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Tissue that is damaged and poorly oxygenated as a result of swelling, trauma or inflammation has been shown to have a positive response to laser therapy irradiation. At present, cutaneous lesions represent a dilemma of global proportions and instigate great clinical interest because of the high morbidity associated with changes in the normal healing process. Among the clinical aspects involving this issue, we emphasize tissue repair time in an effort to make the process quicker and more harmonious, reduce possible complications in lesion resolution, and allow an adequate choice of therapy. Laser light energy is highly absorbed by skin and subcutaneous tissue and therefore penetration is key to therapeutic results. Among the methods currently available, low-level laser therapy (LLLT) stands out. Here we present a case of 78 years old lady with multiple variable non healing ulcers on back. Appropriate antibiotics and regular dressing failed to heal the lesions. So we have decided to apply low level laser therapy. At the end of 8th week the wound looked pretty healthy. No untoward reaction or side effect was reported by the patient. Journal of Surgical Sciences (2014) Vol. 18 (1) : 38-42

Background: Heart Failure (HF) is a major public health burden worldwide. Approximately 5 million Americans, 0.4–2% of the general European population and over 23 million people worldwide are living with heart failure. Like few other chronic disease, low serum albumin is common in patients with heart failure (HF). However, very few studies evaluated the outcome of albumin infusion in different stages of HF. Therefore, the objective of this study is to assess the outcome of albumin infusion in heart failure patients. Methods: It was a cross-sectional study. A total of 50 cases of chronic heart failure with reduced ejection fraction and NYHA class III or IV with serum albumin level

Chikungunya virus (CHIKV) is an RNA alphavirus of the Togaviridae family that produces an acute febrile illness in humans followed by Joint pain, Itchy rash and leg swelling. This emerging virus has caused several large outbreaks in parts of Africa, Asia, and the Indian Ocean Islands and more recently in the Caribbean. This study was done from December 2015 to November 2016 on 24 confirmed Chikungunya patients with leg swelling. Peripheral vascular duplex study was done in every patients to find out the cause of leg swelling. Unilateral leg swelling 83% and Bilateral leg swelling 17%. Lower limb vascular Duplex was done in all patients. Moderate resersible lymphatic oedema in subcutaneous tissue of lower limb was found in 22 patients only. 2 patients had cellulites with mild lymphatic swelling. DVT was absent. There was mild reduction of peak systolic arterial flow in 13 patients which is secondary to pressure effect of lymphedema and leg swelling. 16 patients had non tender lymphadenopathy (>1cm in diameter), 2 had tender lymphadenopathy in inguinal region and no enlarged lymph glands was observed in rest of the 6 patients. 6 patients had neutropenia and 8 had lymphopenia. Gradual improvement of symptoms was observed with conservative treatment. Lymphedema is reversible and conservative therapy is appropriate. And Non tender lymphadenopathy does not require treatment.University Heart Journal Vol. 13, No. 1, January 2017; 13-16

Background: Coronary artery disease (CAD) is predicted to be the most common cause of death and disability globally by 2020. In Bangladesh, for better management of coronary artery disease and to reduce the burden of acute coronary events patients with non ST elevated acute coronary syndrome (NSTE–ACS) should be focused. B-type natriuretic peptide (BNP) can be suggested as a tool to predict severity of coronary atherosclerotic lesion even with normal left ventricular (LV) function and thus to categorize the patients for appropriate referral and invasive evaluation.Aims: This study is designed to assess the relationship between level of BNP and severity of coronary artery disease assessed with SYNTAX score in NSTE-ACS patients with normal LV function. Methods: This cross sectional observational study was conducted at UCC, BSMMU during the period of May 2014 to April 2015 among the patients with non ST elevated myocardial infarction (NSTEMI) and unstable angina. 116 patients were enrolled by non-random purposive sampling who was admitted for coronary angiogram. All the data were recorded in structured questionnaire including details of medical history, coronary risk factors and physical findings. In NSTE-ACS patients with normal LV function venous blood samples were collected for BNP and later SYNTAX scoring was assessed during coronary angiogram. The relationship between level of BNP and SYNTAX score in patients with both UA and NSTE-MI was assessed statistically to evaluate the validity of BNP as a tool to predict severity of coronary atherosclerotic lesions among the patients with NSTE-ACS.Results: The mean age was 57.84±8.82 years. Among the 116 patients, highest frequency of patients was in the age group 51-60 years 55(47.4%) .In which 88(75.9%) were male. Male:Female ratio is 3.1:1.The percentage of risk factors was higher in NSTEMI group and difference with UA was statistically significant (p

Objectives: The purpose of this study was to investigate pattern and involvement of peripheral artery disease of lower limbs in patients suffering from clinically significant coronary artery disease.Methods: Total 58 patients with clinically diagnosed peripheral arterial disease of lower limb undergoing angiographic evaluation. Selective CAG in addition to peripheral arteriography was performed in all the study population as per ACC/AHA guidelines for CAG (class IIa recommendation).Result: In this study, It was found that the proportion of aorto-iliac disease was higher among the patients with coronary arterial disease (77.8%) and the association was statistically significant (p0.05).Conclusion: Patients of coronary artery disease (CAD) are more likely to have severe peripheral arterial disease (PAD) involvement. Peripheral angiogram is useful tool in patient with CAD to detect previously undetected PAD and pattern of CAD reflects the severity and involvement of peripheral arteries.University Heart Journal Vol. 11, No. 2, July 2015; 68-70

Objective: Diabetes mellitus, a common metabolic disorder, is often associated with severe coronary artery disease. In this study, we compared the angiographic severity of coronary artery disease in diabetic patients compared with that of non diabetic patients.Methods: This observational study comprised of 102 subjects who had coronary artery disease on coronary angiography in the Department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2009 to December 2009. The patients were divided into two groups: one group with 24 (23.5%) diabetic patients and another group with 78 (76.5%) non diabetic patients. Demographic, clinical, laboratory and angiographic data were analyzed and compared between two groups.Results: Mean age±SD of the study subjects was 52.8±9.5 years and 94 (92%) of them were male. Diabetic patients were older (mean age±SD; 57.6±9.5 versus 51.3±9.9 years; p 004), and had higher frequency of hypertension (75% versus 50%, p 0.036), chronic stable angina (71% versus 41%, p 0.018), and lower frequency of smoking (42% versus 67%, p 0.034) and acute coronary syndrome (29% versus 59%; p 0.018) in comparison to non diabetic patients. Left main stem disease (21% versus 5%, p 0.031) and three-vessel disease (50% versus 31%, p 0.094) were more prevalent in diabetic patients. Severe coronary artery stenosis was significantly more present in diabetics than non diabetics (Gensini score, 50.9±29.9 versus 32.6±21.9, p 0.001).Conclusion: Diabetic patients are more likely to have severe and extensive coronary artery disease. Left main stem and triple vessel disease are more commonly seen in diabetic patients compared to non diabetic patients.University Heart Journal Vol. 10, No. 1, January 2014; 13-17

Mitral stenosis (MS) affects right ventricular (RV) function as a result of myocardial and hemodynamic factors. Although the long-term effects of mitral commissurotomy are well known, the aim of this study was to evaluate the immediate and midterm impact of percutaneous mitral commissurotomy (PTMC) on RV function in patients with MS. This is an observational study conducted at University cardiac centre, Bangabandhu Sheikh Mujib Medical University during December 2012 to November 2013 (one year), among 50 patients Patients presenting with mitral stenosis, who fulfill the criteria to PTMC procedure attending Cardiology department of BSMMU during the study period were enrolled in this study whereas, patients with systemic hypertension, diabetes mellitus, more than mild mitral and aortic regurgitation and or aortic stenosis, with history of previous mitral and aortic valve surgery, atrial fibrillation and bundle branch block were excluded from the study. The current study shows female predominance (66%) and majority (68%) of study population were in age group between 36-40 years. 90% of study population presented with fatigue and other symptoms includes shortness of breath (85%), palpitation (65%), chest pain (28%), dizziness (25%), ankle edema (15%) and headache among 10%. Echocardiographic measurement showed, MVA significantly improved immediately and 6 months after PTMC among the study population. Hemodynamic function of the study sample revealed significantly reduction of PASP, PADP and mean PAP immediately and 6 months after PTMC. 2 D echocardiographic parameter of right ventricular systolic function showed RVOTfs%, Tei index significantly improved immediately and 6 months after PTMC.Others parameters of RV systolic function TAPSE, RVFAC and RVEF(2D and 3D) remain stable immediately after but showed significant improvement 6 months after PTMC. There was significant reduction in IVA during the immediate period following PTMC and also after 6 months.. Immediately and 6 months after successful PTMC, significant decrease in RV contractility as assessed by IVA was observed whereas other parameters of infundibular and global RV function as assessed by RVOTfs and Tei index showed significant improvement. TAPSE,RVFAC and RVEF(2D and 3D) remain stable immediately after PTMC but showed significant improvement 6 months after PTMC. Further work using larger numbers of patients is needed to confirm our findings and to assess their utility in patient followup and management.University Heart Journal Vol. 9, No. 2, July 2013; 88-98

Our aim was to see the association between lesions in coronary arteries and atherosclerotic renal artery stenosis (RAS) in suspected IHD patient. Data collected prospectively from 200 consecutive patients who underwent simultaneous coronary and renal angiography in suspected IHD patients. In 168 individuals of the study population, significant CAD was present (84%). Prevalence of RAS was 11% (22 patients). Significant (?50% luminal diameter stenosis) RAS was present in 12 patients (6%). Older age, higher systemic blood pressure at the time of catheterization, and 3-vessel coronary artery disease (CAD) were more associated with significant RAS. Simultaneous renal angiography is justified in patients with significant CAD particularly in older patients with hypertension. DOI: http://dx.doi.org/10.3329/uhj.v8i1.11664 University Heart Journal Vol. 8, No. 1, January 2012

A prospective randomized cohort study was done in 100 patients and the study population consisted 50 patients with unheralded acute myocardial infarction and 50 with uncomplicated stable angina pectoris. The main objectives of the study were to compare the angiographic severity between the two clinical subsets of IHD. The study observed that regarding number of vessels diseased , the AMI group had 1.52±0.68 compared with 2.37±0.85 vessels for the angina group reflecting significantly higher diseased vessel in latter group (P

Background: A history of ischemic-type discomfort & the initial 12- lead ECG are the primary tools for screening patients with acute myocardial infarction in the emergency department. ST elevation in inferior leads indicates an evolving myocardial infarction of the inferoposterior wall. The outcome of patients with inferoposterior myocardial infarction due to occlusion of right coronary artery depends mainly on the location of occlusion (distal versus proximal). Hypothesis: Value of ST-segment depression in lateral leads (I and aVL) and ST-segment changes in lead V1 to predict the site of right coronary artery occlusion in the case of an inferoposterior myocardial infarction. Objective: To predict the site of right coronary artery (RCA) occlusion ( proximal or distal) in acute inferoposterior myocardial infarction by ST segment depression in leads 1 & aVL and ST-segment changes( is electric/ elevated or depressed) in V1.Methods and Results: A total of fifty four patients of ST-segment elevation inferoposterior wall AMI due to suspected RCA occlusion, admitted within 12 hours of onset of chest pain, and subsequently underwent coronary angiography during hospitalization, were selected for the study. Patients were divided into two groups on the basis of angiographic findings: proximal RCA occlusion (group I) and distal RCA occlusion (group II). A 12 lead ECG was taken on admission. ST segment deviation in lateral leads (I & aVL) as well as in precordial lead (V1) was calculated. Isoelectric or elevated ST-segment in V1 predicted proximal RCA occlusion whereas depressed ST-segment predicted distal RCA occlusion. It was demonstrated that, STsegment changes in precordial lead (V1) was a sensitive & specific marker to discriminate proximal & distal RCA occlusion in inferoposterior wall AMI with high positive & negative predictive value, but ST-segment changes in lateral leads (I & aVL) although more specific for proximal RCA occlusion did not seem to be of clinical value due to its low sensitivity. DOI: http://dx.doi.org/10.3329/uhj.v7i2.10844 University Heart. Journal Vol. 7, No. 2, July 2011

Blood pressure is a vital parameter. Stephen Hales first measured BP and Scipione Riva-Rocci developed the prototype of the present day sphygmomanometer. Both directly and indirectly BP can be measured. The indirect method Includes sphygmomanometric method, ultrasound doppler method, oscillometric method, self measurement and ambulatory BP monitoring. For proper measurement of BP by auscultatory method, one should have adequate knowledge of equipment and cuff size, proper technique and Korotkoff sounds. In different situations like arrhythmias, shock, hyperkinetic circulatory states and aortic regurgitation, BP should be measured carefully. In recent years home BP monitoring and ambulatory BP monitoring are becoming popular. Care must be taken to avoid both underestimation and overestimation of BP recording. doi: 10.3329/uhj.v5i1.3438 University Heart Journal Vol. 5, No. 1, January 2009 28-31

Diabetes mellitus adversely influences the outcome of acute coronary syndrome. This study evaluated the in-hospital outcome of acute coronary syndrome in patients with diabetes mellitus. In this prospective observation study 130 patients with acute coronary syndrome were enrolled. They were divided into diabetic and nondiabetic group. Diabetic patients were taken as case and nondiabetic patients as control. Outcome parameter studied were in-hospital mortality, cardiogenic shock, congestive heart failure, different arrhythmias and recurrent angina. In this study, one third (32%) of the patients were diabetic with mean age 58±10.0 years vs. 53.0±13.6 years in diabetic and nondiabetic group, respectively. Majority of the patients in both groups were male. Congestive heart failure and arrhythmias were more common in case group compared to those in control group (19% vs. 13.6% p=0.424; 23.8% vs. 13.6%, p= 0.148, respectively). Cardiogenic shock developed in 7.1% of diabetic patients and 8% of nondiabetic patients. In hospital mortality was 7.1% and 5.7% in diabetic and nondiabetic group, respectively. Recurrent angina developed only in diabetic patients. Therefore, diabetic patients with acute coronary syndrome encountered more in- hospital adverse outcome. doi: 10.3329/uhj.v5i1.3437 University Heart Journal Vol. 5, No. 1, January 2009 24-27

To correlate magnitude and distribution of coronary Artery Disease (CAD) with ischaemic limb changes in patients with Peripheral Arterial Disease (PAD) of lower limbs.Most common cause of PAD is atherosclerosis. Atherosclerosis is a generalized disease and often atherosclerotic CAD is associated with PAD. Because of ischaemic limb changes in patient with PAD they do not always experience angina even after having CAD. This prospective observational study was conducted in National Institute of cardiovascular Diseases (NICVD) Dhaka, Bangladesh during July 2004 to June 2005. Total 58 patients with PAD were included in the study. Patients were classified as group I having normal coronary artery, group-II insignificant CAD (L M

No abstract available DOI: http://dx.doi.org/10.3329/uhj.v7i2.10845 University Heart. Journal Vol. 7, No. 2, July 2011

The purpose of the study was to investigate the trends of permanent pacemaker implantations in the University Cardiac Center (UCC), Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. This retrospective study conducted in the department of Cardiology, UCC, BSMMU, Dhaka to evaluate demographic distribution, indications, complications of the permanent pacemaker (PPM) implantation and its hospital outcome. Data of this retrospective study was collected from hospital registry and patient's record files. Total 98 patients were studied. Among them male were 64.28% (n=63) and female were 35.71% (n=35). Most of them were elderly patients (58%). Complete heart block was the most common cause for PPM implantation, which was 67.35% (n=66). Single chamber multiprogrammable PPM (VVI) was implanted in 86.73% (n=85) and Dual chamber PPM (DDI) was implanted in 13.26% (n=13) cases. No Major complications occurred during the procedure and short term in-hospital outcome was good for all the cases. This study showed that PPM implantation is rapidly increasing modality of treatment for patients with cardiac bradyarrhythmias as effective technique with good in-hospital outcome. Â doi:10.3329/uhj.v4i2.2072 University Heart Journal Vol. 4 No. 2 July 2008 p16-18

Most common cause of Peripheral Arterial Disease (PAD) is atherosclerosis. Atherosclerosis is a generalized disease, also involving coronary and carotid arteries. Often atherosclerotic coronary artery disease (CAD) is associated with PAD. This prospective observational study was conducted in the National Institute of Cardiovascular Diseases, Dhaka, Bangladesh, during July 2004 to June 2005. Total 58 patients with PAD were included in the study. Patients were classified as group I having normal coronary artery, group II insignificant CAD (Left main