Intracranial cavernous angiomas

To describe the clinical presentation, diagnosis, and management of patients presenting with intracranial cavernous angiomas [CAs] at a tertiary care hospital in Pakistan. Case series. Section of Neurosurgery, The Aga Khan University Hospital [AKUH], Karachi, from January 1990 to September 2008. A retrospective case note review of all patients diagnosed with intracranial CAs at AKUH during the study period. The studied variables included patient demographics, clinical presentation, family history of intracranial CAs or other space occupying lesions, modality of diagnosis, management, and outcome. Results were described as frequency percentages. During the review period, 18 patients [11 males and 7 females] were diagnosed with intracranial CAs. The median age at diagnosis was 28.5 years. The most common location of malformations was cerebrum [n=13] followed by brain stem [n=3], and cerebellum [n=2]. Nine patients had multiple lesions. Family history was present in 2 patients. Seizures and focal neurologic deficits were the main clinical manifestations. The detection rate was 93.8% with magnetic resonance imaging, but less with angiography and computerized tomography. Ten cases were treated surgically; 8 were managed conservatively. The outcome was satisfactory except for one patient, who died within 6 months of diagnosis. Surgery was performed for gross haemorrhage, rapidly increasing neurologic deficits, and intractable or long-standing seizures. Cavernomas tend to occur at younger age in females than males. This data raises a possibility of a higher frequency of multiple cavernomas in Pakistani patients. The main clinical manifestations are seizures and focal neurologic deficits. MRI is most sensitive and specific neuroradiologic modality for detecting this vascular malformation

Comparison of cardiovascular disease patterns in two data sets of patients admitted at a tertiary care public hospital in karachi five years apart

To compare the disease patterns in two data sets of patients, five years apart, at the National Institute of Cardiovascular Diseases [NICVD], a tertiary care cardiac hospital in Karachi. The underlying objective was to determine any changes in cardiovascular disease patterns at an acute cardiac unit over a period of five years. A retrospective descriptive study was conducted on patients admitted in West Ward, National Institute of Cardiovascular Diseases [NICVD], Karachi in September, 2000 and September, 2005. Patient's record files were reviewed and the relevant information was recorded on a pro forma designed for the purpose. In September, 2000, a total of 414 patients were admitted. Of these 71.25% were males. Majority of patients [72.92%] were in the fifth decade of life or beyond. Acute coronary syndrome [ACS] was the commonest presentation, present in 39.8% of the patients. 27.3% had myocardial infarction [MI] while 10.34% were diagnosed with heart muscle diseases. The overall mortality was 3.4%. In September, 2005, a total of 446 patients were admitted. Of these, 63% were males. 71 .29% were in the fifth, sixth, and seventh decades of Life. 43.04% patients were admitted with acute coronary syndromes [ACS], 26% with myocardial infarction [MI] and 13.45% with heart muscle diseases. The overall mortality was 1.34%.The almost similar results in two. data sets of patients five years apart suggests that the cardiovascular disease burden and pattern has not changed significantly at this center. There is a preponderance of cardiovascular illnesses in males and older age groups. ACS and MI account for majority of admissions

Ascorbic acid contents of Pakistani fruits and vegetables

Fresh fruits and vegetables are good sources of vitamin C which is known for its antioxidant and immune-enhancing effects. The objective of this study was to determine ascorbic acid [vitamin C] contents of regularly consumed fruits and vegetables available in Pakistani markets. Most commonly used fresh fruits and vegetables were homogenized in 5% trichloroacetic acid, and ascorbic acid contents in the extracts were determined using a spectrophotometric method. Banana, custard apple, orange, lemon, guava and papaya were found to be very rich in ascorbic acid. Among vegetables, capsicum [green sweet pepper], cauliflower, bittergourd, roundgourd, beetroot, spinach, cabbage and radish contained high concentrations of ascorbic acid. Chikoo, grapes, pear, apricot, peach, carrot, cucumber, lettuce and 'kakri' were found to be poor sources of ascorbic acid. Several Pakistani fruits and vegetables [pear, melon, onion, sweet green pepper, spinach, cucumber] had ascorbic acid values similar to those reported by US Department of Agriculture in these fruits and vegetables in USA. However, wide differences in vitamin C contents were also observed in certain other fruits and vegetables from these two countries. This indicates that regional varieties of fruits and vegetables could vary in their ascorbic acid contents. Since subclinical deficiency of vitamin C appears to be quite common in developing countries like Pakistan, there is a need to develop awareness among masses to consume fresh fruits and vegetables with high contents of vitamin C