Background: Dyslipidemia is one of the main risk factors with prognostic significance in relation to coronary heart disease. Aggressive treatment has been recommended in acute coronary syndrome (ACS). We examined pattern of dyslipidemia in ST Elevation myocardial infarction (STEMI) and Non- ST elevation myocardial infarction (NSTEMI). We also compare the lipid status in between two types of myocardial infarction (MI).Methods: This cross sectional observational study was carried out enrolling 100 subjects with ST elevation and Non ST elevation Myocardial Infarction, in the Department of Cardiology, BIRDEM General Hospital, Shahbag, Dhaka, over a period of six months from January 2012 to June 2012. Fasting lipid profile was done in next morning of admission in both type of MI.Results: Mean age and gender difference was significant between STEMI and NSTEMI. Mean Cholesterol (chol), Triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were not statistically significant between male and female groups. All mean cholesterol, TG, HDL, LDL were significantly high in older age group. The Mean cholesterol (220.7±28.1Vs208.4±20.9), triglyceride (182.8±34.4 Vs 147.4±28.9), HDL (35.14±5.7 Vs 41.65±3.8) and LDL (160.7±26.2 Vs148.3±16.8)were also statistically significant between STEMI and NSTEMI groups (p<0.05).Conclusion: Dyslipidemia is the dominating coronary risk factors. It could be concluded that significant differences are observed between two types of MI. Lipid status is relatively more uncontrolled in ST elevated MI and must be managed with all possible therapeutic modules to minimize further complications.Bangladesh Crit Care J September 2017; 5(2): 106-109

Objective: To find out association between creatinine clearance rate (CCR) and in-hospital outcome of acute coronary syndrome (ACS).Methodology: This prospective observational study was carried on 100 patients with acute coronary syndrome, in Coronary Care Unit (CCU) of BIRDEM General Hospital, Shahbag, Dhaka, over a period of six months from July 1, 2012 to December 31, 2012.Results: Subjects were divided into three groups (A:CCR>60,B :CCR-30-60and C:CCR<30) depending on their CCR (ml/min). Mean creatinine clearance rate was 56.15 (±29.57) ml/min and mean serum creatinine level was 3.68 (±2.59) mg/dl. Among 20 patients of Group A subjects 15(75%) were discharged in a stable condition. 2(10%) and 3(15%) patients developed isolated left ventricular failure (LVF) and isolated hypotension respectively. No patient died in this group and none of them developed any bleeding episode (epistaxis,melaena,haematemesis, haematochezia or per vaginal bleeding etc), sepsis or multi-organ dysfunction syndrome (MODS). Among 35 patients of Group B subjects 8(22.8%) were discharged in a stable condition. 9(25.7%) and 6(17.1%) patients developed isolated LVF and isolated hypotension respectively. 2(5.7%) patients died in this group and 7(20%), 2(5.7%),1(2.8%) patients developed bleeding episode, sepsis and MODS respectively. Among 45 patients of Group C subjects 3(6.6%) were discharged in a stable condition. 12(26.7%) and 8(17.7%) patients developed only LVF and only hypotension respectively . 4(8.8%) patients died in this group during their hospital stay and 11(24.4%), 3(6.6%) and 4(8.8%) patients developed bleeding episode, sepsis and MODS respectively. ANOVA test suggested that decreased creatinine clearance rate was significantly related to poor clinical outcome(P<0.05).Conclusion: This study showed that decreased creatinine clearance is directly related to poor outcome of acute coronary syndrome. So subjects with ACS should be closely monitored for decreased creatinine clearance rate to avoid life threatening complications. And subjects with renal impairment suffering from ACS should be closely observed as patients with decreased CCR has poor clinical outcome.Bangladesh Crit Care J March 2015; 3 (1): 3-6

Osteoarthritis (OA) is a leading cause of disability in the elderly. The goal of OA treatment is to control symptoms, prevent disease progression, minimize disability, and improve quality of life. The management can be divided into non pharmacologic interventions, pharmacologic interventions, and surgical options. Pharmacologic interventions can be further subdivided into symptomatic therapy and potential structureor disease-modifying therapy. There are, at present, no specific pharmacologic therapies that can prevent the progression of joint damage due to OA. Acetaminophen is the first line of therapy, although most of the patient requires NSAIDs. Risk of gastrointestinal (GI) bleeding and cardiovascular risk need to be considered, especially for elderly. With inflammatory components, intra-articular glucocorticoid injection gives short term benefit. Compared with corticosteroid injections, hyaluronan injections have similar clinical effects. But it is more costly. So far research with potential structure- and disease-modifying drugs in osteoarthritis includes tetracyclines, glycosaminoglycan polysulfuric acid, pentosan polysulfate, diacerein, glucosamine and others. Scientists are looking for new therapeutic targets like IL-1 receptor antagonist (IL-1Ra), mitogen-activated protein (MAP) kinases inhibitors, NF-kappaB inhibitors. Gene therapy, Chondrocyte and stem cell transplants showed some promise in animal models. Keyword: Osteoarthritis, pharmacologic therapy, disease modifying therapy DOI: http://dx.doi.org/10.3329/jom.v12i2.7690 JOM 2011; 12(2): 142-148

Background and objectives: Cardiovascular disease is the most common cause of death worldwide and Coronary Care Unit (CCU) plays a central role in reducing this mortality. Currently the data on mortality in CCU is very limited in our country. Our purpose of this study to provide data on mortality so that we can focus and improve the factors determining deaths in CCU. Methodology: The data of all death cases admitted inthe CCU of a tertiary level hospital between 1 January 2016 and 31 December 2017 were included for assessing the data on demography, diagnosis, and comorbidities at the time of death. Results: Among 802 cases admitted in CCU in two years, 40 patients died (5%). Male was 55% and female was 45%. Most of the death occurred in their 6 th decade of life, due to Non-ST-Elevation Myocardial Infarction (NSTEMI) and sepsis, within 24-hour of CCU admission.Common associated co-morbidities were DM (75%), hypertension (42.5%), CKD (27.5%), and hypokalemia (12.5%).Conclusions: The death rate is much lower in our CCU in comparison to global rate. The common cause of death is still NSTEMI. The common co-morbidities we found are DM, hypertension and CKD. Most of the deathsoccurred within 24-hour of admission.

Background and objective : C-reactive protein (CRP) is a well-known inflammatory biomarker and is associated with cardiovascular risk. Our objective was to see whether it is also associated with hypertension and its complications.Methodology : This prospective observational study was carried out in general outpatient department (OPD) of a tertiary level hospital on a total of 112 patients, among them 71 were hypertensive and 41 were normotensive. Baseline CRP was measured in all subjects and followed them up to six months to see any association between the level of CRP and hypertensive complications.Results : It is found that mean CRP was 2.923 (± 0.294) in hypertensive subjects and 1.058 (± 0.330) in normotensive subjects. No association is found between level of CRP and hypertensive complications.Conclusion : CRP is raised in hypertension. But it is not established that its level can predict the complication of hypertension.Bangladesh Crit Care J March 2018; 6(1): 3-6