A BSTRACT Aims and Objectives: To determine the incidence, spectrum, and predictors of musculoskeletal (MSK) disorders among patients initiated on statins. Methods: In this singlecenter, prospective, and observational study (February 2022–July 2024), 250 consecutive adults newly started on atorvastatin or rosuvastatin were followed for 18 months. Baseline evaluation included clinical examination and laboratory testing (complete blood count, liver and renal function, creatine phosphokinase [CPK], thyroidstimulating hormone, and 25OHVitamin D and lipid profile). Followup visits were scheduled at 1 month and every 2 months thereafter. New or worsening muscle pain, cramps, or weakness persisting ≥2 weeks and resolving within 2 weeks of statin withdrawal (and recurring on rechallenge) were classified as SAMS. Multivariable logistic regression was employed to identify the factors associated with SAMS. Results: Of 250 participants (68% men; mean age 54 ± 11 years), 41 (16%) developed MSK symptoms. Myalgia accounted for 92·7% of cases; myopathy, enthesitis, and rhabdomyolysis each occurred in ≤4·9%. Symptoms developed within 3 months in 73% of cases. Elevated CPK (>5 × upper limit) was seen in six patients (22%) among symptomatic group and 1 (0.95%) patient in asymptomatic group. The incidence was similar with atorvastatin (17·3%) and rosuvastatin (15·8%; adjusted odds ratio [OR] 1·08, P = 0·83). High-intensity dosing showed a nonsignificant trend toward SAMS (OR 1·50, P = 0·28). Elevated poststatin CPK was the only independent predictor of SAMS (OR 2·85, 95% confidence interval 1·12–7·25, P = 0·03). Conclusion: SAMS occurred in 16% of patients, predominantly as self-limited myalgia within the first 3 months of therapy. Atorvastatin and rosuvastatin carried comparable risk. Routine clinical enquiry and CPK monitoring during the early treatment phase facilitate timely recognition and management of SAMS.

A BSTRACT Context: Bromocriptine is in practice of prescribing for peripartum cardiomyopathy patients in the hospital. However, prospective studies demonstrating the effect of bromocriptine on the LV function were lacking. Aims: The aim of this study was to assess the effect of bromocriptine in addition to standard guideline-directed medical therapy on the left ventricular function and clinical outcomes in patients with peripartum cardiomyopathy in South India. Settings and Design: A single-center, investigator-initiated, single-blinded prospective cohort study performed in a government general hospital. Methods: A total of 30 patients diagnosed with peripartum cardiomyopathy between April 2023 and Mar 2024 were consecutively classified into a study and control group. The primary outcome was short-term assessment of a difference in the left ventricular ejection fraction (LVEF) from baseline to 6 months. Statistical Analysis: Two-tailed Student t -test for continuous variables and Chi-square test for categorical variables. Statistical difference between the groups was tested with an independent samples T -test and with Fisher’s F -test two-tailed for variance between the two groups. Results: There is a significant difference in the mean LVEF improvement from baseline to 6 months with 16.7 (47.04%) increase in the bromocriptine group versus 11.53 (29.5%) increase in nonbromocriptine group with a P = 0.04. Conclusions: This study found that those treated with bromocriptine along with standard guideline-directed medical therapy have better marginal improvement in left ventricular systolic function compared to those treated with standard guideline-directed medical therapy alone.

A BSTRACT The emergence of multiple COVID-19 vaccines has prompted evaluation of their clinical effects in high-risk patient groups. In this retrospective cohort study, we explored outcomes among 620 individuals with a history of coronary revascularization who later contracted COVID-19. Participants were stratified into vaccinated ( n = 484) and unvaccinated ( n = 136) cohorts. Findings revealed notably increased rates of hospitalization and mortality among unvaccinated patients. Booster-vaccinated individuals demonstrated the most favorable clinical course. These results suggest a strong association between vaccination and reduced severity of COVID-19 in patients with prior cardiovascular interventions, underlining the need for focused immunization efforts in this vulnerable subgroup.

A BSTRACT Background: Hypertension remains a significant public health challenge in Nigeria, particularly in the low-resource settings such as Northwestern Nigeria with limited healthcare access. Self-monitoring of blood pressure (SMBP) is a proven strategy to improve hypertension control, yet its adoption remains suboptimal. Objectives: This study assessed the awareness, practice, and factors influencing SMBP among hypertensive patients attending follow-up clinic in Northwestern Nigeria. Materials and Methods: A descriptive and cross-sectional study was conducted among 260 hypertensive patients attending Federal Medical Center Gusau, a tertiary hospital in Northwestern Nigeria. Data were collected using structured questionnaires were analyzed using the SPSS software version 25. Associations between the categorical variables were analyzed with Chi-square, with a P < 0.05 was considered statistically significant. Results: Of the 260 participants, 183 (70.4%) were aware of SMBP, but only 118 (45.4%) practiced it. Healthcare professionals were the primary source of information (55.8%). Digital monitors were most commonly used (62.3%). Gender significantly influenced SMBP practice ( P = 0.036), with females practice SMBP than males. No significant association was found between SMBP and BP control ( P = 0.300). Conclusion: Despite high awareness, SMBP practice remains suboptimal among hypertensive patients in Northwestern Nigeria. Targeted health education, better access to affordable BP monitors, and increased provider engagement are needed to improve SMBP uptake and hypertension outcomes.

ABSTRACT Coronary artery disease remains a leading global cause of morbidity and mortality necessitating the identification of high-risk individuals as soon as possible. Recent research suggests that specific dermatological markers-including arcus juvenilis, xanthelasma, early hair graying, and creases in the lobes of the ears, may serve as noninvasive indicators of underlying atherosclerosis and cardiovascular risk. These outward manifestations could be a reflection of underlying systemic or metabolic abnormalities that are related to atherosclerosis and cardiovascular diseases such as diabetes, hypertension, and high cholesterol, making early diagnosis feasible hence, facilitating the use of preventive measures. However, to create standardized procedures for integrating these indicators into regular cardiovascular evaluations, more study is necessary.

ABSTRACT Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are frequently encountered medical emergencies and can be fatal if not treated promptly. HHS is considered to be a more serious condition than DKA and is usually seen in settings with poor drug compliance and several stressful events including infections, trauma, and stroke. HHS has also been implicated as a cause for acute myocardial infarction (AMI) and acute ischemic stroke (AIS). However, concurrent occurrence of AMI and AIS, also termed as cardiocerebral stroke, is a very rare entity which has been reported with aortic dissection and marijuana use; and as a complication of myocardial infarction, we report here a fatal case of cardiocerebral stroke associated with HHS.

ABSTRACT Background: Neutrophil-to-lymphocyte ratio (NLR) refers to the absolute ratio of peripheral blood neutrophils to lymphocytes, which can reflect the state of systematic inflammation, and coronary artery disease is closely related to systemic inflammation. We aimed to define the severity of inflammation by evaluating the correlation of NLR with coronary angiographic profile and left ventricular ejection fraction (LVEF) in patients with acute myocardial infarction (MI). Materials and Methods: This study was conducted on newly diagnosed acute MI patients who were admitted to our tertiary healthcare center. NLR was calculated as absolute values of neutrophil divided by absolute lymphocyte count from the venous blood collected at admission. Echocardiography and coronary angiography were done as per the routine standard of care protocol for these patients. The association of NLR with coronary angiographic profile and EF was evaluated, and P < 0.05 was considered statistically significant. Results: A total of 102 patients were included in the study. Males were more than females in the study population (78 vs. 24), and the mean age of the study population was 60.4 years. Non-ST elevation MI was the most prevalent MI in this cohort (35.3%), followed by anterior wall MI (29.4%) and inferior wall MI (7.8%). There was a negative correlation between NLR and EF, and Pearson’s correlation coefficient was 0.5136 (P < 0.05). The mean NLR was 4.15, 5.03, and 4.97 in single vessel disease, double vessel disease, and vessel disease patients, respectively, which was statistically significant (P < 0.001). Conclusion: NLR had a good ability in predicting prognosis in terms of coronary angiographic severity and change in LVEF in acute MI patients.