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Atrial fibrillation (AF) is a common arrhythmia with increasing incidence and prevalence, associated with increased morbidity and mortality. The list of predisposing factors is extensive and includes coronary artery disease (CAD) as a significant trigger. Coronary spasm, an uncommon form of CAD, can very rarely present with AF. We report an adult male with no significant risk factors or family history, except for smoking, who presented with recurrent palpitations diagnosed and managed as paroxysmal AF. Within one year, the patient experienced recurrent attacks of acute chest pain associated with paroxysms of AF. Coronary angiography showed normal coronary anatomy, and coronary spasm was confirmed by a provocation test, which was associated with the development of arrhythmia. The calcium channel blocker (CCB) nifedipine and isosorbide mononitrate prevented the recurrence of these attacks. CAD should be managed as part of the holistic management of paroxysmal AF, and coronary artery spasms should be considered and treated with coronary dilators, especially CCBs., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, El Sady et al.)

Interleukin-18 (IL-18) is a pro-inflammatory cytokine that rises approximately 24-48 h before a diagnosis of acute kidney injury (AKI). Kidney injury molecule-1 (KIM-1) is one of the most promising early biomarkers. It participates in the process of both kidney injury and healing, although the precise mechanism of the restoration of tubular integrity after injury still remains unclear. The renal resistive index (RRI) is used for evaluating changes in intrarenal perfusion occurring in renal parenchyma diseases. The study included 80 critically ill patients with sepsis, divided into 40 patients who developed AKI and 40 patients without AKI. All patients were evaluated through their history, clinical examination, laboratory investigations of serum IL-18 and KIM-1, and the RRI. Serum IL 18, serum KIM-1, and the RRI were significantly higher in critically ill patients with sepsis and AKI. Receiver operating characteristic analysis for detecting AKI 1 day after admission showed that the area under the curve (AUC) for serum IL-18 was 86.1%, the AUC for serum KIM-1 was 86%, and the AUC for the RRI was 88%, demonstrating statistical significance for the diagnosis of AKI within the next 24 h. Serum IL-18, KIM-1, and the RRI represent early predictors of AKI in critically ill septic patients., (Copyright © 2023 Copyright: © 2023 Saudi Journal of Kidney Diseases and Transplantation.)

MicroRNA-208a is a cardiac specific oligo-nucleotide. We aimed at investigating the ability of microRNA-208a to diagnose myocardial infarction and predict the outcome of primary percutaneuos coronary angiography (PCI). Patients (n = 75) presented by chest pain were recruited into two groups. Group 1 (n = 40) had ST elevation myocardial infarction (STEMI) and underwent primary PCI: 21 patients had sufficient reperfusion and 19 had no-reflow. Group 2 (n = 35) had negative cardiac troponins (cTns). Plasma microRNA-208a expression was assessed using quantitative polymerase chain reaction and patients were followed for occurrence of in-hospital major adverse cardiac events (MACE). MicroRNA-208a could diagnose of MI (AUC of 0.926). After primary PCI, it was superior to cTnT in prediction of no-reflow (AUC difference of 0.231, P = 0.0233) and MACE (AUC difference of 0.367, P = 0.0053). Accordingly, circulating levels of miR-208a can be used as a diagnostic marker of MI and a predictor of no-reflow and in-hospital MACE. Graphical abstract Receiver operating curve analysis of no-reflow prediction of miRNA208a, CK-MB and hs-Troponin T. MicroRNA-208a shows significantly higher prediction of no-reflow as compared to routine cardiac biomarkers.

End-stage renal disease (ESRD) patients have been associated with accelerated vascular disease of the cerebral circulation due to uremic toxins. Furthermore, anemia increases cerebral oxygen extraction fraction which impairs the cerebral vasodilatory capacity. We evaluated the effect of correction of anemia on cerebral blood flow by measuring the mean blood flow velocity, resistance index (RI), and pulsatility index (PI) in the middle cerebral artery (MCA) in relation to cognitive functions. We measured the mean blood flow velocity, RI, and PI in MCA of 120 ESRD patients when the hemoglobin (Hb) ranges between 8 and 10 g/dL and after correction of anemia to two Hb ranges between 10-11.5 g/dL and 11.5-12.5 g/dL in the same patients using transcranial Doppler (TCD) ultrasound in relation to cognitive functions assessment by Mini-Mental State Examination. We observed that there is a mild-to-moderate cognitive impairment in hemodialysis (HD) patients associated with anemia. With the improvement of anemia, the cognitive functions improved. There was an improvement of blood flow of MCA with improvement of Hb. The improvement was obvious at Stage 3 (Hb 11.5-≤12.5 g/dL) in comparison to Stage 2 (Hb 10-<11.5 g/dL) with P <0.001 at all. The optimal Hb for HD patients ranges from 11.5 to ≤12.5 g/dL which associated with better improvement of cognitive function and cerebral circulation investigated by TCD ultrasound for MCA., Competing Interests: None

Renal ischemia/reperfusion injury is a major cause of acute kidney injury (AKI). The lack of early biomarkers for predicting AKI has hampered our ability to initiate preventive and therapeutic measures in an opportune way. Fibroblast growth factor 23 (FGF-23) is elevated in chronic kidney disease, but data on FGF-23 in humans with AKI are limited. Herein, we tested whether FGF-23 levels rise early in the course of AKI following cardiac surgery. We prospectively evaluated eighty adult patients who underwent cardiac surgery. Patients were divided into two groups (AKI and non-AKI group) on the basis of whether they developed postoperative AKI within 24 h after surgery. Plasma FGF-23 levels were measured before surgery and 24 h after surgery. The primary outcome was AKI diagnosed using the AKI Network criteria. Forty-five patients (56.2.5%) developed AKI after surgery. Plasma FGF-23 increased significantly from a mean of 26.8 ± 2.47 ng/mL at baseline to 341.7 ± 38.1 ng/mL 24 h after cardiopulmonary bypass. Univariate analysis showed a significant correlation between AKI and the following: percent change in plasma FGF-23, postoperative serum level of creatinine, FGF-23, and neutrophil gelatinase-associated lipocalin. Receiver operating characteristic curve analysis revealed that, for percent change in plasma FGF-23 concentrations at 24 h, the area under the curve was 0.9, sensitivity was 100%, and specificity was 97.1%. Plasma FGF-23 percent change is more valid compared with FGF-23 before or after procedure in the prediction of AKI and represents a novel and highly predictive early biomarker for AKI after cardiac surgery., Competing Interests: None declared

Equilibrium and kinetics of Cu(2+) adsorption onto soil minerals (kaolinite and hematite) in the absence and presence of humic acid have been investigated under various conditions. The influences of ionic strength, pH and solution cations on the rate of the adsorption have been studied. The rate and the amount of adsorbed Cu(2+) onto soil minerals in the absence or the presence of humic acid increased with decreasing ionic strength, increasing pH and in the presence of the background electrolyte K(+) rather than Ca(2+). Humic acid enhanced the rate and the amount of adsorbed Cu(2+) onto soil minerals. The adsorption equilibrium data showed that adsorption behavior of Cu(2+) could be described more reasonably by Langmiur adsorption isotherm than Freundlich isotherm in the absence or presence of humic acid. Pseudo first and pseudo second order models were used to evaluate the kinetic data and the rate constants. The results indicated that the adsorption of Cu(2+) onto hematite and kaolinite in the absence and presence of humic acid is more conforming to pseudo second order kinetics., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Kinetics of humic acid (HA) adsorption onto soil minerals (kaolinite and hematite) has been investigated under various conditions. The influence of ionic strength, pH, and solution cations on the rate of adsorption has been studied. The rate and the amount of adsorbed humic acid onto soil minerals increased with increasing ionic strength, decreasing pH, and in the presence of Ca(2+) as background electrolyte. The adsorption equilibrium data showed that adsorption behavior of humic acid could be described more reasonably by Freundlich adsorption isotherm than Langmiur adsorption isotherm. Pseudo first order and pseudo second order kinetic models were used to evaluate the kinetic data and the rate constants. The results explained that humic acid adsorption on hematite and kaolinite was more conforming with pseudo second order kinetics.

The kinetics and mechanism of the reaction of hydrogen peroxide with some Fe(II) Schiff base complexes were investigated spectrophotometrically in aqueous solution at pH 8 and 35 degrees C under pseudo-first-order conditions. The used ligands were derived from salicylaldehyde or o-hydroxynaphthaldehyde and some amino acids (l-leucine, l-iso-leucine, l-serine, l-methionine and dl-tryptophan). It was found that the formation of the purple interaperoxo complex appears only above pH 7.5. The reaction consists of two steps. The first step involves reversible formation of the intraperoxo intermediate which renders irreversible at pH 8. The second step consists of inner-sphere electron transfer. The suggested scheme illustrated first-order kinetics at low [H(2)O(2)] and zero-order at high [H(2)O(2)]. Moreover, the activation parameters of the reaction were evaluated.

The kinetics and mechanism of the disproportionation of MnO(4)(-) via [CMC-MnVIO(4)(2-)] intermediate complex formation during the oxidation of carboxymethyl-cellulose (CMC) polysaccharide have been investigated spectrophotometrically at pH>/=12 and various temperatures (15-35 degrees C). The rate law was suggested as rate=k(obs)[MnO(4)(-)]. Kinetic and spectrophotometric measurements revealed the base-catalyzed formation of manganate(VI) transient species. A mechanism was postulated consistent with the experimental data. Copyright 2001 Academic Press.

We studied 78 cases of traumatic aseptic osteitis pubis among Saudi athletes to elucidate the clinical and radiological features of the condition as well as the outcome of management and the etiology. The most common presenting complaints were pain in the groin and lower abdomen, and tendernedd over the symphysis pubis. Widening and osteolysis of the symphysis pubis were the most frequent radiological changes. Routine laboratory tests showed no abnormalities in any of our patients. Conservative treatment, consisting of avoidance of sporting activity, use of nonsteroidal antiinflammatory drugs, and physiotherapy, effected cure in 75% of our patients. Further management was needed in the remaining 25%. The disorder is relatively common among Saudi football players, with trauma the likely cause. Conservative treatment is successful in most patients.