The goal of this study was to determine the sensitivity and specificity of the Myocardial Performance Index (MPI)for the assessment of acute right ventricular Infraction. This was a descriptive type of cross-sectional study. The study was carried out in the Coronary Care Unit, Department of Cardiology, Sir Salimulla Medical College, and Mitford Hospital. After exclusion total of 72 patients were included in this study, of which 24 had acute inferior MI with RV involvement diagnosed by ≥ 1mm ST-segment elevation in V3R-V5R of right-sided ECG (group-I) and 48 had acute inferior MI without RV involvement (group-II). All patients underwent echocardiography within 24 hours of admission.  The study revealed that RV MPI was significantly increased (0.57± 0.13) in RVMI patients compared to IMI without RVMI (0.24± 0.12). MPI detected RVMI in 08 patients (0.45± 0.09) who did not have ECG findings of RVMI (Group-II). Repeat MPI estimation after 05 days in 21 RVMI (Group-I) and 08 isolated IMI (Group-II) patients who had RVMPI > 0.30showed dramatic reduction of MPI (0.19± 0.07 and 0.22±0.09), respectively. RV MPI ≥ 0.30 has high sensitivity (100%) and specificity (89%) for the diagnosis of RVMI in the presence of acute IMI.  The study recommended that MPI may be a new non-invasive echocardiographic gold standard tool in diagnosing acute RVMI and also assessment of right ventricular function in acute inferior myocardial infarction with high sensitivity and specificity. MPI changes can be serially followed in acute RVMI patients to assess changes in RV function. TAJ 2022; 35: No-1: 17-24

This descriptive type of cross-sectional study was conducted to determine the learning styles of undergraduate medical students and their relation with preferred teaching-learning Methods. The study period was from July 2017 to June 2018. The study was carried out among the students of the 2nd, 3rd, and 4th phases of the MBBS course at three government and four nongovernment medical colleges in Bangladesh. Out of seven medical colleges, four were within Dhaka and three outside Dhaka. The sample size was 1004. Medical colleges were selected purposively, and a convenience sampling technique was adopted for data collection. Bangla translated version of Fleming's VARK (visual, auditory, read/write, and kinesthetic) questionnaire was used to identify the learning styles of students. Linear regression was used to compare the VARK learning styles scores with teaching-learning Methods. The study revealed that out of 1004 medical students 64.2% preferred multimodal learning styles, and the rest, 35.8% preferred unimodal learning styles. Among unimodal learning preferences, auditory (A) and kinesthetic (K) were the most preferred sensory modalities of learning. The most preferred teaching Methods among the students were bedside teaching (29.9%), followed by tutorials (25.9%), and practical sessions (20.6%). The most preferred learning method among the students was mixed Methods (60.3%). A positive correlation was present between VARK modes and teaching-learning Methods (P <0.05). Majority of students preferred multimodal learning styles. Students are able to learn effectively as long as the teacher provides a blend of visual, auditory, read/writing, and kinesthetic activities. The study recommended that teachers be aware of the medical students' learning styles and that aligning teaching-learning Methods with learning styles will improve their learning and academic performance. TAJ 2022; 35: No-2: 19-26

Changes in cardiac structure and function detected by echocardiography are common in patients with type 4 cardiorenal syndrome and have been recognized as key outcome predictors. This study aimed to evaluate echocardiographic patterns in severe chronic kidney disease CKD in type 4 cardiorenal syndrome patients. This was a descriptive type of cross-sectional study. The study was carried out in the Cardiology and Nephrology Department of Bangabandhu Sheikh Mujib Medical University, Dhaka. After exclusion total of 44 patients having severe CKD (GFR <30 ml/min/1.73 m2) with type 4 cardiorenal syndrome were included in this study. All patients underwent echocardiography.  Most of the patients with type 4 cardiorenal syndrome were in the 6th decade (Mean age was 58.9±5.9 (SD)in severe CKD with male predominant. Ischemic heart disease(65.9%), arrhythmia(13.63%), and heart failure(22.72%) were significantly noted in severe CKD in type 4 cardiorenal syndrome patients. Mean systolic blood pressure was 178.2±18.7 mmHg & mean diastolic blood was 97.7±5.9 mmHg among the study subjects.  Left ventricular hypertrophy (54.6%), systolic dysfunction (27.3%), pericardial effusion (36.4%), valvular calcification (63.6%), and diastolic dysfunction (54.5%) were most common finding in severe CKD with type 4 cardiorenal syndrome.  The study recommended that a Careful analysis of echocardiographic findings in patients with type 4 cardiorenal syndrome may discover the signs of cardiovascular changes. Thus appropriate measures can be taken. From this current study, it is evident that most of the patients with type 4 CRS with severe CKD developed left ventricular hypertrophy, so periodic 24-hour ambulatory blood pressure monitoring may be advised to address the unusual rise of blood pressure and treat it properly. TAJ 2022; 35: No-1: 11-16