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There are few studies on the relationship between socio-economic factors and rheumatic fever (RF) in the populations where the burden of both socio-economic deprivation and RF is still very high. The aim of this study is to assess the association between some socio-economic factors and RF by examining data available from a RF hospital in Bangladesh. We have reviewed the medical records of patients presenting with manifestations suggestive of RF during a 1-year period. From the patients who showed group A beta-haemolytic streptococcal upper respiratory infection (ABHS infection), 44 RF cases defined by the Jones criteria and 86 control subjects, who did not satisfy the criteria, were identified for analysis. The median age was 12 years and 60% were female. RF was significantly associated with low income (odds ratio [OR] 2.37; P = 0.04); poor living conditions: substandard (kacha) house (OR 2.93, P = 0.02); and poor nutritional status: low height for age (OR 2.68, P = 0.02). Multiple logistic regression analysis revealed an increased OR for kacha house (OR 3.18, P = 0.02) but the same estimate for low height for age (OR 2.68; P = 0.04). Our analysis shows that, among the patients presenting to the RF hospital with proven ABHS infection, acute RF is associated with socio-economic deprivation.

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

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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.

Objective: Diabetes mellitus, a common metabolic disorder, is often associated with severe coronary artery disease. In this study, we compared the angiographic severity of coronary artery disease in diabetic patients compared with that of non diabetic patients.Methods: This observational study comprised of 102 subjects who had coronary artery disease on coronary angiography in the Department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2009 to December 2009. The patients were divided into two groups: one group with 24 (23.5%) diabetic patients and another group with 78 (76.5%) non diabetic patients. Demographic, clinical, laboratory and angiographic data were analyzed and compared between two groups.Results: Mean age±SD of the study subjects was 52.8±9.5 years and 94 (92%) of them were male. Diabetic patients were older (mean age±SD; 57.6±9.5 versus 51.3±9.9 years; p 004), and had higher frequency of hypertension (75% versus 50%, p 0.036), chronic stable angina (71% versus 41%, p 0.018), and lower frequency of smoking (42% versus 67%, p 0.034) and acute coronary syndrome (29% versus 59%; p 0.018) in comparison to non diabetic patients. Left main stem disease (21% versus 5%, p 0.031) and three-vessel disease (50% versus 31%, p 0.094) were more prevalent in diabetic patients. Severe coronary artery stenosis was significantly more present in diabetics than non diabetics (Gensini score, 50.9±29.9 versus 32.6±21.9, p 0.001).Conclusion: Diabetic patients are more likely to have severe and extensive coronary artery disease. Left main stem and triple vessel disease are more commonly seen in diabetic patients compared to non diabetic patients.University Heart Journal Vol. 10, No. 1, January 2014; 13-17

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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.