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  Citation statistics : Table of Contents
   2010| October-December  | Volume 11 | Issue 3  
    Online since February 22, 2011

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Epicardial fat and its association with cardiovascular risk: A cross-sectional observational study
Farouk Mookadam, Ramil Goel, Mohsen S Alharthi, Panupong Jiamsripong, Stephen Cha
October-December 2010, 11(3):103-108
DOI:10.4103/1995-705X.76801  PMID:21577377
Background: The association between visceral obesity and cardiovascular risk has been well described. Some studies show a proportional relationship between the presence of visceral obesity and epicardial fat. Measuring the amount of epicardial adipose tissue (EAT) can be a novel parameter that is inexpensive and easy to obtain and may be helpful in cardiovascular risk stratification. However, the relationship between epicardial fat and cardiac function and that between epicardial fat and cardiac risk factors is less well described. Objectives: To evaluate the association between echocardiographic epicardial fat and the morphologic and physiologic changes observed at echocardiography and to evaluate the association between epicardial fat and cardiac risk factors. A cross-sectional study of 97 echocardiographic studies (females, n = 42) was conducted. Two groups were identified: epicardial fat ≥ 5 mm (group I) and <5 mm (group II). Results: Epicardial fat >5 mm was associated with LA enlargement, with lower ejection fraction, increased left ventricular mass, and abnormal diastolic function. On a multivariable regression analysis, all these parameters also correlated individually with EAT thickness independent of age. Hyperglycemia (DM), systolic hypertension, and lipid parameters for metabolic syndrome showed a trend for positive association, but this was not statistically significant. The association was not significant even for higher cutoff limits of EAT thickness. Conclusion: Epicardial fat >5 mm is associated with cardiac abnormalities on echocardiography. This is a sensitive assessment of body fat distribution, is easily available at echocardiography, and is simple to acquire at no added cost. Further studies looking at the appropriate cut-off thickness of EAT and the sites of measurement to be used are needed. Comparison of this simple and inexpensive measure with other measures of obesity, such as waist-hip ratio, body mass index, Dexa scan of visceral fat, and magnetic resonance imaging of visceral, are needed.
  49 13,718 338
Acute coronary syndrome in young adults from Oman: Results from the gulf registry of acute coronary events
Prashanth Panduranga, Kadhim Sulaiman, Ibrahim Al-Zakwani, Said Abdelrahman
October-December 2010, 11(3):93-98
DOI:10.4103/1995-705X.76799  PMID:21577375
Objective: To assess the prevalence, risk factors, presenting features, and in-hospital outcomes of acute coronary syndrome (ACS) patients ≤40 years of age from Oman. Methods: Data were analyzed from 1579 consecutive ACS patients from Oman during May, 2006 to June, 2007, as part of Gulf RACE (Registry of Acute Coronary Events). ACS patients ≤40 years of age were compared with patients >40 years of age. Results: A total of 121 (7.6%) patients were ≤40 years of age with mean age of 36 ± 4 vs. 61 ± 11 years in young and old adults, respectively (P<0.001). More men were seen in the younger age group (81 vs. 60%; P<0.001). Among all the coronary risk factors, young patients had more history of smoking (47 vs. 15%; P<0.001), obesity (72 vs. 58%; P = 0.009), and family history of coronary artery disease (CAD) (16 vs. 7%; P = 0.001). Both groups received aspirin, statins, thrombolytic therapy, and anticoagulants equally; however, younger patients received clopidogrel, glycoprotein IIb/IIIa inhibitors, b-blockers, and in-hospital coronary angiogram more. Younger patients experienced less heart failure (6 vs. 27%; P<0.001) and in-hospital mortality, especially among STEMI patients (0 vs. 10%; P = 0.037). Conclusions: Young ACS patients from Oman have different risk profile. They were treated more aggressively and their outcome was better, which is similar to other populations. However, smoking, along with obesity and family history of CAD were strong risk factors in the young Omani ACS patients. There is a need for prevention programmes to control smoking and obesity epidemic by targeting young adults in the population.
  23 8,381 310
Acute cardiac toxicity of Nerium oleander/indicum poisoning (Kaner) poisoning
Ibraheem Khan, Chandra Kant, Anil Sanwaria, Lokesh Meena
October-December 2010, 11(3):115-116
DOI:10.4103/1995-705X.76803  PMID:21577379
We present a case of oleander leaf extract poisoning manifested by vomiting, lightheadedness, and heart block. Practicing physicians should understand the potential lethal properties of oleander and its availability throughout the world.
  22 11,056 369
Takayasu's arteritis associated with tuberculosis in a young Yemeni woman
Khaled Al-Aghbari, Ahmed Al-Motarreb, Faiza Askar
October-December 2010, 11(3):117-120
DOI:10.4103/1995-705X.76804  PMID:21577380
Takayasu's arteritis (TA) is an autoimmune disease that affects the big arteries. A possible relationship between TA and tuberculosis (TB) has been suggested. Both diseases have similar chronic inflammatory lesions and occasionally granulomas on the arterial walls. We report a case of TA associated with TB.
  17 5,928 150
Quantitative lung perfusion scintigraphy in patients with congenital heart disease
Ahmed Fathala
October-December 2010, 11(3):109-114
DOI:10.4103/1995-705X.76802  PMID:21577378
The objectives of this article are to review different patterns and potential pitfalls of quantitative lung perfusion scintigraphy (LPS) in patients with congenital heart disease (CHD). The patterns of quantitative LPS in patients with CHD include normal symmetrical bilateral perfusion to both lungs, unilateral absent perfusion in one lung, unilateral decreased perfusion, and multiple segmental perfusion abnormalities that suggest pulmonary embolism. Knowledge of several potential pitfalls is very important to avoid false interpretations; common pitfalls are related to type of site of injection (upper versus lower extremities), right or left upper extremity in case of persistence of left superior vena cava and previous surgery. An important incidental finding that may prompt immediate attenuation is multiple segmental defect that suggests asymptomatic pulmonary embolism, which is relatively common in this population.
  10 8,329 183
Tricuspid valve endocarditis in an intravenous drug abuser masquerading as pulmonary tuberculosis
Prashanth Panduranga, Mohammed Al-Mukhaini, Kadhim Sulaiman, Seif Al-Abri
October-December 2010, 11(3):121-124
DOI:10.4103/1995-705X.76805  PMID:21577381
Intravenous drug abuse contributes to considerable illness burden in developed and developing countries. Tricuspid valve endocarditis (TVE) is rare in Middle East countries, though many reports of it in intravenous drug abusers are found in other countries. We describe a case of TVE mimicking pulmonary tuberculosis in a 33-year-old man with a history of intravenous heroin use.
  3 9,710 154
The underutilization of adjunctive pharmacotherapy in treating acute coronary syndrome patients admitted to a tertiary care hospital in Southwest region, Saudi Arabia
Abdullah S Assiri
October-December 2010, 11(3):99-102
DOI:10.4103/1995-705X.76800  PMID:21577376
Background: Acute coronary syndrome (ACS) is the most prevalent cardiac disorder. Adjunctive pharmacotherapy has proved to be safe and effective in treating patients with this syndrome. Underutilization of such pharmacotherapy was reported in different studies. Objectives: In this study, we evaluated the underutilization of these pharmacotherapies on patients admitted to Aseer Central Hospital (ACH) with ACS, find out factors that may predict utilization of these therapies, and determine the effect of such pattern of drug utilization on survival at discharge. Materials and Methods: A retrospective cohort of 562 patients admitted with the diagnosis of ACS to ACH during the period from March 2007 to February 2009 was studied. Results: β-blockers (B-blocker) and angiotensin-converting enzyme inhibitors (ACEI) were used in only 69 and 59% of cases, respectively. Aspirin, clopidogrel, and statin were used in 98.4, 82.6, and 89.3% of cases, respectively. The presence of diabetes predicts the use of ACE inhibitors, whereas the diagnosis of unstable angina and ST-elevation myocardial infarction predict the use of statin. Survival rate at discharge was 95.6%. Use of statin and aspirin improved survival. Conclusion: Certain adjunctive pharmacotherapies were underutilized in ACS patients in Southwest region, Saudi Arabia, specifically β-blockers and ACEI. Standard of care should be revised and updated, aiming to improve adherence to guidelines of management of patients with ACS.
  1 6,493 141
R on T phenomenon causing ventricular fibrillation during LV angiography
Naveen Garg, Nagaraja Moorthy
October-December 2010, 11(3):125-125
DOI:10.4103/1995-705X.76806  PMID:21577382
  - 4,850 98
Fortunate finger deviation of a fatal heart bullet injury
Duilio Divisi, Carmine Villani, Sergio Di Tommaso, Alessandro Mazzola
October-December 2010, 11(3):126-127
DOI:10.4103/1995-705X.76810  PMID:21577383
  - 4,510 74
An appeal to supernatural force
Rachel Hajar
October-December 2010, 11(3):128-129
  - 3,723 90