Objective: This cross sectional study was conducted in the dept. of clinical pathology in collaboration with dept. of cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Bangladesh Institute of Research & Rehabilitation of Diabetes Endocrine and Metabolic Disorders (BIRDEM) to evaluate the role of platelet distribution width (PDW) in diagnosing acute coronary syndrome (ACS). Patients & Methods: A total of 142 patients were selected for the study. Of them 79 were cases (patients with acute coronary syndrome) and 63 were controls (patients with non cardiac chest pain). The cardiologist established the diagnosis by clinical examination, ECG and biochemical markers especially troponin I. A structured questionnaire was used which addressed all the variables of interest. Blood samples of the selected patients were taken to investigate their platelet distribution width level and to find its association with ACS. The blood samples was taken properly and processed in a Haematology auto analyzer within 2 hours of collection, which again rechecked manually by peripheral blood film. Statistical analyses were done using mean± standard deviation (SD), t-test, Chi-square (x2) with 95% confidence interval. Test of validity done by receiver operative characteristic curves.Result: In the present study, platelet counts were 273.1±50.15 x 109/L in patients with ACS and 290.78±74.86 x 109/L in control subjects. Platelet counts were slightly low in patients with ACS compared to control subjects. There were no statistical significant differences between the groups in unpaired t- tests. MPV was 12.48±1.17 fl and 10.45±0.66 fl in patients with ACS and control subjects. PDW was 16.23±2.56 fl and 11.89±1.42 fl in patients with ACS and control subjects. Both MPV and PDW were statistically significant between the groups (P<0.001) in unpaired t-test. Patients with acute coronary syndrome the sensitivity, specificity, positive predictive value and negative predictive value of platelet counts, MPV and PDW were obtained by ROC curve and compared with control subjects. The best cut off value of platelet count, MPV & PDW were >225 x 109/L, > 10.7 fl and >12.7 fl respectively. The sensitivity, specificity, accuracy, positive and negative predictive value of platelet counts, MPV and PDW were 83%, 28.1%, 42.3%, 37.6%, 64%; 90.6%, 49.4%, 64.8%, 51.6%, 89.8%; and 94.3%,52.8%, 69%,54.9%, 94.1% respectively. In our study, we found that PDW had higher sensitivity and specificity in contrast to MPV. These PDW are used as predictor for early detection of ACS and risk stratification when other cardiac biomarkers are negative.Conclusion: The PDW is an early indicator to diagnose ACS and correlates with the prognosis of ACS. DOI: http://dx.doi.org/10.3329/uhj.v9i1.19430 University Heart Journal Vol. 9, No. 1, January 2013; 3-8

No abstract

Background: Patients of acute leukemia require careful assessment of liver function prior to start chemotherapy to determine which drugs may be appropriate or to be modified. Post chemotherapy abnormalities of liver function tests may be due to drugs or due to disease process itself. Objective: To evaluate the status of liver function in acute leukemia patients before and after induction chemotherapy. Methodology: This was a prospective cross-sectional study conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh from January 2017 to December 2017 on fifty (50) newly diagnosed patients of acute leukemia who fulfilled the selection criteria. Blood samples for serum total bilirubin, alanine transaminase (ALT) and aspartate transaminase (AST) were collected before chemotherapy (Day 1) and after induction chemotherapy on 14 th day and 30 th day. Serum ALT and AST were measured by kinetic method and serum total bilirubin was measured by DMSO method. Data were analyzed and compared by statistical tests. Result: In this study, the mean level of serum total bilirubin before chemotherapy at day 1 was 0.89 ± 0.64 mg/dl. It was significantly (p < 0.001) raised to 1.55 ± 1.05 mg/dl at day 14 of chemotherapy, and again significantly (p < 0.002) reduced to 0.72 ± 0.35 mg/dl at day 30 of chemotherapy as compared to day 1. Similarly the mean serum ALT at day 1 was 47.46 ± 15.

83%, 28.1%, 42.3%, 37.6%, 64% and 90.6%, 49.4%, 64.8%, 51.6%, 89.8% respectively. In our study, we found that MPV had higher sensitivity and specificity in contrast to platelet count. MPV may used as predictor for early detection of ACS and risk stratification when other cardiac biomarkers are negative.

Background: Coronary artery disease is the principal cause of disability and mortality worldwide. Its prevalence is increasing around world. It is about 75% of deaths occurring in developing countries like Bangladesh. It is very important to know about the inflammatory risk factors of coronary artery disease for early assessment of coronary artery disease. Serumβ2-microglobulin (²2m) is a newly identified biomarker that has been found to increase in patients with coronary artery disease. Aims: To determine the role of â2m in predicting the severity of coronary artery disease. Methods: This cross-sectional study was carried out in Department of Cardiology and Laboratory Medicine, BSMMU, Shahbag, Dhaka during March 2017 to February 2018. Total seventy four patients who underwent coronary angiography as per criteria where included in this study. Serum β2-microglobulin (²2m)was done before angiography procedure by indirect ELISA method and severity of coronary artery disease was assessed by extent of diseased coronary vessels and SYNTAX score. Results: β2-microglobulin level was found higher (≥3/ml) in coronary artery disease patients which was statistically significant (p<0.001).β2-microglobulin was also correlated with number of diseased coronary vessels (r=0.562, p<0.001). Mean â2m level was found 4.48±0.95 μg/ml with range from 3-6.1 μg/ml and the mean SYNTAX score was found 16.27±08.99 with the range from 1 to 44. Pearson’s correlation coefficient was done between â2m level and SYNTAX score. Then the result is r=0.547 and p<0.001. Therefore, there was a positive correlation between â2m level and SYNTAX score. The area under the receiver-operator characteristic (ROC) curves ²2m cut off value of 3.6 with 81.4% sensitivity and 86.7% specificity as the value for identifying the coronary artery disease. Conclusion: Our study revealed that β2-microglobulin effectively correlates with the severity of coronary artery disease. So it may be used as a reliable marker for assessment of coronary artery disease severity. University Heart Journal Vol. 16, No. 1, Jan 2020; 22-27

Ascites is the most frequent nding of decompensated liver cirrhosis. Mannitol may be used with conventional diuretics for increase urinary volume for the treatment of cirrhotic ascites.is case control study was done in the

Background: Postoperative hypoparathyroidism is a common complication after total thyroidectomy. It is necessary to diagnose hypoparathyroidism immediately after total thyroidectomy for minimizing complications. Objective: The objective of this study was to measure and to evaluate the serum parathyroid hormone level in total thyroidectomy patients. Methods: This prospective observational study was carried out in the Department of Clinical Pathology in collaboration with Department of Surgery & Department of Otolaryngology of BSMMU and Department of Otolaryngology of DMCH, Dhaka, during the period of September 2010 to August 2011. Results: Total 65 patients were studied irrespective of age and sex. Decreased serum PTH was found in 9 cases and normal parathyroid hormone was found in 56 cases. Male was 16.0% and female was 84.0%. Females were predominant. The incidence of hypoparathyroidism was 41.5%. Asymptomatic hypoparathyroidism was found in 8 and symptomatic hypoparathyroidism was found in 1 cases. Decreased serum PTH was developed mostly in malignant thyroid diseases. In relation to preoperative PTH values, intraoperative PTH levels were lower from 5.48% to 90.0%, (mean±SD in percentage is 65.3±16.7, p=.001) which is significant in paired t test. The mean difference of intraoperative (20 minutes after total thyroidectomy), parathyroid hormone levels were statistically significant (p<0.05) between patient with decreased parathyroid hormone and patient with normal parathyroid hormone in unpaired t-test. Conclusion: Serum parathyroid hormone level significantly decreased 20 minutes after total thyroidectomy. If clinical sign symptoms of hypoparathyroidism are not developed in postoperative period, patient is safe and can be discharged from hospital. Bangladesh J Otorhinolaryngol; April 2017; 23(1): 5-10

Patients with systemic lupus eythematosus (SLE) have increased susceptibility to infection by Pneumocystis jerovecii but this condition has rarely been reported in Bangladesh. Pneumonias due to Pneumocystis jerovecii commonly occur in immunocompromised hosts. Although it is a treatable infection, it is associated with high motility. Patient with systemic lupus erythomatosus increased susceptibility to infection by Pneumocystis jerovecii. Here we describe a patient with SLE who developed Pneumocystis pneumonia (PCP). A 37-years old female is a known case of SLE for 12 years admitted in BSMMU with the complaints of fever & cough for 3 months and breathlessness for 1 month. The patient is treated with corticosteroids and cyclosporine within 2months before presentation. Diagnosis is established based on the findings of induced sputum by Giemsa staining.This case demonstrates that PCP should be included in the differential diagnosis of patients of SLE presenting with pneumonic process.