Outcomes of Bolus Dose Furosemide Versus Continuous Infusion in Patients With Acute Decompensated Left Ventricular Failure and Atrial Fibrillation.

Background: This prospective, randomized trial aimed to compare the efficacy and safety of different intravenous diuretic regimens in acute decompensated heart failure (ADHF) patients.

Methods: ADHF patients were enrolled and randomized into three groups: continuous intravenous furosemide infusion (cIV), bolus furosemide injection (bI), and furosemide plus hypertonic saline solution (HSS). Clinical outcomes were assessed over 48 h.

Pectoral Nerve Block II for Cardiac Implantable Electronic Devices.

Aim: This study aimed to assess the feasibility and effectiveness of the pectoral nerves (PECS) II block in facilitating cardiac implantable electronic device (CIED) insertion in a sample of 120 patients, with a focus on the percentage of cases completed without additional intraoperative local anesthesia.

Methods: PECS II blocks were performed on the left side using ultrasound guidance in all 120 patients. Feasibility was assessed by the proportion of cases completed without the need for extra intraoperative local anesthetic.

Physicians' Perspective on Percutaneous Left Atrial Appendage Closure in Patients with Atrial Fibrillation and Chronic Kidney Disease in Pakistan.

This study, conducted in Pakistan, examines the perspectives of 1200 physicians across diverse specialties regarding Left Atrial Appendage Occlusion (LAAO) procedures for atrial fibrillation (AF) patients with chronic kidney disease (CKD). Using a random sampling approach, physicians participated in a survey that assessed their familiarity with LAAO, views on its effectiveness and safety, experience levels, and encountered challenges. The results unveil a spectrum of knowledge levels among physicians, reinforcing the need for tailored medical education and training programs.

Outcomes of graft angiography with distal radial access: a retrospective cohort study.

This retrospective cohort study aimed to compare the outcomes of graft angiography using these two approaches. Medical records and angiographic data of adult patients who underwent graft angiography between January 2020 and December 2022 were analyzed. The study included 452 patients in the distal radial access (DRA) group and 960 patients in the femoral access group.

Sex disparity of DAPT noncompliance in patients with left main stem PCI with DES.

This retrospective study aims to explore the sex disparity in dual antiplatelet therapy (DAPT) noncompliance among left main stem percutaneous coronary intervention (PCI) patients with drug-eluting stent (DES) and identify predictors associated with non-adherence. Data were collected from the medical records of 1585 patients, including 1104 males and 481 females, who underwent left main stem PCI with DES. Baseline characteristics, angiographic features, and DAPT compliance rates at 1 month and 12 months were analyzed.

Efficacy and safety of semaglutide in patients with heart failure with preserved ejection fraction and obesity.

Background: Semaglutide, a once-weekly glucagon-like peptide-1 receptor agonist, has shown promise in weight management and cardiovascular outcomes in other populations. This study aimed to evaluate the efficacy of semaglutide in heart failure with preserved ejection fraction (HFpEF) patients with obesity.

Methods: A retrospective study analyzed 318 patients with HFpEF, of which 104 received semaglutide and 214 received placebo.

Clinical outcomes of myocardial infarction with non-obstructive coronary arteries presenting with diabetic ketoacidosis: a propensity score-matched analysis.

Introduction And Objective: There is a paucity of data on patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) and a decompensated diabetic state, diabetic ketoacidosis (DKA). Therefore, we aimed to investigate the outcomes of patients with MINOCA presenting with or without DKA.

Methods: We conducted this retrospective propensity score-matched analysis from January 1, 2015, to December 4, 2022.

Outcomes of European Society of Cardiology 0/1-h algorithm with high-sensitivity cardiac troponin T among patients with coronary artery disease.

Objective: The European Society of Cardiology (ESC) 0/1-h Algorithm with high-sensitivity cardiac troponin T (hs-cTnT) has shown promising results in risk stratification and management of patients with coronary artery disease (CAD). However, its outcomes and clinical implications in the context of developing countries remain understudied.

Methods: This cohort study aimed to evaluate the outcomes and clinical significance of the ESC 0/1-h Algorithm in a developing country setting.

Predicting stroke and mortality in mitral stenosis with atrial flutter: A machine learning approach.

Background: Our study hypothesized that an intelligent gradient boosting machine (GBM) model can predict cerebrovascular events and all-cause mortality in mitral stenosis (MS) with atrial flutter (AFL) by recognizing comorbidities, electrocardiographic and echocardiographic parameters.

Methods: The machine learning model was used as a statistical analyzer in recognizing the key risk factors and high-risk features with either outcome of cerebrovascular events or mortality.

Results: A total of 2184 patients with their chart data and imaging studies were included and the GBM analysis demonstrated mitral valve area (MVA), right ventricular systolic pressure, pulmonary artery pressure (PAP), left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) class, and surgery as the most significant predictors of transient ischemic attack (TIA/stroke).

Gender Disparity in Work Distribution Among Cardiology Trainees: Pakistan's Perspective.

Gender disparity in work distribution among cardiology trainees is a crucial issue that can impact career development and the overall representation of women in the field. This cross-sectional survey aimed to examine the gender disparity in work distribution among cardiology trainees in Pakistan. A total of 1156 trainees from various medical institutions across the country participated in the study, with 687 male trainees (59.

Association of Epicardial Fat Volume with Coronary Artery Ectasia and Coronary Artery Disease.

Epicardial fat may play an important role in the pathogenesis of coronary artery disease (CAD). We investigated the relationship between coronary artery ectasia (CAE) and epicardial fat volume (EFV). This retrospective study included 506 patients with CAE (group 1), 500 with CAD (group 2), and 500 patients with normal coronaries as controls (group 3).

Pyrexia of unknown origin and its aetiology in Pakistan.

Pyrexia of unknown origin (PUO) and its aetiology vary considerably according to geography. We conducted a retrospective study to update our knowledge of PUO in Pakistan. PUO was defined as a febrile illness of >3 weeks' duration, a temperature of >38.

Evaluating the frequency of successful guidewire crossing through a complex lesion in coronary artery disease patients having chronic total occlusion.

Objectives: To determine the frequency of successful guidewire crossing through chronic total occlusion (CTO) in patients having a J-CTO Score = 2 (difficult lesion).

Methods: A prospective, cross-sectional study was conducted at the Armed Forces Institute of Cardiology (AFIC) in Rawalpindi. Patients with high calcium score on CT-angiogram were sent for elective coronary angiogram out of which patients diagnosed with chronic total occlusion (CTO) were selected and J-CTO Score was assessed.

Engineering processive cellulase of Clostridium thermocellum to divulge the role of the carbohydrate-binding module.

The processive cellulase (CelO) is an important modular enzyme of Clostridium thermocellum. To study the effect of the carbohydrate-binding module (CBM3b) on the catalytic domain of CelO (GH5), four engineered derivatives of CelO were designed by truncation and terminal fusion of CBM3b. These are CBM at the N-terminus, native form (CelO-BC, 62 kDa); catalytic domain only (CelO-C, 42 kDa); CBM at the C-terminus (CelO-CB, 54 kDa) and CBM attached at both termini (CelO-BCB, 73 kDa).

Secreted protein markers in oral squamous cell carcinoma (OSCC).

Background: Oral squamous cell carcinoma (OSCC) is a main cause of oral cancer mortality and morbidity in central south Asia. To improve the clinical outcome of OSCC patients, detection markers are needed, which are preferably non-invasive and thus independent of a tissue biopsy.

Methods: In the present study, we aimed to identify robust candidate protein biomarkers for non-invasive OSCC diagnosis.

Echocardiography in a critical care unit: a contemporary review.

Introduction: Echocardiography is a rapid, noninvasive, and complete cardiac assessment tool for patients with hemodynamic instability. Relevant articles were extracted after searching on databases by two reviewers and incorporated in this review in anarrative style.

Areas Covered: his review provides an overview of the evidence for current practices in critical care units (CCUs), incorporating the use of echocardiography in different etiologies of shock.

Circulating miR-146a expression as a non-invasive predictive biomarker for acute lymphoblastic leukemia.

Dysregulation of non-coding microRNAs during the course of tumor development, invasion and/or progression to the distant organs, makes them a promising candidate marker for the diagnosis of cancer and associated malignancies. This exploratory study aims at evaluating the usefulness of plasma concentration of circulating mir-146a as a non-invasive biomarker for acute lymphoblastic leukemia (ALL). Total RNA including miRNA was isolated from 110 plasma samples of patients (n = 66), healthy controls (n = 24) and follow up (n = 20) cases and reverse transcribed.

Tricuspid insufficiency after cardiac-implantable electronic device placement.

Objective: Device-related stimates of incidence and significance of tricuspid regurgitation (TR) is mainly based on case reports and small observational studies. We sought to determine whether right-heart device implantation increased the risk of TR in this interventional study.

Methods: All patients who underwent permanent pacemaker (PPM) or other device implantation were assessed for degree of TR at one year.

Balance between Protection and Pathogenic Response to Aerosol Challenge with (Mtb) in Mice Vaccinated with TriFu64, a Fusion Consisting of Three Mtb Antigens.

Tuberculosis vaccines capable of reducing disease worldwide have proven difficult to develop. BCG is effective in limiting childhood disease, but adult TB is still a major public health issue. Development of new vaccines requires identification of antigens that are both spatially and temporally available throughout infection, and immune responses to which reduce bacterial burden without increasing pathologic outcomes.

Diagnostic challenge: an atypical presentation of infective endocarditis.

It is recognised that infective endocarditis is frequently a challenging diagnosis to make, as it may present with a range of non-specific symptoms. A middle-aged man was admitted with an 8-day history of profuse non-bloody diarrhoea and vomiting. He had no medical history and no identifiable risk factors for infective endocarditis, and so this in combination with the patient's atypical symptoms presented a diagnostic challenge.

SUMO-fusion and autoinduction-based combinatorial approach for enhanced production of bioactive human interleukin-24 in Escherichia coli.

High-level production of recombinant human interleukin-24 (IL-24), a multifunctional immunomodulatory cytokine, has been challenging due primarily to its aggregation as inclusion bodies in the bacterial host while persistent poor-expression in the insect/mammalian expression systems. The present study presents a robust, vector-host combination (pE-SUMO-IL24), auto-inducible medium (YNG/M9NG), and a simple purification scheme for soluble, bioactive, and cost-effective production of native-like IL-24 (nIL-24) in Escherichia coli. The final protein yield, following a three-step purification scheme (IMAC, SEC, dialysis), was 98 mg/L in shake-flask culture (with scale-up potential), which was several folds higher than reported earlier.

Improvement in activity of cellulase Cel12A of Thermotoga neapolitana by error prone PCR.

Using multi-step error prone PCR (ep-PCR) of the gene encoding endoglucanase Cel12A (27 kDa) from Thermotoga neapolitana, mutants were obtained with many fold increase in the enzyme activity. The best mutant (C6, N47S/E57 K/ V88A/S157 P/K165 H) obtained after four rounds of ep-PCR showed 2.7-, 5- and 4.