RESUMO
Background: Acute Kidney Injury (AKI) is a strong predictor of in-hospital adverse outcomes, which is a common complication of acute coronary syndromes (ACS). ACS patients with renal impairment during hospitalization are associated with adverse outcomes like heart failure, cardiogenic shock, arrhythmia, dialysis requirement and mortality. Objective: To compare ACS patients with or without AKI has significant risk of in-hospital adverse outcomes. Methods: This prospective comparative study was conducted in the Department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, during the period of July 2017 to June 2018. A total of 70 eligible patients were included in this study. Electrocardiography, blood test for serum creatinine (on admission, 12 hours, 48 hours and at the time of discharge), lipid profile, RBS, 2-D echocardiography along with serum troponin, CK MB and electrolytes were done for all patients. Results: It was observed that mean age was 58.0±8.5 years in group A (ACS with AKI) and 55.6±12.3 years in group B (ACS without AKI). Male population was predominant in both the groups (85.7% and 74.2%, respectively). Heart failure was more common in group A than in Group B (74.3% vs 34.2% p=0.001 respectively). Arrhythmia was more common in group A than in Group B (100% vs 74.2% respectively). The mean duration of hospital stay was significantly higher in Group A than in the Group B (9.4±2.3 vs 7.2±0.6; p=0.001) days. Conclusion: This study showed adverse outcomes including longer duration of hospital stays were more common in the patients with AKI (group A) than in the patients without AKI (group B).
RESUMO
Rheumatic heart disease & rheumatic fever is important public health issue. overall incidence and prevalence of acute rheumatic fever is in downtrend in Bangladesh. But exact incidence & prevalence of chronic rheumatic heart disease (CRHD) is unknown. Objective: We wanted to find out prevalence of CRHD among adult patients undergoing echocardiography in a tertiary level hospital of Bangladesh. Methods: The study was conducted in the department of cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka between January 2018 to December 2018. Echocardiography was done with VividE9® machine. Patients who underwent echocardiography for various indication on indoor and outdoor basis were screened for this study. Among them 1000 male & female patients, age between 18-65 years who had their echo done by the investigators were enrolled for analysis. CRHD was defined as per latest echocardiography guideline. Frequency & pattern of CRHD were calculated. Results: Out of 1000 patients 74 cases were diagnosed as CRHD (7.4%), among them 52 patients were female. Mitral stenosis (MS) was found in 28.3% cases, Isolated mitral regurgitation (MR) in 5.4%, MS with MR in 18.9%, Aortic stenosis (AS) in 8.1%, Aortic regurgitation (AR) in 10.85%, AS with AR in 13.5%, involvement of both aortic & mitral valve in 27%, involvement of mitral, aortic & tricuspid valve in 1.3%. Conclusion: Findings of the study will help to set public health programs for primary & secondary prevention of CRHD. Further population-based study is required to know the exact prevalence of the disease.