Background: Among all percutaneous coronary interventions (PCIs), 30 to 40% involve small coronary arteries. Small vessel PCI has historically been associated with poor outcome in terms of coronary artery dissection, acute vessel closure, myocardial infarction, emergent coronary bypass grafting, and restenosis, but the scenario has been changing in recent years. The outcome of small vessel coronary intervention in Bangladeshi population is largely unknown.Objectives: The study was carried out to assess and compare the immediate outcome of PCI in small vessels with that in large vessels.Methods: This prospective, comparative study involved 100 patients undergoing PCI with stent implantation; group I constituted 50 patients having target vessel diameter of <3.0 mm, whereas group II constituted 50 patients having target vessel diameter of >3.0 mm. Immediate outcome of PCI was compared between the two groups. Angiographic, procedural and clinical successes were assessed. Acute complications e.g. major adverse cardiac events (MACE), arrhythmia, hemorrhage, pericardial tamponade, coronary dissection, no flow, vessel rupture and shock were observed.Results: No statistically significant differences in baseline clinical characteristics existed between the two groups. Favourable outcomes were observed in both groups. Angiographic success was 100% in group I, as well as, in group II; procedural and clinical success was 94% vs. 98%, and 90% vs. 94% in small and large vessel groups respectively (p> 0.05). Complications were infrequent in both groups. Also, no statistically significant difference was found in duration of hospital stay post-procedure between group I and group II.Conclusion: Small vessel coronary stenting may be safe and effective. However, these findings require further study involving larger population and long term follow up.Bangladesh Heart Journal 2015; 30(1) : 22-26

ound: ound: Though hyponatraemia is a common scenario in our daily clinical practice, the mortality and morbidity are very high without early detection and prompt treatment. Both under and over treatment of hyponatraemia may cause permanent brain damage. Proper and meticulous treatment may prevent development of permanent brain disorder. So, a study was carried out to see the prevalence of hyponatraemia in acute confusional states and coma. The effect of hyponatraemia on consciousness level was also observed. (60) cases with acute confusional state and coma were recruited in our study. Among 60 patients with acute confusional states including coma, 85% (51) patients were presented with hyponatraemia. In the study, mild, moderate and severe hyponatraemia were 20%, 13.33% and 51.67% respectively. Of the total study population, 31.67%, 33.33% and 35% presented with coma, stupor and drowsiness respectively. Severe hyponatraemia was found in 68.42% in comatose, 50% in stuporous and 38.1% in drowsy patients. 47.06% of hyponatraemic patients were noticed in several intracranial disorders. Hepatic encephalopathy, gastrointestinal disorders, chronic renal failure and ischemic heart disease comprised 13.73%, 11.76%, 9.80% and 5.89% respectively. Diabetic ketoacidosis and hypoglycaemic shock comprised 3. 92% each and congestive heart failure and acute respiratory distress syndrome comprised 1.96% each of hyponatraemic patients. Conclusions:Conclusions: Conclusions: Conclusions: Conclusions: Hyponatraemia is a common clinical problem in our day to day clinical practice. If neglected this may result in permanent brain malfunction which may be prevented with earlier detection and correction under meticulous supervision. K K K K Ke e e e eyw yw yw yw ywor or or

Aims: The prevalence of Rheumatic Heart Disease (RHD) is estimated to be higher in developing countries like Bangladesh than in developed countries, ranging from 24/1,000 to 0.3/1,000 respectively. There is no authentic national data since 2005 on prevalence of RHD in our country. Aim of this study is to find out present status of RHD among children in Bangladesh so that government can take further action to strengthen RHD prevention activity. Methods: A cross-sectional survey of children aged 5–15 years from 20 schools of urban non slum, urban slum and rural area was carried out by a team of cardiologists. Children were screened by clinical examination and diagnosis confirmed by echocardiography. Children who were not willing to enroll in the study and absent students at the day of data collection were excluded from the study. Ethical permission was taken from the institutional review board. Results: Total 5024 school children aged 5 to 15 years were screened for rheumatic heart disease. Male female ratio was 1.01. Prevalence of RF and RHD were 1.6/1000 and 0.8/1000 respectively. Prevalence of RHD was significantly higher among urban slum children (3.78/1000) than rural (0.33/1000) and urban non slum children (0.66/1000). Conclusion: The encouraging observation in our study is a decreasing trend of Rheumatic Fever and Rheumatic Heart Disease in Bangladesh