<p class="Abstract">This study aims to evaluate the histopathological analysis as well as the effect of coronary endarterectomy with severe calcified coronary artery disease. During the year of 2015 to 2017, a total of 135 patients (56 patients of stable angina and 79 patients of unstable angina) underwent atherectomy in adjunct to off-pump coronary artery bypass graft surgery. Histopathological study of atheroma specimen demonstrates the presence of calcification, foam cell, cholesterol clefts, thrombus, smooth muscle cell, and also necrotic tissue using standard hematoxylin and eosin stain techniques. However, smooth muscle cells and foam cell were identified with plaque using the monoclonal antibodies. Thrombus was more common in unstable angina group of patients (64.4%) in comparison to the patients with stable angina (23.2%). An accelerated progression pattern of smooth muscle cell proliferation and calcification were observed which was also common and significantly higher in unstable angina group of patients. The presence of thrombus and accelerated progressive pattern of smooth muscle cell proliferation in unstable angina patients imply the episodic disruption of atheromatous plaque followed by subsequent healing and may play a vital role in the pathophysiology of underlying angina pectoris.</p>

<p><span>This article has no abstract. The first 100 words appear below:</span></p><p>A 24 year old male attended the outpatient department of a local hospital with the chief complaints of pain in the central chest for two years and easy fatigability of the left upper limb for one and half years. After performing various examinations and investigations, he was sent to Al Helal Specialized Hospital with the preliminary diagnosis of coarctation of the aorta. The pain was dull aching in nature, continuous in duration, mild in intensity mostly, but sometimes intense sharp stabbing, radiating to the back. There was no known aggravating factor but lying down relieved it partially.</p>

Mitral regurgitation (MR) associated with secundum Atrial Septal Defect (ASD) is not widely recognized but the association is not unusual. MR has been found in less than 10% of adults with large ASD which is mainly caused by mitral valve prolapse (MVP). We are reporting a case of congenital ostium secundum ASD with MVP associated with MR, review the clinical relevance of this association, and discuss the related literature. Our patient has shown dramatic improvement in symptoms and signs after ASD closure with mitral valve replacement along with improvement in tricuspid regurgitation. More general awareness of this association will further help the surgeon for better management of the patient with this rather unusual combination of lesions.University Heart Journal Vol. 12, No. 2, July 2016; 91-94

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Background: Vigilance ensures safety in cardiac surgery. Performance in cardiac surgery is often measured by short-term mortality. Several risk factors like advanced age, female gender, higher body mass index, decreased left ventricular function, emergent, and redo operations have appeared recurrently as poor prognostic variables. Evaluation of postoperative mortality is crucial to find loopholes to provide proper care and reduce preventable mortality after cardiac surgery in developing countries with limited infrastructures and resources. Methods: This is a retrospective study conducted in the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University. Perioperative data of 100 cases of mortality after cardiac surgery performed from 1 January 2014 to 30 May 2018 were collected from the university medical record. The data on age, gender, body mass index, preoperative investigations, diagnoses, types of operations, details of cardiopulmonary bypass, and postoperative period of the study populations were evaluated. Results: During the study period, about 1627 cases of cardiac surgery were done with an overall mortality rate of 6.15%. The mean age was 41.05 ± 20.19 (0-68) years, and 66% of patients were male. Preoperative ejection fraction (EF) of the study population was an average 56.63% ± 11.85%; 9% of the patients had EF < 40%. Off-pump coronary artery bypass (32.27%) was the most commonly performed surgery followed by mitral valve replacement (24.28%). On-pump cardiac surgery was done among 65% of the study population with a mean cross-clamp time and bypass time of 32.56 ± 11.55 minutes and 80.57 ± 18.09 minutes, respectively. Most of the mortality was found in the first two weeks after surgery. Conclusion: Mortality after cardiac surgery is multifactorial. A large-scale prospective study with comparative groups is required to find out preventable measures of mortality after cardiac surgery which will improve the quality of services provided to the patients in developing countries.

Coronary arteries supply blood and nutrients to the heart. Coronary Artery Disease (CAD) develops by narrowing of the arteries. Once the inner walls of the arteries are damaged, fatty deposits made of cells, connective tissue elements, lipids and debris decrease their lumens which block blood flow to distal tissues. This process is called arteriosclerosis. This study intends to detect the composition of human coronary atheroma collected from the arteries during bypass surgeries in Bangladesh. It shows that all lesions are present in the advanced types, namely, type 4, 5 and 6. Infrequently thrombotic materials and necrotic debris were found in type 6 plaque. The mean length of plaque was 3.36 ± 1.71 cm and mean weight was 0.13 ± 0.12 gm. Insufficient lipid was obtained from each atheroma. Few raised areas were lipid laden whereas most of the strands were fibrous. Biochemical assessment was formidable. The cholesterol composition of coronary plaque ranged between 0.20% -9.83% with mean 3.06% ± 2.09% and total fatty acids ranged between 0.47% -3.04% with mean 1.31% ± 0.63%. The most abundant fatty acid was oleic acid (unsaturated) closely followed by palmitic acid (saturated). The mean calcium content was 41,180.20 ± 34,918.59 ppm and ranged from 1148.00 -140,311.00 ppm or, 0.115% -14.031%. This study was undertaken to detect the composition of human coronary atheroma in Bangladesh which revealed that it depended upon the type of lesion.

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Dazzle Capsule, a Poly herbal formulation is marketed in management of Arthritis and joint-musculo skeletal pain. In this study, safety and efficacy of this polyherbal formulation was investigated in which it was being proved safe for use via acute toxicity study and efficacy was being evaluated by carrageenan-induced rat paw oedema test in rats in order to explore its anti-inflammatory activity at the dose level of 90 and 180 mg/kg, p.o, compared with Indomethacin (10 mg/kg, p.o.). It showed an highly significant reduction in oedema (p<0.001). Indomethacin inhibited oedema by 30.054% and 36.216% at 2 and 3 hr after carrageenan injection, respectively. The inhibitory effect of Dazzle Capsule began at 2 hr or later after carrageenan injection depending upon the administered dose. Low doses of Dazzle Capsule (90 mg/kg) gave highly significant inhibitory effects of 37.894-39.378%, and higher doses (180 mg/kg) caused highly significant inhibition of 19.125-30%. The reduction of oedema by Indomethacin and Dazzle Capsule at 2 hr or more after carrageenan injection suggested that both compounds produce anti-inflammatory effects in the second phase of oedema, indicating inhibition of prostaglandin synthesis. Hence, it was concluded that, Dazzle Capsule is having potent anti-inflammatory activity yet safe polyherbal formulation for use in arthritis management.