Tag: Bangladesh

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ssnimcj2026v11i2s16

Association of Serum Total Cholesterol with Type 2 Diabetes Mellitus in Bangladeshi Male Adults: A Cross-Sectional Analytical Study
*Mumu NS
*Dr. Naureen Sayeed Mumu, Assistant Professor, Department of Physiology, President Abdul Hamid Medical College and Hospital,Karimganj, Kishoreganj. naureenmumu@gmail.com.  https://orcid.org/0009-0005-3512-8391

Abstract
Introduction: Type 2 Diabetes Mellitus is a chronic metabolic disorder characterized by persistent hyperglycaemia and is often associated with abnormalities in lipid metabolism. Serum total cholesterol is one of the commonly measured lipid parameters and may provide useful information about cardiovascular risk in diabetic patients.
Objective: To evaluate and compare serum total cholesterol levels in Bangladeshi male adults aged above 40 years with Type 2 Diabetes Mellitus and healthy age-matched controls, and to determine the association between elevated cholesterol and diabetic status.
Methods: This cross-sectional analytical study was conducted among 200 Bangladeshi male participants aged above 40 years. Among them, 100 diagnosed Type 2 Diabetes Mellitus patients were included as the study group, and 100 healthy age-matched male individuals were included as the control group. Fasting blood samples were collected after overnight fasting, and serum total cholesterol was measured as the principal biochemical parameter. Data were expressed as mean ± standard deviation, and comparison between groups was performed by unpaired Student’s t test.
Result: The mean serum total cholesterol level was higher in the study group than in the control group, with values of 174.91 ± 45.5 mg/dL and 145.08 ± 31.83 mg/dL, respectively. The mean difference was 29.83 mg/dL, with a t value of 5.37 and p < 0.001. This indicates a statistically highly significant elevation of serum total cholesterol among patients with Type 2 Diabetes Mellitus. The diabetic group also showed approximately 20.56% higher serum total cholesterol than controls.
Conclusion: The findings suggest that elevated serum total cholesterol is an important biochemical abnormality among Bangladeshi male patients with Type 2 Diabetes Mellitus aged above 40 years. However, as this was a cross-sectional study, the result should be interpreted as an association rather than proof of causation or disease progression.

[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):228-233]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.16

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ssnimcj2026v11i2s14


Original
Short-Term Outcome of Ischemic Stroke Patients with and without Atrial Fibrillation
*Sarkar BK,1 Moontaha H,2 Iqbal MH,3 Paul MR4

  1. *Dr. Bikash Kumar Sarkar, Junior Consultant (Medicine), Infectious Disease Hospital, Mohakhali, Dhaka, Bangladesh. drbikashrmc@gmail.com. ORCID: https://orcid.org/0009-0008-5832-053X
  2. Dr. Hashiba Moontaha, Assistant Professor and Resident Surgeon, Department of Gynecology and Obstetrics, Dhaka Medical College Hospital, Dhaka, Bangladesh. ORCID: https://orcid.org/0009-0002-6133-7064
  3. Dr. Md. Hasan Iqbal, Assistant Registrar, Department of Cardiology, National Institute of Cardiovascular Disease, Dhaka, Bangladesh. ORCID: https://orcid.org/0009-0004-1186-9956
  4. Dr Mira Rani Paul, Lecturer, Department of Pedodontics and Dental Public Health, Rajshahi Medical College, Rajshahi, Bangladesh. ORCID: https://orcid.org/0009-0004-7980-1165

*For correspondence

Abstract
Introduction: Atrial fibrillation (AF) is a significant risk factor for ischemic stroke, associated with increased stroke severity and poorer outcomes. However, limited data exist from developing countries regarding the impact of AF on stroke outcomes. Hence, this study aimed to investigate the short-term outcomes of ischemic stroke patients with and without atrial fibrillation in a tertiary care hospital in Bangladesh.
Methods: This cross-sectional comparative study was conducted at Rajshahi Medical College Hospital over six months, enrolling 60 ischemic stroke patients (30 with AF, 30 without AF). Outcomes were assessed using the modified Rankin Scale (mRS) at one- and three months post-stroke. Data analysis included chi-square tests, t-tests, and multivariable logistic regression.
Results: AF-associated strokes occurred more frequently in females (53.33% vs 26.67%, p=0.035) and showed significantly higher mRS scores at one month (3.60 vs 1.73, p=0.001) and three months (3.47 vs 1.40, p=0.001). Three-month mortality was significantly higher in the AF group (46.7% vs 12.3%, p=0.005). After adjustment for confounders, AF was associated with significantly higher odds of poor functional outcome at one month (AOR: 5.49, 95% CI: 1.4-21.20).
Conclusion: Ischemic stroke patients with AF experience significantly worse short-term outcomes compared to those without AF. These findings emphasize the need for enhanced AF screening and prevention strategies in Bangladesh, particularly among high-risk populations.

[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):212-219]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.14

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ssnimcj2026v11i2s11


Original
Assessment of Drug Utilization Patterns of Supportive Therapy in Pediatric Patients with Acute Viral Hepatitis at a Tertiary Care Hospital
*Sattar S,1Quddush AR2

  1. *Dr. Shamima Sattar, Associate Professor, Department of Pharmacology and Therapeutics, Community Based Medical College, Bangladesh. shamimacbmcb@gmail.com. ORCID: https://orcid.org/0009-0006-3640-1721.
  2. Professor Dr. ASM. Ruhul Quddush, Professor & Head, Department of Pediatrics, Community Based Medical College and Hospital, Bangladesh. ORCID: https://orcid.org/0009-0005-8025-5912.

*For correspondence

Abstracts
Background: Acute viral hepatitis (AVH) remains a significant public health concern in pediatric populations, particularly in developing countries where inadequate sanitation and limited healthcare access facilitate the spread of hepatotropic viruses. Supportive therapy constitutes the mainstay of management; however, data on prescribing patterns in children are limited in Bangladesh.
Objective: To assess the drug utilization patterns of supportive therapy in pediatric patients with acute viral hepatitis admitted to Community Based Medical College Hospital, Bangladesh.
Methods:This descriptive observational study included 155 children aged <15 years with confirmed AVH, admitted between January 2024 to December 2024. The study was carried out through a collaborative effort between the Departments of Pediatrics and Pharmacology. Demographic data, viral etiology, clinical presentation, drug utilization for supportive therapy, length of hospital stay, and clinical outcomes were recorded. Supportive medications were categorized as oral rehydration solution (ORS), intravenous fluids, antiemetics, antipyretics, vitamin supplements, hepatoprotective agents, and antibiotics. Data were analysed using SPSS v26, and the association between antibiotic use and clinical outcomes was assessed using Chi-square or Fisher’s exact test, with p <0.05 considered statistically significant.
Results:The mean age of participants was 7.8 ± 3.4 years, with a male-to-female ratio of 1.35:1. Hepatitis A virus (HAV) was the most prevalent etiology 65.8%, followed by hepatitis E virus (HEV) 21.9%, while HBV and HCV were less common. Oral rehydration solution was administered to 80.0% of patients, antiemetics to 62.6%, antipyretics to 56.8%, intravenous fluids to 50.3%, vitamin supplements to 46.5%, hepatoprotective drugs to 34.8%, and antibiotics to 18.7%. The mean hospital stay was 6.4 ± 2.7 days. Clinical outcomes were favourable, with 72.3% fully recovered, 23.2% improved, and 4.5% experiencing complications. Antibiotic use was significantly associated with adverse outcomes (p = 0.041).
Conclusion: Hepatitis A virus is the predominant cause of pediatric AVH in Bangladesh, and supportive therapy remains the cornerstone of management. While overall prognosis is favourable, inappropriate antibiotic use was linked to adverse outcomes, emphasizing the need for rational prescribing. These findings highlight the importance of guideline-driven supportive care and provide insights into pediatric drug utilization patterns in resource-limited settings.

[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):180-188]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.11

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ssnimcj2026v11i2s10


Original
Diagnostic Value of Chest X-Ray in Ischemic Cardiomyopathy  Validated by Echocardiography
*Khan PR,1 Ferdouse F,2 Hasan M,3 Ahmed TU,4 Haque A5

  1. *Dr. Parvez Rahman Khan, Assistant Professor, Cardiology, Community Based Medical College Bangladesh Mymensingh.  drprkhan36@gmail.com. ORCID: https://orcid.org/0009-0006-0601-7817
  2. Dr. Farzana Ferdouse, Assistant Professor (in situ), Radiology & Imaging, Mymensingh Medical College Hospital, Mymensingh. ORCID: https://orcid.org/0009-0003-0142-2213
  3. Dr. Mehedee Hasan, Registrar, Cardiology, Community Based Medical College Hospital Bangladesh, Mymensingh. ORCID: https://orcid.org/0009-0006-1882-2004
  4. Dr. Tofayel Uddin Ahmed, Associate Professor & Head, Cardiology, Community Based Medical College Bangladesh, Bangladesh Mymensingh. ORCID: https://orcid.org/0009-0009-2030-1111
  5. Dr. Amdadul Haque, Associate Professor, Cardiology, Community Based Medical College  Bangladesh, Mymensingh. ORCID: https://orcid.org/0009-0001-3303-8293

*For correspondence

Abstract
Background: Ischemic cardiomyopathy (ICM) is one of the leading causes of heart failure in Bangladesh and worldwide. Chest radiography is the most universally available and affordable cardiac imaging tool. Knowing how well its findings correlate with echocardiographic indices of ventricular dysfunction can help doctors make faster and more accurate diagnoses, especially where echocardiography is not immediately available.
Methods: This was a cross-sectional observational study conducted in the Department of Cardiology, Community Based Medical College & Hospital (CBMCB), Mymensingh, from January 2025 to January 2026. A total of 96 purposively selected patients with confirmed ICM were enrolled. All patients underwent standard posteroanterior chest radiography and comprehensive transthoracic echocardiography (TTE). Key echocardiographic indices including left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and regional wall motion abnormality (RWMA) were correlated with radiographic findings. Data were analyzed using SPSS version 22.
Results: Mean age was 57.2 ± 9.4 years; 68 patients (70.8%) were male. Mean LVEF was 30.2 ± 6.8%. Cardiomegaly (Cardio Thoracic Ratio, CTR >0.5) was the commonest radiographic finding (80.2%), followed by pulmonary vascular congestion (73.0%), Kerley B lines (50.0%), and pleural effusion (46.9%). Cardiomegaly correlated significantly with LVEDD (r = +0.64, p<0.001) and inversely with LVEF (r = −0.58, p<0.001). Pulmonary congestion was strongly associated with LVEF ≤30% (p=0.003). RWMA was present in 92.7%. Sensitivity of chest radiography for detecting severe LV dysfunction (LVEF ≤30%) was 83.1%, with specificity 71.4%.
Conclusion: Chest radiographic findings in ICM — particularly cardiomegaly and pulmonary congestion — correlate meaningfully with echocardiographic indices of ventricular dysfunction. Though radiography cannot replace echocardiography, it serves as a valuable, low-cost surrogate that can guide early diagnosis and timely referral.

[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):170-179]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.10

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ssnimcj.2026.11.1.12

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026

Association of High Sensitive C- Reactive Protein with Female Metabolic Syndrome Patients in Bangladesh
*Mohammad S,1 Begum S,2 Saad MN,3 Naha S4

Abstract
Background: Raised level of high sensitive C-reactive protein (hsCRP) is found in Metabolic Syndrome patients (MS).
Objective: To observe association of serum hsCRP with Metabolic Syndrome in female patients.
Methods: This cross–sectional study was conducted from March 2019 to July 2020 in the Department of Physiology, Bangladesh Medical University (BMU), Shahbagh, Dhaka, Bangladesh. Female (n=30, 25 to 45 year) were diagnosed with MS in the study according to the criteria of International Diabetes Federation (IDF). Apparently healthy female (n=30, age matched) were included in the study as control. Serum hsCRP level was measured by Immuno-turbidimetric method and Chi-square test was done to observe associations of serum hsCRP with MS.
Results: Median value of hsCRP was found significantly higher (p value ≤0.01) in MS patients than that of control subjects. Around 53.3% of MS patients were found to have elevated level of hsCRP.

Conclusion: This study may conclude that elevated hsCRP was associated with MS.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):87-93]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.12 

Keywords: Metabolic syndrome (MS), High sensitive C-reactive protein (hsCRP), Female, Bangladesh.

  1. *Dr. Sumaiya Mohammad, Department of Physiology, Shaheed Syed Nazrul Islam Medical College,     Kishoreganj, Dhaka, Bangladesh. wajeeh@gmail.com
  2. Dr. Shelina Begum,, Department of Physiology, Bangladesh Medical University, Dhaka, Bangladesh.
  3. Dr. Mir Nur Us Saad, Department of Community Medicine & Public Health, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Dhaka, Bangladesh.mirsaad81@gmail.com
  4. Dr. Susmita Naha, Associate Professor, Department of Pathology, Shaheed Syed Nazrul Islam Medical College, Kishoreganj.

 *For correspondence

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ssnimcj.2026.11.1.10

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026

Postoperative Complications of Mastoid Surgery: A Hospital-Based Cross-Sectional Study
Mahdee SN,1 Efa SS,2 Kali F,3 *Nurunnabi M4

Abstract
Background: Mastoid surgery is a common procedure in otolaryngology, but postoperative complications can occur, affecting patient outcomes. Evaluating the incidence and clinical profile of these complications is essential for improving surgical care.
Objective: This study aimed to evaluate the incidence and types of complications following mastoidectomy.
Methods: A hospital-based cross-sectional study was conducted in the Department of Otolaryngology and Head-Neck Surgery at Sylhet MAG Osmani Medical College Hospital, Sylhet, from December 2014 to May 2015. All patients undergoing mastoid surgery during the study period were included using purposive sampling, excluding those with previous mastoid surgery, pre-existing middle ear complications, or unwillingness to participate. Mastoid surgeries included cortical, modified radical and radical mastoidectomies.
Results: Postoperative complications occurred in 7 patients (14%). Complications were more frequent in younger patients, with a mean age of 16.8±10.9 years. Minor complications (71.4%) were more common than major complications (28.6%). Modified radical mastoidectomy was the most performed procedure (84%), followed by radical (12%) and cortical mastoidectomy (4%). Complications were highest after radical mastoidectomy (33.3%). Specific complications included wound infection/gap (8%), meatal stenosis (4%), and major complications such as facial nerve paralysis, meningitis, and minor dural injury (2% each). Follow-up showed that most patients were complication-free at 1 week (88%), while 3-month follow-up indicated dry cavities (14%), discharging cavities (20%), and meatal stenosis (4%), with 64% lost to follow-up.
Conclusion: Postoperative complications after mastoidectomy were relatively low and mostly minor. Younger patients and more extensive surgeries had higher complication rates, emphasizing the need for careful monitoring and follow-up.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):68-74]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.10

Keywords: Postoperative complications, radical mastoidectomy, modified radical mastoidectomy, Sylhet, Bangladesh. 

  1. Dr. Syed Nafi Mahdee, Assistant Professor, Department of Otolaryngology and Head-Neck Surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh.
  2. Dr. Syeda Sumaiya Efa, Deputy Director, Program & Research, BADAS TB Initiative Diabetic Association of Bangladesh.
  3. Dr. Fatema Kali, Assistant Professor, Department of Anaesthesia, Analgesia and Palliative Care, National Institute of Ophthalmology and Hospital, Dhaka, Bangladesh.      
  4. *Dr. Mohammad Nurunnabi, Assistant Professor, Department of Community Medicine and Public Health, Sylhet Women’s Medical College, Sylhet, Bangladesh. nur.somch@gmail.com

 *For correspondence

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ssnimcj.2026.11.1.7

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026

An Outbreak of Diarrhoea Attributed to Consumption of Street-Foods- Bangladesh, March 2018
*Afreen N,1 Faruque AM,2 Jony MK,3 Flora MS4

Abstract
Background: Diarrhoea outbreaks are common in Bangladesh and usually reported through event-based surveillance. Increased admission of diarrhoea cases was noticed in Upazila-health-center in early March, 2018 and reported to IEDCR on 11 March.  The event was investigated to confirm outbreak, identify possible exposures and provide control measures.
Methods: We investigated outbreak since 12-14 March; conducted informal interviews, reviewed clinical records, created area-maps of case-patients, tested stool and water samples. For case-control study, we defined case-patients as “Any resident of that sub-district having ≥3 loose stools in 24 hours since 25th February’18 to date of investigation” and recruited 16 recently admitted case-patients mainly (most previous case-patients lacked contact information) and 32 neighborhood unmatched controls. Calculation of odds ratio and logistic regression were done to identify possible exposures with 95% confidence interval.

Results: Outbreak started since 3rd March; median age of line-listed case-patients (n=251) was 35 years (IQR 25-50) with male predominance (67%). Most case-patients were from municipality (53%, n=207). For case-patients versus controls, median age was 35 years (IQR 23-45.5) (versus 30 years (IQR 24-45)); 75% male (versus 31%); 60% (9/15) had occupations exposing them frequently to municipality (versus 19%). Odds ratios of consuming street-foods between 25 February-12 March (aOR 14.19, 95% CI 1.11-181.35) and similar illness among family members (aOR 35.4, 95% CI 2.71-461.98) were higher adjusting for sex and occupation. Interviews revealed that many people consumed available street foods in a fair occurred at this municipality from 2-10 March (prior to outbreak notification).
Conclusion: Duration of fair and outbreak showed that consumption of street foods from the fair was most likely source of this outbreak. Similar illness among family members might be due to person-to-person transmission or sharing same street food among family members. We suggested safety monitoring of street food sold in large gatherings (e.g., fair) to prevent similar outbreaks in future.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):42-53]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.7 

Keywords: Diarrhoea, Outbreak, Gatherings, Street food, Bangladesh 

  1. * Dr. Nawroz Afreen, Assistant Professor, Department of Epidemiology, National Institute of Preventive and Social Medicine. nawroz.afreen@gmail.com.
  2. Dr. Abdullahel Maruf Faruque, Upazila Health and Family Planning Officer, Bahubal Upazila Health Complex.
  3. Dr. Manjur Hossain Khan Jony, Assistant Professor, Department of Virology, Institute of Epidemiology, Disease Control and Research.
  4. Dr. Meerjady Sabrina Flora, Former Additional Director General, Planning and Research, Directorate General of Health Services.

 *For correspondence

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ssnimcj.2026.11.1.3

Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026

Acute Watery Diarrhoea Outbreak from Contaminated Municipal Water Supply in Jashore, Bangladesh, 2015

*Billah MM,1 Rahaman MR,2 Samad MS,3 Habib ZH,4 Billah SB,5 Rahman M6

Abstract

Background: Diarrhoeal outbreaks commonly occur during pre- and post-monsoon seasons in Bangladesh. On October 12, 2015, the Superintendent of the 250-bedded General Hospital, Jashore, informed the Institute of Epidemiology, Disease Control and Research, Bangladesh, of an increase in admission of patients with acute watery diarrhoea from Jashore Municipality. We investigated the event to ascertain the cause of the outbreak and its associated risk factors.
Methods: We conducted a descriptive study followed by a case–control study in Jashore Municipality from October 13 – 20, 2015. We defined a case as any person living in Jashore Municipality having three or more episodes of loose motion per day with symptoms lasting ≤7 days. A control was defined as any person living in Jashore Municipality without a history of loose motion in the preceding 7 days. Stool samples of untreated patients were tested for a rapid dipstick test for Vibrio cholerae O1 and culture sensitivity. Water samples from the municipal water pump and households were tested for microbial contamination. Cases were enrolled from hospitals and asymptomatic controls were identified by convenience sampling from the same hospitals’ outpatient clinics, matched by municipal residence and household access to municipal water. Descriptive analysis and logistic regressions were performed. We calculated adjusted odds ratios (AOR) and 95% confidence intervals (CI).
Results: Between 9–14 October, 214 patients were admitted to the hospital; 115 (53.7%) lived in Jashore municipality. Cases were from all age groups, with 57% males. We enrolled 27 cases and 49 controls. Drinking municipal supplied water in the preceding 24 hours was significantly associated with illness (AOR 4.5; 95% CI: 1.3–15.3; p=0.015). In stool samples, Vibrio cholerae O1 was identified by rapid test in 3/8 (37.5%) samples and two were confirmed by culture. Household-level municipal water had total coliforms up to 8,000 CFU/ml. Environmental inspection found multiple breaches in water supply pipes running through open drains.
Conclusion: The investigation confirmed a cholera outbreak in Jashore district, most likely spread through the contaminated municipal water supply. We recommended repairing leakages, chlorination, and public education to prevent future outbreaks in similar urban settings.

[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):14-23]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.3
Keywords: Acute Watery Diarrhoea, Cholera, Water Supply, Disease Outbreaks, Case-Control Studies, Environmental Monitoring, Bangladesh

 

  1. *Dr. Mallick Masum Billah, MSc in Applied Epidemiology, MPH (Epidemiology), MBBS, Resident Advisor, Field Epidemiology Training Program, Nepal, South Asia Field Epidemiology and Technology Network Inc. (SAFETYNET) https://orcid.org/0000-0002-8545-2879 . drmasumbillah@yahoo.com
  2. Md Rezanur Rahaman, PhD, MSc in Applied Epidemiology, MPH, Assistant Professor National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT 2601, Australia https://orcid.org/0000-0003-4782-4149
  3. Mohammad Sohel Samad, PhD, MPH; MS, Associate Professor & Head (Community Medicine & Public Health, Mugda Medical College, Dhaka, https://orcid.org/0000-0003-4502-8747
  4. Zakir Hossain Habib, Professor of. Microbiology & Chief Scientific Officer, Department of. Microbiology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka https://orcid.org/0000-0003-2163-3600
  5. Syed Md Baqui Billah, PhD, MPH (Epidemiology), MBBS, Deputy Director, Directorate General of Medical Education, Mohakhali, Dhaka, Bangladesh https://orcid.org/0000-0001-9337-9627
  6. Professor Mahmudur Rahman, PhD, MPH, Former Director, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka https://orcid.org/0000-0002-3698-4852

*For correspondence

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ssnimcj2025v10i1s9

Original

Effect of Pre-existing Ischemic Heart Disease on 30-Days Mortality in COVID-19 Patients

 Iqbal MH,1 *Moontaha H,2 Sarker BK,3 Paul MR,4 Chowdhury AW5

 

  1. Dr. Md. Hasan Iqbal, MBBS, Department of Cardiology, National Institute of Cardiovascular Disease (NICVD), Dhaka, Bangladesh
  2. *Dr. Hashiba Moontaha, MBBS, FCPS (Gynaecology& Obstetrics), Department of Gynaecology& Obstetrics, Dhaka Medical College &Hospital, Dhaka, Bangladesh;hashibapriom@gmail.com
  3. Dr. Bikash Kumar Sarker, Infectious Diseases Hospital, Mohakhali, Dhaka, Bangladesh
  4. Dr. Mira Rani Paul, Rajshahi Medical College Hospital, Rajshahi, Bangladesh.
  5. Professor Dr. Abdul Wadud Chowdhury, Director, National Institute of Cardiovascular Disease, Dhaka, Bangladesh.

 *For correspondence

Abstract

Background: COVID-19 has emerged as a multisystem inflammatory disorder with significant cardiovascular implications. Patients with pre-existing cardiovascular conditions may be particularly vulnerable to severe outcomes, yet data from developing countries regarding the impact of pre-existing ischemic heart disease (IHD) on COVID-19 outcomes remains limited.

Objective: To investigate the effect of pre-existing ischemic heart disease on 30-day mortality in COVID-19 patients at a tertiary care hospital in Bangladesh.

Methods: This case-control study was conducted at Dhaka Medical College Hospital over twelve months, enrolling 120 RT-PCR-confirmed COVID-19 patients (60 with pre-existing IHD, 60 without IHD). Clinical characteristics, laboratory parameters, and treatment modalities were assessed. Outcomes included in-hospital mortality, complications, and 30-day mortality. Data analysis included chi-square tests, t-tests, and multivariable logistic regression.

Results: COVID-19 patients with pre-existing IHD showed significantly higher rates of critical disease (30.0% vs 11.6%, p=0.002), cardiac complications including acute myocardial infarction (45.0% vs 0%, p=0.001), and heart failure (28.3% vs 6.66%, p=0.001). The IHD group required more intensive care (71.6% vs 36.6%, p<0.001) and demonstrated higher in-hospital mortality (36.6% vs 10%, p<0.001) and 30-day mortality (60.0% vs 16.6%, p<0.001). After adjusting for confounders, pre-existing IHD independently predicted 30-day mortality (OR=7.25, 95% CI=2.17-24.23).

Conclusion: COVID-19 patients with pre-existing IHD experience significantly worse outcomes, including higher rates of complications and mortality. These findings emphasize the need for enhanced monitoring and aggressive management strategies for COVID-19 patients with pre-existing IHD in Bangladesh.

[Shaheed Syed Nazrul Islam Med Col J 2025, Jan; 10 (1):63-72]

DOI: https://www.doi.org/10.69699/ssnimcj2025v10i1s9

Keywords: COVID-19, Ischemic Heart Disease, Bangladesh, Mortality, Cardiovascular Complications

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ssnimcj2024v9i2a8

Original Contribution

Sociodemographic and Etiological Profile of Patients with Metabolic Acidosis Admitted in an Intensive Care Unit of a Specialized Hospital in Bangladesh

*Rahman MM,1 Islam U,2 Mamun AA3

  1. *Dr. Md Muhibur Rahman, FCPS (Medicine), FCPS (Gastroenterology), Medical Officer, Department of Gastroenterology, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh. dmc@gmail.com
  2. Ummehoney Islam, MD (Dermatology), Resident, Sylhet MAG Osmani Medical College Hospital, Sylhet, Bangladesh
  3. Abdullah Al Mamun, FCPS (Medicine), Senior Consultant, Department of Medicine, Evercare Hospital, Dhaka, Bangladesh

 

*For correspondence

Abstract

Background: Metabolic acidosis is a serious acid-base disorder frequently encountered in intensive care units (ICUs). Early diagnosis and management of its underlying causes are crucial for improving patient outcomes. However, there is a paucity of local data on the etiologies of metabolic acidosis among critically ill patients in Bangladesh.

Objectives: To determine the causes of metabolic acidosis and distinguish the etiologies associated with an elevated anion gap from those with a normal anion gap among patients admitted to the Medical ICU of a specialized hospital in Bangladesh.

Methods: This hospital-based observational study was conducted at the Medical ICU of Evercare Hospitals, Dhaka, Bangladesh, from March 2012 to August 2012. Fifty patients diagnosed with metabolic acidosis were enrolled. Data on patient demographics, comorbidities, clinical features, and biochemical investigations were collected.

Results: The mean age of patients was 58.04 years, with a predominance of males (68%). Renal failure was the most common cause of metabolic acidosis (58%), followed by lactic acidosis (28%), diabetic ketoacidosis (6%), and methanol poisoning (6%). The majority (82%) had high anion gap metabolic acidosis. Hypoalbuminemia was observed in 62% of patients.

Conclusion: Metabolic acidosis more commonly occurred in patients with renal failure, particularly in the sixth and seventh decades of life, with a male predominance and higher prevalence among individuals from higher socioeconomic backgrounds. Causes of high anion gap metabolic acidosis were more common than normal anion gap acidosis in ICU patients. Prompt diagnosis and management of the underlying etiology are crucial for improving outcomes.

[Shaheed Syed Nazrul Islam Med Col J 2024, Jul; 9 (2):94-102]

doi: https://doi.org/10.69699/ssnimcj2024v9i2a8

Keywords: Metabolic acidosis, anion gap, intensive care unit, Bangladesh, etiology

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