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Background: Anemia is a common complication in chronic kidney disease (CKD), and is associated with a reduced quality of life, and increased morbidity and mortality. The mechanisms involved in ananaemiassociated with CKD are diverse and complex. They include a decrease in endogenous erythropoietin (EPO) production, absolute and/or functional iron deficiency, and inflammation with increased hepcidin levels, among others. Objective: The objective of our study was to investigate the prevalence and severity of anaemia in pre-dialysis patients, and chronic kidney disease patients in Bangladesh.Material & Methods:This was a case-control prospective study conducted with over 300 Bangladeshi non-patients as the control group A and 87 with different stages of chronic kidney disease (CKD) patients as the case group B in the department of Nephrology BSMMU from April’2004 to June 2006. The normal people who had no history of diabetes mellitus, hypertension, or CKD and were not on any medication were controlled and different stages of the CKD patients who had no history of blood transfusion, erythropoietin and parental iron infusion were cases.Results:Out of 300 normal populations male was 158(52.7%) and the female was 142(47.3%) and the mean haemoglobin level of the male was 13.94 g/dl and the female was 12.29 g/dl. Among males 24(15.2%) and females 55(38.7%) were anaemic and the overall prevalence of anaemia was noted at 26.3%. Of the total anaemic people, 25% was microcytic anemia. Out of 87 CKD patients, 56 (64%) were male and 31 (36%) were female. The overall prevalence of anaemia in CKD patients was 95.4%. The haemoglobin level was <11g/dl in 57.14% patients with CCr 30-59 ml/min/1.73m2 which increases to 87.5 % in patients with CCr 15-29 ml/min/1.73m2, which also increases to 94.2 % in patients with CCr<15 ml/min/1.73m2. Mean haemoglobin was observed at 8.6 g/dl, 9.54 g/dl and 11.25 g/dl in stage V, stage IV and stage III CKD patients respectively. Anaemia appeared at 43.53 ml/min/1.73 m2 of CCR.Conclusions:The results demonstrate that patient with reduced renal function is more likely to have anaemia and the prevalence and severity of anaemia increase with declining kidney function. CCr and TSAT is the important predictor of anaemia. In a significant number of the CKD, patient anaemia was associated with iron deficiency.
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Background: Throughout any surgical procedure, the immune system is generally activated as a physiological response to the surgical trauma. Cardiopulmonary bypass can trigger the inflammatory response in three ways: direct contact activation of the immune system due to exposer of blood to foreign surfaces, ischaemia-reperfusion injury to vital organs as a result of aortic cross clamping, and splanchnic hypoperfusion. Objective: The aim of the study was to observe the acute phase response variables in Bangladeshi patients and to assess the acute phase response and morbidity of the patients after prolonged bypass surgery.Methods:This cross sectional study was conducted in the Department of Cardiac Surgery, BSMMU from January 2009 to December 2010. Fifty patients were selected for the study and were divided into 2 groups on the basis of cardiopulmonary bypass time. Group I was cardiopulmonary bypass time less than 90 minutes and Group II was more than 90 minutes. Data were stored and analyzed with standard computer software (SPSS-15). P < 0.05 was considered statistically significant.Results:The mean duration of cardiopulmonary bypass (CPB) time (55.76�.8 in group I, 131�.35 in group II; P<0.001) and Aortic cross clamp time (28.48�31 in group I, 83.48�.99 in group II; P<0.001) was higher in group II than group I. Analysis of outcome variables showed that mean postoperative ventilation time was 6.24�20 in group I and 9.16�33 in group II. There was significant difference in the ventilation time between two groups (P<0.001). This study showed that there is a definite relationship of wound infection with the prolonged cardiopulmonary bypass time (P<0.001) and also persistently rising CRP increases the chance of wound infection.Conclusions:We may conclude that prolonged cardiopulmonary bypass time is associated with increased acute phase response and morbidity of Bangladeshi patients.
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Objective: In this study our main objective is to evaluate effectof serum IgE level between frequent relapse and infrequentrelapse nephrotic syndrome in children.Methodology: This Cross-sectional comparative studyconducted at the Department of Paediatric Nephrology,Bangabandhu Sheikh Mujib Medical University (BSMMU) andDepartment of Paediatrics, Dhaka Medical College Hospital,Dhaka from February 1, 2010 to October 1, 2010. During thestudy, 60 children were included in the study according tojudgmental or purposive sampling method and they weregrouped as follows: Group A (n = 30): Frequent RelapseNephrotic Syndrome (FRNS), Group B (n= 30): InfrequentRelapse Nephrotic Syndrome (IFRNS).Results: During the study, majority (60%) were of age groupA, 2-5. On the other hand in group-B, majority (66.8%) were ofage groups 2-5 years followed by (16.7%) were of age group 6-9 years and 5 (16.6%) were of age group 10-15 years. Duringrelapse of the disease serum immunoglobulin E (IgE) level wasapproximately 3.5 times higher in group A than that of group Bwhich was 1573.60IU/ml (SD ±197.01) vs. 438.46IU/ml (SD±51.6).Conclusion: From our study we can conclude that, that serumIgE level in frequent relapse nephrotic syndrome wassignificantly higher (P < 0.001) in comparison to infrequentrelapse nephrotic syndrome in children during both relapse andremission irrespective of history of atopy. So serum IgE levelmight have an influence for the occurrence of relapse inchildhood idiopathic nephrotic syndrome
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Background: Bronchodilators, by dilatation of bronchial tree through relaxation of bronchial smooth muscle increases the vital capacity, tidal volume and total lung capacity and reduces gas trapping. This study was conducted to assess the pulmonary function after off-pump coronary artery bypass graft (CABG) surgery between patients with impaired pulmonary function treated with or without preoperative bronchodilator. We also compared duration of mechanical ventilation and days spent in the surgical intensive care unit (ICU) after CABG in both group of patients. Methods: This prospective cohort study was carried out in the department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from July 2009 to April 2011. This study included 50 patients (25 patients in each group) with multi-vessels coronary artery disease with impaired pulmonary function who underwent off-pump CABG. Results: Spirometry was done in both groups of patients after admission, day before operation and on 7th post-operative day. The difference in Forced vital capacity (FVC) and Forced expiratory volume in 1st second (FEV1 ) between two groups were not statistically significant after admission (P>0.05). On the day before surgery the values of FVC and FEV1 were increased (more in Group-I who were treated with bronchodilator) and 7th postoperative day the values were decreased (more in Group-II who were not treated with bronchodilator). The results were found statistically significant in between groups (P<0.05). Conclusion: Bronchodilator should be considered pre-operatively in all patients having impaired pulmonary function undergoing off-pump CABG for better preservation of postoperative pulmonary function.
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The methanolic extract obtained from the leaves of Tabernaemontana divericata (Family: Apocynaceae) was evaluated for in vitro antioxidant potential by determination of total antioxidant capacity, assay of nitric oxide scavenging activity and reducing power test. The extract was also screened for its cytotoxic effect using brine shrimp lethality bioassay. The results revealed potent antioxidant property in all antioxidant assays compared to the reference antioxidant, ascorbic acid in a dose dependent manner. Further, the methanolic extract of Tabernaemontana divericata showed significant cytotoxic effect (LC50: 3.12μg/ml) compared with positive control, Vincristine Sulphate (LC50: 0.331μg/ml).