Pakistan Heart Journal

Breaking Barriers: CCBs and Beta-Blockers Redefine the Landscape of Hypertension Treatment

2024-05-31T07:27:20+00:00

Background: Hypertension is a significant global health challenge, with resistant hypertension posing a formidable clinical dilemma. Combination therapy with calcium channel blockers (CCBs) and beta-blockers has emerged as a promising approach to optimize blood pressure control in these patients.

Methods: We conducted a retrospective cohort study involving 2134 subjects with resistant hypertension. Data on demographics, clinical characteristics, medication history, and outcomes were collected from electronic medical records. Subjects were categorized into two groups based on their antihypertensive regimen: Group A received CCBs and beta-blockers, while Group B received other antihypertensive agents. The primary outcome was the change in systolic and diastolic blood pressure, with secondary outcomes including blood pressure control and adverse events.

Results: Combination therapy with CCBs and beta-blockers led to significant reductions in both systolic and diastolic blood pressure compared to other antihypertensive medications. A higher proportion of subjects in Group A achieved blood pressure control targets compared to Group B. The incidence of adverse events was low and comparable between the two groups.

Conclusion: Our study provides evidence supporting the efficacy and safety of combination therapy with CCBs and beta-blockers in the management of resistant hypertension. Despite limitations inherent to the retrospective design, these findings highlight the potential benefits of this treatment approach in improving blood pressure control and reducing the risk of adverse cardiovascular outcomes.

Keywords: Hypertension, resistant hypertension, calcium channel blockers, beta-blockers, combination therapy, blood pressure control, adverse events.

Evaluation Of Histomorphological And Immunohistochemical Parameters As Biomarkers Of Cervical Lymph Node Metastasis In Squamous Cell Carcinoma Of Oral Cavity: A Retrospective Study

2024-07-02T10:11:45+00:00

Abstract
Background: Cervical lymph node metastasis is a critical prognostic factor in squamous
cell carcinoma (SCC) of the oral cavity. Identifying reliable biomarkers for metastasis
could enhance diagnosis, treatment planning, and prognosis. This study aims to evaluate
histomorphological and immunohistochemical parameters as potential biomarkers for
cervical lymph node metastasis in oral SCC.
Materials and Methods: A retrospective study was conducted involving 100 patients
diagnosed with oral SCC from 2015 to 2023. Histomorphological analysis included
parameters such as tumor size, differentiation, and lymphovascular invasion.
Immunohistochemical staining was performed using antibodies against p53, Ki-67, and Ecadherin. The association between these parameters and cervical lymph node metastasis
was statistically analyzed using chi-square and multivariate logistic regression tests.
Results: Among the 100 patients, 45% exhibited cervical lymph node metastasis. Tumor
size >4 cm and poor differentiation were significantly associated with metastasis (p < 0.01).
Lymphovascular invasion was observed in 60% of metastatic cases compared to 25% of
non-metastatic cases (p < 0.001). Immunohistochemical analysis revealed that high p53
expression and Ki-67 index >20% were significantly correlated with metastasis (p < 0.05).
Loss of E-cadherin expression was noted in 70% of metastatic cases versus 30% of nonmetastatic cases (p < 0.001). Multivariate analysis identified lymphovascular invasion, high
Ki-67 index, and loss of E-cadherin as independent predictors of cervical lymph node
metastasis.
Conclusion: Histomorphological parameters, particularly lymphovascular invasion, along
with immunohistochemical markers such as high Ki-67 index and loss of E-cadherin
expression, are significant predictors of cervical lymph node metastasis in oral SCC. These
biomarkers could be integrated into routine pathological evaluation to improve the accuracy
of metastasis prediction and patient management.

Heat shock protein (HSP70) as a marker of epithelial dysplasia in oral dysplastic lesions: A clinicopathological study

2024-07-02T10:18:21+00:00

Abstract
Background: Heat shock proteins (HSPs), particularly HSP70, play a crucial role in
cellular stress responses and have been implicated in the development and progression of
various cancers. This study aims to evaluate the expression of HSP70 as a marker of
epithelial dysplasia in oral dysplastic lesions.
Materials and Methods: A total of 50 patients with clinically and histologically confirmed
oral dysplastic lesions were included in this study. Biopsy samples were collected and
subjected to immunohistochemical staining to detect HSP70 expression. The intensity and
distribution of HSP70 staining were evaluated and correlated with the degree of epithelial
dysplasia. Statistical analysis was performed using chi-square and Fisher's exact tests.
Results: HSP70 expression was observed in 80% of mild dysplasia, 90% of moderate
dysplasia, and 100% of severe dysplasia cases. The intensity of HSP70 staining increased
with the severity of dysplasia, with mean staining intensities of 1.2 ± 0.4, 2.4 ± 0.5, and 3.8
± 0.3 for mild, moderate, and severe dysplasia, respectively (p < 0.01). A significant
correlation was found between HSP70 expression and the degree of epithelial dysplasia,
suggesting that higher HSP70 levels are associated with more severe dysplastic changes.
Conclusion: HSP70 is significantly overexpressed in oral dysplastic lesions and its
expression correlates with the severity of epithelial dysplasia. HSP70 could serve as a
valuable biomarker for assessing the progression of dysplasia in oral lesions, potentially
aiding in early detection and targeted therapeutic interventions.
Keywords: Heat shock protein 70, HSP70, epithelial dysplasia, oral dysplastic lesions,
biomarker, immunohistochemistry, clinicopathological study.