226 Management of Closed Fractures of the Hand; Single Centre Audit

Aim

To compare current practice at the local Plastic Surgery Department to national Standard

British Society for Surgery of the Hand BSSH guidelines recommend for closed hand fractures.

Method

Retrospective data collection

All procedures done within one month June 2021, compare it to previous audit done in Feb 2021 and close the audit loop

Electronic data records

Results

June 2021 (90.5 %) meet the standard of time to presentation compared to 76% in Feb 2021

June 2021 62% meeting the standard for time to surgery compared to 46% in Feb 2021

Main reasons for delay unavailable dedicated Plastic Surgery theatre lists, busy emergency theatre lists.

Conclusions

Documentation of delays in presentation/Management has improved.

More theatre capacity is required to avoid cancelation and delayed management.

Bioassessment of flaxseed powder and extract against hyperglycemia and hypercholesterolemia using Sprague Dawley rats

Background

Flaxseed has emerged as a potential source of bioactive components that can be utilized in routine diet to address lifestyle disorders.

Methods

In this context, three studies were carried out on the basis of induction therapies i.e. Study I (Normal diet), Study II (Hyperglycemic diet; 40% sucrose) and Study III (Hypercholesterolemic diet; 1.5% cholesterol) using Sprague Dawley rats. Each study was further split into three groups based on diets; Control (free from flaxseed powder or extract), Functional diet (incorporation of flaxseed powder; 10%) and Nutraceutical diet (inclusion of ethanolic extract of flaxseed; 5%). During experimental period, hyperglycemic and hyperlipidemic parameters were evaluated alongside, alterations in hematological aspects were also assessed.

Results

Feed intake and body weight demonstrated significant response (p < 0.05) of diets and study intervals however, water intake was substantially influenced by study intervals. In study II (hyperglycemic rats), maximum decline in glucose level was recorded (9.02%) in rats administered with extract based diet. In the same group, maximum increase in insulin (5.90%) was noted. Regarding lipid profile, the bioevaluation trials revealed maximum reduction in serum cholesterol (13.10%) in study III (hypercholesterolemic rats) on the provision of flaxseed extract (nutraceutical diet) followed by flaxseed powder (functional diet) i.e. 7.85%. Further, maximum decrease in low density lipoprotein-cholesterol (LDL-c) was reported i.e. 14.28% on supplementation of flaxseed extract to hypercholesterolemic rats.

Conclusions

Thus, flaxseed extract based intervention has shown higher bioefficacy to address hyperglycemia and hypercholesterolemia in comparison to flaxseed powder.

Bioefficacy of red cabbage against hypercholesterolemic diet mediated oxidative stress

Background

The shift towards hypercaloric diets and sedentariness has raised lifestyle related disorders and escalated health care cost. In order to tackle this epidemiological transition, healthy, affordable food choices should be introduced in the routine menu. In this context, red cabbage is known for its rich phytochemistry, minerals, antioxidant vitamins and dietary fiber. Considering these evidences, red cabbage leaves and its extract were assessed against hypercholesterolemia and associated oxidative stress.

Methods

In bioefficacy assessment trial (12 weeks), there were two dietary regimens; normal and hypercholesterolemic (1% cholesterol) that were further split into three groups each. In both feeding trials, red cabbage leaves (20%) and its extract in dose equivalent to red cabbage leaves were assessed against control diets. At termination of trial, serum lipidemic parameters and oxidative stress biomarkers were assessed to test the efficacy of diets.

Results

In hypercholesterolemic rabbits, red cabbage leaves showed significant reduction in cholesterol, LDL-c and triacylglycerol levels i.e. 15.19, 18.09 and 9.42% than extract administered groups; 10.79, 12.24 and 5.72, respectively. Besides, red cabbage leaves also portrayed momentous enhancement of superoxide dismutase (SOD) and catalase (CAT) activity up to 13.29 & 17.63% by lowering lipid peroxidation by 27.86% in hypercholesterolemic diet fed groups, whereas red cabbage extract administered group depicted relatively lesser amelioration in lipid peroxidation i.e. 21.42%.

Conclusions

Red cabbage leaves possess higher ameliorative potential against altered lipidemic profile and lipid peroxidation as compared to its extract thus explains its ability to prevent exhaustion of endogenous antioxidant enzymes; SOD and CAT.

Prophylactic Potential of Conventional and Supercritical Garlic Extracts to Alleviate Diet Related Malfunctions

OBJECTIVES

The present research was tailored to explore the prophylactic role of garlic extracts to mitigate some diet related malfunctions. The recent patents regarding antidiabetic agents (US 20140147528 A1) and garlic compositions (US 20110129580 A1) also helped in the study design.

METHODS

Bioevaluation trials were conducted on Sprague Dawley rats by feeding garlic extracts for a period of sixty days. Accordingly, three studies were carried out comprising of normal, hyperglycemic and hypercholesterolemic rats. Drink & feed intakes and weight gain were measured throughout the trial. After sixty days, collected sera from rats were analyzed for serum cholesterol, LDL, HDL & triglyceride levels and glucose & insulin concentrations. Finally, the data obtained were subjected to statistical modeling.

RESULTS

Results concerning the bioevaluation trials revealed that maximum 12.39% reduction was observed in serum cholesterol in Study III (hypercholesterolemic rats) on the provision of garlic supercritical extract (nutraceutical diet) followed by 10.24% decline in rats fed on solvent extract supplemented diet (functional diet). Regarding LDL, maximum decrease (17.02%) was recorded on the administration of diet having garlic supercritical extract to the hypercholesterolemic rats. While in Study II (hyperglycemic rats) maximum decrease of 11.03% in glucose level was recorded in rats fed on supercritical extract containing diet. In the same group maximum increase in insulin (7.95%) was recorded.

CONCLUSIONS

From the current investigations, it can be concluded that garlic based designer foods possess the prophylactic perspectives to alleviate the risk of metabolic ailments. Thus, it can be used in the diet based therapeutic interventions as an adjuvant to pharmaceuticals.

Effect of amnioinfusion for meconium stained amniotic fluid on perinatal outcome

OBJECTIVE

To see the effect of amnioinfusion on perinatal outcome in cases of meconium staining of liquor.

METHODS

This study was conducted in department of Obstetrics and Gynaecology, unit 1, Jinnah Postgraduate Medical Centre, Karachi, from 1st January 1998 to 31st December 2000. Four hundred patients were included in this study, assigning 200 for amnioinfusion and 200 as control. All patients were matched in both the groups with respect to age, antenatal booking, parity, gestational age, stage of labour, colour of amniotic fluid and fetal birth weight. Both the groups were found to be comparable.

RESULTS

The rate of Caesarean section was found to be 37% in amnioinfusion group, which collaborates with other international studies. The fetal outcome was better i.e. 91% alive and healthy, after amnioinfusion due to dilution of meconium stained amniotic fluid with physiological solutions. The perinatal outcome was recorded by Apgar score at 5 minutes. The perinatal morbidity and mortality both were significantly lowered and was found to be 6% as compared to 14% in control, which was also noticed by less number of admissions in nursery i.e. 12% and perinatal deaths. The incidence of meconium aspiration syndrome was found to be 56% in control and was reduced to 22% after amnioinfusion in the other arm of the study.

CONCLUSION

These results are very encouraging and suggestion can be safely made that in future amnioinfusion will be the ideal method of preventing fetal distress due to meconium stained amniotic fluid.