Paroxysmal atrial fibrillation presenting as anterior wall STEMI in an elderly woman

A 77-year-old woman without traditional risk factors for coronary artery disease (CAD) underwent coronary CT-angiography for evaluation of palpitations after negative Holter monitoring and non-diagnostic ECG exercise stress test. Coronary artery calcium score was reported zero; 1 day later, she was admitted with anterior-wall ST elevation myocardial infarction. Acute left anterior descending artery thrombus was treated with mechanical thrombectomy and Percutaneous Coronary Intervention (PCI). Interestingly, the coronary arteries were angiographically normal. During hospitalisation, paroxysmal atrial fibrillation was noted followed by initiation of anticoagulation. Echocardiogram did not show thrombus or atrial shunt. Cardioversion with Sotalol was successful. Myocardial infraction was most likely cardioembolic secondary to paroxysmal atrial fibrillation-consistent with longstanding history of palpitations. Accounting for 3% of acute coronary syndromes, coronary embolism is treated with therapeutic anticoagulation for at least 3 months irrespective of cause and carries a higher risk of adverse cardiovascular events

Transcatheter Therapies for Aortic Regurgitation: Where Are We in 2023?

Aortic regurgitation (AR) is retrograde flow across the aortic valve in diastole and is classified from stage A to D based on severity and symptoms. Severe symptomatic AR (stage D) is a class I indication for surgical aortic valve replacement per the 2020 American College of Cardiology/American Heart Association guidelines. Though off-label, patients with prohibitive surgical risk may benefit from transcatheter aortic valve replacement (TAVR) in appropriately selected patients. However, TAVR is challenging in AR due to a lack of leaflet and annular calcification and dilation of the perivalvular apparatus, compromising the optimal anchorage of the bioprosthesis with a risk of prosthetic valve leak and embolization. Valve oversizing by 10–15% is frequently required, with caution not to oversize beyond 20%. Multimodality imaging, including echocardiography, magnetic resonance imaging, and computerized tomography, is essential for procedural planning. Registry data shows acceptable results for off-label TAVR with newer generation valves such as Medtronic Evolut and Edwards Sapien 3 for native AR. The JenaValve designed especially for TAVR for native AR is currently undergoing clinical trial. Until the results of randomized clinical trials are available, careful selection of native AR patients for TAVR is paramount to procedural and clinical success

Utilization of indigenously isolated single strain starter cultures for the production of sourdough bread

Sourdoughs were prepared with Saccharomyces cerevisiae (T0) and indigenously isolated starter cultures i.e Lactobacillus brevis (T1), Lactobacillus fermentum (T2) and Lactobacillus plantarum (T3). Breads were prepared from all sourdoughs samples in triplicate and analyzed for pH, Total Titratable Acidity (TTA), loaf volume, microbial characteristics (total plate count and fungal count) and sensory profile (internal and external) in triplicate. The breads prepared from Saccharomyces cerevisiae (T0) exhibited the highest pH with the lowest TTA while T1 showed the lowest pH with the highest TTA. The T0 breads got the highest values for loaf volume followed by T1. The breads produced with the addition of hetero-fermentative starter cultures (T1 and T2) showed resistance against the growth of the contaminating microorganisms. In the sensory evaluation, the breads produced with T1 ranked the best for color (crust and crumb), taste, aroma, texture and overall acceptability by the panelists.Â

Genotypic response of chickpea (Cicer arietinum L.) for resistance against gram pod borer (Helicoverpa armigera)

Background: Chickpea is an important pulse crop of Pakistan. The pod borer, Helicoverpa armigera (Hubner), is the major pest in most of the chickpea growing areas of the country. A field trial was carried out at Entomological Research Area, Ayub Agriculture Research Institute (AARI), Faisalabad, during growing season of 2012-13 to evaluate the resistance of chickpea genotypes against gram pod borer (Helicoverpa armigera).Methods: Experiments were conducted in randomized complete block design (RCBD) with four replications having plot size of 3 ft × 20 ft. Morphological characters of chickpea like pod trichome, pod wall thickness, pod length, pod breadth, pod area and number of pods per plant were measured. The pod borer larval population/pod infestation was recorded from fifteen randomly selected plants per plot after ten days interval.Results: It was found that the genotypes which had higher trichomes length and density and pod wall thickness were more resistant against Helicoverpa infestation. Significant genetic variation for resistance against Helicoverpa armigera attack was found in chickpea and variety K-70005 showed resistant behavior followed by K-08004 and K-60062.Conclusions: It was concluded from prescribed study that the most susceptible genotypes were K-70005, K-08004 and K-70008 for the attack of Helicoverpa armigera to reduce grain yield

Reply to: ‘Browning capabilities of human primary adipose-derived stromal cells compared to SGBS cells’

10.1038/s41598-020-64706-wScientific Reports101963

BLACK WOMEN DEMONSTRATE WORSE CORONARY ARTERY DISEASE BURDEN AND CLINICAL OUTCOMES WHEN ADMITTED WITH FIRST ACUTE MYOCARDIAL INFARCTION

Therapeutic Area: ASCD/CVD in Women Background: We aimed to determine ethnic and gender discrepancies in coronary artery disease (CAD) burden and clinical outcomes in patients admitted with first acute myocardial infarction (AMI). Methods: We conducted retrospective analysis of middle-aged (35-60 years) patients admitted with AMI from 2017-2020. Ethnicity, gender, body mass index (BMI) and cardiovascular (CV) risk factors (history of smoking, diabetes mellitus, hypertension, hyperlipidemia, peripheral arterial disease, and chronic kidney disease) were analyzed. CAD burden was classified into single vessel disease (SVD), 2 vessel disease (2VD) and >2 or multiple vessel disease (MVD). Clinical outcomes were defined as type of intervention (PCI or CABG) and in-hospital mortality. Data was analyzed in STATA 16 and multinomial logistic regression was used to calculate adjusted (for age and CV risk factors) relative risk ratios (aRRR) for CAD burden and outcomes. Results: 434 patients (39.4% females) were divided into the following ethnicities: 61% Caucasians, 33% African Americans (AA), and 6% Hispanics. Mean age was 55+/-14 and mean BMI was 29 +/- 5.5 kg/m2. Analysis revealed higher occurrence of 2VD (aRRR 4.81, [2.64-7.22], p<0.001) and MVD (aRRR 8.23, [6.56-9.09], p<0.001) in AA vs. Caucasians (Figure 1). Hispanics showed increased incidence of 2VD (aRRR 2.21, [2.61-7.23], p<0.001) when compared to Caucasians. AA also had an increased rate of CABG (aRRR 4.11, [3.63-5.31], p<0.001) and in-hospital death (aRRR 3.61, [2.66-6.16], p<0.001). In contrast, Hispanics had similar rate of CABG and mortality compared to Caucasians. Subgroup analysis stratified by gender revealed an increased incidence of MVD (aRRR 3.21, [2.02-4.01], p<0.001) in AA females compared with other subgroups (Figure 2). Hispanic patients did not show a difference in CAD burden or clinical outcomes when stratified by gender. Conclusion: African American and Hispanic patients have increased incidence of 2VD and MVD during first AMI. AA females have the highest incidence of MVD when compared to other subgroups necessitating stricter optimization of cardiovascular health for this subset

<b>Development and application of edible skin coatings to improve the quality of kinnow during storage

This study aimed to develop and investigate the effect of application of indigenous skin coating materials for kinnow fruit, which surely would have superior effect on shelf stability and an attractive alternate for inedible coatings. Economical and underutilized sources were explored for this purpose. Eight different formulations were developed to check their suitability through various physico-chemical analyses. It was concluded that edible coating prepared from corn starch, stearic acid, jojoba oil and monoglycerides (T8) was observed best in terms of physico-chemical properties of fruits and significantly increased the shelf life