Objective: To find out association between creatinine clearance rate (CCR) and in-hospital outcome of acute coronary syndrome (ACS).Methodology: This prospective observational study was carried on 100 patients with acute coronary syndrome, in Coronary Care Unit (CCU) of BIRDEM General Hospital, Shahbag, Dhaka, over a period of six months from July 1, 2012 to December 31, 2012.Results: Subjects were divided into three groups (A:CCR>60,B :CCR-30-60and C:CCR<30) depending on their CCR (ml/min). Mean creatinine clearance rate was 56.15 (±29.57) ml/min and mean serum creatinine level was 3.68 (±2.59) mg/dl. Among 20 patients of Group A subjects 15(75%) were discharged in a stable condition. 2(10%) and 3(15%) patients developed isolated left ventricular failure (LVF) and isolated hypotension respectively. No patient died in this group and none of them developed any bleeding episode (epistaxis,melaena,haematemesis, haematochezia or per vaginal bleeding etc), sepsis or multi-organ dysfunction syndrome (MODS). Among 35 patients of Group B subjects 8(22.8%) were discharged in a stable condition. 9(25.7%) and 6(17.1%) patients developed isolated LVF and isolated hypotension respectively. 2(5.7%) patients died in this group and 7(20%), 2(5.7%),1(2.8%) patients developed bleeding episode, sepsis and MODS respectively. Among 45 patients of Group C subjects 3(6.6%) were discharged in a stable condition. 12(26.7%) and 8(17.7%) patients developed only LVF and only hypotension respectively . 4(8.8%) patients died in this group during their hospital stay and 11(24.4%), 3(6.6%) and 4(8.8%) patients developed bleeding episode, sepsis and MODS respectively. ANOVA test suggested that decreased creatinine clearance rate was significantly related to poor clinical outcome(P<0.05).Conclusion: This study showed that decreased creatinine clearance is directly related to poor outcome of acute coronary syndrome. So subjects with ACS should be closely monitored for decreased creatinine clearance rate to avoid life threatening complications. And subjects with renal impairment suffering from ACS should be closely observed as patients with decreased CCR has poor clinical outcome.Bangladesh Crit Care J March 2015; 3 (1): 3-6

Background and objective : C-reactive protein (CRP) is a well-known inflammatory biomarker and is associated with cardiovascular risk. Our objective was to see whether it is also associated with hypertension and its complications.Methodology : This prospective observational study was carried out in general outpatient department (OPD) of a tertiary level hospital on a total of 112 patients, among them 71 were hypertensive and 41 were normotensive. Baseline CRP was measured in all subjects and followed them up to six months to see any association between the level of CRP and hypertensive complications.Results : It is found that mean CRP was 2.923 (± 0.294) in hypertensive subjects and 1.058 (± 0.330) in normotensive subjects. No association is found between level of CRP and hypertensive complications.Conclusion : CRP is raised in hypertension. But it is not established that its level can predict the complication of hypertension.Bangladesh Crit Care J March 2018; 6(1): 3-6

artery disease.1 A strong correlation between glycaemic status and shock or development of heart failure has also been reported.2 Elevated blood glucose levels per se adversely affect outcome through the cumulative effects of several mechanisms, including induction of endothelial dysfunction, oxidative stress, hyper coagulability and impaired fibrinolysis. 2,3Patients with diabetes have increased in-hospital mortality following acute myocardial infarction (AMI), with studies suggesting higher risk with both hypoglycemia and hyperglycemia. 5So, optimal control is needed for better outcome. In this study, we assessed whether there is any relation of glycemic status in ST elevation myocardial infarction (STEMI) and non ST elevation myocardial infarction (NSTEMI). Methodology:This prospective observational study was done in

Gitelman's syndrome is an autosomal recessive disorder caused by a defect of the thiazide-sensitive sodium chloride co-transporter at the distal tubule, characterized by hypomagnesemia, hypokalemic alkalosis and hypocalciuria. We report a case of Gitlman's syndrome in a 44 years old female patient who presented with generalized muscle weakness and carpal spasm and characteristic electrolyte abnormalities. This condition is sometimes confused with Bartter's syndrome.Ibrahim Med. Coll. J. 2012; 6(1): 34-36