No abstract

Objective: Heart failure (HF) has become an increasingly frequent cause of hospital admission and carries a poor prognosis. There is a paucity of data in Indo-Asians particularly in Bangladesh on characteristics of heart failure patients. The purpose of this study was to determine the etiological factors and co-morbidity of hospitalized heart failure patients. Method: A hospital based cross sectional study was done at a tertiary cardiac hospital in Dhaka city. Hospital medical records of 14009 patients admitted between January 2005 and August 2006 were reviewed and 1970 patients with the diagnosis of HF were identified. Relevant etiological information and socio demographic data were abstracted from the hospital record files. Result: About one-seventh of total hospital admitted patient had HF. Mean age (SD) was 54.1 (15.3) years. Majority (35.79%) had ischaemic heart disease (IHD) as the principal etiological factor but this frequently coexisted with a history of hypertension (46.8%). Hypertension was considered the primary risk factor of HF in 29.14% of cases. Hypertension alone and in coexistence with other etiology was found in 48.07% (947) cases. Diabetes Mellitus (DM) co-existed with IHD in 41.4% (292) and it (32.64%) was found more prevalent in Dilated Cardiomyopathy (DCM) patient with HF. Conclusions: The mean age of hospitalized HF patients is remarkably lower than other related studies done abroad. The single most common etiology for HF is ischemic heart disease in this population. Hypertension is the most common risk factor. Measures to prevent ischaemic heart disease and control of risk factors are essential to prevent premature onset of HF. DOI: 10.3329/jbcps.v28i1.4640 J Bangladesh Coll Phys Surg 2010; 28: 24-29

Objective Healthcare personnel (HCP) are undoubtedly one of the major frontline fighters in the coronavirus disease 2019 (COVID-19) pandemic. Therefore, it comes as no surprise that many HCP have become infected by COVID-19 globally. The infection of HCP has received great attention in social media and is frequently reported from different parts of the world. However, there are few scientific reports addressing this aspect of the COVID-19 pandemic. The aim of this study was to evaluate the characteristics of clinical presentation, treatment, and outcome of COVID-19 infection among the HCP of our setting. Methods This cross-sectional study was performed in the National Heart Foundation Hospital & Research Institute of Bangladesh from April 29 to July 20, 2020. HCP employed in this hospital who experienced fever or respiratory symptoms or came in close contact with COVID-19 patients at home or their workplace were included in this study. The presence of COVID-19 disease was confirmed by real-time reverse transcriptase-polymerase chain reaction on nasopharyngeal samples. A total of 394 HCP were sampled and 139 had a positive corona test. Structured interviews were conducted to document symptoms for all HCP with confirmed COVID-19. Data analysis was performed in July 2020. Results Out of 1,409 HCP, 139 subjects tested positive for COVID-19. Among the HCP, infection rate was 9.86%. The mean age of the study population was 34.08±11.11 years (range: 20-69 yrs), of whom 82 (59%) were female. Most of this cohort were nurses (56 [40.3%]) and physicians (25 [18%]), and the remaining 58 (41.7%) were other staff. The mean duration of onset of symptoms to test was 2.89±2.07 days. The most common symptoms were fever (84.2%), fatigue (56.1%), cough (54%), body ache (39.6%), headache, and anosmia (38.8%). Most subjects had mild disease (125 [93%]), three (2.1%) of the HCP had moderate disease and one (0.7%) had severe disease. Ten of the HCP (7.2%) were asymptomatic. Most of them were treated either by ivermectin plus azithromycin or ivermectin plus doxycycline. Only 20 (14.4%) of the HCP were hospitalized, while others were treated either in home isolation (59.7%) or in institutional isolation (25.9%). Recovery was almost uneventful except one healthcare worker who died. Conclusion Most HCP had mild symptoms and a few of them were asymptomatic also. HCP with mild COVID-19 symptoms may be treated in home or institutional isolation. As they are a vulnerable group for infection, providing adequate protection to HCP is absolutely mandatory to safeguard them from this pandemic.

Background Speckle‐tracking imaging is a novel method for assessing left ventricular function and ischemic changes. This study aimed to predict the presence of significant coronary artery stenosis in patients with non‐ST‐segment elevation acute coronary syndrome (NSTE‐ACS) by 3D strain analysis using speckle tracking echocardiography (3DSTE) at rest. Methods This cross‐sectional study included a total 60 patients with NSTE‐ACS who underwent 3DSTE immediately prior to coronary angiography. Subsequently, patients undergone coronary angiogram (CAG) and divided into two groups; group‐ I: significant stenosis (n = 36), group‐II: non‐significant stenosis (n = 24). Results Global peak systolic longitudinal strain (GPSLS), circumferential strain (CS), area strain (AS), and radial strain (RS) were obtained successfully in 60 patients. All strain parameters were significantly reduced in patient group of significant stenosis. Receiver operating characteristic (ROC) curve analysis demonstrated that GPSLS could effectively detect patients with significant stenosis (area under ROC curve = 0.840, 95% CI = 0.735–0.945). GPSLS with a cutoff value of −13.50% showed good sensitivity and specificity for predicting significant stenosis (sensitivity 88.9% and specificity 70.8%). Conclusion Global peak systolic longitudinal strain using 3D speckle tracking echocardiography at rest was significantly lower in patients with significant stenosis and might be useful for identifying patients with a significant stenosis with good degree of sensitivity and specificity.

No abstract