Articles

Background: Idiopathic intracranial hypertension (IIH or pseudotumor cerebri) has two major morbidities: papilledema with visual loss and disabling headache. Intracranial Venous Hypertension (IVH) is a fundamental mechanism of IIH. Although traditionally considered limiting to the central nervous system, evidence suggests IIH as a systemic disease associated with cardiorespiratory disorders, which has been far less comprehended. Case Report: A 60-year-old female with Chronic Obstructive Pulmonary Disease (COPD) was admitted for dyspnea and developed a coma with a pH of 7.01 and pCO2 of 158 mmHg. She was intubated and had persistent nuchal rigidity, a brief myoclonus episode with a negative electroencephalogram, and negative CT head studies. A Lumbar Puncture (LP) revealed elevated opening pressure (35 cmH2O) with normal Cerebral Spinal Fluid (CSF) studies. Her nuchal rigidity improved after the removal of 40 mL CSF. The ophthalmology examination the next day after her the large volume LP didn’t show visual loss or papilledema. The patient improved clinically and was extubated two days later. Her echocardiogram showed a dilated right ventricle with pulmonary hypertension. The patient was discharged home.Discussion: IIH is different from hypercapnic encephalopathy and characterized by increased intracranial pressure with papilledema, vision loss, and debilitating headache. Hypercapnia-induced increased intracranial venous flow and pulmonary hypertension-caused elevated central venous pressure with consequent outflow resistance lead to IVH. In hypercapnic encephalopathy, the presentation is mostly cognitive changes. In this case, nuchal rigidity with a negative CT head scan triggered the investigation of IIH. Conclusion: A deep understanding of the relationship between COPD and IIH is vital. There is insufficient evidence to recommend routine eye examinations in COPD patients for papilledema and to conduct a pulmonary function test for a newly diagnosed IIH patient. However, we highly suggest a timely ophthalmology exam prior to performing an LP in COPD patients with suspecting IIH to avoid unnecessary procedures and meanwhile improve clinical outcomes.

We reviewed our outcomes of patients with relapsed/refractory Hodgkin Lymphoma treated with autologous stem cell transplant over a 30-year period, 1992 to 2022 and are reporting 15-year Disease-Free Survival (DFS) and Overall Survival (OS) of the 36 patients treated (19 men, 17 women, median age 41). Over the years there were different preparative regimens employed (carmustine, etoposide, melphalan and BCNU, etoposide, cytarabine, and melphalan) as well as post-transplant consolidation therapy (brentuximab). With a median follow-up of 15 years, the DFS is 52% and OS is 64%. Long-term complications include cardiomyopathy and second malignancies.The use of better salvage regimens and post-transplant consolidation therapy should lead to better outcomes.

New synthetic compounds - thioxopyrimidine derivatives as regulators of vegetative growth and photosynthesis of spring barley (Hordeum vulgare L.) variety Acordine were studied. The growth-regulatory effect of new synthetic compounds, thioxopyrimidine derivatives, used in a concentration of 10-6M, was compared with the growth-regulatory effect of a plant hormone auxin IAA (1H-indol-3-yl)acetic acid) or synthetic plant growth regulators, derivatives of sodium and potassium salts of 6-methyl-2-mercapto-4-hydroxypyrimidine (Methyur, Kamethur), N-oxide-2,6-dimethylpyridine (Ivin), used in a similar concentration of 10-6M. The conducted study showed the similarity of the growth-regulatory effects of synthetic compounds, thioxopyrimidine derivatives, the plant hormone auxin IAA, and synthetic plant growth regulators Methyur, Kamethur, and Ivin. Morphometric parameters (average length of shoots (mm), average length of roots (mm), and average biomass of 10 plants (g)) and biochemical parameters (content of photosynthetic pigments chlorophylls a, b, a+b and carotenoids (µg/ml)) of barley plants treated with the plant hormone auxin IAA or synthetic plant growth regulators Methyur, Kamethur, Ivin or thioxopyrimidine derivatives were increased after 4 weeks compared to control plants. The dependence of the growth-regulatory effect of synthetic compounds, thioxopyrimidine derivatives on their chemical structure was analyzed. The use of the synthetic plant growth regulators, derivatives of sodium salt of 6-methyl-2-mercapto-4-hydroxypyrimidine (Methyur), potassium salt of 6-methyl-2-mercapto-4-hydroxypyrimidine (Kamethur), N-oxide-2,6-dimethylpyridine (Ivin) and selected most active synthetic compounds, thioxopyrimidine derivatives for regulating the growth and photosynthesis of spring barley (Hordeum vulgare L.) variety Acordine is proposed.

Introduction: Despite the benefits of Cardiac Rehabilitation (CR), local and national CR referral and participation rates remain low when compared to established cardiovascular therapies, especially amongst racial/ethnic groups. Objectives: This study investigated the effects of the implementation of a CR program and electronic order set (EOS) in a large health system on CR referral and participation rates among a diverse group of patients with Coronary Heart Disease (CHD). Methods: A total of 360 patients from UCSD Health who presented with ACS were prospectively evaluated during initial hospitalization and 6- and 12-weeks post-discharge. The multivariable logistic regression model assessed referral and participation rates by week 1 and -12 post-discharge, adjusting for gender, age, race, ethnicity, geography, and referring physician subspecialty. Results: UCSD CR program implementation led referral rates to increase at week 1 (Pre- 38.6% and Post-54.9%, p = 0.003) and week-12 (Pre- 54.1% and Post- 59.8%, p = 0.386). Post-CR referrals were more likely at week-1 (OR: 1.93, 95% CI 1.27-2.95) and week-12 (OR: 1.26, 95% CI 0.79-2.00). EOS implementation increased referral rates at week-1 (Pre- 40.3% and Post- 58.7%, p < 0.001) and week-12 (Pre- 54.9% and Post- 60.4%, p = 0.394) with referrals more likely at week-1 (OR: 2.1, 95% CI 1.35-3.29) and week-12 (OR: 1.25, 95% CI 0.795-1.98). Participation in CR following EOS was more likely at both week-1 and week-12. Multivariable analysis revealed disparities in referral based on race, geographic location, and referring physician subspecialty. Conclusion: A CR program and EOS implementation were shown to increase referral rates with long-term potential for increasing referral and participation rates. Condensed abstract: This prospective study investigated the implementation of a Cardiac Rehabilitation (CR) program and Electronic Order Set (EOS) within the same health system on CR referral and participation rates. 360 patients with ACS were evaluated over 12 weeks. UCSD CR program and EOS implementation led referral rates to increase at week-1 and -12. CR participation was more likely to increase at week-1 and -12 following EOS. Multivariable analysis revealed disparities in referrals disproportionally affecting racial and ethnic minority groups and rural communities. CR and EOS implementation may increase CR referral rates for diverse patients with CHD.

Urinary Tract Infection (UTI) is very common in our community most specifically in married females with numerous antecedent risk factors. The aim of the study was to find out about the current risk factors and clinical profile of urinary tract infections in patients admitted to the cardiology ward of Afghan Momand Medical Complex for various purposes.It was a cross-sectional descriptive hospital-based study including both male and female patients visiting the Afghan Momand Medical Complex from January 2022 to June 2022. Of all 960 patients, 202 (21%) patients had urinary tract infections with gender distribution as 69 (34.2%) males and 133 (65.8%) females. In fact, 33 (16.3%) patients with urinary tract infections were single while the rest 169 (83.7%) patients were married. In addition, regarding clinical profile, the following clinic was respectively more prevalent: Dysuria in 120 (59.4%) patients, flank pain in 73 (36.1%) patients, urine frequency in 67 (33.1%) patients, urgency in 36 (17.8%) patients, fever in 24 (11.8%) patients, and nausea and vomiting in 19 (9.4%) patients. Moreover, the following risk factors were respectively the most common ones: Diabetes mellitus 86 (42.5%), pregnancy 30 (14.9%), stones 15 (7.4%), 10 (4.9%) devices, 10 (4.9%) prostatic hyperplasia, and 4 (2%) anatomical anomalies.Urinary tract infection is a common disease in the admitted patients in Afghan Momand Medical Complex specifically being more common in females and early 20s of the age. In fact, diabetes, pregnancy, and kidney stones were the leading associated factors with UTI. Moreover, dysuria, bladder emptying irritative symptoms, and abdominal pain were the most prevalent clinical profile of the patients. Special attention should be paid to infectious diseases in cardiac patients since infection itself is a stress and a threat to such patients and authorities should design special measures to prevent UTI in the general population to avoid a sum of burden on the health system.

The psychological burden of physicians has been the focus of many researchers since the 1950s, and some papers have found a high prevalence of anxiety and depressive disorders among medical staff. Recent studies have shown that the coronavirus pandemic didn’t go easy on healthcare workers. The fact that it has been three years since the outbreak, has motivated our study. Which aims to evaluate the intensity of anxiety among medical personnel and the risk factors that could be incriminated post-COVID pandemic and if the level of anxiety is back to normal. This is a cross-sectional study, carried out with a survey split into 2 parts sociodemographic and work-related data, and the French version of the Hamilton anxiety scale, Statistical analysis was performed using Jamovi et Microsoft Excel. About half of the 116 physicians in our study had no anxiety (55.2%), while 21.6% had mild anxiety, 10.3% had moderate anxiety, and 12.9% had severe anxiety. The identified risk factors for anxiety were female gender, personal and family history of anxiety disorder, doing night shifts, and being a general practitioner. The anxiety rate of physicians is back to normal post-COVID pandemic. But we shouldn’t stop there. The mental health status of medical personnel depends on several of the factors listed above. Determining them would imply a call for the implementation of preventive measures for anxiety and depressive disorders among physicians. Because taking care of physicians is taking care of patients.

Autoclaved aerated concrete is becoming an increasingly popular building material, and for good reason. It is ecological, energy efficient, strong, and durable. Studies show that the production of autoclaved aerated concrete saves 85% of energy compared to the production of heavy concrete. However, the use of steel reinforcement in large-sized aerated concrete products leads to deterioration of thermal insulation properties, corrosion, and destruction of the material. Replacing steel reinforcement with discrete fiber strands can solve this problem. The fiber does not affect the thermal insulation properties, is not prone to corrosion, and can be evenly distributed over the entire volume of the product.

The inflationary epoch, occurring shortly after the Big Bang, initiated an extraordinarily rapid exponential expansion of the universe. Following this period, the rate of cosmic expansion decelerated for approximately 9.8 billion years, until observations indicated a transition to an accelerated expansion of space-time. This paper aims to estimate the minimum possible deceleration of cosmic expansion during the post-inflationary epoch, addressing an unresolved aspect of cosmological studies. The observable universe is modeled as a spherical region defined by the particle horizon in the FLRW metric. The model operates on the principle that the speed of light cannot exceed the speed of space-time expansion, given that photons are bound by space-time constraints. This paper hypothesizes that at the end of the 9.8 billion years of deceleration, the expansion speed was at its lowest, nearly equating to the speed of light. Subsequently, this speed has increased, correlating with the current accelerated expansion. Through a graphical representation assuming a uniform rate of change in expansion speed (for minimum possible values), we apply concepts of onedimensional motion to derive our estimates. This novel approach provides a foundational calculation of the minimum deceleration, significantly contributing to the understanding of the dynamics of cosmic expansion and offering a basis for future research and observational refinement.

The current study included a variety of phytochemical substances that were extracted from Centaurium pulchellum and showed a wide range of medicinal properties from the plant's reproductive and vegetative parts against the pathogenic fungus Aspergillus flavus. The vegetative and reproductive components of Centaurium pulchellum were subjected to (GC-MS) analysis for phytochemical study. The data indicated that fungal activity was the highest. Four extract concentrations of 5, 10, 15, and 20 mg/ml were utilized in the investigation, and the diameter of the colonies measured at each concentration was 90.00, 36.00, 28.00, 18.00, and 0.00 mm, respectively.Nine bioactive phytochemical compounds were found in Centaurium pulchellum's vegetative and reproductive portions, according to GC-MS analysis of the chemicals. Another study reported phytochemical substances that: 1-H-Imidazole-2-carboxaldehyde, 1-methyl-;Acetaminophen; n-Hexadecanoic acid; Mercaptoacetic acid, 2TMS derivative; 1.2,3-Dimethyl-5-(trifluoromethyl)-1,4-benzenediol #; Mercaptoethanol, 2TMS derivative-; Bis-(3,5,5-trimethylhexyl) phthalate Tetrakis(trimethylsilyl) orthosilicate #;- 1.1-Isopropoxy-3,3,3-trimethyl-1-[(trimethylsilyl)oxy]disiloxanyl tris(trimethylsilyl) orthosilicate #.

Carfilzomib, a highly selective proteasome inhibitor, is commonly used in the treatment of multiple myeloma and AL amyloidosis. While its efficacy is well-established, there is increasing recognition of its association with cardiovascular adverse events, including hypertension, heart failure, and arrhythmias. However, cases of carfilzomib-induced pericardial disease remain rare. Here, we present a case of a 78-year-old female with multiple myeloma who experienced two episodes of hemorrhagic pericardial effusion following carfilzomib therapy, highlighting the importance of vigilant cardiovascular monitoring during treatment.