Women and Cardiovascular Health: Unraveling Gender-Specific Factors, Risks, and Therapeutic Approaches in Contemporary Medicine.

Background and objective Cardiovascular diseases (CVDs) constitute a significant global health challenge, causing millions of deaths annually and straining healthcare systems worldwide. This study aimed to investigate and elucidate gender-specific factors, risks, and therapeutic approaches related to cardiovascular health in women within the context of contemporary medicine. Methodology We conducted a prospective observational study spanning one year (November 2022 to October 2023) at the Peshawar Medical Complex Hospital, to meticulously explore the field of women's cardiovascular health. With a diverse cohort of 435 women (age range: 18-55 years), representing various socioeconomic backgrounds and geographic locations, our study aimed to elicit comprehensive insights. Through structured interviews covering reproductive history, lifestyle, and psychosocial aspects, coupled with clinical assessments, we gathered multifaceted data. Statistical analysis was done using SPSS Statistics version 23.0 (IBM Corp., Armonk, NY). By employing descriptive and t-tests for quantitative analysis and by thematically analyzing qualitative insights, our approach ultimately sought to provide a nuanced understanding of gender-specific factors impacting women's cardiovascular health. Results The study, involving 435 women, revealed various prevalent cardiovascular risk factors. Notable findings include a high incidence of a family history of CVD (n=213, 48.96%, p=0.013), hypertension (n=207, 47.58%), hypercholesterolemia (n=114, 26.21%), elevated triglycerides (n=162, 37.24%), and diabetes (n=64, 14.71%). Physical inactivity was also significantly more common (53.56%, p=0.004) compared to those engaging in regular activity. Women-specific risk factors comprised miscarriage (n=191, 43.91%). Therapeutic preferences varied, with a majority opting for lifestyle modifications (n=263, 60.39%) and pharmacological interventions (n=331, 76.33%). Conclusions This study provides a comprehensive understanding of prevalent cardiovascular risk factors, distinctive women-specific contributors, and diverse therapeutic preferences, highlighting the importance of personalized and targeted interventions to optimize women's cardiovascular health outcomes in contemporary medicine.

Transient downregulation of NR4A1 leads to impaired osteoblast differentiation through the TGF-ß pathway, and Elesclomol (STA-4783) rescues this phenotype.

Bone formation is regulated by numerous factors, such as transcription factors, cytokines, and extracellular matrix molecules. Human hormone nuclear receptors (hHNR) are a family of ligand-regulated transcription factors that are activated by steroid hormones, such as estrogen and progesterone, and various lipid-soluble signals, including retinoic acid, oxysterols, and thyroid hormone. We found that an hHNR called NR4A1 was the most highly expressed after human MSC differentiation into osteoblasts by whole-genome microarray. NR4A1 knockout decreased the osteoblastic differentiation of hMSCs in terms of ALPL expression and key marker gene expression. Whole-genome microarray analysis further confirmed the decrease in key pathways when we knocked down NR4A1. Further studies with small molecule activators identified a novel molecule called Elesclomol (STA-4783), which could activate and enhance osteoblast differentiation. Elesclomol activation of hMSCs also induced the gene expression of NR4A1 and rescued the phenotype of NR4A1 KD. In addition, Elesclomol activated the TGF-ß pathway by regulating key marker genes. In conclusion, we first identified the role of NR4A1 in osteoblast differentiation and that Elesclomol is a positive regulator of NR4A1 through activation of the TGF-ß signalling pathway.

Evaluation of the Possible Protective Role of Nobiletin against Arsenic-Induced Liver Damage in Male Albino Rats.

Arsenic (As) is a toxic contaminant present in organic and inorganic forms in the environment. Nobiletin (NOB) is a polymethoxy flavone that has recently gained substantial consideration due to its curative impacts. The present experiment was conducted to assess the hepatoprotective efficiency of NOB on As-generated hepatotoxicity. Twenty-four adult rats were equally distributed into four groups and designated as control, As (50 mg/kg)-treated, As + NOB (50 mg/kg and 25 mg/kg, respectively), and NOB (25 mg/kg)-treated groups. After 30 days, experimental animals were decapitated, then blood and tissue samples were collected for further analysis. The group treated with As showed a significant decrease in the activity of antioxidant enzymes, including catalase (CAT), superoxide dismutase (SOD), peroxidase (POD), glutathione (GSH), glutathione reductase (GSR), and total antioxidant status (TAS), and a substantial increase in the accumulation of As in liver tissues, levels of total oxidant status (TOS), hydrogen peroxide (H2O2), and lipid peroxidation (TBARS). Significant increases in alanine aminotransferase (ALT), alkaline phosphatase (ALP), and aspartate aminotransferase (AST) levels were observed in As-treated rats. Moreover, nuclear factor (NF)-κB, tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, interleukin (IL)-6, and cyclo-oxygenase (COX)-2 activity, as well as the levels of pro-apoptotic markers (Bax, Caspase-3, and Caspase-9) were increased on exposure to As. In contrast, the anti-apoptotic marker (Bcl-2) level was significantly decreased. As administration showed a significant disturbance in hepatic tissue histology. However, cotreatment of NOB with As considerably increased the antioxidant enzyme activity, with a noteworthy reduction in the deposition of As in hepatic tissues, TBARS, and H2O2 levels. NOB-administrated rats showed considerable recovery in terms of inflammation, apoptosis, and histological damage. Hence, NOB can be considered a useful curative compound due to its medicinal properties against As-prompted hepatotoxicity.

Neurological complications of COVID-19 in children and the associated immunological responses.

The high spread rate, severe symptoms, psychological and neurological problems, and unavailability of effective medicines are the major factors making Coronavirus disease 2019 (COVID-19) a massive threat to the world. It is thought that COVID-19 causes mild symptoms or mild infectious illness in children. However, we cannot rule out the possibility of serious complications such as the multisystem inflammatory syndrome. COVID-19 induces mild to severe neurological problems in children, such as stroke, encephalopathy, mild shortness of breath, and myalgia. The development of these conditions is associated with pro-inflammatory responses and cytokine storms, which alter the physiology of the blood-brain barrier and allow the virus to enter the brain. Despite the viral entry into the brain, these neurological conditions can also be caused indirectly by severe immune responses. In this article, we describe COVID-19 and the associated neurological and immunological complications in children.

Multiple arterial variations in the right upper limb of a caucasian male cadaver / Múltiples variaciones arteriales en el miembro superior derecho de un cadáver caucásico masculino

Anatomical variations of the arterial patterns in the upper limb have been describe in many anatomical studies, but the occurrence of four variations in a ipsilateral upper limb is rare. These arterial variations were observed in the right upper limb of a 65 -year old Caucasian male cadaver during routine dissection in the anatomy department, College of Medicine at the King Saud University, Riyadh. These arterial variations include: 1) a large common trunk of the axillary artery giving origin to subscapular artery, profunda brachii artery, common circumflex humoral artery and superior ulnar collateral artery, 2) superficial brachial artery; 3) superficial brachioulnar artery, and 4) the radialis indicis branch from superficial palmar arch. Appreciation of variations in the upper limb vessels is important due to increasing number of procedures both diagnostic and therapeutic as in breast cancer surgery, flap harvesting and arteriogaphy.

En numerosos estudios se han descrito las variaciones anatómicas de los patrones arteriales en el miembro superior, sin embargo, la aparición de cuatro variantes ipsilaterales en un miembro superior es poco frecuente. Estas variaciones arteriales fueron observadas en el miembro superior derecho de un cadáver caucásico masculino de 65 años de edad, durante la disección de rutina en el Departamento de Anatomía de la Facultad de Medicina de la Universidad de King Saud, en Riad. Estas variaciones arteriales incluyen: 1) un gran tronco común de la arteria axilar dando origen a las arterias subescapular, braquial profunda, braquial común y colateral ulnar superior; 2) la arteria braquial superficial; 3) la arteria braquioulnar superficial y 4) la rama radial del índice desde el arco palmar superficial. La observación de variaciones en los vasos del miembro superior es importante debido al número cada vez mayor de procedimientos diagnósticos y terapéuticos, como en la cirugía del cáncer de mama, la recolección de colgajos y arteriografías.

Does the existing traditional undergraduate Anatomy curriculum satisfy the senior medical students? A retrospective evaluation / O currículo tradicional de Anatomia é satisfatório para os estudantes do último ano de medicina? Uma avaliação retrospectiva

Objetivo: Apresentar os resultados de um estudo sobre opiniões e conhecimento de residentes de primeiro ano e estudantes de medicina sobre o Currículo de Anatomia e suas sugestões para organizar um curso de bases clínicas em anatomia. Métodos: Residentes de primeiro ano, ao final de seu ano clínico, e estudantes de medicina ao final de seu ano de graduação foram solicitados a avaliar o Currículo de Anatomia que tiveram nos anos pré-clínicos. Resultados: A maioria dos respondentes avaliou o ensino geral de anatomia adequado, mas a grande maioria considerou os cursos de anatomia clínica, anatomia de imagem e anatomia de superfície e viva muito curtos. Os residentes de primeiro ano e estudantes classificaram os cursos de anatomia e temas clínicos integrados como essenciais para seu treinamento clínico e sentiram a necessidade de um curso de anatomia orientado para a clínica, com estudos de casos e participação de docentes de clínica nos anos de ciclo básico. Conclusões: Avaliações retrospectivas ao final do primeiro ano de residência e no último ano de graduação são ?evidências? úteis a serem consideradas na reforma do currículo de anatomia, especialmente para desenvolver um Curso de Bases Clínicas em anatomia. Os resultados de tais estudos devem ser levados em conta ao se discutirem as modificações do currículo de anatomia.

Altered liver morphology and enzymes in streptozotocin induced diabetic rats / Morfología y enzimas del hígado alteradas en ratas con diabetes inducida por estreptozotocina

This study was undertaken to evaluate the relationship and effects of diabetes on liver morphology, architecture and function. The hepatic effects of diabetes were evaluated in vivo using streptozotocin (STZ)-induced diabetic rats as an experimental model. The degree of hepatic dysfunction was measured by using biochemical parameters like serum transaminases (ALT and AST), alkaline phosphatase (ALP)and pseudocholinesterase (PChE) while the histopathological studies were carried out to support the enzymic Parameters. The aim of the study was to investigate the association between diabetic hepatic complications and liver enzyme alterations. This study was performed in the Department of Anatomy; Institute of Pharmaceutical Sciences and Institute of Diabetology and endocrinology of Baqai Medical University, Karachi. Diabetes was induced by a single dose of STZ (45 mg/kg, b.w.) given intraperitoneally in sodium citrate buffer at pH 4.5. Eighty albino rats were divided into five groups: control (A) and STZ treated (B, C, D, and E) which were sacrificed 2, 4, 6 and 8 weeks post treatment respectively. Histopathological examination of liver showed accumulation of lipid droplets, lymphocytic infiltration, increased fibrous content, dilatation and congestion of portal vessels and proliferation of bile ducts. Increased levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), ALP and PChE were observed in the liver. It seems that the diabetic complications in the liver like hepatocyte destruction etc. are likely to be due to alterations in enzyme levels.

Este estudio se realizó para evaluar la relación y los efectos de la diabetes sobre la morfología, arquitectura y la función del hígado. Los efectos hepáticos de la diabetes se evaluaron in vivo utilizando estreptozotocina (STZ) para inducir diabetes en ratas como un modelo experimental. El grado de disfunción hepática se midió mediante el uso de parámetros bioquímicos, como las transaminasas séricas (ALT y AST), fosfatasa alcalina (ALP) y pseudocolinesterasa (PChE), mientras que los estudios histopatológicos se llevaron a cabo para apoyar los parámetros enzimáticos. El objetivo del estudio fue investigar la asociación entre las complicaciones hepáticas diabéticas y la alteración de enzimas hepáticas. Este estudio se realizó en el Departamento de Anatomía, Instituto de Ciencias Farmacéuticas y el Instituto de Diabetología y Endocrinología de la Baqai Medical University, Karachi. La diabetes fue inducida por una dosis única de STZ (45 mg/kg de peso corporal) administrada por vía intraperitoneal en tampón citrato de sodio a pH 4,5. Ochenta ratas albinas se dividieron en cinco grupos: control (A) y tratados con STZ (B, C, D y E), las que se sacrificaron a las 2, 4, 6 y 8 semanas después del tratamiento. El examen histopatológico de hígado mostró acumulación de gotitas de lípidos, infiltración linfocítica, aumento del contenido de fibras, dilatación y congestión de los vasos portales, y la proliferación de conductos biliares. Aumento de los niveles de aspartato aminotransferasa (AST), alanina aminotransferasa (ALT), ALP y PChE fueron observados en el hígado. Parece que las complicaciones de la diabetes en el hígado como la destrucción de los hepatocitos etc., son probablemente debido a alteraciones en los niveles de las enzimas.

Altered kidney morphology and enzymes in streptozotocin induced diabetic rats / Morfología y enzimas renales alteradas en ratas con diabetes inducida por estreptozotocin

We studied the effects of streptozotocin (STZ)-induced diabetes on kidney morphology, anatomy, architecture and on the activities of aminotransferases (AST and ALT), alkaline phosphatase (ALP) and pseudocholinesterase (PChE) in albino rats. The aim of the study was to investigate the association between diabetic kidney complications and kidney enzyme alterations. This study was performed in the Department of Anatomy and Institute of Pharmaceutical Sciences, Baqai Medical University, Karachi and Pathology department of College of Physicians & Surgeons (CPSP) Pakistan in 2007-08. Diabetes was induced by a single dose of STZ (45 mg/kg, b.w.) given intraperitoneally in sodium citrate buffer at pH 4.5. Eighty (80) albino rats were divided into five groups: control (A) and STZ treated (B, C, D, and E) which were sacrificed 2, 4, 6 and 8 weeks post treatment respectively. Histopathology of kidney showed lesions similar to human glomerulosclerosis, glomerular membrane thickening, arteriolar hyalinization and tubular necrosis. Increased levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and pseudocholinesterase (PChE) were observed in the kidney. It seems that the diabetic complications in the kidney are likely to be associated with alterations in enzyme levels.

Se estudiaron los efectos de la diabetes inducida por estreptozotocin (STZ) sobre la morfología, anatomía, arquitectura y sobre las actividades de aminotransferasas (ALT y AST), fosfatasa alcalina (ALP) y pseudocolinesterasa (PChE) en los riñones de ratas albinas. El objetivo del estudio fue investigar la asociación entre las complicaciones renales diabéticas y la alteración de las enzimas renales. Este estudio se realizó en el Departamento de Anatomía y el Instituto de Ciencias Farmacéuticas, Universidad de Medicina Baqai, Karachi y el departamento de Patología de Colegio de Médicos y Cirujanos (CPSP) Pakistán entre el 2007-2008. La diabetes fue inducida por una dosis única de STZ (45 mg / kg de peso corporal) administrada por vía intraperitoneal en tampón de citrato de sodio a pH 4.5. Ochenta (80) ratas albinas fueron divididas en cinco grupos: control (A) y STZ tratados (B, C, D y E), que se sacrificaron a las 2, 4, 6 y 8 semanas después del tratamiento, respectivamente. La histopatología del riñón mostró lesiones similares a la glomeruloesclerosis en humanos, engrosamiento de la membrana glomerular, hialinización arteriolar y necrosis tubular. Aumento de los niveles de aspartato aminotransferasa (AST), alanina aminotransferasa (ALT), fosfatasa alcalina (ALP) y pseudocolinesterasa (PChE) fueron observados en el riñón. Parece que las complicaciones de la diabetes en el riñón están directamente asociadas con alteraciones en los niveles de las enzimas.

Pattern of coronary arterial distribution and its relation to coronary artery diameter.

BACKGROUND: This study was carried out to determine the pattern of coronary arterial distribution and its relation with coronary artery diameter in adult Pakistani population as demonstrated by selective coronary angiography. METHODS: Consecutive series of 220 adult subjects who underwent diagnostic coronary angiography at National Institute of Cardiovascular Disease (NICVD) between May 2000 and December 2000 were studied. Patients whose age was more than 18 years, with no apparent disease in the proximal arterial segment, proximal artery and tip of the catheter in the middle of the frame and catheter of a No. 6 French size of same manufacturer used were included in this study. Patients who were given vasodilator before or during the procedure, angiograms showing complete proximal occlusions or ectatic arteries were excluded. RESULTS: Sixty percent subjects had right dominance pattern of which 78.1% were male and 21.8% female. By contrast 15% had left coronary dominance, of which 78.7 % were male and 21.2% female. Where as, 24% patients had co-dominant (balanced) circulation with 83.3% male and 16.6 % female. In patients with left dominant pattern, the mean diameter of the right coronary artery (RCA) was significantly smaller (p < 0.001) as compared to dominant right or co-dominant pattern. Where as in patients with right dominant pattern, the mean diameter of the circumflex (CX) artery was significantly smaller (p < 0.001) as compared to dominant left. CONCLUSION: The coronary arterial distribution in Pakistani population is not significantly different from that given in the literature and the diameter of the RCA and the CX artery are significantly affected by dominance pattern.