A Misdiagnosis of Brucellosis Leads to Prosthetic Valve Endocarditis Complicated by Cerebrovascular Accident.

Cardiovascular complications of Brucellosis are not common and affecting less than 2% of cases. In clinical practice, endocarditis is the most frequent cardiovascular complication and is responsible for most of the brucellosis-related mortality cases and usually diagnosed lately in the course of the disease with mostly aorta valve involvement. In this case report, we present the case of a 27-year-old woman who was admitted to the hospital with fever, sudden onset right side hemiparesis, and horizontal gaze palsy.

Availability and affordability of antidiabetic medicines in Herat of Afghanistan in 2023.

Objectives: This study aims to investigate the availability, affordability, and accessibility of antidiabetic medications in Herat, Afghanistan, in 2023.

Methods: Adhering to WHO and HAI guidelines, a systematic survey approach was utilized to collect data on the pricing, availability, and affordability of commonly prescribed antidiabetic medications. Data collection spanned a month and involved four investigators using a standardized template.

Mavacamten Safety and Efficacy in a Heart Transplant Patient Exhibiting Obstructive Hypertrophic Cardiomyopathy Phenotype.

Hypertrophic cardiomyopathy is the most common inherited cardiac disease, exhibiting diverse phenotypes. Obstructive hypertrophic cardiomyopathy occurs in about two-thirds of cases and carries a worse prognosis. Mavacamten use in heart transplant recipients is limited.

Epigenetic regulation of noncanonical menin targets modulates menin inhibitor response in acute myeloid leukemia.

Menin inhibitors that disrupt the menin-MLL interaction hold promise for treating specific acute myeloid leukemia (AML) subtypes, including those with KMT2A rearrangements (KMT2A-r), yet resistance remains a challenge. Here, through systematic chromatin-focused CRISPR screens, along with genetic, epigenetic, and pharmacologic studies in a variety of human and mouse KMT2A-r AML models, we uncovered a potential resistance mechanism independent of canonical menin-MLL targets. We show that a group of noncanonical menin targets, which are bivalently cooccupied by active menin and repressive H2AK119ub marks, are typically downregulated after menin inhibition.

Mavacamten in real-life practice: Initial experience at a hypertrophic cardiomyopathy centre.

Aims: In clinical trials, mavacamten reduced left ventricular outflow tract obstruction (LVOTO) and improved symptoms in patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM). We aimed to share our real-world experience with the efficacy and safety of mavacamten in this patient population.

Methods And Results: This retrospective, single-centre study included patients with symptomatic oHCM from March 2023 to November 2023.

Cost-Effectiveness and Budget Impact Analysis of Apixaban and Rivaroxaban Versus Warfarin in the Prevention of Stroke in Patients With Non-Valvular Atrial Fibrillation (NVAF) in Iran.

Introduction: This study evaluates the cost-effectiveness of Apixaban and Rivaroxaban, compared to Warfarin, for stroke prevention in patients with non-valvular atrial fibrillation in Iran.

Method: A Markov model with a 30-year time horizon was employed to simulate and assess different treatment strategies' cost-effectiveness. The study population comprised Iranian adults with NVAF, identified through specialist consultations, hospital visits, and archival record reviews.

Klotho as an Early Marker of Acute Kidney Injury Following Cardiac Surgery: A Systematic Review.

Acute kidney injury is a common complication following cardiac surgery (CSA-AKI). Serum creatinine levels require a minimum of 24-48 h to indicate renal injury. Nevertheless, early diagnosis remains critical for improving patient outcomes.

Clinical Interpretation of Genetic Variants in the Evaluation and Management of Thoracic Aortic Aneurysm and Dissection.

Background: We aimed to elucidate clinical implications of genetic variant interpretation in assessing disease severity and progression in thoracic aortic aneurysm and dissection (TAAD) patients.

Methods: Consecutive TAAD patients with aortic root and/or ascending aortic aneurysms seen between 2011 and 2020 were included. Serial echocardiography, family history of TAAD, and management information were retrospectively collected and analyzed.

The prevalence and causes of self-medication among medical university students in Iran during COVID-19 outbreak and its implications for public health and health systems: A cross-sectional study.

Background And Aims: Self-medication is a worldwide phenomenon that brings advantages and disadvantages to public health and health systems. This study investigated the extent and causes of self-medication among medical university students and its implications for public health in Iran in 2020.

Methods: The present study was designed as a descriptive-analytical cross-sectional study that examined the knowledge, attitude, and practice of self-medication.

Massive Left Ventricular Hypertrophy With Acromegaly: Hypertrophic Obstructive Cardiomyopathy Phenocopy or Phenotype?

Acromegaly-a rare endocrine disorder-results when a growth hormone-secreting somatotroph pituitary adenoma leads to increased insulin-like growth factor 1 production. Acromegaly is known to cause left ventricular hypertrophy. We present a case of acromegaly with massive left ventricular hypertrophy that was determined to be coexistent with gene-positive hypertrophic obstructive cardiomyopathy.

Myocardial work indices in bileaflet mitral valve prolapse patients.

Aims: Mechanisms underlying left ventricular dysfunction and arrhythmogenesis in bileaflet mitral valve prolapse (BMVP) patients are not well defined. Myocardial work index (MWI) is a non-invasive assessment that correlates with myocardial oxygen consumption. We aimed to compare global and regional MWI in BMVP patients with normal controls.

Advancing Preoperative Strategies for Thyroidectomy in Graves' Disease: A Narrative Review.

Graves' disease is an autoimmune disorder characterized by thyroid-stimulating antibodies that can potentially lead to thyrotoxicosis, goiter, skin disease, and eye disease. Available treatment options for Graves' disease include management with antithyroid drugs (ATDs), thyroid ablation with radioactive iodine (RAI), and surgical thyroid gland removal. For individuals unable to reach a normal thyroid hormone level, promptly considering a thyroidectomy is essential.

Hypertrophic Cardiomyopathy-Septal Perforator Arteries Doppler Flow Dynamics.

Background: Patients with hypertrophic cardiomyopathy (HCM) have been shown to exhibit abnormal diastolic vessel flow; however, flow pattern profiles and their possible association with different grades of diastolic dysfunction have not been studied. Color Doppler two-dimensional echocardiography permits visualization of the septal perforator arteries, and pulsed-wave Doppler allows recording of diastolic septal artery flow (SAF). Through routine visualization of the septal perforator arteries and acquisition of SAF, we noticed 3 patterns of SAF in patients with HCM.

Challenge in mitral valve intervention: Super-elongated anterior and diminutive posterior mitral valve.

Diminutive posterior mitral valve leaflet with an extremely elongated anterior leaflet is a rare phenomenon. We share such a case discovered in an 82-year-old patient with severe, symptomatic mitral regurgitation. LA, left atrium; LV, left ventricle; MR, mitral regurgitation.

Cost-effectiveness and budget impact analysis of lisdexamfetamine versus methylphenidate for patients under 18 with attention-deficit/hyperactivity disorder in Iran.

Background: Lisdexamfetamine (LDX) and Methylphenidate (MPH) are stimulant agents that have been shown to provide significant benefits in the management of attention-deficit/hyperactivity disorder (ADHD) in patients.

Aim: This study aimed to assess the cost-effectiveness and the budget impact of LDX compared to MPH as the first-line treatment for ADHD.

Methods: A one-year cost-effectiveness analysis (CEA) was conducted to compare the effects of LDX and MPH in reducing disease symptoms and patient costs and improving quality of life (QoL) from a social perspective.

Large Symptomatic Ventricular Fibromas: A Surgical Challenge.

• Cardiac fibromas are benign clinical entities that are rarely diagnosed in adulthood. • Echocardiography is considered the first imaging modality used for evaluation. • Multimodality imaging is critical for diagnosis and perioperative intervention.

Barlow's mitral valve with a dancing chorda.

We present a case of a ruptured mitral valve chorda visualized using the high temporal and axial resolution of transthoracic M-mode echocardiography.

Sigmoid volvulus secondary to undescended testicle: Report of first case in the literatures.

Sigmoid volvulus accounts for 20%-50% of colonic obstructions in Eastern countries. This occurs mostly in patients with a lack of mobility and a history of chronic constipation. There are some very known complications of a undescended intra-abdominal testicle such as cancer, ischemia, and infertility; But the rotation of the colon around the spermatic cord of one UDT is a very rare phenomenon that there is no similar report.