Abstract. Atherosclerosis predominantly affects systemic arteries as compared to pulmonary arteries; however, the reasons for this differential predilection are not clear. Oxidative damage caused by free radicals is a key initiating event in atherogenesis and the lungs are able to produce large quantities of free radicals even under physiological conditions. The present study investigated whether pulmonary venous blood reaching the aorta contained greater quantities of lipid peroxides, a marker of oxidative stress, compared to the pulmonary artery. Aortic and pulmonary artery blood samples were collected at the time of cardiac catheterization from 45 consecutive patients (38% female) without acute coronary event and free of other medical disorders, who were scheduled to undergo coronary angiography for anginal chest pain. Lipid peroxides were measured in terms of malondialdehyde (MDA). MDA levels were significantly higher in the aorta compared to the pulmonary artery (4.93±1.97 vs. 3.36±1.14 nmol/ml; P<0.001); the difference was significant in patients with angiographic coronary artery disease (CAD) (P<0.001) compared to the patients without CAD (P=0.071). Higher aortic MDA levels were associated with the presence of CAD even following adjustment for major risk factors. The results of the present study demonstrate that aortic blood contains significantly greater levels of lipid peroxides compared to pulmonary artery. This differential oxidative stress between systemic and pulmonary arteries could provide a mechanistic explanation for their difference in the propensity to develop atherosclerosis.
a p o l l o m e d i c i n e 1 2 s ( 2 0 1 5 ) S10-S29 S17 seen in 75% of patients at three months which improved and reached 60% at the median follow-up of 9.2 months.
Background: Pilonidal sinus is a chronic inflammatory disease predominantly involving Sacrococcygeal region. Despite advances in medical sciences, management of pilonidal disease is still not well defined. Treatment varies from simple techniques to more sophisticated surgeries with their own pros and cons.
Methods: This prospective observational study comprised of forty-two patients who underwent the surgery for pilonidal sinus as per the procedure described. This study was carried from 1 May 2019 till 30 November 2022. Median age of the patients was 24.5 years, ranging between 19-32 years. Sinus discharge was the predominant symptom of our study population with 34 patients (80.94%) complaining of same.
Results: Mean operative time was 54 minutes with a range of 45-78 minutes. Average hospital stay was 1.8 days though it ranged from 1 to 3 days. Five patients (11.90%) developed seroma while four patients (9.52%) had superficial wound site infection. We had two recurrences (4.76%) over the follow-up period of 1 year.
Conclusions: Excision and primary closure of the pilonidal disease is effective with comparable complication rates and shorter time off work. The surgery can be easily performed.
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