Status of Plasma Vitamin-D Level in Predicting Adverse In-Hospital Outcome in Patients with First Attack of Acute Myocardial Infarction

Acute myocardial infarction has many risk factors and etiologies. Different factors are responsible for adverse in-hospital outcome after acute MI. Status of plasma vitamin D level has been found to be a good predictor of future adverse cardiovascular outcomes in patients with acute MI. Plasma vitamin D level has been considered as a potential marker for identifying individuals under risk of CAD and associated events. This study was done to investigate the role of plasma vitamin D level in predicting in-hospital adverse cardiac events in patients with acute MI. This cross sectional descriptive type of study was conducted in the cardiology department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh from October 2017 to March 2019. Total 257 patients of first attack of acute MI were included considering inclusion and exclusion criteria. Fasting blood samples were analyzed for plasma vitamin D level. Sample population were grouped at first into two, normal and low vitamin D level, taking 30ng/ml as cut-off value, low vitamin D level is further subdivided into insufficiency (21-29ng/ml), deficiency (10-20ng/ml) and severe deficiency (<10ng/ml). Adverse in-hospital cardiac outcomes were observed. In-hospital adverse outcomes occurred in 42.9% patients having normal vitamin D level (>30ng/ml), 66.2% of patients having vitamin D insufficiency (21-29ng/ml), 78.2% of patients having vitamin D deficiency (10-20ng/ml) and 94.4% patients having severe vitamin D deficiency (<10ng/ml), which was statistically significant (p<0.05). Heart failure (30.3%, 47.7%, 63.6% and 77.8%, p<0.05), cardiogenic shock (12.6%, 27.7%, 34.5% and 33.3%, p<0.05), Arrhythmias (14.3%, 21.5%, 23.6% and 22.2%, p>0.05), death (2.5%, 0%, 3.6% and 11.1%, p>0.05) occurred more in low vitamin D groups. Mean vitamin D level was significantly different between Group I and Group II (42.59±10.08 vs. 18.64±6.54, p<0.0001). Multivariate regression analysis showed vitamin D is an independent predictor of in-hospital adverse cardiac events (p=0.001). Age (p=0.001) and obesity (p=0.048) were also other predictors of in-hospital adverse cardiac events. Low plasma vitamin D level is an important predictor for in-hospital adverse cardiac events in patients hospitalized with first attack of acute MI.

Magnetic Resonance Imaging of Cerebral Palsy in the Assessment of Time of Brain Insult

The aim of this cross-sectional study was to find out the role of Magnetic resonance imaging (MRI) in the assessment of time of brain insult in cerebral palsy (CP). The study was conducted in the Department of Radiology & Imaging, Mymensingh Medical College Hospital, Mymensingh and a total number of 35 patients with were enrolled from January 2015 to December 2016. Maximum patients (57.2%) were under five years followed by 34.3% were of 5 to <8 years and 8.7% were of 8 to <12 years of age and mean age was 4.7 years. Majority of the patients were male 28(80%) and female were 7(20%). Among the patients 23(65.7%) came from poor, whereas 11(31.4%) came from middle class and only one (2.9%) from rich socioeconomic group. According to gestational age of the patients, 26(74.3%) were term (≥37weeks) at delivery and rest (25.7%) were preterm (<37 weeks). Delayed cry after birth were present in 32 (80%) patients. Regarding types of cerebral palsy spastic diplegia, spastic quadriplegia, hemiplegia and extrapyramidal were found 3(8.6%), 25(71.4%), 4(11.4%) and 3(8.6%) respectively. Abnormal MRI was reported in 94.2% patients and gave clues to time of insult in 79.9% (excluding the 14.3% miscellaneous findings). The findings were mal-developments (5.7%), periventricular white matter lesions (25.7%), cortical or deep grey matter lesions (48.6%), miscellaneous (14.3%) and normal (5.7%). Brain mal-developments were more seen in term than in preterm born children (5% vs. 0%). Periventricular white matter lesions were seen significantly more in preterm than in term born children (77.8% vs. 3.9%). Cortical or deep grey matter lesions occurred significantly more in term than in preterm born children (60% vs. 20%). Based on the study it can be concluded that Magnetic Resonance Imaging (MRI) can help in the assessment of time of insult to the developing brain in cerebral palsy (CP).

Giant Quantum Hall Plateau in Graphene Coupled to an InSe van der Waals Crystal

We report on a "giant" quantum Hall effect plateau in a graphene-based field-effect transistor where graphene is capped by a layer of the van der Waals crystal InSe. The giant quantum Hall effect plateau arises from the close alignment of the conduction band edge of InSe with the Dirac point of graphene. This feature enables the magnetic-field- and electric-field-effect-induced transfer of charge carriers between InSe and the degenerate Landau level states of the adjacent graphene layer, which is coupled by a van der Waals heterointerface to the InSe.

Ultrasound guided fine needle aspiration cytology: a sensitive diagnostic tool for diagnosis of intra-abdominal lesions

Ultrasound guided fine needle aspiration cytology is widely accepted as a safe diagnostic procedure in various neoplastic and non-plastic disorders. This study was conducted to determine the usefulness and diagnostic accuracy of ultrasound guided fine needle aspiration cytology in the diagnosis of intraabdominal lesions. This cross sectional study was conducted in the Department of Radiology and Imaging, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh during the period of June 2007 to June 2009. A total 78 patients with intra abdominal lesions were included in this study. Fifty nine (75.6%) were males and 19 (24.4%) were females. Out of total aspirates 29 (37.2%) were categorized as benign, 41 (52.6%) were malignant and 8 (10.3%) were non-representative, as it contained only blood. Most of the benign lesions were liver abscess 19 (24.4%). A diagnosis of primary malignancy was established in 26 (33.3%) and that of secondary in 15 (19.2%). The results showed a sensitivity of 89.7%. Ultrasound guided fine needle aspiration cytology is a sensitive diagnostic tool in a wide spectrum of intra-abdominal neoplastic and non-neoplastic disorders. It is a simple, safe, rapidand inexpensive technique.

Assessing Environmental and Health Impact of Drought in the Northwest Bangladesh

Drought, the result of regional climatic variability is one of the dominant threats to environment. This study focuses on the biophysical, environmental and health issues concerning drought occurrence in northwest region of Bangladesh. Using both primary and secondary data, the analysis revealed that, during the drought period, rainfall as the dominant factor of supplying surface water and normalizing the dryness of the nature was almost 46% lower than the previous (normal) years. Similarly, average monthly sunshine hours in the drought year was about 7% higher compared to that of the normal year. On an average, groundwater level declined more than one meter compared to the previous years. Thus, many of the tubewells turned dry or failed to supply the required quantity of water for household and irrigation purposes. A significant number of surface water bodies including ponds, ditches, canals and streams had little volume of low quality water. In normal years, almost all households used hand tubewells (HTWs) as the major source of drinking water, while in the drought period only 90% households could use HTW water since substantial proportion of the HTWs turned dry. People had to collect drinking and domestic water from far distance to meet the basic requirements. Increase in temperature and prevalence of severe dust during drought periods compared to the normal years caused different health hazards including dysentery and diarrhoea due to unsafe drinking water. DOI: http://dx.doi.org/10.3329/jesnr.v4i2.10141 J. Environ. Sci. & Natural Resources, 4(2): 89-97, 2011  

Mucoepidermoid carcinoma of the lung--a case report

Mucoepidermoid carcinoma is an uncommon primary lung tumor. Mucoepidermoid carcinomas have been reported in all age group and equally in both sexes. A case of mucoepidermoid carcinoma histologically confirmed by biopsy is reported here. The patient is a 15 years old male presented with cough and dyspnoea for 5 days. Chest roentgenography showed segmental consolidation of right lower lobe. Chest computed tomography revealed a soft tissue mass with calcification within the lumen of lower trachea in precarinal location. The patient underwent thoracotomy for endotracheal mass and resection was done. Following operation, the patient is symptom free and follow-up CT scan shows normal tracheal outline.

Utilization of health care facilities in Bangladesh

This study was conducted among 310 families at some urban and rural areas of Mymensingh district to know the pattern of utilization of available health care facilities by them. Out of 310 families, 150 were from 4 villages of Muktagacha thana (rural) and 160 were from Mymensingh pouroshava (urban). It was observed that 93.3 percent from rural and 95.6 percent of urban population were utilizing modern health care facilities. Of them 40.6 percent from urban and 33.3 per cent of rural areas were found to prefer private sector facilities. More than three-fourth of the urban children and half of the rural children of the families under study were found immunized. About 70 per cent of the town dwellers were availing MCH care. On the contrary the rate of utilization of MCH services by the village people was only 37.3 per cent.