RESUMO
This study was designed to compare the blood lipid profile and conventional cardiovascular risk factors in patients with acute coronary syndrome (ACS) and chronic stable angina (CSA). A total of 110 patients, 55 of which were of ACS and 55 with chronic stable angina (CSA) who underwent coronary angiography in the Department of Cardiology, BSMMU, Dhaka were enrolled for the study. Lipid profile and age, sex, diabetes mellitus, hypertension, hyperlipidemia, smoking habit, family history of premature coronary artery diseases (CAD) of the patients were recorded and compared. Mean±SD age of the studied patients was 52.2±10 years. Prevalence of diabetes mellitus (p<0.05) and hypertension (p <0.05) was significantly higher in patients with CSA than that with ACS. Frequency of hyperlipidemia, smoking habit and family history of CAD was similar between groups. Patients with CSA had significantly higher triple vessel diseases (TVD) (p < 0.001) and significantly lower high-density lipoprotein cholesterol (HDLc) (p < 0.05) compared to that of patients with ACS. ACS patients had significantly higher single vessel diseases (SVD) (p <0.001) compared to that of CSA but the distribution of low-density lipoprotein cholesterol (LDLc), total cholesterol and triglycerides were variable between groups. This study showed that CSA patients had substantially higher frequency of having some CVD risk factors with alteration in certain lipid profile parameters and higher number of triple vessels disease than patients with ACS. This might aid in selecting appropriate criteria for angiographic evaluation and better management of patients with coronary artery diseases.
RESUMO
The objective of the study was to evaluate and compare the role of total and free/total ratio of serum prostate specific antigen level in diagnosing carcinoma prostate. A cross sectional study was conducted at the Department of Biochemistry, Dhaka Medical College (DMC) with collaboration of the Department of Urology, Dhaka Medical College Hospital (DMCH), Dhaka from July 2008 to June 2009. This study was carried out on 60 patients above 50 years of age who attended the Department of Urology, Dhaka Medical College Hospital, complaining of irritative or obstructive lower urinary tract symptoms (LUTS) suspected as clinically benign prostatic hyperplasia (BPH) or cancer prostate. It was aimed to assess the role of total and free/total ratio of serum PSA in diagnosis of BPH and carcinoma prostate with reference to histological diagnosis. All the cases were evaluated by history, physical examination including digital rectal examination, serum prostate specific antigen level, transabdominal/ trans-rectal ultra- sonogram. From all patients, blood sample were collected before digital rectal examination or any per urethral manipulation. Final diagnosis was obtained by histo-pathological examination, specimen being obtained by perrectal biopsy with biopsy-gun. Histopathological examination detected prostate cancer in 20 out of 60 patient and 17 of these Cap 20 have a total PSA 4 ng/ml and only 3 have total PSA 4 ng/ml. 18 of these 20 have free to total ratio 0.16 and 02 have f/t ratio 0.16. Among 60 patients, 40 patients were detected BPH on histopathological diagnosis. 20 of these BPH patient have tPSA 4 ng/ml and 20 of BPH have tPSA 4 ng/ml. 38 of 40 BPH patient have f/t ratio>0.16 and 2 of 40 patient are f/t ratio 0.16. Receiver operating characteristic analysis indicated a threshold f/t ratio 0.16 was optimum discriminatory level. The sensitivity of total serum PSA (at cut off value of>4 ng/ml) in correctly differentiating prostatic carcinoma of those who have the condition is 85%, while the specificity of the test in correctly detecting those who do not have the disease is 50%. The PPV is 45.9%, NPV is 87% and accuracy is 61.7%. The sensitivity of free/total serum PSA (at cut off value of 0.16 ng/ml) in correctly differentiating prostatic carcinoma from BPH is 90%, while the specificity of the test in correctly detecting those who do not have prostatic carcinoma is 95%. The PPV of the test is 90% and the NPV of the test is 95%. The overall accuracy of the test is 93.3%. This study showed significant difference of total and free/total ratio of serum prostate specific antigen (PSA) in differentiating benign prostatic hyperplasia (BPH) from carcinoma prostate. Receiver operating characteristic curves showed advantage for the f/t PSA ratio when compared with total PSA in detecting prostate cancer. From the study it may be concluded that total and f/t ratio of prostate specific antigen (PSA) is a useful marker in diagnosis of carcinoma prostate. Free/total ratio is more accurate than total PSA.
RESUMO
Preeclampsia is a leading cause of fetal growth retardation, infant morbidity, mortality and maternal death. Several biochemical changes occur during the course of the disease, among them serum total calcium and 24 hr urinary calcium excretion rate have drawn remarkable attention. A case control study was designed to see the association of serum calcium and 24 hours urinary excretion of calcium in patients of pre- eclampsia. The study was done from July 2008 to June 2009 in the Department of Biochemistry, Dhaka Medical College, Dhaka. Total 60 subjects were selected as study population. Among them 30 were diagnosed case of preeclampsia and 30 were age- and sex-matched normal pregnant female healthy control. It was found that the mean measured serum calcium level in case group were 1.96 ±0.17 ( mean±SD ) mmol / l and that of control group were 2.34±0.12 (mean±SD) m mol/ l respectively. The mean 24 hr urinary calcium excretion level were 94.40 ±10.68mg/24 hr (mean±SD) in case group and that of control group were 154.35±66.68 (mean ±SD) mg / 24 hr respectively. The study suggests that low level of serum calcium and urinary excretion of calcium was associated with Pre-eclampsia.