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Background: Optimal timing of PCI and comparative outcome between early invasive strategy and ischaemia guided delayed invasive strategy is still in debate in reducing long-term cardiovascular complications in NSTEMI. Objective: The aim of the study was to assess the impact of an early invasive strategy or ischaemia guided delayed invasive strategy on six months clinical outcomes in NSTEMI patients undergoing PCI, from a Bangladesh health service perspective. Materials and Method: It was an observational cross-sectional comparative study conducted in cardiology department of BSMMU from November 2019 to February 2021. Study procedure: This study enrolled 389 adult patients of NSTEMI who underwent PCI which met inclusion and exclusion criteria. Study subjects were divided into two groups: early and delayed groups. This study considered an early invasive strategy as - revascularization within 72h for patients presented with NSTEMI with high-risk features defined by a GRACE score > 140 and for those at lower risk with GRACE score 0.05). Conclusion: Adoption of an early invasive strategy in NSTEMI patients undergoing PCI may be beneficial in reducing the risk of MACEs and associated with improved clinical outcome after PCI at 6 months follow-up. University Heart Journal 2022; 18(1): 22-28

Background: Due to the wide spectrum of risk for death and recurrent events among patients with NSTE-ACS, management guidelines emphasise the importance of early risk stratification. In addition to prognostic assessment, predicting the anatomical extension of coronary artery disease is potentially useful for clinical decision. The aim of the study is to determine whether the GRACE risk score correlates with the angiographic extent and severity of coronary artery disease in patients with non ST-elevation ACS Methods: A total of 50 patients with non-ST-elevation acute coronary syndrome were enrolled to the study. Based on the GRACE risk score classification system, the patients were divided into low (140) risk groups. All patients underwent coronary angiography within five days after admission. The severity of the coronary artery disease was assessed by Gensini score. Relation between Grace score and Gensini score was evaluated. Results: Mean Gensini score were 12.20 ± 13.60, 34.52 ± 13.50 and 48.41 ± 14.56 in low group, intermediate group and high GRACE risk group respectively and the difference of mean Gensini score was statistically significant (p

Introduction: Ischemic heart disease (IHD) or coronary artery disease (CAD) has become predominant cause of death across the world and frequently stable angina, which is the most common presentation of this disease, gives hard time to reach a proper diagnosis due to duality of non-invasive testing. While Exercise Treadmill Test (ETT) is an inexpensive non-invasive modality which may have many output depending on method of interpretation, ST segment depression is much utilized but traditionally less perfect than available treadmill scores. We have compared its accuracy to Duke Treadmill Score (DTS), Simple Treadmill Score (STS) and Cleveland Clinic Score (CCS) among Bangladesh people to generate a local insight. Objective: To estimate and compare accuracy of ST segment response, DTS, Simple Treadmill Score and Cleveland Clinic Score to predict CAD. Method: In a cross-sectional study total 130 patients who had visited at a medical university with stable chest pain were selected according to predefined inclusion and exclusion criteria over one year. After taking proper history and physical examination their ETT report and Coronary Angiogram (CAG) finding, which were done according to indication defined by their consultants. ETT interpretation as ST segment response and treadmill scores were compared with gold standard test for CAD that is CAG. Accuracy of STdepression and treadmill scores were calculated by the formula “Accuracy = TP+TN / Total Sample”. Result: Among the total sample (n=130) male and female were 93 & 37, respectively. Nearly half of male sample fell into 5th decade and around same portion of female sample was in 4th decade. About 58%, 28% & 14% patients came with typical, atypical & non-cardiac chest pain. As calculated with above mentioned formula accuracy of ST segment response alone to diagnose IHD came about 68.4% (p value 0.004). Similarly DTS, STS and CCS had 83.3%, 83.9% and 77.2% accuracy, respectively (p value 0.000). Conclusion: During ETT relying on ST segment depression alone to diagnose CAD is significantly less accurate than treadmill scores namely, Duke Treadmill Score, Simple treadmill Score or Cleveland Clinic Score. Applying any of these treadmill scores during exercise test interpretation can identify ischemic heart disease patients with more accuracy. University Heart Journal Vol. 17, No. 1, Jan 2021; 10-15

Background: The use of Warfarin reduces the rate of ischemic stroke in patients with atrial fibrillation but requires frequent monitoring and dose adjustment. Rivaroxaban, an oral factor Xa inhibitor, may provide more consistent and predictable anticoagulant effects than Warfarin. Methods: In this Open comparison trial, the researchers compared Rivaroxaban (at a daily dose of 20 mg or 15 mg daily in patient with a creatinine clearance of 30-49 ml/min ) with dose adjusted Warfarin (target INR 2.0 to3.0) in 2,846 patients with nonvalvular atrial fibrillation and CHA2DS2-VASc Score 2 or more. The primary efficacy outcome was stroke or systemic embolism and primary safety outcome was major or minor bleeding. This research was designed to determine whether Rivaroxaban have more efficacy and safety than Warfarin for the primary outcomes. Results: Total follow-up period was 6 months. Risk factors and co-morbidities were similar in both groups. Baseline investigations were also similar. Age and sex of both groups were matched. The rate of ischaemic stroke was 1.8% in Rivaroxaban group, as compared with 2.18% in the Warfarin group (p 0.479, nonsignificant). The rate of haemorrhagic stroke was 0.53% in Rivaroxaban group, as compared with 1.36 % in the Warfarin group (p 0.026, significant). Systemic embolism was 0.08% in Rivaroxaban group, as compared with 0.15 % in the Warfarin group (p 0.561, non-significant). The rate of major bleeding was 0.4% in Rivaroxaban group and 0.53 % in the Warfarin group (p 0.361, non-significant). The rate of minor bleeding was 2.10% in Rivaroxaban group, as compared with 2.33% in the Warfarin group (p 0.681, non-significant). Conclusions: Rivaroxaban have similar efficacy and better safety profile than Warfarin in patients with nonvalvular atrial fibrillation in Bangladeshi population. University Heart Journal Vol. 16, No. 2, Jul 2020; 99-105

Acute coronary syndrome may leads to heart failure. Severity of heart failure is identified by NYHA classification clinically. Color Doppler echocardiography is the key investigation to identify the acute systolic heart failure. For the quantification of systolic heart failure diagnosis, Ejection fraction (EF) can be measured by Simpson method. EF > 30% is defined as severe systolic heart failure. Pulsus alternans is found in severe heart failure patients. Pulsus alternans is a poor prognostic sign of severe heart failure patients in acute MI setting. This cross sectional observation study was aimed to identify the objective evidence of Pulsus alternance noninvasively by Echocardiography. Color Doppler echocardiography was done 100 acute coronary syndrome with heart failure NYHA III and IV patients in department of Cardiology, BSMMU, from July 2018 to June 2019. Age 18 to 70 yrs, male is 79 and female is 21. Pulsus alternans was found in 32 patients, 39 had low volume and 29 had normal volume pulse. 50% patients had ST depression and T inversion and diagnosed as case of Unstable Agina or Non STEMI, 44 had STEMI and 7 had developed new onset of LBBB. 87 Patients who have EF < 30 % was marked as Severe LV systolic dysfunction. Among them, 3 had mild, 14 had moderate and rest 70 had severe Mitral regurgitation. 38 (43.67%) patients had Doppler alternans in severe LV systolic dysfunction group. P value for Doppler alternans is 0.039 which is significant. Doppler alternans by Echocardiography in Severe LV systolic dysfunction patients showed 49% sensitivity and 78% specificity. 38 patients had Severe RV systolic dysfunction by M- mode echo measurement of TAPSE

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

The aim of this study is to find out the facile and effective pretreatment technique to enhance the capacity of jute stick powder (JSP) in adsorbing dye from raw textile effluent. Hence, different pretreatment techniques, i.e., radiation treatment, alkali treatment, ammonia treatment, steam treatment and CaCl2 treatment were applied to JSP and the adsorbing performance were examined for synthetic dye solutions (Blue FCL and Red RL dye). Different gamma radiation doses were applied on JSP and optimum dye removal efficiency was found at 500 krad in removing these two dyes (50 ppm) from solutions. Among the different pretreatment techniques, gamma irradiated JSP (500 Krad) exhibits highest dye uptake capacity for RED RL dye, whereas steam-treated JSP shows highest performance in adsorbing blue FCL dye. Subsequently, we applied the gamma irradiated and steam-treated JSP on real textile effluent (RTE) and these two techniques shows potentiality in adsorbing dye from raw textile effluent and in reducing BOD5, COD load and TOC to some extent as well. Fourier transform infrared spectroscopy (FTIR) analysis also proved that dye has been adsorbed on pretreated JSP.

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

Hypertrophic Cardiomyopathy (HCM) shows considerable clinical heterogeneity, both between and within families. So far 18 genes have been identified and about 1400 different mutations have been found. Among these mutations human beta-Myosin Heavy Chain (β-MHC) and Myosin Binding Protein C (MyBP-C) mutations account for about 50% of cases. In this study, Genotype and phenotype correlations in HCM in β-MHC and MyBP-C genes mutation were screened in 60 Bangladeshi HCM patients. Patients referred from Department of Cardiology, of BSMMU a tertiary care hospital, Dhaka, Bangladesh were included in this study. Clinical evaluation included a full clinical history, physical examination, 12-lead Electrocardiography, ambulatory holter monitor, and two dimensional M-mode echocardiography and Doppler echocardiography was done by expert cardiologist. Determination of genotype of β-MHC& MyBP-C genes were done by Miseq next gene sequencer (NGS). DNA was isolated from blood. Four primers for each gene were designed to cover the whole gene sequences and amplicons were prepared by long range PCR. Library preparation for NGS was done by Nextera XT library preparation kit. The barcoded libraries were sequenced using the MiSeq sequencer with v3 kits. All sequencing data were aligned automatically to the reference genome (GRCh37/hg19) using the MiSeq Reporter v2.5 which converted sequencing raw data to Binary Alignment/Map (BAM) and Variant Call Format (VCF) v4.1 files. The VCF files were comprehensively analyzed and interpreted by VariantStudioTM v2.3 software. Evaluation of phenotype was completed after determination of genotype. Genetic screening revealed Glu965Lys/E965K, Arg442Cys/R442C (CGC>TGC), Arg663His/R663H (CGC>CAC) genes mutation in head domain of MYH7 protein in six patients, Ar435Trp/R35W (CGG>TGG) & Asp770Asn/D770N (GAC/AAC). Single gene mutations were identified in MYBPC3 protein in 15 patients and 3 patients found to be compound mutation. Two were found in intronic regions and are thought to be responsible for alternate splicing. Proband with compound mutations had a significantly greater left ventricular wall thickness and non-sustained ventricular tachycardia than the single mutation patients. Multiple gene mutation in HCM raises many issues of which haplotype of family member will be needed for microsatellites repeat to find out Bangladeshi population specific founder mutation.

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