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Understanding Bharati Mukherjee
\"Bharati Mukherjee was an important, bold, pioneering American writer. Born in Calcutta, India on July 27, 1940 to Sudhir Lal Mukherjee and Bina (née Chatterjee), a Bengali Brahmin couple, the young Bharati--the middle of three daughters--enjoyed a privileged early life. Mukherjee's father was a biochemist who ran a successful pharmaceutical company and supported a wide network of some fifty relatives all based within the same house in Ballygunge, south Calcutta. A precociously intelligent child, Mukherjee was always highly literate, stimulated by her parents to read and study. Consuming books in a quiet corner was often a refuge from the claustrophobic demands of traditional Indian joint family living, and she began writing stories as a young child. Mukherjee was inspired by the storytelling of her paternal grandmother and her mother. Indeed, she consistently paid tribute to Bina, who proudly defended and encouraged Mukherjee and her two sisters, Mira and Ranu, against a patriarchal backdrop of ridicule from Bina's older, female in-laws for having borne Sudhir no sons\"-- Provided by publisher.
BOOK
The Optical Solutions of the Stochastic Fractional Kundu–Mukherjee–Naskar Model by Two Different Methods
In this paper, we focus on the stochastic fractional Kundu–Mukherjee–Naskar equation perturbed in the Stratonovich sense by the multiplicative Wiener process. To gain new elliptic, rational, hyperbolic and trigonometric stochastic solutions, we use two different methods: the Jacobi elliptic function method and the (G′/G)-expansion method. Because of the significance of the Kundu-Mukherjee equation in a magnetized plasma, the obtained solutions are useful in understanding many remarkable physical phenomena. Furthermore, we show the effect of the multiplicative Wiener process on the obtained solutions of the Kundu–Mukherjee–Naskar equation.
Journal Article
Contemporary Diagnosis and Management of Patients with MINOCA
Purpose of Review
Myocardial infarction with nonobstructive coronary arteries (MINOCA) is defined as acute myocardial infarction (MI) with angiographically no obstructive coronary artery disease or stenosis ≤ 50%. MINOCA is diagnostically challenging and complex, making it difficult to manage effectively. This condition accounts for 6–8% of all MI and poses an increased risk of morbidity and mortality after diagnosis. Prompt recognition and targeted management are essential to improve outcomes and our understanding of this condition, but this process is not yet standardized. This article offers a comprehensive review of MINOCA, delving deep into its unique clinical profile, invasive and noninvasive diagnostic strategies for evaluating MINOCA in light of the lack of widespread availability for comprehensive testing, and current evidence surrounding targeted therapies for patients with MINOCA.
Recent Findings
MINOCA is not uncommon and requires comprehensive assessment using various imaging modalities to evaluate it further.
Summary
MINOCA is a heterogenous working diagnosis that requires thoughtful approach to diagnose the underlying disease responsible for MINOCA further.
Journal Article
Coronary Intervention Outcomes in Patients with Liver Cirrhosis
Purpose of Review
This review assesses the outcomes of coronary interventions in patients with liver cirrhosis and coronary artery disease (CAD), focusing on the clinical challenges posed by cirrhosis-related hemodynamic and coagulopathic changes. It highlights essential considerations for managing these patients, who have an increased risk of adverse events during coronary procedures.
Recent Findings
Recent studies have shown that patients with liver cirrhosis undergoing PCI experience significantly higher mortality rates compared to non-cirrhotic patients, particularly in the context of STEMI and NSTEMI. Coagulopathy and thrombocytopenia increase the risk of bleeding and vascular complications during interventions. Radial access has been suggested as a safer alternative to femoral access in these patients due to reduced bleeding complications. Additionally, contrast-induced nephropathy (CIN) is a prevalent risk, with cirrhotic patients demonstrating higher rates of acute kidney injury post-PCI. Preventive strategies such as minimizing contrast exposure and utilizing intravascular ultrasound (IVUS) are recommended.
Summary
Managing CAD in cirrhotic patients requires careful consideration of their unique pathophysiological state. Higher in-hospital mortality, bleeding risks, and vascular complications necessitate tailored procedural strategies, such as radial access and contrast minimization. The balance between thrombotic and bleeding risks is critical in decision-making, with IVUS and hydration strategies being promising approaches. Further research is required to optimize treatment protocols and improve long-term outcomes for this high-risk population.
Journal Article
Association Between Obesity and Cardiovascular Outcomes: Updated Evidence from Meta-analysis Studies
Purpose of ReviewThe prevalence of obesity and cardiovascular disease (CVD) has been increasing worldwide. Studies examining the association between adiposity and CVD outcomes have produced conflicting findings. The interplay between obesity and CVD outcomes in the general population and in specific subpopulations is complex and requires further elucidation.Recent FindingsWe report updated evidence on the association between obesity and CVD events through a review of meta-analysis studies. This review identified that obesity or high body mass index (BMI) was associated with an increased risk of CVD events, including mortality, in the general population and that cardiac respiratory fitness (CRF) and metabolic health status appear to stratify the risk of CVD outcomes. In patients with diabetes, hypertension, or coronary artery disease, mortality displayed a U-shaped association with BMI. This U-shaped association may result from the effect of unintentional weight loss or medication use. By contrast, patients with other severe heart diseases or undergoing cardiac surgery displayed a reverse J-shaped association suggesting the highest mortality associated with low BMI. In these conditions, a prolonged intensive medication use might have attenuated the risk of mortality associated with high BMI.SummaryFor the general population, a large body of evidence points to the importance of obesity prevention and maintenance of a healthy weight. However, for those with diagnosed cardiovascular diseases or diabetes, the relationship between BMI and cardiovascular outcomes is more complex and varies with the type of disease. More studies are needed to define how heterogeneity in the longitudinal changes in BMI affects mortality, especially in patients with severe heart diseases or going under cardiac surgery, in order to target subgroups for tailored interventions. Interventions for managing body weight, in conjunction with improving CRF and metabolic health status and avoiding unintentional weight loss, should be used to improve CVD outcomes.
Journal Article
Red Meat Consumption and Hypertension: An Updated Review
Purpose of Review
Hypertension (HTN) is a major risk factor for cardiovascular diseases (CVD). The global prevalence of HTN and related CVD mortality continues to rise. The development of HTN is influenced by genetic predisposition and modifiable risk factors, including diet. One area of ongoing debate is the relationship between red meat consumption and risk of HTN.
Recent Findings
Processed red meat has become increasingly implicated in the pathogenesis and morbidity of HTN, though randomized control trials comparing HTN-related outcomes associated with red meat subtypes have yielded heterogenous results.
Summary
This review summarizes the existing relevant literature and highlights the methodological challenges that complicate definitive conclusions, with a focus on processed versus unprocessed red meat consumption and HTN. It explores pathophysiologic mechanisms contributing to this relationship and reviews practical, evidence-based dietary guidelines that address red meat consumption to mitigate the risk of adverse HTN-related CVD outcomes.
Journal Article
Cardiac Manifestations of Post-Acute COVID-19 Infection
Purpose of ReviewThere is emerging evidence that the post-acute and chronic phases of COVID-19 infection are associated with various significant cardiovascular sequelae.Recent FindingsLong COVID has been shown to be associated with multiple cardiovascular sequelae including direct myocardial injury, arrhythmias, and cardiomyopathies. Hypotheses on the mechanism of myocardial injury include direct viral infiltration and autoimmune dysregulation. Long COVID is associated with persistent cardiac ischemia in patients with no previous history of coronary disease, atrial and ventricular arrhythmias, and the development of new-onset heart failure in previously healthy patients. Onset of long COVID may be related to severity of the initial SARS-CoV2 infection. Cardiac MRI is a valuable tool in assessing myocarditis and the development of cardiomyopathies in the setting of long COVID.SummaryBoth patients with and without pre-existing cardiovascular disease are at risk of developing myocardial injury in the setting of long COVID. Future studies will elucidate both cardiovascular mortality and cardiac rehabilitation in the post-acute and chronic phases of COVID-19.
Journal Article
Cardiac Outpatient Care in a Digital Age: Remote Cardiology Clinic Visits in the Era of COVID-19
Purpose of ReviewThe worldwide pandemic caused by the novel coronavirus disease transformed healthcare in many ways. The impact of the pandemic was also noted in outpatient settings with various clinics adopting telehealth as the new normal. The goal of this paper is to investigate how the pandemic impacted the outpatient cardiology setting, specifically regarding the use of telehealth, and can the lessons learned from the adoption of telehealth in the backdrop of COVID-19 be applied to facilitate the wider and routine use of telemedicine in the outpatient cardiology clinic.Recent FindingsSeveral studies have been conducted showcasing COVID-19’s impact on the telehealth field of cardiology. Studies showed advantages for patients. Among these advantages are reduction in wait and travel time, easier medication reconciliation, and convenience. They also showed a general comfortability with the transition to telehealth among cardiologists. Furthermore, the adoption of telehealth in the outpatient cardiology setting, specifically with respect to the management of common cardiac conditions of congestive heart failure, atrial fibrillation, and ischemic heart disease, revealed the potential of telemedicine to be used to adequately address these conditions. The transition to telehealth was not without its challenges, such as lack of a physical exam, barriers with certain patient populations to adopting the technology, and changes were noted in frequencies of medication ordering and cardiology-specific laboratory and diagnostic imaging.SummaryThis transition to telehealth during the pandemic allowed for various studies to be conducted on how telehealth impacted the field of cardiology in the outpatient setting. While patient and practitioner advantages were revealed when compared to traditional outpatient cardiology visits, barriers to the adoption of the technology among specific patient populations were noted as were changes in practice among cardiologists. The use of telemedicine to adequately address common cardiac conditions was also shown. Further investigation into understanding the barriers of specific patient populations and overcoming these barriers, understanding the reason for the changes in practice of cardiologists with the use telemedicine, and investigating the use and incorporation of existing technology such as smart watches and patient portals or apps to make the transition to telehealth not only simpler, but to also optimize the cardiologist management of common cardiac conditions, have the potential to lead to the wider and routine use of telemedicine in the outpatient cardiology clinic.
Journal Article