Impact of Total Ischemic Time on Clinical Outcomes in Patients With ST-Elevation Myocardial Infarction: Lost Time Is Never Found Again.

Introduction A dedicated relationship between total ischemic time (TIT) and clinical outcomes has been reported in ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI); however, this claim is yet to be clarified. Accordingly, this study was carried out to determine the association of TIT with in-hospital and one-year follow-up outcomes in STEMI patients undergoing primary PCI. Material and methodology Between December 2020 and December 2021, a total of 113 consecutive STEMI patients undergoing primary PCI were prospectively included. According to TIT, all patients were categorized into two groups: (a) shorter TIT (<180 minutes) and (b) prolonged TIT (≥180 minutes). Data regarding baseline, clinical, and angiographic characteristics, as well as in-hospital and one-year follow-up outcomes were noted among the two groups. Results A total of 113 STEMI patients with a mean age of 69.3 ± 13.6 years were studied, and males [92 (81.4%)] were predominately affected with STEMI. A median TIT was 348 minutes. Of 113, 30 (23.0%) patients had a TIT of <180 minutes and 83 (73.5%) had a TIT of ≥180 minutes. Prolonged ischemia duration was significantly associated with composite of death, rehospitalization, and revascularization (p=0.02) at one-year follow-up. Conclusion TIT can be considered a good quality indicator, together with door-to-balloon time and other clinical determinants, in order to improve survival in STEMI patients.

Assessment of Right Ventricular Function in Patients With Acute Myocardial Infarction.

Introduction We assessed the right ventricular function in patients with first acute anterior wall myocardial infarction (AWMI) and inferior wall myocardial infarction (IWMI) without associated right ventricular infarction and assessed the relation between right ventricular function and the in-hospital clinical outcomes. Methods The present study was an observational cross-sectional study, which enrolled a total of 200 patients with chest pain of <24 hours who were diagnosed with acute ST-segment elevation myocardial infarction (MI) for the first time. Echocardiography was performed with a special emphasis on the tricuspid annular plane systolic excursion (TAPSE) score. The in-hospital clinical outcomes include major adverse cardiac events (MACE), which refer to all-cause mortality, cardiovascular mortality, recurrent MI, heart failure, or stroke in patients with acute myocardial infarction (AMI). Results A total of 200 patients with AMI were enrolled in the study of which 66% were males. Of patients, 68% had AWMI and 32% had IWMI. Patients with AWMI had more right ventricular dysfunctional changes as compared to IWMI, as measured by TAPSE score (17.8 ± 4.64 mm vs. 19.87 ± 3.61; p = 0.01, respectively). The incidence of MACE was 27.9% in AWMI as compared to 12.5% in IWMI (41.9% vs. 18.75% had right ventricular dysfunction, respectively). The outcome of AWMI patients was poor as compared to IWMI patients, as measured by duration of hospital stay (9.5 ± 4.73 days and 6.6 ± 4.70 days, respectively) and mortality (17.64% in AWMI vs. 6.25% in IWMI). The patients of AMI with TAPSE score ≤18 mm, suggesting right ventricular dysfunction, had a higher rate of MACE compared to those with TAPSE score >18 mm, respectively, 36.23% vs. 12.2%. Conclusion From this study, it is concluded that AWMI results in a higher incidence of right ventricular dysfunction as compared to IWMI. Furthermore, patients with AMI with concomitant right ventricular dysfunction were found to have poorer outcomes in terms of longer duration of hospital stay, higher incidence of MACE, and higher mortality rate, as compared to patients of AMI without right ventricular dysfunction.

Selective Disruption of Survivin's Protein-Protein Interactions: A Supramolecular Approach Based on Guanidiniocarbonylpyrrole.

Targeting specific protein binding sites to interfere with protein-protein interactions (PPIs) is crucial for the rational modulation of biologically relevant processes. Survivin, which is highly overexpressed in most cancer cells and considered to be a key player of carcinogenesis, features two functionally relevant binding sites. Here, we demonstrate selective disruption of the Survivin/Histone H3 or the Survivin/Crm1 interaction using a supramolecular approach. By rational design we identified two structurally related ligands (LNES and LHIS ), capable of selectively inhibiting these PPIs, leading to a reduction in cancer cell proliferation.

Comparative analysis of various electrostatic potentials on docking precision against cyclin-dependent kinase 2 protein: a multiple docking approach.

The fundamental of molecular modeling is the interaction and binding to form a complex, because it explains the action of most drugs to a receptor active site. In the present study, different semiempirical (RM1, AM1, PM3, MNDO) and ab initio (HF, DFT) charge models were investigated for their performance in prediction of docking pose against CDK2 proteins with their respective inhibitor. Further, multiple docking approaches and Prime/MM-GBSA calculations were applied to predict the binding mode with respective charge model against CDK2 inhibitors. A reliable docking result was obtained using RRD, which showed significance improvement on ligand binding poses and docking score accuracy to the IFD. The combined use of RRD and Prime/MM-GBSA method could give a high correlation between the predicted binding free energy and experimental biological activity. The preliminary results point out that AM1 could be a precious charge model for design of new drugs with enhanced success rate. As a very similar result was also found for a different system of the protein-ligand binding, the suggested scoring function based on AM1 method seems to be applicable in drug design. The results from this study can provide insights into highest success rate for design of potent and selective CDK2 inhibitors.

A study of sexual dimorphism in the femur among North Indians.

Determination of sex of unknown skeleton remains is the most important step in the identification process. Racial and regional differences in the populations create and maintain specificity in their dimorphic characteristics. Moreover, considering continued secular changes in the population structure, constant revision of osteometric standards becomes mandatory. In an effort to establish osteometric standards for the femur of contemporary North Indian populations, 122 adult femora of known sex (M: 94; F: 28) were collected in the Department of Forensic Medicine, IMS, BHU, Varanasi. Eight standard parameters were measured and analyzed by discriminant function analysis using SPSS 16. The accuracy of sex prediction ranged from 70.5% to 83.6% with single variables. In stepwise analysis, epicondylar breadth, proximal breadth, and antero-posterior diameter of the lateral condyle were found to be the most discriminating variables providing an accuracy of 90.2%. The results clearly indicate the importance of the ends of femur in the determination of sex.

Sex estimation from the mastoid process among North Indians.

Determination of sex from fragmentary crania is a critical problem in forensic anthropology. Osteometric analysis of mastoid can serve forensic anthropologists better in sex identification by virtue of the noticeable dimorphic characteristics. The present study aims to develop population-specific, sex-differentiating anthropometric standards for the mastoid process of North Indian skulls. Eight parameters of the mastoid region were measured on 138 adult crania (M/F 104:34, 22-65 years) and analyzed using SPSS 16.0. All parameters showed significant sexual dimorphism (p < 0.000). In stepwise analysis, asterion-mastoidale and mastoid breadth have provided an accuracy of 87%. Receiver operating characteristic curves were obtained for each variable to observe their overall performance in sex determination. Posterior end of incisura mastoidea-depression of suprameatal triangle was found to be the best variable with maximum area under curve and highest predictive accuracy (82.6%).

An osteometric study of northern Indian populations for sexual dimorphism in craniofacial region.

Sex identification is an initial crucial objective in the revelation of the complete identity of the human skeleton as it also renders significantly clearer guidance towards age and stature estimation. Population specific standards are of great practical relevance in the present era of increasing population intermixing. Size differences and robusticity are the two well-elaborated pillars holding most of the dimorphic burdens of the skull. This study is designed to explore dimorphic characteristics of the craniofacial region to establish anthropometric standards for contemporary North Indian populations, which have not been available so far. One hundred and twelve adult crania of known age (23-65 years) and sex (M:F; 82:30) were collected in the Department of Forensic Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. Ten standard metric parameters of craniofacial region were measured and subjected to stepwise and direct discriminant function analysis employing SPSS 16.00. Bizygomatic breadth emerged as the single best parameter in stepwise analysis, providing an average accuracy of 85.5%.

Mandibular ramus: an indicator for sex in fragmentary mandible.

Mandible is the hardest and most durable bone of the skull exhibiting a high degree of sexual dimorphism. Especially ramus of mandible is subjected to greater stress than any other bone of the skull because of the process of mastication. This study has been performed to establish the osteometric standards for practical use in forensic context over Indian population using mandibular ramus. The sample consists of 116 mandibles of Northern Indian population (M:F; 92:24, mean age 37.4 years), collected from the Department of Forensic Medicine, IMS, BHU, Varanasi. Osteometric informations about five metric parameters (coronoid height, projective height, condylar height, and maximum breadth and minimum breadth of ramus) were taken with sliding calipers. These parameters were subjected to different discriminant function analysis using SPSS 16.0. All parameters showed significant sexual dimorphism (p < 0.001 in all cases) with an overall accuracy of 80.2%, and coronoid height was the single best parameter providing an accuracy of 74.1%.