A. Etiuma, A. Umana, R. Mgbe, Steve Egbe, Roseline Akpeke, O. Bassey
There are many etiological factors for foreign body impaction in the oesophagus. Such impaction could pose a major morbidity 3 and sometime mortality. We report an unusual table spoon impaction in the lower oesophagus complicating domestic emergency management of convulsion in an epileptic.
{"title":"Impacted Table Spoon In The Oesophagus Complicating Emergency Domestic Management Of Epilepsy","authors":"A. Etiuma, A. Umana, R. Mgbe, Steve Egbe, Roseline Akpeke, O. Bassey","doi":"10.5580/2c16","DOIUrl":"https://doi.org/10.5580/2c16","url":null,"abstract":"There are many etiological factors for foreign body impaction in the oesophagus. Such impaction could pose a major morbidity 3 and sometime mortality. We report an unusual table spoon impaction in the lower oesophagus complicating domestic emergency management of convulsion in an epileptic.","PeriodicalId":330833,"journal":{"name":"The Internet Journal of Thoracic and Cardiovascular Surgery","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129537115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Tatebe, M. Taoka, I. Tei, Shuko Nakamura, E. Tei
A 75-year-old female with persistent long-lasting atrial fibrillation (AF) spontaneously reverted to sinus rhythm (SR). She had been suffering from mitral stenosis and secondary tricuspid insufficiency with AF since her 50’s. She underwent mitral valve replacement and tricuspid annuloplasty 3 years previously. Spontaneous defibrillation improved cardiac status and remained in SR for 3 years. Possible mechanisms of this uncommon phenomenon are discussed. Cilostazol was suggested to play a role on this case.
{"title":"Chronic Atrial Fibrillation Spontaneously Reverted After Surgery.","authors":"S. Tatebe, M. Taoka, I. Tei, Shuko Nakamura, E. Tei","doi":"10.5580/2bec","DOIUrl":"https://doi.org/10.5580/2bec","url":null,"abstract":"A 75-year-old female with persistent long-lasting atrial fibrillation (AF) spontaneously reverted to sinus rhythm (SR). She had been suffering from mitral stenosis and secondary tricuspid insufficiency with AF since her 50’s. She underwent mitral valve replacement and tricuspid annuloplasty 3 years previously. Spontaneous defibrillation improved cardiac status and remained in SR for 3 years. Possible mechanisms of this uncommon phenomenon are discussed. Cilostazol was suggested to play a role on this case.","PeriodicalId":330833,"journal":{"name":"The Internet Journal of Thoracic and Cardiovascular Surgery","volume":"72 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114029079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chest tube insertion (thoracostomy) is a common procedure performed in the emergency department, the operating theatre and the intensive care unit. Inserting a drain into the pulmonary artery is a rare but life threatening complication. We report a case of successful non-operative management of a pulmonary artery injury after tube thoracostomy insertion.
{"title":"Non-Operative Management Of Chest Tube Induced Pulmonary Artery Injury","authors":"J. V. D. Niet, M. Koeman, I. Purmer, W. Steup","doi":"10.5580/2b3c","DOIUrl":"https://doi.org/10.5580/2b3c","url":null,"abstract":"Chest tube insertion (thoracostomy) is a common procedure performed in the emergency department, the operating theatre and the intensive care unit. Inserting a drain into the pulmonary artery is a rare but life threatening complication. We report a case of successful non-operative management of a pulmonary artery injury after tube thoracostomy insertion.","PeriodicalId":330833,"journal":{"name":"The Internet Journal of Thoracic and Cardiovascular Surgery","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129982140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Touré, A. Leye, M. Diop, Y. Léye, M. Leye, Y. Mahamat, N. Ndiaye, A. Dia, A. Phiri, C. T. Tall, M. Diop, S. Elfajri, M. M. Ka
A pseudo aneurysm due to the rupture of myocardium can occur after trauma, infarction, cardiac surgery or bacterial endocarditis. This false aneurysm has a high morbidity, a risk of spontaneous rupture and sudden death. We report a case of a left ventricular pseudo aneurysm in a 14-year-old male patient with past medical history of chest blunt trauma associated with a distal lower humerus fracture treated in 2005. He was admitted for moderate hematemesis associated with left upper quadrant and flank pain and dyspnea on exertion. The physical examination revealed a tender mass extending from the epigastrium to the left flank. Gastro esophageal duodenal endoscopy revealed a bleeding ulcer Forrest class IIb in the posterior wall of the fundus. The aneurysm first seen in the CT scan was confirmed by MRI which displayed the presence of a pseudo aneurysm of the left ventricle ruptured in the apex in a loculated pericardium. As soon as the diagnosis of left ventricle pseudo aneurysm was confirmed, the patient was sent to the cardiovascular surgery department where he underwent aneurysmectomy under extracorporeal circulation. The postoperative course was characterized by a hemodynamic instability. He died two days later of cardiogenic shock. In the face of any chest trauma even blunt trauma, an exploration by echocardiography or chest CT scan is desirable to detect this complication in time in order to improving the prognosis of patients with large and complicated aneurysms.
{"title":"A Giant Pseudo Aneurysm Of The Left Ventricle Revealed By Hematemesis.","authors":"P. Touré, A. Leye, M. Diop, Y. Léye, M. Leye, Y. Mahamat, N. Ndiaye, A. Dia, A. Phiri, C. T. Tall, M. Diop, S. Elfajri, M. M. Ka","doi":"10.5580/2c15","DOIUrl":"https://doi.org/10.5580/2c15","url":null,"abstract":"A pseudo aneurysm due to the rupture of myocardium can occur after trauma, infarction, cardiac surgery or bacterial endocarditis. This false aneurysm has a high morbidity, a risk of spontaneous rupture and sudden death. We report a case of a left ventricular pseudo aneurysm in a 14-year-old male patient with past medical history of chest blunt trauma associated with a distal lower humerus fracture treated in 2005. He was admitted for moderate hematemesis associated with left upper quadrant and flank pain and dyspnea on exertion. The physical examination revealed a tender mass extending from the epigastrium to the left flank. Gastro esophageal duodenal endoscopy revealed a bleeding ulcer Forrest class IIb in the posterior wall of the fundus. The aneurysm first seen in the CT scan was confirmed by MRI which displayed the presence of a pseudo aneurysm of the left ventricle ruptured in the apex in a loculated pericardium. As soon as the diagnosis of left ventricle pseudo aneurysm was confirmed, the patient was sent to the cardiovascular surgery department where he underwent aneurysmectomy under extracorporeal circulation. The postoperative course was characterized by a hemodynamic instability. He died two days later of cardiogenic shock. In the face of any chest trauma even blunt trauma, an exploration by echocardiography or chest CT scan is desirable to detect this complication in time in order to improving the prognosis of patients with large and complicated aneurysms.","PeriodicalId":330833,"journal":{"name":"The Internet Journal of Thoracic and Cardiovascular Surgery","volume":"251 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114252402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Solitary fibrous tumours (SFT) of the pleura are neoplasms thought to arise from the mesenchymal tissue. Intrapulmonary malignant fibrous tumours are rare although histologically identical to pleural lesions and should be managed as such. Surgical excision with clear margins is the accepted treatment in the literature, for both benign and malignant disease. Solitary fibrous tumours (SFT) of the pleura are neoplasms thought to arise from the mesenchymal tissue. They often present as a pleurally based mass on X-ray and CT, whilst there are many case series on solitary fibrous tumours arising from the pleura, intrapulmonary lesions are rare. We present a case of an intrapulmonary malignant solitary fibrous tumour and a brief literature review.
{"title":"Intrapulmonary Malignant Solitary Fibrous Tumour: A Rare Entity","authors":"V. An, S. Theodore, P. Antippa, J. Tatoulis","doi":"10.5580/2abe","DOIUrl":"https://doi.org/10.5580/2abe","url":null,"abstract":"Solitary fibrous tumours (SFT) of the pleura are neoplasms thought to arise from the mesenchymal tissue. Intrapulmonary malignant fibrous tumours are rare although histologically identical to pleural lesions and should be managed as such. Surgical excision with clear margins is the accepted treatment in the literature, for both benign and malignant disease. Solitary fibrous tumours (SFT) of the pleura are neoplasms thought to arise from the mesenchymal tissue. They often present as a pleurally based mass on X-ray and CT, whilst there are many case series on solitary fibrous tumours arising from the pleura, intrapulmonary lesions are rare. We present a case of an intrapulmonary malignant solitary fibrous tumour and a brief literature review.","PeriodicalId":330833,"journal":{"name":"The Internet Journal of Thoracic and Cardiovascular Surgery","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132313987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sudden death in adults after non-penetrating chest blows are rare cases which are successfully resuscitated. Commotio cordis is the most described report during sporting activities in the youth. There have been very few reports of commotio cordis caused by other traumas. They endure a low survival rate. We reported a rare case of commotio cordis caused by a horse kick injury in a middle-aged male, who was successfully resuscitated and discharged without any neurological sequelae. This case can be classified as commotio cordis as the ventricular fibrillation (VF) had developed immediately after chest injury. The patient was a 46 year-old male who suffered a severe horse kick impact to the chest while examining the horse. He had no history of cardiac disease or other system diseases. The patient was transported to our hospital in a private car. He arrived at the emergency room within 10 minutes of the accident. There was no basic life support until he arrived. Evidence of ventricular fibrillattion led the doctor to carry out immediate defibrillation with a biphasic defibrillator and started cardiopulmonary resuscitation. We performed endotracheal intubation. Return of the spontaneous circulation was restored within 10 minutes of CPR, and establishment of normal sinus rhythm was confirmed. The patient was immediately examined for internal organ injuries that might cause death. General physical examination determined an 8 cm in length abrasion in the chest wall resulting from blunt trauma, and computerized tomography of the chest showed pulmonary contusion on the left lung. There wasn’t any pneumothorax, hemothorax or cardiac tamponade in the imaging of the mediastinum. The patient was transported to our hospital’s Intensive Care Unit. On arrival, he was hemodynamically stable and image studies were clear. The vital signs were stable (blood pressure: 125/77 mmHg, heart rate: 88 bpm, respiratory rate: 24 bpm, body temperature: 36.0 c). Glasgow Coma Scale score was 3 (E1 V1 M1). Serum CKMB and Troponin I levels were normal. No evidence of any other critical injury was detected. The patient remained in the ICU for two days. During the clinical course, the patient remained hemodynamically stable and there was no recurrence of arrhythmia. On day 2, he had woken up and extubation had been performed by the ICU doctors. He was able to communicate and asked for discharge. Three days after being accepted to the intensive care unit, he was discharged on his request.
{"title":"A Case of Commotio Cordis Caused by Horse Kick","authors":"Z. Karakaya, S. S. Ay, E. Demir","doi":"10.5580/2ee2","DOIUrl":"https://doi.org/10.5580/2ee2","url":null,"abstract":"Sudden death in adults after non-penetrating chest blows are rare cases which are successfully resuscitated. Commotio cordis is the most described report during sporting activities in the youth. There have been very few reports of commotio cordis caused by other traumas. They endure a low survival rate. We reported a rare case of commotio cordis caused by a horse kick injury in a middle-aged male, who was successfully resuscitated and discharged without any neurological sequelae. This case can be classified as commotio cordis as the ventricular fibrillation (VF) had developed immediately after chest injury. The patient was a 46 year-old male who suffered a severe horse kick impact to the chest while examining the horse. He had no history of cardiac disease or other system diseases. The patient was transported to our hospital in a private car. He arrived at the emergency room within 10 minutes of the accident. There was no basic life support until he arrived. Evidence of ventricular fibrillattion led the doctor to carry out immediate defibrillation with a biphasic defibrillator and started cardiopulmonary resuscitation. We performed endotracheal intubation. Return of the spontaneous circulation was restored within 10 minutes of CPR, and establishment of normal sinus rhythm was confirmed. The patient was immediately examined for internal organ injuries that might cause death. General physical examination determined an 8 cm in length abrasion in the chest wall resulting from blunt trauma, and computerized tomography of the chest showed pulmonary contusion on the left lung. There wasn’t any pneumothorax, hemothorax or cardiac tamponade in the imaging of the mediastinum. The patient was transported to our hospital’s Intensive Care Unit. On arrival, he was hemodynamically stable and image studies were clear. The vital signs were stable (blood pressure: 125/77 mmHg, heart rate: 88 bpm, respiratory rate: 24 bpm, body temperature: 36.0 c). Glasgow Coma Scale score was 3 (E1 V1 M1). Serum CKMB and Troponin I levels were normal. No evidence of any other critical injury was detected. The patient remained in the ICU for two days. During the clinical course, the patient remained hemodynamically stable and there was no recurrence of arrhythmia. On day 2, he had woken up and extubation had been performed by the ICU doctors. He was able to communicate and asked for discharge. Three days after being accepted to the intensive care unit, he was discharged on his request.","PeriodicalId":330833,"journal":{"name":"The Internet Journal of Thoracic and Cardiovascular Surgery","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128148677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTION : Myocardial infarction is a common presentation of ischemic heart disease. Ischemic heart disease is the leading cause of death in developed countries, but third to AIDS and lower respiratory infections in developing countries. In India, cardiovascular disease (CVD) is the leading cause of death. The deaths due to CVD in India were 32% of all deaths in 2007 and are expected to rise from 1.17 million in 1990 and 1.59 million in 2000 to 2.03 million in 2010. Although a relatively new epidemic in India, it has quickly become a major health issue with deaths due to CVD expected to double during 1985-2015. [ Mortality estimates due to CVD vary widely by state, ranging from 10% in Meghalaya to 49% in Punjab (percentage of all deaths). Punjab (49%), Goa (42%), Tamil Nadu (36%) and Andhra Pradesh (31%) have the highest CVD related mortality estimates. State-wise differences are correlated with prevalence of specific dietary risk factors in the states. Moderate physical exercise is associated with reduced incidence of CVD in India (those who exercise have less than half the risk of those who don't). CVD also affects Indians at a younger age (in their 30s and 40s) than is typical in other countries. QTc dispersion is an important marker that reflect variations of ventricular repolarisation and arrythmogenic potential. This study is based on various studies suggesting significant reduction in QTc dispersion after thrombolytic therapy in acute myocardial infarction. AIMS OF THE STUDY : 1.To calculate the QT, QTc, QTd, QTcd in all patients with acute myocardial infarction. 2. To determine the difference of QT parameters in patients treated with thrombolytic agents(streptokinase) against those not treated with thrombolytic agents(streptokinase). MATERIALS AND METHODS : 102 patients admitted in KAPV Government Medical College Hospital, Tiruchirapalli for Acute Myocardial infarction were taken up for the study. All patients were followed for a period of 8±2 days during their stay in the hospital. The study group was chosen taking into consideration of the following criteria: INCLUSION CRITERIA : 1. Acute Myocardial infarction • Chest pain >30 minutes, • Chest pain not relieved by rest or nitrates, • ST elevation >1mm or 0.1mv in ≥2 limb leads ST elevation >2mm or 0.2mv in ≥ 2 precordial leads, • NSTEMI. 2. Treatment with Thrombolytic therapy (streptokinase) / without Thrombolytic therapy EXCLUSION CRITERIA : 1. The contraindications for thrombolytic therapy for those patients who were treated with thrombolytic therapy. 2. Drugs affecting QT interval eg. Quinidine, procainamide, tricyclics & tetracyclics depressants, astemizole, digitalis. 3. Hypertrophic cardiomyopathy, Acute carditis. 4. Atrial fibrillation, Bundle branch blocks. 5. Prior coronary bypass surgery. 6. Serum potassium 5.0mmol/l. 7. Congenital long QT Syndromes. METHODS : In Patients admitted for Acute Myocardial infarction, a standard 12 lead ECG
{"title":"A Study On Qt Dispersion And Thrombolytic Therapy In Acute Myocardial Infarction","authors":"S. PrabhuShankar., N. Ramya","doi":"10.5580/792","DOIUrl":"https://doi.org/10.5580/792","url":null,"abstract":"INTRODUCTION : \u0000Myocardial infarction is a common presentation of ischemic heart \u0000disease. Ischemic heart disease is the leading cause of death in developed \u0000countries, but third to AIDS and lower respiratory infections in developing \u0000countries. \u0000In India, cardiovascular disease (CVD) is the leading cause of \u0000death. The deaths due to CVD in India were 32% of all deaths in 2007 and are expected to rise from 1.17 million in 1990 and 1.59 million in 2000 to 2.03 million in 2010. Although a relatively new epidemic in India, it has quickly become a major health issue with deaths due to CVD expected to double during 1985-2015. \u0000[ Mortality estimates due to CVD vary widely by state, ranging from 10% in \u0000Meghalaya to 49% in Punjab (percentage of all deaths). Punjab (49%), Goa (42%), Tamil Nadu (36%) and Andhra Pradesh (31%) have the highest CVD related mortality estimates. State-wise differences are correlated with prevalence of specific dietary risk factors in the states. Moderate physical exercise is associated with reduced incidence of CVD in India (those who exercise have less than half the risk of those who don't). CVD also affects Indians at a younger age (in their 30s and 40s) than is typical in other countries. \u0000QTc dispersion is an important marker that reflect variations of \u0000ventricular repolarisation and arrythmogenic potential. This study is based on various studies suggesting significant reduction in QTc dispersion after \u0000thrombolytic therapy in acute myocardial infarction. \u0000AIMS OF THE STUDY : \u00001.To calculate the QT, QTc, QTd, QTcd in all patients with acute myocardial infarction. \u00002. To determine the difference of QT parameters in patients treated with \u0000thrombolytic agents(streptokinase) against those not treated with thrombolytic agents(streptokinase). \u0000MATERIALS AND METHODS : \u0000102 patients admitted in KAPV Government Medical College Hospital, \u0000Tiruchirapalli for Acute Myocardial infarction were taken up for the study. All \u0000patients were followed for a period of 8±2 days during their stay in the hospital. \u0000The study group was chosen taking into consideration of the following criteria: \u0000INCLUSION CRITERIA : \u00001. Acute Myocardial infarction \u0000• Chest pain >30 minutes, \u0000• Chest pain not relieved by rest or nitrates, \u0000• ST elevation >1mm or 0.1mv in ≥2 limb leads \u0000ST elevation >2mm or 0.2mv in ≥ 2 precordial leads, \u0000• NSTEMI. \u00002. Treatment with Thrombolytic therapy (streptokinase) / without Thrombolytic therapy \u0000EXCLUSION CRITERIA : \u00001. The contraindications for thrombolytic therapy for those patients who were treated with thrombolytic therapy. \u00002. Drugs affecting QT interval eg. Quinidine, procainamide, tricyclics & tetracyclics depressants, astemizole, digitalis. \u00003. Hypertrophic cardiomyopathy, Acute carditis. \u00004. Atrial fibrillation, Bundle branch blocks. \u00005. Prior coronary bypass surgery. \u00006. Serum potassium 5.0mmol/l. \u00007. Congenital long QT Syndromes. \u0000METHODS : In Patients admitted for Acute Myocardial infarction, a standard 12 lead ECG ","PeriodicalId":330833,"journal":{"name":"The Internet Journal of Thoracic and Cardiovascular Surgery","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131375994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Ibrahim, N. Kamaruddin, N. Wahab, Mohammad Sohel Rahman
Objectives: The study was aimed to evaluate the effect of fasting during Ramadan on cardiovascular bio-markers [high sensitive C reactive protein (hs-CRP), plasminogen activator inhibitor type-1 (PAI-1)] with other conventional cardiovascular risk factors like diabetes (DM), hypertension (HPT) and dyslipidaemia before, during and after Ramadan of the subjects under study. Methodology: It was a prospective cohort study with 76 subjects (41 males and 35 females) who were observed before during and after Ramadan.).At each visit anthropometric parameters were measured including the body weight, body mass index (BMI) and blood pressure. Blood was analyzed for metabolic index [fasting blood glucose (FBG), glycosylated hemoglobin A1c (HbA1c) and fasting serum lipids], hs-CRP and PAI-1.More than 50% of the subjects under study had 4 risk factors such as DM, HPT, dyslipidaemia and either family history of CAD or smoking. Results: A significant reduction of hs-CRP and PAI-1 was observed during Ramadan compared to pre-Ramadan (p < 0.001 and 0.031). The reduction of PAI-1 levels was continued till post-Ramadan (p = 0.005). A rebound in the levels of hs-CRP was observed in post-Ramadan compared to Ramadan (p < 0.001).Significant (p<.001) reduction of the body weight, BMI, systolic and diastolic blood pressure was observed during Ramadan compared to pre-Ramadan and post-Ramadan. LDL-C levels were reduced during and post-Ramadan, (p = 0.037 and p = 0.030), however, no significant effect on triglyceride and total cholesterol was found throughout the study. Conclusion: The practice of fasting during the month of Ramadan by the people with multiple CVD risks might be cardio-protective as it resulted in the lowering of both hs-CRP and PAI-1. However this benefit is short-lived as the hs-CRP rebound a month later. Ramadan fasting practice was found to give short-term benefit against cardiovascular diseases among the patients with multiple cardiovascular risks factors.
{"title":"Ramadan Fasting And Cardiac Biomarkers In Patients With Multiple Cardiovascular Disease Risk Factors","authors":"O. Ibrahim, N. Kamaruddin, N. Wahab, Mohammad Sohel Rahman","doi":"10.5580/2717","DOIUrl":"https://doi.org/10.5580/2717","url":null,"abstract":"Objectives: The study was aimed to evaluate the effect of fasting during Ramadan on cardiovascular bio-markers [high sensitive C reactive protein (hs-CRP), plasminogen activator inhibitor type-1 (PAI-1)] with other conventional cardiovascular risk factors like diabetes (DM), hypertension (HPT) and dyslipidaemia before, during and after Ramadan of the subjects under study. Methodology: It was a prospective cohort study with 76 subjects (41 males and 35 females) who were observed before during and after Ramadan.).At each visit anthropometric parameters were measured including the body weight, body mass index (BMI) and blood pressure. Blood was analyzed for metabolic index [fasting blood glucose (FBG), glycosylated hemoglobin A1c (HbA1c) and fasting serum lipids], hs-CRP and PAI-1.More than 50% of the subjects under study had 4 risk factors such as DM, HPT, dyslipidaemia and either family history of CAD or smoking. Results: A significant reduction of hs-CRP and PAI-1 was observed during Ramadan compared to pre-Ramadan (p < 0.001 and 0.031). The reduction of PAI-1 levels was continued till post-Ramadan (p = 0.005). A rebound in the levels of hs-CRP was observed in post-Ramadan compared to Ramadan (p < 0.001).Significant (p<.001) reduction of the body weight, BMI, systolic and diastolic blood pressure was observed during Ramadan compared to pre-Ramadan and post-Ramadan. LDL-C levels were reduced during and post-Ramadan, (p = 0.037 and p = 0.030), however, no significant effect on triglyceride and total cholesterol was found throughout the study. Conclusion: The practice of fasting during the month of Ramadan by the people with multiple CVD risks might be cardio-protective as it resulted in the lowering of both hs-CRP and PAI-1. However this benefit is short-lived as the hs-CRP rebound a month later. Ramadan fasting practice was found to give short-term benefit against cardiovascular diseases among the patients with multiple cardiovascular risks factors.","PeriodicalId":330833,"journal":{"name":"The Internet Journal of Thoracic and Cardiovascular Surgery","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128459850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: Lipid and lipoprotein cholesterol levels are not predictive of coronary artery disease (CAD) risk in all the subjects. The heterogeneity of lipoprotein particles plays an important role in this respect. This fact needs to be studied in normolipidemic CAD patients. The aim of the present study was to evaluate the role of small dense LDL particles in relation to LDL oxidation in normolipidemic coronary artery disease patients. Methods and Results: One hundred and twenty eight CAD patients and 200 age and sex matched normal individuals were studied. Subjects were screened for various biochemical investigations such as lipid profile, serum apoB, LDL apoB carbonyl content, MDA-LDL levels. Log (TG/HDL-C) ratio was taken as an index of LDL particle size. In the present study, lipid levels could not discriminate well between patients and normal subjects. However normolipidemic CAD patients had increased positive values of log (TG/HDL-C) as compared to controls indicating the predominance of small dense LDL particles. This was further supported from the raised serum apoB levels. LDL apoB carbonyl content (LDL protein oxidation) and MDA-LDL levels (LDL lipid peroxidation) were raised in normolipidemic CAD patients as compared to normal subjects. Conclusions: Assessment of LDL particle size and LDL oxidation status might be more predictive of CAD risk even in subjects with normal lipid and lipoprotein cholesterol levels.
{"title":"Small Dense LDL Particles in Relation to LDL Oxidation in Normolipidemic CAD Patients","authors":"Ritu S. Sharma, Balwant Singh, M. Mahajan","doi":"10.5580/2548","DOIUrl":"https://doi.org/10.5580/2548","url":null,"abstract":"Aims: Lipid and lipoprotein cholesterol levels are not predictive of coronary artery disease (CAD) risk in all the subjects. The heterogeneity of lipoprotein particles plays an important role in this respect. This fact needs to be studied in normolipidemic CAD patients. The aim of the present study was to evaluate the role of small dense LDL particles in relation to LDL oxidation in normolipidemic coronary artery disease patients. Methods and Results: One hundred and twenty eight CAD patients and 200 age and sex matched normal individuals were studied. Subjects were screened for various biochemical investigations such as lipid profile, serum apoB, LDL apoB carbonyl content, MDA-LDL levels. Log (TG/HDL-C) ratio was taken as an index of LDL particle size. In the present study, lipid levels could not discriminate well between patients and normal subjects. However normolipidemic CAD patients had increased positive values of log (TG/HDL-C) as compared to controls indicating the predominance of small dense LDL particles. This was further supported from the raised serum apoB levels. LDL apoB carbonyl content (LDL protein oxidation) and MDA-LDL levels (LDL lipid peroxidation) were raised in normolipidemic CAD patients as compared to normal subjects. Conclusions: Assessment of LDL particle size and LDL oxidation status might be more predictive of CAD risk even in subjects with normal lipid and lipoprotein cholesterol levels.","PeriodicalId":330833,"journal":{"name":"The Internet Journal of Thoracic and Cardiovascular Surgery","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116550432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The incidence of patent ductus arteriosus (PDA) ranges from 40 to 60 percent in infants born before 28 weeksgestation. In recent years, there has been growing debate regarding the need to treat PDA during the neonatal period. Objective: To study the short-term outcome of PDA treated with different treatment modalities in preterm infants of = 32 weeks gestational age. Methods : This study is a descriptive retrospective chart review conducted at NICU Womens Hospital, Hamad Medical Corporation, State of Qatar. The files of all infants born in the hospital with a gestational age of = 32 weeks and a diagnosis of PDA over a five-year period, January 2003 to December 2007 were reviewed. Results: For the five-year period, a total of 82 cases of PDA were diagnosed in infants of = 32 weeksgestational age. Pharmaceutical intervention was used in 63/82 infants (76%), 20/82 infants (24%) required surgical ligation after failed medication, while the PDA in 32 infants (39%) closed spontaneously. Medication was successful in only 30/63 cases (47%). Large PDA significantly increased the mortality, IVH, and ROP (P value 0.002-0.003). However, PDA size had no protective effect on BPD or NEC (P value 0.54, 0.06, respectively). Infants who received medication or surgery experienced no significant difference in all adverse outcomes except for ROP, which had a P value of 0.003. Preterm infants =32 weeks who had spontaneous closure of their PDA experienced a lower rate of CLD, ROP, NEC and IVH (p<0.001-0.045). Conclusion: The results suggest that conservative treatment of PDA is the first-choice approach before resorting to medical and surgical treatment.
{"title":"Short-Term Outcome Of Different Treatment Modalities Of Patent Ductus Arteriosus In Preterm Infants. Five Years Experiences In Qatar","authors":"N. Nimeri, H. Salama","doi":"10.5580/2b49","DOIUrl":"https://doi.org/10.5580/2b49","url":null,"abstract":"Background: The incidence of patent ductus arteriosus (PDA) ranges from 40 to 60 percent in infants born before 28 weeksgestation. In recent years, there has been growing debate regarding the need to treat PDA during the neonatal period. Objective: To study the short-term outcome of PDA treated with different treatment modalities in preterm infants of = 32 weeks gestational age. Methods : This study is a descriptive retrospective chart review conducted at NICU Womens Hospital, Hamad Medical Corporation, State of Qatar. The files of all infants born in the hospital with a gestational age of = 32 weeks and a diagnosis of PDA over a five-year period, January 2003 to December 2007 were reviewed. Results: For the five-year period, a total of 82 cases of PDA were diagnosed in infants of = 32 weeksgestational age. Pharmaceutical intervention was used in 63/82 infants (76%), 20/82 infants (24%) required surgical ligation after failed medication, while the PDA in 32 infants (39%) closed spontaneously. Medication was successful in only 30/63 cases (47%). Large PDA significantly increased the mortality, IVH, and ROP (P value 0.002-0.003). However, PDA size had no protective effect on BPD or NEC (P value 0.54, 0.06, respectively). Infants who received medication or surgery experienced no significant difference in all adverse outcomes except for ROP, which had a P value of 0.003. Preterm infants =32 weeks who had spontaneous closure of their PDA experienced a lower rate of CLD, ROP, NEC and IVH (p<0.001-0.045). Conclusion: The results suggest that conservative treatment of PDA is the first-choice approach before resorting to medical and surgical treatment.","PeriodicalId":330833,"journal":{"name":"The Internet Journal of Thoracic and Cardiovascular Surgery","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121868929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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