The Morphometric Measurements of the Gross Structural Changes of Mitral Valve in Valvular Stenosis With or Without Regurgitation.

Rheumatic mitral stenosis is still a cardiac problem in developing countries. Reconstructive and replacement surgery of the diseased valves are often needed. Most of the studies on stenotic mitral valves are echocardiographic one. Morphometric measurements of the stenotic mitral valve and comparison with that in the normal mitral valve is done in this study. Thirty seven hearts of normal adult-male unclaimed dead-bodies from the mortuary of Forensic Medicine, Dhaka Medical College, Dhaka; and twelve surgically excised stenotic mitral valves of the adult-male cardiac patients from the National Institute of Cardiovascular Diseases, Dhaka, Bangladesh were studied in fresh condition. The detail morphometric findings were compared between two groups. Though the total annular circumference was similar in both groups, yet the effective orifice area reduced significantly in stenotic valves. The anterior leaflet-area was increased, but the posterior leaflet-area was decreased in the stenotic valves. The thickness of the stenotic leaflets and chordae tendineae were increased compared to that in normal valves. The knowledge of the pathological changes of the valves would help to understand the exact pathophysiological mechanisms involved in the cardiac valve diseases.

ABO and Lewis Blood Grouping with ABH Secretor and Non-secretor Status: A Cross Sectional Study in Dhaka.

A cross sectional study was done with 42 apparently healthy persons aged 6 years and above from both sexes. Most of them are blood donors in the department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Few, other than blood donor, were selected from the same locality. Five ml venous blood was collected with all aseptic precautions. ABO blood grouping and Lewis phenotyping were done by tube method. ABO reverse grouping was also done from serum. With all precautions 2 ml of saliva was collected from all subjects. Secretor status was detected from the saliva by haemagglutination inhibition method. ABO blood grouping shows 36% 'O' group, 24% 'A' group, 33% 'B' group and 7% 'AB' group. Distribution of Lewis phenotype are Le(a+b-) 19%, Le(a-b+) 53%, Le(a-b-) 26% and Le(a+b+) 2% only. 60% of study population was ABH secretor and 40% non-secretor.

Effect of Pleurotomy During Internal Mammary Artery Harvest on Pulmonary Function.

Background: Pulmonary function after coronary artery bypass graft surgery using harvested Internal mammary artery(IMA) were assessed in this prospective case control Clinical study comparing two groups of Patients with or without pleurotomy. Method: we conducted this Study at National Institute of Cardiovascular Diseases (NICVD), Dhaka, in the Department of Cardiovascular Surgery.A total of 60 consecutive patients undergoing CABG with use of IMA between july 2005 to June 2007 were reviewed. Study population were divided into Group A (n=30,undergone CABG with pleurotomy during IMA harvestion).Group B (n=30,undergone CABG with intactpleura during IMA harvestion). Results: in lung function spirometry revealed FEV1 significantly decreased in group A than B (56.81±17.76% Vs 79.85±7.7%; p=0.035)and when FEV1correalated with inspiratory vital capacity the advantage of intact pleura were confirmed at 6th postoperative day (78.02 ±12.17; B, 82.08 ±11.72 p=0.045). Vital capacity was significantly decreased in-group A than B at 3 months postoperatively (A 88.79 ± 14.38%;B 98.11±30.25%; p=0.009), but not on 6th Postoperative day. Pleuropulmonary complication like atelectasis, pleural effusion insignificantly higher in groupA than B(16.7 %VS6.7%) and (10% vs. 6.7%)at 6th postoperative day but not at 3months postoperatively. Conclusions: These results demonstrate that pleurotomy during Internal mammary artery harvesting significantly deteriorated pulmonary function variably than intact pleura group of patients.

Study Of Serum Lipid Profile In Pre-Eclampsia And Eclampsia.

The present study was designed to evaluate the association of lipid profile in pre- eclampsia and eclampsia. This case-control study was carried out in the department of biochemistry, M.A.G. Osmani Medical College, Sylhet, during July 2005 to June 2006. Total 100 study subjects were evaluated, 40 normotensive pregnant women (mean age 24.90 ± 4.04) as normal and 60 already diagnosed preeclamptic & eclamptic women (mean age 24.17 ± 4.90) as study group. Age range was 15-45 years, gestational age 24 weeks to term were included. Patients with pre-existing hypertension were excluded. Serum lipid profile (total lipids, cholesterol, triglycerides, HDL-cholesterol and LDLcholesterol) of hundred women with Pre-eclampsia and Eclampsia (n=60), normotensive women (n=40) were monitored. The preeclampsia was associated with a significant rise in triglyceride (225.6 ± 28.93 vs 165.6 ± 17.22) and fall in HDL cholesterol concentration (42.4 ± 9.29 vs 55.7 ± 7.11), while eclamptic women showed significant fall in HDL cholesterol (41.8 ± 8.79 vs 55.7 ± 7.11) and rise in LDL cholesterol (133.4 ± 11.75 vs 115.2 ± 10.72) as compared to normal pregnant women. Lipid metabolism plays a key role in the pathophysiology of Pre-eclampsia and Eclampsia. Increased triglycerides levels along with decreased HDL-cholesterol levels and delayed triglycerides clearance and high blood pressure are associated with development of preeclampsia and eclampsia. This association may be significant in understanding the pathologic processes of preeclampsia and may help in developing strategies for prevention or early diagnosis of the disorder.

Effects of cervical traction and exercise therapy in cervical spondylosis.

A randomised clinical trial was conducted in the Department of Physical Medicine, Chittagong Medical College Hospital from July, 2001 to June, 2002. The objectives of the study were to find out the effects of cervical traction (CT) and exercise on the patients with chronic cervical spondylosis. A total of 199 patients with cervical spondylosis were included in the clinical trial. One hundred patients were treated with cervical traction plus exercise and 99 patients were treated with non-steroidal anti-inflammatory drug (NSAID). Posture correction advice was given to all patients. The patients were treated for 6 weeks. There was a marked improvement in both the groups after treatment (P<0.001). But there was nearly significant difference regarding improvement in treatment with CT plus exercise than with NSAID (P = 0.06). The results indicate that the improvement of the patients with chronic cervical spondylosis was more in CT plus exercise than analgesics. So, CT & neck muscle strengthening exercise may have some more beneficial effects than NSAIDs on chronic cervical spondylosis.

Prevalence of urinary tract infection in adult women.

Five hundred adult women of Sylhet town of different socio-economic status were screened to detect urinary tract infection by a random "door-to-door" survey. Significant bacteriuria was considered as an important criterion in the diagnosis of urinary tract infection. Pyuria with bacteriuria was, but without bacteriuria was not, considered a good evidence of infection. The ratio between the asymptomatic and symptomatic bacteriuria was found to be 7:1. The significance of asymptomatic bacteriuria in preventive medicine has been stressed.