Eisenmenger Syndrome - a Case Report.

Eisenmenger syndrome (ES), the most advanced form of pulmonary arterial hypertension associated with congenital heart disease, is a devastating condition that has a considerable impact on patient's life. Patients who develop ES typically exhibit one or more of a range of cardiac defects including ventricular septal defects (VSD), atrial septal defects (ASD) and patent ductus arteriosus (PDA). The nature of the congenital defect underlying ES is important because it has prognostic implications. Early diagnosis & treatment of cardiac defect before development of pulmonary hypertension is the key to definite management, otherwise only supportive management can be offered. Our patient Mr. Abdul Khaleque, 55 years old, businessman, non diabetic, non hypertensive admitted in DAMCH, cardiac unit with the complaints of shortness of breath on exertion since childhood, bluish discoloration of nails and toes for 10 years, headache and vertigo for 2 weeks. Initially it was during severe exertion and relieved by rest. Gradually the severity of breathlessness has increased. Now he has developed NYHA class III. He had history of repeated attacks of cough with expectoration of mucoid sputum with occasional scanty amount of blood which did not foul smell and did not change with posture. We diagnose him as Eisenmenger syndrome secondary to ASD and treat him with only medical measure.

Role of CT scan in the Evaluation of Lung Tumor with Cytopathilogical Correlation.

Lung cancer is an important & widespread disease that contributes a major health problem worldwide. Lung cancer kills over 1 million people per year. Cigarette smoking is the major cause of lung cancer. CT scan is the principal radiological examination adjunct to X-Ray chest examination in diagnosis & management of lung cancer. The main Objective of the study was to assess the diagnostic usefulness of CT scan in evaluating & characterize the different types of lung tumors and to correlate CT findings of lung tumors with that of cytopathology. This study was carried out in the department of Radiology & Imaging, Dhaka medical college hospital, Dhaka during the period from 1st January 2007 to March 2008. It was a cross sectional study. Total 51 patients were selected conveniently, detailed history particularly symptoms related to lung tumors was carefully elicited to obtain maximum possible information regarding the illness. Possible diagnosis was established by the combination of history, physical examination, laboratory & radiological investigations. Then patients were underwent CT examination of lung. Cytopathological sample were obtained from the lesion by guided aspiration. Collected FNAC samples were send for cytopathology & collected reports were compared with CT scan reports. Sensitivity of CT to diagnose lung tumor was 97.4%, specificity 76.9% & accuracy 92.2 %.

Result of Simultaneous Correction of Alar Deformity with Primary Repair of Unilateral Cleft Lip.

Cleft lip and cleft palate has been a recognized congenital malformation from a very early stage in recorded history. The infant born with an orofacial deformity, which leads to develop an unwilling psychosocial problem among the parents and also among the relatives. Successful treatment of cleft is based on overcoming in tissue shortage and repositioning of the tissues in normal anatomical pattern so that it restores both appearance and function. Various modalities of theme, works, observations and involvement of multidisciplinary approaches were tried to achieve better cosmetic, aesthetic and functional aspect in management of cleft face. Poorly performed primary surgery carries a high risk of iatrogenic disturbances of subsequent orofacial growth. Delayed nasal repair in patient with cleft lip did not produce satisfactory aesthetic and functioning result. Aim & objective of the study is to achieve a cosmetically well-accepted face in respect to lip, philtrum and nose of both sides after cleft lip surgery and to reduce the incidence of secondary correction of deformed nose in a patient with cleft lip. In our study total 86 cases are studied according to preformed inclusion and exclusion criteria. Simultaneous correction of alar cartilage deformity at the time of primary repair of cleft lip may lessen the staged operative procedure and markedly reduce the economic burden to the family.

An exercise training combined with dietary program for patients with hypertension.

A controlled clinical trial was conducted to determine whether combined exercise training and diet alone reduce blood pressure (BP), body weight and body mass index (BMI) in three weeks. Twenty eight patients with diastolic BP < or = 110 mmHg were assigned to a hypertensive group and another 28 subjects with diastolic BP < or = 90 mmHg were subjected to the same intervention as control group (normotensive group). Exercise training and diet reduced diastolic BP by 24.7 mmHg and systolic BP by 32.8 mmHg in hypertensive group. There was a mean decreased of 5.3 mmHg in the diastolic BP in the normotensive group (P < 0.001). The systolic BP decreased only minimally. The weight loss ranged from 1 kg to 3 kg in hypertensive and 1 kg to 2 kg in the normotensive group. The mean weight loss was 1.6 kg (0.7) in hypertensive and 1.5 kg (0.5) in the normotensive group. In both the groups the weight reduction was highly significant (P < 0.001) and moderately positive correlation was also noted with the fall of BPs. The mean fall of BMI was 0.61 kg/m2 (0.21) and 0.51 (0.2) kg/m2 in the hypertensive and normotensive groups respectively. The findings indicated that a combined exercise training and dietary program could lower BP in patients with mild to moderate hypertension, but its long-term consequences on morbidity and mortality remain to be determined.