Background: In patients undergoing surgery for mitral valve replacement (MVR) for valvular heart disease, pulmonary artery hypertension (PAH) has been considered a major risk factor. In this prospective study, we have studied the early hemodynamic changes and post-operative outcomes of MVR among patients with mild to severe PAH in Bangladesh perspective. Methods: Total 60 patients who underwent mitral valve replacement for predominantly mitral regurgitation (MR) and mixed lesion with mitral stenosis (MS) having pulmonary arterial hypertension ranging from mild to severe pulmonary artery pressure (PAP) were studied prospectively for immediate postoperative haemodynamic and outcome. The mean age of the patients was 36.23±9.18 years. Total 13 (21.66%) patients had mitral regurgitation and 47 (78.33%) had mixed lesion with mitral stenosis. Patients were divided into two groups based on preoperative pulmonary artery pressures. Group A patients with mild to moderate pulmonary hypertension (PASP 40-59 mm of Hg) and Group B patients with severe pulmonary hypertension (PASPe” 60 mm of Hg). Results: After mitral valve replacement, pulmonary arterial systolic pressure (PASP) decreased significantly in Group A to near normal levels (PASP41.25±7.25). In Group B also the PASP decreased insignificantly (PASP 61.85±9.12) but significant residual PAH remained. Operative mortality was nil (0%) in Group A and 6.7% in Group B. Conclusions: Mitral valve replacement is safe and effective at the presence of PAH as long as the PASP is below or equal to 60 mm of Hg. With PASP >60 mm of Hg, MVR carries a high risk of mortality and the patients continues to have severe PAH in the postoperative period. Cardiovasc j 2021; 14(1): 30-36

Introduction: Stomach cancer related to higher rate for blood group A over other ABO types, a prospective assessment of relation between blood group and carcinoma stomach was performed with a view to state the role of ABO blood group in the development of gastric cancer with relationship of clinico-pathological variation. This study sought to investigate the relationship between ABO blood groups and the risk of gastric cancer as well as clinical pathological parameters. Materials and Methods: A Prospective random observational study carried between October 2005 to September 2006 in Dhaka Medical College Hospital, Department of Surgery & Radiotherapy. Maximum patients admitted in the surgery units with diagnosed case of carcinoma stomach were taken as sample or study population & rest attended in radiotherapy department in DMCH. Results: Among the 70 cases the mean age is 44.3(18-65) (M/F=4:1) years. All the information and data taken from Hospital records and patients themselves or first degree relatives. Results Blood group B-42.85%, A-34.28%, O- 15.71% only 11.42% gave positive family history. Histopathological report show's Adenocarcinoma 95% and among them blood group B 40% and A 31.42%. The differentiation of carcinoma stomach are categorized as Grade-I well differentiated, 37.14% cases moderately differentiated 15.71% and poorly differentiated 45.71%. Among them blood group B is more in case of poorly differentiated carcinoma 25.71%, blood group A is more in well differentiated carcinoma 17.14%. Conclusion: Blood group 'A' has an established relationship with carcinoma stomach. In this study it is found that blood group 'B' is more associated with carcinoma stomach and with poorly differentiated adenocarcinoma. Medicine Today 2021 Vol.33(1): 27-33

Background: Cardiopulmonary bypass is associated with increased incidence of hyperglycemia. Many studies have shown that diabetes is associated with increased morbidity and mortality in coronary artery bypass (CABG) surgery. We reviewed the outcome of on-pump versus off pump CABG in diabetic patients. Methods- 80 Adult diabetic patients undergoing isolated CABG both on-pump and OPCAB were divided into 2 groups – 40 patients in each group. To evaluate both preoperative, perioperative and postoperative out come and to compare their in hospital outcome mortality and morbidity. Results: Diabetic patients undergoing coronary artery bypass grafting without cardiopulmonary bypass had fewer complications, including neurological dysfunction (7.5% vs. 10.0%, p=0.1), and reduced incidence of prolonged ventilation (7.5% vs. 12.5%, p = 0.709), atrial fibrillation (15.0% vs. 20.0%, p = 0.002), and renal dysfunction (10.0% vs. 17.5%, p=0.556). In postoperative period, 70% patients in OPCAB group did not experience any cardiac events whereas 30% patients developed myocardial infarction, 5% had cardiac arrest and 7.5% had low output syndrome. . In on pump group 65% patients had no cardiac events whereas 35% patients developed one or more cardiac events. Of them 20% patients developed atrial fibrillation, 2.5% developed myocardial infarction, 2.5% develop cardiac arrest and 10% had low output syndrome. 2.5% patient developed both atrial fibrillation and low output. Conclusion: Diabetic patients undergoing CABG without cardiopulmonary bypass compared with those having coronary artery bypass grafting with cardiopulmonary bypass had higher mean predicted mortality and morbidity. Cardiovasc. j. 2020; 13(1): 12-18