Browsing by Author "Ali, M A"
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Item Association of Left Atrial Spontaneous Echocardiographic Contrast with Inflammatory Markers in Mitral Stenosis Patients.(2014) Islam, M J; Majumder, A A S; Ali, M A; Dutta, B; Karmoker, K K; Imrana, F; Saha, J N; Razzaque, M A; Rahman, M A; Das, P R; Jannat, S; Islam, M SBackground: Spontaneous echocardiographic contrast (SEC) is a risk factor for left atrial thrombus formation and an important indicator of potential systemic embolism originated from heart. An established relation exists between the inflammatory status and the prothrombotic state. The present study was conducted to evaluate the association between left atrial spontaneous echocardiographic contrast with inflammatory markers in mitral stenosis patients. Methods: This observational analytical study was undertaken in the department of Cardiology, National Institute of Cardiovascular diseases (NICVD), Dhaka. A total of 70 patients with mitral stenosis were categorized into two groups: group I with left atrial SEC and group II without left atrial SEC. All patients underwent transthoracic as well as transoesophageal echocardiography. Complete blood count with ESR was done and neutrophil lymphocyte ratio was calculated. The high sensitive C-reactive protein (hs-CRP) was assayed. Results: The hs-CRP levels were significantly greater in the SEC-positive group (5.6±2.1vs 1.5±0.7, p=0.001). The mean ESR level was significantly greater in the SEC-positive group (32.6±15.5 mmvs15.8±4.7 mm).The neutrophil levels ((76.1±1.9 vs 63.7±3.3) were significantly greater in the SEC-positive group, and the lymphocyte levels (33.3±3.0 vs 21.5±1.3) were significantly greater in the SEC-negative group (p=0.001 for each). The neutrophil/lymphocyte (N/L) ratio was also significantly greater in the SEC-positive group (3.4±0.4 vs2.1±0.6, p=0.001).On multivariate analysis hs-CRP, neutrophil/lymphocyte ratio, raised ESR, mitral valve area and left atrial diameter were independent risk factors for SEC in patients with mitral stenosis. Conclusion: From this study it may be concluded that left atrial SEC is associated with raised inflammatory markers in majority of patients with mitral stenosis. So, SEC may be considered as a reflection of ongoing inflammatory process in patients with mitral stenosis.Item Atrial Tachycardia: A Rare Type of Supra Ventricular Tachycardia.(2012) Aziz, M; Ullah, M; Hossain, M; Ali, M AAtrial tachycardia is a relatively uncommon form of SVT. Atrial tachycardia can be observed in persons with normal heart and in those with congenital heart disease and particularly after surgery for repair or correction of congenital or valvular heart disease. Atrial tachycardia tends to be refractory to pharmacologic therapy and is therefore frequently treated with ablative therapy. If untreated, it may lead to tachycardia-induced cardiomyopathy. So, atrial tachycardia needs to be discussed for recognition and appropriate management. We have gone through different journals to review the latest informations about atrial tachycardiaItem Carotid Duplex Ultrasound Findings in Patients with Coronary Artery Disease (CAD)- A Study in 50 Cases.(2008) Bari, M S; Kabir, M S; Ali, M A; Alam, S A N; Majumder, A A S; Islam, M NBackground: Patients with angina pectoris or myocardial infarction are more likely to experience stroke. Ischaemic stroke has been found to develop in approximately 2-5% of patients in the first 1- 2 weeks after myocardial infarction Methods: Fifty patients with coronary artery disease admitted to the National Institute of Cardiovascular Diseases (NICVD), Dhaka, were screened for presence of carotid atherosclerosis by duplex ultrasound study during the period of July 98 to August 98. Results: Carotid lesion were found in 34 patients (68%) and normal carotids found in 16 patients (32%). Age range of patients with and without carotid lesions was 56±5.39 yrs and 47±7.91 yrs respectively. Out of 34 patients, 30 were male (88.2%) and 4 were female (11.7%). 29 patients (85.3%) were smokers, 22 patients (64.7%) were hypertensive and 9 patients (26.4%) were diabetic. Dyslipidaemia was found in 16 patients (47%) and a history of transient ischaemic attack (TIA) was found in 10 patients (29.4%). A coexistent CAD on coronary (CAG) was found in 31 patients (91.1%). Conclusion: Cortaid duplex ultrasound study findings of atherosclerotic lesions in Carotid arteries are good predictors of CAD.Item A case of appendiceal-sigmoid fistula of non-diverticular origin.(2001-01-12) Ganesh, J S; Ali, M AItem Comparison of haematological values among different groups of low birth weight babies and normal birth weight babies.(2008-07-16) Ali, M A; Shahidullah, M; Hossain, M A; Ahmed, N U; Kawsar, C AThis prospective cross sectional study was carried out in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. This study was undertaken to compare the haematological value (reference range) among Small for gestational age-low birth weight (SGA-LBW), Appropriate for gestational age-low birth weight (AGA-LBW) and Normal birth weight (NBW) babies. Total 90 (ninety) newborn babies were enrolled in this study. They were ultimately divided into three groups as a) Group I (SGA-LBW), b) Group II (AGA-LBW), c) Group III (NBW). Study period was one year (December 2003 to December 2004), Relevant informations were collected from the guardian of the babies before inclusion in the study. In group I, 19(63.3%) were preterm and 11(36.7%) were term. In group II, 30(100%) were preterm and in group III, 30(100%) were term. Mean Hb, and HCT levels were highest in group I (SGA-LBW) and the value was 17.14+/-1.41 gm/dl (Hb) and 0.51+/-0.04 (HCT) respectively. Mean Hb and HCT value were lowest in group II (AGA-LBW) and the value was 14.57+/-1.78 gm/dl (Hb) and 0.43+/-0.05 (HCT) respectively. In between value was found in group III (NBW) and the value was 16.14+/-1.09 gm/dl (Hb) and 0.48+/-0.04 (HCT) respectively. Differences were statistically significant. On the contrary, MCV Values were highest in group II (AGA-LBW) and the value was 103.23+/-4.99 (fl). Lowest MCV value was in group III (NBW) and the value was 98.13+/-3.93 (fl). In between result of MCV value was found in group I (SGA-LBW) and the value was 99.27+/-10.73 (fl). Differences were also statistically significant. MCH and MCHC level was also highest in group I (SGA-LBW). Difference was also statistically significant. No significant differences of TC of WBC and platelet counts were not found among different groups. Hb and HCT level had significant positive correlation with gestational age. Other parameters had no Positive correlation with gestational age.Item Coronary Angiographic Characteristics of Patients with First Myocardial Infarction Admitted in a Tertiary Care Cardiac Hospital in Bangladesh.(2010) Kabiruzzaman, M; Ali, M A; Islam, M NBackground: Coronary artery lesion characteristics of patients with First myocardial infarction (First MI) of Indian subcontinent origin in UK, is different from indigenous white population. The present study was aimed to observe coronary angiographic profile of first MI patients, hospitalized in a tertiary care hospital, in Bangladesh and to compare the results with published data of study done home and abroad. Methods: This is a prospective observational study. A total of 100 cases of First MI patients were included in this study. Clinical history, physical examination, major risk factors, relevant investigations including ECG & Echocardiogram and coronary angiogram of all patients were recorded. Results: The coronary angiographic features of 100 patients revealed that 88% of the study population had significant coronary artery lesion (stenosis e”70%). Normal coronary arteriogram was found in 5 patients (5%); although they had myocardial infarction previously. Insignificant lesion (stenosis < 70%) was detected in 7 patients (7%). Left anterior descending (LAD) arteries were affected in most of the patients (78%), followed by right coronary artery (62%) and left circumflex artery (55%). Single vessel disease (33%) and triple vessel diseases were equally prevalent among the study population. Conclusion: Present study observed that triple vessel disease, diffuse pattern of lesions and combined type of lesions were more prevalent among the first MI patients. Increase in the number of risk factors was associated with progressive increase in severity of disease as defined by number of significant stenosis. Comparison of results of present study population with that of study done abroad shows that single vessel disease was more prevalent among European white patients who had first MI but triple vessel disease was more prevalent among our patients.Item Coronary Angiographic Profile in Patients with Conduction System Disorder Requiring Permanent Cardiac Pacing.(2011) Majumder, A A S; Ali, M A; Rashid, M T B ABackground: The association between conduction disturbances and atherosclerotic coronary artery disease has been investigated in a few small studies in the early 1970s and the study result was inconclusive. Thereafter some investigators found in their separate study that a group of patients with conduction disturbances that required permanent pacemaker who had coronary atherosclerotic disease that might be responsible for conduction disturbances. Method: 40 consecutive patients that required permanent pacemaker and 40 control patients were investigated. The coronary angiographic study was performed in both groups which included classification of pathological coronary anatomy, qualitative assessment of flow and stenosis severity. Results: The location of the lesions was found significantly different between two groups. 14 patients(35%) of 40 study patients had type IV lesion, whereas only 2 patients(5%) of 40 control patients had type IV lesion (p=0.001). Flow quality was found poor in more patients in study group specially that had type IV lesion. Severity of the lesions in the LAD & RCA was found identical in both groups. Conclusion: It may be concluded that the location of the lesions rather than diffuse coronary atherosclerosis might be responsible for a subset of patients with conduction disturbances that required permanent pacemaker.Item Early detection of cervical intraepithelial lesions by simple visual inspection after acetic acid among women in Rajshahi medical college hospital.(2011) Yusuf, N; Islam, F; Akhter, H; Ali, M A; Khanam, J AAim: To evaluate the performance of visual inspection of acetic acid (VIA) in the detection of precancerous and early cancerous lesions of cervix. Materials and methods: Total 5593 eligible women who randomly came to the Gyenae out patient department (OPD) of RMCH (Rajshahi Medical College Hospital) were examined by VIA. Detection of well defined, opaque, acetowhite lesions close to the squamocolumner junction or in transitional zone or dense acetowhitening of ulceroproliferative growth on the cervix constituted a positive VIA. Those who had abnormal results in screening test & those who had clinically suspicious lesions were sent for colposcopic evaluation (n= 442) & directed biopsy were taken from colposcopically suspected areas (n=214). The final diagnosis was based on histology. Results: Out of 5593 patients, 442 (7.20%) were VIA positive. 442 patients were colposcopically evaluated .Among them, 228 (51.58%) were normal and 202(45.70%) had different stages of cervical intraepithelial lesions (CIN) and 12 ( 2.71 % ) had carcinoma of cervix. Out of 214 patients biopsied, 23.36 % patients had a final diagnosis of CIN lesions, 5 (2.33%) had carcinoma in-situ & 17 cases (7.94%) had invasive carcinoma. Besides to find out the predictable factors of cervical lesions data have been collected from VIA positive patients regarding age of first coitus and first delivery, history of extra marital exposure and STI, use of contraceptive methods and family history of cancer. Age of first coitus between 12 to 15 years and 16 to 20 years were observed among 203 (46 %) and 40 % (177) women respectively. More than half of the patients (62%) were experienced with their first delivery within the age 15-20 years which was below 15 years of 12 % (53) patients. Fifty four percent patients used OCP and barrier methods used were only 10 %. Family history of cancer was observed among 09 % women. 58% patients were belonged to lower middle class and upper group were only 9% (table 1) Conclusion: In our study detection of different grades of intraepithelial lesions (CIN-I, CIN-II, CIN-III, invasive carcinoma) of cervix by VIA was comparable to that of colposcopy. So VIA is suitable for detection of precursor lesions of cervical cancer in low resource settings and also for diagnosis, follow up treatment and epidemiological studies of cervical cancer.Item Effect of ascorbic acid in the treatment of tetanus.(1984-06-01) Jahan, K; Ahmad, K; Ali, M AThe effect of daily intravenous administration of 1000 mg ascorbic acid (AA) in tetanus patients aged 1-30 years was studied. In the age group of 1-12 years, 31 patients were treated with AA as additional to antitetanus serum, sedatives and antibiotics. It was found that none of the patients died who received AA along with the conventional antitetanus therapy. On the other hand, 74.2 per cent of the tetanus patients who received the conventional antitetanus therapy without AA (control group) were succumbed to the infection. In the other age group of 13-30 years, there were 27 and 38 patients in the treatment and control groups respectively. The mortality in the AA and control groups were 37 percent and 67.8 percent respectively. These results suggest that AA might play an important role in reducing the mortality of tetanus. This was supported by the fact that AA was found to mitigate the toxic effects of strychnine producing tetanus like condition in young chicks in the present study.Item Effect of Statin Therapy In Ventricular Arrhythmias In Patient With Acute Anterior Myocardial Infarction.(2013) Kawsar, S M; Majumder, A A S; Ali, M A; Ullah, M; Islam, A K M MBackground: Though statins are widely used in acute coronary syndrome (ACS), there is a paucity of information on the efficacy of high dose statin therapy in reducing the incidence of ventricular arrhythmias after acute myocardial infarction. Arrhythmias are relatively common in acute myocardial infarction (AMI) anterior, and sometimes progress to cardiac arrest. This study was planned to evaluate the role of high dose atorvastatin therapy in prevention of ventricular arrhythmias after acute anterior myocardial infarction. Methods: This study was conducted in NICVD from December 2010 to October 2011. Total 200 patients with newly diagnosed acute anterior myocardial infarction who received thrombolytic therapy were included in the study. They were divided into two groups. Group I (n=100) was selected for high dose atorvastatin therapy and group II (n=100) was selected for conventional doses of atorvastatin therapy. 24 hours Holter monitoring was performed 48 hours after hospital admission to evaluate arrhythmia. Results: Majority of the patients belonged to age range of 40 to 59 years with a male predominance. Patient characteristics regarding age, sex, drug use, risk factors for ventricular arrhythmia, body mass index, left ventricular ejection fraction were similar in two study groups. There was no electrolyte imbalance or renal impairment in any patient in either group. A significant difference in frequency of ventricular arrhythmias was found between the two groups. Ventricular premature beats were found in 66% patients in group I and 97% patients in group II (p=0.001) whereas non sustained ventricular tachycardia were observed in 0% and 4% in group I and group II respectively. Conclusion: High dose atorvastatin therapy is associated with lower frequency of ventricular arrhythmias after acute anterior myocardial infarction.Item Effects of mesencephalic lesion on testes, seminal vesicles and adrenal glands of albino rats.(1993-04-01) Ali, M AThe role of mesencephalic reticular formation on testicular structure, seminal vesicles, adrenal glands and kidneys of albino rats was investigated. Mesencephalic reticular formation lesions were produced using two epoxy-coated stainless steel electrodes. Electrolytic lesions resulted in atrophy of the testes, seminal vesicles and adrenal glands. The degree of atrophy was statistically significant in these organs (P < 0.01). However, there were no significant changes in the kidneys of lesioned animals. This study strongly suggests that the mesencephalic reticular formation influences the histomorphology of testes, seminal vesicles and adrenal glands.Item Effects of mesencephalic lesion on the histomorphology of testis and spermatogenesis.(1986-01-01) Ali, M AMesencephalic reticular formation lesions were produced bilaterally by using two epoxy-coated stainless steel electrodes. Electrolytic lesions resulted in atrophy of testes, and decreased spermatogenesis. Seminiferous tubules of lesioned rats were characterised by a general decrease in the number of cells from different generation of germinal epithelium, empty spaces, degeneration of spermatogonia, degeneration of spermatocytes I and of young spermatids. There were significant reductions in weights of the testes (P less than 0.01). Similarly the areas of cross-sections of seminiferous tubules were significantly reduced (P less than 0.05). Another note-worthy feature was a gross reduction in the complete cross section count of interstitial cells. The study strongly suggests that the mesencephalic reticular formation influences the testes and spermatogenesis.Item Epidemiologic study of type II diabetes associated vascular complications.(1987-03-01) Radwan, M; Massoud, A A; Botros, M; Ali, M AItem Evaluation of Efficacy and Tolerability of Perindopril 8 mg in Bangladeshi Hypertensive Patients: Results from an Open-label, Observational, Multi-center Study (CONTROL).(2012) Islam, M N; Majumder, A A S; Mahmud, R S; Sadequzzaman, M; Bashar, M A; Ali, M R; Akanda, M A K; Siddiqui, F M; Islam, K Q; Reza, A Q M; Ali, M A; Choudhury, A K; Rahman, M M; Khan, R C; Ghose, T C; Ahmed, J; Basak, S K; Azam, S; Pasha, K; Khan, T FBackground: The CONTROL (COversyl in Newly diagnosed stage-II & unconTROlled hypertensive patients triaL) was performed with an objective to evaluate the blood pressure (BP) lowering efficacy and tolerability of Perindopril 8mg in newly diagnosed stage II patients and uncontrolled hypertensive patients among Bangladeshi population. Methods: This was an open-label, observational, multi-center study conducted in consultation centers for out-patients located in different cities of Bangladesh. Adults, aged above 18 years with newly diagnosed stage-II hypertension or uncontrolled hypertension, were recruited. Patients were treated with Perindopril 4mg daily for first 1 week, afterwards uptitrated to Perindopril 8 mg daily and continued treatment for 12 weeks. Patients were followed-up at week-1, week-4, week-8 and week-12. Results: In total, 245 patients were enrolled. Among them, 88 were newly diagnosed stage-II (Group- I) and 157 were uncontrolled (Group-II) hypertensive patients. Male and female distribution was 57% and 43% respectively. Mean age of patients was 54.5 ±11.7 years. After 12 weeks treatment, there was a significant reduction in BP from baseline (p<0.001) in overall population as well as in Group I and in Group II. In overall population, the mean BP reduction was -31/-15 mmHg (from 163.7/96.8 mmHg to 132.4/81.7 mmHg. In Group I, the reduction was -33/-16 mmHg (from 166.5/98.2 mmHg to 133.4/82.0 mmHg) and in Group II, -30/-14 mmHg (from 159.3/ 95.6 mmHg to 129.1/81.6 mmHg). 10 patients (4.1%) had to discontinue the treatment due to adverse effects. Dry cough (2%) and hypotension (1.2%) were the main cause of discontinuation. Perindopril 8mg was well tolerated as indicated by the high proportion of physicians (81%) reporting ‘good’ to ‘excellent’ tolerability at week 12. Conclusion: This study suggests that Perindopril 8mg is effective and safe in the treatment of hypertension in Bangladeshi patients.Item Gallstone disease in children--case report and management guidelines.(1997-04-01) Kanth, S R; Jeswanth, S; Manoharan, G; Rathnasamy, A; Ali, M AItem Giant epithelioid leiomyoblastoma of the stomach--a diagnostic dilemma.(1992-03-01) Ali, M A; Jayanthi, V; Geetha, PEpithelioid leiomyoblastoma (ELB) of the stomach is an uncommon slow growing smooth muscle tumour, attaining enormous size and presenting with bizzare symptoms. We report one such case which posed a diagnostic problem to both the clinician and the radiologist; the condition was diagnosed after laparotomy and histological examination.Item Histological and histometrical studies of testicular hypertrophy following hemicastration of albino rats.(1982-01-01) Osuide, G; Ali, M A; Wambebe, CThis project was designed to study the effects of hemicastration in male albino rats of different ages and weights. Significant compensatory hypertrophy was seen in young rats (5 and 20 days old). The concentration of seminiferous tubules was profoundly reduced while the tubular diameter was increased in young hemicastrated rats. The weights of the kidneys were increased while the weights of the adrenal glands were not different in hemicastrated young rats. These histological and histometrical changes may be associated with specific endocrine activity.Item Incidence and prognostic significance of right bundle branch block complicating acute myocardial infarction.(2002-04-18) Islam, M N; Ali, M A; Saha, G K; Islam, M F; Islam, K Q; Rahman, M SThe incidence and hospital courseofacute myocardial infarction wereobserved among randomly selected 560 patients. The mean age of the patients was 53 +/- 6.67 years with male-female ratio 2.6:1. The incidence of right bundle branch block (RBBB) was 15% (84 out of 560 patients). New RBBB, old RBBB and RBBB of indeterminate age were observed in 33 (39.25%), 23 (27.40%) and 28 (33.25%) cases respectively. RBBB was isolated in 50 (60%) cases and bi-fascicular in remaining 34 (40%) cases. The rate of use of thrombolytic was greater in RBBB group than non-RBBB group (52% vs 30.67%, P < 0.05). The complications were more frequently observed in patients with RBBB: in-hospital mortality, 27.40% vs 10.90% (P < 0.01); use of temporary pacemaker, 15% vs 9% (P < 0.05); and heart failure, 50% vs 35% (P < 0.05). In sub-group analysis, in-hospital mortality rate was higher among bi-fascicular group than isolated RBBB group (P < 0.05). Thus it appeared from the results that the incidence of RBBB is relatively common i.e. 15% over all (84 out of 560) and 5.90% new (33 out of 560) and despite greater use of thrombolytics, some specific in-hospital complications were significantly higher in patients with RBBB than without, RBBB.Item Incidence of spontaneous echocontrast in left atrium in mitral stenosis detected by transoesophageal echo cardiography and related factors.(2000-08-18) Saha, G K; Ali, M A; Hossain, N; Zaher, A; Miah, M A; Zaman, M AThe incidence of left atrial (LA) spontaneous echo contrast (SEC) and the clinical and echocardiographic variables related to it were prospectively evaluated in a series of 60 patients with mitral stenosis (MS) undergoing transoesophageal echocardiography (TEE) with a 5 MHz multiplane transducer. LA-SEC was found in 39 patients (65%) employing TEE. Statistical analysis showed a significant relationship between the presence of SEC and MS without mitral regurgitation (MR) (P < 0.05), MS with < or = MR grade II (P < 0.05), atrial fibrillation (P < 0.001) and increased left atrial dimension (P < 0.05). Age, sex, mitral valve area and ejection fraction did not show any positive association (P > 0.05). Thus, it is concluded that LA-SEC is a common finding observed in approximately 65% of MS patients undergoing TEE and associated with conditions favouring stasis of left atrial blood.Item Long-Term Follow -Up After Radiofrequency Catheter Ablation of Fascicular Ventricular Tachycardia at National Institute of Cardiovascular Diseases.(2009) Ali, M A; Hossain, M M; Hashem, S; Jami, M A; Hossain, A; Foran, J P; Ahmed, RIntroduction: Verapamil-sensitive, idiopathic left ventricular tachycardia (ILVT) with right bundle branch block configuration and left-axis deviation is known to be due to re-entry mechanism but the exact nature of reentrant circuit in ILVT is not fully elucidated. In this study we evaluate the results of long-term clinical outcome in patients who underwent radiofrequency catheter ablation of idiopathic fascicular ventricular tachycardia in National Institute of Cardiovascular Diseases. Methods: Electrophysiological studies and radiofrequency ablation were performed in 46 consecutive patients (42 men,04 women), age ranging from 16 to 36 years (mean 20±5 years) with verapamilsensitive ILVT and structurally normal hearts. VT could be terminated by the intravenous administration of verapamil in all patients. Mapping was performed using a Bard electrophysiology system. The target site for ablation was the mid-septum of left ventricle where the earliest Purkinje potentials were recorded during VT. RF current was applied to the target site with or without late diastolic potential during VT in all patients to meet the ablation endpoints which were termination of the VT and non-inducibility of the tachycardia. Results: All 46 patients had successful ablation of the ILVT. During 3 years follow up 02 patients had recurrence. Conclusion: Idiopathic left ventricle tachycardia occurs most commonly in young population. Prompt recognition of this arrhythmia is important since radiofrequency ablation can cure this rhythm problem. This can be achieved in a country like Bangladesh where resources are limited.