A Case of Single Atrium, Mitral Valve Prolapse Spontaneously - Closed Inlet VSD with Polydactyly

Single Atrium is a complex cardiac anomaly and generally a component of certain congenital syndromes. It is extremely rare for SA to be observed as an isolated defect. We report here a 14 year-old male patient with SA with MVP with spontaneously-closed inlet-VSD with polydactyly. He was examined first at "L. Harun Health Complex" 77 Sehora, Mymensingh, Bangladesh on 11th September 2016 and then at National Heart Foundation Hospital, Mirpur, Dhaka, Bangladesh on 17th October 2016.

Long-term survival in an un-operated single ventricle

Single ventricle is a rare and complex congenital heart disease. Neonates with single ventricle have a high mortality. Survival into adulthood is rare without surgical intervention. A case of single ventricle with double inlet and double outlet combined with severe valvular pulmonary stenosis and mitral regurgitation (Grade II) is being reported here. A 36 years old man was admitted for bluish discoloration of lips, tongue and fingers; shortness of breath and recurrent palpitation. His ECG showed atrial fibrillation with fast ventricular rate. Chest X-Ray depicted an enlarged cardiac shadow and right sided pleural effusion. Final diagnosis was made by echocardiogram which demonstrated single ventricle with double inlet and double outlet, severe valvular pulmonary stenosis and mitral regurgitation (Grade II) with good ventricular systolic function.

Disseminated tuberculosis presenting as acute coronary syndrome

Tuberculosis is a major public health problem in Bangladesh. Though tuberculosis is common but acute myopericarditis can rarely be caused by tuberculosis infection. A case of disseminated tuberculosis presenting with features of acute coronary syndrome is presenting here. A 26 years old man was admitted for severe central chest pain for 2 days and fever for 2 months. His ECG showed ST segment elevation in chest leads, V1 to V4 with elevated Troponin I and high ESR. Chest X-Ray depicted an enlarged cardiac shadow. Echocardiography demonstrated multiple dynamic cavitary lesions involving interventricular septum as well as anterior wall of the left ventricle within myocardium with moderate pericardial effusion with trivial mitral regurgitation. A CT scan of chest with contrast revealed multiple calcific communicating cavities within endocardium and myocardium involving interventricular septum and anterior wall of the left ventricle of heart and multiple cavitary lesions in the mid zone of left lung with bilateral mild pleural effusion. The patient made an excellent recovery on management of acute coronary syndrome and on antitubercular therapy.

Evaluation of processes controlling the geochemical constituents in deep groundwater in Bangladesh: spatial variability on arsenic and boron enrichment

Forty-six deep groundwater samples from highly arsenic affected areas in Bangladesh were analyzed in order to evaluate the processes controlling geochemical constituents in the deep aquifer system. Spatial trends of solutes, geochemical modeling and principal component analysis indicate that carbonate dissolution, silicate weathering and ion exchange control the major-ion chemistry. The groundwater is dominantly of Na-Cl type brackish water. Approximately 17% of the examined groundwaters exhibit As concentrations higher than the maximum acceptable limit of 10 microg/L for drinking water. Strong correlation (R(2)=0.67) of Fe with dissolved organic carbon (DOC) and positive saturation index of siderite suggests that the reductive dissolution of Fe-oxyhydroxide in presence of organic matter is considered to be the dominant process to release high content of Fe (median 0.31 mg/L) in the deep aquifer. In contrast, As is not correlated with Fe and DOC. Boron concentration in the 26% samples exceeds the standard limit of 500 microg/L, for water intended for human consumption. Negative relationships of B/Cl ratio with Cl and boron with Na/Ca ratio demonstrate the boron in deep groundwater is accompanied by brackish water and cation exchange within the clayey sediments.

Hydrogeochemistry and arsenic contamination of groundwater in the Ganges Delta Plain, Bangladesh

Geochemical composition and the level of Arsenic (As) contamination of groundwater in the Ganges Delta Plain, southwestern Bangladesh were elucidated. Hydrogeochemical data of tube well samples suggested that the groundwater is mostly Ca-Mg-HCO(3) type with bicarbonate (HCO(3)(-)) as the dominant anion, though other type waters are also observed. In contrast, the elevated EC, Cl(-) and high content of Na(+) relative to Ca(2+), Mg(2+) and K(+) in six groundwater samples suggest their saline origin. Low concentrations of NO(3)(-) and SO(4)(2-), and high concentrations of dissolved organic carbon (DOC), HCO(3)(-) and PO(4)(3-) indicate the reducing conditions of subsurface aquifer where sediments are deposited with abundant organic matter. The total As concentration in the analyzed samples is very high (0.0431-1.352 mg/L) along with high Fe (2.791-17.058 mg/L) and relatively low Mn (0.134-1.972 mg/L) at different depths. Distinct relationship of As with Fe and Mn, and strong correlation with DOC suggests that the biodegradation of organic matter and reductive dissolution of Fe-oxyhydroxide is considered to be the dominant processes to release As in aquifers. Moreover, negative correlation between As and SO(4)(2-) demonstrates the As may not be directly mobilized from sulfide minerals like arsenopyrite.