Gastric cancer (GC) is a prevalent malignancy worldwide; the Epstein-Barr Virus (EBV) also affects many people worldwide. An important association has been seen in these two diseases that could explain causality and a possible viral etiology of GC as has been seen with Helicobacter pylori. This study aims to identify genes expressed in malignant cells that are infected with EBV and see if one could be more oncogenic than the other. We conducted a systematic review based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. We had 29 observational studies after inclusion/exclusion criteria and quality assessment for every single study. A total of 1022 patients were evaluated for different types of genes in 29 papers. It was demonstrated that the most expressed genes or the gene most involved were genes that are seen in Epstein-Barr virus-associated gastric cancer (EBVaGC) as latent genes of the EBV-infected cells, which are found in tumor cells. VY-3-135 solubility dmso The genes that were mostly involved were LMP2, BNLF2a, and the absence of LMP1 that lead to the expression of BARF1, among other genes. These studies were made on mostly Asian populations, so it is still unknown if these genes involved have a geographical association more than an EBV and GC association.Background and objective Emerging evidence suggests that sleep problems are more common among individuals with diabetes mellitus (DM) than in the general population; these sleep issues are associated with poor glycemic control and they negatively affect the overall prognosis of the disease by increasing cardiometabolic risk. Our study aimed to determine the frequency of poor sleep quality and its association with glycemic control among Pakistani adult patients with DM. Methods This prospective cross-sectional study was conducted at the outpatient department (OPD) of The Indus Hospital (TIH), Karachi, and included 329 participants. To be eligible, participants had to be 14 years or older, should have been visiting the OPD at TIH for six months or more to seek treatment for DM, and had to give informed consent. Participants were assessed for poor sleep quality using the Pittsburgh Sleep Quality Index (PSQI) score and glycemic control using HbA1C levels ascertained through electronic health record review, with h sleep disturbance and DM in Pakistani adults, by employing objective measures of sleep quality and involving a larger sample of individuals with DM to determine if these results hold true.In 2018, 23,558 confirmed cases and 10,108 probable cases of Lyme disease were reported in the United States, with 96% of all cases coming from 14 states. Lyme carditis is well described, occurring in less than 1% of Lyme disease. High-grade heart block is uncommon in early disseminated Lyme disease. In Lyme carditis due to sinus node dysfunction and/or high grade atrioventricular block, the pulse rates are significantly lower which can lead to syncope. This can happen in the setting of an unstable ventricular escape rhythm with pulse rates ranging around 30 beats per minute or lower. In patients with low cardiovascular reserve, high-degree AV block can cause sudden death. Here we describe a rare case of profound bradycardia in disseminated Lyme disease. The patient’s only two symptoms are bradycardia and jaw pain. He lacks erythema migrans, neurological symptoms or syncope – despite having high-degree AV block. Initially prescribed doxycycline 100mg BID, his PR interval begins to normalize, but once a Lyme titre was positive for IgM (p41, p39, p23) and IgG (p66, p45, p41, p39, p23, p18), the patient was switched to 2g ceftriaxone IV Q 24h, per Infectious Disease Society of America (IDSA) guidelines. After several days he feels better and was discharged home to complete antibiotics and wear a cardiac event monitor. Lyme disease has three distinct stages that include early localized infection, early disseminated disease, and late infection. At the time of Lyme carditis diagnosis, common symptoms include erythema migrans, malaise, polyarthritis, Bell’s palsy and other neurological symptoms – all of which were lacking in our patient. The prognosis for Lyme carditis is generally good, despite disagreement over the incidence of persistent B. burgdorferi infection. This patient’s unique presentation of Lyme carditis is further evidence of variability in cardiac symptoms depending on one’s immunological and physiological ability to combat acute spirochete infection.Acute pericarditis is commonly diagnosed in patients who present with chest pain. Accurate diagnosis of acute pericarditis is essential because of its relative similarity to ST-elevation myocardial infarction (STEMI) in both clinical presentation and electrocardiogram (EKG) changes. Additionally, troponin elevation is occasionally seen in acute pericarditis due to myocardial involvement (myopericarditis), which makes accurate diagnosis more challenging. A 12-lead EKG remains the most useful diagnostic test in differentiating acute pericarditis from STEMI. Spodick’s sign is a less recognized electrocardiographic feature of acute pericarditis and is frequently overlooked by clinicians. We present a case of a 52-year-old male who initially presented with acute onset substernal chest pain. His EKG revealed diffuse subtle ST elevation and downsloping TP segment (Spodick’s sign). A coronary angiogram demonstrated normal coronaries which eliminated the possibility of coronary artery disease. In this article, we will discuss how to differentiate between acute pericarditis and myocardial infarction, with a focus on Spodick’s sign, amongst other EKG findings suggestive of pericarditis.Ascites has multiple etiologies, including cirrhosis and heart failure, which can be differentiated by point-of-care ultrasound (POCUS). One cause of cardiac ascites that can be difficult to identify is portopulmonary hypertension (PPH), a rare disorder caused by pulmonary artery vasoconstriction due to advanced liver disease. POCUS can readily identify right ventricular dysfunction which can accelerate a PPH diagnosis. This case report describes the use of POCUS to work-up new onset ascites and expedite diagnosis of cardiac ascites due to PPH.