Relationship between recurrent Laryngeal nerve [RLN] and inferior Thyroid artery [ITA] in our population

Objectives: To find out the relationship between recurrent laryngeal nerve[s] [RLN] and inferior thyroid artery [ITA] in patients undergoing thyroid surgery in our population

Study Design: Descriptive, cross-sectional study

Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi and Combined Military Hospital Rawalpindi from Aug 2008 to Dec 2014

Material; and Methods: One hundred recurrent laryngeal nerves, 50 right and 50 left were studied in 64 patients. All cases of benign goiter, malignant T1, T2 goiter, completion thyroidectomy cases on virgin side were included. Malignant T3, T4 cases, redo surgery, and large multi nodular goiter, cases in which posterior nodules have displaced the nerve [s] were excluded from the study. The course of the nerve was dissected in the thyroid vicinity and its relation with the inferior thyroid artery was recorded and photographed. All the data and special points were noted by the surgeons themselves in a register in all the cases and photographs were also taken. The data was entered and analyzed using statistical package for social sciences [SPSS] version 16. A p-value of <0.05 was considered significant

Results: Hundred RLN were studied in 64 patients. In 36 patient RLN on both sides and in 14 patients the right and in 14 patients the left RLN were studied. The age ranged from 15-65 years with mean age 36.4 years. Male to female ratio was, 1: 4.3. Percentage of male patients was 18.75 percent as compared to female was 81.25 percent. In our study the nerve was more commonly found passing posterior to inferior thyroid artery on both sides and in both sexes. On the right side it was seen in 60 percent of cases and on the left side it was seen in 70 percent of the cases

Conclusion: Relationship of RLN with ITA is variable in our population. The surgeon should be aware of these variations and meticulous dissection of RLN is mandatory in tumor surgery and redoes thyroid surgery to avoid injury to these nerves

Effects of Allium sativum [Garlic] on systolic and diastolic blood pressure in patients with essential hypertension

The present study evaluated the effects of garlic on blood pressure in patients with essential hypertension Patients [n=210] with stage 1 essential hypertension were divided into 7 groups named as A, B, C, D, E, F and G. Each group comprised of 30 patients. Each patient in group A, B, C, D and E has received garlic tablets at the dose of 300/mg. 600/mg, 900/mg, 1200/mg and 1500/mg in divided doses per day respectively for 24 weeks while Group F and group G were given tablet atenolol and placebo respectively. Blood pressure readings were recorded at weeks 0, 12 and 24. Present study showed significant decrease in both Systolic and Diastolic blood pressure in both dose and duration dependent manner. In each garlic treated group, significant reduction in SBP and DBP [p<0.005] were observed when compared with atenolol [P<0.005] and placebo

Garlic [Allium sativum] supplementation with standard antidiabetic agent provides better diabetic control in type 2 diabetes patients

Garlic has been used safely since ancient times as both food and medicine in human populations, but studies of its efficacy in the management of diabetes have yielded conflicting results. This study has evaluated the potential hypoglycemic effects of garlic in type 2 diabetic patients. The study was conducted in diagnosed type 2 diabetic patients [n=60] with fasting blood sugar level above 126 mg/dl to evaluate the effects of adding garlic tablets with standard antidiabetic therapy on blood sugar. Patients were divided randomly into 2 groups. Group 1 [n=30] was given tablet Garlic [KWAI] 300 mg thrice daily + Metformin 500 mg twice daily and Group 2 [n=30] was given Placebo+Metformin 500 mg twice daily respectively for 24 weeks. Serum lipids and fasting blood glucose were measured at week 0, 12 and week 24. Group 1 showed significant reduction in fasting blood sugar at week 24 with a percentage decrease of [-3.12 percent] [P = <0.005] as compared to group 2 [0.59 percent]. At the end of week 24, GR1 group also showed considerable decrease in mean total cholesterol [6.2 mg/dl, -2.82%, P=<0.005], LDL-C [-3 mg/dl, 2.18% P=0.005], triglycerides [-5.2 mg/dl, 3.12%, P<0.005] while HDL cholesterol was significantly increased [2.36 mg/dl, 6.72%, P<0.005] as compared to GR2 group. Combination of garlic with typical antidiabetic remedy has shown to improve glycemic control in addition to antihyperlipidemic activity. Garlic may be a good addition in the management of patients with diabetes and hyperlipidemia

Essential hypertension

Hypertension and type 2 diabetes mellitus also tend to coexist. The goal of antihypertensive therapy should consist of reducing cardiovascular morbidity and mortality associated with hypertension by a strategy focused on lowering blood pressure while minimizing the impact on other associated cardiovascular risk factors like diabetes mellitus. To observe and compare any change in serum glucose in patients with newly diagnosed essential hypertension with Atenolol and Amlodipine. Department of Pharmacology and Therapeutics, Basic Medical Science Institute [BMSI], Jinnah Post Graduate Medical Centre [JPMC], Karachi. 12 weeks [90 days] Patients with newly diagnosed essential hypertension [N=70] were enrolled in this study and were divided into two groups, each comprised of 35 patients and were given tablet Atenolol 150/100mg once daily and tablet Amlodipine 5/10 mg once daily respectively for 90 days. Fasting Blood glucose was measured on day of inclusion i.e. day 0, day 45 and day 90. At each fortnightly visit, blood pressure was recorded. Atenolol raised mean blood glucose levels from baseline levels of 91.82 +/- 1.34 mg/dl to 99.73 +/- 1.33 mg/dl on day 90 [P<0.001] while Amlodipine had no significant effect on blood glucose level [P= N.S]. Atenolol may not be a good choice for essential hypertensive patient with type 2 diabetes mellitus as it is found to impair the normal glucose metabolism. Long term clinical trials in diabetic patients are needed to confirm the observation of the present study