Effect of hypertension duration on relationship between blood pressure and signs and symptoms in hypertensive patients:a cross sectional survey

Background: Hypertension is defined as a systolic blood pressure of 140 mmHg or more, or a diastolic blood pressure of 90 mmHg or more or taking anti-hypertensive medication. The clinical presentation of high blood pressure may depend upon several factors such as age, gender, severity and duration of hypertension. There is a paucity of data exploring the role hypertension duration may play in shaping the relationship between blood pressure and signs and symptoms of hypertension. To evaluate the effect of hypertension duration on relationship between blood pressure and signs and symptoms in hypertensive patients.Methods: A cross-sectional study was carried out among 250 patients, aged 18 or above, with self-reported history of hypertension and on anti-hypertensive medication. Data were collected by means of a structured questionnaire whereas the blood pressure level was measured with the help of sphygmomanometer using stethoscope. Inferential analysis was performed by applying chi-square test whereas the significance level was set at 0.05.Results: The study results revealed that among patients with ≥5 years duration of hypertension headache history (P=0.021), edema (P=0.034), increased urinary frequency (P=0.031), sleep apnoea (P=0.016), palpitation (P=0.005) and confusion (p=0.021) were significantly associated with systolic whereas only increased urinary frequency (P=0.009) was significantly associated with diastolic blood pressure. Moreover, among patients with <5 years duration of hypertension vision problems (P=0.03), sleep apnoea (P=0.015) and palpitation (P=0.035) were significantly associated with systolic whereas sleep apnoea (P=0.048) and palpitation (P=0.028) were significantly associated with diastolic blood pressure.Conclusions: The study results showed that patients with higher blood pressure were more likely to have the signs and symptoms of hypertension. Also, patients with longer duration of hypertension had greater number of signs and symptoms associated with systolic hypertension

Sonographic Association of Uterine Artery Pulsatility Index with Hypertension During Third Trimester of Pregnancy

Background: Hypertension (HTN) in pregnancy is the second most basic reason for maternal death and cause obstetric complications in 5-10% of all pregnancies. HTN directly affects the blood flow of uterine artery.  Doppler screening test is a valuable method to do safe and non-invasive detection and has high reliability in the detection of uterine artery blood flow characteristics. Objective: The purpose of the present study is to find association between predictive value of uterine artery pulsatility index in normal and hypertensive pregnancy during third trimester. Methods: A descriptive cross-sectional study was conducted with the sample size of 138 patients by selecting the convenient sampling from Ghurki Trust Teaching Hospital, Lahore. The pulsatility index of uterine artery of all the women with normal singleton pregnancy and hypertensive during third trimester of pregnancy were obtained using Doppler ultrasound. Data was analyzed with the help of Anova .The results were derived by mean, frequency and standard deviation . Results: The significance between groups was 0.002. The mean values of right and left uterine artery pulsatility index of 36 hypertensive patients were 1.40 and 1.41 and standard deviation 0.4 and 0.5 respectively whereas the mean values of right and left uterine artery pulsatility index of 102 normal patients were 0.739 and 0.77 and standard deviation 0.23 and 0.5 respectively Conclusion: Our study concluded that there was an association between uterine atery pulsatility index and hypertension during pregnancy. The uterine artery pulsatiltiy index has increased with hypertension in third trimester of pregnancy. Keywords: Hypertension, Pulsatility Index, Doppler Ultrasound DOI: 10.7176/JHMN/72-07 Publication date:March 31st 202

Male infertility: Role of vitamin D and oxidative stress markers

Spermatozoa are vulnerable to oxidative stress because of their inherent reduced antioxidant defence and DNA repair mechanisms. Polyunsaturated fatty acids in sperm plasma membrane break down to cytotoxic lipid aldehyde, 4-Hydroxynonenal, whereas 3-Nitrotyrosine is generated by peroxynitrite induced tyrosine nitration. Both oxidative stress markers contribute to altered sperm function and infertility. Vitamin D, a membrane antioxidant, has a potential scavenger capacity. We compared oxidative stress markers and vitamin D in male subjects with normal and altered sperm parameters and explored association of these markers: 4-Hydroxynonenal and 3-Nitrotyrosine with Vitamin D. Higher 4-Hydroxynonenal levels in altered sperm parameter group and a negative correlation with sperm count, motility and morphology (p \u3c 0.001) was observed. Vitamin D serum concentration in altered sperm parameters was less (p = 0.016) showing a significant positive correlation with sperm count and morphology. 4-Hydroxynonenal was significantly higher in altered sperm parameters showing negative correlation with vitamin D. Highest serum concentrations of 4-Hydroxynonenal were observed in vitamin D-deficient subjects. Significantly higher concentration of 4-Hydroxynonenal was estimated in altered sperm parameters of vitamin D sufficient group (p \u3c 0.001). This suggests 4-Hydroxynonenal as an oxidative stress marker leading to altered sperm function and infertility with some association with vitamin D; needs to be explored

SIRT1 and antioxidants in infertile females: Exploration of the role of vitamin D

Background: Deficiency of silent information regulator 1 (SIRT1) can trigger inflammation, mitochondrial malfunctioning, and apoptosis through the hypothalamic-pituitary-ovarian axis, producing poor quality oocytes, leading to infertility. Normal vitamin D (VD) levels promote SIRT1 activity required for optimal fertility, and low levels of either may result in fertility problems owing to cell-membrane de-stabilization, increased autophagy, DNA damage leading to increased reactive oxygen species and mitochondrial dysfunction. Therefore, in this study, we want to estimate the levels of VD, SIRT1 and antioxidants (MnSOD; manganese superoxide dismutase, GR; glutathione reductase, visfatin) and oxidants (adrenaline & cortisol) in individuals living with infertility and explore the association of VD with SIRT1 expression (levels), antioxidants, and oxidants contributing to infertility in women. The significance of this study is that it highlights the importance of maintaining optimal levels of VD for reproductive health in females. Methods: This cross-sectional study included 342 (135 infertile and 207 fertile) female subjects. Serum levels of MnSOD, SIRT1, visfatin, GR, VD, adrenaline, and cortisol were analyzed by ELISA and were compared in fertile and infertile samples using the Mann Whitney U test. Results: There were significantly high levels of VD, SIRT1, GR, MnSOD and visfatin in fertile female participants. However, mean adrenaline and cortisol levels were higher in infertile samples with a significant negative correlation with VD. A significant negative correlation of VD with MnSOD, SIRT1, visfatin and GR was observed (p \u3c0.01). In VD subset groups, MnSOD levels were significantly high in VD sufficient groups however, adrenaline and cortisol levels were significantly high in groups suffering from VD deficiency. Conclusions: Deficiency of VD is associated with a decrease in SIRT1 and other antioxidants, which may deter natural reproductive functions leading to infertility. Further studies are required to determine the cause-effect relationship of VD deficiency on conception and interpretation of the involved mechanis

Genetic association of vitamin D receptor gene with female infertility

Background: Infertility is defined as failure to achieve a clinical pregnancy after 12 months of unprotected intercourse. It affects 15% of couples globally and 22% of couples within Pakistan. Female infertility can be caused by numerous genetic or environmental factors including hormone imbalances and exposure to chemicals or radiation. The prevalence of vitamin D deficiency among the adult population was reported to be 14-59% with a higher prevalence in Asian countries. Furthermore, the expression of Vitamin D receptor (VDR) can play a vital role in the reproductive organs of females. Hence, the aim of our present study was to check the association of VDR polymorphisms with infertile females. For this purpose, blood samples were collected for genotyping of four known VDR mutations [FokI (rs2228570), TaqI (rs731236), ApaI (rs7975232), and BsmI (rs1544410)] via PCR-based RFLP assay. Results: Genotyping indicated that FokI, TaqI, and ApaI are associated with infertility (p = 0.004*, p = 0.013*, and p = 0.033*, respectively). However, BsmI did not show any significance. Multinomial regression analysis indicated that FokI heterozygous genotypes increase the risk of infertility by 2.5 times (hetero: OR = 2.5, 95%, p = 0.001*) as compared to wild type. Heterozygous genotypes of TaqI and ApaI were found to play a protective role and reduce the risk of infertility by 58 and 52%, respectively [TaqI: OR = 0.42, 95%, p = 0.004*, ApaI: OR = 0.48, 95%, p = 0.01*, respectively] as compared to wild type. Multinomial logistic regression analysis was also performed for allelic data as well. Conclusion: Thus, it could be summarized that among the studied polymorphisms of VDR, FokI SNP greatly increased the risk of infertility, while TaqI and ApaI genotypes protect from infertility. However, BsmI does not influence the risk of infertility in Pakistani female

Genome Identification and Characterization of <i>WRKY</i> Transcription Factor Gene Family in Mandarin (<i>Citrus reticulata</i>)

WRKY proteins are an important group of transcription factors (TFs) gene family and were identified primarily in plants. WRKY TFs play vital roles in modulating gene expression when plants face detrimental effects due to the environment. In the current study, we focused on using the mandarin citrus (Citrus reticulata) genome to understand the impact of the WRKY gene family on the extraction of alleles mining in mandarins. The mining of the C. reticulata genome identified 46 CrWRKY genes that were classified into three main groups (G1, G2, and G3) further with five subclasses (IIa, IIb, IIc, Iid, and IIe) in the G2 group, and all were presented on 29 scaffolds representing numerous segmental duplications of 100% events established. Multiple sequence analysis predicted the presence of the “WRKYGQK” domain and metal-chelating zinc-finger motif C2H2 in 45 genes, while the “WRKYGQK” domain was replaced with “WRKYGKK” only in CrWRKY20. The comparative relationship of CrWRKY with other plant species using dual synteny analysis revealed that the divergence between C. reticulata and C. grandis occurred after the evolutionary divergence of C. clementine, C. sinensis, C. medica, and C. ichangensis. The possible functions of the CrWRKY genes in mitigating environmental effects were predicted using cis-regulatory elements analysis and in silico RNAseq analysis, for the development of plants. These results provide a robust platform and absence of knowledge for the functional identification from key genes of CrWRKY genes in the mandarin for the possible use to improve key desirable agronomic and consumer-driven fruit quality traits in mandarins and related species

National cervical cancer burden estimation through systematic review and analysis of publicly available data in Pakistan

Abstract Background Cervical cancer is a major cause of cancer-related deaths among women worldwide. Paucity of data on cervical cancer burden in countries like Pakistan hamper requisite resource allocation. Objective To estimate the burden of cervical cancer in Pakistan using available data sources. Methods We performed a systematic review to identify relevant data on Pakistan between 1995 to 2022. Study data identified through the systematic review that provided enough information to allow age specific incidence rates and age standardized incidence rates (ASIR) calculations for cervical cancer were merged. Population at risk estimates were derived and adjusted for important variables in the care-seeking pathway. The calculated ASIRs were applied to 2020 population estimates to estimate the number of cervical cancer cases in Pakistan. Results A total of 13 studies reported ASIRs for cervical cancer for Pakistan. Among the studies selected, the Karachi Cancer Registry reported the highest disease burden estimates for all reported time periods: 1995–1997 ASIR = 6.81, 1998–2002 ASIR = 7.47, and 2017–2019 ASIR = 6.02 per 100,000 women. Using data from Karachi, Punjab and Pakistan Atomic Energy Cancer Registries from 2015–2019, we derived an unadjusted ASIR for cervical cancer of 4.16 per 100,000 women (95% UI 3.28, 5.28). Varying model assumptions produced adjusted ASIRs ranging from 5.2 to 8.4 per 100,000 women. We derived an adjusted ASIR of 7.60, (95% UI 5.98, 10.01) and estimated 6166 (95% UI 4833, 8305) new cases of cervical cancer per year. Conclusion The estimated cervical cancer burden in Pakistan is higher than the WHO target. Estimates are sensitive to health seeking behavior, and appropriate physician diagnostic intervention, factors that are relevant to the case of cervical cancer, a stigmatized disease in a low-lower middle income country setting. These estimates make the case for approaching cervical cancer elimination through a multi-pronged strategy

Enhancement of the Solubility and Bioavailability of Pitavastatin through a Self-Nanoemulsifying Drug Delivery System (SNEDDS)

The purpose of the study was to develop an SNEDDS to improve the solubility and bioavailability of pitavastatin. The solubility of pitavastatin in different oils, surfactants, and co-surfactants was determined and a pseudo-ternary phase diagram was constructed. The SNEDDS was characterized by zeta-sizer, zeta-potential, FTIR, DSC, and TGA. Release and permeation of pitavastatin from the SNEDDS was studied for 12 and 24 h, respectively. The lipolysis test, RBC lysis, effect on lipid profile, and pharmacokinetics were studied. The SPC3 formulation showed a 104 &plusmn; 1.50 nm particle size, a 0.198 polydispersity index (PDI), and a &ndash;29 zeta potential. FTIR, DSC, and TGA showed the chemical compatibility and thermal stability. The release and permeation of pitavastatin from SPC3 was 88.5 &plusmn; 2.5% and 96%, respectively. In the lipolysis test, the digestion of SPC3 yielded a high amount of pitavastatin and showed little RBC lysis. The lipid profile suggested that after 35 days of administration of the SNEDDS, there was a marked decrease in TC, LDL, and triglyceride levels. The SNEDDS of SPC3 showed an 86% viability of Caco-2 cells. Pharmacokinetics of SPC3 showed improved values of Cmax, Tmax, half-life, MRT, AUC, and AUMC compared to the reference formulation. Our study demonstrated that the SNEDDS effectively enhanced the solubility and bioavailability of a BCS class II drug