Serum Lipid Profile status of Type 2 Diabetic Patients in the cross section population in Dhaka City of Bangladesh.

Objectives: Serum lipid profile viz the level of total cholesterol (TC), Triglyceride (TG), HDL-cholesterol and LDL-cholesterol of type2 diabetic patients have been studied and compares them with levels of control subjects. Results: The mean value of the TG level for male diabetics was higher than that for the female diabetics and the mean values of TC, HDL-C and LDL-C were not found significantly different between male and female diabetics. Hyperlipidemia has a documented causative relation with CAD, but the major risk associated with diabetes may be due to the associated hyperlipidemia. The study revealed that dyslipidemia is very common in type2 diabetics and the most common abnormality observed was increased serum triglyceride levels (58%). The next common abnormality was decreased serum high-density lipoprotein cholesterol (HDL-C) levels and increased serum low-density lipoprotein cholesterol (LDL-C) levels. A high total serum cholesterol levels was found in 41% patients. 39% of the patients examined were overweight, and 7% were overtly obese. Conclusion: Thus, the study clearly shows the relationship between type2 diabetes and hyperlipidemia, which may influence the mechanism by which type2 diabetes is associated with increased CAD risk.

Observation and treatment of some adult fracture cases initially treated by indigenous physicians.

From December 2000 to November 2009, 10 cases of closed fracture which were usually needed definitive operative treatment were included in this study. All the patient were adult. Among them 8 patients were male and 2 were female. Patients were initially treated by Kabiraji method by indigenous physicians and ultimately referred to district hospital within 7 days to 6 weeks. All the fractures were treated by conservative method and the fractures were healed within 3 months. ROM were full. Among the fracture 3 were Galeazzi fracture dislocation, 5 were fracture radius and ulna and 2 were fracture shaft of femur. Average age of the patients were 28years.

Device Closure of Perimembranous Ventricular Septal Defect Under Deep Sedation and Transthoracic Echo Guide: A Case Report.

T, an eight years old girl was diagnosed as a case of perimembranous Ventricular Septal Defect (VSD) since 6 months of her age. She had recurrent chest infection since early infancy. Her Echocardiography with colour Doppler showed a 4.5 mm perimembranous VSD which was 5 mm away from the aortic valve. As pulmonary artery pressure was normal, she was kept under follow up and device closure was planned. At last she was taken into the catheterization laboratory of combined military Hospital, Dhaka on 1st July 2008 and VSD was closed with an 8 mm Amplatzer perimembranous VSD device. Whole procedure was done under deep sedation with Ketamine and transthoracic echocardiography (TTE) and fluroscopy guide. It is the first ever case of VSD device closure where procedure was done under sedation and TTE guide which lead to the writing of this report.

Cost- Effective Management of Venous Ulcer.

Background: Venous disorders are very common. About 20% of the population suffer from varicose veins, 2% have skin changes which may precede venous ulceration1. Venous ulcers represent a common and debilitating condition associated with significant financial loss for the patients as well as the society. Treatment options for these patients are costly and time consuming. In this study we tried to find out cost -effective measures for treating this group of patients. Method: To evaluate the effectiveness and safety of superficial and perforating leg venous surgery along with pharmacotherapy 66 patients with chronic venous leg ulcers are prospectively studied. After proper history taking and clinical examination all patients underwent venous duplex ultrasonography. Patients were divided into two groups. Group I (n=30) includes patients undergoing saphenofemoral ligation and stripping of the great saphenous vein (GSV). In group II (n=36) patients underwent saphenofemoral and incompetent leg perforator ligation along with stripping of the GSV. Conservative measures, local ulcer care and pharmacotherapy were common in both groups. Result: Postoperative complications, total hospital stay and ulcer healing were studied. Ulcer healing was earlier in group II. Remarkable complications were similar in both the groups. Conclusion: For effective and economic care of venous leg ulcers, combination of standard surgical procedures including incompetent perforator and saphenofemoral ligation with great saphenous vein stripping and standard physio-pharmacotherapeutic care is essential. This combined modality of treatment is highly effective in early and complete ulcer healing in patients suffering from venous ulcers.

Duplex evidence of recanalization of deep venous thrombosis with conservative management.

A female patient was admitted in vascular surgery department of Bangabandhu Sheikh Mujib Medical University (BSMMU) after confirmation of diagnosis with duplex ultrasonographic examination. The patient was treated with intra-venous heparin for 10 (ten) days and elevation of the affected limb with application of crepe bandage. Later on the patient was discharged with oral anti-coagulant e.g. Tab. Warfarin for 06 (six) months along with application of crepe bandage on the affected limb. During the patient received oral anti-coagulant therapy the patient was asked to do Prothrombin time every week for adjustment of dose of oral anti-coagulant therapy. After 01 (one) month duplex ultrasonographic examination of deep veins of the affected limb was performed, which showed good recanalization of deep and superficial veins of right lower limb. It can be stated that, serious complications like pulmonary embolism can be avoided with effective and timely treatment of deep venous thrombosis with complete recanalization.