Acute coronary syndrome (ACS) remains the leading cause of death in the developed world and second leading cause of death in developing countries. Elevated troponin levels and extent of ST-segment depressions are clinically important because they may act as an effective prognostic marker .This cross-sectional study has been designed to see the correlation of ST-segment depression and level of troponin I with in-hospital outcome of NSTEMI patients. The study was conducted in the Department of Cardiology, Dhaka Medical College Hospital, Dhaka during the period of April, 2011- March, 2012. A total of 90 patients were selected by purposive sampling. In this study,the mean ±SD age of the patients was 55.9±9.1 years with a range of 36-80 years with a male -female ratio of 2:1.Over all dyslipidaemia was the most common risk factor present in 55(61.10%) patients followed by smoking in 48(53.3%) patients then obesity in 32(35.60%) then hypertension in 31(34.4%) patients. Troponin I level was significantly high in patients who developed acute LVF (10.36±7.4 vs 7.0124±6.8, p=.027), and cardiogenic shock (13.72±11.37 vs 8.64±7.35, p=.033). Troponin I was significantly high in patients who developed complication (10.72±8.84 vs 6.24±5.41, p=.005) than the patients who were discharged without complication. ST segment depression was significantly more in patients who developed acute LVF(1.07±1.63 vs.55±.74, p=.048). Logistic regression analysis of acute LVF with Troponin I and ST-segment depression showed that ST-segment depression and level of Troponin I were important correlates of acute LVF .Medicine Today 2015 Vol.27(2): 14-19
Background: Uric acid is an independent risk factor for cardiovascular disease. Hospital admission for ischemic heart disease (IHD) is increasing rapidly in our country. Although studies were conducted abroad regarding association of serum uric acid with in-hospital outcomes in patients with acute coronary syndrome (ACS), no data is yet available to show the association in our country. Objective: The objective of this study was to assess the association of serum uric acid level on admission with in-hospital outcomes of the patients with ACS. Materials and Methods: This cross sectional comparative study was done in the Department of Cardiology, Dhaka Medical College Hospital (DMCH) from January to December 2012. After proper ethical consideration total 93 ACS patients were enrolled in the study by nonrandom sampling. Serum uric acid of all subjects was measured within 24 hours of admission. Then in-hospital outcomes were observed in all subjects. Results: The frequency of hyperuricemia among ACS patients was 24.7% (22.54% in male and 31.82% in female). Hyperuricemic patients significantly developed heart failure (30.4% vs 11.4%, p=0.032) and conduction defect (13.0% vs 1.4%, p=0.017) than normouricemic subjects. The mean ejection fraction was significantly lower in hyperuricemic patients than patients with normal uric acid level (50.87 ± 10.27% vs 55.94 ± 6.66%). The mean ± SD duration of hospital stay of hyperuricemic group was significantly longer in patients with ACS (8.26 ± 1.18 vs 7.51±1.18 days, p=0.010). Conclusion: The measurement of serum uric acid level, an easily available and inexpensive biochemical tool, might turn out as a valuable risk marker for prediction of in-hospital outcomes in patients with ACS. DOI: http://dx.doi.org/10.3329/jemc.v5i1.21492 J Enam Med Col 2015; 5(1): 15-22
A quality diagnosis mostly depends on the availability and proper utilization of radiology and imaging equipments in the modern medical technology. Every year, huge amount of revenue is spent to purchase costly and sophisticated radiology and imaging equipments for the district hospitals of Bangladesh. But radiology and imaging equipments are underutilized in most of the developing Asian and African countries, including Bangladesh. This descriptive cross-sectional study was conducted to find the functional status, workload, utilization, and factors affecting the utilization of radiology and imaging equipments in the district hospitals of Bangladesh. Interviewer-administered questionnaire was used to take interview of relevant human resources. Work time study method was applied where multiple checklists were used to measure consumed time for each procedure and daily actual work time of radiology and imaging equipments. In this study, 46.9% radiology and imaging equipments were found functional, 40.6% radiology and imaging equipments nonfunctional, and 12.5% radiology and imaging equipments functional but not in use. This study revealed that 53% of total radiology and imaging equipments of district hospitals were nonfunctional, and functional but not in use, where 8 equipments became nonfunctional before 10 years due to unavailability of spare parts and inadequate maintenance fund. Work time in radiography identified 83.51% and in ultrasonography (USG) 71.08% among the respondents of radiology and imaging department in the district hospitals. Utilization rate of general radiography equipments was found to be 67.01%, portable radiography equipments 16.5%, and USG equipments 71.08%. Average utilization rate of radiology and imaging equipments was found to be 51.53% in the district hospitals of Bangladesh. Utilization rate of radiology and imaging equipments more than 50% is considered as standard utilization. Current status of utilization rate needs to accelerate to get maximum turnover of the equipments among the district hospitals of Bangladesh. Important factors affecting the utilization of radiology and imaging equipments were observed -shortage of manpower, inadequate physical infrastructure, and less incorporation of advanced technology with existing facility.
Background: In epidemiological studies and clinical trials renal function has been shown to be an independent predictor of coronary artery disease (CAD). We conducted this study to find out the association between creatinine clearance rate (CCr) and coronary angiographic severity in patients with (CAD). Method: It was a cross sectional study carried out in the department of Cardiology, Dhaka Medical College Hospital, Dhaka during the period of April, 2011 to March, 2012. All the patients with Ischaemic heart disease (IHD) admitted in the department of Cardiology who fulfill the inclusion and exclusion criteria and underwent coronary angiogram were taken as sampling population. Sampling technique was purposive and sample size was 118. By Cockcroft-Gault formula, CCr was estimated from serum creatinine. Coronary angiographic severity of coronary artery disease was assessed by vessel score and stenosis score. Statistical analysis was carried out by descriptive statistics, correlation coefficient test and one way ANOVA test. Level of significance was set at 0.05. Results: Mean CCr among study subjects was 72.57 ± 17.78 ml/min. Vessel score showed 18.6% had normal coronaries, 37.3% single vessel disease, 31.4% double vessel disease and 12.7% triple vessel disease. There was significant positive relationship between serum creatinine and vessel score, and also negative relationship between CCr and vessel score. The study also showed significant negative correlation between CCr and stenosis score. Conclusion: Angiographic severity of coronary artery disease is associated with degree of renal dysfunction. Decreased creatinine clearance is associated with more extensive CAD. DOI: http://dx.doi.org/10.3329/cardio.v7i2.22257 Cardiovasc. j. 2015; 7(2): 108-113
Background:Acute coronary syndrome is a cardiac emergency. It is increasing dramatically and becoming a major burden in our health care system. Relation between serum lipid profile and acute coronary syndrome is well established. Our study tried to reveal association of high density lipoprotein cholesterol (HDL-C) with in-hospital outcome of patients with acute coronary syndrome. Methods: The study was a cross sectional comparative study. Clinical & biochemical evaluation was done in hospital settings. A total number of 271 patients were included in the study and divided into two groups. Patients with low HDL-C level were in group I and patients with normal HDL-C were in group II. Results: Group I populations had more complications & more in-hospital stay than group II (74.3% vs 28.9%, P<0.001 and 6.65±2.04 days vs 5.09±1.44 days, p<0.001 respectively). Conclusion: The study revealed significant association of HDL-C with outcome of acute coronary syndrome patients. Complications of acute coronary syndrome were more in patients with low HDL-C level.
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