Medico Research Chronicles

Comparison of MACE between High and Low TIMI Risk

Md. Abdul Mukid — 2023-05-16

Introduction: Patients with ST-segment elevation myocardial infarction (STEMI) have increased risk for death and adverse cardiac events. Of great concern is the risk of cardiac arrest that accounts for the majority of early deaths and other major adverse cardiac events. Significant hospital resources are dedicated to these high risk patients.

Objective: To see the correlation of MACE between High and Low TIMI Risk.

Methodology: This cross-sectional prospective study was conducted in the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from July 2017 to June 2018. Fifty patients with definite diagnosis of acute STEMI, received streptokinase, aged above 18 years and both sex were included. Prior myocardial infarction, coronary revascularization procedures either CABG or angioplasty or coronary stenting; co-morbidities such as renal failure, heart failure, cardiomyopathy, valvular heart disease and congenital heart disease were excluded. On admission TIMI was recorded. In hospital MACE were also recorded.

Results: The mean age of patients was 52.64 (SD 11.88) years and majority of the patients were male (84%) with male to female ratio was 5.25:1. The mean TIMI risk score for STEMI 4.50 (SD 2.38). In hospital major adverse cardiac events (MACE) occurred in 19 (38.0%) cases. TIMI risk score for STEMI was significantly higher in patients with MACE compared to without MACE (16.95, SD 1.78 versus 3.00, SD 1.10; p<0.001) respectively.

Conclusion: In hospital major adverse cardiac events (MACE) occurred in 19 (38.0%) cases. TIMI risk score for STEMI was significantly higher in patients with MACE compared to patients without MACE (16.95, SD 1.78 versus 3.00, SD 1.10; p<0.001) respectively. From the study we conclude that TIMI risk score (5 or above) is a reliable tool in predicting in- hospital major adverse cardiac events in ST-segment elevation myocardial infarction.

Evaluation and Outcome of Surgical Management of Plateau Fracture- A Study in Shaheed Monsur Ali Medical College, Dhaka, Bangladesh

Nabil Zunayed Sidny — 2023-05-03

Introduction: Orthopaedic tibial plateau fractures are common. These fractures affect the knee's articular tibia. Plateau fractures may be simple or complicated. Skeletal and ligamentous injuries determine stability.

Methodology: The Department of Orthopaedic and Trauma Surgery at Shaheed Monsur Ali Medical College and Hospital in Dhaka, Bangladesh, performed this prospective study from June to December 2022. This study operated on 22 tibial plateau fracture patients. These individuals have significant injuries from motor vehicle accidents, falls, attacks, etc. These patients were assessed pre- and post-surgery. Schatzker, Hohl-Moore, and AO categorised these examples.

Results: 22 individuals had tibial plateau fractures. Patients averaged 45,4 years old. RTA damaged most patients. Schatzker's classifications called for CRIF, percutaneously cannulated cancellous screws, ORIF with buttress plate with or without bone transplantation, and external fixation for the identified fractures. Post-surgery range of motion started early. Weightless for 6-8 weeks. Weight bearing is delayed until fracture union or 12 weeks. POP casts immobilise unstable fractures for 3-6 weeks. After union, locomotion, weight bearing, and knee range of motion were excellent to very good. Fractures healed as expected. The series showed no non-union. Union averaged 14 weeks (10-22 weeks). Due to the severity of the injuries and infections, ten of the twenty-two surgical cases had excellent outcomes, whereas one had a poor result.

Conclusion: As car accidents grow, so do high-velocity tibial plateau fractures. In depressed and displaced fractures, surgery may stabilise the knee.

Comparison Between the Efficacies of Amlodipine and Cilnidipine in Treating Hypertensive Patients

Md. Ahsanul Kabir — 2023-05-27

Background: Controlling systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertension (HTN) patients is one of the main challenges. Amlodipine is one of the calcium channel blockers (CCBs) with a remarkable pharmacokinetic and pharmacodynamic profile. But we have not enough research-based information regarding the effectiveness of amlodipine and cilnidipine in treating hypertension patients. Aim of the study: The objective of this study was to assess the effectiveness of amlodipine and cilnidipine in treating hypertensive patients.

Methods: This study was conducted at the Upazila Health Complex in Shahrasti, Chandpur, Bangladesh, from January 2021 to December 2021. In the study, 200 patients of either sex between the ages of 18 and 60 years were involved. The total number of participants were divided into two equal groups. There were 100 patients in each of the groups. As the part of the hypertension treatment protocol, patients in the first group, received oral amlodipine 5–10 mg/day whereas in other group, patients received oral cilnidipine 10–20 mg/day. During the checkup, the mean systolic and diastolic blood pressure values were noted and evaluated. SPSS 22.0 was used to analyze the data. Results: After 8 weeks of treatment, the cilnidipine group’s SBP gradually decreased from 146.2±12.60 to 130.04±5.023 and its DBP gradually decreased from 94.21±6.86 to 84.34±1.79. On the other hand, in the amlodipine group, a gradual decline of SBP from 151.46±11.21 to 131.62±3.91 and DBP from 95.5±5.80 to 83±2.55 was observed. The results of the paired t-test statistical analysis were statistically significant, where the P value was found as 0.00001. Conclusion: Considering the findings of this current study we can conclude that, both amlodipine and cilnidipine have significant role in controlling blood pressure. But cilnidipine shows some superiority over amlodipine in lowering systolic blood pressure which is equally effective in lowering diastolic blood pressure.