A systematic review of clinical applications and diagnostic efficacy of intravascular optical coherence tomography in cardiology

Intravascular Optical Coherence Tomography (OCT) has emerged advanced imaging modality in cardiology, offering high-resolution visualization of coronary artery structures. Since its inception in the late 1990s, OCT has undergone significant advancements, transitioning from time-domain to frequency-domain systems, thereby enhancing its clinical viability and diagnostic efficacy. We aimed to comprehensively assess the clinical applications and diagnostic efficacy of intravascular OCT in cardiology, particularly in guiding percutaneous coronary interventions (PCI) and evaluating coronary artery diseases. In methodology, A systematic search was conducted in PubMed and Google Scholar databases for studies published between 2013 and 2023, comparing OCT with intravascular ultrasound (IVUS) and conventional angiography (C.A.) in guiding PCI procedures. Studies were selected based on predefined inclusion and exclusion criteria, focusing on major adverse cardiovascular events (MACE), cardiac death, and revascularizations as outcomes. In results we included 28 studies from databased and 3 manuals, highlighting OCT's superior resolution in identifying thin-capped fibroatheromas (TCFAs), optimizing stent placement, and assessing plaque composition. Comparative analyses revealed no significant differences in clinical efficacy between OCT and IVUS, with both modalities showing superiority over C.A. in reducing cardiovascular events. The OCTIVUS trial further confirmed the non-inferiority of OCT-guided PCI compared to IVUS-guided PCI, with lower procedural complications reported in the OCT group. In conclusion, Intravascular OCT has revolutionized the diagnostic and interventional landscape in cardiology, offering unparalleled insights into coronary artery pathology. Its high-resolution imaging capabilities facilitate accurate plaque characterization, stent optimization, and real-time intervention guidance, thereby improving clinical outcomes in PCI procedures. Future research should focus on expanding OCT's applications and further validating its efficacy in diverse clinical settings

Evaluation of hematological parameters and platelet yield in voluntary blood donors by plateletpheresis: a one-year study at the blood centre in a teaching hospital

Background: The present study was planned to compare of pre and post donation hematological parameters in healthy donors by plateletpheresis. Also to assess the platelet yield following plateletpheresis procedure with its correlation to pre donation platelet count. Methods: This is a retrospective cross-sectional study carried out in the Blood Centre of a tertiary care hospital in Haryana, India between January to December 2022. Plateletpheresis was done on Trima Accel Automated Collection System with ACD‐A as an anticoagulant. The data was collected from the hospital for hematological parameters (Hb, hematocrit, Total WBC count, total platelet count) pre and post donation. Categorical data is presented as frequency, percentage, mean±SD range. Correlation was established between the pre donation platelet count and the platelet yield. Results: A total of 125 donors were included in the study with majority of the donors 69 (55.2%) in the age group 21-30 years. Mean age of the donors included in the study was 31.58±7.5 years. The levels of hemoglobin dropped from 14.16±0.95 to 13.92±1.002 gm/dl, hematocrit dropped from 41.19±1.33 to 40.91±2.89%, total WBC count reduced from 7.64±1.38 to 7.61±1.36 103/ l and platelet count dropped from 279.5±62.96 to 259.9±58.38 lac/ l. There was a significant drop in the levels of platelet post donation by 7.01% compared to pre donation levels. majority of the donors (44%) had a mean platelet yield 2.49±0.33 with a platelet count between 1.5-2.5x1011/l. The maximum platelet yield was 4.93±0.34 in 6% donors with pre-donation platelet count of >4.5 5x1011/l. A linear significant relationship was established between the platelet count and the platelet yield (r=0.99). Conclusions: There were significant changes in the pre donation and post donation hematological parameters among the donors. It was concluded that donors with a high pre-donation platelet count can be considered for better platelet yield

Carotid intima-media thickness in patients with non-alcoholic fatty liver disease: a study from eastern part of India

Background: Carotid intima-media thickness (CIMT) is a reliable marker of atherosclerosis and cardiovascular events. Association between CIMT with non-alcoholic fatty liver disease (NAFLD) is well known; however, such data are limited from India. This study aimed to assess CIMT in NAFLD patients compared to the healthy control, its relationship with other metabolic covariates, and predators of increased CIMT. Methods: In an observational study, involving 150 subjects (84 NAFLD and 66 healthy controls), B-mode ultrasound was used for the evaluation of CIMT. Results: The mean CIMT was significantly higher in NAFLD patients compared to the control group: 0.77±0.27 versus 0.57±0.11 mm on left side, p<0.001 and 0.79±0.22 versus 0.54±0.12 mm on right side, p<0.001. The difference was significant even after adjustment of metabolic confounders. Eight NAFLD patients had carotid plaques compared to none in the controls. The mean CIMT did not differ significantly between lean, overweight and obese subjects. A progressive increase in mean CIMT was noted with increasing grades of hepatic steatosis. High CIMT values (>95th percentile value in controls, 0.79 mm) were found in 52.3% of NAFLD. On multivariate regression analysis, age [odds ratio (OR) 1.42, p<0.001], serum HDL cholesterol [OR 0.92), p=0.02] and NAFLD [OR: 3.5, p<0.001] were found to be independently associated with high CIMT. Conclusions: NAFLD was significantly associated with CIMT which increased progressively with increasing grades of hepatic steatosis. Over half of NAFLD had increased CIMT, and NAFLD along with higher age and lower HDL- cholesterol independently predicted high CIMT values

Hepatitis B virus total core antibody status in unvaccinated general population in a community of Bangladesh

Background: Hepatitis B virus (HBV) infection poses a significant health challenge in Bangladesh, with the hepatitis B core antibody (anti-HBc) being a crucial marker due to its lifelong presence in the bloodstream. This study aimed to evaluate the prevalence of anti-HBc (total) positivity among unvaccinated adults in Northeastern Bangladesh. Methods: This cross-sectional observational study was conducted in the Sobhanighat area of Sylhet, Bangladesh, in collaboration with the department of gastroenterology, Sylhet MAG Osmani Medical College, from November 2022 to August 2023. A total of 216 participants were selected using consecutive sampling. HBsAg, anti-HBs, and anti-HBc (total) were tested for all subjects, and data were collected using a pre-formed questionnaire and analyzed using statistical package for the social sciences (SPSS) version 24. Results: Among the participants, 16 (7.4%) tested positive for anti-HBc (total), while HBsAg was positive in 6 (2.77%) individuals. Anti-HBs was detectable in 23 (10.6%) participants, with 3 (1.38%) showing isolated anti-HBc positivity. Notably, 20% of HBsAg-positive cases exhibited heterotypic anti-HBs. Moreover, 56.25% of respondents with anti-HBc (total) positivity had detectable anti-HBs (p<0.001). Gender did not show significant associations with HBsAg, anti-HBc (total), anti-HBs, or isolated anti-HBc (p>0.05). Conclusions: The study underscores a notable prevalence of anti-HBc (total) positivity among unvaccinated individuals in Bangladesh, indicative of past HBV exposure. It underscores the necessity for enhanced vaccination coverage and robust infection control measures to mitigate HBV transmission in this demographic

Association between transient receptor potential melastatin genotypes and the prostate surface antigen levels in BPH patients

Background: Benign Prostate Hyperplasia (BPH) is a prevalent condition among older males, characterized by an enlarged prostate gland leading to lower urinary tract symptoms and impacting quality of life. Transient receptor potential melastatin (TRPM) genes regulate various physiological processes. Methods: We studied 194 BPH patients and 194 healthy controls, genotyping six selected TRPM gene SNPs. PSA levels were measured using the Cobas® e411 analyzer. Results: Prostate-specific antigen (PSA) levels were significantly higher in BPH patients (135.76±578.03 ng/mL) than in controls (2.01±1.09 ng/mL). TRPM2 (rs168355) and TRPM7 (rs2362295) genotypes were significantly associated with elevated PSA levels. The TRPM2 GG genotype was associated with decrease in the likelihood of severe PSA levels (OR=0.34, 95% CI: 0.12-0.96, P=0.034), while the TRPM7 CC genotype showed increased odds for severe PSA levels (OR=1.48, 95% CI: 1.08-3.56, P=0.041). Conclusions: Our findings suggest a potential link between TRPM gene variants and the severity of prostatic changes reflected in PSA secretions, indicating the need for further research to understand the underlying mechanisms and clinical implications

Riding under the influence: unravelling substance abuse patterns among motorcyclists in South-Eastern Nigeria

Background: Drug and substance abuse has been outlined as a worldwide problem that is wreaking havoc on both social and public health across many nations. It is a global problem that affects both developed and developing countries. The objective of this study was to assess substance abuse among Okada riders in Nnewi, Anambra State, Eastern Nigeria. Methods: Drug and substance abuse has been outlined as a worldwide problem that is wreaking havoc on both social and public health across many nations. It is a global problem that affects both developed and developing countries. The objective of this study was to assess substance abuse among Okada riders in Nnewi, Anambra State, Eastern Nigeria. Results: About 221 Okada riders were assessed. Majority of them were middle aged. The mean age of the respondents were 39.5±11.1 years, with a range of 19-65 years. About 100% of the respondents were aware of substance abuse. Overall 73.3% of the respondents abuse at least a substance, with alcohol recording the highest use with 93.8% prevalence. About 77.2% of the abusers have taken these drugs before driving, and 65.2% have been involved in an accident, however only 5.4% admitted it was as a result of substance used. Conclusions: The prevalence of substances use among Okada riders in Nnewi was high. There was however a high awareness of the negative consequences of use of substance. Non-governmental organizations should target Okada riders for interpersonal communication interventions to help mitigate the use of substances

Observation of cardiac profile among the adult population of Sreemangal

Background: Cardiovascular diseases are a leading cause of morbidity and mortality worldwide. The prevalence and risk factors of CVDs vary across different populations and regions. This study aimed to observe the cardiac profile among the adult population of Sreemangal, Bangladesh, to identify the prevalence and risk factors of CVDs in this population. Methods: This prospective observational study was conducted over a six-month period at a public health camp in Sreemangal, Bangladesh. A total of 137 adult participants were purposively selected. Data were collected through a structured questionnaire and physical examination, including measurements of blood pressure and laboratory analysis of blood samples. Results: The study found that 44.53% of participants had elevated blood pressure, and 21.90% had stage 1 hypertension. Interestingly, 36.50% of participants were unaware of their hypertension status. Furthermore, 26.28% of participants had a known history of diabetes, but blood glucose level analysis revealed an additional 14.85% of participants were prediabetic, and 6.93% were diabetic based on fasting blood glucose levels. A statistically significant association was found between increasing age and the stage of hypertension (p<0.001), and between fasting and normal blood glucose levels and the stage of hypertension (p<0.005 and p<0.05, respectively). Conclusions: The findings of this study underscore the need for targeted interventions to prevent and manage CVDs in the adult population of Sreemangal, Bangladesh. These interventions should include regular screening for CVD risk factors, health education to increase awareness of these risk factors, and strategies to promote healthy lifestyle behaviors

Role of histopathological and microbiological investigations for a definitive diagnosis of benign sinonasal masses: a tertiary care institute study

Background: This research aimed to study the clinical presentation of various sino nasal masses (SNM), to study the importance of Histopathological and microbiological investigations in making diagnosis of SNM and to study the correlation between clinical, radiological, histopathological, and microbiological findings of SNM. Methods: In the present study 50 patients attending the ENT outpatient department with clinical evidence of nasal mass were selected based on inclusion and exclusion criteria. Patients were examined clinically and radiologically followed by surgical intervention. Histopathological and microbiological examination was done to make a definitive diagnosis. Results: Majority of cases were from 21-40 years age group (66%) with male preponderance. Nasal obstruction was most common symptom 45 (90%) followed by nasal discharge 43(86%). On histopathology highest incidence was of inflammatory polyps 22 (44%) followed by allergic polyps 14(28%) and non-invasive fungal sinusitis (NIFS) 11 (22%) respectively. Microscopically in KOH, fungal elements, yeast and hyphae were seen in total 11 (22%) cases and with SDA, Aspergillus niger was seen in 7 (14%) cases, Candida albicans in 3 (6%) and both in 1 (2%) case. Correlation of provisional diagnosis with HPE was found to be highly significant. Conclusions: It was observed that histopathological and microbiological examination is irreplaceable as both are the “GOLD STANDARD” for making a definitive diagnosis

Clinico-pathological profile of breast cancer patients in a radiation therapy centre

Background: The aim of the study was to evaluate the clinico-pathological characteristics of patients with breast cancer at the Radiation Center of Bangabandhu Sheikh Mujib Medical University (BSMMU), a tertiary‑care cancer center in Dhaka, Bangladesh.   Methods: This descriptive study was conducted from March 2021 to February 2022 where patients receiving radiotherapy for breast cancer were included. Data were collected from face-to-face interviews with patients and from their investigation reports. Data regarding age, presenting symptoms, histological type, tumor size, involvement of regional nodes, hormonal receptor status, and human epidermal growth factor receptor 2 (HER2) amplification were recorded and then analyzed. Results: The mean age of the patients was 52.53 years. Most of the patients (93%) were multiparous and 62.24% were postmenopausal. The most common symptom was breast lump (91.6%). Infiltrating ductal carcinoma and lobular carcinoma were seen in 136 (95.1%) and 7 (4.9%) cases respectively. The TNM stage distribution was stage I, 6 (4.2%); stage II, 52 (36.36%); stage III, 76 (53.15%); and stage IV, 9 (6.29%). Locally advanced breast cancer constituted 42.66% of the cases. Among the patients 90 (62.94%) patients were ER/PR positive and 42 (29.37%) patients were HER2 positive. Triple negative breast cancer (TNBC) constituted 25.17% (36) of the study population. All receptors were positive in 25 patients (17.48%). Conclusions: Majority of our patients receiving breast radiotherapy at our center are middle aged and have advanced disease. TNBC and HER2 positive breast cancer are more common in our population

Evaluation of antimicrobial activity of Lactobacillus acidophilus and Lactobacillus rhamnosus against clinically isolated Klebsiella pneumoniae: an in vitro study

Background: Klebsiella pneumoniae are Gram-negative opportunistic pathogen, belonging to the family Enterobacteriaceae that can cause severe nosocomial infections particularly in immuno-compromised individuals. They exhibit co-resistance to multiple antibiotics which emphasize the need for non-antibiotic therapies. The goal of the presented study was to investigate the antimicrobial ability of probiotic Lactobacilli on clinical isolates of K. pneumoniae. Methods: In this cross-sectional study, antimicrobial activities of probiotic L. acidophilus and L. rhamnosus on K. pneumoniae were evaluated by Agar overlay interference technique. Clear zone around Lactobacilli were taken as positive inhibition. Antibiotic susceptibility profiles of K. pneumoniae were determined by Kirby-Bauer disk diffusion method, analyzed using interpretive standards of CLSI M100-S33 and categorized into MDR, XDR and Non MDR groups. Statistical analysis was done using descriptive statistics such as mean and standard error and inferential statistics such as ANOVA single factor. Results: K. pneumoniae exhibited positive inhibition with both the probiotic strain. On comparing the zone of inhibition of L. acidophilus and L. rhamnosus (both treated-pH adjusted and untreated), L. acidophilus had greater zone of inhibition against K. pneumoniae but concluded that statistically the values are insignificant (p>0.05). Based on antibiotic susceptibility pattern of K. pneumoniae, 63% of isolates were XDR, 3% were MDR and 34% were Non MDR Conclusions: It can be concluded that L. acidophilus and L. rhamnosus had significant inhibitory effect against K. pneumoniae in vitro and should be further studied for their human health benefit