Fasting glycaemia is a predictor of outcome after acute myocardial infarction

Background: Patients with recent myocardial infarction have an increased incidence of impaired fasting glucose (IFG) and new-onset diabetes. There is a clear relationship between elevated fasting glucose during acute myocardial infarction and increased mortality and morbidity risk. Objective: To find out the impact of fasting glycaemia as a predictor of outcome of patients with acute myocardial infarction. Methods: A total of 102 patients with acute myocardial infarction of first attack were selected according to inclusion and exclusion criteria. Fifty-one patients with acute myocardial infarc­tion having fasting hyperglycaemia were enrolled as case group and another 51 patients with acute myocardial infarctions having fasting euglycaemia were enrolled as control group. Results: Among the diabetic patients, acute left ventricular failure (ALVF) developed in 22 (68.8% ), arrhythmias in 5 (16.6%) and cardiovascular mortality in 8 (25.0% ) patients ; it was 7 (36.8%), 4 (21.1 %) and 4 (21.1 %) respectively in IFG patients; and 7 (13.7%) ,4 (7.8%) and 2 (3.9%) respec­tively in euglycaemia patients. Acute left ventricular failme and 30 days CV mortality significantly differed among the groups (p<0.001 and p=0.015 respectively). But no significant difference in arrhythmias (p=-0.284). Conclusions: The patients of impaired fasting glucose (IFG) and diabetes mellitus both were predictor for in hospital heart failure (ALVF) and 30-day cardiovascular mortality as compared to euglycaemia

Association of CagA+ helicobacter pylori infection and gastric carcinoma

The aim of this study was to find out the association of the CagA+ Helicobactor pylori infection and gastric carcinoma. This cross sectional comparative study was conducted on 40 patients of gastric carcinoma and 40 healthy volunteers from January 2011 to December 2012.  Then, Cag A status was ascertained in both the groups by ELISA method. There was no significant difference between the case and control in relation to Cag A status.  &nbsp

Castlemans Disease- A Case Report

Castlemans disease(CD) is a heterogeneous group of lymphoproliferative disorders of uncertain cause presenting with lymphadenopathy. It is histologically and prognostically distinct from malignant lymph-node hyperplasia. It was first described in a group of patientswith benign localised hyperplastic lymph-nodes in 1956 by Castleman et al. We report a case of a 70 year old gentleman who was clinically suspected to have lymphoma , but later histologically confirmed to have Castlemans disease.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.11031 BSMMU J 2012; 5(1):79-80

Salbutamol in acute organophosphorus insecticide poisoning - a pilotdose-response phase II study

Treatment of acute organophosphorus (OP) insecticide poisoning is difficult, with many patients dying despite best care. Pre-clinical studies have shown benefit from salbutamol, possibly due speeding alveolar fluid clearance or reducing bronchoconstriction. In this small pilot dose-response study, we aimed to explore whether addition of nebulized salbutamol to standard care might improve resuscitation.We performed a single-blind phase II study comparing the effect of two different doses of nebulized salbutamol versus saline placebo, in addition to standard treatment. Primary outcome was oxygen saturations over the first 60 min of resuscitation; secondary outcomes included heart rate, incidence of dysrhythmias, time to 'atropinization', atropine dose required, and mortality.Seventy-five patients were randomized to receive 5 mg (Salb5, n = 25) or 2.5mg (Salb2.5, n = 25) of salbutamol, or saline placebo (NoSalb, n = 25), by nebulizer. Oxygen saturations did not differ between groups over the first 60 min of resuscitation (median AUC NoSalb: 1376 [95% CI 1282 to 1470], Salb2.5: 1395 [1305 to 1486], Salb5: 1233 [1100 to 1367]; p = .9898). Heart rate was also similar across the three arms. Median time to full atropinization, and atropine dose required, were the same for all three arms (NoSalb 15.0 [10-16] min and 12.6 [8.0-13.4] mg, Salb2.5 15.0 [10-16] min and 12.6 [9.3-16.8] mg, and Salb5 15.0 [10-20] min and 12.6 [10.7-20.6] mg; p = .4805 and p = .1871, respectively). Three (12%) patients died in the Salb2.5 and Salb5 groups and two (8%) in the NoSalb group.This pilot study, within the limitations of its small size and variation between patients, found no apparent evidence that administration of nebulized salbutamol improved resuscitation of patients with acute OP insecticide self-poisoning. The data obtained provides a basis to design further studies to ultimately test the role of salbutamol in OP insecticide poisoning

Fasting glycaemia is a predictor of outcome after acute myocardial infarction

Background: Patients with recent myocardial infarction have an increased incidence of impaired fasting glucose (IFG) and new-onset diabetes. There is a clear relationship between elevated fasting glucose during acute myocardial infarction and increased mortality and morbidity risk. Objective: To find out the impact of fasting glycaemia as a predictor of outcome of patients with acute myocardial infarction. Methods: A total of 102 patients with acute myocardial infarction of first attack were selected according to inclusion and exclusion criteria. Fifty-one patients with acute myocardial infarc­tion having fasting hyperglycaemia were enrolled as case group and another 51 patients with acute myocardial infarctions having fasting euglycaemia were enrolled as control group. Results: Among the diabetic patients, acute left ventricular failure (ALVF) developed in 22 (68.8% ), arrhythmias in 5 (16.6%) and cardiovascular mortality in 8 (25.0% ) patients ; it was 7 (36.8%), 4 (21.1 %) and 4 (21.1 %) respectively in IFG patients; and 7 (13.7%) ,4 (7.8%) and 2 (3.9%) respec­tively in euglycaemia patients. Acute left ventricular failme and 30 days CV mortality significantly differed among the groups (p<0.001 and p=0.015 respectively). But no significant difference in arrhythmias (p=-0.284). Conclusions: The patients of impaired fasting glucose (IFG) and diabetes mellitus both were predictor for in hospital heart failure (ALVF) and 30-day cardiovascular mortality as compared to euglycaemia

Association of caga+ helicobacter pylori infection and gastric carcinoma

The aim of this study was to find out the association of the CagA+ Helicobactor pylori infection and gastric carcinoma. This cross sectional comparative study was conducted on 40 patients of gastric carcinoma and 40 healthy volunteers from January 2011 to December 2012.  Then, Cag A status was ascertained in both the groups by ELISA method. There was no significant difference between the case and control in relation to Cag A status

Frequency of ischemic heart disease within metabolic syndrome

Background: The common clustering of glucose intolerance, abdominal adiposity, high triglyceride level, low high­density lipoprotein cholesterol level and high blood pressure in a single individual is referred to as Metabolic Syndrome (MS) and it is associated with ischaemic heart disease (IHD). Objectives: To find out the relationship between MS and lHD. Design: Cross sectional observational study. Materials: 100 subjects were selected following simple random sampling technique. 50 patients of MS and another 50 non MS were enrolled as case and controlled respectively in the department of medicine and cardiology at Sylhet M.A. G. Osmani medical college hospital. Results: Proportion of IHD was found to be high among the MS (40%) compared to non MS (16%) and the difference was statistically significant (p=0.008) indicating there is a relationship between MS and lliD. Among the components of MS proportion of hyperten­sion (39.2%), diabetes mellitus (41.9%), dyslipidernia (42.6%) and family history of cardiovascular disease (47.1 %) had significant higher association with patients with IHD (p&lt;0.05). Conclusion: The MS has a significant association with IHD by electrocardiogram criteria

Association of COPD with osteoporosis in male smokers: A case control study in a tertiary medical college hospital in Bangladesh

OBJECTIVES: Chronic obstructive pulmonary disease (COPD) may increase the risk of osteoporosis and resulting fractures can contribute to disability and mortality of patients. We intended to evaluate the frequency of osteoporosis in male smokers with and without COPD and study whether any correlation existed between osteoporosis and COPD. MATERIALS AND METHODS: This case-control study was carried out in the Department of Medicine, Sylhet M.A.G. Osmani Medical College Hospital, Sylhet, Bangladesh between July 2013 and June 2015. Seventy four male smokers with COPD and 66 age-matched male smokers without COPD were enrolled. All individuals underwent Bone Mass Densitometry (BMD) by Dual-Energy X-Ray Absorptiometry (DEXA). RESULTS: COPD and non-COPD groups did not differ regarding age and smoking pack-years. Osteoporosis at femoral neck (48.6% versus 16.7%; p< 0.001) and lumbar spine (68.9% versus 37.9%; p< 0.01) was significantly higher in COPD compared to controls. Osteopenia did not differ significantly. Patients with COPD were 4.5 times more likely to develop osteoporosis than controls after adjusting age, smoking-pack years and BMI (adjusted OR = 4.5; 95% CI = 1.8–11.5). CONCLUSIONS: Osteoporosis is more frequent in male smokers with COPD compared to smokers without COPD. COPD is a risk factor of osteoporosis independent of age, smoking and BMI

Frequency of ischemic heart disease within metabolic syndrome

Background: The common clustering of glucose intolerance, abdominal adiposity, high triglyceride level, low high­density lipoprotein cholesterol level and high blood pressure in a single individual is referred to as Metabolic Syndrome (MS) and it is associated with ischaemic heart disease (IHD). Objectives: To find out the relationship between MS and lHD. Design: Cross sectional observational study. Materials: 100 subjects were selected following simple random sampling technique. 50 patients of MS and another 50 non MS were enrolled as case and controlled respectively in the department of medicine and cardiology at Sylhet M.A. G. Osmani medical college hospital. Results: Proportion of IHD was found to be high among the MS (40%) compared to non MS (16%) and the difference was statistically significant (p=0.008) indicating there is a relationship between MS and lliD. Among the components of MS proportion of hyperten­sion (39.2%), diabetes mellitus (41.9%), dyslipidernia (42.6%) and family history of cardiovascular disease (47.1 %) had significant higher association with patients with IHD (p<0.05). Conclusion: The MS has a significant association with IHD by electrocardiogram criteria

Wasp stings (Vespa affinis) induced acute kidney injury following rhabdomyolysis in a 25-year-old woman

Wasp sting is a relatively common arthropod assault. This usually results in pain and mild allergic reactions, but sometimes may cause severe systemic reaction and multiorgan dysfunction including rhabdomyolysis, hemolysis, coagulopathy, hepatic, renal and cardiac complications. Along with several other pathomechanisms, rhabdomyolysis is a distinguished cause of acute kidney injury (AKI) in patients with wasp sting. We herein report a case in which the patient developed rhabdomyolysis followed by AKI due to multiple wasp stings. The offending wasp was brought to the hospital and the species was confirmed by a zoologist (Vespa affinis)