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Aims: Coronary artery disease is a devastating disease precisely because an otherwise healthy person in the prime of life may die or become disabled without warning. The objectives were to study the clinical profile, risk factors prevalence, angiographic distribution and severity of coronary artery stenosis in acute coronary syndrome (ACS) patients admitted in Cardiology Department of Dhaka Medical College Hospital, Dhaka. Materials and Methods: A total of 800 patients of ACS were analyzed for various risk factors, angiographic patterns and severity of coronary artery disease at DMCH, Dhaka, Bangladesh. Results: Mean age of presentation was 51.27±8.80 years. Majority were male 628 (78.5%) and rest were females (21.5%). Most patients had ST elevated myocardial infarction (STEMI) 509 (63.6%) followed by non-STEMI (NSTEMI) 207 (25.9%) and Unstable Angina (UA) 84 (10.5%). Risk factors: smoking was present in 388 (48.5%), hypertension in 289 (36.13%), diabetes in 235 (29.38%), dyslipidaemia in 169 (21.13%) and obesity in 356 (44.5%) patients. Singlevessel disease was present in 30.32% patients, Doublevessel disease was present in 23.23% patients and Triple vessel disease was present in 27.15% patients. Conclusion: STEMI was the most common presentation. ACS occurred earlier in comparison to Western population. Smoking was most prevalent risk factor. Diabetic patients had more multivessel disease.

This study was undertaken to identify existing reproductive tract infection (RTI) treatment practices of the government family planning (FP) paramedics in rural Bangladesh. It also assessed the knowledge and perceptions of the clients about RTIs as well as the service-seeking behaviour of the clients and their husbands. Data on paramedic treatment practices were collected by observing paramedic-client interactions at the family welfare centres (FWCs) and satellite clinics (SCs). One hundred clients seeking RTI treatment were observed. The same clients were interviewed at departure from the health-care facility to assess their knowledge and perceptions about RTIs as well as service-seeking behaviour of the clients and their husbands. Twenty-four village practitioners were also interviewed to assess their knowledge on the subject. Results of the study showed that in the treatment of RTI, paramedics of government FP services commonly: (i) did not do a physical examination, (ii) used a substandard dosage of drugs, and (iii) made no attempt to notify or treat male partners. Thirty-one of the 97 clients reported that their husbands had some kind of genital problem. It was revealed from the study that as an alternative to the government FP services, the clients and their husbands often seek RTI treatment from the village practitioners though the village practitioners' knowledge concerning RTI is poor. Based on the findings of this study, it is recommended that the knowledge and skills of the paramedics and village practitioners for RTI treatment be strengthened. Prevention of RTI through awareness campaigns is essential for the control of RTIs, and especially of STDs.

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Background Early revascularization and treatment is key to improving clinical outcomes and reducing mortality in acute myocardial infarction (AMI). In low- and middle-income countries such as Bangladesh, timely management of AMI is challenging, with pre-hospital delays playing a significant role. This study was designed to investigate pre-hospital delay and its associated factors among patients presenting with AMI in the capital city of Dhaka. Methods This retrospective cohort study was conducted on 333 patients presenting with AMI over a 3-month period at two of the largest primary reperfusion-capable tertiary cardiac care centres in Dhaka. Of the total patients, 239(71.8%) were admitted in the National Institute of Cardiovascular Diseases, Dhaka and 94(28.2%) at Ibrahim Cardiac Hospital & Research Institute, Dhaka Data were collected from patients by semi-structured interview and hospital medical records. Pre-hospital delay (median and inter-quartile range) was calculated. Statistical significance was determined by Chi-square test. Multivariate logistic regression analysis was done to determine the independent predictors of pre-hospital delay. Results The mean age of the respondents was 53.8±11.2 years. Two-thirds (67.6%) of the respondents were males. Median total pre-hospital delay was 11.5 (IQR-18.3) hours with median decision time from symptom onset to seeking medical care being 3.0 (IQR: 11.0) hours. Nearly half (48.9%) of patients presented to the hospital more than 12 hours after symptom onset. On multivariate logistic regression analysis, AMI patients with absence of typical chest pain [OR 5.21; (95% CI: 2.5–9.9)], diabetes [OR: 1.7 (95% CI: 1.0–2.9)], residing/staying > 30 km away from nearest hospital at the time of onset [OR: 4.3(95% CI = 2.3–7.2)] and belonged to lower and middle class [OR: 1.9(95% CI = 1.0–3.5)] were significantly associated with pre-hospital delays. Conclusion Acute myocardial infarction (AMI) patients with atypical chest pain, diabetes, staying far away from nearest hospital and belonged to lower and middle socioeconomic strata were significantly associated with pre-hospital delays. The findings could have immense implications for improvements about timely reaching of AMI patients to the hospital within the context of their sociodemographic status and geographic barriers of the city.

Background: C-reactive protein (CRP) and glycohemoglobin (HbA1c) are established risk factors for the development of cardiovascular disease. We investigated the joint effects of these parameters on the severity of coronary artery disease (CAD) in patients with ischemic heart disease.Methods: This cross sectional study was performed on 668 patients of ischemic heart disease. CRP value were divided into normal (<6 mg/L), borderline (6-10 mg/L) and high (>10 mg/L) and HbA1c was divided <6.5% and ≥ 6.5%. After performing Coronary angiography the extent of disease was divided into insignificant CAD of (<50% stenosis), significant CAD considered as >50% stenosis and single vessel, double vessel, triple vessel CAD and normal coronaries.Results: Most (65.0%) of the patients belonged to age 41-60 years. The mean age was found 51.4±10.7 years. Majority (82.3%) of patients were male. Among risk factors, highest (40.0%) patients had hypertension followed by 209 (31.3%) diabetes mellitus and 204 (30.5%) smoker. The relationship of CRP with the whole spectrum of ischemic heart disease was found statistically significant (p<0.05). The relationship of HbA1c and CRP were significantly associated with the severity of coronary artery disease. At HbA1c e”6.5 percent, severe CAD (double vessel and triple vessel) were found higher in high CRP than normal and borderline CRP group.Conclusion: Inflammation, presented by CRP, and hyperglycemia, presented by HbA1c, jointly contributes to the cardiovascular risk of patients. Patients with high CRP and elevated HbA1c are associated with severe coronary artery diseases.Cardiovasc. j. 2018; 11(1): 53-58

Abstract:Introduction: Brain abscess is a complication of congenital cyanotic heart disease with or without shunt anomaly. It is more common in children. Here, we delineated a case of 19-year-old young BangladeshiBengali male who presenting with brain abscess, an unusual presentation of cyanotic complex congenital heart disease. This case report focuses not only on the unusual presentation of congenital heart disease but also emphasizes the importance of early recognition of neurological complication for referal management.

Background: Inflammation has been shown to play a role in atherosclerosis and acute coronary syndrome. This study was carried out to evaluate the relationship between baseline white blood cell (WBC) count and C-reactive protein (CRP) with angiographic severity of coronary artery disease in patients with acute coronary syndrome and to identify those subsets of patients with acute coronary syndrome who may need to undergo invasive or conservative strategies.Method: A total of 100 patients with acute coronary syndrome including unstable angina, non-ST elevated myocardial infarction & ST elevated myocardial infarction were evaluated in National Institute of Cardiovascular Disease (NICVD), Dhaka with a view to correlate angiographic findings, C-reactive protein and WBC count. Results: This study observed that either raised WBC count or raised CRP independently and combination of both WBC count and CRP elevation were significantly associated with more severe coronary artery disease. Either raised WBC count or raised CRP or combination of raised WBC    count and CRP were significant predictor of multivessel disease and high stenosis score. Conclusion: Elevation of WBC count and CRP in patients with acute coronary syndrome are associated with severe coronary disease. WBC count and CRP can be used as a new and even simpler tool for risk stratification in acute coronary syndrome. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12209 Cardiovasc. j. 2012; 5(1): 23-29