Association of Cardiovascular Diseases With Post-Traumatic Stress Disorder: An Updated Review.

The intricate relationship between post-traumatic stress disorder (PTSD) and cardiovascular disease (CVD) has garnered increasing attention due to its bidirectional impact and potential for significant health consequences. Epidemiological evidence suggests that PTSD may serve as a risk factor for incident CVD, while acute CVD events can trigger PTSD, subsequently increasing the risk of recurrent cardiovascular events. This dynamic interplay is characterized by the human stress response, disrupted behavioral and lifestyle factors, and potential physiological mechanisms. Notably, the immediate aftermath of a cardiovascular event presents a critical window for intervention, offering the possibility of preventing the development of PTSD and its associated physiological and behavioral sequelae. However, while candidate mechanisms linking PTSD and CVD have been identified, determining which mechanisms are most amenable to intervention remains a challenge. This article emphasizes the urgency of addressing key unanswered questions in this domain. Despite an evolving understanding of the association between PTSD and CVD, causal relationships remain to be firmly established. Comprehensive investigations into the intricate interplay of behavioral and biological mechanisms are essential for identifying precise targets for intervention. Innovations in research methodologies, including the exploration of PTSD symptom dynamics and their impact on cardiovascular function, hold the potential for identifying crucial intervention points. Drawing parallels from prior challenges in translating identified risk factors into effective interventions, the field must prioritize systematic investigations and early-phase intervention trials. By doing so, researchers and clinicians can potentially develop strategies to mitigate CVD risk in the context of PTSD and improve both cardiovascular and mental health outcomes.

Nematicidal Characterization of Newly Synthesized Thiazine Derivatives Using Caenorhabditis elegans as the Model Organism.

In humans, animals, and agriculture, parasitic nematode infection is a very serious issue. Many drugs are being used to control nematode infections. Owing to toxicity and nematodes' resistance to the available drugs, special attention is required to synthesize new drugs that are environmentally friendly with high-level efficacy. In the present study, various substituted thiazine derivatives (1 to 15) were synthesized, and the structures were confirmed by infrared, proton (1H), and 13C NMR spectroscopies. The nematicidal potential of the synthesized derivatives was characterized using Caenorhabditis elegans (C. elegans) as a model organism. Among all synthesized compounds, 13 (LD50 = 38.95 µg/mL) and 15 (LD50 = 38.21 µg/mL) were considered the most potent compounds. Most compounds showed excellent anti-egg-hatching activity. Fluorescence microscopy confirmed that compounds 4, 8, 9, 13, and 15 displayed a high apoptotic effect. The expressions of gst-4, hsp-4, hsp16.2, and gpdh-1 genes were high in affected (treated with thiazine derivatives) C. elegans in comparison with normal C. elegans. The present research revealed that modified compounds are highly effective as they showed the gene level changes in the selected nematode. Due to structural modification in thiazine analogues, the compounds showed various modes of action. The most effective thiazine derivatives could be excellent candidates for novel broad-scale nematicidal drugs.

Nematicidal Characterization of Solanum nigrum and Mentha arvensis Leaf Extracts Using Caenorhabditis elegans as a Model Organism.

Considering foremost global issues instigated by parasitic nematodes, Solanum nigrum (S. nigrum) and Mentha arvensis (M. arvensis) nematicidal potential at the gene level has been explored herein. Methanol, ethyl acetate, chloroform, n-hexane, and distilled water were used for extract preparation. Caenorhabditis elegans (C. elegans) was used as the model organism. Nematicidal and anti-egg hatching assays, fluorescence microscopy, and quantitative real-time PCR were done. S. nigrum chloroform (LD50 = 1.21 mg/mL) and M. arvensis methanol (LD50 = 2.47 mg/mL) extracts exhibited excellent nematicidal potential. Both plants showed potent anti-egg hatching activity (1 mg/mL). S. nigrum methanol and M. arvensis ethyl acetate extracts showed high apoptotic effect in muscles, gonads, and uterus (eggs). Stress genes, that is, gst-4, hsp-16.2, and gpdh-1 were highly expressed in affected C. elegans (treated with S. nigrum and M. arvensis leaf extracts) when compared with normal C. elegans. Phytochemicals and bioactive compounds present in plants may be the major cause of their excellent nematicidal potential, which further confirmed that both plants could be an alternative candidate(s) for novel broad-scale anthelmintic drug(s).

Synthesis, in vitro antiurease, in vivo antinematodal activity of quinoline analogs and their in-silico study.

Synthesis of quinoline analogs and their urease inhibitory activities with reference to the standard drug, thiourea (IC50 = 21.86 ± 0.40 µM) are presented in this study. The inhibitory activity range is (IC50 = 0.60 ± 0.01 to 24.10 ± 0.70 µM) which displayed that it is most potent class of urease inhibitor. Analog 1-9, and 11-13 emerged with many times greater antiurease potential than thiourea, in which analog 1, 2, 3, 4, 8, 9, and 11 (IC50 = 3.50 ± 0.10, 7.20 ± 0.20, 1.30 ± 0.10, 2.30 ± 0.10, 0.60 ± 0.01, 1.05 ± 0.10 and 2.60 ± 0.10 µM respectively) were appeared the most potent ones among the series. In this context, most potent analogs such as 1, 3, 4, 8, and 9 were further subjected for their in vitro antinematodal study against C. elegans to examine its cytotoxicity under positive control of standard drug, Levamisole. Consequently, the cytotoxicity profile displayed that analogs 3, 8, and 9 were found with minimum cytotoxic outline at higher concentration (500 µg/mL). All analogs were characterized through 1H NMR, 13C NMR and HR-EIMS. The protein-ligand binding interaction for most potent analogs was confirmed via molecular docking study.

Tubercular septal abscess in a postoperative patient: a novel entity.

Extrapulmonary tuberculosis is a rather uncommon and potentially challenging phenomenon. Such manifestation, particularly in the scenario of a late postoperative period, is extremely rare and requires a high index of suspicion, prompt diagnosis and appropriate treatment.We present the case scenario of a patient with history of successfully treated pulmonary tuberculosis many years earlier, without any signs of recurrence, who developed primary nasal septal tuberculosis after undergoing septoplasty to correct his septal deviation. His postoperative course remained uneventful for 4 months. He then presented with a spontaneous nasal septal abscess, which proved to be tubercular in nature on investigations. Appropriate diagnosis was established, and the patient was treated successfully with antituberculous therapy.Recurrent tuberculosis may present a diagnostic challenge for healthcare professionals. Only a high index of suspicion, modern diagnostic tools and institution of appropriate treatment including surgical intervention as required will ensure a promising outcome.

Endonasal endoscopic laser-assisted resection of septal glomangiopericytoma.

Glomangiopericytoma is a rare vascular neoplasm characterised by a pattern of prominent perivascular growth with myoid phenotype. It is categorised as a borderline low-malignancy tumour by WHO and accounts for less than 0.5% of all sinonasal tumours. After curative resection, patients of glomangiopericytoma need long-term endoscopic follow-up due to high risk of recurrence.We report a case of a 23-year-old man complaining of nasal obstruction off and on and frequent epistaxis. A reddish mass in the right nasal cavity was observed on endoscopy and treated with endoscopic excision.Biopsy revealed this to be glomangiopericytoma arising from the septum of right nasal cavity, which was excised in toto with endonasal endoscopic approach using diode laser.

Primary tuberculosis of cystic duct lymph node.

Tuberculosis (TC) is very common and significant cause of morbidity and mortality worldwide. Isolated cystic duct lymph node TC cases without involvement of gallbladder are exceedingly rare. It is difficult to diagnose preoperatively because of lack of characteristic signs and symptoms of TC. We report a man aged 45 years who presented with right upper abdominal pain since 1week. It was associated with nausea and postprandial fullness. There was no evidence of jaundice and lymphadenopathy. Abdominal examination showed moderate right upper quadrant tenderness with positive Murphy's sign and splenomegaly but no signs of peritonism. Abdomen ultrasound revealed sludge in gallbladder, dilated pancreatic duct, coarse exotexture of liver, splenomegaly and no lymphadenopathy. He underwent laparoscopic cholecystectomy; histological report showed chronic caseating granulomatous lymphadenitis with Langhans type of giant cells in lymph node near cystic duct with chronic cholecystitis of gallbladder. Standard antituberculosis therapy was given for 12 months.

True brachial artery aneurysm in a child aged 2†years.

Congenital brachial artery true aneurysms are exceedingly rare. Most are pseudoaneurysms secondary to trauma or infection. We report a boy aged 2 years who presented with painless, pulsatile swelling on the medial aspect of the right arm, 4 cm above the elbow joint that had been present since birth. Spiral CT angiography showed a fusiform aneurysm of the distal right brachial artery with a peripheral crescent-shaped thrombus. Distal arteries were normally opacified. There was no evidence of abnormal dilation or stenosis in any other artery. The aneurysm was surgically resected, with vascularisation re-established using a reversed great saphenous vein graft. His postoperative course was uneventful. Early surgery should be performed for moderately sized to large aneurysms that recently increased in size, exhibited luminal thrombus formation or caused neurovascular distal limb compromise. Early surgery could prevent complications such as a ruptured aneurysm, thromboembolism or limb ischaemia or loss.

Safety and efficacy of ureteroscopic pneumatic lithotripsy.

OBJECTIVE: To determine the safety and efficacy of ureteroscopic pneumatic lithotripsy (PL) for the clearance of ureteral calculi (UC). STUDY DESIGN: Experimental study. PLACE AND DURATION OF STUDY: Department of Urology, KRL Hospital, Islamabad, from March 2006 till December 2008. METHODOLOGY: Ureteroscopic PL was performed on 104 patients with ureteric calculus measuring > 6 mm; using Swiss Lithoclast through a 9.5 French semi-rigid ureteroscope. At the end of the procedure, a DJ stent was inserted. Complications were noted. Stone clearance was assessed through X-ray KUB. DJ stent was removed within 3 - 6 weeks after the procedure. RESULTS: Sixty-eight patients (65.4%) were males and 36 (34.6%) females. The average hospital stay was 2.6 + 2.8 days; 72 (69.6%) patients were discharged on the first post-procedure day. Complete stone clearance was achieved in 98 (94.2%) patients, at 3-6 weeks. Four patients (26.7% of upper ureteral stones) had stone retropulsion. The only major complication was perforation occurring in 2 (1.9%) distal ureters. One case was successfully managed by endoscopic DJ stent placement, the other required open repair. CONCLUSION: Ureteroscopic PL is effective in clearing majority of middle and distal UC. Patients with proximal stones may have stone retropulsion. Ureteric perforation is an uncommon complication.

Pre-treatment predictors of response for assessing outcomes to standard treatment in infection with HCV genotype 3.

OBJECTIVE: To determine the role of pre-treatment predictors of response in assessing outcomes to standard treatment in HCV genotype 3. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Medicine, KRL General Hospital, Islamabad, from December 2004 to December 2006. METHODOLOGY: All patients with positive anti-HCV and PCR genotype 3a were recruited and written and informed consent was taken. Patients were treated with standard Interferon plus Ribavirin therapy (IFN alpha-2a, 3MU t.i.w 24 weeks plus Ribavirin 1000-1200 mg/day) for 6 months. The effect of pre-treatment factors influencing outcome i.e. age, gender, weight, baseline ALT, necroinflammatory grade, fibrosis and steatosis on the final outcome were further analyzed by univariate logistic regression analysis. RESULTS: Response rates to standard Interferon plus Ribazole therapy were studied in 190 patients. The end-of-treatment complete response (EOTCR) was seen in 81% (n=155) of the patients, whereas 17% (n=33) were non-responders (NR). Sustained viral response (SVR) was seen in 58% (n=112) patients and 24% (n=45) were relapsers. SVR was higher in patients without steatosis (OR=2.52, 95% CI=1.356- 4.71, p=0.04). Higher SVR was seen in patients weighing less than 65 kg, as compared with weight>65 kg (OR=2.277, 95% CI=1.246-4.161, p=0.007). The other variables were not found to be significantly associated with improved SVRs. CONCLUSION: Out of the studied predictors, body weight and presence of steatosis, were statistically related to treatment outcome. Pre-treatment host factors can predict response to treatment that can help in individualizing treatment and patient selection and optimize treatment outcomes.