ABSTRACT
Background:Various studies done in the past few decades have shown association of hyperuricemia with the increase in cardiovascular [CV] mortality
Objective: To determine the association of hyperuricemia and in hospital complications in acute coronary syndrome patients
Methodology: This cohort study was conducted on 154 patients in department of Cardiology Sheikh Zayed Medical College/Hospital, Rahim Yar Khan from 1st January to 30th June 2017. Hyperuricemia was defined as serum uric acid level >/= 7.2 mg/dl in males and serum uric level >/= 6 mg/dl in females.The data collection was started after getting informed consent of the patients admitted through accident and emergency department. Consecutive patients of acute coronary syndrome were selected and those with hyperuricemia were labeled as exposed [Group I] and those with normouricemia were considered as non-exposed [Group II]. The two groups were followed for 7 days and outcome i.e inhospital complications in terms of conduction defect and heart failure were noted as per operational definition. The data were collected on a proforma like age and sex. Effect modifiers like age, sex, family history of ACS, history of T2DM, history of hypertension, smoking and BMI were stratified to see the impact of these on outcomes. Chi square test were applied to determine the association of hyperuricemia with in hospital complications like conduction defect and heart failure. P value . 5% was taken as significant
Results: Among the total study subjects [n=154], 100[65%] were male and 54[35%] were female. The mean age and BMI of Group I [ACS with hyperuricemia] and Group II [ACS without hyperuricemia] were 65+/- 2 years vs. 62+/-11 years and BMI 27+/- 3.2 vs 25+/- 2.8 respectively. Out of 154 patients, 28 [18.1%] have conduction defect and only 40[26%] patients suffered heart failure. From these 28 patients with conduction defects, 19 [24.6%] were with ACS and hyperuricemia and 09[11.6%] were with ACS without hyperuricemia. From these 40 patients with heart failure,33 [42.8%]were with ACS and hyperuricemia and 07 [9%] were with ACS without hyperuricemia
Conclusion: This study showed that in-hospital complications were significantly higher in patients with ACS with hyperuricemia as compared to patients with ACS without hyperuricemia
ABSTRACT
Aneurysms of the distal brachial artery are usually of an acquired variety producing local neurovascular compressive lesions and digital embolisation. For these reasons, the recommended treatment includes excision of the aneurysm, in addition to revascularisation surgery. An interesting case report is described here, of a middle-aged man, presenting with a giant aneurysm of the distal brachial artery near the elbow joint, caused by a pistol wound. The progressive pseudoaneurysm had produced neuropathy and claudication of the hand. Clinical, neurological, electrophysiological, Doppler and angiographic assessments were followed by excision of the aneurysm and restoration of circulation by a long saphenous vein graft. Neurolysis of the affected nerves was also performed. Following surgery, the symptoms resolved fully
Subject(s)
Male , Vascular Diseases , Aneurysm/etiologyABSTRACT
This is a preliminary report of an ongoing prospective trial of percutaneous chemical lumbar sympatholysis in carefully selected male patients suffering from small vessel disease of the lower limbs. The study is reported mainly because of the immense impact it seems to have made in completely replacing surgical lumbar sympathectomy. It appears to offer symptom-resolution in a short interval of time but the subjective symptom improvement is not matched by objective improvement of perfusion. The technique used is cost-effective, fairly simple, easily reproducible in different hands and exhibits negligible side-effects. However, a much larger study is required to assess its adjunctive and palliative role in the long-term management of a diffusely atherosclerotic patient with small vessel disease of the legs