31 research outputs found
COVID-19 PANDEMIC AND IMPENDING GLOBAL MENTAL HEALTH IMPLICATIONS
No full textThe increase in organisms transference and infectious pandemics across the globe have been accelerated by an increase in travel, international exchange and global changes in earth’s climate. COVID-19, a virus caused by the novel coronavirus that was initially identified on December 2019, in Wuhan city of China is currently affecting 146 territories, states and countries raising distress, panic and increasing anxiety in individuals exposed to the (actual or supposed) peril of the virus across the globe. Fundamentally, these concerns ascend with all infections, including those of flu and other agents, and the same worldwide safeguards are compulsory and suggested for protection and the prevention of further diffusion. However, media has underlined COVID-19 as rather an exclusive threat, which has added to panic and stress in masses which can lead to several mental health issues like anxiety, obsessive compulsive disorder and post-traumatic stress disorder which should be contained immediately in its initial phases
Navigating cardiovascular events in non-cardiac surgery: A comprehensive review of complications and risk assessment strategies
No full textCardiovascular complications following non-cardiac surgery pose a significant global concern, affecting millions of patients annually. These complications, ranging from asymptomatic troponin elevations to major adverse cardiac events, contribute to heightened morbidity, mortality, and health care expenditures. The underlying mechanisms involve oxygen supply-demand imbalances and acute coronary syndromes precipitated by perioperative stressors. High-risk surgeries, including vascular and major abdominal procedures, are particularly susceptible to these complications. Risk assessment tools and biomarkers, especially high-sensitivity cardiac troponins, play pivotal roles in prognostication. However, despite advances in perioperative care, optimal management strategies remain elusive, as underscored by conflicting guidelines regarding interventions such as β-blockers and statins. This review aims to consolidate current evidence on cardiovascular complications following non-cardiac surgery, evaluate the utility of biomarkers, and discuss international guidelines for risk mitigation. An enhanced understanding regarding the standardized approaches is imperative in mitigating these complications effectively. Further research is essential to refine risk prediction models, validate biomarker thresholds, and elucidate the efficacy of preventive measures. Addressing these challenges can eventually lead to improved patient outcomes and more efficient healthcare resource utilization worldwide
Harnessing Artificial Intelligence in Cardiology: Advancements in Diagnosis, Treatment, and Patient Care
No full textHeart disease remains a leading cause of morbidity and mortality globally, straining healthcare systems worldwide. Artificial intelligence (AI) offers transformative solutions in cardiology, enhancing early diagnosis, personalized treatment, and surgical precision. This review examines the impact of AI on cardiology, focusing on its role in analyzing medical images, predicting risk, and managing chronic diseases. AI algorithms and intense learning models have demonstrated exceptional proficiency in interpreting imaging modalities, surpassing human diagnostic capabilities. Predictive analytics models utilizing electronic health records, genomic data, and lifestyle information significantly improve early detection and risk prediction of heart conditions. In addition, AI facilitates personalized treatment plans by predicting patient responses to specific medications and adjusting therapies in real time. In chronic disease management, AI-powered wearable devices and telehealth platforms enable continuous monitoring and timely interventions, reducing hospital readmissions. Furthermore, AI enhances surgical outcomes through real-time assistance and precision. While AI’s potential in cardiology is vast, ethical considerations and challenges such as data privacy, bias, and the “black box” nature of some algorithms must be addressed. AI stands poised to revolutionize cardiovascular medicine, offering promising avenues for improved patient outcomes and healthcare efficiency
Validity and Reliability of the Urdu Version of the McLean Screening Instrument for Borderline Personality Disorder
No full textIntroduction: Although the translation and the validation of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) are performed in various languages and samples, no study has established the validity and reliability of the Urdu version of MSI-BPD in individuals with cardiac problems.Materials and Methods: The Urdu version of the MSI-BPD was prepared through the standard back-translation method. The translation and adaption were completed in four steps: forward translation, adaption and translation, back translation and committee approach, and cross-language validation. The sample, selected through the purposive sampling method, comprised of 150 adults with cardiac problems (men = 75 and women = 75), with an age range of 23–78 years (M = 55, SD = 10.6). The Cronbach alpha reliability and factorial validity of the MSI-BPD were assessed through confirmatory factor analysis (CFA) and Pearson correlation analyses. Internal consistency and test–retest reliability (at 2 weeks' interval) were used to evaluate the reliability. Statistical analyses were performed, using SPSS (version 22) and Structural Equation Modeling (SEM) software.Results: Preliminary analysis revealed that the overall instrument had good internal consistency (Urdu MSI-BPD α = 0.79; English MSI-BPD α = 0.77) as well as test–retest correlation coefficients for 15 days (r = 0.94).Conclusions: Findings suggested that the MSI-BPD, with important limitations, can be used as an effective preliminary screening tool to measure BPD in Urdu-speaking adults with cardiac problems. Further validations should be conducted to make the translated version of the MSI-BPD an appropriate tool to screen BPD in hospitals and mental health care settings
Optical Coherence Tomography-Guided vs. Angiography-Guided Percutaneous Coronary Intervention for Complex Coronary Lesions: A Systematic Review and Meta-Analysis
No full textBackground: Despite advances in coronary artery disease (CAD) treatment, challenges persist, particularly in complex lesions. While percutaneous coronary intervention (PCI) is widely used, its outcomes can be affected by complications like restenosis. Optical coherence tomography (OCT), offering higher-resolution imaging than angiography, shows promise in guiding PCI. However, meta-analytical comparisons between OCT-guided and angiography-guided PCI remain limited. Methods: Databases, including PubMed, Scopus, Cochrane Library, and ClinicalTrials.gov, were queried through May 2025 to identify randomized controlled trials (RCTs) comparing OCT-guided PCI with angiography-guided PCI. Data were pooled using risk ratios (RRs) and mean difference (MD) with 95% confidence intervals (CIs) in a random-effects model. Results: Five RCTs involving 5737 patients (OCT: 2738 and angiography: 2999) were included. On pooled analysis, OCT-guided PCI was associated with a notable reduction in major adverse cardiovascular event (MACE) (RR: 0.71, p = 0.0001), cardiac mortality (RR: 0.43, p = 0.003), target lesion revascularization (TLR) (RR: 0.53, p = 0.007), and stroke (RR: 0.17, p = 0.02), compared to angiography-guided PCI. No significant differences were noted for all-cause mortality and myocardial infarction. Conclusions: In patients with complex coronary lesions, OCT-guided PCI reduces the risk of MACE, cardiac mortality, TLR, and stroke, compared to angiography-guided PCI only. This study supports incorporating advanced imaging techniques like OCT to improve clinical outcomes, especially in complex PCIs
Mortality Trends Associated With Acute Myocardial Infarction and Psychoactive Substance Use in Older Adults: A US Nationwide Analysis (1999-2020).
No full textThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2025 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC.Background: Acute myocardial infarction (AMI) remains a leading cause of mortality in the USA, particularly among individuals aged 65 and older. There is limited research about the association between psychoactive substance use and cardiovascular death due to AMI. This study aims to analyze trends in AMI-related mortality among older adults (aged ≥ 65) associated with psychoactive substance use in the USA from 1999 to 2020, with a focus on demographic and geographic variations.
Methods: We conducted a descriptive analysis using death certificates from the CDC's WONDER database. Data were extracted for age, sex, race/ethnicity, urban-rural status, and geographic region. Crude mortality rates and AAMR were calculated, and temporal trends were assessed using Joinpoint regression.
Results: Between 1999 and 2020, there were 231 359 AMI-related deaths among older adults with substance use disorders. Men (39.2) had a markedly higher mortality rate than women (15.0). Mortality rates increased across all age groups, with the most pronounced rise in those aged 85 and older (33.9). Metropolitan areas (22.3) experienced lower mortality rates than nonmetropolitan areas (37.9). The Midwest (32.3) consistently recorded the highest mortality rates, followed by the Northeast (25.0), South (24.5), and West (18.7).
Conclusion: The study reveals notable temporal trends in AMI mortality among older adults with psychoactive substance use, highlighting significant demographic and regional disparities. These findings underscore the need for targeted interventions to address this growing public health issue
DRY POWDER INHALERS TECHNIQUE OF COMMUNITY PHARMACISTS: AN OBSERVATIONAL STUDY FROM LAHORE, PAKISTAN
No full textIntroduction: Inaccurate utilization of various inhaler devices may severely influence the drug therapeutic effectiveness. The aim of this study is to evaluate the community pharmacist knowledge, attitudes and practice regarding the use of dry powder inhalers (DPIs).
Method: The present observational study was conducted for the evaluation of pharmacist’s knowledge and patient counseling attitude concerning the use of DPIs. A total of 114 community pharmacists from various community pharmacies of Lahore, Punjab were selected and a validated questionnaire was used to assess the knowledge of community pharmacists. The DPI technique presented by “National Heart, Lung and Blood Institute” was used as criteria for evaluation. The covert simulated patient approach was used to evaluate the DPI technique of pharmacists without any biasness.
Results: Out of 114, only 27.2% pharmacists presented adequate knowledge about the correct use of inhaler device (DPIs). Pharmacists from chain pharmacies presented higher adequacy 66.7% as compared to individual pharmacies i.e., 33.3%. Pharmacists whose working experience was more than 5 years presented better DPIs technique knowledge.
Conclusion: The study demonstrated that majority of the community pharmacist (72.8%) have inadequate dry powder inhaler technique at baseline. Setup type (Chain pharmacies) and work experience were the demographic variables that were positively associated with the adequate technique.
Peer Review History:
Received 15 July 2024; Reviewed 7 September 2024; Accepted 21 October; Available online 15 November 2024
Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, [email protected]
Reviewers:
Antonio José de Jesus Evangelista, Federal University of Ceará, UFC, Brazil, [email protected]
Asmaa Ahmed Mohamed Ahmed Khalifa, Pharos University, Alexandria, Egypt, [email protected]
Efficacy and safety of Mavacamten for symptomatic Hypertrophic cardiomyopathy – an updated Meta-Analysis of randomized controlled trials
No full textHypertrophic cardiomyopathy (HCM) is an autosomal dominant disorder with risk of sudden cardiac death (SCD) in children and adolescents. Mavacamten, also referred to as MYK-461, a myosin inhibitor of cardiac myocytes is studied in symptomatic HCM. The safety and efficacy of this medication is not well studied in pooled meta-analysis. Online database search was performed from inception to September 2023. We selected randomized clinical trials that compared Mavacamten with placebo/guideline medical treatment for HCM. We studied safety outcomes (Serious adverse events (SAEs), treatment emergent adverse events (TEAs) and Atrial fibrillation). Functional status of patients was assessed as New York Heart Association (NYHA) Classification improvement of at least + 1 grade, Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS) change from baseline). Relative risk ratios were used in randomized model using Review Manager Version 5.4 statistical software. A total of 4 RCTs comprising 503 patients were included in meta-analysis. On random effect model, we found that HCM patients that received Mavacamten had significant symptomatic improvement as depicted by improvement in NYHA class by at least + 1 grade (RR = 2.15; P < 0.0001) and KCCQ CSS score improvement (MD = 8.38; P < 0.00001) as compared to placebo arm. There was no statistically significant difference in SAEs (RR = 0.87; P = 0.69) and atrial fibrillation onset (RR = 0.80; P = 0.73) between HCM and placebo arm. The studies had low heterogeneity/publication bias. Mavacamten can improve symptoms in HCM patients, and can be additive to other alternative regimen in HCM patients with no statistical significance of risk of SAE or atrial fibrillation onset as compared to placebo
D-3 Comparative Mortality Trends in Atrial Fibrillation vs. Other Arrhythmias in Acute Myocardial Infarction: A CDC WONDER Database Analysis
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