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1.
Cureus ; 16(6): e62052, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38989362

RESUMO

Recent studies suggest a potential association between myocardial bridging (MB) and accelerated atherosclerotic plaque formation. We describe the case report of a 37-year-old South Asian male with no established risk factors for coronary artery disease (CAD) who presented with a non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) with a coincident widowmaker lesion and severe MB. He was successfully managed with comprehensive guideline-directed medical therapy (GDMT) and urgent percutaneous coronary intervention (PCI) of the culprit lesion, sparing the MB segment. The clinician should be cognizant of MB implicating ACS as a major adverse cardiovascular event (MACE) and its key management strategies.

2.
Cureus ; 16(2): e54601, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38384868

RESUMO

INTRODUCTION: This retrospective study investigated the effectiveness and safety of left distal transradial access (LDTRA) in patients with cardiovascular disease in Trinidad undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). METHOD: Procedural parameters, including technical success and safety outcomes such as vascular complications and radial artery occlusion (RAO), were assessed in 111 consecutive patients undergoing CAG or PCI from January 2023 to June 2023 at the Eric Williams Medical Sciences Complex, Trinidad and Tobago. Eighty-eight patients underwent LDTRA, while 23 received left transradial access (LTRA). RESULTS: There was no difference in procedural success with LDTRA compared to LTRA, 90.9% vs. 100%, p-value 0.202, non-significant (ns). LDTRA was associated with shorter fluoroscopy times (8.4 ± 6.8 minutes vs. 12.4 ± 7.7 minutes, p-value = 0.02), procedural duration (26.7 ± 18 minutes vs. 35.8 ± 20 minutes, p-value = 0.04), and hemostasis time (142 ± 41 minutes vs. 186 ± 44 minutes, p-value < 0.05). There were no significant differences in procedural-related complications (8% for LDTRA vs. 4.3% for LTRA, p-value = 0.476, ns). There were no reported cases of RAO. In the subgroup of patients with prior coronary artery bypass grafting (CABG), the fluoroscopy and procedure times were similar for both access sites; however, LDTRA was associated with a shorter hemostasis time (128 ± 30 minutes vs. 194 ± 39 minutes, p-value = 0.01). CONCLUSIONS: LDTRA is effective and safe for coronary procedures and is associated with a shorter hemostasis time. This study may prove clinically pertinent in a limited-resource Caribbean setting.

3.
Food Sci Biotechnol ; 33(4): 791-804, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38371681

RESUMO

A clear vision for the future of the world's food supply must be developed by all stakeholders, including consumers, farmers, and governments, especially in light of the rapid improvements in the production of genetically modified crops. It has been possible through biotechnology and genetic engineering, genetically modified (GM) crops have been engineered to have certain qualities, such as resistance to pests, illnesses, or herbicides. Concerns about risks and unintended effects of GM crops include ecosystem impacts, new pests or diseases, and health effects on humans and animals. There is mounting evidence that consumers may respond unfavourably to the introduction of genetically altered foods. This research focuses at how genetic engineering can raise agricultural yields, improve nutrient content, and lessen the use for hazardous pesticides and herbicides in food production. Regulatory framework for GM foods may impact on perception and acceptance of consumers.

4.
Cureus ; 14(7): e26740, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35836715

RESUMO

Ludwig's angina describes fulminant cellulitis involving the oro- and hypopharynx, which typically stems from bacterial pathogens, whereas "pseudo-Ludwig's angina" is ascribed to sublingual swelling due to noninfectious causes. There is a paucity of case reports implicating warfarin as the culprit for sublingual hematoma mimicking Ludwig's angina; however, we describe a novel case of apixaban-induced pseudo-Ludwig's angina, which was successfully managed with urgent surgical intervention and supportive care with antibiotic and glucocorticoid therapy.

5.
Front Plant Sci ; 13: 829118, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35251100

RESUMO

Raffinose family oligosaccharides (RFOs) are widespread across the plant kingdom, and their concentrations are related to the environment, genotype, and harvest time. RFOs are known to carry out many functions in plants and humans. In this paper, we provide a comprehensive review of RFOs, including their beneficial and anti-nutritional properties. RFOs are considered anti-nutritional factors since they cause flatulence in humans and animals. Flatulence is the single most important factor that deters consumption and utilization of legumes in human and animal diets. In plants, RFOs have been reported to impart tolerance to heat, drought, cold, salinity, and disease resistance besides regulating seed germination, vigor, and longevity. In humans, RFOs have beneficial effects in the large intestine and have shown prebiotic potential by promoting the growth of beneficial bacteria reducing pathogens and putrefactive bacteria present in the colon. In addition to their prebiotic potential, RFOs have many other biological functions in humans and animals, such as anti-allergic, anti-obesity, anti-diabetic, prevention of non-alcoholic fatty liver disease, and cryoprotection. The wide-ranging applications of RFOs make them useful in food, feed, cosmetics, health, pharmaceuticals, and plant stress tolerance; therefore, we review the composition and diversity of RFOs, describe the metabolism and genetics of RFOs, evaluate their role in plant and human health, with a primary focus in grain legumes.

6.
Front Public Health ; 10: 818545, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35252095

RESUMO

We report here a Nipah virus (NiV) outbreak in Kozhikode district of Kerala state, India, which had caused fatal encephalitis in a 12-year-old boy and the outbreak response, which led to the successful containment of the disease and the related investigations. Quantitative real-time reverse transcription (RT)-PCR, ELISA-based antibody detection, and whole genome sequencing (WGS) were performed to confirm the NiV infection. Contacts of the index case were traced and isolated based on risk categorization. Bats from the areas near the epicenter of the outbreak were sampled for throat swabs, rectal swabs, and blood samples for NiV screening by real-time RT-PCR and anti-NiV bat immunoglobulin G (IgG) ELISA. A plaque reduction neutralization test was performed for the detection of neutralizing antibodies. Nipah viral RNA could be detected from blood, bronchial wash, endotracheal (ET) secretion, and cerebrospinal fluid (CSF) and anti-NiV immunoglobulin M (IgM) antibodies from the serum sample of the index case. Rapid establishment of an onsite NiV diagnostic facility and contact tracing helped in quick containment of the outbreak. NiV sequences retrieved from the clinical specimen of the index case formed a sub-cluster with the earlier reported Nipah I genotype sequences from India with more than 95% similarity. Anti-NiV IgG positivity could be detected in 21% of Pteropus medius (P. medius) and 37.73% of Rousettus leschenaultia (R. leschenaultia). Neutralizing antibodies against NiV could be detected in P. medius. Stringent surveillance and awareness campaigns need to be implemented in the area to reduce human-bat interactions and minimize spillover events, which can lead to sporadic outbreaks of NiV.


Assuntos
COVID-19 , Vírus Nipah , Criança , Surtos de Doenças , Humanos , Masculino , Vírus Nipah/genética , Pandemias , SARS-CoV-2
7.
Indian J Med Res ; 156(4&5): 669-673, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36926784

RESUMO

Background & objectives: There are limited data from India on the post-COVID multisystem inflammatory syndrome in adults (MIS-A). The objective of the present study was to evaluate the clinical profile of patients with MIS-A admitted to a tertiary care centre in southern India. Methods: This single-centre retrospective study was conducted from November 2020 to July 2021, and included patients aged >18 yr admitted to the hospital as per the inclusion and exclusion criteria. Results: Nine patients (5 male, mean age 40±13 yr) met the criteria for MIS-A. Five patients had proven COVID-19 infection or contact history 36.8±11.8 days back. All patients were positive for SARS-CoV-2 IgG antibody, negative for COVID-19 PCR, and had negative blood, urine and sputum cultures. All patients had fever and gastrointestinal (GI) symptoms, and five patients had left ventricular dysfunction. All patients had neutrophilic leucocytosis at presentation and elevated biomarkers such as C-reactive protein serum procalcitonin, D-dimer and ferritin. The majority of the patients (7/9 i.e. 77.78%) were treated with intravenous hydrocortisone (50-100 mg q6h-q8h). Six patients recovered completely whereas three patients expired. Interpretation & conclusions: Fever and GI symptoms were the most common presentation of MIS-A. Elevated serum procalcitonin may not be useful in differentiating bacterial sepsis from MIS-A. Most patients responded to corticosteroids.


Assuntos
COVID-19 , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , COVID-19/complicações , SARS-CoV-2 , Centros de Atenção Terciária , Estudos Retrospectivos , Pró-Calcitonina , Febre , Índia/epidemiologia
8.
Am J Forensic Med Pathol ; 43(1): 66-68, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33950883

RESUMO

ABSTRACT: Imidacloprid (IMI) is a systemic insecticide that belongs to the neonicotinoid group of insecticides. It is highly effective against sucking, boring, and root-feeding insects. Besides, it has a favorable toxicological profile on humans. Currently, IMI is the largest selling insecticide in the world by replacing organophosphates and carbamates. It acts as nicotinic acetylcholine receptor agonist in the central nervous system of insects. To date, there is no specific antidote available for IMI poisoning. Despite a better safety profile on humans, severe toxicity from IMI poisoning is not uncommon. Here, we report a series of 4 cases who were admitted to our tertiary care center with a history of IMI poisoning.


Assuntos
Inseticidas , Receptores Nicotínicos , Humanos , Neonicotinoides , Nitrocompostos
9.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-21267278

RESUMO

BackgroundWe report here a Nipah virus (NiV) outbreak in Kozhikode district of Kerala state, India which had caused fatal encephalitis in an adolescent male and the outbreak response which led to the successful containment of the disease and the related investigations. MethodsQuantitative real-time RT-PCR, ELISA based antibody detection and whole genome sequencing were performed to confirm the Nipah virus infection. Contacts of the index case were traced and isolated based on risk categorization. Bats from the areas near the epicenter of the outbreak were sampled for throat swabs, rectal swabs and blood samples for Nipah virus screening by real time RT-PCR and anti-Nipah virus bat IgG ELISA. Plaque reduction neutralization test was performed for the detection of neutralizing antibodies. ResultsNipah viral RNA and anti-NiV IgG antibodies were detected in the serum of the index case. Rapid establishment of an onsite NiV diagnostic facility and contact tracing helped in quick containment of the outbreak. NiV sequences retrieved from the clinical specimen of the index case formed a sub-cluster with the earlier reported Nipah I genotype sequences from India with more than 95% similarity. Anti-NiV IgG positivity could be detected in 21% of Pteropus medius and 37.73% of Rousettus leschenaultia. Neutralizing antibodies against NiV could be detected in P.medius. ConclusionsStringent surveillance and awareness campaigns needs to be implemented in the area to reduce human-bat interactions and minimize spill over events which can lead to sporadic outbreaks of NiV.

10.
Cureus ; 13(7): e16681, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34466318

RESUMO

The Africanized honey bee commonly referred to as the "killer bee," is a hybrid of the East African lowland honey bee with various European honey bees. These bees tend to be more hostile as compared to other bee species. Their stings may have devastating clinical sequelae, including cardiovascular, cerebrovascular events, and fatalities. We report the first-in-Caribbean case of a middle-aged woman who experienced stress-related, Takotsubo cardiomyopathy (also known as stress-related cardiomyopathy [SRC]) after being afflicted with innumerable Africanized honey bee stings. Key clinical message: The clinician should be cognizant of Takotsubo's cardiomyopathy as a potential sequela of Hymenoptera envenomation and anaphylaxis.

11.
Cureus ; 13(3): e13890, 2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33880246

RESUMO

We describe a case of a suspected cutaneous hypersensitivity reaction to ticagrelor. The patient displayed a localized bullous fixed drug eruption after being loaded with ticagrelor, which resolved with oral antihistamines and topical steroids after one week. Clopidogrel and rivaroxaban were successfully administered as alternative antithrombotic therapy without any apparent further hypersensitivity skin reaction.

12.
Mol Carcinog ; 57(9): 1130-1143, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29683208

RESUMO

Pancreatic Cancer (PC) is a deadly disease in need of new therapeutic options. We recently developed a novel tricarbonylmethane agent (CMC2.24) as a therapeutic agent for PC, and evaluated its efficacy in preclinical models of PC. CMC2.24 inhibited the growth of various human PC cell lines in a concentration and time-dependent manner. Normal human pancreatic epithelial cells were resistant to CMC2.24, indicating selectivity. CMC2.24 reduced the growth of subcutaneous and orthotopic PC xenografts in mice by up to 65% (P < 0.02), and the growth of a human patient-derived tumor xenograft by 47.5% (P < 0.03 vs vehicle control). Mechanistically, CMC2.24 inhibited the Ras-RAF-MEK-ERK pathway. Based on Ras Pull-Down Assays, CMC2.24 inhibited Ras-GTP, the active form of Ras, in MIA PaCa-2 cells and in pancreatic acinar explants isolated from Kras mutant mice, by 90.3% and 89.1%, respectively (P < 0.01, for both). The inhibition of active Ras led to an inhibition of c-RAF, MEK, and ERK phosphorylation by 93%, 91%, and 87%, respectively (P < 0.02, for all) in PC xenografts. Furthermore, c-RAF overexpression partially rescued MIA PaCa-2 cells from the cell growth inhibition by CMC2.24. In addition, downstream of ERK, CMC2.24 inhibited STAT3 phosphorylation levels at the serine 727 residue, enhanced the levels of superoxide anion in mitochondria, and induced intrinsic apoptosis as shown by the release of cytochrome c from the mitochondria to the cytosol and the further cleavage of caspase 9 in PC cells. In conclusion, CMC2.24, a potential Ras inhibitor, is an efficacious agent for PC treatment in preclinical models, deserving further evaluation.


Assuntos
Antineoplásicos/uso terapêutico , Proliferação de Células/efeitos dos fármacos , Curcumina/análogos & derivados , Neoplasias Pancreáticas/tratamento farmacológico , Transdução de Sinais/efeitos dos fármacos , Proteínas ras/metabolismo , Animais , Antineoplásicos/farmacologia , Linhagem Celular Tumoral , Curcumina/farmacologia , Curcumina/uso terapêutico , Feminino , Humanos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos NOD , Camundongos Nus , Camundongos SCID , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/patologia
13.
Coron Artery Dis ; 28(2): 166-172, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27845996

RESUMO

Highly active antiretroviral treatment (HAART) has considerably increased the life expectancy of patients infected with HIV. Coronary artery disease is a leading cause of mortality in patients infected with HIV. This is primarily attributed to their increased survival, HAART-induced metabolic derangements, and to HIV itself. The pathophysiology of atherosclerosis in HIV is both multifactorial and complex - involving direct endothelial injury and dysfunction, hypercoagulability, and a significant contribution from traditional cardiac risk factors. The advent of HAART has since heralded a remarkable improvement in outcomes, but at the expense of other unforeseen issues. It is thus of paramount importance to swiftly recognize and manage acute coronary syndromes in HIV-infected patients to attenuate adverse complications, which should translate into improved clinical outcomes.


Assuntos
Síndrome Coronariana Aguda/epidemiologia , Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/mortalidade , Síndrome Coronariana Aguda/terapia , Fármacos Anti-HIV/efeitos adversos , Terapia Antirretroviral de Alta Atividade , Diagnóstico Precoce , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Humanos , Expectativa de Vida , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
14.
Nature ; 540(7632): 248-251, 2016 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-27929014

RESUMO

Unlike spiral galaxies such as the Milky Way, the majority of the stars in massive elliptical galaxies were formed in a short period early in the history of the Universe. The duration of this formation period can be measured using the ratio of magnesium to iron abundance ([Mg/Fe]) in spectra, which reflects the relative enrichment by core-collapse and type Ia supernovae. For local galaxies, [Mg/Fe] probes the combined formation history of all stars currently in the galaxy, including younger and metal-poor stars that were added during late-time mergers. Therefore, to directly constrain the initial star-formation period, we must study galaxies at earlier epochs. The most distant galaxy for which [Mg/Fe] had previously been measured is at a redshift of z ≈ 1.4, with [Mg/Fe] = . A slightly earlier epoch (z ≈ 1.6) was probed by combining the spectra of 24 massive quiescent galaxies, yielding an average [Mg/Fe] = 0.31 ± 0.12 (ref. 7). However, the relatively low signal-to-noise ratio of the data and the use of index analysis techniques for both of these studies resulted in measurement errors that are too large to allow us to form strong conclusions. Deeper spectra at even earlier epochs in combination with analysis techniques based on full spectral fitting are required to precisely measure the abundance pattern shortly after the major star-forming phase (z > 2). Here we report a measurement of [Mg/Fe] for a massive quiescent galaxy at a redshift of z = 2.1, when the Universe was three billion years old. With [Mg/Fe] = 0.59 ± 0.11, this galaxy is the most Mg-enhanced massive galaxy found so far, having twice the Mg enhancement of similar-mass galaxies today. The abundance pattern of the galaxy is consistent with enrichment exclusively by core-collapse supernovae and with a star-formation timescale of 0.1 to 0.5 billion years-characteristics that are similar to population II stars in the Milky Way. With an average past star-formation rate of 600 to 3,000 solar masses per year, this galaxy was among the most vigorous star-forming galaxies in the Universe.

16.
BMJ Case Rep ; 20142014 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-25342188

RESUMO

A 70-year-old woman on four antihypertensive drugs including diuretics presented with accelerated hypertension and acute pulmonary oedema. She had a bounding brachial pulse with feeble femoral pulses. A 256 slice CT scan revealed the presence of severe diffuse thoracoabdominal atherosclerosis. Cardiac catheterisation revealed 125 mm Hg gradient across the atherosclerotic segment at the level of thoracic 10-11 vertebrae. A self-deploying stent was implanted in the thoracoabdominal segment reducing the gradient across the disease segment to 20 mm Hg with a significant improvement in the luminal diameter of the aorta. Her upper limb blood pressure normalised on two antihypertensive drugs 6 weeks later.


Assuntos
Doenças da Aorta/complicações , Aterosclerose/complicações , Pressão Sanguínea , Procedimentos Endovasculares , Hipertensão/etiologia , Stents , Idoso , Anti-Hipertensivos/uso terapêutico , Doenças da Aorta/cirurgia , Aortografia , Aterosclerose/cirurgia , Determinação da Pressão Arterial , Cateterismo Cardíaco , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/cirurgia , Edema Pulmonar/etiologia , Edema Pulmonar/cirurgia , Pulso Arterial
17.
J Thromb Thrombolysis ; 36(3): 348-51, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23143651

RESUMO

Ischemic heart disease is uncommon during pregnancy, occurring in approximately 1/10,000 pregnancies resulting in live births. However, the increased age and fertility of mothers has suggested that the coexistence of pregnancy and coronary artery disease is likely to increase. A subject of debate is the management of dual antiplatelet therapy among pregnant women. The potential teratogeneous effects, particularly with regards to thienopyridines, on the fetus are not fully established. In addition, the use of dual antiplatelet therapy is associated with an increased risk for bleeding events, raising concerns in the peripartum period with regards to the route of delivery and choice of anesthestic techniques. Limited data and experience is available with clopidogrel, the most commonly used thienopyridine. Prasugrel is third generation thienopyridine recently introduced into clinical practice with ever growing use in the setting of acute coronary syndrome patients undergoing percutaneous coronary interventions. The present manuscript describes the first case report of a pregnancy while on prasugrel therapy.


Assuntos
Nascido Vivo , Isquemia Miocárdica/tratamento farmacológico , Piperazinas/administração & dosagem , Inibidores da Agregação Plaquetária/administração & dosagem , Complicações Cardiovasculares na Gravidez/tratamento farmacológico , Antagonistas do Receptor Purinérgico P2Y/administração & dosagem , Tiofenos/administração & dosagem , Adulto , Feminino , Humanos , Cloridrato de Prasugrel , Gravidez
18.
Nature ; 487(7407): 338-40, 2012 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-22810697

RESUMO

Although grand-design spiral galaxies are relatively common in the local Universe, only one has been spectroscopically confirmed to lie at redshift z > 2 (HDFX 28; z = 2.011); and it may prove to be a major merger that simply resembles a spiral in projection. The rarity of spirals has been explained as a result of disks being dynamically 'hot' at z > 2 (refs 2-5), which may instead favour the formation of commonly observed clumpy structures. Alternatively, current instrumentation may simply not be sensitive enough to detect spiral structures comparable to those in the modern Universe. At z < 2, the velocity dispersion of disks decreases, and spiral galaxies are more numerous by z ≈ 1 (refs 7, 13-15). Here we report observations of the grand-design spiral galaxy Q2343-BX442 at z = 2.18. Spectroscopy of ionized gas shows that the disk is dynamically hot, implying an uncertain origin for the spiral structure. The kinematics of the galaxy are consistent with a thick disk undergoing a minor merger, which can drive the formation of short-lived spiral structure. A duty cycle of <100 Myr for such tidally induced spiral structure in a hot massive disk is consistent with its rarity.

19.
Nature ; 469(7331): 479-81, 2011 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-21270883
20.
Econ Hum Biol ; 9(1): 23-9, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21126931

RESUMO

The present study examines patterns and socioeconomic and demographic correlates of adult height among Sri Lankan adults. Data were available for height and socio-demographic factors from a nationally representative cross-sectional sample of 4477 subjects above 18 years. Recruitment was between 2005 and 2006. Mean age of all subjects was 46.1±15.1 years. Mean height of males and females were 163.6±6.9cm and 151.4±6.4cm respectively. Mean height showed a significant negative correlation with age (p<0.001, r=-0.207). Highest mean height in females 154.0±5.9cm and males 165.6±6.9cm were observed in those born after 1977. Rural females (151.4±6.2cm) were significantly taller than the urban (151.3±7.2cm). However, this was not observed in males. In multivariate analysis, year of birth, level of education and household income were significantly associated with height. Height demonstrated a significant negative correlation with systolic blood pressure (r=-0.032), presence of diabetes (r=-0.069), total cholesterol (r=-0.106), HDL cholesterol (r=-0.142) and LDL cholesterol (r=-0.104). Height was associated with household income and level of education in Sri Lanka and demonstrated a distinct increasing trend over successive generations.


Assuntos
Estatura , Glicemia/metabolismo , Pressão Sanguínea/fisiologia , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Análise Multivariada , Valores de Referência , Análise de Regressão , Fatores Socioeconômicos , Sri Lanka , Estatística como Assunto
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