Orthostatic hypotension (OH) is one of the most common autonomic dysfunctions, with high prevalence in populations of elderly, hypertensive, diabetic, or Parkinson’s patients. Evidence is emerging that OH co-occurs with postprandial hypotension (PPH); a greater prevalence of PPH than of OH is reported for Parkinson’s disease patients. OH is diagnosed by measuring the blood pressure changes associated with postural changes and often produces alterations in consciousness or other such bothersome symptoms as fainting. PPH is diagnosed by measuring the blood pressure changes associated with ingesting high carbohydrate test meals. Because of the time lag between food ingestion and absorption, PPH is often not reported as symptomatic and, therefore, not diagnosed as PPH. OH and PPH are independent predictors for all causes of mortality. Relative underdiagnosis may qualify PPH as a “silent killer” disease. This review is aimed at providing updates on the epidemiology, pathophysiology, and clinical aspects associated with the diagnosis and treatment of PPH. Highlighting the current gaps in knowledge and research about PPH is expected to make medical practitioners more cognizant of the dangers of underdiagnosis and motivate future research to identify individuals and populations at high risk for PPH and its sequelae.

There are many approaches to changing a community to ensure it serves the people’s fundamental needs. For example, enabling equitable access to critical aspects of the community, such as quality healthcare, high-quality education, and job training, is vital for promoting community safety through enhancing tolerance and respect for diversity. However, creating a community that serves the fundamental needs of the people demands a substantive investment of effort. Understanding the nature of these efforts requires discussion of community engagement, examining community networks and their role in fostering cooperative action, enhancing public safety, and identifying the structures of involvement and pertinent routes for developing community land. Understanding such efforts entails knowing the issues related to gentrification and disbandment. These hands-on possibilities can help avert the possibility of people being pushed out of their community settings. These insights further shed light on how the family unit and larger community are able to create collective unity and foster each member’s responsibility in community service provision that promotes community integration. Examining how violence and other factors affect a community’s collective power is necessary to determine how a community can avoid such violence and encourage positive changes at the individual and family levels to promote community cooperation and safety. Essentially, changing a community can yield significant improvements in public health. Addressing factors such as access to nutritious food, healthcare, physical activity, and social amenities and fostering social cohesion through community engagement can collectively contribute to reducing the burden of chronic diseases and promoting overall well-being. This review provides insight into crucial issues that have long plagued the societal disconnect between the local community and the leadership, policymakers, or other authoritative institutions that govern them, thus affecting the implementation of strategic social and public health initiatives. We will also explore strategies to mitigate these potential pitfalls.

Public health guidelines and a myriad of studies have proven that exercise is beneficial in the alleviation of various cardio-metabolic diseases. Congenital heart disease (ConHD) is one of the most frequently occurring congenital structural malfunctions in the pediatric population, affecting nine of every 1,000 live births. Only a few studies have established the impact of a structured exercise program on cardiopulmonary fitness in diverse groups of patients with ConHD. It is also alarming to know that a substantial number of these patients and their caregivers often remain very wary of exercise. Anxiety about exercise may increase the risk of developing morbid obesity and other long-term health complications of ConHD. The present review of a critically appraised topic is undertaken to answer the question, “Does structured exercise intervention (cardiac rehabilitation) improve cardiorespiratory fitness in children and young adults with ConHD?” Exercise science and the medical literature were searched for studies that engaged the use of aerobic exercise in patients with different ConHD diagnoses. The search yielded four studies after screening with the inclusion and exclusion criteria, which were further narrowed to three studies after a full-text review. These studies yielded results showing significant increments in peak exercise workload, duration, power output, peak oxygen uptake, or improved tissue oxygenation and muscle strength after an exercise training intervention. It is noteworthy that a group identified as “cyanotic palliated” exhibited the most significant impairment both at baseline and after the exercise intervention. This review provides level 1b medical evidence that a structured exercise program may improve cardiopulmonary fitness in patients with ConHD, which is likely to be beneficial to their overall physical, motor, and psychosocial development. The results of this review may be useful for alleviating the anxiety of patients and their caregivers about participation in structured exercise programs. This review should also motivate future research investigations to develop clinical guidelines for the management of patients with ConHD by adding exercise prescriptions to their daily therapeutic regimens.

Systemic hypertension (HTN) is the hallmark of cardiovascular disease and the forerunner of heart failure. These associations have been established over decades of research on essential HTN. Advancements in the treatment of patients diagnosed with HTN, consisting of alpha- or beta-adrenergic receptor blockers, calcium channel blockers, angiotensin-converting enzyme inhibitors, thiazide, or aldosterone receptor blockers known as anti-mineralocorticoids, in the presence or absence of low sodium salt diets, often fail to control blood pressure adequately to prevent morbidity and mortality. Low sodium diets have had limited success in controlling HTN because low sodium intake is associated with renin-angiotensin-aldosterone system upregulation. Therefore, upregulating aldosterone secretion, sodium, and water retention which, in turn, moves the blood pressure back toward the range of HTN dictated by the baroreceptor reset value, as a compensatory mechanism, especially in resistant HTN. These impediments to blood pressure control in HTN may have been effectively circumvented by the advent of a new class of drugs known as aldosterone synthase inhibitors, represented by baxdrostat. The mechanism of action of baxdrostat as an aldosterone synthase inhibitor demonstrates the inextricable linkage between sodium and blood pressure regulation. Theoretically, combining a low sodium diet with the activity of this aldosterone synthesis inhibitor should alleviate the adverse effect of renin-angiotensin-aldosterone system upregulation. Aldosterone synthesis inhibition should also decrease the oxidative stress and endothelial dysfunction associated with HTN, causing more endothelial nitric oxide synthesis, release, and vasorelaxation. To the best of our knowledge, this is the first systematic review to summarize evidence-based articles relevant to the use of a novel drug (aldosterone synthase inhibitor) in the treatment of HTN and cardiovascular disease. Making the current database of relevant information on baxdrostat and other aldosterone synthase inhibitors readily available will, no doubt, aid physicians and other medical practitioners in their decision-making about employing aldosterone synthase inhibitors in the treatment of patients.

Introduction The burden of multiple drug resistance in human pathogens has necessitated the search for and development of antimicrobial agents with a wide range of structural classes and potentials to selectively act on the several mechanisms of actions exhibited by the pathogens. However, most synthetic antimicrobial agents have been linked with adverse side effects and high costs, furthering the need to explore more options. Syzygium cumini, Moringa oleifera, and Tinospora cordifolia are three medicinal plants used in traditional medicine systems for various infectious diseases. They contain various phytochemicals that exhibit antimicrobial activities against various bacteria, fungi, and parasites. The mechanisms of their antimicrobial action may involve the disruption of microbial cell walls and membranes, the inhibition of microbial enzyme and biofilm formation, the modulation of microbial gene expression and quorum sensing, and the induction of microbial cell death. Therefore, the present study evaluated the potentials of aqueous and ethanol extracts of S. cumini, M. oleifera, and T. cordifolia in managing infections as measured by their inhibitory effects on species. Materials and method Syzygium cumini, M. oleifera, and T. cordifolia were obtained and authenticated, and their aqueous and ethanol extracts were prepared. The antibacterial properties of the aqueous and ethanol extracts were examined. In addition to broth microdilution and biofilm development experiments, we also employed disk diffusion and agar-well diffusion techniques. The inocula of various species, including krusei, parapsilosis, utilis, albicans, and glabrata, were prepared for these assays. The synergistic effect of plant extracts with fluconazole was also evaluated. Results Syzygium cumini, M. oleifera, and T. cordifolia emerge as promising sources for the development of effective and sustainable antimicrobial interventions. Interestingly, the aqueous and ethanol extracts were effective against the selected species. Also, the synergistic combination of plant extracts with fluconazole was observed to triple the potency of the extracts. Furthermore, the potency of the plant extract as an antifungal and synergistic agent was ranked as S. cumini > M. oleifera > T. cordifolia. Conclusively, the plant extracts are effective in the management of opportunistic fungal infections.

BACKGROUND Sodium fluoride (NaF) is a daily necessity consumed as the major ingredient of fluorinated drinking water, milk, salts, mouthwashes, toothpaste, and dentistry medications. However, the use of NaF products has also been associated with increased fluoride anion distribution in the body, leading to hypertension. AIM This study evaluated the antihypertensive effect of sweet orange peels-enriched white melon seed protein concentrate (WSP) biscuit meal in eight-week-old albino rats exposed to NaF for 14 days. METHODS Forty-two (42) male Wistar albino rats were assigned at random into 7 groups of 6 rats per group (control group and six experimental groups). The experimental groups received various treatments that lasted for two weeks. Twenty-four hours after the last administration, hemodynamic parameters were evaluated, rats were sacrificed, blood samples were collected, and the heart was harvested. Blood serum was assessed for cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), and lactate dehydrogenase (LDH). At the same time, the heart homogenate was assayed for angiotensin-1 converting enzyme (ACE) activity, proinflammatory cytokines, nitric oxide concentrations, and antioxidant status. Cardiac tissues were stained with Hematoxylin and Eosin, Masson’s Trichrome, and cTnI. Also, the safety of the WSP biscuit diet was evaluated. RESULTS Results obtained showed that NaF administration elevated the collagen content of cardiac tissues, activities of ACE, and concentrations of cTnI, CK-MB, LDH, tumor necrosis factor-alpha, and interleukin 1 beta, while there was a reduction in the concentration of nitric oxide and antioxidants; however, their alterations were significantly prevented in WSP-biscuit-fed rats. The WSP biscuit meal is safe for consumption and possesses dose-dependent antihypertensive ability at 10% and 20% inclusion. CONCLUSION The WSP biscuit diet may be recommended in diet formulation for the management of individuals or communities that are predisposed to NaF contaminations.