A Case Report of Non-Atherosclerotic Driven Myocardial Infarction in a Patient Presenting with Coronary Artery Spasm Non-atherosclerotic driven myocardial infarction

Background: Non-atherosclerotic processes are regarded as equally important contributors to a substantial number of coronary problems mainly myocardial infarction. This includes coronary spasm which has been considered as one of the coronary syndromes leading to myocardial infarction. These non-atherosclerotic events ensuing in major averse cardiac events (MACE) not only require various diagnostic and therapeutic strategies but also there is a need to delineate the underlying etiology for their effective treatment and management. Case Summary: We report a case of anterior wall myocardial infarction (AWMI) driven by a non-atherosclerotic event i.e. Coronary spasm. Concomitant marked ST-segment elevation recorded on ECG revealed a diffuse mid distal disease in our patient. We report here the initial presentation, coronary care & intervention and throughout the clinical course of our patient. Conclusion: Myocardial infarctionsinvolving non-atherosclerotic causes in young individuals as in our study should be reported by medical practitioners and given equal importance as they might indicate the underlying root cause of such events. Effective treatment of such future cases can be done by taking management strategies, diagnostic findings and prognostic data into consideration.

Formulation and Characterization of Cardioprotective Nanosuspensions from Indigenous Medicinal Plants

Present research work was planned for the formulation of cardioprotective nanosuspensions of four indigenous medicinal plants with improved bioavailability and better therapeutic efficacy. Ongoing research was divided into four different phases. First phase of the study was comprised of formulation and optimization of formulative parameters for the preparation of stable nanosuspensions by using CCD design of RSM. Characterization (ZP, SEM, AFM and FTIR) and stability studies of optimized nanosuspensions was the second phase of the study. In third phase of study, in-vitro dissolution testing and in-vivo pharmacokinetic profile of selected nanoformulations was determined. In fourth phase, different in-vitro and in-vivo bioactivities and toxicity studies of optimized nanosuspensions were evaluated with reference to the respective coarse plant suspensions. Results of stabilizer screening demonstrated that SLS was the best stabilizer for the formulation of A. cepa and C. oxyacantha nanosuspensions. HPMC was the selected stabilizer for P. nigrum and P-80 was chosen for the formulation of T. arjuna nanosuspensions. Among the optimized nanosuspensions, minimum particle size with appropriate PDI value was possessed by T. arjuna (79.1nm, 0.244) followed by C. oxyacantha (121.3nm, 0.241), P. nigrum (172.9nm, 0.328) and A. cepa (275.5nm, 0.415) nanosuspension. Results of zeta potential studies confirmed the stability of the optimized nanosuspensions. Results of AFM and SEM illustrated that nanosuspensions were in nanometer range with varied particle size and morphology. FT-IR studies indicated slight interaction between herbal extracts and stabilizers. Moreover, optimized nanosuspensions of all the four medicinal plants showed better stability at refrigerated conditions. Dissolution and pharmacokinetic studies demonstrated improved results for nanosuspensions as compared to coarse suspensions of the respective plant extracts. In-vitro (antioxidant, antimicrobial, hemolytic, thrombolytic) and in-vivo (cardioprotective) bioactivities also revealed better therapeutic efficacy of nanosuspensions over coarse suspensions. Results of toxicity studies confirmed the non-toxic nature of formulated nanosuspensions. From the present results it was concluded that nanosuspensions of the selected herbal extracts can be used as a better alternative to treat cardiovascular diseases with improved therapeutic efficacy as compared to their conventional coarse suspensions.