Right Ventricular Dysfunction in Myocardial Infarction: A New Risk Factor for Clopidogrel Resistance?

Right ventricular dysfunction (RVD) in acute coronary syndromes occur either primary in infarction of the right ventricle mainly caused by proximal occlusion of the right coronary artery or secondary ininfarction of the left ventricle with consecutive increase of pulmonary pressure. 

The incidence of right myocardial infarction has ranged widely according to the diagnostic technique used and the patients profile. It is recognizable clinically in two thirds of hypotensive inferior infarction and most inferior infarctions with cardiogenic shock. The recommended treatment in acute myocardial infarction is percutaneous coronary intervention (PCI) with stent deployment in order to restore myocardial perfusion. Dual inhibition of platelet aggregation with a thienopyridine like clopidogrel and aspirin showed a dramatic reduction of major adverse cardiac events after PCI. Read More>>>>>>>>>>>

Endothelial Dysfunction Evaluated using Photoplethysmography in Patients with Type 2 Diabetes

Cardiovascular disorders represent the principal cause of preventable death globally and efforts to early detect cardiovascular disease will definitely contribute to the prevention of it. Type 2 diabetes mellitus (T2DM) includes a group of metabolic abnormalities that share hyperglycemia secondary to a deficit in insulin secretion, a defect in its metabolic activity, or both. 

 

Type 2 Diabetes

Diabetes is associated with chronic vascular, microvascular and/or neuropathic complications. Life expectancy of diabetic patients is reduced by a third; patients with chronic complications have twice the risk of dying than the general population.  Endothelial cells (EC) through physical and chemical changes induce con blood vessels abnormal response to functional adaptations. This is the result of a process of genetic expression, and synthesis and processing of highly regulable proteins. Read More>>>>>>>>>>

Internal Jugular Vein Aneurysm Presenting after Emesis Episode

Proper classification of venous malformations has not been established and the applied terms for venous dilatation lesions are variable. Although some authors frequently use “phlebectasia” to describe fusiform dilatations and “aneurysm” for saccular ones, these terms are often used as synonyms. Even though venous aneurysms occur equally between genders and are seen at any age, the vast majority of jugular vein aneurysms (JVAs) cases, about 75%, are diagnosed in children.

 Jugular Vein Aneurysm

Case Report: A 40-year-old woman developed a right cervical mass after anintense emesis episode five years before presenting to our institution. The mass enlarged over the years and when the patient sought for treatment she described aesthetical complaints and a sensation like the bulge “was about to rupture” during situations associated with increased central venous pressure such as exercises and defecation. Read More>>>>>>>>

Putting Evidence Based JNC 8 Guideline into Primary Care Practice

The global hypertension prevalence is estimated to increase from 40% to 50% in the year 2025, with a significant upsurge in future morbidity and mortality due to heart disease and strokes. In the Kingdom of Bahrain, hypertension control has been achieved in only 1 out of 6 treated patients, which suggests that there is a major shortcoming either in clinician inertia or failure to take appropriate action to drive blood pressures ("BPs") down to guideline recommended levels.

Primary Care Practice

We suggest that clinicians and the Ministry of Health ought to select one of the current guidelines and follow its recommendations. The Joint National Committee for Hypertension Detection and Management updated the JNC 8 guideline (2013), which if followed correctly, will achieve enhanced patient management and improve outcome indicators . The JNC 8 panel has a different, focused and more simplified treatment approach than other expert panels, with a single BP recommendation (140/90 mm Hg) for both the pharmacologic treatment threshold and treatment goal for patients between the ages of 18 to 60 years old with/without diabetes ("DM") or chronic kidney disease ("CKD").  Read More>>>>>>>>>

Racial Differences Affecting Night Time Blood Pressure Dipping Groups in Hypertensive Patients

Blood Pressure (BP) dipping is defined as the difference in BP from average waking to sleeping measurement. BP follows normal circadian rhythm of dipping at night at about 10-15% as compared to the day. Night time dipping is further divided into 4 types, reverse dipper (<0%), non-dipper (0-10%), dipper (10-20%) and extreme dipper (>20%).

Hypertensive Patients

The dip is thought to be affected by an inability to excrete sodium during the daytime. It has also been found to be greatly reduced in populations who are regularly exposed to seasonal changes. Studies have shown how different dipping status of blood pressure during the night time affects the prognosis of diseases. This is especially so in the case of reverse dippers, which are frequently linked to higher mortality in Cardiovascular Diseases (CVD), perhaps related to nocturnal hypoperfusion and/or an exaggerated morning BP surge. Read More>>>>>

Oximeter Behavior While Using a Tourniquet

This letter is a case report presenting the behavior of an approved for marketing oximeter device under tourniquet test, while comparing it with another approved for marketing device, the Cnoga TensorTip MTX (this letter is not a clinical trial report). Pulse oximeter is aimed for measuring pulse and arterial oxygen saturation (SpO2) in the blood. 

Oximeter

The Tensor Tip MTX can measure over 15 bio parameters, among them are pulse and oxygen saturation. Pulse oximetry is a noninvasive technique widely used. It was developed during the 1970’s and its main use is to measure the oxygen saturation level of arterial peripheral blood, an indicator of oxygen supply. Conventionally, a pulse oximeter has both a coherent light source, such as a LED, emitting red (660 nm) and infrared (940 nm) light, and a photodiode detector to measure the absorption of light. Read More>>>>>>>>