insight into the brugada syndrome

In 1992, on the basis of a small patient series, the brothers Pedro and Josep Brugada described a new syndrome characterized by syncopal episodes and/or sudden death in young and otherwise healthy adults, and less frequently in infants and children with a structurally normal heart and a characteristic electrocardiogram [ECG] pattern of right bundle branch block [RBBB] with ST segment elevation in leads V1 to V3. The ECG manifestations of Brugada syndrome [BS] are often dynamic or concealed and may be unmasked or modulated by sodium channel blockers, a febrile state, vagotonic agents, alpha-adrenergic agonists, beta-adrenergic blockers, tricyclic or tetra cyclic antidepressants, a combination of glucose and insulin, hypo and hyperkalemia, hypercalcemia, and alcohol and cocaine toxicity. Patients with a spontaneously appearing Brugada ECG have a high risk for sudden arrhythmic death secondary to ventricular tachycardia/ fibrillation. Recent genetic studies have confirmed the genetic heterogeneity of the disorder. Mutations of the cardiac sodium channel SCN5A have been detectable in <20% of patients with Brugada syndrome. Antiarrhythmic drugs appear to be of little use in prolonging survival and in preventing recurrences of ventricular arrhythmias. To date, implantable cardioverter defibrillator remains the best therapy to prevent sudden death in these patients. In recent years, an exponential rise in the number of reported cases and a striking proliferation of articles defining the clinical, genetic, cellular, ionic, and molecular aspects of the disease have been published. This article summarizes the current understanding of pathophysiology and clinical features of BS, risk stratification and diagnostic criteria and current clinical management

Womens' beliefs and practices regarding food restrictions during pregnancy and lactation: a hospital based study

Maternal diet is an important determinant of outcomes of pregnancy. Malnutrition during pregnancy and its consequences maximally affect the health and long-term outcomes of the population. Low birth weight accounts for almost 30% of all births; with maternal malnutrition as a dominant risk factor. This study aims to investigate the existing beliefs and practices regarding food restrictions during pregnancy and lactation and also to assess whether there is any relationship with education level of the respondent and their beliefs and practices. A cross-sectional survey was conducted at Community Health Center [CHC] of The Aga Khan University Hospital, Karachi from July- September 2000. Four hundred adult female respondents, who came to the outpatient services as a patient or as an attendant, were interviewed after taking verbal consent. A self administered pre-coded and pre-tested questionnaire was filled by the respondent. More than three fourths of respondents were literate. Twelve% believed in restricting some food item during pregnancy and about 25% believed the same during lactation. No statistically significant association was found between belief about food restriction during pregnancy or during lactation and education level of the respondent. Undue food restrictions during pregnancy and lactation do exist in our culture. To assess the true picture we need to conduct larger studies in the community. The information obtained from the studies will help us in addressing these issues for improvement of nutritional knowledge and dietary practices and to avoid undue food restrictions

Women's perception about food properties in A teriary care Hospital

To understand the existing food beliefs regarding hot, cold and badi [gas-producing] properties of different food items and also to assess whether there is any relationship with education of women and these beliefs. Design: A cross-sectional study. Place and Duration of Study: Community Health Center [CHC], The Aga Khan University Hospital, Karachi from July to September 2000. Subjects and Four hundred adult female respondents, who came to CHC as a patient or as an attendant, were interviewed after taking verbal consent. A self-administered pre-coded and pre-tested questionnaire was filled by the respondent. Descriptive frequencies and cross tabulation were computed to assess the existing food beliefs. Chi-square test was used to assess the association between education level of women and belief regarding these food items. More than three-fourth of respondents were literate. The percentages of respondents saying that certain foods were hot, cold and badi were 71%, 55% and 80% respectively. Meat, either beef or mutton, fish, egg, chicken, was perceived as hot by majority of the respondents. Majority of vegetables was perceived as cold foods in our study. The other foods like rice, yogurt, banana, watermelon, milk and cold drink were also thought to be cold by many of the respondents. Cabbage, cauliflower, potato, rice, gram and mash pulses [chane and mash-ki-dal] were highly rated as badi foods. Level of education of women didn't show any statistically significant difference in keeping beliefs regarding hot, cold and badi properties of food items. A significant concept of different properties of food exists in our culture. We recommend future studies to explore scientific basis for classifying hot, cold or badi foods and also to look into its impact on health by their restriction based on their beliefs