The use of radio-contrast agents are increasing day by day in modern imaging modalities. But they are not completely risk free. Among others, contrast-induced encephalopathy is a rare adverse effect. We report a patient with end-stage renal disease developing contrast induced encephalopathy following coronary angiogram (CAG).Bangladesh Crit Care J September 2014; 2 (2): 85-86

not availableBangladesh Crit Care J September 2014; 2 (2): 90-91

A 19-year-old male presented with rapidly progressing shortness of breath for three days. He noticed puffiness of face and swelling of feet, developing over three weeks, and some painless reddish lesions on the palms and soles [Image A & B], for two months. Examination revealed "butterfly-rash" on the face, sparing the anti-ds-DNA antibodies were strongly positive, complements (C3 & C4) were low, and there was nephrotic range proteinuria with altered renal function. He was diagnosed as Systemic Lupus Erythematosus (SLE) according to the SLICC classification criteria. 1 Subsequent endocarditis, either infective, or "LibmanSacks" was excluded by trans-esophageal and transthoracic echocardiography and multiple sets of negative blood cultures (aerobic and anaerobic). So the Janeway lesions were attributed to not as peripheral stigma of endocarditis, but as a vasculitic manifestation of SLE. After stabilization and control of acute features, he was referred to the specialized SLE clinic at the medical university for further management. Janeway lesions are erythematous or haemorrhagic nontender macules found on palms and soles, commonly known as a stigma of infective endocarditis (IE).

Dengue is an arthropod-borne viral illness, mostly asymptomatic, but may present with a wide variety of clinical manifestations, from mild febrile illness to severe and fatal disease. Cardiac involvement is a significant yet under-reported one because of lack of awareness. We report a case of myocarditis in Dengue Fever with an intention to create awareness among the physicians.Bangladesh Crit Care J September 2016; 4 (2): 125-127

This Quality Improvement Project (QIP) aimed to assess the acceptability and utility of the National Early Warning Score 2 (NEWS2) in a Bangladeshi level-2 care setting. All nurses and physicians were trained on NEWS2 scores and a proper response before starting the QIP. Utilization of NEWS2 and patient outcome were documented and analyzed. Acceptability was acknowledged by increase in utilization, and utility by reduction in unrecognized deterioration of patients. The modified NEWS2 was well adopted and utilized by the nursing staff. There was a statistically significant reduction in unrecognized deterioration leading to cardiac arrest and the need for transfer to the Intensive Care Unit after implementation of NEWS2. With adequate training, motivation and appropriate modification, NEWS2 can become a well-accepted, widely adopted and realistic bedside monitoring tool in resource-limited settings like Bangladesh.