Role of caveolin-eNOS platform and mitochondrial ATP-sensitive potassium channel in abrogated cardioprotective effect of ischemic preconditioning in postmenopausal women

Abstract Caveolin, the protein of the caveolar membrane, interacts and binds with endothelial nitric oxide synthase (eNOS), forming a caveolin-eNOS complex leading to suppression of the eNOS activity. Caveolin, therefore, maintains eNOS in the inactivated state leading to reduced nitric oxide (NO) production. Ischemic preconditioning disrupts the caveolin-eNOS complex leading to activation of the eNOS and thus results in cardioprotection. During ischemic preconditioning, NO produces cardioprotection by the opening of the KATP channel, and the caveolin forms a suitable signalling platform facilitating the interaction of NO with the KATP channel. Estrogen deficiency has been reported to upregulate caveolin-1 expression. The article aims to review the various mechanisms that placed the women at the risk of coronary artery diseases after postmenopausal estrogen deficiency and their role in the cardioprotective effect of ischemic preconditioning.

Effect of maternal age and gestational weight gain on anthropometry of the newborn in semi urban area of Chhattisgarh, India

Background: Maternal undernutrition is a known to be a major factor contributing to adverse pregnancy outcomes. Gestational weight gain and young maternal age at childbearing years is associated with an increased risk low birth weight babies and infant mortality.Methods: Prospective observational study carried out in the post-natal ward of a tertiary care hospital (CM hospital) in a semi-urban area over a period of 1 year in between March 2018 and March 2019. Total 150 mothers who satisfied the inclusion criteria were enrolled. Age of the mothers was noted and were divided into 5 groups. Last known pre-pregnancy weight was recorded on re-call basis, recorded data on first visit during first month of pregnancy and again they were weighed in the third trimester at the time of admission using standard electronic weight machine. Data collected were entered in Microsoft Excel Work sheet 2018 which was imported to SPSS (version16) for data analysis. Quantitative data has been analysed by Mean, Standard deviation, T test and Karl Pearson correlation.Results: Mean birth weight among young age' mother (<20 years) was 2068 g (95%CI,'223.99) which was significantly lower than mean birth weight of 20-30 year old mother (271.19 g'95%CI, 437.02) and >30 year old mother (2932.78, 95%CI'429.99). With increase in gestational weight gain there was a corresponding increase in mean birth weight and this increase was statistically significant (r=0.435, p=<0.001).Conclusions: Maternal age and gestational weight gain had significant impact on new-born anthropometry. Young age (<20yrs) and decreased gestational weight gain is associated with increased number of low birth weight babies.

Chronic postthoracotomy pain in transapical transcatheter aortic valve replacement

Objective: Chronic postthoracotomy pain (CPTP) is a persistent, occasionally debilitating pain lasting >2 months following thoracic surgery. This study investigates for the first time the prevalence and clinical impact of CPTP in patients who have undergone a transapical transcatheter aortic valve replacement (TA-TAVR). Design: This was a single-institution, prospective observational survey and a retrospective chart review. Setting: The study was conducted in the University Hospital. Participants: Patients. Materials and Methods: A survey of 131 participants with either a previous TA TAVR or transfemoral (TF) TAVR procedure was completed. A telephone interview was conducted at least 2 months following TAVR; participants were asked to describe their pain using the Short-Form McGill Pain Questionnaire. Measurements and Main Results: Odds ratio (OR) was calculated using the proportions of questionnaire responders reporting “sensory” descriptors in the TA-TAVR versus the TF-TAVR groups. Results were then compared to individual Kansas City Cardiomyopathy Questionnaire (KCCQ12) scores and 5-min walk test (5MWT) distances. A total of 119 participants were reviewed (63 TF, 56 TA). Among TA-TAVR questionnaire responders (n = 16), CPTP was found in 64.3% of participants for an average duration of 20.5-month postprocedure (OR = 10, [confidence interval (CI) 95% 1.91–52.5];P = 0.003). TA-TAVR patients identified with CPTP had significant reductions in 5MWT distances (−2.22 m vs. 0.92 m [P = 0.04]) as well as trend toward significance in negative change of KCCQ12 scores OR = 18.82 (CI 95% 0.85–414.99;P = 0.06) compared to those without CPTP. Conclusions: CPTP occurs in patients undergoing TA-TAVR and is possibly associated with a decline quality of life and overall function.

Histomorphometric Assessment Of Wharton’s Jelly Area In Normal And Pre-eclamptic Pregnancies And Its Correlation With Placental Weight

Introduction: Fetal capability to grow in utero depends on placental development and function. The goal of thisstudy was to appraise the effects of hypertension on placental weight and Wharton’s jelly area (WJA); andcorrelate them in normal and pre-eclamptic pregnancies.Material and Methods: Eighty placentae along with umbilical cord divided into forty each of normotensive andpre-eclamptic pregnancies were studied. The cross-sectional area of the umbilical cord and vessels area wasmeasured with the help of vernier scale and ocular micrometer respectively. WJA was calculated by deduction ofthe vascular area from the umbilical cord area. Placental weight was recorded by using a weighing machine andcorrelated with the WJA.Results: In the present study, mean placental weight was 445.45 ± 40.31 grams and WJA was 35.28 ± 8.42 mm2 inthe normal group. Whereas, in the pre-eclamptic group, mean placental weight was 408.95 ± 47.15 grams andWJA was 29.04 ± 8.09 mm2. Mean placental weight and WJA was significantly lower in the pre-eclamptic group.A significant positive correlation was found between WJA and placental weight (r = 0.710, p<0.0001) in normalgroup and (r = 0.764, p<0.0001) in pre-eclamptic group.Conclusion: Pre-eclampsia is associated with reducing placental weight and WJA. Low WJA may hamper the fetalgrowth. The current study shows a strong positive correlation between WJA and placental weight. So, the awarenessof this correlation will be helpful in the early observation of placental insufficiencies and provide sufficientinformation to take additional care in such conditions.

Study Of Palmar Patterns In Carcinoma Breast Patients Of Central India

Background: Breast cancer is very common among females these days, it’s occurrence has a strong genetic basiswhich has been already established. Palmar patterns also develop under genetic control during early developmentalmost at the same period when the mammary buds develop in intrauterine life. And they do not get alteredsignificantly after that, and thus remains almost constant during rest of the life. So these patterns may beassessed as a non-invasive anatomical marker to find the risk of developing breast cancer later in life.Methodology: In this study assessment of the palmar patterns of both hands of 109 female breast cancerpatients were taken and compared with the patterns of 109 age matched normal healthy females. The Patternswere obtained by Ink method in an A4 size white paper. Palmar ridge count (a-b ridge count), palmar angles ( atdangle and adt angle) of both the groups was measured and analysed.Results: On statistical analysis it was observed that mean a-b ridge count of right and left hands of cases weresignificantly lower when compared with the mean a-b ridge count of right and left hands of the normal healthyfemales respectively in Madhya Pradesh.Conclusion: The palmar ridge counts are significantly associated with breast cancer and in a highly populatedcountry like India with limited medical resources, it may be employed as an inexpensive and effective tool forscreening the high-risk population for breast cancer

Looking inside the third generation left ventricular assist device using color doppler transesophageal echocardiography

HeartWare is a third-generation continuous flow left ventricular assist device (LVAD) and generates centrifugal pattern of blood flow. In the perioperative setting, interrogating the HeartWare devices is very difficult due to the interference of the Doppler by the impeller frequency and generation of the waterfall artifact. We present a case where using color Doppler a view “inside“ the impeller can be seen which corresponds to the centrifugal flow of blood. With time, these images can be looked into in pathological states such as pump thrombosis, to come to a more meaningful conclusion regarding the flow of blood within the centrifugal chamber. Newer technologies are constantly evolving to give us more meaningful insights into the flow of blood within the heart chambers. We believe similar technologies can be applied to see the flow of blood inside the LVAD devices.

Low grade follicular lymphoma with high proliferation index; diagnostic and management issues.

Follicular Lymphoma (FL) is the second most common B-Non Hodgkin Lymphoma after diffuse large B cell lymphoma (DLBCL). Low grade FL is known for its indolent behavior; however, one subset of FL behave aggressively and may require intensive therapy. One of the diagnostic issues in FL is to identify this subgroup of cases. Proliferation index can have prognostic importance in this subset of cases. We discuss one case of low grade FL with a paradoxically high proliferative index. A 63 year male presented with generalized lymphadenopathy of one year duration, which was gradually increasing in size. On examination, patient had bilateral cervical, axillary and inguinal nodes. Biopsy of the left cervical lymph node was reported as FL - Grade 2, with high proliferative Index (60%). The patient was put on CHOP regimen targeted for high grade lymphomas, and had complete remission. High proliferative index in FL is a poor prognostic factor irrespective of the histologic grade. So, proliferative index should be assessed in all cases of FL as an adjunct to histologic grading.

Sida cordifolia (Linn) – An overview.

Our world is fulfilled by various medicinal plants which are widely have been used in treatment of various diseases since ancient time. Medicinal plants still play an important role in emerging and developing countries. They also generate income to people of many Asian countries who can earn their livelihood from selling collected materials from the forest or by cultivating on their farms. Thus the medicinal plants constitute very important rational resources. In India plants have been trditionally used for human and veterinary health care needs. This reflects that medicinal plant and their products have taken an increasing demand. Herbs are staging a comeback and herbal ‘renaissance’ is happening all over the globe. The herbal products today symbolize safety in contrast to the synthetics that are regarded as unsafe to human and environment. Although herbs had been priced for their medicinal, flavoring and aromatic qualities. Malvaceae, commonly known as Bala, is an Ayurvedic medicine that is used to treat bronchial asthma, cold and flu, chills, lack of perspiration, head ache, nasal congestion, aching joints and bones, cough and wheezing, and edema. The root infusion is given in nervous and urinary diseases and also in disorders of the blood and bile. Sida cordifolia has been reported to posess analgesic, anti-inflammatory and hypoglycemic activities as well as hepatoprotective activity. Traditionally the plant Sida cordifolia (linn) syn has been used as CNS depressant, fat lose, analgesics, anti-inflammatory, hypotensive, hepatoprotectiv. Presence of ephedrine has highlighted the utility of this plant .various ayurvadic preparation of this plant used in asthma diseases, fat lose and increase energy, Oil preparation is also cure pain, swelling disorder, and Gritha cures Heart diseases. This plant has great potential to develop the Ayurvedic, modern medicine and athletic supplements by pharmaceutical industries. The present review is highlights the traditional uses, Ayurvedic preparation, chemical constituents and pharmacological properties of Sida cordifolia (linn) syn. Country Mallow.