Device's design and clinical perspectives for resistant hypertension therapy.

Introduction: Hypertension is the leading cause of death in the cardiovascular system. Indeed, untreated hypertension can affect one's general health, but medicine can help hypertensive people reduce their chance of developing high blood pressure. However, secondary hypertension remains an unresolved illness. Areas covered: This review will go through the typical and unusual device-based therapies for resistant hypertension that have arisen in recent years. Further to that, the innovations developed in device-based RH treatment will be covered, as well as the research and studies assessing these novel technologies. Expert opinion: The innovative device-based techniques that target resistant hypertension provide a potential therapy that has been backed by a number of studies and clinical trials, whereas pharmacological non-adherence and increased sympathetic activity are recognized to be the primary causes of resistant hypertension. Nevertheless, some limitations will be critical for the future of these RH systems, with the device's design and larger RCTs playing a significant role in determining whether a position in routine treatment could be warranted.

Recurrent/Subsequent Stroke and Associated Outcomes in Geriatric Patients with OSA and Prior Stroke Events: A Retrospective Study Using the 2019 National Inpatient Sample.

Background: Obstructive sleep apnea (OSA) increases the risk of stroke and cardiovascular diseases. However, its impact on geriatric patients with a prior history of stroke/transient ischemic attack (TIA) has not been adequately studied. Methods: We utilized the 2019 National Inpatient Sample in the US to identify geriatric patients with OSA (G-OSA) who had a prior history of stroke/TIA. We then compared subsequent stroke (SS) rates among sex and race subgroups. We also compared the demographics and comorbidities of SS+ and SS- groups and utilized logistic regression models to assess outcomes. Results: Out of 133,545 G-OSA patients admitted with a prior history of stroke/TIA, 4.9% (6520) had SS. Males had a higher prevalence of SS, while Asian-Pacific Islanders and Native Americans had the highest prevalence of SS, followed by Whites, Blacks, and Hispanics. The SS+ group had higher all-cause in-hospital mortality rates, with Hispanics showing the highest rate compared to Whites and Blacks (10.6% vs. 4.9% vs. 4.4%, p < 0.001), respectively. Adjusted analysis for covariates showed that complicated and uncomplicated hypertension (aOR 2.17 [95% CI 1.78-2.64]; 3.18 [95% CI 2.58-3.92]), diabetes with chronic complications (aOR 1.28 [95% CI 1.08-1.51]), hyperlipidemia (aOR 1.24 [95% CI 1.08-1.43]), and thyroid disorders (aOR 1.69 [95% CI 1.14-2.49]) were independent predictors of SS. The SS+ group had fewer routine discharges and higher healthcare costs. Conclusions: Our study shows that about 5% of G-OSA patients with a prior history of stroke/TIA are at risk of hospitalization due to SS, which is associated with higher mortality and healthcare utilization. Complicated and uncomplicated hypertension, diabetes with chronic complications, hyperlipidemia, thyroid disorders, and admission to rural hospitals predict subsequent stroke.

The Efficacy and Safety of Imusil® Tablets in the Treatment of Adult Patients With Mild COVID-19: A Prospective, Randomized, Multicenter, Open-Label Study.

Introduction Coronavirus disease 2019 (COVID-19) is a serious concern of the new era. Along with antiviral synthetic medications, there is a need to discover efficacious herbal antiviral medicines with minimum side effects in patients against COVID-19. This study aimed to assess the efficacy and safety of Imusil® among patients with mild COVID-19. Methods A prospective, randomized, multicenter, open-label, interventional study was conducted in patients with mild COVID-19 infection. Patients received either Imusil one tablet four times a day (seven days) along with the standard of care (SoC) or only SoC. The study endpoints were reverse transcription-polymerase chain reaction (RT-PCR) negativity, changes in cycle threshold (CT), clinical improvement, change in blood inflammatory indexes, and safety assessment. Results A total of 100 patients were enrolled, and 98 received at least one dose of treatment. The median age of patients was 36.0 years, and 58 were males. By day 4, 85.4% of patients in the Imusil+SoC group tested negative for RT-PCR compared to 64% of patients exhibiting the same outcome in the SoC group (P=0.0156). After eight days, clinical improvement was observed in all patients from the Imusil+SoC group, while in the SoC group, clinical improvement was observed in 94.0% of patients (P=0.4947). During follow-up visits, the average C-reactive protein (CRP) levels decreased from baseline in both treatment groups. The decrease in the levels of CRP (-7.3 mg/dL versus -5.5 mg/dL), D-dimer (-231.0 ng/mL versus -151.6 ng/mL), and interleukin 6 (IL-6) (-2.3 pg/mL versus -2.0 pg/mL) at eight days was comparatively higher in the Imusil+SoC group versus the SoC group. There were no serious treatment-emergent adverse events in the drug arm. Conclusion Imusil provides effective antiviral activity and safety in mild COVID-19 patients. Imusil ensures faster RT-PCR negativity and clinical improvement and ensures effective reduction of inflammatory markers such as CRP, D-dimer and interleukin 6.

Prevalence of Entamoeba histolytica and Giardia Lamblia Associated with Diarrhea in Children referring to lbn Al-Atheer Hospital in Mosul, Iraq.

Amebiasis and giardiasis are major health problems caused by Entamoeba histolytica and Giardia Lamblia which are the two most common intestinal protozoan parasites with worldwide distribution, especially in developing countries. Both protozoa are spread by the fecal-oral route; that is to say, by eating or drinking contaminated food or water. The present study aimed to assess the prevalence of E. histolytica and G.lamblia in children with clinical signs of diarrhea referring to Ibn Al-Atheer Hospital in Mosul, Iraq, from January 2019 to December 2020. A total of 2,296 samples were examined by the direct swab of stool method. The patients were within the age range of less than 1 year and above 12 years. The results demonstrated that in 2019 and 2020, the prevalence rates of E. histolytica infections were (152, 13.2%) and (181, 15.7%); moreover, the prevalence rates of G.lamblia were obtained at (10, 0.86%) and (12, 1.04%) (P<0.01). The prevalence of intestinal parasite infections was significantly associated with age and gender, and the prevalence of both E. histolytica and G.lamblia infections were higher in males. Furthermore, the highest and lowest prevalence rates of E. histolytica and G.lamblia infections were reported in the age groups of under 1 year and above 12 years (P<0.05). The high prevalence of protozoan infection in the age group of under 1 year can be attributed to their lack of developed immunity system and resistance. Due to disease transmission, the enhancement of health conditions is of utmost importance in controlling the prevalence of intestinal protozoan parasites.

Noninvasive prediction of carotid artery atherosclerosis by multiple abdominal fat indices measured via ultrasonography

Purpose@#The purpose of this study was to evaluate the efficiency of multiple abdominal fat indices as measured via ultrasonography for predicting the presence and severity of carotid artery atherosclerosis and to compare the predictive capacity of ultrasonographic measurements to that of anthropometric measurements. @*Methods@#A total of 92 patients were included in this study. All participants underwent clinical and laboratory assessments, and anthropometric measurements were obtained. Ultrasound examinations were performed to measure the values of all abdominal fat indices and the intimamedia thickness, as well as to detect the presence of atherosclerotic plaques. Univariate and multivariate logistic regression analyses were performed. @*Results@#In the multivariate analysis, significant associations were detected between carotid artery atherosclerosis and posterior right perinephric fat thickness (PRPFT) (hazard ratio [HR], 15.23; P<0.001), preperitoneal fat thickness (PPFT) (HR, 4.31; P=0.003), visceral adipose tissue volume (VAT) (HR, 7.61; P<0.001), visceral fat thickness (VFT) (HR, 8.84; P<0.001), the ratio of VFT to subcutaneous fat thickness (VFT/SCFT) (HR, 9.39; P<0.001), and waist-to-height ratio (WHtR) (HR, 2.65; P=0.046). In the multivariate analysis, significant associations were also detected between carotid artery plaque and PRPFT (HR, 7.09; P<0.001), the abdominal wall fat index (AFI) (HR, 3.58; P=0.010), and VFT/SCFT (HR, 4.17; P=0.006). @*Conclusion@#Many abdominal fat indices as measured by ultrasound were found to be strong predictors of carotid artery atherosclerosis, including PRPFT, VFT/SCFT, VFT, VAT, PPFT, and WHtR. Moreover, PRPFT, VFT/SCFT, and AFI were identified as strong predictors of the presence of carotid artery plaque.

Beamforming Optimization in Internet of Things Applications Using Robust Swarm Algorithm in Conjunction with Connectable and Collaborative Sensors.

The integration of the Internet of Things (IoT) with Wireless Sensor Networks (WSNs) typically involves multihop relaying combined with sophisticated signal processing to serve as an information provider for several applications such as smart grids, industrial, and search-and-rescue operations. These applications entail deploying many sensors in environments that are often random which motivated the study of beamforming using random geometric topologies. This paper introduces a new algorithm for the synthesis of several geometries of Collaborative Beamforming (CB) of virtual sensor antenna arrays with maximum mainlobe and minimum sidelobe levels (SLL) as well as null control using Canonical Swarm Optimization (CPSO) algorithm. The optimal beampattern is achieved by optimizing the current excitation weights for uniform and non-uniform interelement spacings based on the network connectivity of the virtual antenna arrays using a node selection scheme. As compared to conventional beamforming, convex optimization, Genetic Algorithm (GA), and Particle Swarm Optimization (PSO), the proposed CPSO achieves significant reduction in SLL, control of nulls, and increased gain in mainlobe directed towards the desired base station when the node selection technique is implemented with CB.

Dilemma of adolescent varicocele: long-term outcome in patients managed surgically and in patients managed expectantly.

OBJECTIVE: To evaluate outcomes of adolescent varicocele in the case of surgical versus conservative management. METHODS: 173 adolescent patients presenting with varicocele were evaluated clinically and sonographically to define varicocele grade and testicular volume. The patients were divided into 2 groups: A (53) with testicular size discrepancy >20% and bilateral varicoceles; B (120) unilaterally affected patients with testicular size discrepancy <20%, who were randomly allocated into 2 equal sub-groups (B1 & B2) of 60 patients. Group A & B1 patients underwent 3× loupe magnified inguinal varicocelectomy while B2 patients were conservatively managed. RESULTS: Mean patient age was 14.3 years with mean testicular volume of 11.75 mL and 10.15 mL for right and left testicles, respectively. There were no significant differences between sub-groups B1 & B2 for age, mean testicular volume, size discrepancy and varicocele grade. Mean follow-up of group A & B1 patients was 78 months showing grade I varicocele recurrence (4 cases), catch-up growth in 70% of cases and normal semen analysis in all cases. Mean follow-up of group B2 patients was 79 months showing catch-up growth in 50% of cases and normal semen analysis in all but 1 case. Four cases were shifted to surgical treatment due to reduction of testicular size (2 cases), varicocele upgrade (1 case) and oligoasthenospermia (1 case). At the last follow-up, the mean testicular volume for groups A, B1 & B2 was 16.2, 16.45 & 16.3 mL for right testes and 14.7, 15.6 & 15.2 mL for left testes, respectively. There was significantly better catch-up growth in sub-group B1 compared to B2 but the testicular volume was not statistically different. CONCLUSIONS: Although adolescent varicocelectomy was associated with a higher percentage of patients showing testicular catch-up growth, the mean testicular volume was not significantly different. Further studies are needed to report on paternity among those patients.