Clopidogrel is an analogue of ticlopidine, used for reduction of atherosclerotic events in patients with acute coronary syndrome (ACS), stroke, peripheral arterial disease and for elective percutaneous coronary intervention (PCI). It selectively and irreversibly blocks ADP binding to platelets. Its primary side effect is bleeding. However potentially fatal types of haematological dyscrasia such as aplastic anaemia, neutropenia, thrombocytopenia, pancytopenia may be associated with clopidogrel therapy. A 50 years old diabetic, hypertensive lady with angina was started to treat with clopidogrel along with other anti-ischaemic and anti-hypertensive drugs. Subsequently the patient developed leucopenia and thrombocytopenia after starting of clopidogrel. Five days later her complete blood count returned to normal after withdrawal of both anti platelets. Aspirin was re-introduced with great precaution. Later repeat leucocyte and platelet count were found to be normal. At follow-up 1 month after discharge patient found asymptomatic with normal blood count. To the best of our knowledge, clopidogrel induced haematological dyscrasia was not reported earlier in our country.

Background: Acute Heart Failure in ST-Elevation Myocardial Infarction can occur in different age and gender. Objective: The purpose of the present study was to see the demographic characteristics of patients presented with acute heart failure in ST-elevation myocardial infarction. Methodology: This case-control study was conducted in the Department of Cardiology at National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from February 2007 to July 2007. The patients admitted in the NICVD with ST-elevation acute myocardial infraction (STEMI) during study period were selected as study population. Patients presented with acute heart failure and patients developed acute heart failure within 24 hours of hospital admission were designed as case group. Patients with no feature of heart failure within 24 hours of hospital admission were designed as control group. Results: A total 186 patients with acute ST-elevation myocardial infarction were screened. Among them 60 patients were finally selected for this study. Of whom 30 were cases (patients with acute heart failure) and 30 were control (patients without heart failure). Patients needed severe cardiac massage and/or underwent DC shock at admission or before collection of blood sample for BNP testing were also excluded. About 70.0% of the cases and 60.0% of the controls were aged more than 50 years. About 80.0% cases of the subjects, both cases and control, were male and rests 20.0% cases were females. Male and female ratio was 4:1. Conclusion: In conclusion most of the patients are in the elder age group and male gender. Journal of National Institute of Neurosciences Bangladesh, July 2022;8(2):126-129

Background: Many stroke patients develop swallowing difficulty and require nasogastric feeding for the maintenance of nutrition. Objectives: The purpose of the present study was to evaluate the complications of nasogastric tube feeding practice on stroke patients. Methodology: This cross-sectional study was conducted from April 2014 to September 2014 in the Department of Medicine at Dhaka Medical College Hospital, Dhaka, Bangladesh. Adult patients aged between 18 to 70 years with stroke was enrolled in the study. The diagnosis of stroke was established by the clinical presentation and neuroimaging. Patients requiring nasogastric tube feeding was included in the study and were systematically examined for any complications related to use of nasogastric tube. Their caregivers were also thoroughly interviewed using a standard pre formed questionnaire regarding any complications as well. Results: Of the 100 patients studied, most common age group for stroke was 51 to 60 years (53.0%). Male to female ratio was 2.22:1. In this study population, 63.0% patients had ischaemic stroke; 26.0% had haemorrhagic stroke; 9.0% population had subarachnoid haemorrhage. The most common indication for NG feeding was difficulty in swallowing (39.0%). Other common indications were semi-consciousness (26%), unconsciousness (22.0%), inability to maintain feed (10.0%). Around 71.0% of the patients had complications from NG tube feeding. Out of them, 53.0% of the patients had nasal irritation, 40.0% patients developed aspiration pneumonia. 38.0% of the patients developed diarrhea, 53.0% had tube blockage. 43.0% of the patients had electrolyte imbalance and tube displacement, 18.0% of the patients were malnourished. Conclusion: In conclusion nasogastric tube feeding is associated with various complications which can increase the morbidities in stroke patients. Journal of National Institute of Neurosciences Bangladesh, July 2022;8(2):136-142