Coronary artery bypass grafting after percutaneous coronary intervention

Following percutaneous intervention (PCI), restenosis, progression of disease and multi-vessel involvement may require further intervention in the form of surgical revascularization. Patients with coronary artery bypass grafting (CABG) done after PCI were evaluated to find out the reason for the need of surgical revascularization. Over a period of 12 months, 610 patients underwent CABG. Out of them, 34 patients had previous PCI/stenting. Coronary risk factors including hypertension in 85%, diabetes mellitus in 60%, dyslipidemia in 60%, tobacco use in 50% and a positive family history was present in 53% of the patients. All patients were symptomatic. Multi-vessel disease was present in 67% and single vessel in 4.7%. The extent of disease and stenosis of stents were responsible for reintervention. Careful selection of patients is required in presence of multiple risk factors for coronary artery disease to provide maximum benefit by either PCI or CABG.     

Cyclic vomiting syndrome in a 27‐year‐old male: A case report

A 27‐year‐old man presented with post‐meal chest tightness followed by vomiting for 3 years. With a multidisciplinary approach, he was labeled as cyclical vomiting syndrome and treated with pharmacotherapy, psychotherapy, and lifestyle modifications.     

<Emphasis Type="Italic">HFE</Emphasis> mutations in heart disease

Given the reported association of cardiac complications with hereditary hemochromatosis and the high carrier frequency of HFE gene mutations in the natural population, it seems reasonable that such mutations might appear more frequently than expected among symptomatic cardiac patients. Thus, H63D, C282Y, and S65C mutations and their possible associations were examined in 477 Caucasian males undergoing coronary angiography. Genotypes were analyzed for differences between ferritin and transferrin levels, coronary artery disease (CAD), cardiomyopathy (CM), and cardiovascular disease (CVD) mortality. No significant differences were found in ferritin levels between those with or without HFE mutations (C282Y P = 0.632, H63D P = 0.765, S65C P = 0.568, and HFE mutation P = 0.568); however, there was a significant difference (P = 0.005) in mean transferrin levels between those with (252 mug/l) and without (275 mug/l) C282Y. No relationship between HFE mutations and CAD (C282Y, P = 0.402; H63D, P = 0.112; S65C, P = 0.170) or CVD death (C282Y, P = 0.560; H63D, P = 0.682; S65C, P = 0.664) was demonstrated using logistic regression. However, an association between S65C and CM was found (odds ratio 4.4; 95% confidence interval 1.3-13.3, P = 0.018). This suggests that the S65C allele may contribute to the development of CM, but that these three HFE mutations do not appear to play a significant role in development of ischemic heart disease.     

Prevalence of irritable bowel syndrome and functional dyspepsia,overlapping symptoms,and associated factors in a general population of Bangladesh

Background

This community-based survey aimed to find out the prevalence of irritable bowel syndrome (IBS), functional dyspepsia (FD), overlapping symptoms, and associated factors for overlap.

Method

By cluster sampling method, 3,000 (1,523 male) randomly selected adult subjects in the Sylhet district of Bangladesh were interviewed by a questionnaire based on ROME III criteria. Multivariate logistic regression analyses were done to find out the factors for overlap with significance level set at ≤0.05.

Results

The mean age of the study population was 33.9?±?16.4 years. Prevalence of IBS and FD and IBS-FD were 12.9 % (n?=?387), 8.3 % (n?=?249), and 3.5 % (n?=?105), respectively. Approximately 27.1 % of IBS patients and 42.1 % of FD patients had overlapping IBS-FD. The odds ratio for IBS-FD overlap was 6.3 (95 % CI, 4.8–8.4). Mean age (p?=?0.011) and epigastric pain (p?=?0.002) were more in overlap patients than FD alone, whereas epigastric pain syndrome subtype (p?<?0.009) was more prevalent in lone FD subjects. In the multivariate logistic analysis, early satiety (OR, 3.0; 95 % CI, 1.2–7.5; p?=?0.018) and epigastric pain (OR, 14.5; 95 % CI, 5.0–42.1; p?=?0.000) in FD patients appeared as independent risk factors for overlap. Bloating (p?=?0.026), <3 stools per week (p?=?0.050), abdominal pain reduced by defecation (p?=?0.002), abdominal pain severity score (p?=?0.004), and overall symptom frequency score (p?=?0.000) were more in overlap patients than IBS-alone patients. In IBS patients, bloating (OR, 3.6; CI, 2.0–6.5; p?=?0.000) was found as potential symptom associated with IBS-FD overlap.

Conclusion

FD was a less prevalent disorder than IBS in our community, and significant overlap existed between the two disorders. Early satiety, epigastric pain, and bloating were important factors associated with overlap.     

Sub-chronic exposure to noise affects locomotor activity and produces anxiogenic and depressive like behavior in rats

Noise is defined as a displeasing and unwanted sound. It is one of the most encountered stressor to which mankind is exposed. Frustration, poor reading, impaired hearing and difficulty in problem solving activities are the common consequences of noise stress. It has been reported to produce atrophy of dendrites and alterations in neurotransmitter levels. Long term exposure to inescapable noise stress induces exhaustion, defeat, annoyance followed by decreased muscle movement, social contacts and mood changes. The present study was aimed to investigate the detrimental effects of noise exposure on behavior of rats and its association with altered neurochemistry. Changes in neurotransmitter levels in different brain regions including hippocampus have been reported following noise exposure and these changes in neurotransmitters levels have also been associated with altered behavior. In the present study, locomotor activity in rats was assessed by open field test (OFT) while anxiety and depressive behavior was monitored by elevated plus maze (EPM) and tail suspension (TST) tests. The results showed that 15 days sub-chronic exposure to noise stress induced anxiety and depression like behavior in male rats. These behavioral deficits observed in the present study suggest that an altered brain serotonergic and dopaminergic activity may be involved in the various psychological disorders following exposure to noise stress.