Antihyperlipidaemic effects of Eugenia jambolana fruit in diet induced hyperlipidaemic rats.

OBJECTIVE: To evaluate the antihyperlipidaemic effects of Eugenia jambolana fruit pulp in diet induced hyperlipidaemic rats and to compare them with Simvastatin. METHODS: An experimental randomised control study was conducted on seventy five male albino rats, divided into five groups labelled A, B, C, D and E with fifteen rats in each group. Group A was kept as normal control, groups B, C, D and E were given hyperlipidaemic diet for six weeks. In group B no further intervention was done, group C and group D were given ethanolic extract of Eugenia Jambolana and Simvastatin respectively for eight weeks. Group E was given combination of both for same duration. Serum total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglycerides were measured at zero, six and fourteen weeks. RESULTS: At fourteenth week significant reductions in total cholesterol, low density lipoprotein cholesterol and triglycerides and a rise in high density lipoprotein cholesterol was observed in interventional groups C, D and E as compared to experimental hyperlipidaemic control group B (p < 0.05). There was no significant difference at baseline (zero weeks) serum total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglycerides of groups A, B, C, D & E; p > 0.24, p > 0.37, p > 0.89, p > 0.2, respectively. On sixth week, there was no significant difference between groups B, C, D and E (p > 0.05). However, 15 rats of group A had significant lower levels of cholesterol, high density lipoproteins, low density lipoproteins and triglycerides when compared to 60 rats of groups B, C, D and E (p < 0.05). CONCLUSION: In male albino rats ethanolic extract of Eugenia Jambolana fruit pulp was as effective as simvastatin in lowering serum total cholesterol, low density lipoprotein cholesterol and triglycerides and increasing high density lipoprotein cholesterol.

Comparison of simvastatin with Eugenia Jambolana fruit pulp in their effects on alanine transferase, aspartate aminotransferase and creatinine phosphokinase levels of hyperlipidaemic rats.

OBJECTIVES: To compare the effects of Eugenia Jambolana fruit extract with simvastatin on liver enzymes, aspartate aminotransferase (AST), alanine transferase (ALT) and muscle enzyme creatinine phosphokinase (CPK) in diet induced hyperlipidaemic rats. METHODS: An experimental randomized control study was conducted on seventy five male albino rats, divided into five groups labelled A, B, C, D and E with fifteen rats in each group. Group A was kept as normal control, groups B, C, D and E were given hyperlipidaemic diet for six weeks. In group B no further intervention was done, group C and group D were given ethanolic extract of Eugenia Jambolana and Simvastatin respectively for eight weeks. Group E was given combination of both for same duration. Serum Total Cholesterol (TC), Low density lipoprotein (LDL), High density lipoprotein (HDL), Triglycerides (TG), ALT. AST and CPK were measured at zero, six and fourteen weeks. RESULTS: At fourteenth week significant reductions in serum ALT , AST and CPK levels were observed in hyperlipidaemic group C as compared to other hyperlipidaemic groups B, D and E (p<0.05). Serum ALT level which is considered to be the most important parameter of hepatotoxicity returned to normal after 8 weeks in group C fed on Eugenia Jambolana fruit pulp only and the values were equal to control group A. There was no significant difference at baseline (zero weeks) serum TC, LDL, HDL, TG, ALT, AST and CPK of groups A, B, C, D and E; p>0.24, p>0.37, p>0.89, respectively. On sixth week, serum ALT, AST and CPK levels of hyperlipidaemic groups B,C,D and E were found to be significantly higher as compared to group A (p<0.05). CONCLUSION: Ethanolic extract of Eugenia Jambolana fruit caused a reduction in serum ALT, AST and CPK level in male albino rats when compared with simvastatin.

Association of common carotid intimal medial thickness (CCA-IMT) with risk factors of atherosclerosis in patients with type 2 diabetes mellitus.

OBJECTIVE: To determine the association of Common Carotid Intimal Medial Thickness (CCA-IMT) with risk factors of atherosclerosis in patients with type 2 diabetes mellitus. METHODS: This is an observational study carried out in 200 type 2 diabetic patients. Age, gender, duration of diabetes, history of ischaemic heart disease, hypertension and smoking was recorded. Body mass index, glycosylated haemoglobin (HbA1c), total cholesterol, triglyceride and high density (HDL) cholesterol were determined in all the patients. CCA-IMT determination was done by Carotid Doppler Ultrasonography. RESULTS: There were 120 (60%) males and 80 females (40%). Ages ranged from 28 to 79, mean 59.5 +/- 9.07 years. IMT on right side ranged from 0.4 mm to 2.4 mm, mean 0.88 mm and on left side mean IMT was 0.93 mm, range 0.5 mm to 2.5 mm. Duration of DM and BMI were correlated with IMT on both the sides (p < .05), statistically inverse correlation was seen with HDL cholesterol (p < .05). No significant correlation was seen with other variables. CONCLUSION: Duration of DM, BMI and HDL cholesterol were associated with CCA-IMT in patients with type 2 DM. No significant association was seen with other risk factors.

Epidural abscess and meningitis, a complication of spinal anesthesia in a bacteraemic patient.

Meningitis can be caused in experimental performing a lumbar puncture (LP) after bacteraemia. Several authors have speculated bacteraemic patient without having meningitis LP might actually cause meningitis. We meningitis and epidural abscess after spinal bacteraemic patient. A 57-year-old male, known admitted for below knee amputation, with infection and gangrene of the left foot. Intravenous were started and a below knee amputation date of admission under spinal anaesthesia. started having backache, fever and became operatively. A cerebrospinal fluid examination meningitis. Patient had seizures and developed failure. Cerebrospinal fluid smear showed the ie, Streptococcus agalactiae that grew on blood wound culture, sent at the time of admission. Resonance Imaging of LS spine showed an and was managed successfully with antibiotics.

Circadian pattern of onset of ischaemic and haemorrhagic strokes, and their relation to sleep/wake cycle.

OBJECTIVE: To determine whether there is a circadian pattern of onset of ischaemic and haemorrhagic strokes, and their relation to sleep/wake cycle. METHODS: A descriptive study with prospective data was conducted at the Combined Military Hospital Lahore from Jan 2004 to Dec 2007. Eight hundred patients above 26 years of age who had their first ever stroke were included in the study. Strokes were classified into cerebral infarction (CIF), intra-cerebral bleed (ICB) and subarachnoid haemorrhage (SAH). Diagnosis was confirmed either by CT or MRI scan of brain. RESULTS: Out of 800 patients, 80% were males and 20% were females. There were 438 (55%) cases of CIF, 329 (41%) of ICB and 33 (4%) of SAH. The age of the patients ranged from 26 to 84 years. Of all stroke cases, 592 (74%) occurred when the patients were awake and 208 (26%) occurred during sleep (p < 0.001). ICB cases showed significant variation with respect to wake/sleep cycle (p < 0.001). In CIF and SAH cases there was insignificant association with wake/sleep state of the patient, (p < 0.180 and 0.792 respectively). Of all strokes 22.5% occurred between 4 am - 8 am, followed by 20.7% between 4 pm - 8 pm, 20.1% between 8 am - 12 noon, 19.5% between 12 noon to 4 PM, 12.7% between 12 midnight and 4 am while 4.3% cases occurred between 8 pm and 12 midnight. The maximum number of CIF (28.5%) occurred between 4 am- 8 am, maximum ICB (29.8%) between 8 am to 12 noon and maximum SAH (30.3%) between 4 pm - 8 pm. The CIF and SAH cases showed smaller peaks between 4 pm to 8 pm and 8 am to 12 noon respectively. The lowest number of ICB cases (4.9%) were around mid night. Significant circadian variation was found in CIF and ICB patients (p < 0.001), however it was insignificant for SAH cases (p = 0.391). CONCLUSION: The findings of this study confirm the presence of circadian variation among cases of ischaemic stroke and intra cerebral bleed while no circadian variation was found in subarachnoid haemorrhage. CIF, ICB and SAH predominantly occur in early morning hours, late morning hours and in late afternoon to early evening respectively. Only intracerebral bleed was affected by wake/sleep state.

Presence of family members during cardio-pulmonary resuscitation after necessary amendments.

OBJECTIVE: To find out the attitudes of health professionals and family members of the deceased, about a witnessed cardiopulmonary resuscitation procedure. METHODS: A cross-sectional analytical study was carried out at Combined Military Hospital Lahore from January 2007 to June 2007. Two hundred and ninety persons related to 190 deceased patients, 40 physicians and 20 nurses were interviewed and were asked to fill a proforma to asses their views about presence of family members during a cardio-pulmonary resuscitation. RESULTS: Ninety eight percent of the family members wanted to be there while cardio-pulmonary resuscitation of their patient was in progress. None of the physicians favoured a witnessed resuscitation, while 3 out of 20 nurses favoured it. CONCLUSION: This study suggests that institutions should consider establishing programmes of witnessed cardio-pulmonary resuscitation for family members.