The prevalence of metabolic syndrome was determined in clinic-based 1,517 hypertensive patients. All traits were present in 1.1% men and 12.8% women. Combination of different three traits were present as follows; hypertension with high triglyceride and low HDL (men 29.4% vs. women 51.8%), hypertension with high blood glucose and low HDL (men 13.5% vs. women 29.8%), hypertension with high glucose and high triglyceride (men 18.1% vs. women 18.1%), hypertension with high blood glucose and large waist (men 2.7% vs. women 25.7%), hypertension with high triglyceride and large waist (men 3.4% vs. women 39.3%) and hypertension with low HDL and large waist (men 2.5% vs. women 70.6%). This study shows that the metabolic syndrome is highly prevalent among hypertensive patients especially women.

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Objective:The objective of this study was to optimize dose of levothyroxine (LT4) based on lean body mass (LBM) in young athyrotic patients with differentiated carcinoma of thyroid (DCT) which has not been properly addressed in Bangladesh before.Materials and Methods:Sixty patients with DCT (age, range: 20-39 years) having total thyroidectomy followed by radioiodine ablative therapy (RIT) and 23 euthyroid volunteers were recruited. Clinical, biochemical parameters were obtained from all patients after 2 months of RIT and on LT4 replacement at a dose of 200 μg/day as first follow up visit and also from control subjects. Then 60 patients were divided into two groups consisting of 30 patients each. Patients of Group-I received LT4 replacement based on LBM measured by dual energy X-ray absorptiometry (DXA) and Group-II continued LT4 replacement in conventional dose. Patients of both groups were assessed again for same parameters at 6 to 12 months at the second visit.Results:Optimized dose of LT4 based on LBM by DXA (131 ±23 μg/day) significantly reduced thyroid hormones and kept thyroid stimulating hormone (TSH) in expected levels in patients of Group-I at the second visit compared to patients of Group-II who continued conventional LT4 dose (200 μg/day). Hyperthyroid symptom scale (HSS) was significantly reduced to 2 ± 1 in patients of Group-I but not in patients of Group-II, HSS, 8 ±1 (P > 0.001).Conclusion:Optimization of LT4 dose based on LBM can avoid chronic exposure of mild excess of thyroid hormone in young patients with low risk DCT.

This retrospective observational study aimed to see the angiographic association of atherosclerotic renal-artery stenosis (ARAS) with coronary artery disease in Bangladesh. It was conducted in department of cardiology, University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2007 to January 2008. A total of 250 patients with coronary artery involvement, on non-emergent coronary angiogram who underwent either selective or nonselective renal angiography were enrolled in this study. Among 250 patients, 52 (20.8%) patient had single vessel disease (SVD), 49 (19.6%) and 149 (59.6%) had double vessel disease (DVD) and triple vessel disease (TVD) respectively. ARAS was detected in 37.2% or 93 patients. ARAS tends to increase with age. In age group of 30-40, ARAS is 7.4% whereas in age group of 51-60 years it is 41%. The incidence of ARAS is high in 50.25±9.98years; p=0.0001. 33.3% male patients with CAD had ARAS whereas it was 44.3% in female patients with CAD. ARAS is more common in female 44.3% vs 33.3%; p=0.02. ARAS prevalence increased with the number of stenosed coronary arteries (3.8% in 1-vessel, 26.5% in 2-vessel, 52.3%in 3-vessel CAD; p=.0001.). Hypertension and angiographically proven CAD were independent predictors of ARAS (p=0.0001). In conclusion, ARAS prevalence and severity increases with the number of arterial territories involved and CAD severity. Hypertension and 2-3-vessel-CAD were identified independent predictors of ARAS.   doi:10.3329/uhj.v4i2.2069 University Heart Journal Vol. 4 No. 2 July 2008 p24-27

Diabetes mellitus (DM) itself increases the risk of Coronary Artery Disease (CAD) by 2-4 fold and in out country we are treating a good number of patients having CAD with DM. On the other hand several studies have reported increased risk of adverse outcomes following balloon angioplasty in diabetic cases. In this situation this study had been carried out at National Institute of Cardiovascular Diseases (NICVD) cath lab to determine the immediate procedural success & in-hospital adverse outcomes in this population. In our study 100 cases were enrolled. Out of which, 40 patients had type II DM & rest were non-diabetic.Diabetic patients were compared with non-diabetic and found no major difference between the two patient group except for a higher number of LCX (Left Circumflex) lesion in the non-diabetic (25% VS 35%, P value 0.038). The lone case of renal complication came from the diabetic group. No MACE (Major Adverse Cardiovascular or Cerebrovascular Events) or death was occur in this series. Angiographic, procedural and clinical success in diabetic was 97.5%, 97.5% & 95% respectively whereas 100% found in non-diabetic group at its all segment. But this results are statistically insignificant and P value is 0.4000 for angiographic success, 0.4000 for procedural success and 0.158 for clinical success. P value for hospital stays is also insignificant i.e. 0.250 (while p value of < 0.05 was considered significant). Therefore in the setting of diabetes mellitus the outcomes of the stenting procedure are quite encouraging.

Background and Aims: The prevalence of cardiovascular diseases (CVD) are on the increase worldwide and more in the developing countries. Coronary artery disease (CAD) constitutes the major brunt of CVD. Despite the increasing morbidity and mortality, Bangladesh has a few published data on CAD in rural population. This study addressed the prevalence of CAD and its risk factors in rural population of Bangladesh.

Introduction:In the early days of mitral valve replacement (MVR), there was an increased rate of mortality associated with low cardiac output syndrome (LCOS). Excision of the sub valvular apparatus (SVA) was one of the reasons for LCOS, as MVR at that time included complete excision of mitral leaflets and SVA that is, chordae tendinae and papillary muscles. Left ventricular function and geometry depend on dynamic interaction between left ventricular wall and mitral annulus which is bridged by SVA. Papillary muscle and chordae moderates wall tension during systole and optimize left ventricular distension during diastole. Interruption of ventricular-papillary-annular complex by excision of SVA during MVR thus causes impairment of normal ventricular stress-strain pattern and thus eventually leads to impaired left ventricular function and low cardiac output. In the early sixties Lillehei and his collegues capitalized on the fact and suggested that the high mortality rate associated with MVR could be reduced by preserving the papillary muscles and chorda tendenae. He preserved the posterior leaflet during MVR and noted a decreased incidence of post operative low output syndrome 1 . Short Term Clinical Outcome in Patients with Abstract:Background: Preservation of subvalvular apparatus (SAP) during mitral valve replacement (MVR) was introduced about forty years back, but the outcome of this procedure is not well studied yet. Our study aimed to measure the in-hospital outcome of this procedure in rheumatic patients.

Introduction:Non invasive evaluation of pulmonary artery pressure is one of the most important concerns in clinical cardiology. Several studies have validated the use of Doppler echocardiography in estimating pulmonary artery pressure noninvasively. 1,2,3 With the use of continuous wave Doppler echocardiography and modified Bernoulli principles, it has been possible to noninvasively estimate pressure gradients across the patent ductus arteriosus. Brachial artery systolic pressure and brachial artery diastolic pressure as measured by sphygmomanometry can be used as an estimation of aortic systolic pressure and aortic diastolic pressure respectively. Continuous wave Doppler echocardiography derived pulmonary artery systolic and diastolic pressure can, therefore, be evaluated by subtracting calculated systolic pressure gradient and diastolic pressure gradient across the patent ductus arteriosus by continuous wave Doppler echocardiography from brachial artery systolic and diastolic pressure, respectively. Subtraction will give the respective pulmonary artery pressure in patients with left-to-right shunt.