Perioperative utilization of angiotensin receptor-neprilysin inhibitor in patients with heart failure with reduced ejection fraction undergoing coronary artery bypass grafting-a narrative review.

Heart failure with reduced ejection fraction (HFrEF) is frequently observed in patients undergoing coronary artery bypass grafting (CABG), and it significantly increases the risk of postoperative death while exerting a crucial influence on the recovery process following the surgical intervention. HFrEF is one of the prevalent risk factors for early readmission in patients who underwent CABG. Angiotensin receptor-neprilysin inhibitor (ARNI) has been recognized as a critical medical therapy in the management of HFrEF; however, its efficacy and safety have yet to be corroborated in the context of CABG.

Imidazole-catalyzed construction of bridged bicyclo [3.3.1] ketals formal [3 + 3]-cycloaddition of naphthols and 2-hydroxyl chromene derivatives.

Bridged bicyclo[3.3.1]nonanes having the ,-ketal subunit are widely found in medicinal compounds.

Measures of Bacterial Endotoxins in Gingival Crevicular Fluid and Peripheral Blood of Aggressive Periodontitis Cases-A Clinical Association.

Introduction: The present study was undertaken with the objective to evaluate the level of endotoxin produced in the gingival crevicular fluid (GCF) and peripheral blood of subjects with generalized aggressive periodontitis (GAgP) in comparison with periodontally healthy subjects at baseline, three months, and six months post-periodontal surgical treatment.

Materials And Methods: A total of 24 subjects aged between 20 and 50 years were selected for the study. They were divided into two groups: generalized aggressive periodontitis (GAgP) subjects (Group A) and periodontally and systemically healthy individuals (Group B).

A Case of Primary Aldosteronism Masquerading as Bartter and Gitelman Syndromes.

Primary aldosteronism (PA) is a common cause of secondary hypertension, with familial hyperaldosteronism (FH) contributing to a lesser number of cases. FH type IV, a rare subtype, has hardly been reported as a subtype of PA cases. We present a case of a 27-year-old female who presented to the emergency department with circumoral tingling and numbness.

A trans-disciplinary agro-ecology strategy to grow medicinal plants.

The scope of the emerging field of Ayurvedic-biology visualized thus far is confined to studies on dimensions pertaining to clinical and experimental pharmacology, basic trans-disciplinary science and drug design. However, given the multiple facets of classical Ayurveda knowledge system, its application in the field of organic agriculture perhaps also needs to be urgently explored. The urgency is due to the growing public acceptance of Ayurveda as a preferred clinical choice for well-being and disease management.

5H-benzo[c]fluorene derivative exhibits antiproliferative activity via microtubule destabilization.

Present study aimed at a single component cyclization of 2-benzylidene-1-tetralones for the preparation of 5H-benzo[c]fluorenes and their antiproliferative activity. This ring closure reaction underwent via reductive cyclization in the presence of a sodium borohydride-aluminium chloride system. Ten diverse 5H-benzo[c]fluorene derivatives were prepared and evaluated for antiproliferative activity against three human cancer cell lines by SRB assay.

Delayed high-altitude retinal hemorrhages in well-acclimatized lowlanders: A hidden risk unveiled.

Background/objectives: High-altitude retinal hemorrhage (HARH), a frequent entity of high-altitude retinopathy (HAR), is associated with acute exposure to high altitudes (HAs) with rapid ascent. However, the delayed occurrence of HARH in well-acclimatized individuals has received less attention. This study explored the prevalence and characteristics of HARH in individuals who were acclimatized to HA for extended periods, aiming to elucidate the physiological responses of the retina to chronic hypoxic conditions.

An environmentally benign process to synthesize vanillin and other substituted phenyl aldehydes using natural phenylpropenes.

The limited vanillin (3a) production from plant sources requires identifying some renewable and sustainable approaches for its synthesis. This study aimed to develop an efficient, eco-friendly process for synthesizing vanillin (3a) from eugenol (1a) and eugenol-rich essential oils. The chemical methodology for vanillin (3a) synthesis involved base-mediated isomerization of eugenol (1a) to isoeugenol (2a), followed by OsO/NaIO mediated oxidation of isoeugenol to vanillin (3a) using different additives such 1,4-diazabicyclo[2.

Respiratory management of acute chest syndrome in children with sickle cell disease.

Acute chest syndrome (ACS) is a leading cause of respiratory distress and hospitalisation in children with sickle cell disease (SCD). The aetiology is multifactorial and includes fat embolism, venous thromboembolism, alveolar hypoventilation and respiratory infections, with the latter being particularly common in children. These triggers contribute to a vicious cycle of erythrocyte sickling, adhesion to the endothelium, haemolysis, vaso-occlusion and ventilation-perfusion mismatch in the lungs, resulting in the clinical manifestations of ACS.

Treating severe paediatric asthma with mepolizumab or omalizumab: a protocol for the TREAT randomised non-inferiority trial.

Introduction: A minority of school-aged children with asthma have persistent poor control and experience frequent asthma attacks despite maximal prescribed maintenance therapy. These children have higher morbidity and risk of death. The first add-on biologic therapy, omalizumab, a monoclonal antibody that blocks immunoglobulin (Ig)E, was licensed for children with severe asthma in 2005.

Pulse oximetry in patients with pigmented skin: What I should know.

Pulse oximetry is widely used to non-invasively estimate the oxygen saturation of haemoglobin in arterial blood (SpO). It is used widely throughout healthcare and was used extensively during the Covid-19 pandemic to detect and treat hypoxic patients. Research has suggested that pulse oximetry is less accurate in patients with darker skin.

Direct ophthalmoscopy as a screening tool to study retinal vascular changes in acute mountain sickness in response to recent ascent to high altitude: A pilot study.

Background Advanced diagnostics are not easily accessible in austere topographical locations. We documented retinal changes in patients with acute mountain sickness (AMS+) and compared these with asymptomatic individuals (AMS-) with recent induction into high altitude using direct ophthalmoscopy as a screening tool. Methods We evaluated 97 individuals (43 AMS- and 54 AMS+) who were inducted to an altitude 3800 m above sea level by direct ophthalmoscopy after pupillary dilatation, on day 2 of arrival.

Role of nebulised magnesium sulfate in treating acute asthma in children: a systematic review and meta-analysis.

Objectives: To review the efficacy of nebulised magnesium sulfate (MgSO) in acute asthma in children.

Methods: The authors searched Medline, Embase, Web of Science and Cochrane Library for randomised controlled trials (RCTs) published until 15 December 2023. RCTs were included if they compared the efficacy and safety of nebulised MgSO as a second-line agent in children presenting with acute asthma exacerbation.

Is employment group insurance financing of expensive gene therapies threatened in the United States?

Despite the potential of gene therapy to transform the lives of patients with rare genetic diseases, serious concern has been raised about the financing of the high up-front costs for such treatments and about the ability of the employer-sponsored insurance system in the United States, particularly in small firms, to pay for discoveries of this type. In this paper, we provide a conceptual framework and empirical evidence to support the proposition that, at present, private group insurance financing of cost-effective gene therapies is not only feasible and competitively necessary in the labor market for employers, regardless of group size, but also that, currently, the number of US workers in small firms who might be stressed by very high-priced claims is a tiny fraction of the group market for genetic treatments. The current system of employer-paid self-insurance supplemented by stop-loss coverage should be able to facilitate the use of new cost-effective gene therapies.

Synthesis of 2,2-dimethyl-chroman-based stereochemically flexible and constrained anti-breast cancer agents.

Receptors are proteinous macromolecules which remain in the apo form under normal/unliganded conditions. As the ligand approaches, there are specific stereo-chemical changes in the apo form of the receptor as per the stereochemistry of a ligand. Accordingly, a series of substituted dimethyl-chroman-based stereochemically flexible and constrained Tamoxifen analogs were synthesized as anti-breast cancer agents.

Subthreshold laser compared to oral spironolactone for the treatment of chronic central serous chorioretinopathy: a retrospective study.

Purpose: To compare functional and morphological outcomes of Subthreshold Laser (STL) and Oral Spironolactone (SPR) in treating chronic central serous chorioretinopathy (CSCR).

Methods: This is a retrospective observational study. Treatment-naïve patients with chronic CSCR treated with STL or SPR were included, and data was reviewed at baseline, 1, 3, 6 and 12-month follow-up.

Impact of Lung Function on Asthma Exacerbation Rates in Children Treated with Dupilumab: The VOYAGE Study.

Background: Severe, uncontrolled asthma and asthma exacerbations in children are associated with abnormal lung function and airway development, and increased risk of chronic obstructive lung disease in adulthood. The rationale for this post hoc analysis was to explore the relationship between changes in asthma exacerbation rates and lung function in children treated with dupilumab.

Methods: This post hoc analysis included children aged 6 to 11 years with uncontrolled, moderate-to-severe type 2 asthma (blood eosinophils ≥150 cells/μL or fractional exhaled nitric oxide ≥20 ppb) who received dupilumab or placebo in the phase 3 LIBERTY ASTHMA VOYAGE study (NCT02948959).

Phase 3 efficacy and safety trial of proposed liraglutide biosimilar for reduction of glycosylated hemoglobin (HbA1c) in patients with Type 2 diabetes mellitus.

Liraglutide is indicated for glycaemic control in adults with Type 2 diabetes mellitus (T2DM) as an adjunct to diet and exercise. A proposed biosimilar of liraglutide (Levim Liraglutide) was investigated for efficacy & safety in a phase 3 study against the originator reference liraglutide (Victoza®) manufactured by Novo Nordisk A/S, Denmark. Patients aged 18-65 years of age with glycosylated hemoglobin (HbA1c) between 7 and 10 %, among other criteria, were included in the study.