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  • ISSN: 2378-9344
    Volume 5, Issue 1
    Radu Stefan Miftode, Viviana Aursulesei*, Larisa Miftode, Amalia Stefana Darie, Ana Maria Buburuz, Adriana Ion, Alexandru Dan Costache, and Irina Iuliana Costache
    Heart failure (HF) represents an important cause of hospitalization throughout the world, with limited therapeutical options and high mortality rates [1]. Frequently, HF is a consequence of myocardial injury of various etiologies, fibrosis and subsequent remodellation further affecting the cardiac function.
    Review Article
    Mohr JP*, Stefani E, and Pile-Spellman J
    A growing awareness of patients discovered to have a brain arteriovenous malformation never having bled prompted population-based assessments based upon noninvasive imaging led to the first randomized clinical trial for management. A Randomized trial of Unruptured Brain Arteriovenous malformations (ARUBA) was an international effort sponsored by the US National Institutes of Health/ National Institute of Neurological Diseases and Stroke (NIH/NINDS) during the years 2007-2013. The randomization phase was ended April 2013 at the recommendation of the NINDS-appointed data and safety monitoring board (DSMB) with 226 patients randomized. The primary outcome for time to first stroke or death at a mean of 33.3 months strongly favored deferred intervention. Later follow-up at a mean of 50.4 months showed similar findings. Further to test external validity, NINDS has recently funded a long-term follow-up for outcomes from clinical registries from a number of large centers and national databases.
    Research Article
    Samreen Riaz*
    Diabetes mellitus is known to the world as one of the most lethal ailments. Presently 415 million adults are estimated to have diabetes. Pakistan is among 10 top diabetes prevalent countries and ranked at 6th place. Diabetes therapies mainly in use from decades are based on the diet, insulin and oral hypoglycaemic agents. The quest of searching out new methodologies, therapy and drugs worth the effort. Specially, the dietary cure and prevention therapies are gaining attraction among the biologists for curing human disease. Aberrant metabolism of methyl group is implicated in diabetes. Folate is the source of Homocysteine methylation and methionine cycle. In this research work, the concentrations of folate and homocysteine pertaining to the human diabetes mellitus in the premises of the University of Punjab, Lahore, Pakistan using modern-technology have been estimated and characterized. Serum Folate level is indicative of folate status, while the RBCs folate level reflects tissue folate storage. A total of 200 samples, 100 diabetic study group and 100 age and sex matched control group, were collected from the Diabetic Clinic, Health Centre, University of the Punjab. Biochemical parameters were studied by subscribed standard assays protocols at Health Centre University of the Punjab. FOLR1 levels were measured using HPLC methodology by utilizing C18 column, and homocysteine levels were analysed at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. Statistically significant (P<0.001) low levels of folate and hyper-homocysteinemia were reported in healthy population and low normal levels were observed in diabetic patients in reference to recommended serum folate levels and blood fasting sugar, lipid profile, HBA1C, MAU were highly raised in diabetic patients. Findings of varied folate-homocysteine levels might help in the early diagnosis and characterization of risk factors for many ailments. As adverse variation in the folate-homocysteine levels has also been implicated in other pathological conditions. The inverse relation between (hcy) and folate, vitamin B6 and B12 has been reported in Pakistani population. Therapy should be given to raise the levels of folate consequently decreasing the homocysteine levels in diabetic and in normal population.
    News Letter
    Vidyasagar Casikar*
    The role of research in clinical practice is a hotly debated concept. Successful busy clinicians see research as a waste of time as “they are too busy to do research”.
    Case Report
    Elena Hernández Garcia*, Anavas Parejo Casado, Mañero Rodríguez, and Peña Ortega
    Granulomatosis with polyangiitis (GPA) is a systemic, multiple-cause vasculitis that affects small and medium vessels. It is characterized by the affectation of the respiratory system and the kidneys, although it can affect other organs. Antineutrophil cytoplasmic antibodies (ANCA) are frequently positive and the most relevant histological feature is the presence of necrotizing granulomas. The diagnosis is based on the clinical manifestations, the biopsy of the affected organs and the presence of ANCA. We report a clinical case of a patient diagnosed with granulomatosis with polyangiitis probably related to the use of ustekinumab. The vasculitis can be idiopathic or secondary, being caused by different causes such as infections, medications, systemic diseases or malignant tumors. All of these possible causes should be considered in the differential diagnosis, such as drug-induced vasculitis, since it is essential to identify and stop the guilty medication. In drugs such as ustekinumab, some rare events, including vasculitis, may not be evident until their wider use and rigorous post-marketing surveillance, the key element is the suspicion for a diagnosis and early and adequate treatment. The histological diagnosis is definitive, which allows us to establish an adequate treatment early, improving the prognosis.
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