Acute myocardial infarction in north Kerala--a 20 year hospital based study.

This is a retrospective study of patients with first attack of myocardial infarction admitted to Medical College Hospital, Calicut during the years 1969 to 1988. The data analysed were compared to other hospital based studies in India and abroad. A striking increase in the percentage of acute myocardial infarction was observed. There was also an increase in the occurrence of myocardial infarction in the young. A properly designed population based study is warranted.     

Short-term heart variability and oxidative stress in newly diagnosed essential hypertension

We sought to evaluate oxidative stress parameters like malondialdehyde, total antioxidant status, and time, frequency domain heart rate variability indices in newly diagnosed untreated hypertension. We also sought to study the correlation between heart rate variability and oxidative stress parameters in normotensive and newly diagnosed untreated essential hypertensives. Fourteen normotensive males and 36 newly diagnosed male hypertensives were enrolled for the study. Malondialdehyde, total antioxidant status, and heart rate variability in the frequency and time domain were studied in the hypertensive and normotensive group. Malondialdehyde was significantly higher in the hypertensive group, whereas total antioxidant status was significantly higher in the control group. SDNN, RR triangular index, RMSSD, log(10) low-frequency power, log (10) high-frequency power, log (10) total power, and heart rate variability during deep breathing test was significantly lower in hypertensive patients compared to normotensive controls. SDNN, RMSSD, high-frequency power, and high-frequency power normalized had significant negative correlation with malondialdehyde. Low-frequency power normalized positively correlated with malondialdehyde. Total antioxidant status had a significant negative correlation with blood pressure. The study gives further evidence for a decreased heart rate variability and elevated oxidative stress in hypertension.     

Breast carcinoma with metastasis to the gallbladder:an unusual case report with a short review of literature

Gallbladder metastases are very rare and usually arise from malignant melanoma, renal cell carcinoma and cervical carcinoma. Breast carcinoma tnetastatic to the gallbladder is extremely rare and only 4 cases have been reported in the English literature. We hereby report a 54-year-old lady who was diagnosed as having breast carcinoma and underwent modified radical mastectomy. One month after the operation, she developed acute abdomenal pain and underwent cholecystectomy after clinical investigation. Histopathological examination revealed metastasis to the gallbladder. Being considered a patient with tnetastatic breast carcinoma she was subjected to taxane and anthracycline-based palliative chemotherapy. Later she had CNS involvement and died of the progressive disease soon after few months.     

Endovascular Treatment of Acquired Atheromatous Postsubclavian Aortic Coarctation

Coral reef aorta is a rare calcifying obstructive disease that involves the thoracoabdominal aorta. Similar presentations in the postsubclavian aorta may result in acquired atheromatous aortic coarctation leading to systemic hypertension and heart failure. The associated calcification makes surgical anatomic or extraanatomic bypass and thromboendarterectomy challenging. Extensive circumferential calcification often precludes endovascular intervention. We present the case of a 25-year-old man with an acquired atheromatous coarctation of the postsubclavian aorta who underwent successful endovascular treatment with use of a balloon-expandable covered stent.     

A new technique for correction of disproportionate preputial growth with phimosis

A new surgical solution to correct the rare anomaly of asymmetric phimosis is described, with a note on its symptomatology and etiopathogenesis.