Monkeypox Virus, A Global Public Health Concern and Challenge for Low-income Countries including Pakistan: A Right Time to Nip the Evil in the Bud
Published on: 13th October, 2023
Monkeypox is a rare zoonotic infection originating in the regions of Central and West Africa. The global threat has been arising since monkeypox is spreading outside of the endemic regions. Pakistan has recently exhausted health funds in a quarrel against SARS-CoV-2, by supplying expensive COVID-19 vaccines to the general public, free of cost. Pakistan’s government has remarkably contributed to lowering the suffering of COVID-19-affected patients by granting the Sehat Sahulat Programme and similar health initiatives to restrict viral propagation in the general public. However, despite all efforts the major constraints are a lack of international funds and limitations on the budget of healthcare systems and medical facilities. Newly emerged cases of monkeypox are very threatening to Pakistan’s economy and health. Therefore, it is very necessary that healthcare authorities take effective measures like surveillance, early identification, separation, monitoring of contacts, immunization, and public awareness in order to stop the spread of the virus and control monkeypox outbreaks.
The Use of Polyetheretherketone (PEEK) in Implant Prosthetics: A Detailed Review of the Literature
Published on: 3rd November, 2023
Nitrogen supply effect on lettuce response to Botrytis cinerea and Sclerotinia minor
Published on: 6th November, 2023
Background information: Cultural practices play an important role on the development of pathogens (Datnoff, et al. 2007). In this context, several authors have been interested in studying the effects of mineral nutrition on the resistance of vegetables and fruits to fungi during storage, especially nitrogen.The purpose of the study: In this work we tested the effects of three contrasted regimes of nitrogen supply, with nitrate concentrations in the nutrient solutions of 2 mM (low), 10 mM (normal) and 20 mM (high) on the susceptibility of Lactuca sativa L towards Botrytis cinerea (BC87) and Sclerotinia minor (SM) during storage.Once harvested, the outerleaves of the plants derived from the three nitrogen regimes were inoculated with either Botrytis cinerea (BC87) or Sclerotinia minor (SM). Data showed that the resistance to this two pathogens increase when plants were developed under low nitrogen concentration. This resistance observed is correlated with low values in oxidative stress indicators (MDA and H2O2) and high values in total phenols.
The Effectiveness of Honey-Based Ferric Perchloride Paste on Post-conization in the Cicatricial and Infectious Context: A Randomized Clinical Trial
Published on: 7th November, 2023
Introduction: The skills, the techniques utilized in the conization and the hemostasis directly affect the healing process of the cervix tissue. Excessively large excisions and unnecessary use of electrocautery or hemostatic sutures are examples of procedures that may negatively affect the scar cascade and wound healing. Objective: The purpose of this study was to examine the effectiveness of honey-based ferric perchloride paste (HBFPP) in reducing bleeding and infection post-conization procedure. Methods: Prospective randomized clinical trial with a sample of 142 patients randomized in two groups: 78 patients who used the HBFPP (intervention) and 64 patients who did not use the HBFPP (control). Statistical analysis was performed utilizing a significance level of 95%. The Chi-Square test and Fisher’s exact test were applied. Results: Results showed that the mean score of the amount of blood lost was lower in the intervention group compared to the control group. The main complaints reported by the two groups in the postoperative period were discomfort in the genitourinary system, heavy bleeding after surgery, and post-operative infection, but not significantly different among both groups. The control group needed further intervention due to excessive bleeding in comparison with the intervention group. Conclusion: The use of HBFPP reduced the amount of blood lost in the postoperative period of conization surgery.
Improvements in the Subjective Sleep of Japanese Middle-aged Managers from the Consumption of an Edible Film Containing Crocetin
Published on: 13th November, 2023
It has been reported that Japanese people sleep for an average of 7 hours and 22 minutes per night, with those in their 40s and 50s sleeping the least. This is much less than in other developed countries. Aging has also been reported to decrease the total sleep time and sleep latency as well as increase wake after sleep onset (WASO). Crocetin is a carotenoid with antioxidant activity. It has been reported that 14 consecutive days of crocetin intake increases delta power during sleep and decreases WASO. However, the benefits of short-term ingestion have not been clarified. In this double-blind, randomized crossover study, we examined the effects of crocetin-containing edible films consumed for seven consecutive days on the sleep quality of healthy Japanese subjects working in management positions who were aged 45 years or older.The study participants comprised 20 subjects (12 males and 8 females; mean age 50.4 ± 4.8 years; body mass index (BMI) 22.5 ± 2.7). An electroencephalography (EEG) measuring device (InSomnograf®) was used to measure sleep objectively and a questionnaire, OSA Sleep Questionnaire MA version (OSA-MA) was used to assess sleep subjectively upon waking. The crocetin group demonstrated significantly higher values of OSA-MA Factor 3 (frequent dreaming) than the placebo group (placebo: 46.8 ± 6.9; crocetin: 49.5 ± 7.4). No differences were observed for the other four factors. No differences were observed in the sleep parameters determined with InSomnograf®.Our findings suggest a new effect of crocetin on sleep quality of frequent dreaming.
Near-miss Women Causes and Prevalence in Alobied Maternity Hospital
Published on: 13th November, 2023
Background: Maternal near-miss (MNM) events occur more frequently than maternal deaths; therefore, more detailed and comprehensive studies on maternal morbidity have been conducted and are of value to clinical audits and practices. Purpose: This study aimed to determine the frequency of maternal near misses and the nature of near-missevents. Methodology: This descriptive, retrospective, cross-sectional study over 12 months duration was conducted at the Alobied Teaching Hospital in 2018. Data were collected from patient notes, partographs, and other relevant documents. Demographic and clinical data concerning personal history, obstetric history, and near-miss events. Results: A total of 15202 women were admitted, 339 cases of maternal near misses, maternal near-missrate (MNMR) of 22.3|1000 live births, 200(59%) had an infection, 80(23.6%) hemorrhage, 20(5.9%) severe pre-eclampsia,12(3.5%) eclampsia, 20(5.9%) anemia, convulsions 5 (1.5%) 17(5%) of the cases were admitted to intensive care unit (ICU), 9(2.7%) had liver dysfunction, 9(2.7%) coagulation dysfunction, 8(2.4%) renal dysfunction, 5(1.5%) cerebral problems, 4(1.2%) cardiac dysfunction, and 2(0.6%) had developed respiratory dysfunction.Conclusion: The maternal near-miss rate was 22.3|1000 live births. Most near-miss cases occurred before the women arrived at the hospital. The major causes of maternal near misses were infection, hemorrhage anemia, pre-eclampsia, and eclampsia.
Rare Case of Dense Deposition Disease with Combined C3 and C4d Deposits with MYH9-related Mutation
Published on: 14th November, 2023
Background: The C3 glomerulopathies are a group of rare forms of glomerulonephritis with an incidence of 1-2 cases per million. It is mainly characterized by dysregulation of the alternative complement pathway. It is further classified morphologically based on electron microscopy ultrastructural findings into Dense Deposition Disease (DDD) and C3 glomerulonephritis. DDD is normally characterised by C3 Deposits. Case: We report a rare case of a young Emirati male who presented with sub nephrotic proteinuria and microscopic haematuria on routine evaluation. Renal biopsy showed features of DDD with combined C3 and C4 deposits. The retinal evaluation showed features of Drusen classically seen in DDD. Genomic study showed heterozygous mutation in c.5842G>C (p.Asp1948His) variant of uncertain significance in MYH9 gene. Discussion: C3 Glomerulopathy is a type of immune mediated disease previously classified as membranoproliferative glomerulonephritis. DDD is mainly characterised by C3 deposits in the glomerular basement Membrane. Our case has both C3 and C4d deposits, which is a rare entity. It shows the activation of both classical and alternate pathways. Conclusion: Dense deposition disease is a rare complement mediated glomerulopathy. It is characterised by C3 deposits. Dense deposition disease with combined C3 and C4d deposits is a new entity. The treatment and prognosis of such cases will be different and unique compared to the normal cases of DDD.
Comparative Evaluation of the Effectiveness of Methods for the Treatment of Surgical Soft Tissue Infection
Published on: 17th November, 2023
Background: The presence of a multifaceted microbiological etiological factor of surgical infection and differentiated sensitivity to antibacterial drugs determines the need to develop more effective means and methods of influencing the purulent microflora of wounds. Physical treatment factors, in particular, low-frequency ultrasound and ionised plasma flows, should be considered promising for solving this problem.Materials and methods: The research was carried out based on the Scientific Center of Microbiology and the clinic of the Tashkent Medical Academy. Bacteriological studies of wound discharge and biopsy material were carried out. We studied the material of purulent-inflammatory diseases of soft tissues.Results: Wound-sounding through a dioxidine solution is most effective against gram-negative bacteria, and ultrasonic cavitation in combination with iodopyrone is most effective against gram-positive microorganisms. Treatment of purulent wounds with low-frequency ultrasound through a mixture of iodopyrone solution and ascorbic acid is effective against gram-positive and gram-negative microbes. Argon plasma flows have a high bactericidal effect mainly on gram-negative bacteria.Conclusion: The obtained data substantiate the need to choose a physical method of treatment of purulent wounds depending on the species composition of the wound microflora.
Biologic Medications for the Treatment of Psoriasis - Main Groups and Dosing System
Published on: 20th November, 2023
This review explores the evolving landscape of psoriasis treatment with a focus on the transformative impact of biologic drugs. Psoriasis, a prevalent and persistent skin condition characterized by red and scaly patches, historically relied on topical, phototherapeutic, and systemic treatments, each with limitations. The advent of biologics represents a significant advancement, offering targeted interventions by addressing specific immunologic mechanisms underlying the disease. Biologics are now considered the preferred systemic therapy for chronic moderate-to-severe plaque psoriasis, particularly when conventional treatments prove ineffective or present disadvantages.The review delineates the mechanisms of action for biologics targeting tumour necrosis factor-alpha (TNF-α), interleukin-17 (IL-17) and interleukin-23 (IL-23). Specific drugs under each category, including etanercept, infliximab, adalimumab, secukinumab, ustekinumab, and others, are detailed with recommended dosages. Biologics have demonstrated substantial effectiveness, with clinical trials and real-world studies showcasing significant improvements in disease severity and patient’s quality of life. Notably, these drugs exhibit rapid action, often yielding noticeable changes within weeks.While biologics have revolutionized psoriasis treatment, the review emphasizes the importance of judicious use due to potential side effects such as injection-site reactions and respiratory infections. Serious adverse events, including infections and autoimmune reactions, necessitate careful patient selection and monitoring for safety. In conclusion, biologics offer a precise and effective approach to psoriasis treatment, promising marked symptom improvement and enhanced quality of life. The review underscores the need for responsible utilization, considering patient-specific factors, and anticipates ongoing advancements in biologics for improved control over this chronic dermatitis.
Strategies to Prevent Lower-Extremity Positioning Injuries During Long-Duration Surgery in the Lithotomy Position: Our Techniques and Clinical Outcomes Following Genital Gender-Affirming Surgeries
Published on: 21st November, 2023
Purpose: Lower-extremity (LE) injuries due to prolonged surgery duration in the dorsal lithotomy (DL) position are often morbid and can significantly affect the patient’s short and long-term quality of life. These include the development of lower extremity pressure ulcers, neuropathies, rhabdomyolysis, and compartment syndromes. As compared to other surgeries, this risk is increased in patients undergoing genital gender-affirming surgery (gGAS) due to the relatively long operative time of these surgeries related to their high complexity. Our study aimed to describe our technique for preventing LE injuries in the DL position, and to evaluate our positioning-related post-operative complications and rates.Materials and Methods: We describe our technique for positioning in the dorsal lithotomy position, with an emphasis on injury prevention. We ensure a specific padding technique of the LE, we alert surgical assistants to not lean/rest on the LE, and we schedule LE checks and repositioning throughout the case to prevent and mitigate occult injuries. Herein, we report our clinical positioning-related outcomes and complications among all patients undergoing gGAS procedures lasting >300 minutes between January 2017 to March 2023. Results: A total of 227 patients underwent 310 surgical procedures (156 masculinizing, 154 feminizing gGAS procedures). Mean operative time was 495.5 minutes+/-156.5 minutes (SD) (Range 300–1095 minutes). A total of 6/227 (2.6%) patients (2 masculinizing and 4 feminizing surgical patients) had transient, self-limited LE pain post-op. No (0%) patients had major complications including chronic nerve injury, pressure ulcers, rhabdomyolysis, or compartment syndrome.Conclusions: Our study is the first to describe a replicable technique, and specifically which integrates the OR team and nursing staff, to prevent LE injuries during DL. We show that it is possible to achieve a 0%-to-rare incidence of major LE injury during long-duration surgeries.
Unmasking the Viral Veil: Exploring the Cardiovascular Intrigue of Pathogenic Infections
Published on: 23rd November, 2023
The intricate interplay between viral infections and cardiovascular complications has garnered significant attention from 2018 to 2023. Extensive research during this period has unveiled substantial connections between various viruses and cardiovascular diseases. Notable examples include Cytomegalovirus (CMV), coxsackievirus, influenza, Human Immunodeficiency Virus (HIV), Epstein-Barr Virus (EBV), Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), as well as coxsackievirus A and B, enteroviruses, adenovirus, and parvovirus B19. These viruses exert diverse influences on cardiovascular health through various pathways, contributing to endothelial dysfunction, inflicting direct damage on cardiac tissue, and triggering inflammatory responses. The intricate interplay between viral infections and cardiovascular health underscores the importance of considering viral pathogens within the framework of cardiovascular disease development, clinical management practices, and future research initiatives. This systematic review comprehensively scrutinizes the cardiovascular impacts stemming from various viral infections, casting a revealing light on their underlying mechanisms and associated clinical implications. These valuable insights can guide clinical management strategies, preventive measures and further investigations into the complex connection between viral infections and cardiovascular diseases, emphasizing the necessity for ongoing research and vigilance in comprehending and managing these pathogen-induced cardiac manifestations.
Emerging One Health Preparedness to Combat National Burden of Diseases in Pakistan: A Comprehensive Insight
Published on: 23rd November, 2023
In order to integrate and enhance the health of people, animals, and the environment, a multidisciplinary “One Health” concept has been coined. However, developing countries have frequently lagged in embracing this innovative vision. Pakistan’s ecology, human health, and animal health have all been severely jeopardized due to a lack of resources. Human health is significantly impacted by the spread and comeback of zoonotic illnesses, especially for people who live in rural regions and frequently interact with domestic or wild animals. More than 75% of zoonotic diseases were transmitted contiguously from animals to humans or indirectly through interactions among agents or vectors (including both humans and other animals). This review article gives critical insights into the most common zoonotic diseases found in Pakistan in addition to underlining the importance of the “One Health” philosophy in the management of these illnesses. Interdisciplinary research efforts are required given the current circumstances in order to politicize sustainable solutions for decreasing the disease burden in human and animal populations simultaneously.
Fever of Unknown Origin in Children: The Challenge of History Taking
Published on: 24th November, 2023
A fever of unknown origin (FUO) in children is usually described as a fever of at least 8 days duration with no apparent diagnosis after initial investigations, including taking medical history and preliminary laboratory assessment. Infectious diseases are the most common cause of FUO, followed by rheumatologic and neoplastic conditions. In this report, we present a case of a 15-year-old Caucasian boy with a silent past medical history, who presented at our Pediatric ER department with a three-day history of fever, fatigue, and abdominal pain with diarrhoea. Initial laboratory testing and microbiological work-up were non-significant. At hospital admission, a broad infectious diagnostic work-up was pursued, including serologies and polymerase-chain-reaction (PCR) for CMV, EBV, HAV, Parvovirus, Toxoplasma gondii and Adenovirus, all negative. Given mild splenomegaly and linfadenopathy, systemic Juvenile Idiopathic Arthritis (s-JIA) was suspected, as well as Multi-inflammatory Syndrome in Children (MIS-C), but the patient did not meet their main diagnostic criteria. Malignancy was ruled out by a negative bone marrow fine-needle aspiration cytology and whole-body PET-CT scan. On hospital day 8, Brucella was identified on a new set of blood cultures and a combined antibiotic therapy was started with IV Gentamicin plus per os Doxycycline. The patient’s general conditions rapidly improved, and both fever and diarrhoea resolved. A reassessment of the patient’s medical history before discharge revealed exposure to unpasteurized soft cheese in the weeks prior to the onset of symptoms. This case underlines the importance of taking a complete medical history, as well as a full diagnostic work-up to unveil unusual infectious etiologies behind FUO. After the preliminary negative microbiological tests, a connective tissue disease was ruled out (i.e. lack of cutaneous or articular involvement), as well as malignancy, which led to a closer evaluation for infection and the diagnosis of Brucellosis.
Women's Perceptions of Medical Treatment Versus Surgical Management of First-trimester Miscarriage
Published on: 27th November, 2023
Background: Miscarriage is a common gynecological problem and early pregnancy loss occurs in the first trimester. Early pregnancy miscarriage is managed expectantly, surgically, and medically. Medical management is a new treatment option, also surgical evacuation is the standard treatment for some types and presentations of miscarriage. Medical management might be more suitable instead of surgical evacuation, it may be less costly than surgical treatment and consequently, due to its lower complications, most patients prefer it.Purpose: This study aimed to determine women's perception of medical treatment versus surgical intervention, complications associated with surgical procedures, and medical treatment.Methodology: It was a comparative, hospital-based study conducted in Bashair Teaching Hospital, on 336 patients diagnosed with miscarriage in the first trimester, 168(group A) were treated medically while 168(group B) were treated surgically. All participating patients in the study fulfilled the selection criteria, that is, the provision of an informed consent and agreement to participate in the study. Results: The total number of women during the period of study was 336. The study found that 239(71%) of women prefer medical management compared to 97 (29%) preferring surgery. The complications associated with the medical treatment were (4.2%) infection, (0.6%) bleeding, and (95.2%) without obvious complications. The complications associated with surgical procedures were (7.7%) developmental infection, (16.1%) bleeding, (10.7%) incomplete evacuation, (1.8%) uterine perforation, and (63.7%) without obvious complications.Conclusion: The study found that over two-thirds of patients Favor medical treatment over surgical procedures. It has also revealed that medical treatment is very effective in terminating pregnancies within the first trimester.
Evaluation of In vitro and Ex vivo Models for Studying the Effectiveness of Vaginal Drug Systems in Controlling Microbe Infections: A Systematic Review
Published on: 28th November, 2023
The survey gives an in-depth examination of medicate assimilation challenges within the genital range and the improvement of vaginal medicate conveyance gadgets to overcome these challenges. It investigates the components involved in medicate discharge within the genital locale and examines commonly utilized vaginal sedate conveyance frameworks such as nanoparticles and hydrogels. The survey centers on the applications of these conveyance frameworks in controlling bacterial vaginal diseases. The plan issues related to vaginal sedate conveyance gadgets are moreover examined, highlighting the significance of considering variables such as mucoadhesion and bodily fluid porousness. The survey portrays different in vitro and ex vivo models utilized for assessing these frameworks, counting organoids and new human cervical bodily fluid. The choice of show depends on the particular objectives and characteristics of the definition. The audit emphasizes the noteworthiness of utilizing these models to pick up important bits of knowledge and make precise forecasts with respect to the execution of medicate conveyance frameworks in vivo. Moreover, grandstands progressed models utilized for other mucosal locales as a potential motivation for future models of the female regenerative framework. Generally, the audit highlights the significance of understanding organic instruments and planning compelling vaginal drug conveyance frameworks to progress sedate conveyance within the genital region. It emphasizes the require for suitable models to evaluate and anticipate the execution of these conveyance frameworks.
Challenges of Novice Nurse Educators’ Transition from Clinical Practice to Academia in Ghana: A Qualitative Study
Published on: 27th November, 2023
Background: The recruitment of experienced clinical nurses into vacant faculty positions is a global strategy for preparing, employing, and retaining competent nurse educators. As clinical nurses transition to academia, many struggle with unique challenges that affect their adaptation to the academic setting. Thus, understanding novice nurse educators’ transitional challenges is critical to addressing this threat. Aim: This study aimed to explore the challenges of novice nurse educators’ transition from clinical practice to academia in Ghana. Methods: A descriptive qualitative study design was employed for this study. A purposive sampling technique was used to recruit 12 novice nurse educators from three health training institutions in the Upper East Region of Ghana. A semi-structured interview guide was used to collect data through in-depth individual interviews. The interviews were audio-recorded, transcribed verbatim, and thematically analyzed.Results: Four themes emerged: poor administrative support, poor preparation, increased workload and stress, and role ambiguity. Novice nurse educators lacked formal orientation, formal mentorship, formal education in teaching, and post-graduate education. Novices were also challenged by increased workload and role ambiguity. Conclusion: Supporting novice nurse educators' transition from clinical practice would be better served by college administrators’ creation and implementation of formal orientation and mentorship programs.
Diversity of Rust Fungi Causing Plant Diseases in Abbottabad, Khyber Pakhtunkhwa (KP), Pakistan
Published on: 27th November, 2023
In 2018, a survey of rust fungi and their associated hosts was attempted in the thandiani regions of Pakistan. In this paper, we provided descriptions and illustrations of six rust species viz. Melampsora euphorbiae, Phragmidium barclayi, Puccinia ambegua, Pucciniia calcitraipae, Pucciniia mentha and Puccinia ustalis. The Melampsora euphorbiae, Puccinia ambegua, and Puccinia ustalis were collected as a new host record from Abbottabad. Most of the rust fungi were collected from herbaceous wild plants. This study suggests further exploration of the area of rust disease in order to assess the diversity of these fungi. This research work is an addition to available data related to the Urediniales of Pakistan having special reference to Abbottabad District, Khyber Pakhtunkhwa, Pakistan.
Update on the Use of Mesenchymal Stem Cells and their Products in Hematopoietic Stem Cell Transplantation
Published on: 29th November, 2023
Graft Versus Host Disease (GVHD) is a major limitation to the success of allogeneic Hematopoietic Stem Cell Transplantation (HSCT) as Steroid-Refractory (SR) acute GVHD carries poor prognosis due to the absence of an efficacious second-line therapy. Mesenchymal Stem Cells (MSCs) which have immunosuppressive, immunomodulatory, and regenerative properties may become a highly effective therapeutic modality for SR-GVHD in the near future. MSCs have already been approved to treat childhood SR-GVHD in Japan, and they have been conditionally licensed in New Zealand and Canada. It is expected that MSCs will be approved for the treatment of SR-GVHD in adults in Europe, North America, and other parts of the world within a few years. Utilization of the recently introduced techniques including the use of MSC products such as exosomes and Extracellular Vesicles (ECVs) instead of the parent MSCs, robotic manufacturing technology, and genetic engineering of MSCs will ultimately overcome the remaining obstacles facing the widespread utilization of MSCs and their products as therapeutics not only in HSCT but also in other medical fields. The aim of this review is to provide an update on the remarkable progress achieved in the use of MSCs and their products in the field of HSCT.
Update on the Use of Mesenchymal Stem Cells in the Treatment of Various Infectious Diseases Including COVID-19 Infection
Published on: 5th December, 2023
Mesenchymal Stem Cells (MSCs) have antimicrobial, anti-inflammatory, immunomodulatory, and regenerative potentials. Additionally, utilization of MSCs in the clinical arena has been shown to be safe and well tolerated. Hence, this form of cellular therapy has gained particular attention in the treatment of several infectious disorders and their complications. MSCs have been successfully used in the treatment of the following infections and their complications: bacterial infections including complicated sepsis; viral infections including Human Immunodeficiency Virus (HIV), hepatitis B and C viruses, and Coronavirus disease (COVID-19) complicated by acute respiratory distress syndrome; parasitic infections including schistosomiasis, malaria, and Chagas disease; and mycobacterial infections including tuberculosis. The use of MSCs derived from certain sources and Extracellular Vesicles (ECVs) derived from MSCs has improved their efficacy and reduced their side effects. However, the clinical application of MSCs in the treatment of several infectious diseases still faces real challenges that need to be resolved. The current status of MSCs and the controversies related to their utilization in various infections will be thoroughly discussed in this review.
Rats with Postinfarction Heart Failure: Effects of Propranolol Therapy on Intracellular Calcium Regulation and Left Ventricular Function
Published on: 28th November, 2023
Patients with heart failure may live longer if they receive chronic treatment with beta-adrenergic blocking medications. Unresolved are the mechanisms underlying the beneficial effects and if they may be applied to ischemic heart failure. Rats (n = 28) underwent echocardiographic-Doppler exams one and six weeks following a simulated operation or myocardial infarction (MI). After the first echocardiography, rats were randomized to either no therapy or 500 mg/l of propranolol in their drinking water. The noninfected left ventricular (LV) papillary muscles were used to record isometric contractions and intracellular Ca transients simultaneously.Untreated MI rats had a restrictive LV diastolic filling pattern, decreased systolic function (13% ± 2%), and significant LV dilatation (10.6 ± 0.4 mm vs. 8.9 ± 0.3 mm, MI vs. control). The LV chamber diameters of the propranolol-treated MI rats were 10.6 ± 0.5 mm, and systolic performance (13% ± 2%). Higher LV end-diastolic pressures (27 ± 2 mmHg vs. 20 ± 3 mmHg) and a more constrained LV diastolic filling pattern (increased ratio of early to late filling velocities and faster E wave deceleration rate) were seen in the propranolol-treated animals. Papillary muscle contractility in untreated MI rats was lower (1.6 ± 0.3 g mm²). Furthermore, the inotropic response to isoproterenol was attenuated, and Ca transients were extended. During isoproterenol stimulation, beta-adrenergic blocking administration had no effect on force development (1.6 ± 0.3 g mm²) or the length of Ca transients.Rats with postinfarction heart failure receiving chronic propranolol treatment did not have improvements in systolic function or LV remodeling. Propranolol exacerbated LV diastolic pressures and filling patterns. Additionally, there was no discernible improvement in intracellular contractility following treatment, Calcium control, or beta-adrenergic sensitivity in the myocardium that is not infarcted).
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