Gut Dysbiosis and Cardiovascular Health: A Comprehensive Review of Mechanisms and Therapeutic Potential.

Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Recent research has identified gut dysbiosis - an imbalance in the gut microbiota - as a significant factor in the development of CVDs. This complex relationship between gut microbiota and cardiovascular health involves various mechanisms, including the production of metabolites such as trimethylamine N-oxide (TMAO) and short-chain fatty acids (SCFAs). These metabolites influence lipid metabolism, inflammation, and blood pressure regulation. In addition, the gut-brain axis and neurohormonal pathways play crucial roles in cardiovascular function. Epidemiological studies have linked gut dysbiosis to various cardiovascular conditions, highlighting the potential for therapeutic interventions. Dietary changes, probiotics, and prebiotics have shown promise in modulating gut microbiota and reducing cardiovascular risk factors. This underscores the critical role of gut health in preventing and treating CVDs. However, further research is needed to develop targeted therapies that can enhance cardiovascular outcomes.

Copper Deficiency Mimicking Myelodysplastic Syndrome: A Case Report.

Copper deficiency can mimic myelodysplastic syndrome, a group of heterogeneous hematopoietic disorders characterized by peripheral cytopenias, with potential progression to bone marrow failure and acute myeloid leukemia. We present the case of an 83-year-old female with a history of Graves' disease, early-stage hormone receptor-positive breast cancer, hypertension, and glaucoma, who presented with fatigue and progressive lower extremity weakness. Laboratory tests revealed macrocytic anemia, neutropenia, and lymphopenia, with normal platelet counts. Bone marrow biopsy showed trilineage hematopoiesis, dyserythropoiesis, ring sideroblasts, and vacuoles in erythroid precursors, indicating copper deficiency. The patient had been using zinc oxide paste for dentures and had increased her zinc intake during the COVID-19 pandemic, leading to severe copper deficiency. Treatment with intravenous and oral copper supplementation resulted in marked improvement in hematologic indices and symptoms. This case underscores the importance of considering copper deficiency in the differential diagnosis of cytopenias and myeloneuropathy in elderly patients, particularly those with a history of excessive zinc intake.

Muir-Torre Syndrome: A Case Report and a Literature Review of Genetic Insights and Cancer Surveillance.

Muir-Torre syndrome (MTS) is a rare autosomal dominant genetic disorder that manifests through the co-occurrence of sebaceous skin tumors and internal malignancies, primarily due to mutations in mismatch repair (MMR) genes such as MSH2, MLH1, and MSH6. This paper presents a detailed case report of a 57-year-old female diagnosed with MTS, highlighting her extensive medical history and the critical role of genetic testing and multidisciplinary management. The patient's dermatological and oncological assessments revealed multiple sebaceous carcinomas and recurrent urothelial carcinoma, confirmed by a pathogenic MSH2 mutation. Through comprehensive preventive surgeries and rigorous follow-up, this case underscores the necessity of proactive cancer surveillance. The discussion integrates findings from key genetic studies and emphasizes the importance of immunohistochemistry in diagnosis. Recommendations for clinical practice include routine genetic testing, stringent surveillance, and multidisciplinary management, underscoring the need for ongoing research to understand better and manage this complex syndrome.

Aortic Dissection Masquerading as Pneumonia: A Case Report of an Atypical Presentation.

Aortic dissection is a critical and life-threatening condition that can present with atypical symptoms, often leading to misdiagnosis and delayed treatment. The report presents a case of a 65-year-old male who initially exhibited fever, right-sided chest pain, and a productive cough, resulting in an initial diagnosis of pneumonia. Despite empirical antibiotic therapy, his symptoms persisted, prompting further investigation. A computed tomography (CT) scan ultimately revealed a Type B aortic dissection. The patient was then transferred to a specialized tertiary care facility for successful endovascular intervention. This case underscores the importance of considering aortic dissection in patients presenting with persistent, atypical symptoms that do not respond to standard treatments, such as unexplained fever and chest pain. It highlights the crucial role of advanced imaging techniques, such as CT scans, in achieving an accurate and timely diagnosis. Clinicians must maintain a high index of suspicion and ensure prompt referral to specialized centers to improve patient outcomes in this potentially fatal condition.

Chemotherapy and Metabolic Syndrome: A Comprehensive Review of Molecular Pathways and Clinical Outcomes.

Cancer therapies, notably chemotherapy, have significantly improved survival rates and quality of life for many patients. However, chemotherapy's cytotoxic effects also impact normal cells, leading to adverse effects, including metabolic disturbances. This paper explores the link between chemotherapy and metabolic syndrome, a cluster of metabolic abnormalities that increase the risk of cardiovascular diseases and type 2 diabetes. Understanding the predictors, such as specific chemotherapy regimens, patient characteristics, comorbid conditions, lifestyle factors, and genetic variations, is crucial for formulating personalized care plans and preventive strategies. Research indicates that older age, female gender, pre-existing diabetes, and baseline obesity are significant predictors of metabolic syndrome in cancer patients. Chemotherapy-induced molecular changes, including insulin resistance, dyslipidemia, chronic inflammation, oxidative stress, and tissue fibrosis, contribute to the development of this syndrome. Effective management strategies require a multidisciplinary approach, incorporating lifestyle interventions, pharmacological treatments, and regular monitoring. This paper underscores the importance of personalized medicine in mitigating the risks associated with metabolic syndrome and improving long-term health outcomes for cancer survivors. Future research directions include longitudinal studies to track metabolic health over time, mechanistic studies to uncover the molecular pathways involved, and the development of integrative therapies. By adopting comprehensive care models, healthcare providers can enhance the overall quality of life for cancer survivors, addressing both cancer and metabolic health challenges.

Cyclical Exacerbation of Asthma Symptoms in Relation to the Menstrual Cycle: A Case Report on Catamenial Asthma.

Catamenial asthma, marked by cyclical exacerbations of symptoms linked to the menstrual cycle, poses distinctive diagnostic and therapeutic challenges. This report discusses a 34-year-old woman who experienced significant asthma flare-ups 3-5 days before menstruation, as confirmed by spirometry (forced expiratory volume in one second (FEV1) dropped from 2.5 to 1.75 liters). Despite adhering to standard asthma treatments, her symptoms remained poorly controlled during these periods. A comprehensive management plan encompassing inhaled corticosteroids, short-acting beta-agonists, montelukast, and oral contraceptives, along with lifestyle modifications and patient education, led to a significant improvement in FEV1 and reduced symptom severity. This case underscores the need for personalized treatment strategies that take hormonal influences into account, suggesting that integrating hormonal therapies with conventional asthma management can yield significant benefits.

Carpal Tunnel Syndrome as an Atypical Presentation of Chikungunya: A Case Report.

Chikungunya virus (CHIKV) is an arbovirus endemic to tropical and subtropical regions, primarily known for causing fever and severe joint pain. However, its capacity to induce neurological complications is less frequently documented. This case report highlights a rare presentation of carpal tunnel syndrome (CTS) following CHIKV infection, expanding the spectrum of CHIKV manifestations beyond its common arthropathic effects. We detail the case of a 45-year-old male who developed acute CTS symptoms, including pain, numbness, and motor dysfunction in the right thumb, six weeks after experiencing typical CHIKV symptoms of high-grade fever and arthralgia. Despite an initial treatment regimen of corticosteroids aimed at reducing inflammation, the patient's symptoms showed minimal improvement, prompting surgical intervention. Following carpal tunnel release surgery, the patient experienced significant relief and functional recovery. This case underscores the importance of considering CHIKV in the differential diagnosis of CTS in endemic areas, particularly when preceded by typical viral infection symptoms. It also supports surgical intervention as a viable treatment option for CTS associated with CHIKV when conservative management is ineffective, highlighting the need for an interdisciplinary approach in treating atypical manifestations of CHIKV infections.

Aryl Hydrocarbon Receptor Signaling in Prostate Cancer Therapy: A Review of Implications for Anti-androgen Treatment Strategies and Resistance.

Prostate cancer is a leading cause of cancer-related morbidity and mortality in men, frequently exhibiting resistance to conventional anti-androgen therapies. This review investigates the emerging significance of the aryl hydrocarbon receptor (AhR) in prostate cancer, focusing on its role in modulating androgen receptor (AR) signaling and its potential as a therapeutic target. AhR, traditionally known for detoxifying harmful compounds, has been increasingly recognized for its dual capacity to either enhance or inhibit AR activity based on cellular context and specific coactivators. Furthermore, AhR influences tumor progression independently of AR by regulating genes involved in cell cycle control and apoptosis. This narrative review synthesizes current research on AhR's multifaceted roles in prostate cancer, evaluates its potential as a biomarker, and discusses the therapeutic implications of targeting AhR, particularly for hormone-refractory prostate cancer. Our findings underscore the necessity for personalized AhR-targeted therapies and advocate for continued clinical research to fully leverage AhR's therapeutic potential.

Acute Radial Artery Thromboembolic Occlusion During Transcatheter Aortic Valve Replacement: A Case Report and Review of Management Strategies.

Acute limb ischemia requires prompt diagnosis and treatment. Thromboembolic events are common, especially in patients with multiple risk factors. This case report describes a rare complication of transcatheter aortic valve replacement (TAVR) involving thromboembolic occlusion of the radial artery and highlights the risk of embolic complications during TAVR. While TAVR is minimally invasive and preferred for high-risk patients, it carries the risk of complications such as paravalvular leakage and cerebrovascular events. Prompt recognition and management are crucial. Various mechanisms, including catheter manipulation and altered hemodynamics, contribute to embolic risks during TAVR. Awareness and management of rare embolic complications during TAVR are essential. Further research is needed to prevent these complications and improve patient outcomes.

Schnitzler-Like Syndrome Presenting With IgG Kappa Monoclonal Gammopathy: A Case Report and Review of Diagnostic and Therapeutic Challenges.

Schnitzler syndrome (SS) is a rare autoinflammatory disorder characterized by a constellation of symptoms that include chronic urticarial rash, recurrent fever, arthralgias/arthritis, and monoclonal gammopathy, typically involving immunoglobulin M (IgM). However, cases with overlapping clinical features but lacking specific criteria fall under the umbrella of Schnitzler-like syndromes. This case report describes a 40-year-old male with Schnitzer-like syndrome and underscores the diagnostic complexities and therapeutic challenges of Schnitzer-like syndrome with IgG kappa monoclonal gammopathy, highlighting the need for a comprehensive diagnostic approach and targeted therapy.

Cutaneous Anaplastic T-Cell Lymphoma Mimicking a Small Abscess: A Case Report.

Non-healing ulcers display a noteworthy demonstrative challenge for clinicians. While often attributed to common causes like infections, these persistent wounds can occasionally mask a more sinister underlying condition: malignancy. This case report presents a 39-year-old Indian man with a non-healing ulcer on his right gluteal region. Despite initial treatments for a presumed bacterial infection, the ulcer persisted. Biopsy ultimately revealed a malignant neoplasm of possible hematopoietic origin, positive for CD30 and focally positive for CD45. Further investigations, including MRI, FNAC, and X-rays, were indicative of lymphoma. Non-healing ulcers present a challenge due to diverse etiologies. A thorough understanding of potential causes, including infectious, vascular, autoimmune, and malignant etiologies, is crucial for navigating the diagnostic process. This case highlights the critical role of maintaining a broad differential diagnosis for non-healing ulcers and the importance of a biopsy in reaching a definitive diagnosis. Early recognition of malignancy in such cases is essential for optimal patient management. This case underscores the importance of considering malignancy in patients with persistent ulcers and performing biopsies for a definitive diagnosis. While the initial presentation mimicked an infectious process, the biopsy revealed a possible cutaneous anaplastic T-cell lymphoma. Further investigations are necessary to definitively classify the specific lymphoma subtype and guide further treatment decisions.

Hypoattenuated Leaflet Thickening-Associated Myocardial Infarction: A Rare Case Report and Literature Review.

Hypoattenuated leaflet thickening (HALT), a potential aftereffect of transcatheter aortic valve replacement (TAVR) procedure, may affect valve performance and clinical outcomes. At this moment we describe an elderly patient who, despite being on prophylactic antiplatelet medication for previous percutaneous intervention (PCI) for coronary artery disease (CAD) and a self-expanding valve in-situ for aortic stenosis (TAVR), presented to the emergency room with non-ST-segment elevation myocardial infarction (NSTEMI), probably as a result of a thromboembolic event from HALT. The case highlights the significance of considering HALT-associated thromboembolism as a potential cause of myocardial infarction (MI) in post-TAVR patients.

Differences in Knowledge and Perspectives on the Usage of Artificial Intelligence Among Doctors and Medical Students of a Developing Country: A Cross-Sectional Study.

Introduction Rapid advancements are being made in the field of Artificial Intelligence (AI) to support digital healthcare transformation and provide evidence-based care. The aim of this cross-sectional study was to evaluate the knowledge of basic principles, limitations, and applications of AI in healthcare among medical students and doctors of a developing country. Methods Two free webinars were hosted for doctors and medical students in northern India (Punjab state) to create awareness about the role of AI in healthcare and the recent advancements made in various medical specialties. The delegates' perceptions about their knowledge and interest in AI were ascertained using the Likert scale (1 = low, 5 = high) in the post-event questionnaire. Using Chi-square and cross-tabulation analysis, associations were examined between knowledge of AI, gender, medical experience, and other variables. Results Out of the total of 621 registrants, 367 filled the post-event questionnaire and were included in the analysis. Although the majority felt that AI will play an important role in delivering healthcare services in the future (74.4%), they did not feel knowledgeable about the applications (79.6%) and limitations of AI (82.8%). A relatively lesser proportion of doctors (51.6%) felt interested to learn more about AI than medical students (69.3%). Furthermore, a lesser proportion of doctors (65.2%) felt that AI will be beneficial for their career as a doctor as compared with medical students (84.4%). The majority of medical students (83.5%) had never attended any webinar/lecture or course on AI in healthcare and felt that they have received minimal advice (80.7%) from their medical school on teaching about AI and its applications. A significantly (P = 0.001) higher proportion of female medical students were unknowledgeable about the principles and applications of AI than male respondents. However, female medical students were significantly (P = 0.004) more interested than male medical students to learn about AI. Conclusions Formal training courses to teach about AI should be focused on to facilitate coherent and scientifically supported dissemination of knowledge in medical schools and hospitals. Further large-scale studies are needed to understand the perception and attitude of medical students and doctors regarding AI to steer policy development and medical education curriculum changes to spark an interest in emerging technologies and drive innovation.