Rheumatic mitral valvular heart disease is common in developing countries although its incidence is decreasing in western countries. Closed mitral commissurotomy (CMC) was the first effective intervention in valvular heart disease which provides excellent long-term hemodynamic and clinical improvement. In this study we are presenting a successful mitral valve replacement in reoperation of a case who had CMC operation 10 years ago. It shows when symptomatic deterioration occurs late after CMC, MVR restores clinical and hemodynamic improvement in many patients.Medicine Today 2014 Vol.26(2): 111-113
Background: Iron deficiency anemia (IDA) is one of the most frequent nutritional deficiency leading to morbidity and mortality in whole world. Oral iron therapy as well as intravenous (IV) iron therapy can be given to treat the IDA patients. Objective: To compare the efficacy and hematological changes of Oral and IV iron preparation in patients with uncomplicated iron deficiency anemia. Method: An interventional, prospective study in patients with uncomplicated IDA anemia receiving IV iron sucrose and Oral iron ferrous sulfate were included. Clinical history, baseline hemoglobin, anemia indices data were recorded in a case record form. A total number of 80 patients were enrolled in this study. 40 patients (Group A) were treated with IV iron sucrose and another 40 patients (Group B) were treated with oral iron ferrous sulfate. After therapy Hemoglobin level, RBC indices and adverse drug reactions (ADRs) were observed. Place and period of Study: Study was carried out in the Department of Hematology at Dhaka Medical College Hospital (DMCH), from July 2015 to June 2016. Results: The mean age of total participants was 35.77 ± 16.08 (range of 13 – 75 years). In this study female (72.5%) is predominant than male (27.5%). Oral and IV iron preparations significantly (P<0.0001) improved mean hemoglobin, anemia indices at the end of study. However, mean increase in hemoglobin were significant (P<0.0001) with IV iron sucrose (7.6 ± 2.9) gm/dl, as compared to Oral ferrous sulfate (6.4± 2.2)gm/dl, after 2 months of therapy. In this study Hemoglobin increases in group A (IV iron arm) almost 1mg/kg/week and in group B (oral iron arm) 0.8 mg/dl/week).Surprisingly, ADRs were more in patients treated with oral ferrous sulfate (38%) compared to iron sucrose (26%). Conclusion: IV iron sucrose improves hemoglobin, anemia indices and replenish iron stores rapidly and is well tolerated than oral iron preparations. J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 175-181
Prosthetic valve endocarditis(PVE) is the most serious complications of valve replacement. Despite improvements in medical treatment and surgery, prosthetic valve endocarditis carries a high mortality. The best treatment strategy for these patients is still debated. Although a surgical strategy is said to be the best treatment option, some authors claim that medical treatment can be sufficient for some patients. Here we presented two cases of prosthetic valve endocarditis where both the patients were treated conservatively using multiple antibiotics. One patient improved within a short period of time, while another patient expired.University Heart Journal Vol. 12, No. 1, January 2016; 45-48
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