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Background: Congenital heart diseases (CHD) are associated with an increased risk for the development of pulmonary vascular disease. Severe and irreversible pulmonary hypertension may then ensue and, eventually, leads to reversal of the shunt. Oral sildenafil is used for preoperative and postoperative treatment of pulmonary hypertension. Methods: A total of 30 patients, who underwent surgical closure of congenital anomaly i.e. ASD and VSD with High Pulmonary Pressure were included in the study. Patients were initially selected by echocardiogram showing pulmonary arterial systolic pressure (PASP) more than 40 mm of Hg. The Group A (sildenafil group) consisted of 15 patients and had received sildenafil during and after operation was given to these patients initially through nasogastric tube and later via the oral route 6 hourly for 44 hours. Results: Reduction in the PA pressure in sildenafil group was found statistically significant (p=.044). ICU stay and total hospital stay were shorter in the intervention group than the control but not statistically significant possibly due to smaller sample size. Conclusion: We conclude that oral sildenafil treatment is a safe, simple and effective alternate for persistent pulmonary hypertension early after congenital cardiac surgery. [ABSTRACT FROM AUTHOR]

Among nations with populations above 100 million, Bangladesh is the most densely populated country. It is located on the most active delta in the world and quite vulnerable to natural calamities. Despite tremendous growth over the last three decades in the service, industrial and remittance sector, agriculture remains the largest single source of the GDP and employment. It also provides the nation with food security, a crucial component of sustainability. Over the past three decades unplanned urbanization and industrialization has adversely affected increased extraction of groundwater and surface water for irrigation, coupled with flood control measures in the upper riparian and lower riparian regions. In this context, spatial planning could be considered as a useful tool to foster sustainable development of the country. Therefore, this paper recommends spatial planning as a tool for the sustainable development of Bangladesh considering the demographic trends, economy, geographic context and existing policy of land use and urban planning. [ABSTRACT FROM AUTHOR]