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Exploring the Role of Serum Cystatin C in Early Detection of Acute Kidney Injury among On-Pump Cardiac Surgery Patients: A Single-Center Investigation in Bangladesh

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World Journal of Cardiovascular Diseases 2024年第6期14卷 363-373页

作者： md. Ahaduzzaman md. abir tazim chowdhury Munama Magdum md. Saiful Islam Khan Satyajit Sharma Monoj Tiwari md. Abul Bashar Maruf md. Alauddin Omar Sadeque Khan md. Mostafizur Rahman Mirza md. Nazmus Saquib Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Dhaka Bangladesh Department of Preventive and Social Medicine National Institute of Preventive and Social Medicine Dhaka Bangladesh Department of Cardiothoracic Anesthesia Evercare Hospital Dhaka Dhaka Bangladesh Department of Cardiac Surgery National Heart Foundation Hospital & Research Institute Dhaka Bangladesh Department of Cardiovascular and Thoracic Surgery B.P. Koirala Memorial Cancer Hospital Bharatpur Chitwan Nepal Department of Cardiac Surgery United Hospital Limited Dhaka Bangladesh Department of Cardiac Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Cardiac Surgery Ibrahim Cardiac Hospital & Research Institute Dhaka Bangladesh

Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria relying on serum creatinine levels exhibit a delayed identification of AKI, prompting an exploration of alternative biomarkers. Aims and Objectives: This study is designed to overcome diagnostic constraints and explore the viability of serum Cystatin C as an early predictor of Acute Kidney Injury (AKI) in individuals undergoing on-pump cardiac surgery. The investigation aims to establish the relationship between serum Cystatin C levels and the onset of AKI in patients subjected to on-pump cardiac surgery. Primary objectives involve the assessment of the diagnostic effectiveness of serum Cystatin C, its comparison with serum creatinine, and the exploration of its potential for the early identification and treatment of AKI. Methodology: Conducted as a single-center study at the cardiac surgery department of BSMMU in Bangladesh from September 2020 to August 2022, a comparative cross-sectional analysis involved 31 participants categorized into No AKI and AKI groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data collection encompassed preoperative, post-CBP (cardiopulmonary bypass) conclusion at 2 hours, postoperative day 1, and postoperative day 2 intervals. Statistical analyses included Chi-squared tests, independent Student’s t-tests, and one-sample t-tests. Significance was set at P Results: The study revealed no significant differences in baseline characteristics between the No AKI and AKI groups, except for CPB time and cross-clamp time. Serum Cystatin C levels in the AKI group exhibited statistical significance at various time points, highlighting its potential as an early detector. Conversely, Serum Creatinine levels in the AKI group showed no statistical significance. The Receiver Operating Characteristic (ROC) curve analysis further supported the efficacy of serum Cyst

关键词： Acute Kidney Injury (AKI) On-Pump Cardiac Surgery Serum Cystatin C Serum Creatinine Diagnostic Biomarkers Early Detection Cardiopulmonary Bypass Single-Center Study Bangladesh

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Comparison of Propofol and Fentanyl for Preventing Emergence Agitation Following Sevoflurane Anesthesia in Pediatric Patients: A Single-Center Study in Bangladesh

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Pharmacology & Pharmacy 2024年第6期15卷 223-235页

作者： md. Saiful Islam Khan md. abir tazim chowdhury Farzana Fardousi Munama Magdum md. Ahaduzzaman Taneem Mohammad Shamima Akter Suriya Akter md. Saiful Islam Azad md. Mozaffer Hossain M. Abdur Rahman Department of Cardiothoracic Anesthesia Evercare Hospital Dhaka Bangladesh Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Bangladesh Department of Pathology National Institute of Cancer Research & Hospital Dhaka Bangladesh Department of Preventive and Social Medicine National Institute of Preventive and Social Medicine Dhaka Bangladesh Department of Anesthesia Sheikh Sayera Khatun Medical College Gopalgonj Bangladesh Department of Anesthesia Dhaka Medical College Dhaka Bangladesh Department of Anesthesia Combined Military Hospital Dhaka Bangladesh Department of Cardiac Anesthesia National Institute of Cardiovascular Disease Dhaka Bangladesh Department of Anesthesia Bangladesh Medical College Dhaka Bangladesh

Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fe

关键词： Emergence Agitation (EA) General Anesthesia Propofol Fentanyl Pediatric Patients Pediatric Anesthesia Emergence Delirium (PAED) Score Bangladesh

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Nipah Virus Unveiled: A Review Article

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Advances in Bioscience and Biotechnology 2024年第3期15卷 161-173页

作者： Munama Magdum md. abir tazim chowdhury Mahmuda Khandaker Razdip Datta md. Naheed Rayhan md. Siffat Uddin md. Junayed Imam Bhuiyan md. Ahaduzzaman md. Abdullah Al-Mahammud Kabir Mohammad Zishan Uddin md. Estiak Ullah Sahid Subrata Saha Department of Community Medicine Shaheed Monsur Ali Medical College Dhaka Bangladesh Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Bangladesh Department of Microbiology Shaheed Monsur Ali Medical College Dhaka Bangladesh Department of Anesthesia Dhaka Dental College & Hospital Dhaka Bangladesh Department of Cardiothoracic Anesthesia Evercare Hospital Dhaka Bangladesh Department of Medicine Times Multicare Hospital Ltd. Dhaka Bangladesh Barking Havering and Redbridge University Hospitals NHS Trust Romford UK

Nipah virus (NiV) is a highly infectious zoonotic pathogen that poses a significant threat to human and animal health. First identified in Malaysia in 1998, NiV has since caused several outbreaks in Southeast Asia, with sporadic cases reported in Bangladesh and India. The virus is primarily transmitted to humans through direct contact with infected animals, primarily fruit bats, or through the consumption of contaminated fruits and their juices. NiV infection presents a wide spectrum of clinical features, ranging from mild respiratory illness to severe encephalitis, with a high case fatality rate. The incubation period typically ranges from 4 to 14 days, during which patients develop fever, headache, myalgia, and respiratory symptoms such as cough and sore throat. As the disease progresses, neurological signs become prominent, including altered consciousness, seizures, and focal deficits. Severe cases may exhibit acute respiratory distress syndrome and multi organ failure. Laboratory findings often include lymphocytopenia, thrombocytopenia, and elevated liver enzymes. Diagnosis of NiV infection requires specialized laboratory testing, including reverse transcription-polymerase chain reaction (RT-PCR) and serological assays. Currently, no specific antiviral treatment exists for NiV infection, and management primarily focuses on supportive care. Prevention and control strategies encompass public health interventions, surveillance, and raising awareness among healthcare providers and the general population. The emergence and re-emergence of NiV highlight the urgent need for continued research, improved diagnostic capabilities, and the development of effective vaccines and therapeutics to mitigate the impact of this deadly virus.

关键词： Nipah Virus Zoonotic Pathogen Outbreaks Surveillance

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Types of Infertility and Its Risk Factors among Infertile Women: A Prospective Study in Dhaka City

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Journal of Biosciences and Medicines 2022年第4期10卷 158-168页

作者： Munama Magdum md. abir tazim chowdhury Nasima Begum Sayeda Riya Department of Community Medicine Shaheed Monsur Ali Medical College Dhaka Bangladesh Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Bangladesh Department of Community Medicine Sir Salimullah Medical College Dhaka Bangladesh

Background: Infertility is a global health issue, and it is a multidimensional problem with social, economic, and cultural influences. Objectives: The study aimed to determine types of infertility and their contributing factors among the respondent infertile women. Methods: This prospective cross-sectional study was conducted among infertile women visiting Sir Salimullah Medical College and Hospital, Dhaka. From January to December 2020, 111 infertile women were included and evaluated for infertility types and their contributing factors. Data were collected by face-to-face interviewing, and data were analyzed statistically. Results: Primary infertility was found among 90 (81%) and secondary infertility among 21 (18.9%). Among the direct risk factors of female infertility, ovulation failure was the majority of the cases, 74 (35.1%), and its mainly observed in primarily infertile women 58 (33.9%). These observations were statistically significant. Conclusions: Infertility should be treated as a public health problem, government and non-government organizations should develop a basic policy to create effective fertility centers.

关键词： Women Infertility Primary Infertility Secondary Infertility Direct Risk Factors of Infertility Indirect Risk Factors of Infertility

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Comparison of Sternal Wound Complication after Off-Pump CABG between Skeletonized and Pedicled LIMA Harvesting: A Single Centre Experience in Bangladesh

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World Journal of Cardiovascular Surgery 2023年第6期13卷 101-110页

作者： M. Asmaul Alam Al Nur md. Aslam Hossain md. abir tazim chowdhury Farhat Tabassum Nishat Munama Magdum Department of Cardiac Surgery National Institute of Cardiovascular Diseases Dhaka Bangladesh Department of Cardiac Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Bangladesh Department of Casualty Dhaka Medical College Hospital Dhaka Bangladesh Department of Community Medicine Shaheed Monsur Ali Medical College Dhaka Bangladesh

Background: Off-pump coronary artery bypass grafting (OPCAB) is a surgical procedure that has gained popularity due to its potential benefits over traditional coronary artery bypass grafting, including reduced morbidity and mortality. However, sternal wound complication (SWC) remains challenging following the procedure. The technique of left internal mammary artery (LIMA) harvesting has been shown to impact the incidence of SWC. This study aimed to compare the incidence of SWC between two techniques of LIMA harvesting, i.e., skeletonized and pedicled. Methods: The study was conducted at the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, and included 60 patients who underwent OPCAB. The patients were divided into two groups of 30 each based on the technique of LIMA harvesting used, i.e., skeletonized (group A) or pedicled (group B). The postoperative ICU care was given to each patient as per the protocol. The statistical analysis was conducted using the SPSS version 26.0 for Windows software. Results: The results showed that 5 (8.33%) patients developed SWC, with 1 (1.67%) patient in group A and 4 (6.66%) patients in group B. However, the occurrence of SWC was not statistically significant between the two groups (p = 0.35). The mean age, gender distribution, and comorbidities such as hypertension, diabetes, dyslipidemia, and anemia were also not statistically significant between the two groups. The number of smokers was statistically significant between the two groups (p = 0.03), and the occurrence of SWC was found to be higher in smoker patients in group B (p = 0.04). Preoperative and postoperative parameters such as duration of operation, duration of mechanical ventilation, duration of chest drains, duration of the central venous line, and amount of postoperative mediastinal bleeding were also not statistically significant between the two groups. The distribution of wound complications, duration of ICU stays, and hospital stay between the two groups was also not statistically signifi

关键词： Sternal Wound Complication (SWC) Off-Pump Coronary Artery Bypass Grafting (OPCAB) Left Internal Mammary Artery (LIMA) Skeletonized LIMA Harvesting Pedicle LIMA Harvesting

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Using Magnesium Sulfate to Prevent Atrial Fibrillation after Coronary Artery Bypass Grafting Surgery: A Single Centre Experience in Bangladesh

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World Journal of Cardiovascular Diseases 2023年第9期13卷 565-577页

作者： Manoj Tiwari md. abir tazim chowdhury Hema Poudel Munama Magdum md. Mostafizur Rahman Vivek Kumar Jha md. Ahaduzzaman md. Abul Bashar Maruf Department of Cardiovascular and Thoracic Surgery B.P. Koirala Memorial Cancer Hospital Bharatpur Chitwan Nepal Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Dhaka Bangladesh Department of Dermatology and Venerology Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Community Medicine Shaheed Monsur Ali Medical College Dhaka Bangladesh Department of Cardiac Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Cardiac Surgery Ibn Sina Specialized Hospital Dhaka Bangladesh

Background: Atrial fibrillation commonly occurs following cardiac surgery, particularly after coronary artery bypass grafting. Magnesium, known for its stabilizing effect on cell membranes, has shown promise in preventing postoperative atrial fibrillation. This study aimed to assess the impact of intravenous magnesium infusion in preventing atrial fibrillation after off-pump coronary artery bypass grafting, where maintaining stable cell membranes is crucial in averting this complication. Methods: A cross-sectional study was conducted at the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, from March 2020 to February 2022. Sixty-six patients who underwent off-pump coronary artery bypass grafting were enrolled and divided into two groups. Group A (n = 33) received intravenous magnesium sulfate (10 mmol/2.47gm) for three days after surgery, while Group B (n = 33) did not receive magnesium sulfate. Postoperative atrial fibrillation occurrence in the Intensive Care Unit (ICU) within three days after surgery was evaluated using convenient sampling. Statistical analysis was performed with SPSS version 26.0, utilizing independent Student’s t-test for continuous data and Chi-square and Fisher’s exact test for categorical data. A p-value of ≤0.05 was considered statistically significant. Results: No significant differences in age or gender were observed between the two groups. Group B exhibited significantly lower magnesium levels than Group A on the 0th, 1st, 2nd, and 3rd days post-surgery. Additionally, Group B experienced a higher incidence of postoperative atrial fibrillation, longer ICU stays, and two mortalities. The study did not detect any adverse effects associated with magnesium infusion. Conclusion: It has been demonstrated that administering magnesium intravenously after off-pump coronary artery bypass grafting can lower the chances of developing atrial fibrillation. This demonstrates the potential advantages of using magnesium as a preventa

关键词： Atrial Fibrillation (AF) Coronary Artery Bypass Grafting (CABG) Postopera-tive Atrial Fibrillation (POAF) Magnesium Sulfate Bangladesh.

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Diagnostic Dilemma with a Case of Primary Bronchopulmonary Actinomycosis Causing Unilateral Destroyed Lung: A Case Report and Literature Review

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Open Journal of Thoracic Surgery 2022年第1期12卷 1-10页

作者： md. abir tazim chowdhury Sohail Ahmed md. Zulfiqur Haider S. M. A. Zulker Nine md. Kamrul Hasan md. Estiak Ullah Sahid Musfaqus Shalehin md. Abdullah Al-Mahammud Kabir Niaz Ahmed Munama Magdum Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Bangladesh Department of Cardiothoracic Anesthesia Evercare Hospital Dhaka Bangladesh Department of Community Medicine Shaheed Monsur Ali Medical College Dhaka Bangladesh

Among chronic pulmonary infections, pulmonary actinomycosis is a rare one, caused by a gram-positive microaerophilic bacterium called Actinomyces. Aside from cervicofacial or abdominopelvic actinomycosis, pulmonary involvement is rare, and sometimes this type of infection results in a misdiagnosis of pulmonary tuberculosis or carcinoma. Clinical presentation of pulmonary actinomycosis could be acute or subacute, with lobar involvement. However, the disease is most commonly diagnosed at the chronic phase, with patients presenting mild fever, weight loss, and occasional hemoptysis. Here, we described the case of a 30-year-old male patient, presented with a history of respiratory complaints for more than three years and was diagnosed clinically and radiologically as a case of a destroyed left lung. Later on, post-operative tissue diagnosis was confirmed—pulmonary actinomycosis.

关键词： Pulmonary Actinomycosis Destroyed Lung Diagnostic Dilemma

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Unusual Presentation of a Large Multi-Septated Cystic Hygroma: A Case Report and Comprehensive Literature Review

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Surgical Science 2023年第7期14卷 486-495页

作者： md. abir tazim chowdhury Sohail Ahmed md. Zulfiqur Haider Niaz Ahmed A. K. M. Fazlul Haque Nasrin Aktar Arup Khan md. Abdullah-Al-Mahammud Kabir md. Sifat Uddin Abrar Bin Ahsan Trishna Sarker md. Khaled Hossain Munama Magdum Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Dhaka Bangladesh Department of Cardiothoracic Anesthesia Evercare Hospital Dhaka Dhaka Bangladesh Department of Plastic and Reconstructive Surgery Evercare Hospital Dhaka Dhaka Bangladesh Department of Community Medicine Shahid Monsur Ali Medical College Dhaka Bangladesh

Background: Cystic hygromas are primarily found in the cervicofacial, thoracic, and abdominal regions, with limited occurrences in other areas. Despite existing literature on this condition, comprehensive descriptions and MRI findings of cystic hygromas in the extremities are rare. Aim: This case report aims to present a unique instance of a cystic hygroma in the left thigh. The objective is to provide detailed insights into the characteristics of this atypical presentation. Case Presentation: The case involves a 2-year-10 month-old girl with a cystic hygroma in her left thigh. The report includes a comprehensive description of the lesion’s clinical features and diagnostic evaluation, emphasizing the MRI findings to enhance understanding of this rare occurrence. Conclusion: This case report highlights the rarity of cystic hygromas outside the cervicofacial, thoracic, and abdominal regions, explicitly focusing on the occurrence in the left thigh. By presenting detailed insights into the clinical features, MRI findings, histopathological findings, and the surgical approach employed, this report contributes to the existing knowledge on this condition in atypical locations and informs future treatment strategies.

关键词： Cystic Hygroma Lymphangioma Multi-Septated Cystic Hygroma Unusual Presentation Vascular Tumors Benign Soft Tissue Tumors

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Laubry-Pezzi Syndrome in an Adult Male Patient and Its Surgical Correction: A Case Report and Literature Review

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World Journal of Cardiovascular Surgery 2022年第10期12卷 219-228页

作者： md. abir tazim chowdhury md. Zulfiqur Haider Sohail Ahmed S. M. A. Zulker Nine Arup Khan Naheed Rayhan Musfaqus Shalehin md. Sifat Uddin Nakib Shah Alam Saiful Islam Khan Niaz Ahmed Munama Magdum Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Bangladesh Department of Cardiothoracic Anesthesia Evercare Hospital Dhaka Bangladesh Department of Community Medicine Shaheed Monsur Ali Medical College Dhaka Bangladesh

This Laubry-Pezzi syndrome is rarely seen in patients with ventricular septal defect (VSD) combined with aortic regurgitation. A 20-year-old male patient presented to the Cardiothoracic and vascular surgery department with a large VSD with severe aortic regurgitation (AR). However, he was first symptomatic at 12 years of age and initially treated by medical management with the suggestion of surgical correction. Nevertheless, he was delayed getting surgical management due to his financial problem. This article reported on an adult patient with Laubry-Pezzi syndrome and his surgical correction and outcome. The association of congenital defects VSD and AR needs to be identified and corrected in early life for better outcomes.

关键词： Laubry-Pezzi syndrome Adult Ventricular Septal Defect (VSD) Aortic Regurgitation (AR) Surgical Correction of Adult VSD

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Evaluation of 100 Cases of Mortality after Cardiac Surgery: A Single-Center Experience in Bangladesh

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World Journal of Cardiovascular Surgery 2020年第7期10卷 131-141页

作者： Dharmendra Joshi Mayank Acharya Niraj Bhattarai md. abir tazim chowdhury md. Alauddin md. Rezwanul Hoque Department of Cardiac Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh

Background: Vigilance ensures safety in cardiac surgery. Performance in cardiac surgery is often measured by short-term mortality. Several risk factors like advanced age, female gender, higher body mass index, decreased left ventricular function, emergent, and redo operations have appeared recurrently as poor prognostic variables. Evaluation of postoperative mortality is crucial to find loopholes to provide proper care and reduce preventable mortality after cardiac surgery in developing countries with limited infrastructures and resources. Methods: This is a retrospective study conducted in the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University. Perioperative data of 100 cases of mortality after cardiac surgery performed from 1 January 2014 to 30 May 2018 were collected from the university medical record. The data on age, gender, body mass index, preoperative investigations, diagnoses, types of operations, details of cardiopulmonary bypass, and postoperative period of the study populations were evaluated. Results: During the study period, about 1627 cases of cardiac surgery were done with an overall mortality rate of 6.15%. The mean age was 41.05 ± 20.19 (0 - 68) years, and 66% of patients were male. Preoperative ejection fraction (EF) of the study population was an average 56.63% ±

关键词： Cardiac Surgery Morbidity Mortality Evaluation

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