effect of multiple risk factors on the severity of coronary artery blockage among the patients who had undergone angiography in the cardiology unit of JHL

Coronary artery disease [CAD] is the leading cause of mortality in the elderly. Traditional cardiovascular risk factors [CVRFs] such as advancing age, diabetes mellitus, hypertension, dyslipidemia, smoking, obesity, and family history of CAD are well recognized for their association with clinical events and acute coronary syndromes; however, the correlation between CVRFs and atherosclerotic burden, assessed angiographically, is not as well established, with the studies reporting variable and inconsistent results. To study the effect of multiple risk factors on the severity of coronary artery blockage among the patients who had undergone angiography. A Descriptive Cross Sectional Study. This study was carried out at Cardiac unit Jinnah Hospital Lahore from May 2010 to July 2010. The study included 120 patients undergoing angiography and were assessed for severity of risk factors. Cross tabulation was performed with dependent variable, severity of coronary artery disease and independent variables like familial tendency, smoking, Diabetes, hypertension, obesity and high cholesterol level. Chi square test was applied to see statistical significance. severity of coronary artery disease was assessed by number of coronary vessels involved. Vessels with more than 50% blockage on angiography were labeled as blockade. Among them 42% of the subjects had one vessel involved and 78% of the subjects had more than one vessel involved. Mean age of subject were 53.0 yrs with SD + 11.7. 76.7% were male and 23.3% were female. 49.2% had familial history of Coronary artery disease 66.7% were smokers. 38.3% of subjects had diabetes mellitus. 68.3% of the subjects had hypertension. 37.5% of the subjects were overweight. 17.5% of the subjects had cholesterol level > 250 mg/dl 75.8% of the subjects had a proximal blockade, 20.0% had a distal blockage and 4.2% had both proximal and distal blockage. Smoking, duration of smoking, number of cigarettes smoked per day and obesity are positively associated with severity of coronary artery disease and are statistically significant [P<.05]. While high cholesterol level, diabetes and Hypertension had a non-significant relationship in our study. There is a significant association between the severity of risk factors and the severity of coronary artery disease. The association of Smoking, duration of smoking, number of cigarettes smoked per day and obesity with severity of coronary artery disease is statistically significant [P<.05]

Complication rate of tram flap breast reconstruction in obese patients

Transverse rectus abdominis myocutaneous [TRAM] flap is one of the common techniques used for breast reconstruction. Yet, it might carry certain risks when performed in obese patients. This study is a trial to quantify such risks. The records of 22 women with locally advanced breast cancer who had undergone unilateral breast reconstruction with the transverse rectus abdominis myocutaneous [TRAM] flap at the Department of Surgery, Alexandria University, were analyzed to determine what effect obesity had on the rate of complications. Patients were categorized into obese and non-obese according to height weight index. Ten patients were obese [group 1] and 12 were non-obese [group 2]. The overall complication rate was 41.7%. In obese patients six patients developed complications [60%] as compared to three non-obese patients [25%]. There was a trend for all forms of complications to be higher in the obese regarding wound sepsis, abdominal wall competence [bulging, hernia and pseudo-hernia], partial flap necrosis and chest infection. Ultimately most obese patients resolved these complications and obtained results that were comparable to the non-obese. The findings in this study suggest that the complication rate of TRAM flap breast reconstruction does increase with obesity; nevertheless, since the difference did not reach the level of significance, they remain acceptable candidates and should not be denied the procedure on grounds of obesity alone

Relation of cholesterol and triglycerides levels in smokers and obese individuals with Ischaemic heart disease

Plasma cholesterol and triglycerides levels were measured in healthy non obese smokers, non smokers obese and non obese, non smokers control subjects independent of sex and age. Significantly higher levels of cholesterol [p 0.05] and triglycerides [p 0.05] were found in obese subjects. Similarly higher levels of cholesterol [p 0.05] and triglycerides [p 0.05] were seen in smokers. Our results showed strong positive correlation of obesity and smoking with levels of cholesterol and triglycerides. It has already been suggested that increased cholesterol and triglycerides levels observed in cigarette smokers and obese individuals are associated with higher incidence of coronary heart disease