Background: Electrical accidents (EA) are rare, but can cause serious and potentially life-threatening injuries to multiple organs. The majority of epidemiological data refers to workplace accidents which account for a significant share of such accidents in adults. Exposure to electric shock has been associated with an increased risk of developing immediate and delayed cardiac arrhythmias. Objective: To evaluate the prevalence of cardiac arrhythmias and different symptoms in patient with high voltage and low voltage electrical injury. Methods: This was observational prospective study was carried out at the Dept. of Cardiology, Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur, Bangladesh from January to June 2021. 51 consecutive patients with electrical injury who were admitted. Admission criteria were age ≥15 years, loss of consciousness, cardiac arrest, electrocardiographic abnormalities, soft tissue damage and burns. Patients were categorized into high and low voltage injury group and their variables were compared. Results: The mean age of the patients was 32.3±10.4 years among them 41 (82.3%) were male. Patients who sustain high voltage electrical injury (>1000V) were 18 (35.2%) and low voltage injury (<1000V) were 33 (64.7%).Cardiac arrhythmias like sinus tachycardia (11.1% vs 6.0%, p=0.054), sinus bradycardia (11.1% vs 3.0% p=0.254), ventricular premature beats (5.6% vs3.0%, p=0.674), atrial fibrillation (11.1% vs 0%, p=0.054) were observed in high voltage and low voltage group. The commonest presenting symptoms in both groups were pain (77.8% vs 81.8% p=0.560) and fatigue (55.6% vs 39.3%, p=0.328). Conclusion: In this study few non-fatal cardiac arrhythmias were observed in both high and low voltage electrical injury group. Parameters considered to be risk factors such as known structural heart disease, loss of consciousness, high voltage electric shock, burn and soft tissue injuries were also not significant predictors of the occurrence of arrhythmias. There is no significant difference in the presenting symptoms and types of arrhythmias observed between low voltage and high voltage injury group.
Introduction: Obesity is a major health problem in western society with rapidly increasing prevalence in most countries. The healthcare burden of obesity is far reaching but many of the consequences are yet to be fully understood. While there is a perception that obesity negatively impacts on outcomes following abdominal surgery there is conflicting evidence for this. Aims: To identify the complications of post-operative obese patients. Methods: Between 1st September, 2016 and 28th February, 2017, patients undergoing GIT, Hepatobilliary and Urological surgery at Shaheed Ziaur Rahman Medical College Hospital in Bogura, Bangladesh were enrolled. Following informed consent, BMI was assessed. High risk patients and complications were identified according to established criteria. Patients were grouped according to BMI categories as Normal, overweight, Obese grade-I and Obese grade-II. A Cost analysis was performed on all patients treated at Shaheed Ziaur Rahman Medical College Hospital using a SQL database. The cost of treatment was analysed with respect to the same BMI catagories. Results: A literature review found evidence of increased risk of wound infection, anastomotic leak, and pulmonary and thrombo-embolic risk. There was mixed evidence or no evidence that obesity increases cardiac risk, sepsis, overall morbidity and mortality or overall cost. A cohort of 100 patients was analysed. Diabetes was more common with increased BMI (p=0.017). Other categories of operative risk were not different. There was no difference in overall morbidity (p=0.903). Obese patients were more expensive than normal weight patients ($9587 versus $5,786(p<0.05)). Conclusion: This study demonstrates that obesity, measured by BMI is associated with more severe morbidity. I have also demonstrated that excess body fat as measured by BMI is associated with a significantly increased cost of treatment (36%) for patients undergoing major abdominal surgery.
Background: Acute kidney injury (AKI, previously known as acute renal failure) is a frequent complication that affects a substantial number of hospitalized patients annually. However, the relationship between severity of AKI and in-hospital outcomes in the setting of acute Acute ST-Elevation Myocardial Infarction (STEMI) has not been well- documented. Chronic kidney disease is a strong predictor of in-hospital mortality in the acute myocardial infarction setting. Objective: To evaluate the Outcome of admitted patients of acute ST elevation myocardial infarction with renal function. Methods: The Prospective observational study was carried out at the Cardiology Department, Bangabandhu Sheikh Mujib Medical College and Hospital, Faridpur, Bangladesh from July 2020 to June 2021. 100 patients of STEMI diagnosed by clinical, biochemical and ECG criteria were included in the study. After getting serum creatinine level from them, eGFR was calculated and patients having <60ml/min were selected for the further studies. Results: In the STEMI patients, the ratio of male patients 76% and females’ patients (35%) was 3.34:1 with mean ± SD of age was 52.84 ±8.40 year. Among the 101 patients, chart indicating the outcome of the study patients where cardiogenic shock was found in 10.8% patients, heart failure was found in 24.7%, arrhythmias were found in 69.3% and death occurred in 5.9% of cases. Table 5 showing Stratification of patients by in relation with eGFR where different pattern and frequency of outcome was observed in relation with level of eGFR described. After calculating levels of eGFR, all the outcomes showed statistically significant (P < 0.05) except cardiogenic shock which didn’t show significance (P > 0.05. Conclusion: In concluded, that those who have renal impairment previously or develop after acute STEMI have inverse outcomes. As renal impairment is associated with an increased risk of coronary artery disease and stroke, the cardiovascular disease may develop early in the course of renal dysfunction.
Original Research Article Background: Carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) have been well recognized as tumor markers for colorectal cancer. Previous studies suggested that body mass index is inversely associated with the screening of CEA and CA19-9 levels and may reduce screening sensitivity. Objective: To assess the relation between CEA & CA 19-9 level and body mass index in colorectal carcinoma. Methods: A Prospective Observational Study was carried out at Department of Surgery, Dhaka Medical College Hospital (DMCH) from January, 2016 to December, 2016 (12 months). Cases were purposively selected according to inclusion criteria. Patients are divided group of on the basis of values of CEA level < 7 ng/dl and ≥ 7 ng/ml, CA 19-9 <37 ng/ml and ≥37 ng/ml. Body mass index divided three groups which are <18.5, 18.5-24.0 and >24 kg/m 2. The quantitative observations were indicated by frequencies and percentages. P values <0.05 were considered as statistically significant. Results: Total 50 cases majority patients belonged to age 41-50 years in both groups (CEA <7 ng/ml and ≥7 ng/ml). The mean age was found 42.5±11.3 years in CEA (<7 ng/ml) group and 40.7±12.1 years in CEA (≥7 ng/ml) group. Male was found 15 (40.5%) in CEA (<7 ng/ml) group and 06 (46.2%) in CEA (≥7 ng/ml) group. Regarding histological type of the patients that tubular adenocarcinoma was 27 (73.0%) in CEA (<7 ng/ml) group and 10 (76.9%) in CEA (≥7 ng/ml) group. Majority patients had tumor size ≤5 cm in both groups, which was 23 (62.2%) in CEA (<7 ng/ml) group and 07 (53.8%) in CEA (≥7 ng/ml) group. Colon tumor was 16 (43.2%) in CEA (<7 ng/ml) group and 07 (53.8%) in CEA (≥7 ng/ml) group. Peritoneal metastasis was 04 (2.7%) in CEA (<7 ng/ml) group and 03 (23.1%) in CEA (≥7 ng/ml) group. Liver metastasis was 02 (5.4%) in CEA (<7 ng/ml) group and 02 (15.4%) in CEA (≥7 ng/ml) group. Regarding TNM staging of the patients CEA (<7 ng/ml) group majority 19 (51.4%) patients had TNM stage II and CEA (≥7 ng/ml) group 07 (53.8%) patients had TNM stage III. Majority patients had moderate histological differentiation in both groups, which was 31 (83.8%) in CEA (<7 ng/ml) group and 10 (76.9%) in CEA (≥7 ng/ml) group. Mean age was found 43.7±10.5 years in CA 19-9 (<37 ng/ml) group and 41.9±11.1 years in CA 19-9 (≥37 ng/ml) group. Colon tumor was 17 (42.5%) in CA 19-9 (<37 ng/ml) group and 06 (60.0%) in CA 19-9 (≥37 ng/ml) group. Peritoneal metastasis was 02 (5.0%) in CA 19-9 (<37 ng/ml) group and 02 (20.0%) in CA 19-9 (≥37 ng/ml) group. Liver metastasis was 03 (7.5%) in CA 19-9 (<37 ng/ml) group and 01 (10.0%) in CA 19-9 (≥37 ng/ml) group. CA 19-9 (<37 ng/ml) group majority 19 (47.5%) patients had TNM stage II and CA 19-9 (≥37 ng/ml) group 06 (60.0%) patients had TNM stage III. Almost two third (62.5%) patients was found tubular adenocarcinoma in CA 19-9 (<37 ng/ml) group and 03 (30.0%) in CA 19-9 (≥37 ng/ml) group. Majority patients had moderate histological differentiation in both groups, which was 32 (80.0%) in CA 19-9 (<37 ng/ml) gr...
Background: Thyroid hormone has the major role in the cardiovascular system function and cardiac a As well as to maintain the cardiovascular homeostasis. A slightly change in thyroid status actually affects cardiovascular mortality hemodynamic. The background of this study was to define the prevalence of thyroid dysfunction in acute coronary syndrome (ACS). Objective: To assess thyroid hormonal profile in patients presenting with acute coronary syndromes (ACS). Methods: A hospital based, retrospective, observational comparative study was carried out at the Dept. of Cardiology, Bangabandhu Sheikh Mujib Medical College and Hospital, Faridpur, Bangladesh from January to June 2020. Data of all patients with acute coronary syndrome presenting to hospital were collected in a pre-structured proforma and analyzed. Results: A total of 100 ACS patients between 21 years to 75 years with mean age of 59.23 ± 11.30 years were studied. One hundred and twenty seven (64.0%) were males. Among them 58 (58%) was ST segment elevated myocardial infarction (STEMI) patients while 42 (42%) were unstable angina/ non-ST elevated myocardial infarction (UA/ NSTEMI) patients. Total 23 (23.0%) patients had abnormal TFT of which 14(60.8%) had Euthyroid Sick Syndrome, 6(26.0%) had subclinical hypothyroidism, 3(13.0%) had subclinical hyperthyroidism and 1(4.2%) had low fT4 with normal fT3 and normal TSH. There was significant difference in TFT in patients with STEMI and UA/NSTEMI (P=0.006).There were higher rates of heart failure (p= 0.001 & 0.003 in STEMI & UA/NSTEMI respectively), longer length of hospital stay (3+0.17 days) and high mortality (more than 4 fold) in all types of ACS patients with abnormal TFT than ACS patients with normal TFT. Conclusion: There is higher prevalence of abnormal thyroid hormonal findings in ACS causing significant morbidity and mortality.
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