Bioinspired chitosan based functionalization of biomedical implant surfaces for enhanced hemocompatibility, antioxidation and anticoagulation potential: an in silico and in vitro study.

Endowing implanted biomaterials with better hemocompatibility, anticoagulation, antioxidant and antiplatelet adhesion is necessary because of their potential to trigger activation of multiple reactive mechanisms including coagulation cascade and potentially causing serious adverse clinical events like late thrombosis. Active ingredients from natural sources including Foeniculum vulgare, Angelica sinensis, and Cinnamomum verum have the ability to inhibit the coagulation cascade and thrombus formation around biomedical implants. These properties are of interest for the development of a novel drug for biomedical implants to potentially solve the current blood clotting and coagulation problems which lead to stent thrombosis. The objective of this study was to incorporate different anticoagulants from natural sources into a degradable matrix of chitosan with varying concentrations ranging from 5% to 15% and a composite containing all three drugs. The presence of anticoagulant constituents was identified using GC-MS. Subsequently, all the compositions were characterized principally by using Fourier transform infrared spectroscopy and scanning electron microscopy while the drug release profile was determined using UV-spectrometry for a 30 days immersion period. The results indicated an initial burst release which was subsequently followed by the sustained release pattern. Compared to heparin loaded chitosan, DPPH and hemolysis tests revealed better blood compatibility of natural drug loaded films. Moreover, the anticoagulation activity of natural drugs was equivalent to the heparin loaded film; however, through docking, the mechanism of inhibition of the coagulation cascade of the novel drug was found to be through blocking the extrinsic pathway. The study suggested that the proposed drug composite expresses an optimum composition which may be a practicable and appropriate candidate for biomedical implant coatings.

Improving resistant starch content of cassava starch by pulsed electric field-assisted esterification.

This study aims to investigate the effect of pulsed electric field (PEF) assisted OSA esterification treatment on the multi-scale structure and digestive properties of cassava starch and structure-digestion relationships. The degree of substitution (DS) of starch dually modified at 1.5-4.5 kV/cm was 37.6-55.3 % higher than that of starch modified by the conventional method. Compared with native starch, the resistant starch (RS) content of esterified starch treated with 3 kV/cm significantly increased by 17.13 %, whereas that of starch produced by the conventional method increased by only 5.91 %. Furthermore, assisted esterification at low electric fields (1.5-3 kV/cm) promotes ester carbonyl grafting on the surface of starch granules, increases steric hindrance and promotes the rearrangement of the amorphous regions of starch, which increases the density of the double-helical structure. These structural changes slow down starch digestion and increase the RS content. Therefore, this study presents a potential method for increasing the RS content of starch products using PEF to achieve the desired digestibility.

Mutation-specific CAR T cells as precision therapy for IGLV3-21R110 expressing high-risk chronic lymphocytic leukemia.

The concept of precision cell therapy targeting tumor-specific mutations is appealing but requires surface-exposed neoepitopes, which is a rarity in cancer. B cell receptors (BCR) of mature lymphoid malignancies are exceptional in that they harbor tumor-specific-stereotyped sequences in the form of point mutations that drive self-engagement of the BCR and autologous signaling. Here, we use a BCR light chain neoepitope defined by a characteristic point mutation (IGLV3-21R110) for selective targeting of a poor-risk subset of chronic lymphocytic leukemia (CLL) with chimeric antigen receptor (CAR) T cells. We develop murine and humanized CAR constructs expressed in T cells from healthy donors and CLL patients that eradicate IGLV3-21R110 expressing cell lines and primary CLL cells, but neither cells expressing the non-pathogenic IGLV3-21G110 light chain nor polyclonal healthy B cells. In vivo experiments confirm epitope-selective cytolysis in xenograft models in female mice using engrafted IGLV3-21R110 expressing cell lines or primary CLL cells. We further demonstrate in two humanized mouse models lack of cytotoxicity towards human B cells. These data provide the basis for advanced approaches of resistance-preventive and biomarker-guided cellular targeting of functionally relevant lymphoma driver mutations sparing normal B cells.

Multimodal Imaging Findings Associated With Cardiac Oxalosis Cardiomyopathy.

We report the case of a 50-year-old woman with secondary oxalosis following bowel resection resulting in restrictive cardiomyopathy and a diagnosis of cardiac amyloidosis based on the initial workup. The case documented findings by cardiac magnetic resonance imaging and technetium Tc 99m-labeled pyrophosphate scan in patients with cardiac oxalosis, which can mimic findings in cardiac amyloidosis, expanding the differential diagnosis.

The genus Neopsittaconirmus (Psocodea: Ischnocera: Philopteridae) from parrots of Pakistan, and evaluation of its distribution on captive parrots (Psittaciformes) around the world.

The genus Neopsittaconirmus Conci, 1942 is a host-specific genus, found on both wild and captive parrots and love birds (order Psittaciformes). Two species of this genus: N. lybartota (Ansari, 1947) and N. chandabani (Ansari, 1947) have been previously reported from the Punjab province, Pakistan. We recorded N. lybartota from Psittacula eupatria nipalensis (n = 2), Psittacula krameri borealis (n = 13), and captive Psittacula krameri krameri (n = 4) with the mean intensity of 2.0 ± 1, 2.13 ± 0.35 and 2.25 ± 0.47, respectively; the prevalence of louse infestation was 62% in P. krameri borealis and 100% in P. krameri krameri and P. eupatria nipalensis. From this material, we redescribed its morphological variations in taxonomic features. Records on P. eupatria nipalensis and P. krameri krameri represent new host associations for this species of louse. We also present a new record of Neopsittaconirmus vendulae from a captive cockatiel, Nymphicus hollandicua (n = 3) in Pakistan, with mean intensity of 2.6 ± 0.66. Intraspecific variability of this species is described in detail, with special reference to the male and female terminalia, and male genitalia. We aimed to update and extend the fauna of chewing lice infesting birds of Pakistan. Previous records of Neopsittaconirmus on captive parrots around the world are summarized and discussed. Despite long-standing systematic veterinary care, some Neopsittaconirmus have cosmopolitan distribution and they are able to survive and successfully reproduce in captivity with their hosts, and even colonize novel hosts.

The role of chromium supplementation in cardiovascular risk factors: A comprehensive reviews of putative molecular mechanisms.

In the recent years, micronutrients play an important role in improving body health with preventing and treating of chronic diseases. Chromium is one of the vital minerals involved in the regulation of insulin action. According to abundant evidences this mineral seems to be an essential factor involved in the reduction of insulin resistance and decreasing the risk of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs). Moreover, it has been proposed that Chromium supplementation affects mechanisms involved in blood pressure, lipid metabolism, inflammation, and oxidative stress. For instance, it may affect blood pressure through alteration of the renin-angiotensin system, as well as reducing the angiotensin-converting enzyme activity. Furthermore, Chromium supplementation might help reduce the coronary heart disease rates. This study aims to provide a comprehensive review regarding to the effects of Chromium supplementation on CVDs risk factors with an emphasis on possible molecular mechanisms.

Progressively Prolonged PR Interval and Aortic Abscess.

Regular electrocardiogram (ECG) monitoring in patients with endocarditis of the aortic region is a simple yet effective approach to help evaluate for the development of aortic abscess. It is important to recognize this condition as it carries a high morbidity and mortality. We report a case of a 62-year-old Caucasian female diagnosed with methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia with mitral and aortic endocarditis. Progressive PR prolongation prompted re-evaluation, ultimately finding the progression of a new aortic abscess, changing the patient's care pathway. With a standardized approach of obtaining regular ECGs in patients with aortic endocarditis, it is possible to identify the progression of aortic valve endocarditis, thereby lowering the risk of morbidity and mortality.

Effect of plasma-activated water and buffer solution combined with ultrasound on fungicide degradation and quality of cherry tomato during storage.

The purpose of this study was to examine plasma-activated buffer solution (PABS) and plasma-activated water (PAW) combined with ultrasonication (U) treatment on the reduction of chlorothalonil fungicide and the quality of tomato fruits during storage. To obtain PAW and PABS, an atmospheric air plasma jet was used to treat buffer solution and deionized water at different treatment times (5 and 10 min). For combined treatments, fruits were submerged in PAW and PABS, then sonicated for 15 min, and individual treatment without sonication. As per the results, the maximum chlorothalonil reduction of 89.29% was detected in PAW-U10, followed by 85.43% in PABS. At the end of the storage period, the maximum reduction of 97.25% was recorded in PAW-U10, followed by 93.14% in PABS-U10. PAW, PABS, and both combined with ultrasound did not significantly affect the overall tomato fruit quality in the storage period. Our results revealed that PAW combined with sonication had a significant impact on post-harvest agrochemical degradation and retention of tomato quality than PABS. Conclusively, the integrated hurdle technologies effectively reduce agrochemical residues, which helps to lower health hazards and foodborne illnesses.

An Appraisal of pH triggered Bacitracin drug release, through composite hydrogel systems.

Comparative investigations on environmentally triggered drug delivery and wound healing characteristics of flexible hydrogel composites, Chitosan-Gelatin (C/G) and 2-Hydroxyethyl Methacrylate-Gelatin (H/G); are presented here. These composites, prepared through facile synthesis and curing methods, indicate the potential to smartly respond to the pH changes in wounds by releasing drug simultaneously and aiding in faster healing. An in-vitro investigation of the composite characteristics were included testing for Equilibrium Water Capacity Studies, Fourier Transform Infrared Spectroscopy (FTIR) investigations as well as UV based drug release and gravimetric hydrogel degradation profiles. This was followed by cutaneous application testing of the hydrogel systems in balb-c mice. Observations and testing results indicated the potential applicability of the hydrogel systems as dressings for topical/transdermal applications, provided that further detailed in-vivo characteristics are accounted for.

High-intensity ultrasonication impact on the chlorothalonil fungicide and its reduction pathway in spinach juice.

Among different novel technologies, sonochemistry is a sustainable emerging technology for food processing, preservation, and pesticide removal. The study aimed to probe the impact of high-intensity ultrasonication on chlorothalonil fungicide degradation, reduction pathway, and bioactive availability of spinach juice. The chlorothalonil fungicide-immersed spinach juice was treated with sonication at 360 W, 480 W, and 600 W, 40 kHz, for 30 and 40 min at 30 ± 1 °C. The highest reduction of chlorothalonil fungicide residues was observed at 40 min sonication at 600 W. HPLC-MS (high-performance liquid chromatography-mass spectroscopy) analysis revealed the degradation pathway of chlorothalonil and the formation of m-phthalonitrile, 3-cyno-2,4,5,6-tetrachlorobenamide, 4-dichloroisophthalonitrile, trichloroisophtalonitrile, 4-hydoxychlorothalonil, and 2,3,4,6-tetrachlorochlorobenzonitrile as degradation products. High-intensity sonication treatments also significantly increased the bioavailability of phenolic, chlorophyll, and anthocyanins and the antioxidant activity of spinach juice. Our results proposed that sonication technology has excellent potential in degrading pesticides through free radical reactions formation and pyrolysis. Considering future perspectives, ultrasonication could be employed industrially to reduce pesticide residues from agricultural products and enhance the quality of spinach juice.

Sustainable emerging sonication processing: Impact on fungicide reduction and the overall quality characteristics of tomato juice.

Sonication is an emerging sustainable and eco-friendly technology that has been broadly explored in food processing and preservation. Sonication has the edges of low energy consumption and high efficiency than conventional decontamination methods and would not pass on secondary pollutants. In the current research, we analyzed the impact of sonication on anilazine fungicide reduction, bioactive compound, antioxidant activity, colloidal stability, and enzymatic and microbial load of tomato juice. Sonicated treatments were carried out at 40 kHz, 480 W, 30 ± 2 °C for 0, 8, 16, 24, 32, and 40 min in an ultrasonic bath cleaner. The GC-MS outcomes revealed that the anilazine maximum reduction in tomato juice attained 80.52 % at 40 min of sonication. The anilazine concentration reduced significantly (p ≤ 0.05) with increased sonication time. In contrast, sonication treatments have acquired the highest TFC, TPC, ascorbic acid, carotenoids, lycopene, ABTS, and ORAC assay than the untreated sample. The Sonication process significantly improved (p ≤ 0.05) colloidal stability by reducing particle size distribution, apparent viscosity, and sedimentation index. Sonication prolonged tomato juice's shelf life by reducing the total viable count from 6.31 to 1.91 log CFU/mL. Polygalacturonase and pectin methyl esterase of the sonication sample at 40 min were inactivated by 44.32 % and 64.2 %, respectively. Considering this issue from a future perspective, sonication processing can be used industrially to enhance fruit juice's nutritional properties and shelf life and reduce pesticides and other organic residues.

Quality Improvement Through Nurse-initiated Kaiser Sepsis Calculator at a County Hospital.

BACKGROUND AND OBJECTIVES: Suspected early onset sepsis drives most antibiotic use in the newborn nursery. The Kaiser Sepsis Calculator (KSC) is a validated tool that safely decreases laboratory evaluation and antibiotic administration in infants aged ≥34 weeks. Our quality improvement aim was a nurse-initiated, KSC-based program to decrease blood cultures (BCx) and complete blood counts (CBC) by 10% from March 2021 to October 2021 among chorioamnionitis-exposed infants born ≥35 weeks' gestation. A secondary aim was to decrease antibiotic administration by 10%. METHODS: The KSC was implemented for infants at University Health, a county hospital affiliate of the University of Texas Health Science Center San Antonio, with a level I nursery and level IV NICU. The multidisciplinary project included pediatric hospitalists, neonatologists, family practitioners, maternal-fetal medicine physicians, fellows, residents, and nurses. All infants born 6 months before (August 2020-January 2021) and 7 months after protocol implementation (March 2021-September 2021) were analyzed. RESULTS: A total of 53 chorioamnionitis-exposed infants were included from the preintervention period and 51 from the postintervention period. CBC utilization decreased from 96% to 27%, BCx utilization decreased from 98% to 37%, and antibiotic utilization fell from 25% to 16%. In no cases were antibiotics prescribed against the KSC, and to our knowledge, no early onset sepsis diagnoses or infection-related hospital readmissions were missed. CONCLUSIONS: The multidisciplinary implementation of the KSC led to a reduction in testing, exceeding our initial goal. A nurse-initiated protocol reduced BCx, CBC, and antibiotic utilization among chorioamnionitis-exposed infants.

Probing the impact of sustainable emerging sonication and DBD plasma technologies on the quality of wheat sprouts juice.

Sonication and dielectric barrier discharge (DBD) plasma are sustainable emerging food processing technologies. The study investigates the impact of sonication, DBD-plasma, and thermal treatment (TT) on wheat sprout juice. The obtained results indicated a significant (p < 0.05) increase in chlorophyll, total phenolics, flavonoids, DPPH assay, and ORAC assay after DBD-plasma (40 V) and sonication (30 mins) treatment as compared to TT and untreated samples. Both emerging technologies significantly (p < 0.05) reduce the polyphenol oxidase and peroxidase activities, but the TT sample had the highest reduction. Moreover, the synergistic application of both technologies significantly reduced the E. coli/Coliform, aerobics, yeast and mold up to the 2 log reduction, but the TT sample had a complete reduction. DBD-plasma and sonication processing significantly decreased (p < 0.05) the particle size, reducing apparent viscosity (η) and consistency index (K); while increasing the flow behavior (n), leading to higher stability of wheat sprout juice. To assess the impact of emerging techniques on nutrient concentration, we used surface-enhance Raman spectroscopy (SERS) as an emerging method. Silver-coated gold nano-substrates were used to compare the nutritional concentration of wheat sprout juice treated with sonication, DBD-plasma, and TT-treated samples. Results showed sharp peaks for samples treated with DBD-plasma followed by sonication, untreated, and TT. The obtained results, improved quality of wheat sprout juice, and lower microbial and enzymatic loads were confirmed, showing the suitability of these sustainable processing techniques for food processing and further research.

Phenotype-based drug screening: An in vivo strategy to classify and identify the chemical compounds modulating zebrafish M-cell regeneration.

Several disease-modulatory FDA-approved drugs are being used in patients with neurodegenerative diseases. However, information on their toxicity-related profiles is very limited. Therefore, measurement of drug toxicity is essential to increase the knowledge of their side effects. This study aimed to identify compounds that can modulate M-cell regeneration by causing neuro-protection and -toxicity. Here, we developed a simple and efficient in vivo assay using Tg (hsp: Gal4FF62A; UAS: nfsB-mCherry) transgenic zebrafish larvae. Interestingly, via the phenotype-based drug screening approach, we rapidly investigated 1,260 compounds from the United States drug collection and validated these in large numbers, including 14 compounds, that were obstructing this regeneration process. Next, 4 FDA-approved drugs out of 14 compounds were selected as the lead hits for in silico analysis to clarify their binding patterns with PTEN and SOCS3 signaling due to their significant potential in the inhibition of axon regeneration. Molecular docking studies indicated good binding affinity of all 4 drugs with the respective signaling molecules. This may point to PTEN and SOCS3 as the signaling molecules responsible for reducing axon regeneration. Moreover, the acute effect of compounds in reducing M-cell regeneration delineated their toxic effect. In conclusion, our in vivo along with in silico screening strategy will promote the rapid translation of new therapeutics to improve knowledge of the toxicity profile of approved/non-approved drugs efficiently.

Oxidative stress and metabolic diseases: Relevance and therapeutic strategies.

Metabolic syndrome (MS) is a prominent cause of death worldwide, posing a threat to the global economy and public health. A mechanism that causes the oxidation of low-density lipoproteins (LDL) is associated with metabolic abnormalities. Various processes are involved in oxidative stress (OS) of lipoprotein. Although the concept of the syndrome has been fiercely debated, this confluence of risk factors is associated with a higher chance of acquiring type 2 diabetes mellitus (T2DM) and atherosclerosis. Insulin resistance has been found to play a significant role in the progression of these metabolism-associated conditions. It causes lipid profile abnormalities, including greater sensitivity to lipid peroxidation, contributing to the increased prevalence of T2DM and atherosclerosis. This review aims to cover the most recent scientific developments in dietary OS, the consequence of metabolic disorders, and their most significant clinical manifestations (T2DM and atherosclerosis). It will also emphasize the effects of dietary approaches in alleviating OS in MS.

Temporal Cortex Microarray Analysis Revealed Impaired Ribosomal Biogenesis and Hyperactivity of the Glutamatergic System: An Early Signature of Asymptomatic Alzheimer's Disease.

Pathogenic aging is regarded as asymptomatic AD when there is no cognitive deficit except for neuropathology consistent with Alzheimer's disease. These individuals are highly susceptible to developing AD. Braak and Braak's theory specific to tau pathology illustrates that the brain's temporal cortex region is an initiation site for early AD progression. So, the hub gene analysis of this region may reveal early altered biological cascades that may be helpful to alleviate AD in an early stage. Meanwhile, cognitive processing also drags its attention because cognitive impairment is the ultimate result of AD. Therefore, this study aimed to explore changes in gene expression of aged control, asymptomatic AD (AsymAD), and symptomatic AD (symAD) in the temporal cortex region. We used microarray data sets to identify differentially expressed genes (DEGs) with the help of the R programming interface. Further, we constructed the protein-protein interaction (PPI) network by performing the STRING plugin in Cytoscape and determined the hub genes via the CytoHubba plugin. Furthermore, we conducted Gene Ontology (GO) enrichment analysis via Bioconductor's cluster profile package. Resultant, the AsymAD transcriptome revealed the early-stage changes of glutamatergic hyperexcitability. Whereas the connectivity of major hub genes in this network indicates a shift from initially reduced rRNA biosynthesis in the AsymAD group to impaired protein synthesis in the symAD group. Both share the phenomenon of breaking tight junctions and others. In conclusion, this study offers new understandings of the early biological vicissitudes that occur in the brain before the manifestation of symAD and gives new promising therapeutic targets for early AD intervention.

A Remarkable Case of Acute Motor-Sensory Axonal Polyneuropathy (AMSAN) Variant of Guillain Barré Syndrome, in a Diabetic Patient Infected With COVID-19: A Case Report and Review of the Literature.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease- 2019 (COVID-19), has been a global epidemic in our healthcare system. SARS-CoV-2 primarily affects the respiratory system, but neurological involvement has also been reported, including Guillain-Barré syndrome (GBS) development. Case Presentation: A 58-year-old male with known co-morbid hypertension and type 2 diabetes mellitus presented to the emergency room with complaints of worsening shortness of breath, dry cough, and fever for the past 10 days. On day 20 of hospitalization, he developed neurological symptoms after being tested positive for COVID-19. A neuroelectrophysiology study was conducted to evaluate neurological symptoms and suggested that the patient suffers from acute motor-sensory axonal polyneuropathy (AMSAN). CSF analysis showed elevated protein levels that confirmed the diagnosis of GBS. He was subsequently treated with oral prednisolone and IVIG, which improved neurological symptoms. Conclusion: Ever since the emergence of COVID-19, GBS has surfaced as to its potentially dangerous outcome. Healthcare professionals should be mindful of GBS and should rule it out in anyone having sensory symptoms or weakness during or after a COVID-19 infection. Its early detection and treatment can result in improved clinical outcomes.

A novel case of lupus nephritis and mixed connective tissue disorder in a COVID-19 patient.

Introduction: Mixed connective tissue disease (MCTD) is a rare autoimmune condition characterized by Scleroderma, Polymyositis, and Systemic Lupus Erythematous (SLE). Though a possible relationship between COVID-19 and autoimmune diseases has been recently reported, its pathophysiological mechanism behind flares in Lupus Nephritis (LN), a complication of SLE, remains unknown. Case presentation: A 22-year-old COVID-19 positive female presented with anemia, bilateral pitting edema, periorbital swelling, and posterior cervical lymphadenitis. Further inspection revealed lower abdominal striae, hepatosplenomegaly, and hyperpigmented skin nodules. Complete blood counts showed elevated inflammatory markers and excessively high protein creatinine ratio. Antinuclear antibody titers were elevated (anti-smith and U1 small nuclear ribonucleoprotein) and Rheumatoid Factor was positive. She was diagnosed with MCTD associated with a flare of LN. To control her lupus flare, a lower dose of steroids was initially administered, in addition to oral hydroxychloroquine and intravenous cyclophosphamide. Her condition steadily improved and was discharged on oral steroid maintenance medication. Discussion: We present a rare phenomenon of newly diagnosed LN, a complication of SLE, with MCTD in a PCR-confirmed COVID-19 patient. The diagnostic conundrum and treatment hurdles should be carefully addressed when patients present with lupus and COVID-19 pneumonia, with further exploration of the immuno-pathophysiology of COVID-19 infection in multi-systemic organ dysfunction in autoimmune disorders. Conclusion: In COVID-19 patients with LN and acute renal injury, it is critical to promptly and cautiously treat symptomatic flares associated with autoimmune disorders such as SLE and MCTD that may have gone unnoticed to prevent morbidity from an additional respiratory infection.

Unilateral Biportal Endoscopic Tumor Removal and Percutaneous Stabilization for Extradural Tumors: Technical Case Report and Literature Review.

Background: Extradural spinal tumors arise from soft or bony tissues in the spine and account for majority of spinal tumors. Interest in the unilateral biportal endoscopic (UBE) technique is rising, because it can easily decompress the bony spinal canal and accommodate all open surgical instruments under endoscopic guidance. However, reports of this technique have been limited to certain diseases. This study first demonstrates the UBE technique for extradural tumor biopsy and removal, and percutaneous stabilization in a 72-year-old female patient with dramatic symptom improvement. Methods: We used the UBE technique for decompression and the percutaneous screw fixation technique for stabilization in a patient with an extradural mass compressing the thecal sac and destroying the posterior element. Under endoscopic guidance, a unilateral approach was used, and decompression and flavectomy were performed bilaterally. After decompression, tumor removal and biopsy were performed using various forceps and biopsy needles. After confirming sufficient spinal canal decompression, the screw was placed percutaneously. We evaluated the technical process of the procedure, the patient's pre- and postoperative pain (using the visual analog scale), and operative radiology and pathologic results. Results: Postoperative pain and disability improved clinically, and spinal alignment stabilized radiologically. As the pathology findings confirmed an aneurysmal bone cyst, the treatment was completed without adjuvant therapy. Conclusions: We treated an unstable spine due to an extradural tumor with the UBE and percutaneous screw techniques.

Evolutionary perspective of drug eluting stents: from thick polymer to polymer free approach.

BACKGROUND: Introduction of Bare Metal Stents (BMS) was itself a revolutionary step in the history of the medical industry; however, Drug Eluting Stents (DES) maintained its superiority over BMS in every aspect from restenosis rate to late lumen loss. The reason behind the magnanimous position of the DES in the stent market is the degree of improvement with which it evolves. New and better stents come into the market every year, surpassing their predecessors by many folds. LITERATURE REVIEW: This review paper discusses the journey of DES with supporting clinical trials in detail. In the first generation, there were stainless-steel stents with thicker coatings. Although they had superior results compared to BMS, there was still room for improvement. Afterward came the second-generation stents, which had superior metal platforms with thinner struts and thin coatings. The drugs were also changed from Paclitaxel and Sirolimus to Zotrolimus and Everolimus. These stents performed best; however, there was an issue of permanent coating, which remained intact over the stent surface after complete drug elution and started to cause issues in longer-term studies. Hence, an improved version of DES was introduced to these permanent coatings called the third generation of drug eluting stents, which initially utilized biodegradable polymer and ultimately moved towards polymer free drug coatings. This generation has introduced a unique amalgam of technologies to achieve its polymer free coatings; however, researchers have numerous prospects of growth in this field. This review paper highlights the major coups of stent technology evolution from BMS to DES, from thick polymeric coatings to thin coatings and from durable polymers to polymer free DES. CONCLUSION: In conclusion, though the medical industry promptly accepted BMS as the best treatment option for cardiovascular diseases; however, DES has provided even better results than BMS. In DES, the first and second generation has ruled the technology for many years and are still on the shelves. Still, the issues aroused due to durable polymer shifted the attention towards biodegradable drug eluting stents, the third generation growing rapidly. But the scientific community has not restricted themselves and is investigating bioresorbable stents that completely eliminate the polymer intervention in drug eluting stent technology.