Cerebrovascular accidents (CVAs) are vascular multifactorial, multigenic ailments with intricate genetic, environmental risk influences. The present study aimed to establish affiliation of CVAs/stroke with blood parameters, differences in prescribed drugs consumption, and with differences in homocysteine pathway genes polymorphisms. The participants in study included controls n = 251, transient ischemic attack (TIA) patients n = 16, and stroke cases n = 122, respectively, (total participants, n = 389). The analyzed single nucleotide polymorphisms (SNPs) included C677T(rs1801133), A1298C(rs1801131) of methylene tetrahydrofolate reductase (MTHFR), A2756G(rs1805087) of methyl tetrahydrofolate homocysteine methyltransferase/methionine synthase (MS), and the A192G(rs662) of paraoxonase 1(PON1) genes, all validated by tetra-primer allele refractory mutation system polymerase chain reaction (T-ARMS-PCR). The insertion deletion (I/D; rs4646994) polymorphism in angiotensin converting enzyme (ACE) gene was analyzed using routine PCR. All studied traits were scrutinized through analysis of variance (ANOVA), and later through regression analysis. Through ANOVA and multiple comparison, there was association of CVA with serum homocysteine, cholesterol, and with diastolic blood pressure readings. When data was subjected to regression, serum homocysteine and diastolic blood pressure (significant through ANOVA), as well as two additional traits, high-density lipoproteins (HDL), and rs1801133 MTHFR SNP sustained statistical significance and noteworthy odds in relation to CVA and stroke. The ailments affecting cerebral vasculature are mutifactorial, whereby genes, proteins, and environmental cues all exert cumulative effects enhancing CVA risk. The current study emphasizes that SNPs and variation in circulating biomarkers can be used for screening purposes and for reviewing their effects in stroke/CVA-linked risk progression.

Cardiovascular disease (CVD) have multifactorial nature, and owing to their disparate etiological roots, it is difficult to ascertain exact determinants of CVD. In the current study, primary objective was to determine association of single nucleotide polymorphisms (SNP) in folate pathway genes, homocysteine, antihypertensive medication, and of known risk factors in relation to CVD outcomes. The participants numbered 477 (controls, n = 201, ischemic heart disease patients, n = 95, and myocardial infarction cases, n = 181, respectively). SNPs that were queried for homocysteine pathway genes included, “methylene tetrahydrofolate reductase (MTHFR)” gene SNPs rs1801133 and rs1801131, “methyltransferase (MTR)” SNP rs1805087, “paraoxonase 1 (PON1)” SNP rs662, and angiotensin-converting enzyme (ACE) gene polymorphisms rs4646994. Medication data were collected through questionnaire, and serum-based parameters were analyzed through commercial kits. The analysis of variance and multiple comparison scrutiny revealed that age, gender, family history, cholesterol, creatinine, triglyceride, high density lipoproteins (HDL), homocysteine, beta-blocker, ACE inhibitors, MTHFR and PON1 SNPs related to coronary artery disease (CAD). On regression, rs662 SNPs and C-reactive protein had nonsignificant odds ratio, whereas age, gender, creatinine, and HDL were nonsignificant. Family history, cholesterol, homocysteine, beta blocker, and ACE inhibitors, homocysteine, rs1801133 and rs1801131 SNP maintained significance/significant odds for CAD. The current study indicates an intricate relationship between genetic variants, traditional factors, and drug usage in etiogenesis of arterial disease. Differences in SNPs, their modulated effects in consensus with medicinal usage may be related to ailment outcomes affecting coronary vasculature.

Objectives: To carry out a comparison between serum BDNF levels as well as enhancement in upper limb motor function in terms of gross movement, pinch, grip, primary grasp, pre and post intervention in the study and control groups. Study design And Setting: It was a Randomized Control Study conducted from March 2015 to March 2016 at Holy Family Hospital Rawalpindi in collaboration with the Multidisciplinary research laboratory at Islamic International Medical College, Rawalpindi. Methodology: In this study; forty stroke patients were randomly designated to either the study group or the control group. Upper limb activity capability which was quantified by Action Research Arm Test (ARAT) and serum Brain Derived Neurotrophic Factor (BDNF) was measured in both control and study group. The control group underwent traditional upper limb physiotherapy for 16 sessions. The study group underwent Constraint Induced Movement Therapy for the upper limb in combination with the use of motion capture video gaming technology for 16 sessions each of twenty minutes duration. Before and after completion of intervention sessions; ARAT and serum BDNF were measured and compared in both control and study groups. Results: Serum BDNF levels was significantly improved in study group as compare to control group (p<0.001). ARAT showed significant improvement in study group participants as compare to control groups (p<0.001). Conclusion: Virtual rehabilitation was an efficacious method for Neuroplastic enhancement in stroke patients

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Introduction: Psychological stress activate two axes: Hypothalamic- Pituitary-Adrenal axis and Sympathoadrenal axis leading to production of cortisol and catecholamines.Autonomic disturbances in the body can be evaluated by estimating heart rate variability.Study Design: Cross sectional study. Setting: Islamic International Medical College. Period:June 2014 to December 2014. Materials and Methods: Subjects were labeled as stress andcontrol on basis of DASS questionnaire proforma. Morning Cortisol level of all the subjectswas measured by quantitative ELISA method. Heart rate variability recording of all the subjectswas done. Results: Low frequency in absolute and normalized unit and low to high frequencyratio was significantly higher in stressed group, compared to control (p≤ .05, p ≤ .001, pp ≤.001 respectively). High frequency in normalized was significantly lower in stressed subjects,compared to control (p ≤ .001). Cortisol level was significantly higher in the stressed group incomparison with control (p ≤ .05). Conclusion: Stress can lead to increase morning cortisollevel and can cause autonomic disturbances which can be evaluated by measuring heart ratevariability.