Full Length Research Article - Volumetric Changes in the Components of Left Ventricle Myocardium of Spontaneously Hypertensive Rats Following Exercise and ACE Inhibitor Treatment

This study was designed to test the possible effects of a combination of physical and pharmacological therapy intervention on myocardial structure of the left ventricle in spontaneously hypertensive rats (SHR). Forty 12 weeks old spontaneously hypertensive rats were divided into four groups of sedentary, Sed as controls, exercise only , (Exer), lisinopril only 20mg/kg/day, (Lis), and exercise + lisinopril, (LisExer). Exercise training was performed on a treadmill (5m/min.) for 60 minutes/day, 5 days/week for 10 weeks. At the end of 10 weeks, all the rats were terminally anaesthetised, the heart was arrested in diastole by intravenous procaine and whole animal perfusion fixation through the abdominal aorta was carried out using Karnovsky's fixative (Ph 7.24). The heart was removed and left ventricle plus the interventricular septum was serially sectioned at a thickness of three millimetres. One piece was randomly chosen, and embedded in JB4 resin. Six sections were obtained from each block, stained with toluidine blue:acid fucin. Measurement of volume fraction Vf, of myocardial components was carried out using Histometrix MIL6 Ver 1.0 stereology software ( Kinetic imaging Ltd.). Mean volume fraction, Vf of capillaries in Sed. group was 0.114 ± 0.01 (SEM). This was significantly increased in LisExer group. The volume fraction of muscle in Sed group was 0.795 ± 0.02 (SEM). This was significantly decreased in Lis but unchanged in Exer group. Capillaries Vf was significantly higher in LisExer as compared to Lis or Exer groups (p<0.05). Muscle Vf was not different between LisExer and Lis groups. The outcome of these changes could well be a better enhancement of cardiac performance in hypertension by combined exercise and ACE inhibitor treatment than either of the interventions alone

Exaggerated blood pressure reactivity in the offspring of first-cousin hypertensive parents

Objective: To study blood pressure and blood pressure reactivity in young offspring of normotensive or hypertensive parents who are consanguineous (first cousins) or are not blood-related. Method: Blood pressure, heart rate and body mass index (BMI) were measured in 9- 10 year-old male offspring of 19 pairs of first-cousins normotensive, 16 pairs of first-cousin hypertensive and 12 pairs of non-blood-related hypertensive parents. Results: The offspring of first-cousin hypertensive parents exhibited the greatest systolic and diastolic blood pressure reactivity to their first casual blood pressure measurement, while the offspring of first-cousin normotensive parents showed the least reactivity. The offspring of the hypertensive parents who were not blood-related showed an intermediate reactivity. Basal systolic blood pressure (SBP) was also highest in the offspring of first-cousin hypertensive parents, and their basal diastolic blood pressure (DBP) was higher than that in offspring of first-cousin normotensive parents. Conclusion: The augmented blood pressure response in the offspring of hypertensive parents may have prognostic implications and serve as an important and significant indicator of predisposition to hypertension later in life. Key words: consanguineous marriage, offspring, blood pressure reactivity, Oman

Implant Impression Accuracy of Parallel and Non-Parallel Implants: A Comparative In-Vitro Analysis of Open and Closed Tray Techniques

Background The outcome of the evaluation of impression techniques accuracy may improve the selection criteria for an ideal technique. The aim was to evaluate the accuracy of the open and closed tray techniques for implant impressions, in a partially edentulous maxilla, replaced with a three-unit fixed partial denture, as well as to assess the effect of implants parallelism on accuracy. Material and methods This is an experimental in vitro study to evaluate impressions accuracy of a simulated area restored with an implant retained FPD, using the open and closed tray implant impression techniques. The effect of implant position angulation, parallelism, and implant systems (Straumann, SIC Invent, Osstem) was also evaluated. Three custom-made acrylic resin test models were prepared with two parallel and two non-parallel implants, on either side of a maxillary arch. One hundred and ninety-two impressions were made using monophase VPS impression material. Their master casts were obtained and evaluated for the horizontal and vertical discrepancy. The casts were scanned using a model scanner. The distances between the two reference points were measured. Results The Straumann and SIC Invent implants showed no statistically significant differences (Mann-Whitney U test), regarding accuracy for both the open and closed tray impression techniques (P = 0.667 and P = 0.472). There were no significant differences for the parallel and non-parallel implants (P = 0.323 and P = 0.814), respectively, while the Osstem system showed statistically significant differences for both the open and closed tray impression techniques (P = 0.035) and between the parallel and non-parallel implants (P = 0.045). For the vertical discrepancies, significant differences were detected (chi-square test) between the open and closed tray impression techniques (P = 0.037). Conclusions Within the limitations of this study, there were generally no significant differences between open and closed, although better results were obtained for the open tray techniques. On the use of the non-parallel implants, the open tray technique provided a better result than the closed tray technique

Safety and Efficacy of Cangrelor in Acute Coronary Syndromes: A Systematic Review and Network Meta-Analysis

Introduction: Cangrelor is a potent intravenous non-thienopyridine P2Y12 inhibitor. We conducted a network meta-analysis to study the efficacy and safety of cangrelor as compared with the oral P2Y12 inhibition, clopidogrel, or placebo in acute coronary syndromes. Methods: This meta-analysis followed the Cochrane collaboration guidelines and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols. Outcomes of interest included all-cause mortality, myocardial infarction, stent thrombosis, target vessel revascularization, major bleeding, minor bleeding, and the need for blood transfusion. Results: The analysis was comprised of 6 studies including 26,444 patients treated with cangrelor, clopidogrel, or placebo. There were no statistically significant differences in the incidence of all-cause mortality, myocardial infarction, stent thrombosis, target vessel revascularization, or major bleeding. Cangrelor was associated with a higher risk of minor bleeding than clopidogrel or placebo, with no difference in requiring blood transfusion. Conclusion: Cangrelor has comparable outcomes to clopidogrel in patients with acute coronary syndromes and can be used as a reliable alternative in this population

Sex difference in outcomes and management of cardiogenic shock: A systematic review and meta-analysis

Background: Cardiogenic shock (CS) is associated with significant morbidity and mortality. Sex differences in the outcomes and management of cardiogenic shock are not well established. The primary objective of this study is to investigate the differences inik cardiogenic shock outcomes between males and females. Methods: A systematic review and meta-analysis were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Studies were searched via the MEDLINE/PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases from inception to December 2022. Results: The analysis included 24 studies comprising 1,567,660 patients. Compared to females, males with CS had a significantly lower risk of in-hospital all-cause mortality (risk ratio [RR] 0.88, 95 % confidence interval [CI] 0.85-0.90, p \u3c 0.001) and 1-year mortality (RR 0.90, 95 % CI 0.89-0.92, p \u3c 0.001). Males were more likely to undergo percutaneous coronary intervention (RR 1.21, 95 % CI 1.13-1.31, p \u3c 0.0001) and intra-aortic balloon pump placement (RR 1.21, 95 % CI 1.11-1.32, p \u3c 0.0001), with no significant sex differences in the use of extracorporeal membrane oxygenation or Impella. During the index hospitalization, males were at higher risk of arrhythmias (RR 1.18, 95 % CI 1.05-1.34, p = 0.003) and less likely to develop acute kidney injury (RR 0.86, 95 % CI 0.79-0.94, p \u3c 0.001). Conclusion: Men have a lower all-cause mortality risk in cardiogenic shock. Addressing disparities in management is crucial for improving CS outcomes, especially for women