Comparative effect of polyunsaturated oils and hydrogenated vegetable ghee on lipid profile, platelet count and atherosclerotic plaque development in albino rats

Objective: To investigate the comparative effect of polyunsaturated and hydrogenated fats onj lipid profile, platelet count and atherosclerotic plaque development in rats

Methods: 80 Albino rats [Ratis Norvagicus] divided into four groups with 20 rats in each were fed canola oil, sunflower oil and vegetable ghee along with normal chick starter diet. Serum lipid analysis, platelet count and histopathology of aorta for the estimation of atherosclerotic plaques was performed for each group at day one, 60 and 90. The data thus obtained was analyzed statistically by using ANOVA. For lipid analysis enzymatic kits were used while platelet count was determined by hemocytometer. Thin sections of aorta were made and were stained with haematoxylin eosin for histopathology of aorta

Results: The results showed significant increase [p<0.05] in average high density lipoproteins [HDL] cholesterol level in canola oil and sunflower oil fed groups while significant decrease [p< 0.05] in average HDL cholesterol level in vegetable ghee fed group as compared to the control group was observed. A significant decrease [p<0.05] in average value of low density lipoprotein [LDL] level was observed in canola oil and sunflower oil fed groups while a significant increase [p<0.05] in average LDL cholesterol level was observed in group that was fed vegetable ghee. Significant increase [p<0.05] in average serum total cholesterol [TC], triglyceride [TG] and total lipids [TL] was observed in vegetable ghee fed group while the canola oil fed group showed significant decrease [p<0.05] in serum lipids, however some variations were observed in sunflower oil fed group where there was a rise in average values of TG and TL level in serum which were non-significant [p>0.05] while non-significant [p>0.05] decrease in level of TC was observed in this group. Decrease in average platelet count from day one to 90th day of the experiment was observed in control group and vegetable ghee fed group. On the other hand increase in average platelet count was observed in canola oil fed group and sunflower oil fed group though it was non-significant. Development of atherosclerotic plaques was observed in vegetable ghee fed group and none of the other groups

Conclusion: It was inferred from the present results that high intake of hydrogenated fats is associated with a high level of serum cholesterol and may lead to cardiovascular abnormalities as revealed by histopathology of rat's aorta in ghee feed group where clear atherosclerotic plaques were observed

Minimally invasive open heart surgery an experience at nicvd

Objective: This study was done to show that open heart surgical procedures can be done through a small sternal incision. Design: This was a single center prospective study. Place and Duration of study: Department of cardiac surgery, National Institute of Cardiovascular Diseases, Karachi. The study was completed in two years i-e Jan 1998 to Dec 1999

Subjects and Methods: A total of 40 patients underwent open heart surgery via minimally invasive approach through a lower median sternotomy. Of these 22 patients had ASD Closures, 8 underwent CABG Surgery and 10 patients had MVR procedure. The approach was via a small incision 8-1 0cm in length from xiphoid upwards and asymetrical lower median sternotomy upto the 2[nd] 1. C. S. deviated from midline on to the right side

Results: 22 patients had ASD Closure of these 21 patients had secundum defects while 1 had sinus venosus defect. In IHD group 2 patients had single vessel disease and 6 patients had 2 vessel disease [LAD and RCA]. 10 patient had MVR of these 5 patient had MR while 5 had mixed lesions. These patients had less postoperative pain. Early mobilization was achieved. No incidence of sternal dehiscence was noted. The scar was cosmetically much better than the conventional sternotomy scar and was completely hidden under the shirt

Conclusion: Open heart surgery is possible through a minimally invasive procedure. The advantages of the procedure are less trauma, less postoperative pain, reduced risk of infection. Patient recovery is quick and excellent cosmetic result

Spontaneous bacterial peritonitis

Spontaneous Bacterial Peritonitis [SBP] is being diagnosed with increasing frequency as the practice of routine paracentesis in cirrhotics is becoming more common. A retrospective study at the Aga Khan University Hospital showed that the prevalence of this complication in 100 decompensated patients with chronic liver disease was 33% which is higher than reported previously. Paracentesis of ascitic fluid was performed within 24 of hours admission on all patients with no serious complications resulting from the procedure. Ascitic fluid was cultured in conventional way and was positive in 45%. Simultaneous blood cultures were positive in 15%. E. coli was the predominant organism in the blood as well as ascitic fluid. It was further shown that the patients who had ascitic fluid protein of less than 1 gm/dl and prothrombin time more than 20 seconds with a control of 13 seconds suffered repeated episodes of SBP. The mortality was 36% in patients with SBP. This study confirmed that SBP is a common complication in patients with cirrhosis admitted to hospitals and should be actively looked for and that routine paracentesis is safe and must be done in all cirrhotic patients with ascites who are admitted to hospitals

Duodenal schwannoma presenting as acute upper gastrointestinal bleed

The following case report is of a patient with von Recklinghausen's disease who had upper gastrointestinal haemorrhage due to a tumour in the gastrointestinal tract. The association of von Recklinghausen's disease with a bleeding gastrointestinal tumour is rare