ABSTRACT
Back ground: Hypertension is one of the most important modifiable risk factors for cardiovascular disease (CVD) and stroke. Dyslipidemia is closely associated with hypertension. Dyslipidemia and hypertension are the commonest risk factors for CVD. The aim of the present study was to compare different lipid parameters among newly diagnosed hypertensive patients with normotensive subjects in Bangladesh and find out the relationship. Methods: This study was a cross sectional study in which 42 newly diagnosed hypertensive patients who were on no antihypertensive medication and 42 subjects with normal blood pressure (normotensive) were enrolled for compare. Lipid parameters total cholesterol (TC), triglyceride (TG), low density lipoprotein ( LDLc) and high density lipoprotein (HDLc) were estimated by Enzymatic colorimetric test. Results: The mean systolic blood pressure of hypertensive and normotensive were 154.6±22.5 vs111.50±3.42 mmof.Hg and mean diastolic blood pressure were 93.2±5.20 vs 71.44± 3.21mm of Hg. The mean of SBP and DBP of hypertensive patients was found to be higher than normotensive (p< 0.05). There was significant increase in different lipid levels namely TC 199.4±44.5 vs188.7±37.9 mg/dl, TG155.9±88.8 vs 121.9±73.2 mg/dl and LDLc 119.8±35.6 vs112.7±28.6 mg/dl in hypertensive patients as compared to normotensive (p<0.05). However there was no significant difference in HDLc level. BMI and waist circumference showed significant association in hypertensive patients (p<0.001). Conclusion: Analytical results of the study revealed that hypertensive patients have been found to have close association with dyslipidemia, BMI and waist circumference. Hypertension and dyslipidemia can be modified either by proper life style changes or medical management or by the combination of the both. This study suggests that hypertensive patients need measurement of blood pressure and lipid profile at regular interval to prevent heart diseases and stroke.
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Background: Few studies have assessed the relation of Serum creatinine and serum blood urea nitrogen (BUN) level with the severity of coronary artery disease (CAD). This study investigated the association between high uric acid BUN levels with the presence of Coronary artery disease. Materials and Methods: This study was designed as an observational cohort study. The study was composed of 170 patients admitted at our institution due to symptoms related to CAD. Patients having angiographic evidence of stenosis in coronary artery were as case group and without stenosis control group. Patients with high serum creatinine were defined as serum creatinine concentration with in 80-105 μmol/L and BUN level with in 10-20 μmol/L. The presence of CAD has been defined as the Gensini score being >1. Results: Patients with or without CAD were similar in terms of age (45.22±6.80 years vs. 52.87±9.31 years, p<0.01) and significant age difference was found between patients. Male gender (p<0.001) and smoking habit (p=0.003) were more frequent and statistically significant in patients with CAD. There was a statistically significant difference between the mean serum creatinine levels (92.89±20.82 μmol/L vs 108.68±23.62 μmol/L respectively, p<0.05) and serum blood urea nitrogen level (10.59±6.15 μmol/L vs. 20.37±6.73 μmol/L respectively, p<0.01) of patients with or without CAD. While looking at the correlation coefficient of Gensini score with different factors; S. creatinine, ejection fraction and BUN were significantly correlated at<0.001 and <0.04 and <0.01 level respectively. Increased serum creatinine levels were found to be independent risk factors for the presence of CAD (for serum cretinine hazard ration 3.9, p<0.001 and in case BUN hazard ration 2.08, p<0.001). Conclusion: In conclusion, a significant association has been found between serum creatinine & BUN level and the presence of CAD. In addition to the evaluation of conventional risk factors in daily clinical practice, the measurement of serum creatinine and BUN level might provide significant prognostic benefits in terms of global cardiovascular risk and management of the patients.
ABSTRACT
Tricuspid valve stenosis is a valvular heart disease which results in the narrowing of the orifice of the tricuspid valve of the heart. It’s relatively a rare condition. It is almost always caused by rheumatic fever and is generally accompanied by mitral stenosis.Other rare causes include carcinoid syndrome, endocarditis, endomyocardial fibrosis, lupus erythematosus, right atrial myxoma and congenital tricuspid atresia. Here we describe a patient with history of prior CMC presented with severe Tricuspid Stenosis with Tricuspid Regurgitation (Grade-IV), Mitral Restenosis (Severe), Mitral Regurgitation (grade-1+), Aortic Stenosis (Mild) and Aortic Regurgitation (Grade-2).
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Heparin-induced thrombocytopenia (HIT) is the most important and most frequent drug-induced, immune-mediated type of thrombocytopenia. It is associated with significant morbidity and mortality if unrecognized. In this review, we briefly discuss the main features of heparin-induced thrombocytopenia, particularly analyzing the most recent advances in the pathophysiology, diagnosis and treatment of this syndrome
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Background: Patients without a history of diabetes often develop hyperglycemia during an acute coronary syndrome (ACS). Our aim was to evaluate the impact of admission hyperglycemia on in hospital outcome of non-diabetic patients admitted for acute coronary syndromes. Methods: The retrospective study was conducted in National Institute of Cardiovascular Diseases among the patients with acute myocardial infarction without history of diabetes. 50 patients with ST elevation MI (STEMI) with complications, 50 patients with STEMI without complications, 50 patients with non-ST elevation MI (NSTEMI) with complications and 50 patients without complications were included in the study. Every patient got the treatment as per protocol of the institute. On admission blood glucose of the patients was recorded. Level of blood glucose was correlated with the frequency of complications. Results : Average on admission blood sugar level was higher in patients who developed complications with STEMI (11.4 vs 8.78 mmol/L). On admission blood sugar level was also significantly higher in patients with NSTEMI with complications (10.6 vs 8.6 mmol/L). The frequency of individual complications had no significant relation with the blood sugar level. Conclusion : Higher level of admission blood glucose is related to poor in hospital outcome in both STEMI & NSTEMI even in nondiabetic patients. It may be used as a predictor of poor outcome of patients with myocardial infarction.
ABSTRACT
Infective mitral valve endocarditis developed in a 35-year-old male patient after a percutaneous transvenous mitral commissurotomy (PTMC). The echocardiogram demonstrated vegetation in the anterior leaflet of the mitral valve and blood culture showed growth of Pseudomonas species which was sensitive to Ceftazidime, Ciprofloxacin, Cotrimoxazole and Imipenem and resistant to Amikacin, Ceftriaxone, Gentamycin and Nitilmycin. The patient underwent treatment with intravenous ceftazidime and ciprofloxacin for six weeks and patient improved significantly and got cure of the disease. Infective mitral valve endocarditis should be recognized as a potentially lethal complication after PTMC. The important measures to prevent bacteremia during PTMC and the appropriate role of antibiotics and operation are discussed