Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. In this study, we present our 10-year experience in the management and clinical outcome of 437 chest trauma cases as a result of blunt and penetrating injuries in two medical college hospitals of Bangladesh. Methods: We reviewed 437 cases of chest trauma between January 2006 and December 2015.The mean age of our patients was 33 ± 15 years mostly males with blunt injuries. Patients were evaluated and compared according to age, sex, etiology of trauma, thoracic and extra-thoracic injuries, complications, and mortality. Results: The leading cause of the trauma was road traffic accident (61%) followed by violence (23%). Hemothorax (62%), Pneumothorax (51%), rib fractures (38%), and lung contusion (35%) were the most common types of injury. Associated injuries were documented in 35% of patients (extremities 18%, abdomen 12%, head 5%). Minority of the patients required thoracotomy (6%), and tube thoracostomy (56%) was sufficient to manage the majority of cases. Mean hospital stay was 5.5 ± 4.8 days. The overall mortality rate was 3.6%. Conclusion: Road traffic accident was the most common cause of chest trauma rather than violence in this series, this necessitates epidemiologic or multi-institutional studies to know what are the causes of RTA contributes to chest trauma in Bangladesh. The number of fractured ribs can be used as simple indicator of the severity of trauma. Cardiovasc. j. 2019; 12(1): 3-8
Native arterio-venous fistula (AVF) are the preferred mode of repeated vascular access for the chronic renal failure patients surviving on hemodialysis because of their easy accessibility, good long term patency, low complication rate and cost-effectiveness. Creation of a fistula between the radial or brachial artery and a suitable adjacent vein is the most commonly practiced option. However the major upper arm veins of the CKD patients are often found thrombosed, cord like and not suitable for AV anastomosis. A 48 years old male patient of chronic kidney disease with a permanent catheter placed in the right subclavian vein was referred to create an AV fistula. On exploration none of the upper limb veins was found suitable for fistula formation. The proximal part of the left GSV was harvested from patient’s left upper thigh and was used to make a connection between left brachial artery at cubital fossa and the left axillary vein. To avoid over flooding of the limb vasculature, partial banding of the left axillary vein was done distal to this anastomosis. When all options in both upper limbs are exhausted, autologous great saphenous grafts may be a very useful tool for the surgeons in creating upper limb AV fistulas in difficult situations Bangladesh Heart Journal 2018; 33(2) : 134-137
Cardiac transplantation is one of the greatest medical marvels of the twentieth century. Performing this miraculous operation on 3rd December 1967, Dr. Christiaan Barnard, an unknown surgeon from the then apartheid state of South Africa suddenly became an international celebrity. Probably no single procedure in the history of medicine had attracted so much media and public attention. But there were many who thought that he didnt deserve much of this glory. A lion share of this should have gone to somebody else. Although Barnard completed the final step in the road to transplant, it was the end product of serious research work carried out in many centers around the World. Most important was Stanford University Medical Center, Palo Alto, California USA, where Dr. Norman Edward Shumway was engaged in transplantation related research work along with his junior colleague Dr. Richard Lower. The most of the techniques used in cardiac transplantation today were actually developed by Dr. Shumway and his team. Barnard worked in the same unit with Shumway at University of Minnesota when he came to USA. He visited USA again in 1966 when he observed the works of Shumways research partner Dr. Richard Lower. During both of his visits he had adopted many techniques from the research work of his American counterparts and later used in his unique accomplishment. Barnard succeeded utilizing techniques developed through Shumways painstaking work over the years depriving Shumway much of the glory he deserved. Both later on continued in the development of transplantation when most others left because of poor outcome. Shumway excelled the technical details and Barnard drew media and public attention to the importance of this procedure. After almost five decades the name of Barnard is still well known by the common people around the World; whereas Shumway remains unknown even to most of the cardiac surgeons as well. This was the destiny of the two main heroes credited behind this exciting medical accomplishment. Here lies a very interesting story, the tale of two surgeons.Cardiovasc. j. 2015; 8(1): 82-86
Abstract:The presence of significant left main arterial stenosis has been considered a relative contraindication to OPCAB surgery. The development of newer techniques and an increasing understanding of the hemodynamic changes make the surgeons confident to perform OPCAB in patients with significant left main artery stenosis.
Introduction: Nutrition is an important factor for recovery following cardiac surgery. Most patients loose appetite and have reduced nutrition following cardiac surgery. Several factors including pain, anxiety, medications, whole body inflammatory response, Cardiopulmonary bypass (CPB) have role in postoperative anorexia and reduced nutrition.Objective: Objective of this study is to find out the role of CPB in postoperative anorexia and nutrition.Methodology: This prospective study was conducted at NICVD. 30 randomly selected adult patients who had undergone open heart surgical procedures were compared to same number of closed heart surgery patients. The daily food intake was calculated from the ICU data-sheets and calorie value obtained. The values were compared between the open and closed heart surgery patients.
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