New Developments in Hypertensive Encephalopathy.

PURPOSE OF REVIEW: This review summarizes the latest science on hypertensive encephalopathy and posterior reversible encephalopathy syndrome (PRES). We review the epidemiology and pathophysiology of these overlapping syndromes and discuss best practices for diagnosis and management. RECENT FINDINGS: Diagnosis of hypertensive encephalopathy largely relies on exclusion of other neurological emergencies. We review the extensive causes of PRES and its imaging characteristics. Management strategies have not changed substantially in the past decade, though newer calcium channel blockers simplify the approach to blood pressure reduction. While this alone may be sufficient for treatment of hypertensive encephalopathy in most cases, management of PRES also depends on modification of other precipitating factors. Hypertensive encephalopathy and PRES are overlapping disorders for which intensive blood pressure lowering is critical. Further research is indicated to both in diagnosis and additional management strategies for these critical conditions.

Normative Data on Heart Rate Variability Time and Frequency Domain Indices in a Healthy Central Indian Population Undergoing Treadmill Exercise.

Background: Heart rate variability (HRV) is becoming one of the most valuable tools for assessing a healthy heart's complex and constantly changing oscillations. This study was a pioneering attempt to establish normative data on HRV during treadmill exercise for monitoring the cardiovascular health of the central Indian population. Methodology: This was a cross-sectional study in the Sports Physiology Laboratory of the Department of Physiology in a Rural Medical College in central India. One hundred and twenty healthy subjects in the age range 17-40 years were recruited. Short-term HRV (5 min) was extracted from ECG recordings obtained using the Power lab system, AD Instruments, Australia. Results: Time domain indices for males were - Standard deviation of N-N interval (SDNN): 162.61±162.11; Square root of mean squared difference of N-N intervals (RMSSD): 355.79±798.27; the percentage of adjacent NN intervals that differ from each other by more than 50 ms (pNN50): 23.10±27.87. Frequency domain indices in males were- LF power (%)- 535.74±3625.96; HF power (%) - 33.15±24.31, LF nu: 33.12± 16.06; HF nu: 57.22±14.89; LF/HF:0.77±0.74. Time-domain indices for females were SDNN as168.49±130.09; RMSSD: 182.41±154.85; pNN50:32.33±26.59. Frequency domain indices in females were LF power (%)-19.85±6.13; HF power (%) 43.03±16.39, LF nu-30.53±9.88; HF nu -60.95±8.70; LF/HF:0.54±0.27. Conclusion: Baseline normative values for HRV spectral and time-domain analysis have been established for their clinical use in comparing the HRV of a healthy individual to that of a deceased individual or an athlete.

Isolation and anticancer activity evaluation of rare Bisaryl anthraquinone antibiotics from novel Streptomyces sp. strain of NW Himalayan region.

Biosynthesis of bisaryl preanthraquinone antibiotics by various microorganisms differs in monomeric subunits as well as their dimerization positions leading to different configurations. The present study relates to the production of rare bisaryl anthraquinone antibiotics by a new Streptomyces strain isolated from Shivalik region of NW Himalayas. In vitro anticancer and anti-migratory effects of Setomimycin (9,9' bisanthraquinone antibiotic) was seen with a significant reduction in the expression of both MEK as well as ERK pathways in a dose dependent manner at 6.5 µM & 8 µM concentration in HCT-116 and 5.5 µM & 7 µM concentration in MCF-7 cells. In vivo studies in aggressive orthotopic mouse mammary carcinoma model (4T1) demonstrated about 76% reduction of primary tumor weight and 90.5% reduction in the tumor volume within two weeks. In vivo pharmacokinetics study of setomimycin revealed that it can be rapidly absorbed with an adequate plasma exposure and half-life which can be linked to its in vivo efficacy.

ATS Core Curriculum 2020. Adult Sleep Medicine.

The American Thoracic Society Core Curriculum updates clinicians annually in adult and pediatric pulmonary disease, medical critical care, and sleep medicine, in a 3-4-year recurring cycle of topics. These topics will be presented at the 2020 Virtual Conference. Below is the adult sleep medicine core that includes topics pertinent to sleep-disordered breathing and insomnia.

Anti-anxiety and Anti-depressant Like Effects of Murraya koenigii in Experimental Models of Anxiety and Depression.

BACKGROUND: Presence of free radical scavenging activity in Murrayakoenigii, commonly known as Curry leaves, has been shown in previous studies. Oxidative stress plays an important role in the development of various neurobehavioral disorders including anxiety and depression. AIM: The present study aimed to evaluate the effects of Murraya koenigii in animal models of depression and anxiety. MATERIALS AND METHODS: The effect of incremental doses of Murraya koenigii aqueous leaf extract was evaluated on spontaneous motor activity (SMA), open arm incursions in elevated plus maze, and despair behaviour in forced swim (FST) and tail suspension (TST) tests as compared to control groups in Swiss albino mice. RESULTS: Murraya koenigii 300 mg/kg, p.o. (MK300) and 400 mg/kg, p.o. (MK400) reduced the SMA count from 754 ± 64.9 to 540 ± 29 and 295 ± 34 respectively, which was statistically significant. MK300 and MK400 reduced significantly the open arm count from 29 ± 8.6 to 16 ± 7 and 10 ± 3.9, respectively. On FST, MK400 reduced the duration of immobility from 145.5 ± 29 to 91 ± 17.3, which was statistically significant. On TST, MK produced a dose-dependent decrease in the duration of immobility; however, it was statistically significant only with MK400. CONCLUSION: Murraya koenigii aqueous leaf extract reduced the despair behavior in experimental animal models, suggesting an anti-depressant like activity. Murraya koenigii extract also reduced spontaneous locomotor activity in a dose-dependent manner suggesting a sedative and/or anxiolytic effect though there wasn't any anxiolytic effect in the elevated plus maze test.