An evaluation of door to needle time (DNT) of thrombolytic therapy following acute myocardial infarction in three large tertiary referral hospitals in Dhaka City.

This study was conducted in three tertiary hospitals in Dhaka city at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College Hospital (DMCH) and National Institute of Cardiovascular Disease (NICVD) as a part of Inter-Heart Study. Secondary data was obtained from the standard questionnaires to determine door to needle time (DNT) following thrombolytic therapy in patients with Acute Myocardial Infarction (AMI) in coronary care units at three large tertiary referral hospitals in Dhaka city. Of total 192 patients studied in three centres, 156 (81.2%) received thrombolytic therapy. In BSMMU, 33 out of 45 (73.33%) patients received thrombolysis. Mean DNT was 147 minutes. Eighteen (55%) patients received thrombolysis within 90 minutes and 9 patients (27%) received with in 91-180 minutes, 6 patients (18%) received thrombolysis after 180 minutes. In DMCH, 44 out of 57 patients (77.1%) received thrombolysis. Mean DNT was 210 minutes. Five patients (11%) received within 90 minutes, 19 (43%) received thrombolysis between 91 to 180 minutes and 20 patients (46%) received thrombolysis outside the range of 180 minutes. In the NICVD, 79 out of total 90 (87.7%) patients received thrombolysis. Mean DTN was 64 minutes. Sixty seven (82%) patients received therapy within 90 minutes, 6 patients (9%) received between thrombolysis 91-180 minutes and 6 (9%) patients received after 180 minutes of reaching hospital. Inspite of overall improvement in the management of patients with AMI in coronary care units of major teaching hospitals, there seem to remain certain difficulty in our system which causes delay in thrombolysing patients with AMI. In this study, the mean DNT for thrombolysis was quickest (64 minutes) at NICVD and slowest (210 minutes) at DMCH. Although the study was conducted almost four years ago, it gives some insight regarding strength and weaknesses in the infrastructure of public sector hospitals in our country.

Dietary calcium; phytate; and zinc intakes and the calcium; phytate; and zinc molar ratios of the diets of a selected group of East African children

Dietary zinc; calcium; and phytate intakes of 66 rural Malawian children aged 4-6 y were determined during three seasons on the basis of weighed food records and analyzed food composition data. Height and weight measurements were also recorded and hair samples were collected for zinc analysis. Seasonal daily zinc; calcium; and phytate intakes of females ranged from 6.2 +/- 1.7 to 6.8 +/- 2.1 mg (mean +/- SD); from 335 +/- 170 to 401 +/- 257 mg; and from 1621 +/- 660 to 1729 +/- 592 mg; respectively and; for males; 7.0 +/- 1.7 to 8.0 +/- 2.3 mg; 342 +/- 164 to 473 +/- 310 mg; and 1857 +/- 530 to 2161 +/- 684 mg; respectively. Cereals provided greater than 42 percent of dietary zinc. Seasonal mean molar ratios of phytate to Zn and Ca x phytate to Zn (per 1000 kcal (4.2 MJ)) and the median Ca to phytate molar ratio ranged from 24 to 27; 151 to 188 mmol/1000 kcal (4.2 MJ); and 3.1 to 3.4; respectively. Over 78 percent of the children consumed diets with phytate-to-Zn and Ca x phytate.Zn-1 . 1000 kcal-1 molar ratios above values suggested to jeopardize zinc status. Correlations between hair zinc; phytate-to-Zn; and Ca x phytate.Zn-1 . 1000 kcal-1 molar ratios suggest that high phytic acid intakes may compromise zinc status in these children