Background: Coronary artery disease (CAD) is the most common cause of sudden death, none and death of men and women over 20 years of age. The aim of the study was to know if there is any linear correlation between oxidants and abnormal lipid profile parameters in CAD. Materials and Methods: The present study includes 42 known CAD cases (age = 41-75 years) and 33 age- and sex-matched healthy controls. Malondialdehyde ( MDA), total cholesterol, high-density lipoprotein (HDL) cholesterol, and triacylglyceride were measured and low-density lipoprotein (LDL) cholesterol was calculated in both cases and controls, respectively. Results: MDA was significantly increased in cases than controls (P = 0.0000001). Total cholesterol was high in cases than controls (P = 0.0000001). HDL cholesterol was significantly decreased in cases than controls (P = 0.0000001). LDL cholesterol was high in cases than controls (P = 0.0000001). Triacylglyceride was high in cases than controls (P = 0.0000001). Insignificant positive correlation were observed between MDA and total cholesterol (r = 0.258), between MDA and LDL cholesterol (r = 0.199), and between MDA and HDL cholesterol (r = 0.134). Negative correlation was observed between MDA and triacylglyceride (r = -0.314). Conclusion: Increased oxidative stress and abnormal lipid profile were observed in CAD cases. Our study showed that statistically significant linear relationship could not be established between increased oxidative stress and abnormal lipid profile parameters, suggesting that increased oxidative stress and abnormal lipid profile are two independent risk factors in the pathomechanism of atherogenesis.

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Objectives: The present cross-sectional study was aimed to investigate obesity measures, metabolic profiles, blood pressure, and intake of dietary fatty acids in rural women of Asian Indian origin. Materials and Methods: A total of 280 healthy rural women aged 25-65 years took part in the study. A random sampling procedure using a local voters' registration list was followed to select the participants. All participants belonged to the Bengalee population and were inhabitants of the Bolpur-Santiniketan area, West Bengal, India. Anthropometric measures, namely, height, weight, circumferences of waist and hip, skinfolds at biceps, triceps, subscapular, and suprailiac regions, etc., were collected using standard techniques. Body mass index (BMI), percentages of body fat (PBFs), basal metabolic rate (BMR), and intra-abdominal visceral fat (IVF) were measured using an Omron body fat analyzer (Omron Corporation, Tokyo, Japan). Fat mass (FM), fat free mass (FFM), waist-hip ratio (WHR), and sum of four skinfolds (SF4) were also taken into consideration. Blood pressure and metabolic and hormonal profiles were measured using standard techniques. The weekly consumption (frequency) of food stuffs was collected using an already validated food frequency schedule. Results: The result showed that the mean age was 41.52 ± 10.95, BMI 23.07 ± 4.34, PBF 31.76 ± 7.06, BMR 1162.34 ± 139.59, WHR 0.83 ± 0.06, systolic blood pressure 118.84 ± 20.35, diastolic blood pressure 77.77 ± 12.12, total cholesterol 185.61 ± 25.19, triglyceride level 135.82 ± 30.39, high-density lipoprotein 48.13 ± 6.13, low-density lipoprotein 109.90 ± 22.53, fasting blood glucose 90.91 ± 7.98, and insulin 11.98 ± 3.42. The result also shows the mean intake of total protein to be 177.01 ± 47.79, total energy 8321.60 ± 1354.86, total fat 210.36 ± 53.57, total PUFA 82.02 ± 49.73, and total MUFA 94.01 ± 16.38. The percentile distribution of the dietary fat intake revealed that the 10th and 95th percentile values of the total protein intake were 125.3 and 261.5, total energy intake were 7491.6 and 10470.2, total fat intake were 178.8 and 273.5, total PUFA intake were 55.5 and 191.7, and of the total MUFA intake were 86.0 and 126.9, respectively. Conclusion: It seems reasonable to argue that dietary management including dietary guidelines across India is essential to retard the growing incidence of cardiovascular diseases in coming years.

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The sticky platelet syndrome (SPS) is a congenital disorder characterized by platelet hyperaggregability to epinephrine and/or adenosine diphosphate; this predisposes affected individuals to acute myocardial infarction, ischemic optic neuropathy, recurrent venous thromboembolism, and transient ischemic cerebral attacks and strokes. Here, we describe an unusual case with recurrent cerebrovascular accidents due to SPS, in the presence of a patent foramen ovale (PFO). We report an unusual case of a 56-year-old female patient with a PFO, who suffered from recurrent strokes despite long-term medication with clopidogrel for SPS. The patient underwent successful transcatheter closure of the PFO, and, in addition, she has been placed on low-dose acetylsalicylic acid. After 18-month follow-up, she demonstrated an intact atrial septum without any vegetations on the percutaneous device until today. She has had no further thromboembolic events.

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Sub acute left-sided bacterial endocarditis is a serious condition that may be overlooked due to highly variable clinical manifestations. We present the case of a 45-year-old man who presented with complaints of fullness in his abdomen and splenomegaly that referred to the surgery clinic. He underwent diagnostic splenectomy.3 month after splenectomy endocarditis was diagnosed. We recommend echocardiography in the work up of isolated splenomegaly.

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Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a kind of heart muscle disease characterized by the gradual replacement of the right ventricular myocardium with fibrous tissue and fat. It could be the major cause of sudden cardiac death with ventricular tachycardia, and there is a variation in the history of the disease. We reported an unusual case of ARVC in a middle-aged woman with congestive heart failure as her first presentation for a long time.

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We describe a case of ruptured aneurysm of the left coronary sinus of Valsalva diagnosed by transthoracic two-dimensional echocardiography. A very few cases with ruptured left sinus of Valsalva have been reported. We are reporting a rupture of the left sinus of Valsalva into the main pulmonary artery in a 40-year-old male diagnosed by transthoracic echocardiography.

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Sternal osteomyelitis with bacteremia due to Mycobacterium abscessus is rarely seen in immunocompetent hosts. Routine pyogenic cultures in these cases are often negative causing a delay in diagnosis and treatment. Clinicians and microbiologists should rule out the possibility of infection due to nontuberculous mycobacteria while managing cases of nonhealing culture-negative wounds with conventional antibiotic therapy. We report a case of bacteremia secondary to a nonhealing sternal wound due to M. abscessus. A combination of radical debridement and prolonged antimicrobial therapy helped in the complete eradication of the infection.

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Endothelial cells (ECs), forming a semi-permeable barrier between the interior space of blood vessels and underlying tissues, control such diverse processes as vascular tone, homeostasis, adhesion of platelets, and leukocytes to the vascular wall and permeability of vascular wall for cells and fluids. Mechanisms which govern the highly clinically relevant process of increased EC permeability are under intense investigation. It is well known that loss of this barrier (permeability increase) results in tissue inflammation, the hall mark of inflammatory diseases such as acute lung injury and its severe form, acute respiratory distress syndrome. Little is known about processes which determine the endothelial barrier enhancement or protection against permeability increase. It is now well accepted that extracellular purines and pyrimidines are promising and physiologically relevant barrier-protective agents and their effects are mediated by interaction with cell surface P2Y receptors which belong to the superfamily of G-protein-coupled receptors. The therapeutic potential of P2Y receptors is rapidly expanding field in pharmacology and some selective agonists became recently available. Here, we present an overview of recently identified P2Y receptor agonists that enhance the pulmonary endothelial barrier and inhibit and/or reverse endothelial barrier disruption.

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Introduction: Several studies have shown that ventricular dysfunction is increased in individuals with diabetes. Insulin resistance (IR) may precede type 2 diabetes, and is a pathogenic factor for it. Furthermore, IR has been shown to be an independent predictor of cardiovascular disease in diabetes. Given that glucose intolerance and IR precede the development of overt diabetes, these factors would be associated with abnormal myocardial performance. Aim of the Work: To evaluate the state of left ventricular structure and function in prediabetic adults in relation with IR. Patients and Methods: A case-control study was performed. One hundred and twenty-one consecutive adults with prediabetes were enrolled for the study. Forty-two of the adults had IR (group A) and 79 had insulin sensitivity (group B). Forty-three healthy (with normal blood glucose) adults matched for age and gender were considered as a control group. All groups were subjected to full medical history and clinical examination and biochemical and echocardiographic studies. Results: There were no statistically significant differences between the insulin-sensitive prediabetic group and the control group in all parameters of left ventricular structure and systolic and diastolic functions. Significant differences were observed between group A and control group in the parameters of left ventricular diastolic function (both isovolumetric relaxation time and E/A ratio). Regarding correlation between the parameters of diastolic function and different variables of IR prediabetic group, there was a statistically significant coefficient correlation with HOMA IR, waist circumference and triglycerides. No correlation was observed with fasting glucose, Hb A1c, body mass index, blood pressure (BP) and total lipids. Conclusion: In prediabetic adults, IR is associated with impaired left ventricular diastolic function, and this association appears to be independent of BP, ventricular geometry, glucose tolerance status, total plasma lipids and obesity.

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Background: Apolipoprotein E (ApoE) plays a role in the regulation of lipid metabolism in humans. ApoE, a 229-amino-acid polypeptide, is classified into three major isoforms (E2, E3, and E4) according to the differences in amino acids at positions 112 and 158. In the normal population, ApoE3 isoform is the most prevalent, and ApoE2 or E4 is frequently associated with hyperlipoproteinemia. The objective of this work was to investigate the relationship between ApoE gene polymorphism and coronary heart disease (CHD) in Gaza Strip and investigate the association between serum lipid levels and CHD. Material and Methods: The study population consisted of 137 subjects including 69 CHD cases (45 male, 24 female) and 68 healthy subjects (33 male and 35 female). Results: The ApoE3/E3 genotype was the most common in the control and the CHD groups. ApoE2/E3 and ApoE3/E4 were the next most common genotypes. The frequencies of ApoE alleles in the CHD subjects were 0.826 for E3, 0.137 for E4, and 0.0362 for E2. These frequencies are comparable to those found in the control group which were 0.875 for the E3, 0.073 for E4, and 0.0515 for E2. No statistically significant differences in ApoE genotypes were found between the patients and the control groups. Moreover, there was no significant difference between the mean of triglyceride (TG) and HDL levels among different ApoE genotypes. However, there was a significant difference in the mean of LDL and ApoE genotypes where the mean of LDL was 218.17 mg/dl in ApoE4, 149.67 mg/dl in ApoE2, and 184.52 mg/dl in ApoE3. A significant difference was also evident between the mean of LDL levels in the CHD and the control group where the mean of LDL was 126 mg/dl in CHD and 111.47 mg/dl in the control group. Our study indicated that there was no significant difference between the mean of cholesterol and TG levels of the CHD and the control groups. Conclusions: To our knowledge, this is the first study in Gaza Strip investigating the relation between ApoE genotypes and CHD. Further investigations are needed to link other genetic factors to CHD.

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The fields of regenerative medicine and cellular therapy have been the subject of tremendous hype and hope. In particular, the perceived usage of somatic cells like mesenchymal stromal cells (MSCs) has captured the imagination of many. MSCs are a rare population of cells found in multiple regions within the body that can be readily expanded ex vivo and utilized clinically. Originally, it was hypothesized that transplantation of MSCs to sites of injury would lead to de novo tissue-specific differentiation and thereby replace damaged tissue. Now, it is generally agreed that MSC home to sites of injury and direct positive remodeling via the secretion of paracrine factors. Consequently, their clinical utilization has largely revolved around their abilities to promote neovascularization for ischemic disorders and modulate overly exuberant inflammatory responses for autoimmune and alloimmune conditions. One of the major issues surrounding the development of somatic cell therapies like MSCs is that despite evoking a positive response, long-term engraftment and persistence of these cells is rare. Consequently, very large cell doses need be administered for raising production, delivery, and efficacy issues. In this review, we will outline the field of MSC in the context of ischemia and discuss causes for their lack of persistence. In addition, some of the methodologies be used to enhance their therapeutic potential will be highlighted.

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Aim: The aim was to assess the effect of renal angioplasty with stent on systolic, diastolic, and mean arterial blood pressure (MAP) in awake and sleep time with ambulatory blood pressure (ABP) monitoring (Holter monitoring). Materials and Methods Patients with angiographically proven atherosclerotic renal artery stenosis (RAS) were referred to the Angiography Department of Imam Hospital for intervention during a 1-year period from June 2008 to December 2009. Primary stent placement was attempted by a single operator in 27 severe RAS cases although 1 case was omitted from the study because of technical failure. Pre- and postprocedure creatinine levels, ejection fraction (EF), history of diabetes mellitus (DM), and ABP were obtained. Twenty-six (17 men, 9 women; average age, 62.6 years; age range, 90-21 years) consecutive patients participated in the study. Results: All patients had severe hypertension resistant to multiple medications; 10 patients had impaired renal function (serum creatinine level greater than 130 μmol/L). A total of 3 (11.5%) patients had congestive heart failure, and 10 (37.7%) were diabetic. Hypertension was cured in 1 (4%) patient, had improved in 23 (88.4%) patients, and had failed to respond to treatment in 2 (7.6%). Serum creatinine decreased significantly from 1.46 ± 0.89 to 1.35 ± 0.61 mg/dL (P<0.05). Conclusion: Percutaneous transluminal angioplasty for atheromatous RAS rarely "cures" hypertension, but improved blood pressure control is often achieved.

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Background: Some clinical evidence revealed that statins, apart from lowering cholesterol levels, also have an antihypertensive effect. Our aim was to evaluate the existence of a possible association of statin therapy with blood pressure (BP) control in clinical practice. Materials and Methods: Patients attending a hypertension/dyslipidemia clinic were prospectively evaluated. Those patients with a diagnosis of stage 1 hypertension and hypercholesterolemia who consented to participate were included in the study, either in the statin group (when taking a statin) or in the control group (when not taking a statin). Exclusion criteria included dementia, pregnancy, or breastfeeding, and history or evidence of stage 2 hypertension. Detailed clinical information was prospectively obtained from medical records. A total of 110 hypertensive patients were assigned to the study (82 in the statin group and 28 in the control group). Results: Although there were no significant differences (P > 0.05) in both groups concerning gender, body mass index, antihypertensive pharmacotherapy, and serum levels of high-density lipoprotein cholesterol and triglycerides, a higher BP control was observed in the statin group (P = 0.002). Significantly lower systolic BP (−6.7 mmHg, P = 0.020) and diastolic BP (−6.4 mmHg, P = 0.002) levels were reported in the statin group. Serum levels of low-density lipoprotein were also significantly lower in the statin group (P < 0.001). Conclusions: This observational study detected an association of statin therapy with BP control in hypertensive hypercholesterolemic patients in clinical practice. These findings raise the possibility that statin therapy may be useful for BP control in the studied population.

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Cardiovascular disease is increased in individuals with type 1 or type 2 diabetes mellitus (DM). Left ventricular hypertrophy (LVH), which is an ominous prognostic sign and an independent risk factor for cardiac events, is often present in type 2 DM patients. The aim of our cross-sectional study was to evaluate the prevalence of LVH, and risk factors for its development, in normotensive type 2 diabetic patients without antihypertensive medication. The objectives of the study were to find out the prevalence of high left ventricular mass (LVM) in normotensive type 2 diabetic patients and compare it with nondiabetics and to uncover the risk factors for the development of high LVM in normotensive type 2 diabetic patients. A total of 130 age- and sex-matched subjects were selected (65 cases, diabetic normotensive, and 65 controls, nondiabetic normotensive) and baseline data were collected. LVM and left ventricular mass index (LVMI) were calculated using echocardigraphic parameters and body surface area. LVMI was significantly higher in patients with type 2 DM compared with age-, sex-matched healthy population (104.9 ± 21 vs. 78.5 ± 22.7 g/m ² , respectively; P < 0.05). BMI, HbA1c, and duration of diabetes were significantly associated with LVH whereas sexes, age, PPBS, were not.

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