Background and Aims: Finerenone, a nonsteroidal MR antagonist (MRA), enhances renal and cardiovascular outcomes in patients with type 2 diabetes (T2DM). Finerenone’s safety and effectiveness in renal function are debatable. This meta-analysis evaluates the efficacy and safety of treatments for patients with diabetic kidney disease.Methods: To find relevant RCTs, the databases PubMed, Embase, and Google Scholar were searched. Finerenone’s effects were quantified using estimated pooled mean differences (MDs) and relative risks with 95% confidence intervals (CIs).Results: This meta-analysis combines seven double-blind trials involving patients with CKD and type 2 diabetes who were randomly assigned to finerenone or placebo. The primary efficacy time-to-event outcomes were cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, heart failure hospitalization, kidney failure, a sustained 57% decrease in estimated glomerular filtration rate from baseline over 4 weeks, or renal death. In this meta-analysis of 39,995 patients, treatment with Finerenone was associated with a lower risk of death due to cardiovascular and renal outcomes than placebo (RR = 0.86 [0.80, 0.93] p=0.0002; I2= 0%) and (RR = 0.56 [0.17, 1.82] p=0.34; I2= 0%), respectively. Finerenone treatment was also associated with a marginally lower risk of serious adverse events (RR = 0.95 [0.92, 0.97] p 0.0001; I2= 0%), but no overall difference in the risk of adverse events was found between the two groups (RR = 1.00 [0.99, 1.01] p=0.56; I2= 0%).Conclusion: The administration of finerenone decreases the likelihood of end-stage kidney disease, renal failure, cardiovascular death, and hospitalization. Therefore, we propose that patients with T2DM and CKD undergo finerenone therapy.Keywords: Diabetes, Chronic kidney disease, CKD, Cardiovascular disease, Finerenone, Non-steroidal Mineralocorticoid receptor antagonist, Meta-analysis.
https://onlinelibrary.wiley.com/doi/epdf/10.1002/ana.23951?src=getftr#:~:text=We%20recorded%208,74%2C%20No.%203 We recorded 8 patients (Table 1) with advanced idiopathic PD with motor fluctuations and/or dyskinesias who gave their informed consent to take part in the study, which was approved by the National Research Ethics Service Committee South Central–Oxford A. Patients underwent DBS surgery on the STN as previously described.10 In Cases 2, 7, and 8 (see Table 1), the locations of the electrodes were confirmed with immediate postoperative fast spin-echo T2-weighted magnetic resonance imaging (MRI) with a Leksell frame still in situ. In the remaining cases, locations were confirmed with immediate postoperative computed tomography (CT) with a Leksell or CRW frame (Integra Radionics, Burlington, MA) still in situ. CT scans were then fused with preoperative T2-weighted MRI.11 Electrode extension cables were externalized through the scalp to enable recordings prior to connection to a subcutaneous DBS pacemaker, implanted in a second operative procedure up to 7 days later. The permanent quadripolar macroelectrode used was model 3389 (Medtronic Neurologic Division, Minneapolis, MN), featuring 4 platinum–iridium cylindrical surfaces. Its contacts are numbered 0, 1, 2, and 3, with 0 being the most caudal and contact 3 being the most cranial
TITLE PAGETitle: Comment on: evaluating age and sex-specific rates of gall bladder disease in children with sickle cell diseaseArticle type: Letter to the editorCorrespondence : 1. Ifra Eeman Ahmed contact : 03335890003 Email : email@example.comInstitution : Federal medical & dental college,IslamabadAddress: House#2,Street#15g,Sector A,Bahria Enclave,IslamabadCo-author : 2. Satesh KumarContact: +92-3325252902 Email:Institute: Shaheed Mohtarma Benazir Bhutto Medical College Liyari, KarachiAddress: Parsa citi Garden east, KarachiWord count: 391Conflict of interest : NoneDeclaration : NoneAcknowledgment : None
Background: Pembrolizumab is a humanized IgG4 antibody from the immune-checkpoint inhibitors (ICI) family that has been proven to improve clinical outcomes in many solid organ malignancies. Despite its great therapeutic results, this novel drug has undesirable side effects, including uncommon cardiac and neuromuscular adverse effects. Case presentation: The patient, a known case of hypertension, COPD, HFpEF and NSCLC presented with mild chest pain and shortness of breath on exertion for 5 days. His CT scan revealed no pulmonary emboli. His echocardiogram indicated an EF of 10-15%, worldwide hypokinesis, reduced RV function, and a moderately enlarged left atrium. He underwent coronary angiography, which revealed no obstructive lesions. He was managed with IV Lasix, IV methylprednisolone in hospital and prednisone, furosemide, metoprolol succinate, and lisinopril on discharge. He was prescribed spironolactone at his two-week follow-up. Conclusion: Pembrolizumab-induced cardiomyopathy is uncommon and should be treated with care because there is no cure.
Title: Letter to the Editor: Management of aortic arch hypoplasia in neonates and infantsArticle type : Letter to the Editor.Correspondence: 1. Maida QaziContact: 03332132159 Email: firstname.lastname@example.orgInstitution: DOW University Of Health SciencesAddress: Bihar Colony, Al-Falah Road, Karachi.Co-authors : 2. Satesh KumarContact: +923325252902 Email: email@example.comInstitute: Shaheed Mohtarma Benazir Bhutto Medical College Liyari, KarachiAddress: Parsa citi, Garden East, Karachi
Background: Coronary artery aneurysms are reported in 1.5 to 4.9 percent of the population receiving coronary angiography. Whether there is coronary stenosis or atrial fibrillation, it might result in an acute coronary syndrome. Case presentation: The patient was in his usual health when he began to experience pain while watching television an hour before his visit to the emergency department . The patient, a smoker with a history of hypertension, presented at our hospital with significant retrosternal chest pain. A CT angiography of the coronary arteries revealed a large RCA aneurysm thrombus-laden aneurysm. He was given 324 mg aspirin, 400 mcg Nitro-glycerin, 80 mg Atorvastatin, and a Heparin infusion immediately. An emergency RCA bypass grafting procedure was performed after a cardiothoracic surgical team assessed the patient. Conclusion: Coronary artery aneurysm is an infrequent disorder that can appear in a variety of ways. Before any further therapy, it should be thoroughly evaluated.