Retroperitoneal hematoma may occur as a result of trauma, rupture of arterial aneurysms (aortic or iliac), surgical complications, tumors and anticoagulation therapy. A life threatening retroperitoneal hemorrhage or hematoma is an infrequent complication of anticoagulation treatment. Enoxaparin is a low-molecular-weight heparin (LMWH) with several advantages over unfractionated heparin. Nevertheless, enoxaparin use is not without risk and severe retroperitoneal bleeding may occur following its use with a potentially fatal outcome. We report a case of sixty six years old female patient who develops a fatal retroperitoneal hematoma two days after enoxaparin treatment for acute coronary syndrome. Keywords: Retroperitoneal hematoma; Enoxaparin; Acute coronary syndrome. DOI: 10.3329/cardio.v3i1.6434Cardiovasc. j. 2010; 3(1): 94-97

Background & objective: Left main coronary artery (LMCA) stenosis (defined as 50 or > 50 percent narrowing of luminal diameter) usually has a bad prognosis unless revascularization done. Isolated left main coronary artery (ILMCA) disease is a rare clinical entity. Although it carries a grave prognosis, its etiology is not well-understood. Determining risk factors for ILMCA disease might be promising in the preventive strategy of ischemic heart diseases. The aim of this study was to determine the demographic and traditional risk factors for left main coronary artery disease.

Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown.Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between presence of PAD and severity of CAD. Material &Methods: This five years retrospective study was conducted at invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, severity of coronary artery and peripheral artery disease.Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension were detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 88.3% and 58.4% had positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients 52 had both coronary and peripheral arterial disease which was statistically significant (p<.014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. Peripheral angiogram revealed 51.9% had superficial femoral artery disease, 24.7% had anterior tibial artery disease, 26% had posterior tibial artery disease, 15.6% had common iliac artery and common femoral artery disease and 2.6% had renal artery disease.Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.University Heart Journal Vol. 11, No. 2, July 2015; 79-84

Background: The incidence and causes of sudden death vary in different societies, and these differences are influenced by demographic and clinical factors such as age, gender, risk factors, past medical history and presumed cause of death. This three years long retrospective study describes the influence of these factors on death from sudden cardiopulmonary arrest.Materials and Methods: This is a retrospective study of sudden death among all the age groups who were seen at Emergency Room (ER) of Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh. Total 414 cases of death were reported between 1stJanuary, 2012 to 31st December, 2014. They were investigated retrospectively and subsequently analyzed on age, sex, risk factors, past medical history, endo-tracheal intubation with resuscitation and cause of death. The statistical analysis was performed as appropriate to illustrate any possible association between different demographic variables and cardiopulmonary arrest.Results: Out of 414 deaths, 72.5% were male, & 27.5% were female. The mean age of subjects was 60.60 ± 13.34 years with male mean age of 60.35 ± 13.62 years and female mean age of 59.70 ± 13.24 years. There were three different age groups in this study. 52 deaths were in 17-45 years of age group, 233 death patients were in 46-65 years age group & 129 deaths were more than 65 years age group. Among 46-65years age group 161 deaths were presumed to be due to cardiac cause which is higher than the other two groups. 75.12% of all the study patients had hypertension, 84.06% had diabetes mellitus, 23.43% had CKD & 69.32% had dyslipidaemia. 31.40% patients were active smoker, & 20.53% had prior h/o smoking. Patients who suffered cardiac cause of death had significant history of hypertension (p<0.001), dyslipidaemia (p<0.001), smoking habit (p<0.001), & CKD (p<0.001). 40.8% (169) of deceased patients had previous ischemic heart disease, 10.4% (43) had previous cerebrovascular disease and 28% (116) had prior morbidity like malignancy, multi organ dysfunction. 73.67% subjects needed endotracheal intubation with urgent cardio pulmonary resuscitation. Out of 414 study patients, 65% had presumed precipitating cardiac cause of death, 15% had presumed neurological cause of death and rest 20% had other causes.Conclusion: The current study indicates a definite influence of age, gender, medical risk factors and past medical history has causal relationship with sudden death. The highest incidence occurred in the middle age group as compared to other age groups. Incidence was also higher in men than in women. Subjects with hypertension, diabetes mellitus and previous coronary artery disease had higher incidence of sudden deathsBangladesh Crit Care J March 2015; 3 (1): 14-16

Massive envenomations by bees are capable of causing multiorgan dysfunction as a result of direct toxic effects of the large venom load received. Although all varieties of honey bee have the potential for these attacks, the Africanized honey bee (Apis mellifera scutellata) is the most commonly implicated subspecies. In the United States, the Africanized strain is found primarily in the southwestern states and is known for its highly defensive behavior if disturbed. Mechanisms behind the multiorgan dysfunction produced by these mass envenomations are not clearly understood. We present a case of an 8-year-old boy who was stung by multiple bees and developed progressive upper-body swelling and systemic manifestations of mass envenomation including rhabdomyolysis, renal insufficiency, and a transient transaminase elevation.Ibrahim Med. Coll. J. 2011; 5(1): 34-36