No abstract

Coronary artery disease is the major cause of mortality world wide. The potentially modifiable risk factors for coronary artery disease were increased concentrations of low density lipoprotein cholesterol, decreased concentrations of high density lipoprotein cholesterol, hypertension, hyperglycemia, and smoking. This cross sectional study which included all UGC employees was conducted in the department of cardiology of BSMMU between January 2007 and December 2007. Detailed clinical history, family history, lifestyle, smoking habit, diabetes mellitus, and hypertension, regular use of any medication or any previous cardiac intervention was taken. Physical examination, Blood pressure measurement, ECG, Echocardiography, fasting blood sugar and fasting lipid profile was done to all subjects.163 subjects (all UGC employees), mean age 44.8±8.3 years were included in this study. (20.9%) presented with angina pectoris, 3.7% were having palpitation, and 8.6% were having shortness of breath and 5.5% with nonspecific chest pain. 16.6% subjects presented with hypertension, 12.3% with diabetes mellitus, and 20.9% with dyslipidemia. 3.1% subjects had previous myocardial infarction. ECG shows 8.0% subjects had inferior ischemia, 6.1% had anterior ischemia and 2.5% had bundle branch block. Echocardiography shows 4.9% subjects were having regional wall motion abnormalities Prevalence of risk factors for CAD is increasing, and with the clinical and cost burdens mounting, identifying and treating those at risk remains a national priority. Abbreviations UGC, University Grants Commission, BSMMU, Bangabandhu Sheikh Mujib Medical University   doi: 10.3329/uhj.v5i1.3436 University Heart Journal Vol. 5, No. 1, January 2009 20-23

Clinicians continue to face the challenges of identifying and treating the idiopathic dilated cardiomyopathy to improve symptoms and survival. A study on idiopathic dilated cardiomyopathy was done in the Department of Cardiology, University Cardiac Center, Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2004 to December 2009. The aim of this study was to examine clinical profile of patients with idiopathic dilated cardiomyopathy. The age range was 18 to 65 years and 70% subjects were male. Most common symptom was dyspnea (86%) and cough (75%). 75% subjects had sinus tachycardia, 42% had ventricular ectopics and 40% had left bundle branch block. Mean diastolic dimension was 60±9 mm, ejection fraction was 28±8%, left atrial dimension was 40±6 mm and 36% were having mitral regurgitation. Left ventricular failure (75%) and various type of arrhythmias (62%) were the main complications. 8% subjects were died during hospital stay. Hence the clinical presentation of idiopathic dilated cardiomyopathy varies from patient to patient, but most patients present later, i.e. at some point in the spectrum of heart failure.

Introduction: Cardiovascular diseases is a major health burden in developing countries like Bangladesh. Patients with acute coronary syndrome(ACS) are at risk for death, myocardial infarction or recurrent ischaemic events. Comorbidity like DM plays a significant role in the outcome of such patients. So the objective of the present study was to see the coronoary angiographic(CAG) findings among diabetic and nondiabetic patients in our context. Methods: Patients presenting with the symptoms of ACS in the Department of Cardiology in a tertiary care center were selected for ECG and cardiac troponin 1. Then according to the defined criteria they was selected for the study. These patients were followed up to their hospital stay period. History of the patient, physical examination and necessary investigations was done. ACS patients were divided into two groups. 1. ACS with DM and 2. ACS without DM. CAG was done among those patients with ACS. Finally CAG findings in two groups were compared systematically. Data were analyzed by SPSS 20. Results: Among the 200 patients total male were 80.5% and total female were 19.5%). Male to female ratio was 5:1. Regarding age distribution it was found matched in both groups. Most patients were at age group 41-50 and 51-60 years which was 31% and 45% respectively. Regarding presence of hypertension in both groups, diabetic group had more hypertensive patients(81%) than the nondiabetic(71%) group (p-0.098). Regarding analysis of CAG findings in diabetic and non diabetic groups LMCA involvement was 16% and 12%, LAD 32% and 28%, LCX 22% and 23%, RCA 23% and 20% and triple vessel was 15% and 14% respectively. Only 5(2.5%) patients were found not to having any lesion. Conclusions: ACS with or without DM has variable CAG findings. So special care should be taken when dealing with such cases. University Heart Journal Vol. 15, No. 1, Jan 2019; 34-36

Diabetes mellitus adversely influences the outcome of acute coronary syndrome. This study evaluated the in-hospital outcome of acute coronary syndrome in patients with diabetes mellitus. In this prospective observation study 130 patients with acute coronary syndrome were enrolled. They were divided into diabetic and nondiabetic group. Diabetic patients were taken as case and nondiabetic patients as control. Outcome parameter studied were in-hospital mortality, cardiogenic shock, congestive heart failure, different arrhythmias and recurrent angina. In this study, one third (32%) of the patients were diabetic with mean age 58±10.0 years vs. 53.0±13.6 years in diabetic and nondiabetic group, respectively. Majority of the patients in both groups were male. Congestive heart failure and arrhythmias were more common in case group compared to those in control group (19% vs. 13.6% p=0.424; 23.8% vs. 13.6%, p= 0.148, respectively). Cardiogenic shock developed in 7.1% of diabetic patients and 8% of nondiabetic patients. In hospital mortality was 7.1% and 5.7% in diabetic and nondiabetic group, respectively. Recurrent angina developed only in diabetic patients. Therefore, diabetic patients with acute coronary syndrome encountered more in- hospital adverse outcome.   doi: 10.3329/uhj.v5i1.3437 University Heart Journal Vol. 5, No. 1, January 2009 24-27

Acute coronary syndrome is a lethal condition. Treatment modality and success mostly depend on time yielded since onset of symptoms. It is known for more than 30 years that delay between symptom onset and treatment of less than 60 min are desirable, but pre hospital delays remain unacceptably long worldwide including Bangladesh. A greater understanding of the contributing factors may help to reduce delays. A number of sociodemographic, clinical, social and proximal factors have been associated with pre hospital delay. The total pre hospital delay period consists of two component: time taken by patients to recognize that their symptoms are serious and to contact medical help (decision time) and the time taken from requesting help to admission where emergency coronary care is available (time to hospital delay). Different factors may affect these two components. In hospital delay also known as door-to-treatment, is defined as time from arriving to hospital to initiation of reperfusion therapy. Regardless of how to shorten in hospital delay, if the pre hospital delay is not reduced, then reperfusion therapy cannot achieve the best results. We set out to discover what factors are specifically associated with three components: decision time, home to hospital delay and First Medical Contact (FMC) to revascularization delay. This review may help the National health management system to identify the factors associated with treatment delay in ACS and thus reduces ACS related morbidity and mortality. University Heart Journal Vol. 15, No. 2, Jul 2019; 79-85

The purpose of this study was to detect elevated uric acid level in maternal blood, presumably due to decrease renal urate excretion, for early detection of hypertensive disorder in pregnancy. This study showed that serum uric acid was significantly elevated in all cases of preeclampsia. The present study showed that serum uric acid levels were significantly elevated in eclampsia as compared with the levels in pregnancies complicated by hypertension (p<0.05). The level of uric acid above 4.5 mg/dl is indicative of preeclamptic process and in such cases; the subjects deserve careful and close clinical follow up. Increasing higher concentration of uric acid i.e. 5.7 mg/dl, 6.3mg/dl, and 6.72mg/dl was observed in pregnancy with chronic hypertension, preeclampsia and eclampsia respectively. These results showed that serum uric acid could be used as a sensitive indicator of severity of preeclampsia. Out of 100 cases, there were 20 preterm baby and others such as stillbirth and IUD. So, these entire abnormal fetal outcomes were in the hyperuricaemic group and 5.37 times higher as compared to low serum uric acid group. Mean birth weight of preeclampsia and eclampsia were 2.31kg and 2.30kg respectively compared with 2.5kg in chronic hypertension group.

Background: Acute Kidney Injury (AKI), a common complication of acute coronary syndromes (ACS), is associated with higher mortality and longer hospital stays. ACS patients with renal impairment during hospitalization are associated with adverse in-hospital outcomes in the form of heart failure, cardiogenic shock, arrhythmia, dialysis requirement and mortality. Objective: To compare the in-hospital adverse outcomesof patients with ACS with or without AKI. Materials and Methods: This prospective comparative study was conducted in the Department of Cardiology, BSMMU, Dhaka, during the period of August 2017 to July 2018. A total of 70 eligible patients were included in this study of which 35 patients were included in group A (ACS with AKI) and 35 patients were included in group B (ACS without AKI). AKI was diagnosed, on the basis of increased serum creatinine level 0.3mg/dL from baseline within 48 hours after hospitalization. They were subjected to electrocardiography, blood test for serum creatinine (on admission, 12 hours, 48 hours and at the time of discharge), lipid profile, 2-D echocardiography along with serum troponin, CK MB and electrolytes. Results: It was observed that mean age was 58.0±8.5 years in group A and 55.6±12.3 years in group B. Heart failure was more common in group A than in Group B (74.3% vs 34.2% p=0.001 respectively) and arrhythmia was more common in group A than in Group B (100% vs 74.2% respectively). 7(20%) patients of group A required dialysis. The mean duration of hospital stay was significantly higher in Group A than in the Group B (9.4±2.3 vs 7.2±0.6; p=0.001) days. Multiple logistic regression analysis revealed that heart failure, cardiogenic shock, duration of hospital stay were found to be the independently significant predictors of outcome of the patients with AKI with odds ratio being 5.53 (p=0.001), 4.353 (p=0.001) and 6.92 (p=0.001) Conclusion: This study shows that, heart failure, cardiogenic shock, arrhythmia, dialysis requirement, were more common in the patients with AKI (group A) than in the patients without AKI (group B). The duration of hospital stays were longer in patients with AKI (group A) than in the patients without AKI (group B). Therefore, an important research target is the identification of high-risk patients with ACS experiencing AKI, thereby appropriate medication and follow-up should be implemented. University Heart Journal Vol. 16, No. 1, Jan 2020; 3-10