RESUMO
Background: Rheumatic fever (RF) and rheumatic heart disease (RHD) continue to affect millions of people around the world, including Bangladesh. Children and adolescents are especially susceptible to this disease. Classical risk factors, i.e. poverty, overcrowding, ignorance and insufficient health care services are responsible for the high incidence and prevalence of these diseases. To assess the prevalence of RF and RHD among children, a school survey was conducted in Bharateswari Homes, in the district of Tangail, Bangladesh. Methods: A total of 947 students were examined. Revised Jones’ criteria (1992), and clinical examination were used for the diagnosis of RF and RHD. Results: Four cases of RF/RHD were found giving the prevalence of 4.22/1000. This is lower than the prevalence reported in eighties, but is consistent with those found in nineties. Conclusion: Among the school children, there is a declining trend in the prevalence of RF/RHD.
RESUMO
Background : Blood testing for biochemical markers of Myocardial injury plays an increasingly important role for the evaluation, diagnosis and triage of patients with chest pain. The guidelines for the diagnosis of Myocardial Infarction ((MI) have recently changed and prominently incorporate the results of cardiac marker testing in the clinical definition of MI. We investigated these updated biomarkers and further compare the differing biology and release kinetics of clinically relevant biomarkers. Methods: Biochemical changes that occurred in the blood of acute myocardial infarction (AMI) patients were investigated. Two hundred and fifty two patients, 180 males and 72 females were included in this study. The mean age was 49.3 ± 9.25 years. Biochemical parameters include serum triglyceride, total protein, albumin , total bilirubin and total cholesterol to albumin ratio were analyzed. Results : Biochemical parameters showed that the increased level of triglyceride and total bilirubin were associated with myocardial infarction. Triglyceride and total bilirubin levels in myocardial infarction patients were 2.3 ±1.4 mmol/ L and 12.3±3.2 μmol/ L respectively, whereas those of healthy controls were 1.7±1.2 mmol/L for triglycerides and 9.7±3.7 μmol/L for bilirubin. On the other hand, serum total protein and albumin concentrations were lower in MI patients compared to those of controls. Total protein level was 65.5 ±3.1 g/L in MI patients and 76.2±5.3 g/L in healthy controls. Albumin levels in both patients and controls were 40.2 ±3.2 g/L and 45.4 ± 4.5 g/L correspondingly. Conclusion : Interestingly, serum total cholesterol level was not significantly different in MI patients compared to controls. In addition, cholesterol/albumin ratio in myocardial infarction patients (0.14 ± 0.04) found to be significantly higher than in healthy controls (0.11± 0.03).
RESUMO
Background: This experimental (Intervention) study was conducted with objective of evaluating the outcome of non-pharmacological approach (lifestyle intervention) through reducing the modifiable risk factors on high normal blood pressure or pre-hypertension (systolic blood pressure130- 139mm of Hg and diastolic blood pressure 85-89 mm of Hg).The study was provided risk reduction management intervention was given on subjects of high normal blood pressure through adequate physical activity, tobacco cessation, dietary advice for unhealthy to healthy diet, reduction of salt intake, reduction of over weight & stress management etc. Materials and methods: The study was conducted among 434 respondents aged 30 -50 years during the period from June 2008 to May 2009 with intervention for 6 months.Random sampling, those cases were fulfilled the inclusion and exclusion. High-normal BP were found out through BP measurement & clinical examination then sample population were selected by randomization: odds numbers in study group (intervention group) and even numbers in control group (comparision group). After obtaing informed consent data were collected by interview, clinical examination, anthropometric measurement and investigations. It was three phases, first phase were case identification & intervention for study group, second phase was follow up and third phase was outcome measurement for both groups. Cases were hold a record card with contact number. Results: After six month mean difference of blood pressure, lipid profile, weight were changed both the groups but changed was significant in the study group. Mean systolic blood pressure reduced 4.1±6.0 in the study group and 1.2±6.4 in the control group,(p< 0.001). Mean diastolic pressure reduced 3.5±4.9 in study group and 1.2±6.4 in control group (p<0.001). Mean total cholesterol, LDL cholesterol and triglycerides decreased in the study group 19.7±18.6, 10.6±14.6 and 15.4 ±21 respectivley and in control group mean of all these parameters decreased to 11.5±16.5, 5.1±12.9 and 6.7±23.2 respectively. Mean HDL cholesterol for men and women in the study group was raised to 5.6±5.9 and 4.5± 6.4 respectively (p<0.001). Mean weight reduced 1.94±1.59 in study group and 0.06±1.44 in the control group (p<0.001). Conclusion: The final outcome of the study was that mean high normal blood pressure was found to reduced due to intervention of non- pharmacological management. So, If we encourages subjects after 40 years for routine health check up in hospital setting & service for risk factor detection & management (preventive cardiology), we will reduce the risk factors of high normal blood pressure (pre-hypertension) & cardiovascular diseases to some extent. Encourages population to stay with normal blood pressure & healthy life style.
RESUMO
The upper limit of normal values of group A streptococcal antibodies should be known for a population concerned because it is influenced by many local conditions. As yet the reference value of the these antibodies has not been determined by using a quantitative method among Bangladeshi children. We determined the reference value of anti-streptolysin O and anti-deoxyribonuclease B among 361 apparently healthy rural Bangladeshi primary school children (aged 5 to 14 years, mean 9.2 years). Anti-streptolysin O was measured by an auto-analyzer and antideoxyribonuclease B was measured by microtitre method. The geometric mean titres for the entire group was 241 IU/ml and 222 IU/ml for anti-streptolysin O and anti-deoxyribonuclease B respectively. The upper limit of normal values (80th percentile) was 390 and 340 for anti-streptolysin O and anti-deoxyribonuclease B, respectively. These limits should be of value to physicians, epidemiologists and clinical laboratory personnel as well.