Coronary artery disease (CAD) is the leading cause of mortality and morbidity both in developed and developing countries. Percutaneous recanalization of occluded coronary artery is one of the treatment options and reinfarction and restenosis negatively affect the outcome following procedure. Although various factors including fibrinogen are suspected as risk factors for this but its role in adverse outcome after stent implantation is controversial. The aim of this study was to determine the impact & relation of periprocedural fibrinogen level on outcome after coronary stent implantation. This prospective study was conducted in the Department of Cardiology, University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University (BSMMU), Hospital, Dhaka over a period of one year between July 2016 to June 2017. Total 53 patients of chronic stable angina (CSA) undergoing elective PTCA followed by stenting were included in this study as per inclusion and exclusion criteria. Plasma fibrinogen level was measured by collecting venous blood samples at three timed points in relation to stenting – 24 h before, 24 h after and 72 h after stenting. Recurrence of angina, myocardial infarction, repeat revascularization (either PCI or Cardiac surgery), and death were considered as adverse outcome during follow up at 1, 3 and 6 months after intervention. During the 6 months follow up period 1 (one) patient developed UA (at 1 month), 2 developed MI (1 at 3 month and 1 at 6 month) and 2 died (1 at 3 month and 1 at 6 month). Patients were grouped on the basis of four outcomes: favorable outcome (those who did not develop any of the four outcomes) and unfavorable or adverse outcome (those who developed any of the four outcomes). The mean age of study population was 53.92 years and 39 (73.6%) were male. Regarding cardiovascular risk factors, 43.4% patients had diabetes mellitus, 88.6% had dyslipidaemia, 56.6% were non-smokers. Baseline plasma fibrinogen level were significantly higher in patients who developed complications following PCI than those who did not develop the complications (394.4 ± 16.0 Vs 271.5 ± 21.8 mg/dl) & remained high after 24 hours and 72 hours following PCI (p < 0.001). Angiographic profiles of the study population reveals 84.9% LAD, 16.9% RCA & 15% LCX involvement but there was no association of post-PCI adverse outcomes with vessels involved, number of stents deployed and types of stents used (p > 0.05). Study showed that the risk of developing unfavorable outcome following PCI in patients with pre-PCI & post-PCI high serum fibrinogen was estimated to be 5.7 times & 12 times higher than those who have had serum fibrinogen lower than 350 mg/ dl respectively (p = 0.023 & 0.025 respectively). High serum fibrinogen can therefore be used as a marker for predicting adverse outcome following PCI. University Heart Journal Vol. 17, No. 2, Jul 2021; 122-127
Background: Preeclampsia is a multisystem disorder, unique to pregnancy that is usually associated with high blood pressure and proteinuria after 20 week of gestation. Abnormal liver function tests occur in 20% to 30% of pregnancies complicated by preeclampsia and are associated with a higher risk of adverse maternal and fetal outcome. Objective: To observe the alteration of hepatic enzymes in preeclampsia. Methods: The present cross-sectional study was carried out in the Department of Biochemistry, Dhaka Medical College, and Dhaka from July 2015 to June 2016. A total number of one hundred pregnant women in third trimester of pregnancy with or without preeclampsia, attending in the outpatient Department of Obstetrics and Gynecology in DMCH, were selected as study subjects. Of them fifty pregnant women in third trimester of pregnancy were with preeclampsia and fifty were normal healthy pregnant women. Estimation of hepatic enzymes like aspartate transaminase, alanine transaminase and gamma glutamyl transferase were done in both preeclampsia and normal pregnant patients and mean values of the variables were compared between them. Results: The mean serum aspartate transaminase level was significantly higher in preeclampsia compared to normal pregnant woman (32.4 ± 15.4 IU/L vs 24.8 ±11.8 IU/L respectively and p 0.007). Serum alanine transaminase level was also significantly higher in preeclampsia than normal pregnancy (38.1±19.9 IU/L vs 18.8±6.95 IU/L, respectively and p < 0.001). Serum gamma glutamyl transferase was also significantly higher in preeclampsia than normal pregnancy (44.7±19.1 IU/L vs 26.6± 6.0 IU/L p < .001). Conclusions: Hepatic enzymes (alanine transaminase, aspartate transaminase, gamma glutamyl transferase) were increased. So routine assessment of these parameters may helpful to prevent worse outcome of preeclampsia patients. J Dhaka Medical College, Vol. 29, No.1, April, 2020, Page 18-22
Studies regarding clinical characteristics of stroke involving the posterior circulation territory of the brain in Bangladesh are rare although large number of patients were found in hospital admission and with a high morbidity and mortality. Study for better understanding of the clinical features, risk factors and aetiologies of posterior circulation stroke (PCS) may be very helpful for early diagnosis, treatment, and also for setting primary and secondary prevention strategies. The objective of the study was to identify clinical features and short-term outcome of PCS. Adult patients admitted in Dhaka Medical College Hospital with clinical features consistent with posterior circulation stroke involving brain stem or, cerebellum or thalamus or occipital area and confirmed by computer tomography (CT) scan of brain were the the cases as respondents. Few cases were needed MRI of brain to confirm diagnosis. This was a hospital based prospective observational study with descriptive and analytical component. Sample was selected from the study population by purposive type of non-probability sampling technique. Sample size was 30. A semi-structured questionnaire was prepared containing patients’ profile as well as stroke patients’ reporting form which included all the essential information regarding clinical profile of PCS as well as short term outcome. Analysis was done using Statistical Package for the Social Sciences (SPSS) software. Thirty consecutive cases of strokes involving posterior circulation territory were included in the study according to inclusion and exclusion criteria. Male female ratio was 1.7:1. Most of the patients in both sexes were affected after the age of 50 years. Hemorrhagic PCS was significantly higher than ischaemic PCS. Among hemorrhagic PCS common symptoms were decreased level of consciousness and motor disturbances. Most common clinical sign in ischemic PCS is impaired consciousness which was present in 55.6% of the total ischemic PCS cases. Whereas this sign was present in all the cases of hemorrhagic PCS (100%). Like presenting symptoms, most of the clinical signs were also more common in hemorrhagic PCS. But few clinical signs were more common in ischemic strokes, such as cranial nerve involvement and nystagmus. Commonest predisposing factors were tobacco abuse, hypertension and dyslipidemia. Mortality was higher in hemorrhagic PCS than ischemic PCS within 7 days of follow up. Bangladesh Med J. 2021 Sept; 50(3): 20-25
Background: Statins are the corner stone therapy of atherosclerotic cardiovascular disease (ASCVD). Statins may cause myalgia, myotoxicity, myopathy and rhabdomyolysis along with its lipid lowering properties and pleiotropic effects. Statins associated muscle symptoms (SAMS) are the leading cause of nonadherent and discontinuation. This study was conducted to evaluate and understand the muscle symptoms of high intensity statin therapy (atorvastatin 40 mg and rosuvastatin 20 mg) for a period of three months in individual patient with clinical atherosclerotic cardiovascular disease.Methods: A total of 280 patients with clinical atherosclerotic cardiovascular disease were studied to once daily atorvastatin 40 mg and rosuvastatin 20 mg. It was a randomized controlled single blind trial. The primary end point was muscle symptoms-muscle pain, fatigue, cramp/spasticity and weakness at 4 weeks and in 3 months of study period. Serum creatinine kinase was measured in every patient with muscular symptoms.Results: Patients of atorvastatin group noticed severe pain more than rosuvastatin group at the end of 3 months of treatment period (14.21% vs 4.38%, p <0.05), respectively). Significantly more patients felt extremely bad (12.78% vs 4.38%, p <0.05) and bad (24.66% vs 14.52%, p <0.05) with atorvastatin compared with rosuvastatin. Patients of atorvastatin group showed more marked increase muscle spasm (3.76% vs 1.46%, p <0.05) and slight increase muscle spasm (36.27% vs 16.01%, p <0.05) than rosuvastatin group by spasticity grade. One patient of atorvastatin group developed considerable increase in muscle spasm. Medical research council (MRC) muscle power grade 4 between atorvastatin and rosuvastatin group was observed 20.05% vs 10.90%, p <0.05, respectively. Three patients of atorvastatin group developed grade 3 muscle power. Serum creatine kinase > 1500 U/L was observed more in atorvastatin than rosuvastatin group (14.21% vs 4.38%, p <0.05, respectively). Statin associated muscle symptoms (more severe muscle problem, myositis/myopathy) observed more in atorvastatin than that of rosuvastatin group ( 34.07% vs 13.08% , p <0.05, respectively). Both treatments were well tolerated. No cases of rhabdomyolysis, incident diabetes, hepatic or renal insufficiency were recorded during the study period.Conclusion: Rosuvastatin had better outcome profile of muscle symptoms than atorvastatin in patients with clinical atherosclerotic cardiovascular disease among the Bangladeshi population. Patients in atorvastatin group experienced more muscle pain, fatigue, cramp/spasticity and weakness than rosuvastatin.University Heart Journal Vol. 14, No. 1, Jan 2018; 9-20
Introduction:At the end of twentieth century, the mortality from cardiovascular diseases allocated nearly half of the statistics of mortality in industrial and a quarter of fatalities in developing countries. Among these diseases is "congestive heart failure (CHF)" which is a very important part of cardiovascular diseases and almost all heart diseases can lead to this syndrome. 1 CHF is a debilitating complaint associated with a large number of readmissions. 2 A large body of research has revealed that CHF-related rehospitalization within six months is around 25-30%, which can increase to 40% within 1 year. 3 Another study showed the readmission from CHF range from 27% to 47% within three to six months after initial discharge. 4 One of the study in USA showed, annual readmission rate was 56.6%, median time to Abstract:Background: Repeated hospital readmissions are frequent and increasing over time in patients with heart failure (HF). The readmission rate within 3-6 months after discharge in these patients is 10-50%.
Background & objectives: Visceral Leishmaniasis (VL) or Kala-azar is a deadly disease putting 350 million people from 88 countries at risk. In Bangladesh, 45 districts are endemic. Zinc is an essential trace element and its relevance for proper functioning of the entire immune system is already well documented. Though low serum zinc levels have been reported in many parasitic diseases, limited information is available regarding zinc status in human leishmaniasis. This study was conducted to evaluate the zinc level in endemic and non-endemic population of kalaazar. Methods: This cross-sectional study was conducted to assess the serum zinc concentrations in kala-azar endemic and non- endemic population of 06 to 60 years of age range during the period of July 2014 to June 2015.Venous blood was collected from 92 subjects to estimate serum zinc concentrations. Results: Mean Serum zinc levels were found 63.66 microgm/dl in kala-azar patients of endemic area, 69.44 microgm/dl in kala-azar endemic populations and77.34 microgm/dl in non-endemic populations. Conclusion: The average serum zinc concentrations is lower in populations of kala-azar endemic zone compared to populations from kala-azar nonendemic zone. It was also found that kala-azar patient had lower zinc concentrations compared to non-kala-azar patients. There may have potential association of low zinc level and occurrence of kala-azar. J Dhaka Med Coll. 2021; 29(1): 111-117
Background and objectives: Noninvasive assessment of coronary artery disease severity remains a clinical challenge. Myocardium subtended by obstructive coronary artery disease may show reduced left ventricular strain. The present study was intended to investigate whether this reduction of strain value correlates with increasing severity of coronary artery disease in Non-ST-Elevation Myocardial Infarction (NSTEMI) patients. Methods: This cross sectional study included 86 patients of NSTEMI. We assessed myocardial strain in global longitudinal strain (GLS) value using two dimensional speckle tracking echocardiography (2DSE). We performed coronary angiogram of the same patients and documented presence or absence of significant disease, number of affected vessels and Gensini score. Significant coronary artery was defined as ≥70% stenosis in any major coronary artery and or ≥50% stenosis in left main coronary artery. Results: Global longitudinal strain value was significantly lower in the significant coronary artery disease group (-13.5±3.4% vs. -19.01±2.3%) (p < 0.001). GLS declined proportionately with increasing severity of coronary artery disease defined by number of affected vessels (p < 0.001). Spearman’s rank correlation coefficient test between GLS value and Gensini score showed that the two variables maintained a linear but inverse relationship (ρ = 0.816, p < 0.001) that implies decreasing GLS is associated with increasing Gensini score. Multivariate logistic regression analysis found global longitudinal strain as an independent predictor of coronary artery disease. Conclusion: Myocardial strain assessed in global longitudinal strain value correlates with angiographic severity of coronary artery disease in patients with Non-ST-Elevation Myocardial Infarction.
Background Rheumatoid arthritis (RA) is the most common form of inflammatory arthritis and affects approximately 0.5-1% of the global population. Early diagnosis and treatment have been advocated to prevent structural damage and eventual long term disability. Bangladesh is a densely populated developing country where majority of the patients, suffering from RA, are being treated by general practitioners, orthopedists and internists because the country has very small number of rheumatologists Objectives This study was conducted to see the joint involvement and the pattern of deformity and its relationship with seropositivity in patients with RA in Bangladesh. Methods The study was carried out in the Department of Medicine, Sir Salimullah Medical College and Mitford Hospital, Dhaka over a period of 9 months from October 2010 to June 2011. A total of 100 RA patients, fulfilling the 1987 American College of Rheumatology (ACR) classification criteria, were the study population. Results All patients had pain in bilateral metacarpophalengial joints. 93% patients had bilateral tarsal and metatarsophalengial joint pain. Bilateral wrist pain and ankle pain were present in 90% of cases. Over 40% complained of pain in both elbow joints while 65% had pain in both knee joints. Swelling of the joints was found in small joints of the hands (98%) and foot (86%), in wrist (85%) ankle (80%) and knee joints (65%) on both sides. Elbow joint swelling was not frequently seen (20%). Joint deformity was found in 63% of cases. Swan-neck deformity in index finger was present in 16% cases, in middle finger in 46% and in ring finger in 38.1% of cases. The boutonniere deformity of middle finger and the Z-deformity of thumb were detected in 7.9 and 4.8% respectively. The mean duration of swan neck, boutonniere and Z-deformity were 22.4±5.7, 15.6±5.8 and 6.0±2.1 months respectively. 9% patients exhibited claw deformity of foot where the mean duration was 3 months. 46% of the patients had deformity of both wrist joints. The mean durations of wrist and elbow deformities were 51.4±6.7 and 12.0±4.5 months respectively. Hand deformity was significantly higher in patients (79.2%) with positive anti-cyclic citrullinated peptide antibody (anti-CCP antibody) when compared to patients with negative anti-CCP antibody (p<0.001). Similarly, wrist joint deformity tend to have higher affinity for positive anti-CCP antibody (p=0.036). Deformities involving hand and wrist joints were more associated with positive RA tests (p<0.001 and p=0.048 respectively). Conclusions RA patients with hand and wrist joint deformities have significantly higher tendency to be seropositive (anti-CCP antibody and RA positive). Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4472
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.