Coconut oil even though rich in saturated fatty acids in comparison to sunflower oil when used as cooking oil media over a period of 2 years did not change the lipid-related cardiovascular risk factors and events in those receiving standard medical care.

H-FABP is a highly sensitive biomarker for the early diagnosis of AMI. H-FABP as early marker and cTnI as late marker would be the ideal combination to cover the complete diagnostic window for AMI. Detection of myocardial injury by H-FABP may also be applied in patients with unstable angina. H-FABP can also be used as a marker for early detection of STEMI before the ECG changes become apparent.

A 38 year old man with history of obstructive sleep apnea and polycythaemia presented with hypercapnic respiratory failure that required intubation. He developed fever with infiltrates on chest radiography that required empiric antifungal therapy with fluconazole along with broad spectrum antibiotics. He developed acute adrenal insufficiency that recovered after fluconazole was stopped. It is believed that this complication of adrenal suppression attributable to fluconazole is underrecognised and it may be prudent to monitor all critically ill patients who are given fluconazole for this complication.A zole antifungal therapy has been in use for nearly a quarter of century when ketoconazole was first introduced. They are generally safe, efficacious, and easy to give orally in treatment of various systemic mycoses. 1Ketoconazole is reported in daily dose exceeding 400 mg to reversibly inhibit synthesis of testosterone and cortisol leading to various endocrine disturbances including adrenal insufficiency.2 Even though fluconazole does not generally inhibit steroidogenesis, there are rare reports 3-5 of adrenal suppression, raising the possibility that this problem is currently underrecognised. We report a patient who developed reversible adrenal suppression on fluconazole. CASE REPORTA 38 year old obese man with medical history significant for obstructive sleep apnea and secondary polycythaemia presented to emergency room with complaints of cough for three days before admission with greenish expectoration. His drug treatment included hydrochlorothiazide, lopressor, and aspirin. He denied taking corticosteroids recently. He was found to be in hypercapnic respiratory failure that required intubation. Chest radiography was normal.He was given ampicillin and sulbactam and azithromycin intravenously for pneumonia. Pulmonary embolus and acute coronary syndrome were ruled out. He developed fever on second day of admission. As fever persisted after 48 hours with new infiltrates on chest radiography, antibiotics were changed to vancomycin and imipenam. Trimethoprin-sulfamethoxazole was added to cover for Pneumocystis carini. A cosyntropin test done on day 4 of admission as a part of an ongoing study showed a peak cortisol concentration of 663 nmol/l. This was consistent with normally functioning adrenals.Later, fluconazole 400 mg intravenous once a day was started empirically as he remained febrile. Two days after starting fluconazole sodium decreased to 113 and potassium increased to 5.6. Cosyntropin test was repeated. Basal cortisol was 45 nmol/l with a peak of 375 nmol/l, at 60 minutes consistent with adrenal insufficiency. 6 Hydrocortisone 100 mg intravenously every eight hours was started.Computed tomography of adrenals was negative for haemorrhage. He became afebrile and fluconazole was stopped after nine days together with other antibiotics. All cultures remained negative. He was extubated and had an uneventful recovery. Repeat cosyntropin test done 10 days after stopping fluconazole showed a basal cortisol of 38 nmo...