Enhanced Case Detection and Improved Diagnosis of PKDL in a Kala-azar-Endemic Area of Bangladesh

PKDL is a skin disorder which usually develops in 10–20% and about 60% of patients with visceral leishmaniasis (VL) after treatment respectively in the Indian subcontinent and Sudan. However, cases among people without prior VL have also been reported. Except skin lesion, PKDL patients are healthy and usually do not feel sick. However, persistence of a few PKDL cases is sufficient to initiate a new epidemic of anthroponotic VL. Thus, identifying and treating people with PKDL is a key strategy for the elimination of kala-azar. Diagnosis of PKDL relies upon clinical criteria and a serological test which is not specific for PKDL. The use of the existing laboratory diagnostic tools for confirmation of PKDL among PKDL suspects is unknown. In the Indian subcontinent, PKDL is not self-limited and needs to be treated with sodium stibogluconate injections for 4–6 months. No data are available relating to treatment compliance by patients, particularly in Bangladesh. The results of the present study showed that trained village volunteers were useful for identifying PKDL suspects, and diagnostic confirmation improved with the use of PCR. However, patients' adherence to prescribed treatment was poor

ORIGINAL ARTICLES Immediate Clinical Outcome of 600 Cases of Percutaneous Coronary Intervention (PCI)

to October 2007, few cases were done in Eurobangla Hear

Stenting of Unprotected Left Main Coronary Artery Stenosis: Immediate out comes in NICVD our Initial Experience

This study aims to describe the initial experiences and immediate outcomes of percutaneous coronary intervention (PCI) in patients with significant left main coronary artery disease with normal LV function in National Institute of Cardiovascular Diseases (NICVD), Dhaka. Left main coronary artery disease is regarded as an absolute contraindication for coronary angioplasty. Recently several reports on protected or unprotected LMCA stenting or both suggested the possibility of percutaneous intervention for this prohibited area. The study was conducted in National Institute of Cardiovascular diseases &amp; Hospital, Dhaka, Bangladesh. Participants of the study were 100 patients with a diagnosis of critical left main coronary artery disease. Information was collected on their demographic characteristics and clinical history. Relevant physical examination and laboratory investigation were performed. Percutaneous transluminal coronary angioplasty (PTCA) with stent implantation were done in the left main coronary artery and other culprit vessel where required. They were followed up thoroughly during the hospital stay. The study subjects were from 35 to 70 years old. 70 male and 30 female were included in this study. According to the clinical history, 12 lead surface ECG reading and cardiac enzyme analysis 40% patient was diagnosed as unstable angina, 40% presented with chronic stable angina and rest of them presented with old myocardial infarction. Among the study population critically isolated LM disease were 30%, critical left main with other vessels disease were 70%. The pattern of LM disease involvement were osteal 40%, mid shaft 10%, distal bifurcation 30%, entire LM involving bifurcation 20%. Procedural success rate was 100%. No patient faced major advance cardiac events (MACE) during hospital stay. Stenting of unprotected LM coronary artery stenosis may be safe effective alternative to CABG in carefully selected patients with normal LV function. Further studies in larger population of this group are needed to assess late out comes.University Heart Journal Vol. 10, No. 1, January 2014; 7-12</jats:p

Outcomes of primary percutaneous coronary intervention (PCI) in NICVD, Dhaka,Bangladesh- our initial experiences

The aim of the study is to determine the out comes of primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction in NICVD the only government cardiac hospital of Bangladesh where resources are very limited. Total 73 (male 70, female 3) patients were enrolled in this study who were brought in to our hospital with STEMI between August 2010 to October 2013. Average age was 55.6 ±11.78. Primary PCI was performed after transferring patient from Emergency Department to cardiac catheterization laboratory. Cardiovascular risk factors among the studied population were Diabetes mellitus, Hypertension, Smoking, Dyslipidemia and Positive family history for IHD. Primary PCI either with Bare Metal Stent (BMS) or Drug Eluting Stent (DES) were performed in total 42 LAD lesions, 28 RCA lesions and 3 LCX lesions. BMS used were 87.7%, DES used were 12.3%. The procedural success was 95.8%.Four patients (5.4%) died during hospital stay. Out of four patients who died, one had cardiogenic shock. No mortality was observed in the 30 days follow up from discharge, while other complications like unstable angina and congestive heart failure were 5.7% and 4.3% respectively. Our findings suggest favorable outcomes, matching the international data which was achieved in our patients with primary PCI in the management of STEMI despite all the limitations. Primary PCI as a preferred method of reperfusion strategy needs to be practiced more often in our part of world.University Heart Journal Vol. 9, No. 2, July 2013; 83-87</jats:p

Percutaneous Coronary Intervention in Left Main Coronary Artery Disease - A Case Report

Not available DOI: http://dx.doi.org/10.3329/uhj.v8i1.11669 University Heart Journal Vol. 8, No. 1, January 2012</jats:p

Mapping the human genetic architecture of COVID-19

The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-191,2, host genetics may also be important. Identifying host-specific genetic factors may reveal biological mechanisms of therapeutic relevance and clarify causal relationships of modifiable environmental risk factors for SARS-CoV-2 infection and outcomes. We formed a global network of researchers to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity. Here we describe the results of three genome-wide association meta-analyses that consist of up to 49,562 patients with COVID-19 from 46 studies across 19 countries. We report 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19. Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases3,4,5,6,7. They also represent potentially actionable mechanisms in response to infection. Mendelian randomization analyses support a causal role for smoking and body-mass index for severe COVID-19 although not for type II diabetes. The identification of novel host genetic factors associated with COVID-19 was made possible by the community of human genetics researchers coming together to prioritize the sharing of data, results, resources and analytical frameworks. This working model of international collaboration underscores what is possible for future genetic discoveries in emerging pandemics, or indeed for any complex human disease