Coronary Angiographic Patency in Patients With Acute Myocardial Infarction With or Without Thrombolytic Therapy.

Background: The myocardial infarction (MI) is a leading cause of morbidity and mortality in developed countries as well as in developing countries including Bangladesh. Streptokinase since its introduction has been shown to reduce mortality significantly. The outcome of MI treated with streptokinase can be evaluated either by CAG measurement of TIMI blood flow or by the measurement of ST segment resolution in 12 lead ECG. Methods: This cross sectional comparative study was conducted in the department of Cardiology in Sylhet M A G Osmani Medical college, to compare the patency between MI patients with or without streptokinase therapy, from Jan 2008 to Dec 2009. Considering enrollment criteria a total of 96 patients with acute MI were evaluated. All patients were categorized into two groups. Group-I (n=48), who received streptokinase and Group-II (n=48), who did not received the same(due to late presentation). CAG was done with in 7- 28 days of on set of pain. The patients admitting in coronary care unit with the diagnosis of STEMI were taken as the study subjects. Results: Adequate TIMI (thrombolysis in myocardial infarction) flow was higher who received streptokinase (85.4%) than those who did not receive the therapy (52.1%). Conclusion: This study indicates that streptokinase therapy is associated with rapid and sustained reperfusion of the infarct related artery in the treatment of acute myocardial infarction.

Role of Mitral Annular Systolic Velocity in The Evaluation of Left Atrial Appendage Function in Mitral Stenosis.

Background : Mitral stenosis (MS) is the most common valvular heart disease. Thromboembolism is one of the most important complications of MS, especially when it is associated with atrial fibrillation (AF).Patients with sinus rhythm (SR) are also sussceptible to this complication when it is associated with left atrial appendage (LAA) dysfunction .LAA dysfunction is an independent predictor of thromboembolism in mitral stenosis. Objectives: To investigate whether there is a relation between mitral annular velocities obtained by Doppler tissue imaging (DTI) and LAA function determined by transoesophageal echocardiography (TEE) and to determine if the annular velocities can predict the presence of the inactive LAA in MS. Methods: Sixty MS patients were evaluated by transthoracic echocardiography and all patients underwent transesophageal echocardiography. The annular systolic (S-wave) and diastolic (Emand Am-waves) velocities were recorded. Inactive LAA was defined as LAA emptying velocity <25 cm/sec. Patients were divided into three groups; group AI (n = 18): sinus rhythm (SR) and LAA emptying velocity e”25 cm/sec, group AII (n =22): SR and LAA emptying velocity <25cm/sec and group B (n = 20): atrial fibrillation. Results: Thrombus was detected in 14 patients and spontaneous echo contrast (SEC) was detected in 48 patients. Both S-wave and peak LAA emptying velocities were decreasing, while SEC frequency and density were increasing from group A to group B. There was a positive correlation between LAA emptying vs. S-wave and LAA emptying vs. Am velocities (p < 0.001, r = 0.708 and p< 0.001, r=0.495). Multivariate regression analysis showed that only S-wave is the independent predictor of inactive LAA (p = 0.001, odds ratio = 0.133, 95% CI = 0.032–0.556). In patients with SR, the cutoff value of S-wave was 14 cm/sec for the prediction of the presence of inactive LAA (sensitivity: 92.3%, specificity: 95.3%). Conclusions: S-wave is an independent predictor of inactive LAA and a useful parameter in estimating inactive LAA in MS with SR..

Biological properties of 8-methoxypyrimido[4(1),5(1):4,5]thieno(2,3-b)quinoline-4(3H)-one, a new class of DNA intercalating drugs.

BACKGROUND & OBJECTIVES: The compounds containing novel tetracyclic condensed quinoline ring system is of interest because of its close relationship with anticancer drug ellipticine. 8-Methoxypyrimido[4(1),5(1):4,5]thieno(2,3-b)quinoline-4(3H)-one (MPTQ) was investigated to study its effect on in vitro growth inhibition and clonogenic cell survival assay on three tumour cell lines, human promyelocytic leukemia HL-60, melanoma B16F10 and neuro 2a. A systematic study was carried out to evaluate its antitumour efficacy against B16 murine melanoma. Antiinflammatory and analgesic activities of MPTQ were also studied. METHODS: The cytotoxicity of MPTQ on HL-60, B16F10 and neuro 2a cells was estimated by trypan blue exclusion test. The antitumour activity was evaluated using single dose, multiple/daily injections (days 3-6) or intermittent treatments over two weeks against s.c. implanted B16melanoma, both in terms of increased life span and tumour growth inhibition. Antiinflammatory activity was seen on carrageenan induced hind paw oedema. Counting the number of abdominal constrictions after the injection of acetic acid assessed the analgesic response. RESULTS: MPTQ is cytotoxic to all the cell lines tested and ID50 being in the range of 0.08-1.0 microM. MPTQ was studied for anticancer activity in the clonogenic assay. Drug was applied over a wide dose range by 24 h exposure, yielding clear dose-response effects. In vivo antitumour efficacy against B16 melanoma showed evidence of major antitumour activity for MPTQ. Single and multiple i.p. doses of drug proved high level activity against the s.c. grafted B16melanoma, significantly increasing survival (P<0.001) and inhibiting tumour growth (T/C of 3.0%). A reduction (76.48%) in paw volume was noted in 40 mg/kg dose of which was comparable to antiinflammatory activity of 150 mg/kg i.p. of phenylbutazone. Analgesic activity was found to be of peripheral type as there was reduction of 74 per cent in writhing response by MPTQ in dose of 40 mg/kg in mice. INTERPRETATION & CONCLUSION: The results suggested that the compounds containing pyrimidothienoquinoline system particularly 8-methoxy derivative might be potentially useful antitumour agent. We conclude that the correlation of physicochemical properties of the new series of pyrimidothienoquinolines with their pharmacological properties, might help in trying to understand the mechanism of pyrimidothienoquinolines series.

Reed-Sternberg-like cells in T-cell rich B-cell lymphoma: a diagnostic dilemma.

T-cell-rich B-cell lymphoma (TCRBCL) is a recently described variant of diffuse Non-Hodgkin's lymphoma (NHL) which requires immunohistochemical analysis for its recognition. Striking similarities exist between TCRBCL and lymphocyte predominant Hodgkin's Disease (LPHD) due to the presence of Reed-Sternberg (R-S) like cells. Hence, the need for distinction between the two is of utmost importance from a prognostic and therapeutic stand point. The present study describes a case of TCRBCL, misdiagnosed as Hodgkin's Disease (HD) on fine needle aspiration (FNA) cytology. However, immunostaining of paraffin embedded sections corrected the cytological diagnosis.