Addressing comprehensive complexities a striking familial hypercholesterolemia case study.

BACKGROUND: Premature aortic involvement and comprehensive management strategies in familial hypercholesterolemia familial hypercholesterolemia (FH), a rare autosomal dominant genetic disorder, poses significant challenges due to its propensity for elevated low-density lipoprotein cholesterol, premature coronary heart disease, and vascular atherosclerosis. CASE PRESENTATION: Unraveling Cardiovascular Complexities: A Striking Familial Hypercholesterolemia. This case study delves into a remarkable instance of FH in a 16-year-old female who presented with chest pain and worsening dyspnea. Diagnostic evaluation revealed distinct electrocardiographic changes, elevated troponin levels, and profound dyslipidemia. Remarkable findings on transthoracic echocardiography, computed tomography angiography, and catheterization prompted multidisciplinary interventions and demonstrated remarkable enhancements in ventricular function, mitral regurgitation, and aortic stenosis. CONCLUSION: The case study underscores the urgency of comprehensive management strategies in confronting the myriad challenges of FH, emphasizing the value of early intervention, innovative therapies, and rigorous imaging modalities for unraveling the intricate cardiovascular manifestations of this condition.

Mitral leaflet separation index correlation with mitral stenosis severity, a reliable easy 2-d echocardiography technique.

Objectives: To evaluate accuracy of mitral leaflet separation index for the determination of mitral stenosis severity in patients with rheumatic mitral stenosis. METHODS: The prospective, cross-sectional study was conducted at the National Institute of Cardiovascular Diseases, Karachi, from March 2021 to February 2022, and comprised patients with rheumatic mitral stenosis detected on echocardiography. The best end-diastole parasternal long axis and apical four-chamber views were acquired and Mitral leaflet separation was measured as the distance between the inner edges of the tip of mitral leaflets. Pearson correlation coefficient was computed for mitral leaflet separation index and mitral valve area. Receiver operating characteristic curve was used to determine the cut-off value of the mitral leaflet separation indexto categorise mitral stenosis. Data was analysed using SPSS 19. RESULTS: Of the 277 patients, 205(74%) were females and 72(26%) were males. The overall mean age was 39.93±11.22 years. The mean mitral leaflet separation index value was 7.65±2.23. The correlation was significant and strong between mitral leaflet separation index and mitral valve area on planimetry (p<0.001), and was significant and moderate when measured by pressure half-time (p< 0.001). Mitral leaflet separation index cut-off value <8.625mm and <8.25mmcould predict severe mitral stenosis with 84% and 86.3% sensitivity and 84.6% and 78.3% specificity on planimetry and pressure half-time, respectively. CONCLUSIONS: The mitral leaflet separation index was found to be an independent, reliable and simple measure for assessing mitral stenosis severity.

In-Hospital Outcomes of Female Patients With Inferior Wall Myocardial Infarction.

Background The aim of this study was to determine the in-hospital outcome of female patients with inferior wall myocardial infarction (MI). Methodology This study was conducted from January to December 2017 at the Department of Cardiology, National Institute of Cardiovascular Disease, Karachi. A total of 59 women admitted with inferior wall MI were enrolled in the study. In all patients, in-hospital outcomes were observed. Descriptive statistics were applied. Stratification was done using chi-square test, and p-value of ≤0.05 was considered significant. Results The mean age of study participants was 58.80 ± 9.17 years, while 247 (79.7%) participants were above 50 years of age. The mean onset of duration of sign and symptoms of inferior wall MI was 3.48 ± 1.53 hours. There were 36 (61.0%) patients who had diabetes mellitus, 46 (78.0%) had hypertension, 17 (28.8%) were obese, nine (15.3%) had a family history of MI, and three (5.1%) were smokers. There were 43 (72.9%) patients who were illiterate. In our study, eight (13.6%) females were found to have sinus bradycardia, seven (11.9%) had sinus tachycardia, three (5.1%) had atrial fibrillation, and 24 (40.7%) had complete heart block. Mortality was noted in five (8.5%) patients. Conclusions Women with an acute inferior wall MI had a higher rate of complete heart block and adverse in-hospital outcomes. Female gender itself with inferior wall MI may be at risk for in-hospital adverse outcomes.

Insulin Sensitivity To Trace Metals (Chromium, Manganese) In Type 2 Diabetic Patients And Non Diabetic Individuals.

BACKGROUND: Diabetes mellitus constitutes one of the most important problems in developing and non-developing countries. The purpose of the study to estimate the concentrations of Chromium and Manganese in diabetic and non-diabetic population of Hazara division. The cross sectional comparative study was carried out on one hundred blood samples of Type 2 Diabetic patients collected non-randomly from Ayub Teaching Hospital and one hundred normal healthy controls from Women Medical College Abbottabad from September 2014 to April 2015. METHODS: The study included two hundred subjects. Among them 100 were diabetic and 100 non diabetic respectively. The blood samples were collected from Ayub Medical College, Abbottabad. The serum Chromium and Manganese levels were determined by Atomic Absorption spectrophotometer. RESULTS: Serum Chromium and Manganese levels were decreased in diabetic and increased in non-diabetic patients. CONCLUSIONS: Low serum level of Chromium and manganese were found in diabetic patients as compare to non-diabetic individuals.

Composition, antioxidant and chemotherapeutic properties of the essential oils from two Origanum species growing in Pakistan

The GC-MS analyses of Origanum majorana L. (OME) and Origanum vulgare L. (OVE), Lamiaceae, essential oils helped identification of 39 (96.4 percent of the total oils) and 43 (92.9 percent of the total oils) components, respectively. The major constituents of OME were terpinene-4-ol (20.9 percent), linalool (15.7 percent), linalyl-acetate (13.9 percent), limonene (13.4 percent) and α-terpineol (8.57 percent), whereas, thymol (21.6 percent), carvacrol (18.8 percent), o-cymene (13.5 percent) and α-terpineol (8.57 percent) were the main components of OVE. In the disc diffusion and the resazurin microtitre assays, OME showed better antibacterial activity than OVE with larger zones of inhibition (16.5-27.0 mm) and smaller MIC (40.9-1250.3 μg/mL) against the tested bacterial strains. Only OVE displayed anti-heme biocrystallization activity with an IC50 at 0.04 mg/mL. In the DPPH assay, OVE showed better radical-scavenging activity than OME (IC50=65.5 versus 89.2 μg/mL) and both OME and OVE inhibited lionleic acid oxidation. However, in the bleaching β-carotene assay, OVE exhibited better antioxidant activity than OME. In the MTT assay, OME was more cytotoxic than OVE against different cancer cell types, such as MCF-7, LNCaP and NIH-3T3, with IC50s of 70.0, 85.3 and 300.5 μg/mL, respectively. Overall, some components of OME and OVE may have antiparasitic and chemotherapeutic activity.