The evidence based wound healing activity of Lawsonia inermis Linn

The ethanol extract of Lawsonia inermis (200 mg/kg/day) was used to evaluate the wound healing activity on rats using excision, incision and dead space wound models. The animals were divided into three groups of six each in the excision model and two groups of six each in the incision model and dead space models. The topical application was made in the case of excision wound model, whereas, oral treatment was done with incision and dead space wound models. The following differences were noted in the group of experimental animals which were treated with an extract of L. inermis when compared with the control and reference standard animals: a high rate of wound contraction (p < 0.001), a decrease in the period of epithelialization (p < 0.001), high skin breaking strength (p < 0.001), a significant increase in the granulation tissue weight (p < 0.001) and hydroxyproline content (p < 0.05). The extract-treated animals showed 71% reduction in the wound area when compared with controls which was 58%. Histological studies of the tissue obtained on day 10 from the extract-treated group showed increased well organized bands of collagen, more fibroblasts and few inflammatory cells when compared with the controls which showed inflammatory cells, scanty collagen fibres and fibroblasts. Enhanced wound contraction, increased skin breaking strength, hydroxyproline and histological findings suggest the use of L. inermis in the management of wound healing.     

Conscious off-pump coronary artery bypass surgery

BACKGROUND: Cardiothoracic surgery has been previously performed successfully under thoracic epidural anesthesia alone. Between October 2001 and December 2003, we performed 123 conscious off-pump coronary artery bypass surgeries using epidural anesthesia as the sole anesthetic. This technique is an alternative to cardiothoracic surgery performed under general anesthesia. Certain modifications in the technique facilitate the process. METHODS AND RESULTS: There were 24 female patients and 99 male patients with mean age of 58.6 +/- 6.2 years; 12 patients underwent repeat coronary artery bypass surgery. All the patients underwent epidural catheterization on the evening before surgery. Out of the 123 patients scheduled for coronary artery bypass graft surgery, 120 underwent off-pump coronary artery bypass graft surgery successfully; 4 patients underwent off-pump surgery via left thoracotomy and the rest through mid sternotomy. These patients received 295 grafts in all (single graft in 26 patients, double in 42 patients, triple in 35 patients, and quadruple in 20 patients). Three patients required conversion to general anesthesia and one to cardiopulmonary bypass. There was no mortality in the group. CONCLUSIONS: Our experience suggests that by modifying the surgical techniques, we can accomplish conscious coronary artery bypass surgery.     

杂交技术在法洛四联症中的应用

目的:总结杂交技术镶嵌治疗儿童法洛四联症(TOF)的经验。方法:外科术前介入治疗:3例有巨大体肺侧支(APCAs)的重症TOF在根治术前予以侧支血管堵塞术。外科术后镶嵌治疗:6例TOF根治术后残余分流,其中4例残余膜周部室间隔缺损,1例残余左室右房通道室间隔缺损,1例残余房间隔缺损,分别予以经导管残余心脏缺损封堵术。结果:3例有巨大APCAs的重症TOF在根治术前予以侧支血管堵塞术后随即进行外科手术,皆获得满意效果。6例TOF根治术后残余分流者行经导管封堵术封堵成功,随访无残余分流及心脏瓣膜异常,未出现心律失常。结论:杂交技术镶嵌治疗伴有巨大APCAs及术后存在残余分流的TOF安全、有效。     

Cutaneous mucormycosis with necrotising fasciitis in a young immunocompetent individual

Primary cutaneous mucormycosis is uncommon and is extremely rare in immunocompetent young individuals. Here we report a case of necrotising fasciitis due to mucormycosis in an immunocompetent young individual following minor trauma. Mucormycosis must be suspected in any wound that is worsening despite appropriate treatment even in immunocompetent individuals.     

Determinants of plasma triglyceride levels in a multiethnic working class Caribbean population: Effect of ethnicity,diet and obesity

AimsObjective of the study is to identify the predictors of plasma triglycerides.Materials and methodsA stratified random sample of university staff categories underwent measurements of anthropometry, blood pressure, and fasting blood glucose, insulin, lipids, CRP and homocysteine. Dietary intakes were assessed using duplicate 24 h recalls. HOMA-IR was calculated. Stepwise, multivariate regression analysis was performed with TAG as the dependent variable.ResultsThe sample (n = 251) was 55% females with a mean age of 44.9 ± 9.7 years. African ancestry comprised 43%, followed South Asian 30% and mixed ethnicity 27%. Prevalence of obesity was 19.4%, insulin resistance 22.7% and metabolic syndrome 21.6%. Males had significantly higher (p < 0.01) triglycerides and VLDL and lower HDL than females. Africans had significantly lower triglycerides and cholesterol than South Asians and Mix. Triglycerides were significantly (p < 0.01) correlated with glucose, cholesterol, insulin, CRP, systolic, diastolic blood pressure, WC, BMI, age and components of MS. Glucose, cholesterol, insulin and total energy intake predicted TAG, to varying extents, in all participants (R² = 45.1%), males (R² = 40.3%), females (R² = 56.0%), Africans (R² = 35.0%), TSA (R² = 31.5%) and mix (R² = 51.0%).ConclusionsAfricans have lower triglycerides and cholesterol than South Asians and mix. Major predictors of triglycerides were fasting glucose and cholesterol independent of gender and ethnicity.     

A cross sectional study comparing traditional risk factors with N-terminal pro-BNP in high risk groups for cardiovascular disease in Trinidad,West Indies

ObjectiveCardiovascular disease is a leading cause of morbidity and mortality worldwide and traditional risk factors for cardiovascular disease have been well-elaborated. In recent years, the use of biomarkers has emerged for identifying individuals at high risk with the aim of earlier identification and risk mitigation. Among the most promising non-traditional markers are BNP and NT-proBNP. This study aims to compare whether serum NT-proBNP co-segregates with traditional cardiovascular risk factors in elderly type 2 diabetic and non diabetic in a population with high prevalence of CVD.MethodsThis study utilized a cross sectional design. Blood samples collected were analyzed for hs-CRP, total serum cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, fasting glucose, insulin, and NT-proBNP.ResultsMean serum NT-proBNP levels were significantly elevated in diabetics (X = 125.5 ± 49.7) compared to non diabetics (X = 64.3 ± 34.6). In diabetics, NT-proBNP demonstrated statistically significant spearman's coefficients with respect to systolic blood pressure, triglyceride, hs-CRP, fasting glucose and insulin. Among non diabetics there was no relationship between NT-proBNP, blood pressure and insulin. Multivariate logistic regression revealed relation between diabetics; elevated NT-proBNP, blood pressure, triglyceride, CRP, fasting glucose and plasma insulin compared with non diabetics where NT-proBNP showed significant relation only to diastolic blood pressure. Diabetics showed significant correlation with elevated NT-proBNP and traditional risk factors (hypertension, diabetes, dyslipidemia and elevated hs-CRP) as compared with non diabetics.ConclusionsNT-proBNP co-segregates with traditional risk factors for CVD among elderly diabetics and may be a useful additional screening test for those at risk for CVD.     

Analysis of N-ras gene mutation and p53 gene expression in human hepatocellular carcinomas

AIM:To study the relationship between N-ras gene mutation and p53 gene expression in the carcinogenesis and the development of human hepatocellular carcinomas (HCC).METHODS:The N-ras gene mutation and the p53 gene expression were analyzed in 29 cases of HCC by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and immunohistochemistry.RESULTS:Thirteen cases of HCCs were p53 positive (44.8%), which showed a rather high Cpercen-tage of p53 gene mutation in Guangxi. The aberrations at N-ras codon 2-37 were found in 79.31% of HCCs and 80.77% of adjacent non-tumorous liver tissues. More than 2 point mutations of N-ras gene were observed in 22 cases (75.86%). Twelve cases (41.37%) of HCCs showed both N-ras gene mutation and p53 gene expression.CONCLUSION:N-ras gene and p53 gene may be involved in the carcinogenesis and the development of HCC.That 38% of HCCs with N-ras gene mutation did not express p53 protein indicates that some other genes or factors may participate in the carcinogenesis and the development of HCC.