Dysfunction of Thyroid Hormones Following Acute Coronary Syndrome in a Tertiary Care Hospital in Dhaka City

In cardiovascular homeostasis thyroid hormone plays an important role. We planned to study the changes in thyroid hormone profile in acute coronary syndrome patients admitted in the coronary care unit and compare them between two groups: unstable angina/non-ST elevated Myocardial infarction (UA/NSTEMI) and ST elevated Myocardial infarction (STEMI). This study was a hospital based descriptive cross sectional study which was conducted from 01 March 2018 to 01 February 2019 in Coronary Care Unit of Bangladesh Medical College Hospital and laboratory tests were done in Microbiology Department of Bangladesh Medical College, Dhaka, Bangladesh. Eighty three cases of acute coronary syndromes were taken for the study. Troponin-I was measured as cardiac marker, Electrocardiogram, Complete blood count, blood glucose level, Blood urea, serum creatinine, serum electrolytes, Fasting lipid profile, Thyroid profile, Echocardiography 2D were done. Most of the respondents were distributed in age group 46-60 years where 34(64.15%) male and 19(35.85%) female. Out of 83 Acute Coronary Syndrome (ACS) patients, 27(32.53%) hypertensive, 22(26.50%) diabetic and 16(19.27%) were Chronic kidney disease (CKD). Abnormal lipid profile was present in 30(43.47%) patients. Among total 52 male and 31 female 9(17.30%) male and 6(19.35%) female had abnormal thyroid function. We further elaborated abnormal thyroid function tests in STEMI group and UA/Non STEMI group of ACS patients. We found 10 patients in STEMI group and 5 patients in UA/Non STEMI group with abnormal thyroid function 29.41% and 10.20% respectively which was not statistically significant (p=0.025). This study depicts abnormality in thyroid hormone profile in 18.07% patients of ACS. Abnormal thyroid function increases risk of coronary artery disease. TSH level of ACS patients on hospital admission could be helpful to evaluate further prognosis of the disease.

Simple Treadmill Score: Does It Have Better Predictability for Coronary Artery Disease?

Coronary artery disease is one of the most prevalent causes of increasing mortalitiy in current time. Early detection of such dreadful condition by a non-invasive test like exercise treadmill test, is a much-required option to prevent future complications like myocardial infarction. The aim of this study was to find out how different the predictability of simple treadmill score in comparison to other treadmill scores namely the well-known Duke treadmill score and Cleveland clinic score. In a cross-sectional analytical study of total 130 individuals with stable angina were included according to criteria set before the study. The treadmill scores of these patients were calculated and compared to coronary angiogram findings where coronary artery angiograms were done according to clinical need. Simple treadmill test had similar predictability for coronary artery disease when we compared it with much-applied Duke Treadmill Test and Cleveland Clinic Score- which is currently used for mortality prediction. Receiver Operator Characteristics (ROC) Curve showd all scores had around 0.7 area under the curve (AUC) which is highly statistically significant (p<0.0001) though simple treadmill score in females has higher sensitivity (92.3%). Simple treadmill score can be considered to exclude female patients from undergoing invasive investigation as it has higher sensitivity than other currently practiced treadmill scores i.e., Duke treadmill score.

Predictive Value of Waist Height Ratio, Waist Hip Ratio and Body Mass Index in Assessing Angiographic Severity of Coronary Artery Disease in Myocardial Infarction Patients

Coronary artery disease (CAD) is the leading cause of mortality and morbidity both in developed and developing countries. The body mass index (BMI), waist hip ratio (WHR) and waist height ratio (WHtR) are some of the clinical tools enabling clinicians to assess obesity. Although for decades there have been controversy regarding the relationship between obesity and CAD; it has been assumed that high BMI is a risk factor for CAD. However, the findings of some recent studies were paradoxical. The aim of this study was to identify the best tool among BMI, WHtR and WHR to evaluate angiographically severe CAD in myocardial infarction patients. This was a cross-sectional analytical study carried out in the Department of Cardiology, Chattogram Medical College and Hospital (CMCH), Chattogram, Bangladesh from January 2017 to December 2017. Three hundred and thirty two consecutive MI patients undergoing CAG during the study period were included in the study as per inclusion and exclusion criteria. Severity of CAD was calculated by using Gensini score. Patients were categorized and compared according to anthropometric indices and CAD severity. The mean±SD of the age of study population was 53.62±10.36 years (range 25-92) and 276(83.1%) were male. Regarding cardiovascular risk factors, 113(34%) patients had diabetes mellitus, 108(32.5%) had dyslipidaemia, 137(41.3%) had hypertension, 205(61.7%) were current or ex-smokers and 59(17.8%) had a family history of CAD. The mean±SD of the patients' BMI was 24.05±3.24kg/m² (range 16.14-32.72), mean±SD of their WHR was 0.964±0.052 (range 0.823-1.125) and mean±SD of their WHtR was 0.546±0.059 (range 0.389-0.748). The mean±SD of the severity of CAD according to the Gensini score was 41.11±28.66 (ranged from 2 to 244). Study findings showed a positive correlation between the severity of CAD with WHtR and WHR but not with BMI, according to Gensini scores (p=0.004, p=0.023 and p=0.43 respectively). Receiver Operating Characteristics (ROC) curve analysis revealed that waist height ratio had the highest area under the curve (AUC) among the three anthropometric parameters for predicting presence of severe CAD. Study showed the superiority of WHtR over WHR and BMI for predicting angiographic severity of CAD in patients with MI. WHtR should therefore be considered as a screening tool.

Cutting down the radiation dose on CT urography: how it is done and what results are received?

Computed tomography urography (CTU) is a very detailed and powerful method of investigating the urinary tract, but an individual approach to each patient is recommended considering also the radiation dose. This article aims to present the initial experience from the diagnosis of urinary tract diseases and congenital variants in the anatomy of the urinary system using low-kV protocols. The image quality and patient dose in CTU were compared when replacing the standard 120-kV protocol with two different low-kV protocols. Totally, 91 patients (41 women and 55 men) with mean age 56.4 were studied with three different low-dose protocols. The patients underwent an unenhanced and excretory low-dose phases and standard corticomedullary and nephrographic phases. Effective dose was reduced by more than 65 % using the 100-kV protocol and by more than 76 % with introduction of 80-kV protocol. At the same time, patient images obtained with the new low-kV protocols maintained their diagnostic quality.

Phytochemical and Pharmacological Investigation of Ethanol Extract of Cissampelos pareira

In this study, the ethanol extract of Cissampelos pareira has been evaluated. The extract was tested for analgesic properties using both hot plate and acetic acid-induced writhing methods. Antiinflammatory effect was investigated using two different doses of 250 and 500 mg/kg body weight on Evans rats by carrageenan-induced paw edema test. The antipyretic activity was evaluated using Brewer's yeast-induced pyrexia in Wistar rats. The phytochemical screening of the extract of Cissampelos pareira exhibited the presence of several phytochemical compounds including saponins, gums and carbohydrates, reducing sugars, alkaloids and terpenoids. Ethanol extract of Cissampelos pareira exhibited significant analgesic, antiinflammatory and antipyretic activity in a dose-dependent manner. The results obtained from these studies confirm its therapeutic value against diseases caused by various pain and fever.

Temperature and saline stress on seedlings of Swietenia macrophylla: a comparative study

Physical responses of plants to change in climatic factors like temperature, precipitation and abiotic factors like salinity intrusion may lead positive or negative effects. Some factor may promulgate growth while other may stunts their vigour. Present study seeks growth of a plantation species at its early stage of life towards elevated temperature and saline water stresses. Growth records of Swietenia macrophylla seedlings were enumerated by measuring height, collar diameter and leaf number development of the replicates growing at an environment-controlled plant growth chamber. One experimented with merely elevated temperature while other tries to find results of combined effect of elevated temperature (30, 32 and 34 degrees C) and saline (0.5, 1.5 and 2.5 g L(-1) NaCl) to said species seedlings. Seedling replicates showed diverse response to elevated temperature and saline irrigation at height, collar diameter and leaf number development. Results depict that elevated temperature alone might be positive for S. macrophylla seedlings, rather most favourable for its growth in height, however, collar diameter and leaf number may remain unaffected. Saline treatment along with higher temperature stresses may lead seedlings toward stunted or very low growth. As saline intensity increases, species growth tends to decrease proportionally. Elevated temperature aided with higher salinity may direct further under development of S. macrophylla seedlings which is distressing to plantation establishment of this species in sites which are vulnerable to salinity intrusion due to climate change. However, S. macrophylla may be a promising plantation species in drier part of the globe in near future.