Differentiating Separate Primary Lung Adenocarcinomas From Intrapulmonary Metastases With Emphasis on Pathological and Molecular Considerations: Recommendations From the International Association for the Study of Lung Cancer Pathology Committee.

Introduction: With the implementation of low-dose computed tomography screening, multiple pulmonary tumor nodules are diagnosed with increasing frequency and the selection of surgical treatments versus systemic therapies has become challenging on a daily basis in clinical practice. In the presence of multiple carcinomas, especially adenocarcinomas, pathologically determined to be of pulmonary origin, the distinction between separate primary lung carcinomas (SPLCs) and intrapulmonary metastases (IPMs) is important for staging, management, and prognostication.

Methods: We systemically reviewed various means that aid in the differentiation between SPLCs and IPMs explored by histopathologic evaluation and molecular profiling, the latter includes DNA microsatellite analysis, array comparative genomic hybridization, TP53 and oncogenic driver mutation testing and, more recently, with promising effectiveness, next-generation sequencing comprising small- or large-scale multi-gene panels.

Global burden of disease attributable to metabolic risk factors in adolescents and young adults aged 15-39, 1990-2021.

Background: Metabolic risk factors are a significant cause of global burden among adolescents and young adults, but there is a lack of attention to the burden attributable to these metabolic risk factors globally.

Aims: This study aims to provide comprehensive estimates of five important metabolic risk factors and the attributable disease burden in people aged 15-39 years from 1990 to 2021, based on the Global Burden of Disease Study (GBD) database.

Methods: Global total deaths and disability-adjusted life years (DALYs) were used to describe the burden attributable to five common metabolic risk factors, including high fasting plasma glucose (FPG), high low-density lipoprotein cholesterol (LDL-C), high systolic blood pressure (SBP), high body mass index (BMI), and kidney dysfunction, in adolescents and young adults.

Percutaneous Transcatheter Closure of Post Myocardial Infarct Ventricular Septal Rupture After Surgical Patch Dehiscence.

Post myocardial infarction ventricular septal rupture (MI-VSR) is a dreaded complication, closure of which is extremely challenging. We here describe a case which was surgically closed after 10 days but had a failure needing continuous intra-aortic balloon pump (IABP) support and was subsequently closed percutaneously with a Post MI-VSR device.

Psychological problems and burnout among healthcare workers: Impact of non-pharmacological lifestyle interventions.

Objective: To evaluate role of rajyoga meditation (RYM) versus stress management counselling (SMC) in addressing burnout syndrome and resultant improvement in electrocardiogram (ECG) so as to automate burnout prediction from raw ECG data with machine learning (ML).

Methods: Healthcare providers were assigned to two groups: RYM (n = 100) or SMC (n = 102). Subjects in RYM received rajyoga for 3 months including one week offline and thereafter, virtual mode.

The Association Between Isometric Shoulder Strength and Sports Performances in University Soccer Players: A Cross-Sectional Study.

Background Soccer, a globally popular sport, demands a complex interplay between physical attributes, including speed, agility, power, and endurance. Although lower-body strength and power are often emphasized, the role of upper-body strength, particularly shoulder strength, remains less explored. Given the importance of upper-body movements in activities such as heading, shooting, and defending, understanding the relationship between shoulder strength and soccer performance is crucial.

Heart Rate Variability for Supplementing Withdrawal Assessment in Patients with Opioid Dependence: An Exploratory Study.

Background: Management of opioid dependence requires titrating medication doses based on withdrawal symptoms, but its clinical assessment presents challenges when it comes to subjective reporting. This study aimed to find out the relationship between heart rate variability (HRV) and opioid withdrawal in patients with opioid dependence.

Methods: Three groups of adult males were recruited: (a) patients with opioid dependence undergoing inpatient detoxification, (b) patients with opioid dependence stabilized on buprenorphine-based opioid substitution treatment, and (c) healthy controls.

Heart failure following cavopulmonary shunt - An unusual story of desmin cardiomyopathy.

Partial cavopulmonary shunt is an established procedure for patients with abnormal right ventricular (RV) physiology. Late failure of the Glenn shunt is usually due to further progression of the primary disease process. However, there may be surprises, as in our patient.

Impact of Obstructive Sleep Apnea on Cardiovascular Health: A Systematic Review.

Obstructive sleep apnea (OSA) is characterized by recurrent interruptions in breathing during sleep and is associated with a wide range of significant health concerns, particularly cardiovascular complications. This review focuses on the two primary forms of sleep apnea, namely, obstructive and central, with OSA being the most prevalent and commonly linked to conditions, such as hypertension, arrhythmias, and heart failure. Intermittent hypoxemia, activation of the sympathetic nervous system, systemic inflammation, and remodeling of the ventricles are some of the pathophysiological mechanisms that link OSA to cardiovascular disease (CVD).

Sympathetic Overdrive and Role of Beta-blockers in Various Forms of Heart Failure: A Consensus Statement from India.

In heart failure, sympathetic overdrive is evidenced by norepinephrine spillover, receptor level changes, etc. Beta-blockers continue to be the cornerstone of treatment in patients with chronic heart failure due to their ability to counteract sympathetic overdrive. Extensive clinical research has demonstrated that long-term beta-blocker treatment with metoprolol succinate, carvedilol, or bisoprolol enhances left ventricular function and reverses left ventricular remodeling, decreases hospitalization risk, and increases survival.

Capturing ultrafast energy flow of a heme protein in crowded milieu.

Energy flow in biomolecules is a dynamic process vital for understanding health, disease, and applications in biotechnology and medicine. In crowded environments, where biomolecular functions are modulated, comprehending energy flow becomes crucial for accurately understanding cellular processes like signaling and subsequent functions. This study employs ultrafast transient absorption spectroscopy to demonstrate energy funneling from the photoexcited heme of bovine heart cytochrome to the protein exterior, in the presence of common synthetic (Dextran 40, Ficoll 70, PEG 8 and Dextran 70) and protein-based (BSA and β-LG) crowders.

A Hermeneutic Phenomenological Study on Experiences of Patients Post Heart Transplantation.

The present study was conducted to explore the lived-in experiences of post-heart transplant patients. This study with a hermeneutic phenomenological approach was conducted on 23 heart transplant recipients in a tertiary hospital, AIIMS, New Delhi, India, from August to December 2020. Participants were selected through total enumerative sampling.

Treatment optimisation for blood pressure with single-pill combinations in India (TOPSPIN) - Protocol design and baseline characteristics.

Background: The burden of over 300 million individuals living with hypertension in India is increasing steadily. Most current guidelines recommend initial combination therapy for effective blood pressure (BP) control. However, there is no randomised evidence to inform which combinations to use in the South Asian population, who account for over one-quarter of the world's population.

Papillary muscles: morphological differences and their clinical correlations.

The complex architecture of the papillary muscles (PMs) of the ventricles plays a crucial role in cardiac function and pathology. This comparative study aimed to examine the differences in PMs morphology between the right and left ventricles, focusing on their number, location, and shape. A total of 38 grossly normal hearts from donated bodies were dissected, and the number, location, and shape of PMs in both ventricles were observed.

Somnometabolic Syndrome Revisited.

The term somnometabolic syndrome has been used to describe a condition where obstructive sleep apnoea coexists with one or more components of metabolic syndrome. We propose a wider definition, stating that somnometabolic syndrome refers to the multifaceted, bidirectional relationship between sleep and metabolic health, including vascular health. This also includes the association of sleep with psychological and neurocognitive function.

Community-level knowledge, attitudes, and practices regarding cardiovascular diseases and modifiable risk factors in India.

Background: Assessment of knowledge, attitudes, and practices regarding cardiovascular diseases (CVD) and cardiovascular risk factors (CVRF) is critical to inform CVD prevention strategies, but limited community-level data exist from developing countries.

Objective: To assess the knowledge, attitudes, and practices regarding CVD and CVRF and acceptability of non-physician health workers and text-message based reminders to guide CVD prevention strategies in India.

Methods: We conducted a telephone-based survey nested in the on-going Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) cohort in Delhi and Chennai, India between January 2021 to February 2021.

Citrus Odour Produces Resilient Response to Cognitive Load and Enhances Performance in the N-Back Task.

Olfactory pathway and limbic system demonstrate a close nexus, which paves common ground for investigating the effects of smell on emotions, cognitive load and autonomic functions. Notably, olfactory stimulation during the administration of cognitive load may interfere with the performance. The study is planned to investigate the effect of citrus inhalation on cognitive performance, through psychophysiological assessments.

Pulmonary tuberculosis and renal amyloidosis: A rare entity in children.

Amyloidosis is a group of disorders with extracellular accumulation of autologous fibrillary insoluble proteins in various tissues and organs such as the kidneys, liver, spleen, heart, and gastrointestinal tract leading to impaired function. Renal amyloidosis is usually considered to be a progressive disease manifesting as nephrotic syndrome and renal insufficiency with tuberculosis being one of the most common causes in adults. However, the occurrence of similar associations is rarely described in children.

Postnatal Growth Trajectories and Risk of Obstructive Sleep Apnea in Middle Age: A Cohort Study.

Study Objectives: Rapid growth in childhood predisposes to obesity and cardiometabolic diseases in adulthood. While obstructive sleep apnea (OSA) is bidirectionally linked to obesity, its developmental origins are sparsely studied. We examined associations between postnatal growth and the risk of OSA in adulthood.