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Background: A high body mass index (BMI) is seems to be associated with an increased incidence of coronary artery disease. If the affected person is young, the consequences are more tragic. There are variable information on the relation of incidence and severity of coronary artery disease in high BMI populations. We have examined the association between BMI and severity of coronary artery disease in young onset Acute Coronary Syndrome (ACS).  Methods: In this prospective observational study a total number of 150 patients, aged ≤45 years presented with acute coronary syndrome were enrolled to analyze association between Body Mass Index (BMI) and severity of coronary artery disease.  Results: The mean BMI in male was 24.6±3.6 and the mean BMI in female was 25.4±3.3. Among the 150 patients, 2(1.3%) was underweight, 78(52%) was normal, 60(40%) was overweight & 10(6.7%) was obese. All underweighted patients were diagnosed as STEMI. Among the normal BMI patients, 18(23.1%) had UA, 12(15.4%) had NSTEMI & 48 (61.5%) had STEMI. Among the overweight patients, 23(38.3%) had UA, 9(15%) had NSTEMI & 28(46.7%) had STEMI. And among the obese patients, 4(40%) had UA, 1 (10%) had NSTEMI & 5(50%) had STEMI. Considering involving coronary artery, left main coronary artery involvement was 0(0%), 6 (7.7%), 5 (8.3%) & 0(0%) in underweight, normal, overweight & obese patients respectively. Left anterior descending coronary artery involvement was 2(100%), 54 (69%), 45 (75%) & 7 (70%) in underweight, normal, overweight & obese patients respectively.  Left circumflex coronary artery involvement was 1(50%), 33 (42%), 25 (41.7%) & 1 (9%) in underweight, normal, overweight & obese patients respectively.  And right coronary artery involvement was 1(50%), 35 (44.9%), 31 (51.7%) & 5 (50%) in underweight, normal, overweight & obese patients respectively. In underweight patients 1(50%) had SVD and 1 (50%) had TVD. In normal BMI patients 40 (51.3%) had SVD, 11(14.1%) had DVD and 19 (24.4%) had TVD. In overweight patients 27 (45%) had SVD, 15 (25%) had DVD and 13 (21.7%) had TVD. And in obese patients 5 (50%) had SVD, 3(30%) had DVD and 0 (0%) had TVD. In all BMI group SVD was more common. Conclusion: There is no statistically significant differences in severity of coronary artery in respect to body mass index (BMI), in patients presented with acute coronary syndrome.

Introduction: Tuberculosis remains an infectious disease with a high prevalence worldwide and represents a major public health issue, especially in our subcontinent. Although venous thromboembolism is a rare complication of this disease, it may be a potentially life threatening event.Case presentation: We report a case of a 43 years male who was diagnosed as a case of pulmonary tuberculosis with tubercular pericardial effusion, developed deep venous thrombosis later in the course of the diseaseConclusion: An association between inflammation induced by tuberculosis and a hypercoagulable state has been described. Therefore, the occurrence of deep venous thrombosis or pulmonary embolic episodes should be considered in patients with tuberculosis particularly during the first weeks of treatment. The physician's awareness of these phenomena is important to an early diagnostic suspicion and prompt treatment in order to prevent fatal outcomes.KYAMC Journal Vol. 6, No.-1, Jul 2015, Page 598-600

Despite promising win-win outcomes of the Reducing Emissions from Deforestation and Forest Degradation (REDD+) program, how and to what extent it can bring real opportunities to forest communities remains debatable. Focusing on inequality and land tenure insecurity in Bangladesh, this study aims to find out whether and to what extent REDD+ can ensure equitable benefits and opportunities for the forest communities in an ethnic conflict area. Based on qualitative case studies on two types of community forest management (CFM) experiences in Bangladesh, the study finds that the distribution of various costs, benefits, and access to forest participation remain highly unequal among different groups within the communities. The existing institutional settings were not able to bring adequate opportunities for the marginal forest people to face the dominant power relation and bring equitable share for them. This study argues that without ensuring the decision-making space for marginalized groups, and without substantial changes towards the tenure complexity, the emerging REDD+ initiatives in Bangladesh can strengthen the dominant power and subsequently intensify the vulnerability of the marginalized people. A careful analysis of how weak institutions are helping to perpetuate inequality can thus help us to understand future risks of CFM–REDD+ relations.

Background: There are variety of established causes of bradycardia (Heart rate <60 bpm), including cardiac & non cardiac diseases, medications & age related degeneration. In few cases we found bradycardia without obvious causes. The patient's, specially in young individuals (age<40 yrs) who have allergic symptoms with bradycardia but without any obvious cause, hyperimmunoglobulin E can be a possible cause. ThisMethods: prospective, cross sectional study included 64 patients aged under 40 years whole have allergic symptoms & ECG showed bradycardia, and in whom no obvious cause of bradycardia was found. In all these cases we have checked S. Immunoglobulin level E & other necessary investigations. Results: Total 64 patients was enrolled with one year of period, among them 42(65.6%) was male & 22(34.4%) was female. Majority of the pt, n- 40(62.5%) was in age group 11-20 years. Total 58 patients S. Immunoglobulin level was found raised, other 6 patients was found within normal range, which is statistically signicant (p<0.05). Follow up ECG & S. Immunoglobulin E was done after 4-6 weeks of symptomatic treatment & found heart rate become normalized with normalized/decreased level of S. Immunoglobulin E. No patients developed any complications during the study period. Raised S. Immunoglobulin E can be a possible cause of bradycardia in young individuals, especially whole haveConclusion: allergic symptoms with no obvious cause of bradycardia.