PurposeTo determine the prevalence of cataract and its association with sun exposure and other environmental risk factors in three different geographically diverse populations of India. DesignPopulation based cross sectional study during ParticipantsPeople aged � 40 years residing in randomly sampled villages were enumerated (12021) and 9735 (81%) underwent ophthalmic evaluation from plains, hilly and coastal regions (3595, 3231, 2909 respectively) MethodsA detailed questionnaire-based interview about outdoor activity in present, past and remote past, usage of sun protective measures, exposure to smoke, and detailed ophthalmic examination including assessment of uncorrected and best corrected visual acuity, measurement of intraocular pressure, slit lamp examination, lens opacities categorization using LOCS III and posterior segment evaluation was done. Lifetime effective sun exposure was calculated using Melbourne formula and expressed as quintiles. These were supplemented with physical environmental measurements. PLOS ONE | https://doi.org/10.1371/journal.pone.Lifetime sun exposure hours, smoking, indoor kitchen smoke exposure and their association with cataract and subtypes. Prevalence of cataract calculated based on lens opacities or evidence of cataract surgery. ResultsCataract was identified in 3231 (33.3%) participants. Prevalence of cataract in males (32.3%) and females (34.1%) was similar. Nuclear cataract was the commonest sub-type identified in 94.7% of affected eyes. Sun exposure had a significant association with cataract with odds ratio (OR) increasing from 1.6 (95% Confidence Intervals [CI]: 1.4, 1.9) in 3 rd quintile, to 2.6 (CI: 2.2, 3.1) in 4 th quintile and 9.4 (CI: 7.9, 11.2) in 5 th quintile (p<0.0001). Cataract also showed a significant association with smoking (OR: 1.4, CI: 1.2, 1.6) and indoor kitchen smoke exposure (OR: 1.2, CI: 1.0-1.4). Nuclear cataract showed a positive association with increasing sun exposure in 3 rd (β coefficient 0.5, CI:0.2-0.7), 4 th (β: 0.9, CI: 0.7-1.1) and 5 th (β: 2.1, CI:1.8-2.4) quintiles of sun exposure, smoking (β: 0.4, CI: 0.2-0.6) and indoor kitchen smoke exposure (β: 0.3, CI: 01-0.5) while cortical cataract showed a positive association with sun exposure only in 5 th quintile (β: 2.6, CI:1.0-4.2). Posterior subcapsular cataract was not associated with any of the risk factors. ConclusionCataract is associated with increasing level of sun exposure, smoking and exposure to indoor kitchen smoke.Prevalence of cataract and its association with sun exposure in India PLOS ONE | https://doi.

DOI: http://dx.doi.org/10.3329/bjch.v35i3.10522 Bangladesh J Child Health 2011; Vol 35 (3): 108-117

The Normal Pulmonary Artery (PA) systolic pressure of children and adults is < 30 mm Hg and the mean PA pressure is < 25 mm Hg at sea level. Pulmonary hypertension (PH) is defined as a mean pulmonary artery pressure > 25 mm Hg at rest or > 30 mm Hg during exercise. An increase in pulmonary flow, vascular resistance, or both can result in pulmonary hypertension. Pulmonary Arterial Hypertension (PAH) commonly arises in patients with Congenital Heart Diseases (CHD) are usually associated with increased pulmonary blood flow. Greater number of patients with Pulmonary Arterial Hypertension (PAH), associated with congenital heart disease, are now surviving into adulthood, many with increasingly complex cardiac defects. Patients with cardiac defects which result in left-to-right shunting tend to develop PAH, owing to the increased shear stress and circumferential stretch induced by pulmonary blood flow, which leads to endothelial dysfunction and progressive vascular remodeling followed by vascular resistance. Pulmonary hypertension in association with congenital heart diseases is seen in large systemicto-pulmonary communications such as Ventricular Septal Defect (VSD), Patent Ductus Arteriosus (PDA) atrioventricular septal defects, aorticopulmonary window defect etc. Pulmonary hypertension associated with large L-R shunt lesions (e.g. VSD, PDA) is called Hyperkinetic Pulmonary Hypertension (PH). It is the result of an increase in pulmonary blood flow, a direct transmission of the systemic pressure to the pulmonary artery, and compensatory pulmonary vasoconstriction. Hyperkinetic PH is usually reversible if the cause is eliminated before permanent changes occur in the pulmonary arterioles. If large L-R shunt lesions are left untreated, irreversible changes take place in the pulmonary vascular bed, with severe pulmonary hypertension and cyanosis due to a reversal of the L-R shunt. This stage is called Eisenmenger syndrome or Pulmonary Vascular Obstructive Disease (PVOD). Surgical correction is not possible at this stage. Due to lack of formal study which of the L-R congenital shunt is more commonly associated with the development of pulmonary hypertension is not known the cross-sectional study therefore intends to find the pattern of congenital L-R heart diseases commonly attributed to the development pulmonary hypertension. The diagnosis of the abovementioned congenital heart disease will be made by echocardiography. In this study, most of the participant [22 (44.0%)] were in the '< 1 years' age group, female were proportionately higher, most patients presented with cough and difficulty in breathing, dyspnoea and tachycardia were the most common clinical findings, murmur mostly systolic were found, Eisenmenger syndrome was not found in any child, ASD was the most common congenital anomaly. About four-fifth of the participants had single congenital anomaly. Two-fifth of the participant was found having severe PAH. Significant correlation were revealed between age group and Pulmonary arterial pressure (R= 0.775), S...

Congenital heart disease(CHD) is the most common congenital problem in children. Presentation can vary from asymptomatic , accidental finding to severe cardiac decompensation and death. Early recognition has great implication on prognosis. Our aim was to study age wise distribution and clinical spectrum of Congenital heart disease (CHD) in Bangabandhu Sheikh Mujib Medical University, (BSMMU), Shahbag, Dhaka. A retrospective analysis of 272 patients over a five year period was done. Clinical examination, echocardiography and Colour Doppler was used as diagnostic tools. Ventricular septal defect (VSD) was the common lesion (33.45 %) followed by Atrial septal defect (ASD) in 13.6 % & Patent ductus arteriosus(PDA) in 10.6 %. Tetralogy of Fallot (TOF)was the common cyanotic heart disease (15.8 %). Maximum number of children with heart disease 64% was diagnosed between 0-5 yrs of age. This is a retrospective descriptive study on all patients with the suspected & confirmed diagnosis of congenital heart disease referred for echocardiography over a period of 5 years from October, 2006 to December, 2011. Patients from day one of life till 18 years were included. Study was conducted in the pediatric cardiology dept. of BSMMU, Dhaka. Clinical examination, 2D echocardiography & colour Doppler were considered as definitive tools for diagnosis of congenital heart disease. We received patients from lower to upper middle class strata. We retrospectively analyzed the records of all paediatric first visit OPD (outpatient department) & IPD (Inpatient department) patients between 0-18 years, during the same period. Children diagnosed with CHD were analyzed further. Preterms with PDA were followed up and not included in this study if it is closed spontaneously within the period of hospital stay or by managing conservatively DOI: http://dx.doi.org/10.3329/uhj.v8i2.16064 University Heart Journal Vol. 8, No. 2, July 2012

Background: Ischemic heart disease remains the leading cause of death in both developed and under developed countries. The use of antiplatelet drugs specifically the thienopyridine has become a standard for the treatment of acute coronary syndrome. These drugs irreversibly inhibit the platelet aggregation by blocking the P2Y12 receptor. But currently this therapeutic choice has become limited due to potential interaction with other drugs, slow hepatic conversion, genetic resistance and narrow therapeutic safety margin. Ticagrerol, a reversible P2Y12 receptor inhibitor may represent a significant advancement over currently available oral antiplatelet drugs.Objectives: The study was intended to compare the effect of Ticagrelor and Clopidogrel on oxidative stress markers in patients of chronic stable angina (CSA) following percutaneous coronary intervention (PCI).Materials & Methods: The present prospective observational study was carried out in the Department of Pharmacology, Cardiology and Microbiology, BSMMU, Dhaka from September 2014 to February 2016. The study included a total of 100 CSA patients. Patients were divided into two groups, Ticagrelor and Clopidogrel treated groups (each having 50 patients). The baseline laboratory parameters-Malondihyde (MDA), Reduced glutathione (GSH), bleeding time, clotting time and platelet count, were measured and then patients of both groups underwent PCI. The same parameters were again assessed at follow up after 4 weeks of intervention. Total 12 patients from Ticagrelor and 14 patients from Clopidogrel groups were dropped out. Comparisons of the laboratory parameters were made between two groups at baseline and at follow up and also within group before and after intervention.Result: In the present study at baseline characteristics of patients treated with ticagrelor and clopidogrel were almost identical in terms of age, sex, diabetes and hypertension. The level of plasma MDA in ticagrelor group was significantly reduced from baseline to follow up(4.5 ± 1.8 to 1.4 ± 0.7, p <0.001) and in clopidogrel group (4.2 ± 1.2 to 1.3 ± 0.7, p <0.001). GSH level was increased from 0.7 mg/dl to 2.5 mg/dl (p <0.001) in ticagrerol group and in clopidogrel group 0.6 mg/dl to 1.4 mg/dl, p <0.001).Conclusion: The study concluded that both ticagrelor and clopidogrel are similar effect on oxidative stress markers, resulting from oxidative injury processes in patients of chronic stable angina.University Heart Journal Vol. 12, No. 1, January 2016; 26-30