Depression as a Risk Factor for Coronary Artery Disease: Myth or Verity

Objectives: To determine the frequency of depression in patients with ischemic heart disease, subgroup analysis of prevalence of depression in patients with heart failure, acute STEMI and non STEMI-ACS and the effect of hospital stay and treatment of primary cardiac illness on depression scores.Methodology: All patients with heart failure, acute STEMI and non STEMI-ACS, presenting to cardiology clinics over a period of March-August, 2016 with a pre-calculated sample size were enrolled into the study by consecutive sampling. HAM-D questionnaire was administered at the time of hospital admission and discharge. SPSS was used for data analysis.Results: A total of 102 patients were included in the study out of which 47 (46%) were females and 55 (54%) were males. The mean age of the study population was 49.5±12 years. At the time of admission, 91/102 (89.2%) patients were found to be depressed, 32 (31.4%) had mild depression, 29 (28.4%) had moderate depression, 10 (9.8%) had severe depression and an alarming number (20 i.e. 19.6%) patients had very severe depression. At the time of discharge, 82/102 (80.3%) patients were found to be depressed, 35 (34.3%) had mild depression, 31 (30.4%) had moderate depression, 12 (11.8%) had severe depression and only 4 (3.9%) had very severe depression. The mean change in HAM-D score during hospital admission was -3.24±4 (Maximum +26, minimum -23). The difference in depression scores during hospital stay tended to inversely correlate with length of hospital stay. A greater proportion of patients with the diagnosis of STEMI had a severe or very severe depression.Conclusion: Depression was found to be alarmingly prevalent in acute coronary syndrome affectees and hospital stay and treatment led to a mean fall in the depression scores

Precipitants of Acute Decompensated Heart Failure and their Correlation with the Severity of Decompensation in a Resource Poor Country

Objective: 1. To determine the frequency of various factors (patient related, disease related and physician related), causing immediate precipitation of congestive cardiac failure in a tertiary care hospital. 2. To establish correlation between these variables and severity of decompensated heart failure. Patients and Methods: This cross-sectional study was carried out over a period of March-August, 2016. All patients admitted to cardiology ward and Coronary Care Unit (CCU) of Pakistan Institute of Medical Sciences during the study period were enrolled in the study using consecutive sampling technique. An arbitrarily predetermined sample size of 115 patients was taken. Precipitants were classified as patient related, disease related and physician related. Data was recorded and analyzed using SPSS version 22. Qualitative variables were reported as percentages and quantitative variables by using mean ± standard deviation. Spearman correlation coefficient was used to determine the correlation between variables and outcome measures. Results: A total of 115 patients were enrolled in this study. The mean age of the population was 51.13±13.6 years. Among these 38.3% of the population was obese. The patients remained admitted to the hospital for the index episode of decompensation for a mean period of 4.14±1.2 days. Infections were found to be the leading precipitant contributing to 57.6% of all decompensation episodes. This was followed by drug non-compliance (17.4%) and arrhythmias (8.7%). Ischemia was noted in 5.2%. Heart failure severity at presentation was found to correlate significantly with the presence of hypertension (Spearman coefficient 0.62, p-value 0.04), baseline hemoglobin (Spearman coefficient -0.58, p-value 0.03), creatinine levels (Spearman coefficient 0.71, p-value 0.05) and precipitant of heart failure (Spearman coefficient 0.257, p-value 0.007). Conclusion: A sizeable majority of heart failure hospitalizations can be prevented by inculcating measures directed at effective infection control at community and health care level and educating patients regarding recognition of early signs of infection that may target the most important immediate precipitant for acute decompensated heart failure.  &nbsp

Hurdles in Vaccine Development against Respiratory Syncytial Virus

Respiratory syncytial virus (RSV) infection is a major cause of severe respiratory disease in infants and young children worldwide and also forms a serious threat for the elderly. Vaccination could significantly relieve the burden of the RSV disease. However, unfortunately there is no licensed vaccine available so far. This is partly due to disastrous outcome of a clinical trial of formalin-inactivated RSV (FI-RSV) in children in 1960s; leading to enhanced respiratory disease upon natural infection. These findings contributed significantly to the delay of RSV vaccine development. Other key obstacles in development of RSV vaccine such as a peak of severe disease at 2–3 months of age, challenging biochemical behavior of key vaccine antigens and dependence on animal models that may not truly reflect human disease processes. These challenges could be overcome through maternal immunization, structure-based engineering of vaccine antigens, the design of a novel platform for safe infant immunization, and the development of improved animal models. Currently, several vaccine candidates are in pre-clinical and clinical trials targeting the diverse age groups; young children or older adults from the infection or can reduce incidence, mortality and morbidity among the RSV infected individuals

Evaluation of different sorghum (Sorghum bicolor L. moench) varieties for grain yield and related characteristics

Abstract Eight sorghum genotypes were evaluated for grain and other associated traits at Maize and Millets Research Institute, Yousafwala, Sahiwal, Punjab, Pakistan in 2011. The results revealed that sorghum varieties differed significantly for grain yield, fodder yield, plant height and days to 50% flowering. Among the varieties, YSS-9, YSS-10 (Cream) and YSS-17 produced higher grain yield (3433, 3167 and 3100 kg ha -1 , respectively) than other genotypes. Varieties YSS-9 and YSS-10 (Cream) produced higher fodder yield of 15833 and 12000 kg ha -1 , respectively. Sorghum variety YSS-10 (cream) took maximum days (86) to 50% flowering, while variety YSS-98 (control) took minimum 79 days to 50% flowering. Among the tested genotypes, YSS-9 produced higher grain yield as well as fodder yield (stay greener at maturity) than all other genotypes. It has a bold grain size of creamy color which has no tannin contents (anti nutritional factor) and strong root anchor system. So it is concluded that YSS-9 proved as a dual-purpose variety with reasonable grain and fodder yields

Carbapenem Resistance: Mechanisms and Drivers of Global Menace

The emergence of carbapenem-resistant bacterial pathogens is a significant and mounting health concern across the globe. At present, carbapenem resistance (CR) is considered as one of the most concerning resistance mechanisms and mainly found in gram-negative bacteria of the Enterobacteriaceae family. Although carbapenem resistance has been recognized in Enterobacteriaceae from last 20 years or so, recently it emerged as a global health issue as CR clonal dissemination of various Enterobacteriaceae members especially E. coli, and Klebsiella pneumoniae are reported from across the globe at an alarming rate. Phenotypically, carbapenems resistance is in due to the two key mechanisms, like structural mutation coupled with β-lactamase production and the ability of the pathogen to produce carbapenemases which ultimately hydrolyze the carbapenem. Additionally, penicillin-binding protein modification and efflux pumps are also responsible for the development of carbapenem resistance. Carbapenemases are classified into different classes which include Ambler classes A, B, and D. Several mobile genetic elements (MGEs) have their potential role in carbapenem resistance like Tn4401, Class I integrons, IncFIIK2, IncF1A, and IncI2. Taking together, resistance against carbapenems is continuously evolving and posing a significant health threat to the community. Variable mechanisms that are associated with carbapenem resistance, different MGEs, and supplementary mechanisms of antibiotic resistance in association with virulence factors are expanding day by day. Timely demonstration of this global health concern by using molecular tools, epidemiological investigations, and screening may permit the suitable measures to control this public health menace

Selection of HyspIRI optimal band positions for the earth compositional mapping using HyTES data

The National Aeronautics and Space Administration (NASA) has proposed the launch of a new space-borne sensor called HyspIRI (Hyperspectral and Infrared Imager) which will cover the spectral range from 0.4–12 μm. Two instruments will be mounted on HyspIRI platform: 1) a hyperspectral instrument which can sense earth surface between 0.4 and 2.5 μm at 10 nm intervals and 2) a multispectral infrared sensor will acquire images between 3 and 12 μm in eight spectral bands (one in Mid infrared (MIR) and seven in Thermal Infrared (TIR)). The TIR spectral wavebands will be positioned based on their importance in various applications. This study aimed to identify HyspIRI optimal TIR wavebands position for earth compositional mapping. A Genetic Algorithm coupled with the Spectral Angle Mapper (GA-SAM) was used as a spectral bands selector. High dimensional HyTES (Hyperspectral Thermal Emission Spectrometer) emissivity spectra comprised of 202 spectral bands of Cuprite and Death Valley regions were used to select meaningful subsets of bands for earth compositional mapping. The GA-SAM was trained for fifteen mineral classes and the algorithms were run iteratively 50 times. High calibration (> 95%) and validation (> 90%) accuracies were achieved with a limited number (seven) of spectral bands selected by GA-SAM. The knowledge of important band positions will help the scientists of the HyspIRI group to place spectral bands in regions where accuracies of earth compositional mapping can be enhanced

2-[(E)-3-Phenyl­prop-2-en­yl]-1,2-benzisothia­zol-3(2H)-one 1,1-dioxide

In the crystal structure of the title compound, C16H13NO3S, the benzisothia­zole group is almost planar (r.m.s. deviation for all non-H atoms excluding the two O atoms bonded to S = 0.009 Å). The dihedral angle between the fused ring and the terminal ring is 13.8 (1)°. In the crystal, mol­ecules are linked through inter­molecular C—H⋯O contacts forming a chain of mol­ecules along b

Cadmium toxicity alleviation through exogenous application of gibberellic acid (GA3) in mustard (Brassica juncea (L.) czern.) and rapeseed (Brassica rapa L.)

An experiment was carried out by considering adverse impact of heavy metals on human health through consumption of crops. To alleviate the adverse effects of cadmium (Cd) toxicity through foliar application of gibberellic acid (GA3), two varieties of Brassica including Indian mustard (Brassica juncea (L.) Czern.) commonly known as ‘Raya’ and rapeseed (Brassica rapa L.) as ‘Toria’ were studied. The Completely Randomized Design (CRD) was used with eight treatments including control in four replicates. Treatments were as following, T0 (control), T1 (150 μM CdCl2), T2 (50 mg/L GA3), T3 (75 mg/L GA3), T4 (100 mg/L GA3), T5 (150 μM CdCl2 + 50 mg/L GA3), T6 (150 μM CdCl2 + 75 mg/L GA3), and T7 (150 μM CdCl2 + 100 mg/L GA3). Gibberellic acid (GA3), a plant growth regulator applied exogenously. The concentration of cadmium (150 μM CdCl2) resulted in Cd toxicity affected adversely the morphological and biochemical parameters. Foliar application of GA3 (50 mg, 75 mg and 100 mg) positively influenced the various growth parameters as root length (30 cm), shoot length (129.75 cm), number of leaves (14.5), pods per plant (88) and biochemical parameters like total chlorophyll (0.19 mg/g), protein content (0.70 mg/mL), carbohydrates (0.37 mg/mL) and CAT (0.56 units/mg). Outcome indicated that GA3 reduces the harmful effects of Cd stress in both varieties. It was concluded that all growth and yield parameters of variety ‘Raya’ were better as compared to variety ‘Toria’, hence Raya recommended for large scale cultivation with GA3 under Cd stress

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020