December 1995, Volume 45, Issue 12

Case Reports

Abstracts from the Journals of the East

Fatema Jawad  ( 7/6, Rimpa Plaza, M. A. Jinnah Road, Karachi. )

Rupture of Brachial Artery as a Result of Supracondy­lar Fracture of Humerus. Iqbal, M., Rehman, H. Pak. J. Surg. 1994;10:66-67.
Sixty two cases of supracondylar fracture were studied. Of these one had a ruptured brachial artery. The patient was a 10 year old boy involved in a road traffic accident who was bleeding profusely from the wound in the cubital fossa. As the ends of the artery could not be approximated they were ligated. The fracture was reduced and fixed with Kirschner wires, Radial and ulnar pulses returned after forty eight hours. Rupture of the brachial artery is a rare occurence and usually follows severe trauma. Ligation if done below the ulnar collateral artery leaves a rich arterial anastomosis around the elbow joint. To prevent reflex bleeding, a ligature should be applied at the distal end also.
Effect of Oral Erythromycin on Patients with Diabetic Gastroparesis. Pan, D. V., Chen, G. H., Chang, C. S., Ho, K.S.,Poon, S. K., Huang, C.K., Kao, C. H., Wang, S. J. Chin. Med. J. (Taipei) 1995;55:447-451.
The effect of erythmmycin estolate was studied on 20 patients of non-insulin dependent diabetes mellitus (NIDDM) with gastroparesis. The patients had typical symptoms as bloating, early satiety and epigastric pain. Gastropaitsis was documented by gastric emptying studies. There were 18 males and 2 females with ages between 49 and 72 years. The duration of diabetes ranged between 0.5 to 28 years and all the subjects used oral hypoglycaemic agents. Erythromycin estolate was given in a dose of 250 mg three times daily, 30 minutes before each meal. A second gastric emptying study was done one day after erythromycin ingestion. The medication was continued for 2 weeks after which a third study was performed. Liver function and renal function tests were performed before starting and after completing the study. All patients continued their usual dose of oral hypoglycaemic agents during the study. The gastric emptying time decreased significantly after two weeks of therapy. This caused the fasting blood sugar to fall also. No side effects of the drug were noted. Gastroparesis, a troublesome complication of diabetes not only causes symptoms but can also lead to difficulties in glycaemic control due to delayed absorption. Erythromycin binds to and stimulated receptors of motilin located through­out the gastrointestinal tract. Positive pmkinetic effects have been demonstrated in the stomach. Other workers have also reported good results with use of erythromycin in cases of gastroparesis encountered in NIDDM patients.
Heavy Smoking Induces Hyperlipidaemia in Healthy Males. Qureshi, M.S. J. Pak Instit. Med. Sci., 1994;5:256-260.
The relationship of cigarette smoking with the body mass index (BMI), adiposity and plasma lipid levels of 88 apparently healthy male subjects between the ages of 20 and 70 years, was assessed. Of these 88 people, 69 were smokers using filter cigarettes and 19 were non-smokers and were used for comparitive studies. Blood was collected in the morning after a 12 hour overnight fast. Serum was separated and assayed for total cholesterol, triglycerides and HDL by kit method. LDL was calculated by the standard formula. Serum cholesterol was found 14% higher in smokers than non- smokers with the heavy smokers having a more significant rise. Serum triglycerides and LDL were also raised by 29% in the smokers group and HDL showed a minor decline in this population. The BMI, sub-scapular and triceps skin fold thickness did not reveal any significant difference in the two study groups. Smoking has been established as a risk factor for coronary artery disease. The mode of action is unclear. The association between smoking and lipid levels is conflicting. The results of studies conducted have been inconclusive. This study shows a significant dyslipidaemia in the heavy smokers which increases tile cumulative risk of smoking for coronary events.
Frequency and Pattern of Pathogenic Intestinal Para­sites in Nawabshah Sindh. Akhund,A. A. Pak.J. Pathol., 1994;5:39-42.
All stool specimens received for examination at Peoples Medical College Hospital, Nawabshah were examined and analysed in the period July 1990 to July 1993. A total of 4690 patients were studied. The presenting comlaints included abdominal pain, nausea, vomiting, indigestion, malabsorp­tion, steatorrhoea and biliary colic. The stool samples were collected in a clean and thy plastic receptale and examined within an hour by direct smear methods in normal saline and Lugol’s Iodine. Parasites were detected in 1326 stool samples Giardia Lamblia was the most common protozoa (45.78%) followed by E. Histolylica (26.32%). Ascaris lumbricoides (16.29%) was the most common nernatode seen. Nextwas Ankylostorna duodenale (5.0%), E. Vermicularis (2.34%) and Trichuns trichura (0.75%) Among cestodes H. Nana and Taenia species were detected. The study revealedahighprevalenceofGiardia lamblia in the population of Nawabshah. The high incidence of E. Histolytica can be attributed to the prevence of open drains, overflowing sewage pipes and narrow dirty lanes. It is suggested that routine stool examination should be carried out in all cases of vague bowel complaints specially in children.

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