdomen. CT scan of chest revealed bilateral axillary lymphadenopathy. Erythema necroticans, sarcoidosis and CTCL were considered as the differential diagnoses.\u0000Lesional biopsy revealed irregular epidermal hyperplasia, parakeratosis and epidermotropism in the absence of spongiosis.There was infiltration of atypical lymphocytes in the epidermis, forming well developed Pautrier’s micro abscesses. The lymphocytes were tagging the dermo-epidermal junction and within the epidermis showing surrounding halo, convoluted nuclei and variable nuclear pleomorphism. Band like papillary dermal lymphoid infiltrate, dermal lymphoid fibroplasia and nodular lymphoid aggregates could be appreciated in the deep dermis. Immunohistochemical tests were performed and the immunophenotypic profile revealed positivity for CD2, CD3, CD5, CD7, CD 8 and TIA1 and negative for CD4, CD20, CD30, CD56 and granzyme B. Based on clinical presentation, histopathology and Immunohistochemical tests, a final diagnosis of MF was made.\u0000The patient was then started on systemic antibiotic therapy, due to increased risk of bacterial super infection of lesions due to skin barrier disruption. He was then referred to Oncology department for further treatment.\u0000Conclusion: In this case, the male","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90302426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Preliminary Study of Menstrual Changes Among Jordanian Women Following COVID-19 Vaccination","authors":"Rana Qawaqzeh, Hussam Al-Din Shehadeh, B. Al-Hanaqtah, K. Albakri","doi":"10.5195/ijms.2022.1826","DOIUrl":"https://doi.org/10.5195/ijms.2022.1826","url":null,"abstract":"Background:  During the last two years, the world witnessed an urgent need for vaccines to tackle the coronavirus disease 2019 (COVID-19) pandemic. Several side effects, mainly non-life-threatening, were reported following COVID-19 vaccination. There are increasing concerns about the potential effects of COVID-19 vaccines on menstrual cycle (MC) changes amid a paucity of scientific studies on this crucial issue. The present study aimed to assess the changes in menstrual cycle (MC) among Jordanian women after receiving a COVID-19 vaccine.   \u0000Method: An online-based cross-sectional study was conducted from 10 to 24 August 2021. The main menstruation-related complaints were identified and included in the survey tool that targeted Jordanian women who received at least one dose of a COVID-19 vaccine. \u0000Results: A total of 633 married and unmarried women were recruited, 222 (35.1%) and 411 (64.9%), respectively. Unmarried women showed a significantly higher occurrence of menstruation dysfunctions after getting a COVID-19 vaccine compared to married women (p = 0.001). During MC, around 34.3% of participants were suffered from increasing back and abdominal pains. The most common dysfunction was a prolonged MC (24.8%), while only 16.1% experienced pre-menstruation bleeding. Additionally, 19.4% of participants stated that the MC dysfunctions last for one month, 8.7 % for two months, and 35.4% for more than two months. \u0000Conclusion: This study showed that COVID-19 vaccines negatively affected the MC in terms of the occurrence of dysfunctions and accompanying symptoms. However, further studies are required to investigate the characteristics of women who are more likely to be affected and the potential mechanisms underlying these effects.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76844093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal Diagnosis of a Fetus with Partial Duplication and Deletion of Chromosome 18 Due to Maternal Pericentric Inversion 18","authors":"Manuel Alejandro Vásquez Salguero, Wilmar Saldarriaga Gil","doi":"10.5195/ijms.2022.1842","DOIUrl":"https://doi.org/10.5195/ijms.2022.1842","url":null,"abstract":"The phenotype of structural chromosome 18 mutations is highly heterogenous, clinical manifestations may range from mild to severe, they have been widely studied in the literature, however, there are few cases where two or more mutations are present in the same individual, reports where these alterations are caused by a maternal pericentric inversion and diagnosed prenatally are even rarer. Affected individuals are generally characterized by low birth weight, intellectual disability, heart defects, musculoskeletal abnormalities, craniofacial anomalies, among others. We describe the case of a masculine fetus from a non-consanguineous marriage obtained at week 29 of gestation. 27-year-old mother, G2C1, she started antenatal care at week 11 of pregnancy in the Hospital Universitario del Valle, in Cali, Colombia. Ultrasound at the 11th week of gestation showed a 3.9 mm nuchal translucency (>95p), subsequently at week 18th a new ultrasound found a 6mm nuchal translucency (>95p); suspecting a chromosomal aberration an amniocentesis was carried out at week 18th, a 756-band resolution karyotype reported: 18 partial trisomy (from 18p.11.2 to the centromere and from 18q11.22 to 18qter), and chromosome 18 partial monosomy (from 18pter to 18p11.2 and from the centromere to 18q11.2). The parents also underwent genetic testing, the karyotype of the mother exhibited a pericentric inversion of the 18 chromosome (46,XX,inv(18)(p11.2q11.2), no abnormalities were found in the father’s genetic material. At week 24 of gestation detailed anatomy ultrasound showed left diaphragmatic hernia, multicystic dysplastic kidney, and polyhydramnios. After explaining the diagnosis and providing genetic counseling, the patient requested voluntary interruption of pregnancy as established by the c-355/06 law of the Colombian constitutional court. A 1,180 g fetus as obtained. The structural rearrangement of this case may be explained by an error in maternal meiosis, oogenesis. During meiosis 2 an anomalous disjunction in the chromosome 18 took place, where the two short arms were separated from the long arms, the latter isochromosome was the one that the fetus received, thus, leading to the described mutation. The aim of this case report is to provide to the scientific literature the first case of prenatal diagnosis of a fetus with partial trisomy and partial monosomy of specific bands of the chromosome 1, due to maternal pericentric inversion, while also highlighting the value of early prenatal diagnosis, in order to make choices regarding voluntary interruption of pregnancy, pregnancy follow up, or planning the delivery method, allowing adequate genetic and reproductive counseling for future pregnancies.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74644282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cover, Credits, & Content","authors":"Executive Committee of IJMS","doi":"10.5195/ijms.2022.1937","DOIUrl":"https://doi.org/10.5195/ijms.2022.1937","url":null,"abstract":"","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78794283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reddit Users' Questions and Concerns about Anesthesia","authors":"Khalid El-Jack, Korey Henderson, Anietie U Andy, Lauren Southwick","doi":"10.5195/ijms.2022.1687","DOIUrl":"https://doi.org/10.5195/ijms.2022.1687","url":null,"abstract":"Background: Patients utilize social media in search of support networks. Reddit is one of the most popular social media sites and allows users to anonymously connect. Anesthesia patients are actively using Reddit to discuss their treatment options and experiences within the medical system.\u0000Methods: Posts published on an active Reddit forum on Anesthesia (i.e., /r/Anesthesia) were used. Big Query was used to collect posts from /r/Anesthesia. We collected 3,288 posts published between December 2015 and August 2019. We collected a control group of 3,288 posts from a Reddit forum not related to Anesthesia. Using latent Dirichlet allocation (LDA) we extracted 20 topics from our data set. The LDA topic themes most associated with posts in /r/Anesthesia compared to the control group were determined.\u0000Results: LDA analysis of posts in /r/Anesthesia relative to a control group produced 6 distinct categories of posts (Table 1). The posts most associated with /r/Anesthesia when compared to a control group were posts belonging to the “Physician-Patient Experience” category (Cohen’s d= 0.389) while the posts least associated with /r/Anesthesia were from the “Uncertainties” category of posts (Cohen’s d= 0.147). Example experiences from members of the /r/Anesthesia forum highlight subjective experiences of patients undergoing anesthesia.\u0000Conclusions: The language used on social media can provide insights into an individual's experience with anesthesia and inform physicians about patient concerns. Anesthesiologists are poised to address these concerns and prevent anonymous misinformation by providing verified physician insights on the forum /r/Anesthesia.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83207531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the Ability of the Vision, Aphasia, and Neglect (VAN) Stroke Scale to Identify Large Vessel Occlusion Strokes Within the Prehospital Setting: A Prospective Cohort Study","authors":"Lydia Leavitt","doi":"10.5195/ijms.2022.1737","DOIUrl":"https://doi.org/10.5195/ijms.2022.1737","url":null,"abstract":"Introduction: There are several stroke assessment scales designed to identify large vessel occlusions (LVOs), and a rising area of research is concerned with identifying those that outperform others in accuracy. One scale that has shown promise in identifying identify large vessel occlusions (LVOs) is the vision, aphasia, and neglect (VAN) scale. Our understanding of this scale’s true performance, however, is limited as a majority of studies have been carried out in the hospital setting. The objective of this study is to evaluate the ability of the VAN scale to predict LVOs in the prehospital setting.\u0000Methods: Prospective cohort study comparing emergency medical service personnel administered VAN results to hospital discharge diagnoses to evaluate VAN’s ability to predict a large vessel occlusion stroke. Main outcome measures included VAN sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and accuracy. \u0000Results: Emergency medical service personnel administered the VAN assessment to 185 patients suspected of having a stroke. VAN had a sensitivity of 0.81 (CI, 0.61 to 0.93), specificity 0.56 (CI, 0.48 to 0.64), positive predictive value 0.24 (CI, 0.61 to 0.34), negative predictive value 0.95 (CI, 0.87 to 0.98), positive likelihood ratio 1.87 (CI, 1.45 – 2.40), negative likelihood ratio 0.33 (CI, 0.15 – 0.73), and 60% accuracy (CI, 53% - 61%) for large vessel occlusion identification.\u0000Conclusion: When negative, VAN offers relatively high assurance that the patient is not suffering a large vessel occlusion stroke. However, VAN is non-specific for large vessel occlusions and results in many false positives. Therefore, pre-hospital decision-making regarding triage should not rely exclusively on VAN due to possible over-triage to facilities with endovascular capabilities.","PeriodicalId":73459,"journal":{"name":"International journal of medical students","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86761163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}