Plasma lipid profile of healthy Saudi population in Makkah region

Five Hundred healthy Saudi subjects aged 10-80 years [48.65 + SEM] [400 males and 100 females] were randomly included in this pilot study from Makkah area for the estimation of plasma lipids. These subjects were subclassified into four age groups with a gap of 15 years. The sample included representative groups of University students, office and executive workers, Religious leaders and the general population. Standard exclusion criteria were laid down. Blood sugar, S. createnine, urea, S. bilirubin, SGOT and SGPT were also estimated along with the lipid profile in the fasting state. The mean total cholesterol TC] and triglycerides [TC] were 191 mg/dl + 2.15 SEM and 172 mg/dl +6.125 SEM respectively. The mean high density lipoprotein [HDL cholesterol] was 41.5 mg/dl being higher in the younger age group. The study revealed that 28% of the subjects had Total Cholesterol >/- 210mg/dl [5.4mmol/L], 16% had HDL cholesterol < 35 mg/dl[0.9 mmol/L] and 35% were active smokers

Arterial embolism in patients with cardiac disease

To define the pattern of aetiological factors and problems in management 29 cardiac patients with 40 acutely ischaemic limbs due to arterial embolism were studied. The mean age was 53 years [range 25-100]. The male to female ratio was 1.2 : 1; and 13 patients were Saudi nationals [44.8%]. There was a delay in management in 18 patients [62%], as they presented after more than 8 h of onset of the ischaemia. Lower limbs were affected in 26 patients [89.7%]. While rheumatic valvular heart disease was found to be the commonest aetiological disease in the non-Saudi patients, atherosclerotic coronary heart disease was encountered more frequently in Saudi patients. Emboli occluded a large artery in 22 patients [75.9%]; four of them were saddle aortic emboli. Embolectomy was considered the treatment of choice and performed on 33 limbs [82.5%] out of the 40 limbs treated, while heparin therapy only was used in treating four limbs [10%]. Seven limbs were amputated, three primary and four after embolectomy. Five of our patients [17.2%] expired and death was associated with a delayed, large peripheral embolism and myocardial ischaemia. In order to increase the chances of saving limbs, early referral of cases is highly recommended, followed by aggressive cardiac and surgical management. Whenever possible, the latter should be performed in vascular units

Civilian vascular injuries in the Jeddah area

Over a 2-year period, 42 consecutive patients who suffered vascular injury and were referred to the vascular surgery service at King Fahd Hospital, Jeddah, Saudi Arabia, were studied to define patterns and problems in their management. The majority were males [n = 35], and the mean age of the whole group was 29 years [range 4-60 years]. Only ten patients [23.8%] were above 40 years of age. Penetrating injuries occurred in 20 patients [47.6%], while blunt trauma was responsible for 16 injuries [38.1%]. Six patients had iatrogenic injuries. Trauma due to road traffic accidents headed the list of underlying aetiological factors, and was encountered in 16 patients [38.1%]. Acute limb ischaemia occurred in 27 patients [64.3%], while bleeding occurred in 19 patients [45.2%]; these being considered the most common modes of presentation. Associated orthopaedic injuries were found in 15 patients [35.7%]. Most of the injuries in our patients involved the extremities [n = 39]. Lower limb injuries were more common [59%] than upper limb injuries [41%]. A delay of more than 8 h from the onset of injury to presentation at our casualty department occurred in 12 cases [28.6%]. Angiography was performed in selected cases [n = 12]. Direct repair was attempted in 15 patients [35.7%] and was the commonest surgical procedure performed in the whole group of patients. No death was encountered in the whole group. Five limbs were lost [12.0%]. In the follow-up period, 32 patients [76.2%] were asymptomatic and only five [12.0%] had residual neurovascular deficits. However, none of them required any further surgery. In conclusion, early diagnosis of vascular injuries, particularly in multiple trauma victims, is essential to save more limbs in the future. Whenever possible, this must be followed by immediate transfer to a centre where angiography and vascular surgery facilities are available. Education of medical colleagues and improvement in transport are recommended