Conectar
by Seid Mohammed Abdu, Hussen Abdu, Endris Seid Muhaba, Ebrahim Msaye Assefa, Gosa Mankelkl
BackgroundThe sciatic nerve (SN), the longest and largest nerve in the body, arises from the L4-S3 nerve roots and exits as a single trunk below the piriformis muscle through the greater sciatic foramen. However, variations in its anatomy are common, believed to originate from embryological development. These variations show significant racial and geographical differences, which have often been overlooked in previous review studies. Therefore, this meta-analysis aims to address this gap by systematically reviewing global data to evaluate the impact of race on sciatic nerve variations.
MethodsA systematic review and meta-analysis were conducted to assess the pooled prevalence of SN variations among racial subgroups. A comprehensive literature search was performed using PubMed, Google Scholar, Hinari, and additional sources, including major anatomical journals and cross-referenced articles. Subgroup analyses by region and country were also conducted using a random-effects model. Heterogeneity was assessed with the Cochrane Q test and the I² statistic.
ResultsType A, considered the normal pattern, had the highest pooled prevalence at 86%. The remaining 14% represented variations of the sciatic nerve (SN). Among these, Type B was the most common at 7%, followed by Type C and G each observed in 2% of limbs, while less frequent variations included Type Type D (1%), Type E (0%), and Type F (0% (0–1)). Racial analysis showed that SN variations occurred in 15% of Asians, 12% of Whites, and 13% of Blacks. Regarding continents, the highest prevalence was in Asia with 15%, the second highest prevalence was observed in Europe with 14%, followed by Africa with 13%, and the lowest in America with 11%. No significant differences were found among the races and continents. However, East Asia showed the highest significant prevalence, with China at 35% and Japan at 32%.
ConclusionThis review revealed only modest and statistically non-significant differences in the prevalence of sciatic nerve variations across broad racial and continental groups. In contrast, substantial variation was observed at the regional level, with particularly high prevalence rates in East Asian countries, specifically China and Japan. These findings suggest that regional factors contribute more to the observed variations than racial factors.
Gestational trophoblastic disease, characterised by abnormal proliferation of trophoblastic tissue in the placenta during pregnancy, contributes to maternal morbidity and mortality. This study aimed to estimate the pooled prevalence and histopathological patterns of gestational trophoblastic disease in Africa, where previous studies have reported inconsistent findings.
Systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.
We searched PubMed, ScienceDirect, Hinari and Google Scholar for studies published between January 2000 and January 2024.
Institution-based observational studies from African countries reporting the prevalence and/or histopathological patterns of gestational trophoblastic disease, using total deliveries as the denominator.
Data were extracted into Excel and analysed using Stata V.17. Pooled estimates were calculated using a random-effects model with Knapp-Hartung adjustment. Heterogeneity was assessed with Cochran’s Q test and the I² statistic, and study quality was evaluated using the Joanna Briggs Institute tool.
Of the 2252 studies identified, 33 were included, comprising 2885 gestational trophoblastic disease cases from eight countries. The pooled prevalence of gestational trophoblastic disease in Africa was 4.35 per 1000 deliveries (95% CI 3.26 to 5.45, I2=99.8%). The pooled prevalence of hydatidiform mole, invasive mole and choriocarcinoma in Africa was 3.49 per 1000 deliveries (95% CI 2.45 to 4.52, I2=99.7%), 0.47 per 1000 deliveries (95% CI 0.14 to 0.79, I2=72.2%) and 0.97 per 1000 deliveries (95% CI 0.54 to 1.40, I2=99.1%), respectively.
This review indicated the prevalence of gestational trophoblastic disease was high. Hydatidiform mole was the predominant histopathological pattern observed. Routine antenatal screening is needed for early detection. Further research should be conducted to identify risk factors and evaluate strategies for the prevention and management of the disease.
CRD42024504268.
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