European Journal of Cardiovascular Medicine

Objective: To know the effect of antiepileptic drugs on liver enzymes.  Study Design: Cross sectional study. Materials & Methods: The study was conducted on 108 patients at Santosh Medical College & Hospital, Ghaziabad between Sep 14 to Oct 14. Patients divided into 3 groups, consisting of 36 patients in each group of phenytoin, carbamazepine and valproate. Results: Total No. of Patients was 108, out of which 36 patients were there is each group of Phenytoin, Carbamazepine and valproate. Most of the patients 36 (33.33%) and 32 (29.62%) belongs to age group of >40 – 50 years and >50 year respectively. Regarding raised SGPT, it was seen in 5 (13.89), 3 (8.33) and 3 (8.33) in phenytoin, carbamazepine and sodium valproate group respectively. SGOT were raised in sodium valproate group respectively. Alkaline phosphatase was raised in 10 (27.78), 20 (55.56) and 22 (61.11) in phenytoin group, carbamazepine group, and sodium valproate group respectively.  Conclusion: From the present study we can conclude that sodium valproate is more hepatotoxic than carbamazepine which is more toxic than phenytoin. It is recommended that base line Liver Function Test (LFT) is essential before starting of AEDs and regular monitoring of LFT is also done between the course of treatment.

Background: Acute febrile illness is also called as Acute undifferentiated febrile illnesses (AUFIs) and cause considerable morbidity, mortality and economic burden specially in developing tropical nations. This study was conducted to study Clinical and microbiological profile of patients with acute febrile illness at a tertiary hospital.  Material and Methods: A Hospital based Prospective Cross sectional study was carried out in consecutive cases of both sexes and all adults (age more than 15 years) admitted to medical wards with a history of fever less than 10 days and continued to have oral temperature above 37.50 c.  Results: Out of the 230 patients satisfied the inclusion criteria, 119 were males and 111 were females. The hospital stay varied from 5 – 10 days and the median hospital stay was 5 days. The AUFI were more during the post monsoon and winter season. The spectrum of clinical profile observed in our study were in the order of Dengue, Enteric fever, Malaria, Typhoid followed by Scrub typhus, Leptospirosis and Chikungunya in 132 (56.2%), 67 (29.13%), 13 (5.53%), 7 (2.97%), 6 (2.55%), 5(2.17%) and 5 (2.13%) respectively. 5 among them had dual infection and suffered from Dengue and Enteric fever. Irrespective of the gender, patients start attending the hospital from the fourth day of fever. The mean affected age was 40.9 years. The presentation of fever was maximum on the fourth day and sixth day of fever. The presenting features were more once the duration of disease increases, even though the commonest were myalgia, headache and chills. None of the patients had any complications and they were discharged within a period of 5 – 10 days.  Conclusion: The distribution of disease among the 230 cases were in the order of Dengue, Enteric fever, Malaria, Typhoid followed by Scrub typhus, Leptospirosis and Chikungunya. 

Pancreaticoduodenectomy (PD) is considered a technically demanding task. Anatomic variations in duodenopancreatic vascularization [celiac axis and the superior mesenteric artery (SMA)] may carry a risk of potentially life-threatening vascular injury. We retrospectively report a modified PD technique performed in two patients presenting with a Common Hepatic Artery (CHA) originating from SMA. The CHA anatomical pattern was known prior surgical procedure. The main modification consisted in cutting pancreas prior dividing the CHA and the gastroduodenal artery. No intraoperative incident was reported. Perioperative outcomes were unremarkable; no vascular injury or hepatic ischemia was reported. Sur-geons planning a PD must analyze in depth imaging (CT-scan with 3D angiography) and     try to find these patterns. Furthermore, some rare arterial variations may be met and change typical surgical plan. Knowing prior procedure, the arterial pattern and keeping in mind expendable or vital vessels allow to accomplish unusual but effective operations

Aim: The purpose of the present research was to evaluate and assess the management of various cases of small bowel obstruction. Methodology: Eighty cases of small bowel obstruction observed in this study presented with common symptoms of abdominal distension, absence of flatus and/or faeces.  Results: Abdominal tenderness was the commonest finding during per abdomen examination. Adhesion was the commonest aetiology observed in this study followed by obstructed hernia. General trend of reporting to the hospital was observed to be on the third day of onset. Higher incidence of small bowel obstruction was observed in cases in sixth decade of life. There was predominance among the males and in cases belonging to lower socio-economic class.  Conclusion: Adhesions and hernias are the most common causes of obstruction as well as of bowel ischemia, necrosis, and perforation.

Aim: Purpose of the present research was to evaluate the clinical considerations as well as the outcome of laproscopic myomectomy in various uterine myomas.  Methodology: This was an observational study in women who have undergone laparoscopic myomectomy (LM) because of single symptomatic myoma > 4 cm in diameter. We collected data about general features, surgical outcomes, intraoperative/ postoperative complications and time to return to normal activity. Results: A total of 200 patients (mean age 36.7 ± 6.4 years) resulted eligible for the study. Myomas sized between 8 and 12 cm were linked to an increased amount of blood loss (significantly higher in intramural than subserosal myoma). The removal of intramural myomas > 8 cm and the subserosal ones >12 cm required a significant longer surgical time. Patients returned 17.9 ± 9.5 days after surgery to their personal activities. Six cases (1.35 %) required conversion to laparotomy, and only in two cases blood transfusion was necessary.  Conclusion: Myomas size and type represent the best predictors of surgical difficulties and possible intrapostoperative complications. Intramural myomas >8 cm and subserosal ones >12 cm should be considered as a challenging procedure. LM remains the gold standard approach.

Objective: To identify and analyse novel lipid biomarkers associated with lipid metabolism that are linked to cardiovascular disease risk. Methodology: This cross-sectional longitudinal observational study evaluated novel lipid biomarkers associated with cardiovascular disease (CVD) risk. A cohort of 200 participants aged 35 to 70 years, including individuals with confirmed CVD or those possessing two or more CVD risk factors, was assessed. Participants were recruited from general population screenings and cardiology outpatient clinics. Blood samples were collected following a 12-hour fast to measure traditional lipid markers (total cholesterol, LDL, HDL, triglycerides) and emerging lipid biomarkers (ceramides, sphingolipids, oxidized LDL). High-performance liquid chromatography and mass spectrometry were used for analysis. Statistical analysis, including multivariate regression and receiver operating characteristic (ROC) curve analysis, was performed to evaluate the predictive value of these biomarkers. Results: The study revealed significantly higher levels of total cholesterol, LDL, triglycerides, ceramides, sphingolipids, and oxidized LDL in the high-risk CVD group compared to the low-risk group (p < 0.05). Multivariate regression analysis demonstrated that ceramides and oxidized LDL had the highest odds ratios, indicating strong associations with CVD risk. ROC curve analysis showed ceramides and oxidized LDL to have greater predictive accuracy than traditional lipid markers, with areas under the curve (AUC) of 0.82 and 0.80, respectively.  Conclusion: The study confirmed that novel lipid biomarkers, particularly ceramides and oxidized LDL, have superior predictive value for cardiovascular disease risk compared to traditional lipid indicators. These findings highlight the potential of incorporating these biomarkers into routine CVD risk assessment, allowing for earlier detection and improved preventative strategies.