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Preoperative Serum Albumin Levels and Postoperative Acute Kidney Injury in Off-Pump Coronary Artery Bypass Surgery: A Single-Center Study in Bangladesh

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World Journal of Cardiovascular Surgery 2024年第8期14卷 131-144页

作者： Ahmad Pear Salahuddin md. ab.r tazim chowdhury Munama Magdum Dewan Iftakher reza chowdhury Nittya Nanda Pal md. Nahedul Morshed md. Zafar-Al-Nimari Latifa Nasrin Farooque Ahmed Department of Cardiac Surgery National Heart Foundation Hospital and Research Institute (NHFH&RI) Dhaka Bangladesh Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Dhaka Bangladesh National Institute of Preventive and Social Medicine Dhaka Bangladesh Mother and Child Welfare Center Cumilla Bangladesh

Background: Serum albumin, a vital plasma protein, helps maintain intravascular colloidal osmotic pressure, cardiac output, and renal function. Low preoperative serum albumin is linked to poor outcomes, including acute kidney injury (AKI), after off-pump coronary artery bypass (OPCab) surgery. This study aimed to assess the relationship between preoperative serum albumin levels and early postoperative renal injury. Methods: This prospective comparative cross-sectional study was conducted from August 2019 to February 2021 at the National Heart Foundation Hospital & research Institute, Bangladesh. It included 160 adult patients with normal preoperative renal function undergoing OPCab. Patients were divided into two groups: Group A (serum albumin ≥ 4.0 gm/dl) and Group B (serum albumin results: Preoperative serum albumin was significantly different between groups (Group A: 4.21 ± 0.05 gm/dl, Group B: 3.69 ± 0.04 gm/dl, p = 0.028). Group B had a higher incidence of hypertension (71.25% vs. 51.25%, p st and 3rd postoperative days were higher in Group B (p th day. Postoperative AKI occurred in 18.75% of Group A and 36.25% of Group B. Multivariate regression indicated that low preoperative serum albumin is an independent risk factor for postoperative AKI (p = 0.012, Or = 1.815, CI: 0.675 - 1.162). Conclusion: Preoperative serum albumin level is a valuable predictor of postoperative renal function. Ensuring high normal serum albumin levels before surgery can help minimize the risk of postoperative AKI.

关键词： Serum Albumin Acute Kidney Injury (AKI) Off-Pump Coronary Artery Bypass Surgery Bangladesh

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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. ab.r 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 analy

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. ab.r 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, propo

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. ab.r tazim chowdhury Mahmuda Khandaker razdip Datta md. Naheed rayhan md. Siffat Uddin md. Junayed Imam Bhuiyan md. Ahaduzzaman md. abdullah Al-Mahammud Kab.r 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. Lab.ratory findings often include lymphocytopenia, thrombocytopenia, and elevated liver enzymes. Diagnosis of NiV infection requires specialized lab.ratory 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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Implications of Elevated Serum Cortisol in the Onset of Postoperative Delirium Following Off-Pump Coronary Artery Bypass Grafting: Insights from a Bangladesh-Based Single Center Experience

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World Journal of Cardiovascular Diseases 2024年第4期14卷 252-267页

作者： Vivek Kumar Jha md.ab.r tazim chowdhury Munama Magdum Manoj Tiwari md.abul Bashar Maruf md.Saiful Islam Khan Priyanka Sinha rajesh Naryan Kapar md. rezwanul Hoque Department of Cardiothoracic and Vascular Surgery BP Koirala Institute of Health Sciences Dharan Nepal 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 Thoracic Surgery BP Koirala Memorial Cancer Hospital Bharatpur Nepal Department of Cardiac Surgery United Hospital Limited Dhaka Bangladesh Department of Cardiothoracic Anesthesia Evercare Hospital Dhaka Dhaka Bangladesh Department of Microbiology Kathmandu Medical College Kathmandu Nepal Department of Nephrology Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Cardiac Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh

Background: Following coronary artery bypass grafting (CabG), delirium emerges as a prevalent complication. This study aimed to assess the correlation between elevated serum cortisol levels and the occurrence of postoperative delirium subsequent to off-pump CabG. Methods: Conducted in the Department of Cardiac Surgery at BSMMU from October 2020 to September 2022, this comparative cross-sectional study included a total of 44 participants. Subjects, meeting specific criteria, were purposefully assigned to two groups based on off-pump CabG. Group A (n = 22) consisted of patients with normal serum cortisol levels, while Group B (n = 22) comprised individuals with high serum cortisol levels on the first postoperative day. Delirium onset was assessed at the bedside in the ICU on the 1st, 2nd, 3rd, 4th, and 5th postoperative days using standard tools, namely the richmond Agitation Sedation score (rASS) and The Confusion Assessment Method (CAM-ICU). Data were collected based on the presence or absence of delirium. Statistical analysis utilized SPSS version 26.0, employing an independent Student’s t-test for continuous data and chi-square and Fischer’s exact test for categorical data. A p-value ≤ 0.05 was considered statistically significant. results: Group-A had a mean age of 54.50 ± 17.97, and Group-B had a mean age of 55.22 ± 15.45, both with a male predominance (81.81% and 86.36% respectively). The mean serum cortisol level was significantly higher in Group B (829.71 ± vs. 389.98 ± 68.77). Postoperative delirium occurred in 27.3% of Group B patients, statistically significant compared to the 4.5% in Group A. However, patients in Group B who developed delirium experienced significantly longer postoperative ICU and hospital stays (79.29 ± 12.27 vs. 11.44 ± 2.85, p ≤ 0.05). There was one mortality in Group B, which was statistically not significant. Conclusion: This study observed a significant association between elevated serum cortisol levels in the postoperative period a

关键词： Coronary Artery Bypass Grafting (CabG) Serum Cortisol Postoperative Delirium Bangladesh

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Off-Pump Coronary Artery Bypass Grafting in Patients with Left Ventricular Dysfunction: Short-Term results from a Single Center in Bangladesh

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World Journal of Cardiovascular Surgery 2024年第9期14卷 145-156页

作者： Muhit abdullah md. ab.r tazim chowdhury Satyajit Sharma rehana Akther Munama Magdum Munjerin refat Synthee md. Zafar-Al-Nimari Saikat Das Gupta Saleh Ahmed Samir Kumar Biswas M. Quamrul Islam Talukder Farooque Ahmed Department of Cardiac Surgery National Heart Foundation Hospital and Research Institute (NHFH&RI) Dhaka Bangladesh Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Dhaka Bangladesh Ispahani Islamia Eye Institute & Hospital Khamarbari Dhaka Bangladesh National Institute of Preventive and Social Medicine Dhaka Bangladesh Square Hospital Dhaka Bangladesh

Background: Off-pump coronary artery bypass grafting (OPCab) is considered a safer alternative to on-pump surgery, especially in patients with left ventricular dysfunction (LVD). Objectives: This study assessed short-term outcomes and functional improvements in LVD patients post-OPCab. Methods: The study included 200 coronary artery disease patients who underwent isolated off-pump coronary artery bypass grafting (OPCab) at the National Heart Foundation Hospital and research Institute between January 2019 and June 2020. Patients were categorized into Group 1, with a left ventricular ejection fraction (LVEF) of 30% - 39%, and Group 2, with an LVEF of 40% or higher. Echocardiographic assessments of left ventricular dimensions and ejection fraction were performed preoperatively, at discharge, and one month postoperatively. results: In Group 1, preoperative left ventricular internal dimensions during diastole (LVIDd) and systole (LVIDs) were 53.48 ± 4.40 mm and 44.23 ± 3.93 mm, respectively, with a left ventricular ejection fraction (LVEF) of 35.28% ± 2.26%. At discharge, these values improved to 51.58 ± 4.04 mm (LVIDd), 41.23 ± 5.30 mm (LVIDs), and 39.25% ± 3.75% (LVEF). One month postoperatively, further improvements were observed: 46.29 ± 3.76 mm (LVIDd), 37.45 ± 3.68 mm (LVIDs), and 43.22% ± 4.67% (LVEF). Group 2 showed similar positive outcomes, with preoperative values of 47.09 ± 5.06 mm (LVIDd), 35.11 ± 5.25 mm (LVIDs), and 50.13% ± 7.25% (LVEF), improving to 42.37 ± 4.18 mm (LVIDd), 31.05 ± 4.19 mm (LVIDs), and 55.33% ± 7.05% (LVEF) at one month postoperatively. Both groups demonstrated significant improvements in left ventricular function and NYHA class, with most patients moving from class III/IV to I/II. Complications were minimal, and no mortality was observed. Conclusion: OPCab is safe and effective for patients with LVEF 30% - 39% and LVEF ≥ 40%, providing significant short-term functional improvements without increased risk.

关键词： Off-Pump Coronary Artery Bypass Grafting Left Ventricular Dysfunction (LVD) Short-Term Outcomes

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Nipah Virus Unveiled: A review Article

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Advances in Bioscience and Biotechnology（生命科学与技术进展） 2024年第3期 161页

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Implications of Elevated Serum Cortisol in the Onset of Postoperative Delirium Following Off-Pump Coronary Artery Bypass Grafting: Insights from a Bangladesh-Based Single Center Experience

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World Journal of Cardiovascular Diseases（心血管病） 2024年第4期 252页

作者： Vivek Kumar Jha md.ab.r tazim chowdhury Munama Magdum Manoj Tiwari md.abul Bashar Maruf md.Saiful Islam Khan Priyanka Sinha rajesh Naryan Kapar md.rezwanul Hoque

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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（药理与制药） 2024年第6期 223页

作者： md.Saiful Islam Khan md.ab.r tazim chowdhury Farzana Fardousi Munama Magdum md.Ahaduzzaman Taneem Mohammad Shamima Akter Suriya Akter md.Saiful Islam Azad md.Mozaffer Hossain M.abdur rahman

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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. ab.r 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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