Current Issue : April-June Volume : 2026 Issue Number : 2 Articles : 5 Articles
Background: This study represents the first registry to assess patients’ clinical characteristics and key predictors of 30-day post-cardiovascular surgery mortality in wartime Yemen. Methods: This study retrospectively analyzed 2169 patients who underwent cardiac surgery. Comprehensive patient data were extracted from Nabdh Al-Hayat Cardiac Center registries across Hadhramaut Governorate, Republic of Yemen, over 7 years from 2018 to 2024. Results: The study cohort comprised predominantly adult patients, with 69% aged 18 years and above, while 31% were under 18 years of age. The overall survival rate was high (95%), yet 5% of the patients experienced 30-day postoperative mortality. Cold cardioplegia and certain solution types were associated with increased mortality. Heart failure and ventricular dysfunction accounted for most mortality, though non-cardiac factors, such as cerebral hemorrhage and multi-organ failure, contributed as well. Conclusions: While Yemen’s crises have devastated healthcare delivery, the 30-day postoperative mortality data highlight the resilience of coordinated efforts. However, current standards remain far from universal benchmarks, highlighting the urgent need to rebuild local capacity and ensure equitable access to cardiac surgical services nationwide....
Cardiovascular diseases remain the leading cause of death globally, with carotid artery stenosis is a major contributor to the global burden of a significant role in ischemic stroke incidence. This study employed Computational Fluid Dynamics (CFD) to analyse pressure, velocity, and wall shear stress (WSS) profiles in carotid stress arteries under three stenosis severities 50%, 70% and 90%. Using COMSOL Multiphysics and the Finite Element method (FEM), simulations were conducted on a two-dimensional artery model, incorating buoyancy forces and energy equations to better reflect hemodynamic behavior. The results demonstrated that as stenosis severity increases, there is a nonlinear rise in peak velocity and pressure drop, accompanied by elevated and more localised WSS at the throat of stenosis. At 90%, stenosis, critical hemodynamic conditions were observed, including excessive WSS (>30 Pa), steep pressure gradients, and downstream flow disturbances. These factors are known contributors to endothelial injury, plaque rupture, and thrombus formation. Additionally, recirculation zones with near zero WSS downstream posed risks for stagnation and atherogenesis. This study highlights CFD as a powerful, non-invasive tool for assessing stroke risk and guiding clinical decision-making. The findings highlight the need for early diagnosis and hemodynamic profiling in managing carotid artery disease, especially in resource limited settings where advanced imaging may be inaccessible....
Background: Differentiating between immune checkpoint inhibitor (ICI) myocarditis and non-ICI myocarditis is clinically important. Cardiovascular magnetic resonance (CMR) is a well-established method for diagnosing acute myocarditis. The value of CMR for distinguishing ICI myocarditis from non-ICI myocarditis remains unclear, which this study sought to determine. Methods: A total of 54 patients (n = 26 ICI myocarditis; n = 28 non-ICI myocarditis) underwent clinical CMR for the assessment of cardiac function (cines), myocardial fibrosis (native T1-mapping, extracellular volume [ECV] fraction, late gadolinium enhancement [LGE]) and myocardial oedema (native T2-mapping). Results: ICI myocarditis patients were older than non-ICI myocarditis patients (75 years [71–78] vs. 39 years [30–64]; p < 0.001). Both groups had similar left ventricular (LV) ejection fraction (58 ± 11% vs. 58 ± 6%; p = 0.970). ICI myocarditis and non-ICI myocarditis patients also had similar native myocardial T1 values (1041 ± 84 ms vs. 1063 ± 60 ms; p = 0.281), native myocardial T2 values (59 ± 6 ms vs. 59 ± 6 ms; p = 0.943) and ECV (0.32 ± 0.07 vs. 0.31 ± 0.04; p = 0.403). Native myocardial T1 values (Rho = −0.553) and ECV (Rho = −0.502) were significantly associated with LVEF in non-ICI myocarditis patients (both p < 0.05). There was no significant association between myocardial T1 values, T2 values or ECV, with LVEF, in ICI myocarditis patients (all p < 0.05). Non-ICI myocarditis patients had a greater frequency of LGE in the LV compared to ICI myocarditis patients (89% vs. 52% p = 0.005). However, the pattern of LGE was similar between the two patient groups (mostly subepicardial and/or mid-wall). Conclusions: In this single centre retrospective cohort, the findings suggest that quantitative parametric mapping methods by CMR may not differentiate between ICI vs. non-ICI myocarditis. Further work is needed to assess the value of CMR for diagnosing standalone ICI myocarditis....
Background: Aerobic and resistance training have acute effects on blood pressure (BP) in peripheral arterial disease (PAD). However, the combined effect of both exercises in a single session is still unknown. The aim of this study was to analyze the effects of a single exercise session combining walking and circuit-based training on BP in patients with PAD. Methods: Participants with PAD (n = 13; 65.0 ± 10.2 years; 76.9% male) underwent a supervised exercise therapy (SET) intervention (312 sessions, 24 sessions/patient) that included 15–30 min of walking, followed by 15 min circuit-based training. Clinic systolic (SBP) and diastolic (DBP) were recorded 5 min before and after each exercise session. Longitudinal changes were analyzed using repeated-measures analysis of variance (ANOVA) and categorical changes in blood pressure levels were evaluated with chi-square tests. Results: After each exercise session, clinic SBP decreased 4.87 mmHg (p < 0.001) and clinic DBP decreased 2.11 mmHg (p < 0.001). Furthermore, there were no differences between the initial stage of training (1–10 sessions) and late (14–24 sessions) for each time that SBD or DBP were measured. Conclusions: After an acute exercise session, both clinical SBP and DBP decreased in patients with PAD compared to pre-exercise values. However, no additional reductions in clinical BP were observed when comparing early (sessions 1–10) and late (sessions 14–24) stages of the full SET intervention....
Introduction: Acute hemorrhage remains a major cause of mortality, particularly in trauma, postpartum, anesthesia, and intensive care. In Africa, data are limited, especially outside the obstetric context. The absence of a national algorithm justifies this study, which aims to evaluate the prevalence, etiology, and prognosis of hemorrhagic shock at the Angré University Hospital. Methodology: This is a cross-sectional analytical study conducted from January 2020 to December 2021 at Angré University Hospital, including all patients admitted to intensive care for hemorrhagic shock. Results: Of the 457 patients admitted to intensive care during the study period, 100 had hemorrhage, including 72 cases of hemorrhagic shock. The mean age was 34.31 ± 14.5 years. The male-to-female ratio was 0.18. The majority of patients came from the operating room (79.2%) and 15.3% had sickle cell disease. Hemodynamic instability, particularly hypotension (72.2%), was the main reason for admission. Surgical conditions accounted for 94.4%, and approximately 75% were transferred from another department. The mean systolic blood pressure was 80.37 ± 16.01 mmHg, and the mean diastolic blood pressure was 47.87 ± 11.44 mmHg. The mean heart rate was 118.83 ± 27.04 bpm, with a mean shock index of 1.4. A Glasgow score ≤ 8 (35%) was noted. Biological abnormalities included hyperlactatemia (69.4%), low PT (40.6%), acidosis (38.8%), and hemoglobin < 9 g/dL (84.7%). Mortality was 47.2%, associated with several significant clinical and biological parameters (p < 0.05). Conclusion: Hemorrhagic shock, which is common in intensive care, affects a young, predominantly female population with high mortality, requiring early and multidisciplinary standardization of care....
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