Comparison of Conventionally Measured Serum Bicarbonate Values with Bicarbonate Values Obtained in Arterial and Venous Blood Gas Analysis.

Bicarbonate (HCO3-) measurement in serum or plasma from a sample of venous blood is routinely practiced in hospital patient management. HCO3- status can also be assumed from Blood gas analysis requiring arterial blood as sample which is cumbersome for both patients and doctors. This study was undertaken to evaluate the extent of agreement among biocarbonate values obtained during venous, arterial blood gas analysis and conventionally measured serum bicarbonate levels in a group of intensive care unit (ICU) patients to determine whether conventionally measured serum HCO3- (from peripheral venous blood) and calculated HCO3-values (from arterial blood gas [ABG] analyzers) can be used interchangeably. A total of 51 adult patients with diverse medical conditions, presenting at a tertiary health centre ICU were enrolled in this study when deemed by the treating physician to have an ABG analysis. Arterial and venous samples were taken as close in time as possible for blood gas analysis and routine blood tests. Bland-Altman analyses were used to compare the three methods. The HCO3- levels from ABG, Venous Blood gas (VBG) and tconventionally measured serum HCO3- showed acceptably narrow 95% limits of agreement using the Bland-Altman method. VBG reveals higher level of agreement with the ABG bicarbonate values compared to measured serum HCO3-. Thus, venous blood can be an alternate for arterial blood where ABG analyzer is available. conventionaly serum HCO3- measurements can also be useful and used as substitute for an expensive ABG analyzer in resource constrained health care sectors when required.

Doppler evaluation of left to right shunt (Qp/Qs) in patients with isolated ventricular septal defect (Vsd).

A prospective observational study was carried out in the department of cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration with the department of cardiology, Combined Military Hospital (CMH), Dhaka from January 2000 to October 2001. All the patients were clinically evaluated. ECG & Doppler echocardiography were done.All the patients underwent cardiac catheterization. Complex congenital heart disease & cyanotic heart disease patients were excluded from the study. Doppler estimated pulmonary to systemic blood flow ratio (Qp/Qs) was done by conventional (velocity time integral method) method. In cardiac catheterization Qp/Qs ratio derived from oximetric data which has become a well established part of clinical practice. Doppler derived Qp/Qs were compared with catheter derived Qp/Qs. 30 patients with VSD were included. In those patients Doppler derived Qp/Qs ranged from maximum 4.5 to minimum 1.10. Mean (+/-SD) was 1.88+/-0.86 In patients with VSD mean (+/-SD) Qp/Qs at catheterization was 1.80+/-0.80. Qp/Qs ranged from maximum 4.10 to minimum 1.1 In those patients the correlation coefficient for invasively determined Qp/Qs versus Doppler estimated Qp/Qs was .92 (standard error of estimate [SEE] = 0.19) & the line of regression passed close to the origin. The results of this study demonstrate that The Doppler technique allows the noninvasive evaluation of Qp/Qs with a high degree of accuracy & allows determination of the stage of VSD by the consecutive assessment of shunt magnititude.

Evaluation of stentangioplasty in university cardiac center.

In this ongoing prospective study conducted in University Cardiac Center, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2004 to January 2006. Fifty (50) patients (mean age 56+/-7.2 years) underwent stentangioplasty were evaluated. The study group of 50 patients consisted of 42 (84%) men and 08 (16%) women. The aim of this study was to evaluate in-hospital success, failure and complications during the procedures. About risk factors 19(38%) had hypertension, 13(26%) were smoker, 11(22%) suffered from diabetes mellitus, 05(10%) had family history of ischaemic heart disease. Average left ventricular ejection fraction was 54+/-7. Target vessel percutaneous coronary angioplasty (PTCA) were done in 61 vessel, intracoronary stent implanted in 58 vessels, direct stenting were done in 35 cases, failed PTCA were in 03(6%) cases and two had dissection. The native vessels had a mean reference diameter of 2.91 mm and their luminal diameter increased significantly after percutaneous coronary intervention (PCI). All the patients were discharged by one to three days of the procedure with improvement of their clinical condition. In conclusion, intracoronary stent deployment in coronary artery stenosis following balloon angioplasty is a valid and beneficial strategy with good in-hospital results.