No abstract

No abstract

No abstract

No abstract

Background: The diagnosis of Non-ST Elevated Myocardial Infarction (NSTEMI) is dependent on elevation of high sensitivity troponin (Hs-troponin). The current cutoff point for Hs-troponin is highly sensitive but not specific for obstructive coronary artery disease (CAD). This study aims to determine the best cutoff point for diagnosing CAD in patients presented with NSTEMI. Methods:Our study included all patients admitted as NSTEMI that underwent coronary angiography (CAG). They were grouped into two groups; A and B. Group A has obstructive CAD of 70% or more stenosis and group B with non-obstructive CAD. Patients were assessed for their demographics, clinical history, laboratory and imaging results. Using SPSS version 22, the pooled cohort of patients were analyzed at significant level <0.05 and the data were tested for significant correlations between two predetermined groups.Results: Group A comprised 87.6% of the patients and both groups had a median age of 53 years. In Group A, 91% were males, 54% diabetics, 54% hypertensives, and median Hs-troponin was 145 ng/L. While in group B, 88% were males, 39% diabetics, 60% hypertensives, and median Hs-troponin was 54 ng/L. There was significant correlation between the two groups in the percentage of diabetes and median troponin level (p < 0.05). A ROC curve has identified a level of 127 ng/dL as the best cutoff of Hs-troponin in detecting obstructive CAD (p=0.03). Interestingly, 60% of patients in group B had alternative diagnoses. Conclusion:Hs-troponin is sensitive but less specific for obstructive CAD. However; increasing its cutoff value will improve its specificity.

We describe a case of 52-year-old female who presented with heart failure, uncontrolled hypertension and worsening renal function with progression of heart failure on starting an Angiotensin Converting Enzyme Inhibitor (ACE-I). Magnetic Resonance Angiography (MRA) revealed significant stenosis of the right renal artery. Her symptoms and blood pressure improved after renal artery stenting.

Bacillus Calmette-Guerin (BCG) and polysaccharide meningococcal (pMen) vaccines are required to travel to some countries, medical staff to deal with disease carriers, and for special cases as well. However, there were not enough studies on the immunogenic intervention between them when given together or in combination. Hence, we tried to assess the antibody-mediated immune response in groups of mice when different BCG vaccines and pMen were combined or given together, either concurrently or with a 14-day break between them. The antibody titer was measured in each group after 21 and 42 days from the first injection. Our results showed that it was safe and effective to give these two vaccines combined or simultaneously. Moreover, they exhibited a potent synergistic effect even if there was a 14 days gap between their administration. However, more research is needed to investigate the immunological intervention's cellular-mediated response.

No abstract