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Original Research Article Introduction: Myopia is an important cause of visual disability throughout the world, and in its higher forms, it is also an important cause of blindness. Myopia is one of the most common causes of visual disability of the eye and important cause of defective vision affecting the younger age groups. Objective: In our study, efforts are made to find out incidence, prevalence, various symptoms and signs of high and pathological myopia in different age groups and their visual acuity. Methods: This is a prospective study of the Demographic pattern, Posterior segment changes and its effect on visual acuity in patients with High and Pathological Myopia in 100 cases attending in Ophthalmology Department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh for a period from June 2015 to May 2017. The patients with refractive error of ≥-6D and with normal corneal curvature are included in the study. Patients with refractive error of <-6D, with index myopia, with abnormal corneal curvature (Curvature Myopia) are excluded from the study. Results: Out of these 100 cases, 196 eyes were diagnosed to have high myopia (>-6.00 Dsph) and pathological Myopia (>-15 D sph) after thorough clinical examination & investigations. Conclusion: High myopic and pathological myopic patients tend to suffer from compromised quality of life owing to various influences from functional, psychological, cosmetic, and financialfactors. So these patients should be given special care, and all modalities of treatment were instituted to improve the quality of life and vision.

Original Research Article Background: Bile duct injury is severe and potentially life threatening complication of cholecystectomy. It ruins the patient physically, mentally, socially and financially. The incidence of bile duct injury is alarming in our country. Management of such patients needs to be explained. Aims: To identify the types of bile duct injury and their subsequent management plan in our perspective. Methods: The study was carried out at Department of Hepatobiliary and Pancreatic surgery, BSMMU, BIRDEM, DMCH & other specialized hospital in Dhaka, Bangladesh. Patient with bile duct injury that occurred in local hospitals following cholecystectomy and subsequent admission in the department of Hepatobilliary and pancreatic surgery; BSMMU, BIRDEM and DMCH, Dhaka, Bangladesh during the period January 2014 to July 2018. A total of 70 patients diagnosed as bile duct injury were included in the study. Bile duct injury that occurs during liver or pancreases surgery or accident was excluded. Data were collected using a predesigned data collection sheet and analyzed using computer software SPSS (Statistical Package for Social Sciences) version 22. Results: Young and female patients suffer more 44(62.9%) than male. Occurrence was common during laparoscopic cholecystectomy 42(60%). Most of bile duct injury occur when cholecystectomy done on acute condition of gall bladder 59(84.3%). Most of bile duct injury patient came to specialized center after several week of injury with billiary stricture 54 (77.14%) with jaundice, some patients presented with abdominal pain 48(68.6%), abdominal distension 18(25.7), biliary peritonitis 16(22.9) and biliary fistula 14(20%). Patients with bile duct injury were evaluated by USG, liver function test, ERCP and MRCP. Maximum BDI patients were Bismath Type II 32(45.7%) and Bismath Type III 18(25.7%). Most of these patients were managed by Roux-eny hepaticojejunostomy 41(59%) alone, some patients were managed by ERCP stenting 4(5.7%) but when patients came on early postoperative period were managed by biloma drainage 2(2.9%), peritoneal toileting 2(2.9%) or T-Tube within CBD 3(4.2%) and laparotomy and drainage 12(17.1%). Bile duct injury with stricture at different level presented more than the acute condition 20(35.5%). Post-operative complication after billiary surgery was 22(31.4%) but most of them managed by conservative treatment. Conclusion: The present study showed that bile duct injury occurs mostly in young female with acute cholecystitis. Common presentation was obstructive jaundice and biliary sepsis. Bismuth Type II and III were most common form of stricture. Biliary reconstruction (Roux-en-Y hepaticojejunostomy) was the treatment for biliary stricture. Peritoneal toileting, controlled fistula and later on biliary reconstruction was the treatment of biliary sepsis.

Background: Coronary heart disease is a global health problem and a major cause of death in both developed and developing countries. Clinical importance of hyponatremia in ST-elevated acute myocardial infarction (STEMI) is an important topic of study among present researchers. Objective: To assess the outcomes and prognostic implications of early development of hyponatremia inhospitalized acute ST-elevated myocardial infarction patients. Methods: This is a prospective observational study performed in the department of Cardiology, Combined Military Hospital (CMH), Dhaka from July 2018 to June 2019. A purposive sampling technique was used on 82 patients with ST-elevated acute myocardial infarction admitted in CCU and treated with thrombolysis. They were evaluated for serum sodium level at admission and at 48 hours after admission. Here sodium concentration <135 mmol/L is defined as Hyponartemia. Fourty one patients with hyponatremia were included in Group-I and 41 patients with normal sodium level were included in Group-II. Then the in-hospital outcome variables were analyzed. Results: Among the study population 86.58% were male and 13.42% were female. Age range was 25 years to 74 years. Considering risk factors highest percentage of study population in group- I had hypertension (60.97%) followed by dyslipidemia (51.21%), diabetes mellitus (51.21%), history of smoking (53.60%), and family history of Coronary Artery Disease (CAD) (31.14%). There were five outcome variables such as heart failure, cardiogenic shock, arrhythmia, duration of hospital stay and death. 10 patients died in Group-I and 2 patients died in Group-II. Among the outcome variables death, heart failure and hospital stay was more in Group-I and was statistically significant. hospital outcome of study population according to serum sodium level. Considering in hospital outcome heart failure occurred in 14 patients (p= .001), arrhythmia developed in 17 patients (p=0.108), cardiogenic shock occurred in 9 patients (p=0.354) and death occurred in 10 patients (p=0.002). P-Value of heart failure and death was statistically significant. Conclusion: Early developed hyponatremia in patients with ST-elevated acute myocardial infarction was an independent predictor of prognosis. It has been found that heart failure, duration of hospital stay and death was more in hyponatremic patients and prognosis worsen with increasing severity of hyponatremia. Plasma sodium level may serve as a simple marker to identify patients at high risk. University Heart Journal Vol. 17, No. 1, Jan 2021; 16-21